Abstract
Abstract The goal of this randomized controlled trial was to examine the effect of a 12-month commercially available web-based lifestyle program (Precision Nutrition (PN), Inc©) on biomarkers of inflammation, compared to usual care among a national cohort of 35 BRCA1/2+ breast cancer survivors with surgically-induced early menopause. The PN program included access to a PN coach and completion of three daily activities: 1) exercises; 2) completing a nutritional/lifestyle habit, and 3) reading health related material. The exercise component was completed at home or at a local gym, and required 160 min/wk of exercise (3 days/week of progressive resistance exercise, 2 days/week of interval aerobic exercise, and 1 day/week of active recovery aerobic exercise). Blood draws, body composition measurements, and fitness capacity were measured at baseline and follow up. The cohort was middle-aged (46.1 ± 4.0 years of age), white, and well-educated. The intervention group (n = 19) was 74.8% adherent to the program (average of all components: fitness, behavioral, education). At baseline, higher insulin levels were associated with higher TNFα levels (r = 0.38, P = 0.04). Higher BMI as well as higher % body fat levels were significantly associated with higher levels of: insulin, IL6, and TNFα. There was a trend for association between lower fitness levels and higher insulin levels (r = −0.33, P = 0.07), and a significant association between lower fitness levels and higher IL6 and TNFα level. Following 12 months of the PN program we did not observe any significant between group differences for change in biomarker levels. Within the control group, IL8 levels decreased (P = 0.04). Within the intervention group, we observed decreased levels of insulin (P = 0.06), and TNFα (P = 0.02). In conclusion, we observed elevation of pro-inflammatory biomarkers in BRCA1/2+ breast cancer survivors with excess body fat and low fitness at baseline. Following the intervention, levels of pro-inflammatory cytokine TNFα were significantly reduced. BRCA1/2+ breast cancer survivors with prophylactic oophorectomy are still at enhanced risk for non-reproductive cancers. In this high risk population, identifying interventions such as PN to decrease chronic inflammation and subsequent DNA damage is critically important.
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