Physiological Effort in Submaximal Fitness Tests Predicts Weight Loss in Overweight and Obese Men with Prostate Cancer in a Weight Loss Trial

Andrew D Frugé, John A Dasher, David Bryan, Soroush Rais-Bahrami, Wendy Demark-Wahnefried, Gary R Hunter, Andrew D Frugé, John A Dasher, David Bryan, Soroush Rais-Bahrami, Wendy Demark-Wahnefried, Gary R Hunter

Abstract

Background: Obesity and weight gain after the diagnosis of prostate cancer are associated with an increased risk of prostate cancer recurrence and mortality; individualized plans to help prostate cancer survivors maintain or lose weight may be beneficial for recurrence risk reduction. Herein, we explore whether gains in cardiovascular fitness predict successful weight loss in men participating in a weight loss trial (NCT01886677).

Methods: Forty men were randomized to receive twice-weekly in-person and telephone-based guidance on calorie-restricted diets and aerobic exercise to promote ~0.91 kg/week weight loss, or wait-list control. Thirty-two men completed submaximal VO2 Treadmill Tests (TT), anthropometric measures and two 24-hour dietary recalls at baseline and follow-up. For this secondary analysis, study arms were combined and associations between baseline and longitudinal changes in physiological effort (PE, measured by heart rate during TT), predicted VO2max, caloric intake and weight loss were analyzed.

Results: Men lost 3.4 kg in 50 ± 23 days on the study. Multivariate linear regression indicated weight change was associated with change in PE at stage 2TT (Partial R = 0.635, p < 0.001), days on study (Partial R = -0.589, p = 0.002) and change in caloric intake (Partial R = 0.457, p = 0.019).

Conclusions: Untrained men experiencing elevated heart rates during stage 2TT at baseline were able to achieve greater weight loss over the study period; this association was strengthened by a decrease in PE at the same level from baseline to follow-up concomitant with reduced caloric intake. Therefore, for these middle-aged and older men with lower aerobic fitness, exercise appears to be a key factor in achieving higher degrees of weight loss.

Keywords: Aerobic fitness; Exercise; Obesity; Prostatic neoplasms; Weight loss.

Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Baseline and follow-up VO2submax treadmill tests were completed by men with prostate cancer participating in a presurgical weight loss trial. If 80% of estimated maximum heart rate was not reached in Stage 3, the following stages ensued: Stage 4) 6.44 km/hr, 4% incline; Stage 5) 6.44 km/hr, 8% incline.
Figure 2
Figure 2
Weight loss correlates with decrease in heart rate in submaximal treadmill test Stage 2 TT (p = 0.0006) in men with prostate cancer participating in a presurgical weight loss trial (n = 32).

