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Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews

BACKGROUND: Elevated body mass index (BMI) in breast cancer survivors (BCS) is associated with cancer recurrence and poorer treatment response. Guidelines recommend 5%–10% weight loss for overweight or obese BCS. OBJECTIVES: To assess effectiveness of lifestyle interventions for female BCS on weight...

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Autores principales: Lake, Blossom, Damery, Sarah, Jolly, Kate
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9557263/
https://www.ncbi.nlm.nih.gov/pubmed/36207046
http://dx.doi.org/10.1136/bmjopen-2022-062288
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author Lake, Blossom
Damery, Sarah
Jolly, Kate
author_facet Lake, Blossom
Damery, Sarah
Jolly, Kate
author_sort Lake, Blossom
collection PubMed
description BACKGROUND: Elevated body mass index (BMI) in breast cancer survivors (BCS) is associated with cancer recurrence and poorer treatment response. Guidelines recommend 5%–10% weight loss for overweight or obese BCS. OBJECTIVES: To assess effectiveness of lifestyle interventions for female BCS on weight loss, BMI, body composition, health-related quality of life (HRQoL), physical functioning, psychosocial measures, biomarkers. DESIGN: Systematic review of reviews and meta-analyses. SETTING: All clinical settings. PARTICIPANTS: Adult female BCS (active treatment or post-treatment). METHODS: Medline, Embase, CINAHL, PsycINFO, Cochrane Library (including Database of Abstracts of Reviews of Effects) were searched for systematic reviews published in English between 1990 and 2022, with weight, BMI or body fat as primary outcome. Narrative reviews, editorials, letters, conference abstracts were excluded. Review quality was assessed using the Joanna Briggs Institute quality assessment tool. RESULTS: 17 reviews were included. Twelve reported significant reductions in one or more anthropometric outcomes: weight −1.36 kg (95% CI:−2.51 to −0.21) to −3.8 kg (95% CI: −5.6 to −1.9); BMI −0.89 kg/m(2) (95% CI: −0.15 to −0.28) to −3.59 kg/m(2) (95% CI: −6.29 to 0.89) or body fat −1.6% (95% CI: −2.31 to −0.88) to −2.6% (95% CI not reported). Significant reductions in two or more anthropometric outcomes were reported in 7/12 reviews, with effective interventions comprising aerobic exercise/aerobic exercise plus resistance training (n=5), or diet and exercise with or without counselling (n=2). Significant improvements were also reported for HRQoL (8/11 reviews), mental health (4/7) and physical functioning (2/3). Group interventions comprising aerobic exercise or aerobic exercise plus resistance training were most likely to improve outcomes. CONCLUSIONS: Lifestyle interventions can significantly improve outcomes for BCS. Multimodal interventions are likely to have the greatest impact in reducing weight, BMI and body fat. Further research must define the optimal combination, intensity and duration of effective interventions. PROSPERO REGISTRATION NUMBER: CRD42021283481.
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spelling pubmed-95572632022-10-14 Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews Lake, Blossom Damery, Sarah Jolly, Kate BMJ Open Oncology BACKGROUND: Elevated body mass index (BMI) in breast cancer survivors (BCS) is associated with cancer recurrence and poorer treatment response. Guidelines recommend 5%–10% weight loss for overweight or obese BCS. OBJECTIVES: To assess effectiveness of lifestyle interventions for female BCS on weight loss, BMI, body composition, health-related quality of life (HRQoL), physical functioning, psychosocial measures, biomarkers. DESIGN: Systematic review of reviews and meta-analyses. SETTING: All clinical settings. PARTICIPANTS: Adult female BCS (active treatment or post-treatment). METHODS: Medline, Embase, CINAHL, PsycINFO, Cochrane Library (including Database of Abstracts of Reviews of Effects) were searched for systematic reviews published in English between 1990 and 2022, with weight, BMI or body fat as primary outcome. Narrative reviews, editorials, letters, conference abstracts were excluded. Review quality was assessed using the Joanna Briggs Institute quality assessment tool. RESULTS: 17 reviews were included. Twelve reported significant reductions in one or more anthropometric outcomes: weight −1.36 kg (95% CI:−2.51 to −0.21) to −3.8 kg (95% CI: −5.6 to −1.9); BMI −0.89 kg/m(2) (95% CI: −0.15 to −0.28) to −3.59 kg/m(2) (95% CI: −6.29 to 0.89) or body fat −1.6% (95% CI: −2.31 to −0.88) to −2.6% (95% CI not reported). Significant reductions in two or more anthropometric outcomes were reported in 7/12 reviews, with effective interventions comprising aerobic exercise/aerobic exercise plus resistance training (n=5), or diet and exercise with or without counselling (n=2). Significant improvements were also reported for HRQoL (8/11 reviews), mental health (4/7) and physical functioning (2/3). Group interventions comprising aerobic exercise or aerobic exercise plus resistance training were most likely to improve outcomes. CONCLUSIONS: Lifestyle interventions can significantly improve outcomes for BCS. Multimodal interventions are likely to have the greatest impact in reducing weight, BMI and body fat. Further research must define the optimal combination, intensity and duration of effective interventions. PROSPERO REGISTRATION NUMBER: CRD42021283481. BMJ Publishing Group 2022-10-07 /pmc/articles/PMC9557263/ /pubmed/36207046 http://dx.doi.org/10.1136/bmjopen-2022-062288 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Oncology
Lake, Blossom
Damery, Sarah
Jolly, Kate
Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews
title Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews
title_full Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews
title_fullStr Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews
title_full_unstemmed Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews
title_short Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews
title_sort effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9557263/
https://www.ncbi.nlm.nih.gov/pubmed/36207046
http://dx.doi.org/10.1136/bmjopen-2022-062288
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