Abstract
Weight gain after breast cancer diagnosis portends a poorer prognosis, and the majority of sufferers appear to gain weight. Metabolic syndrome is a common co-condition with breast cancer. The Mediterranean diet has been used to reduce excess weight, metabolic syndrome, and to improve the inflammatory profile, and therefore may offer the breast cancer survivor specific benefits over and above the currently recommended nutrition guidelines to eat a low fat, healthy diet. The aim of this randomised controlled trial was to investigate whether a Mediterranean (MD) or low-fat diet (LF) reduce weight and general health in survivors of stage 1–3 breast cancer through a six-month, six-session education package to support dietary change. A control dietary arm received no intervention. Outcome measures for weight, body mass index (BMI), waist circumference, blood lipids, blood glucose, dietary adherence, 3-day food diary, and PREDIMED questionnaire and quality of life were assessed. Both dietary intervention arms, on average, lost weight over the course of the intervention, with significant (p < 0.05) decreases seen in BMI and waist circumference measurements. The control arm gained weight and significantly (p < 0.05) increased BMI and waist circumference measurements overall (1.10 ± 3.03 kg, 0.40 ± 1.65 kg/m2, and 1.94 ± 2.94 cm respectively). Positive trends in blood biomarkers were observed for the intervention arms. Dietary adherence was sufficient. Nutritional education and group support appears to exert beneficial effects on health in breast cancer survivors, of lesser importance is the type of diet that forms the basis of the education.
Highlights
On the basis of observational studies, women with breast cancer who are overweight or gain weight after diagnosis are found to be at greater risk for breast cancer recurrence and death compared with lighter women
The mean body mass index (BMI) across all dietary arms showed that the participants were categorised as being overweight according to the BMI
All other variables, including weight, waist circumference, HbA1c %, total cholesterol, high density lipoproteins (HDLs) and LDL cholesterols, triglycerides, non-HDL cholesterol, and total cholesterol:HDL cholesterol ratio levels were matched across the three dietary arms
Summary
On the basis of observational studies, women with breast cancer who are overweight or gain weight after diagnosis are found to be at greater risk for breast cancer recurrence and death compared with lighter women. Obesity is associated with hormonal profiles likely to stimulate breast cancer growth [1]. Evidence exists for a connection between obesity, metabolic syndrome, and poor outcomes in breast cancer patients [1]. Metabolic syndrome is known as insulin insensitivity syndrome, and is defined as central obesity together with two of the following risk factors: elevated glucose, insulin resistance, elevated triglycerides, reduced high density lipoproteins (HDLs), and/or hypertension. Breast cancer patients with metabolic syndrome undergoing chemotherapy are found to respond poorly to treatment [1], Med. Sci.
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