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7–30.
    1. Allott EH, Masko EM, Freedland SJ. Obesity and Prostate Cancer: Weighing the Evidence. Eur Urol. 2013;63:800–809.
    1. Ligibel JA, Alfano CM, Courneya KS, Demark-Wahnefried W, Burger RA, et al. American Society of Clinical Oncology Position Statement on Obesity and Cancer. J Clin Oncol. 2014;32:3568–3574.
    1. Greenlee H, Shi Z, Sardo Molmenti CL, Rundle A, Tsai WY. Trends in Obesity Prevalence in Adults With a History of Cancer: Results From the US National Health Interview Survey, 1997 to 2014. J Clin Oncol. 2016;34:3133–3140.
    1. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:243–274.
    1. Demark-Wahnefried W, Clipp EC, Lipkus IM, Lobach D, Snyder DC, et al. Main outcomes of the FRESH START trial: A sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol. 2007;25:2709–2718.
    1. Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: Renew: A randomized controlled trial. JAMA. 2009;301:1883–1891.
    1. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2013;129:S102–S138.
    1. Mohamad H, McNeill G, Haseen F, N’Dow J, Craig LC, et al. The Effect of Dietary and Exercise Interventions on Body Weight in Prostate Cancer Patients: A Systematic Review. Nutr Cancer. 2015;67:43–60.
    1. Weiss EP, Albert SG, Reeds DN, Kress KS, McDaniel JL, et al. Effects of matched weight loss from calorie restriction, exercise, or both on cardiovascular disease risk factors: A randomized intervention trial. Am J Clin Nutr. 2016;104:576–586.
    1. van Gemert WA, May AM, Schuit AJ, Oosterhof BY, Peeters PH, et al. Effect of Weight Loss with or without Exercise on Inflammatory Markers and Adipokines in Postmenopausal Women: The SHAPE-2 Trial, A Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev. 2016;25:799–806.
    1. Brunelli DT, Chacon-Mikahil MP, Gaspari AF, Lopes WA, Bonganha V, et al. Combined Training Reduces Subclinical Inflammation in Obese Middle-Age Men. Med Sci Sports Exerc. 2015;47:2207–2215.
    1. Duggan C, de Tapsoba JD, Wang CY, McTiernan A. Dietary Weight Loss and Exercise Effects on Serum Biomarkers of Angiogenesis in Overweight Postmenopausal Women: A Randomized Controlled Trial. Cancer Res. 2016;76:4226–4235.
    1. Hall KS, Morey MC, Dutta C, Manini TM, Weltman AL, et al. Activity-Related Energy Expenditure in Older Adults: A Call for More Research. Med Sci Sports Exerc. 2014;46:2335–2340.
    1. Hunter GR, Fisher G, Neumeier WH, Carter SJ, Plaisance EP. Exercise Training and Energy Expenditure following Weight Loss. Med Sci Sports Exerc. 2015;47:1950–1957.
    1. Brock DW, Chandler-Laney PC, Alvarez JA, Gower BA, Gaesser GA, et al. Perception of exercise difficulty predicts weight regain in formerly overweight women. Obesity (Silver Spring) 2010;18:982–986.
    1. Hunter GR, Bickel CS, Fisher G, Neumeier WH, McCarthy JP. Combined aerobic and strength training and energy expenditure in older women. Med Sci Sports Exerc. 2013;45:1386–1393.
    1. Hunter GR, Fisher G, Bryan DR, Zuckerman PA. Weight loss and exercise training effect on oxygen uptake and heart rate response to locomotion. J Strength Cond Res. 2012;26:1366–1373.
    1. Parker ND, Hunter GR, Treuth MS, Kekes-Szabo T, Kell SH, et al. Effects of strength training on cardiovascular responses during a submaximal walk and a weight-loaded walking test in older females. J Cardiopulm Rehabil. 1996;16:56–62.
    1. Demark-Wahnefried W, Nix JW, Hunter GR, Rais-Bahrami S, Desmond RA, et al. Feasibility outcomes of a presurgical randomized controlled trial exploring the impact of caloric restriction and increased physical activity versus a wait-list control on tumor characteristics and circulating biomarkers in men electing prostatectomy for prostate cancer. BMC Cancer. 2016;16:61.
    1. Kohl HW, Gibbons LW, Gordon NF, Blair SN. An empirical evaluation of the ACSM guidelines for exercise testing. Med Sci Sports Exerc. 1990;22:533–539.
    1. De Keyzer W, Huybrechts I, De Vriendt V, Vandevijvere S, Slimani N, et al. Repeated 24-hour recalls versus dietary records for estimating nutrient intakes in a national food consumption survey. Food Nutr Res. 2011:55.
    1. Subar AF, Kirkpatrick SI, Mittl B, Zimmerman TP, Thompson FE, et al. The Automated Self-Administered 24- Hour Dietary Recall (ASA24): A Resource for Researchers, Clinicians and Educators from the National Cancer Institute. J Acad Nutr Diet. 2012;112:1134–1137.
    1. Bodner-Montville J, Ahuja JKC, Ingwersen LA, Haggerty ES, Enns CW, et al. USDA Food and Nutrient Database for Dietary Studies: Released on the web. J Food Comp Anal. 2006;19:S100–S107.
    1. Scott JM, Hornsby WE, Lane A, Kenjale AA, Eves ND, et al. Reliability of maximal cardiopulmonary exercise testing in men with prostate cancer. Med Sci Sports Exerc. 2015;47:27–32.
    1. Carter SJ, Hunter GR, McAuley E, Courneya KS, Anton PM, et al. Lower rate-pressure product during submaximal walking: A link to fatigue improvement following a physical activity intervention among breast cancer survivors. J Cancer Surviv. 2016;10:927–934.
    1. Martin EA, Battaglini CL, Hands B, Naumann F. Higher-Intensity Exercise Results in More Sustainable Improvements for VO2peak for Breast and Prostate Cancer Survivors. Oncol Nurs Forum. 2015;42:241–249.
    1. Hunter GR, Weinsier RL, Zuckerman PA, Darnell BE. Aerobic fitness, physiologic difficulty and physical activity in Black and White women. Int J Obes Relat Metab Disord. 2004;28:1111–1117.
    1. Gaskin CJ, Fraser SF, Owen PJ, Craike M, Orellana L, et al. Fitness outcomes from a randomised controlled trial of exercise training for men with prostate cancer: The ENGAGE study. J Cancer Surviv. 2016;10:972–980.
    1. Demark-Wahnefried W, Jones LW. Promoting a Healthy Lifestyle among Cancer Survivors. Hematol Oncol Clin North Am. 2008;22:319–342.

Source: PubMed

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