A Low-Glucose Eating Pattern Improves Biomarkers of Postmenopausal Breast Cancer Risk: An Exploratory Secondary Analysis of a Randomized Feasibility Trial.

Susan M Schembre,Yue Liao,Cynthia A Thomson,Erin D Giles,Dorothy D Sears,Michelle R Jospe,Karen M Basen-Engquist

doi:10.3390/nu13124508

Abstract

Postmenopausal breast cancer is the most common obesity-related cancer death among women in the U.S. Insulin resistance, which worsens in the setting of obesity, is associated with higher breast cancer incidence and mortality. Maladaptive eating patterns driving insulin resistance represent a key modifiable risk factor for breast cancer. Emerging evidence suggests that time-restricted feeding paradigms (TRF) improve cancer-related metabolic risk factors; however, more flexible approaches could be more feasible and effective. In this exploratory, secondary analysis, we identified participants following a low-glucose eating pattern (LGEP), defined as consuming energy when glucose levels are at or below average fasting levels, as an alternative to TRF. Results show that following an LGEP regimen for at least 40% of reported eating events improves insulin resistance (HOMA-IR) and other cancer-related serum biomarkers. The magnitude of serum biomarkers changes observed here has previously been shown to favorably modulate benign breast tissue in women with overweight and obesity who are at risk for postmenopausal breast cancer. By comparison, the observed effects of LGEP were similar to results from previously published TRF studies in similar populations. These preliminary findings support further testing of LGEP as an alternative to TRF and a postmenopausal breast cancer prevention strategy. However, results should be interpreted with caution, given the exploratory nature of analyses.

Highlights

The goal of the current study is to explore the impact of low- vs. high-glucose eating patterns on changes in body weight and the selected serum biomarkers of breast cancer risk after 16 weeks and compare these results with those reported in recent timerestricted feeding paradigms (TRF) studies in similar populations of older women and with the intensive lifestyle intervention conducted by Fabian et al in postmenopausal overweight and obese women at increased risk for breast cancer
ANCOVA adjusting for baseline measures) did not result in a synergistic effect when added to the Diabetes Prevention Program (DPP) on changes in body weight or the cancer-related serum biomarkers assessed in the parent study, including those reported in the current study [42]
This study supports the potential efficacy of a low-glucose eating pattern (LGEP) to improve metabolic and cancer risk biomarkers, including insulin resistance, in older women

Summary

Introduction

High obesity rates among women in the United States and worldwide are leading to a continued rise in obesity-related cancers, most notably postmenopausal breast cancer [1], which is the leading cause of obesity-related cancer deaths among women in the U.S [2]. Research shows that excessive weight gain and obesity are significant risk factors for postmenopausal breast cancer among women with and without increased genetic risk [3,4,5,6,7,8,9]. Postmenopausal breast cancer and obesity are linked through insulin resistance—a key modifiable risk factor. Women with obesity improve their metabolic- and cancer-related risk biomarkers, including insulin resistance and insulin-signaling adipokines, and circulating pro-inflammatory cytokines that promote tumorigenesis [10,11]

Objectives

Methods

Results

Conclusion