Dana-Farber Cancer Institute, Boston, MA
Cameron Christopher , Dong-Woo Kang , Amber Normann , Mary Norris , Christina Marie Dieli-Conwright
Background: Hispanic and Black adults have a heightened risk of metabolic syndrome compared to non-Hispanic white adults, increasing the risk of cardiovascular disease, diabetes, and co-morbid outcomes. Further, Hispanic and Black adults are more likely to be sedentary and obese than non-Hispanic white adults, leading to an increased risk of insulin resistance and poor metabolic health. Exercise improves cardiometabolic health, including insulin sensitivity and adiponectin, however few studies have focused on minority cancer survivors. The aim of our (NCT03284346) was to determine whether a 4-month circuit-based aerobic and resistance exercise intervention can improve insulin resistance and adiponectin levels in breast, prostate, and colorectal Hispanic and Black cancer survivors. Methods: Overweight or obese (BMI > 25.0 kg/m2), sedentary breast, prostate or colorectal cancer survivors who self-identified as Hispanic or Black were randomized to exercise (n = 30) or usual care (n = 10). Survivors in the 4-month supervised exercise intervention participated in a thrice weekly, circuit, interval-based moderate-vigorous aerobic (65-85% of VO2max) and resistance (65-85% of 1-repetition maximum). Insulin resistance, assessed by Homeostasis Model of Assessment (HOMA-IR), and adiponectin levels were collected at baseline and post-intervention from fasting blood sample collection. Repeated-measures analysis of variance and t-tests were performed to assess within- and between-group differences. Results: The study sample was 66 ± 10.4 years old, Hispanic (55%), Black (45%), overweight (78%), and female (60%). Adherence to the intervention was 90% and post-intervention outcome measures were available on 100% of participants. Post-intervention, insulin resistance (within group mean difference: -3.2, p < 0.01; between group mean difference: -4.5, p < 0.01) and adiponectin levels (6.1 ug/mg, p < 0.01; 8.6 ug/mg, p < 0.01) significantly improved in the exercise group when compared to baseline and to usual care, respectively. Conclusions: A circuit, interval-based aerobic and resistance exercise intervention improved insulin resistance and adiponectin levels in breast, prostate, and colorectal minority cancer survivors. Accessible exercise interventions for minority cancer survivors may be effective to mitigate metabolic dysregulation and co-morbid conditions in survivorship and support cardiometabolic health. Clinical trial information: NCT03284346.
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