Effects of a Home-Based Lifestyle Intervention Program on Cardiometabolic Health in Breast Cancer Survivors during the COVID-19 Lockdown

Valentina Natalucci, Carlo Ferri Marini, Marco Flori, Francesca Pietropaolo, Francesco Lucertini, Giosuè Annibalini, Luciana Vallorani, Davide Sisti, Roberta Saltarelli, Anna Villarini, Silvia Monaldi, Simone Barocci, Vincenzo Catalano, Marco Bruno Luigi Rocchi, Piero Benelli, Vilberto Stocchi, Elena Barbieri, Rita Emili, Valentina Natalucci, Carlo Ferri Marini, Marco Flori, Francesca Pietropaolo, Francesco Lucertini, Giosuè Annibalini, Luciana Vallorani, Davide Sisti, Roberta Saltarelli, Anna Villarini, Silvia Monaldi, Simone Barocci, Vincenzo Catalano, Marco Bruno Luigi Rocchi, Piero Benelli, Vilberto Stocchi, Elena Barbieri, Rita Emili

Abstract

This study aimed to evaluate the cardiometabolic effects of a home-based lifestyle intervention (LI) in breast cancer survivors (BCSs) during the COVID-19 lockdown. In total, 30 BCSs (women; stages 0-II; non-metastatic; aged 53.5 ± 7.6 years; non-physically active; normal left ventricular systolic function) with a risk factor for recurrence underwent a 3-month LI based on nutrition and exercise. Anthropometrics, Mediterranean diet adherence, physical activity level (PAL), cardiorespiratory fitness (VO2max), echocardiographic parameters, heart rate variability (average standard deviation of NN intervals (ASDNN/5 min) and 24 h very- (24 hVLF) and low-frequency (24 hLF)), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein (hs-CRP)) were evaluated before (T0) and after (T1) the LI. After the LI, there were improvements in: body mass index (kg/m2: T0 = 26.0 ± 5.0, T1 = 25.5 ± 4.7; p = 0.035); diet (Mediet score: T0 = 6.9 ± 2.3, T1 = 8.8 ± 2.2; p < 0.001); PAL (MET-min/week: T0 = 647 ± 547, T1 = 1043 ± 564; p < 0.001); VO2max (mL·min-1·kg-1: T0 = 30.5 ± 5.8, T1 = 33.4 ± 6.8; p < 0.001); signs of diastolic dysfunction (participants: T0 = 15, T1 = 10; p = 0.007); AS-DNN/5 min (ms: T0 = 50.6 ± 14.4, T1 = 55.3 ± 16.7; p = 0.032); 24 hLF (ms2: T0 = 589 ± 391, T1 = 732 ± 542; p = 0.014); glycemia (mg/dL: T0 = 100.8 ± 11.4, T1 = 91.7 ± 11.0; p < 0.001); insulin resistance (HOMA-IR score: T0 = 2.07 ± 1.54, T1 = 1.53 ± 1.11; p = 0.005); testosterone (ng/mL: T0 = 0.34 ± 0.27, T1 = 0.24 ± 0.20; p = 0.003); hs-CRP (mg/L: T0 = 2.18 ± 2.14, T1 = 1.75 ± 1.74; p = 0.027). The other parameters did not change. Despite the home-confinement, LI based on exercise and nutrition improved cardiometabolic health in BCSs.

Keywords: COVID-19; Mediterranean diet; breast cancer survivors; cardiotoxicity; cardiovascular fitness; exercise; heart rate variability; home-based lifestyle intervention; secondary and tertiary prevention.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study design. Abbreviation: HRR, heart rate reserve; RS, remotely supervised; OS, on-site supervised; RSadpt, remote supervision adapted due to COVID-19 pandemic restrictions.

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Source: PubMed

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