Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial.

BACKGROUND: Exercise is an effective strategy to improve quality of life and physical fitness in breast cancer survivors; however, few studies have focused on the early survivorship period, minorities, physically inactive and obese women, or tested a combined exercise program and measured bone health. Here, we report the effects of a 16-week aerobic and resistance exercise intervention on patient-reported outcomes, physical fitness, and bone health in ethnically diverse, physically inactive, overweight or obese breast cancer survivors. METHODS: One hundred breast cancer survivors within 6 months of completing adjuvant treatment were assessed at baseline, post-intervention, and 3-month follow-up (exercise group only) for physical fitness, bone mineral density, serum concentrations of bone biomarkers, and quality of life. The exercise intervention consisted of moderate-vigorous (65-85% heart rate maximum) aerobic and resistance exercise thrice weekly for 16 weeks. Differences in mean changes for outcomes were evaluated using mixed-model repeated measure analysis. RESULTS: At post-intervention, the exercise group was superior to usual care for quality of life (between group difference: 14.7, 95% CI: 18.2, 9.7; p < 0.001), fatigue (p < 0.001), depression (p < 0.001), estimated VO2max (p < 0.001), muscular strength (p < 0.001), osteocalcin (p = 0.01), and BSAP (p = 0.001). At 3-month follow-up, all patient-reported outcomes and physical fitness variables remained significantly improved compared to baseline in the exercise group (p < 0.01). CONCLUSIONS: A 16-week combined aerobic and resistance exercise program designed to address metabolic syndrome in ethnically-diverse overweight or obese breast cancer survivors also significantly improved quality of life and physical fitness. Our findings further support the inclusion of supervised clinical exercise programs into breast cancer treatment and care. TRIAL REGISTRATION: This trial is registered on ClinicalTrials.gov: NCT01140282 as of June 9, 2010.

Comparison of two systems of measuring energy expenditure.

BACKGROUND: Health care professionals typically use resting metabolic rate (RMR) via indirect calorimetry to determine a person's energy expenditure. Traditional indirect calorimetry measurements involve an expensive, cumbersome piece of equipment that requires careful calibration. The recent development of a handheld indirect calorimeter makes it easier to measure RMR. The purpose of this study was to compare simultaneous measurements of RMR with handheld and traditional indirect calorimeters. METHODS: Healthy, free-living subjects (n = 50) age 18 years and older were tested simultaneously with both indirect calorimeters. All subjects breathed through the handheld device using a mouthpiece while wearing noseclips to prevent leaks. The handheld indirect calorimetry device was placed inside a canopy. The exhaled gas from the handheld was positioned directly over the inlet to the port delivering gases to the traditional device's mixing chamber. The canopy facilitated the simultaneous collection of all expired gases into the traditional device. During the measurement, oxygen consumption and RMR were continuously recorded on a personal computer. RESULTS: Mean oxygen consumption and RMR did not significantly differ between the two devices, with a mean difference of 0.58 +/- 15.33 mL/min (p = .790) and 4.66 +/- 113.39 kcal/day (p = .773) and an absolute difference of 12.3 +/- 8.99 mL/min and 86.58 +/- 72.32 kcal/day, respectively. Correlation coefficients for oxygen consumption and RMR were 0.945 and 0.941, respectively. CONCLUSIONS: No significant difference was found between the measurements of indirect calorimetry with the MedGem (HealtheTech, Golden, CO) device compared with the DeltaTrac device (Datex-Ohmeda, Madison, WI). These findings suggest that the handheld indirect calorimeter may provide an accurate measure of oxygen consumption and RMR measurements for spontaneously breathing subjects.