Effects of an exercise and hypocaloric healthy eating intervention on indices of psychological health status, hypothalamic-pituitary-adrenal axis regulation and immune function after early-stage breast cancer: a randomised controlled trial
Identifieur interne : 002B37 ( Main/Exploration ); précédent : 002B36; suivant : 002B38Effects of an exercise and hypocaloric healthy eating intervention on indices of psychological health status, hypothalamic-pituitary-adrenal axis regulation and immune function after early-stage breast cancer: a randomised controlled trial
Auteurs : John M. Saxton [Royaume-Uni] ; Emma J. Scott [Royaume-Uni] ; Amanda J. Daley [Royaume-Uni] ; M Nicola Woodroofe [Royaume-Uni] ; Nanette Mutrie [Royaume-Uni] ; Helen Crank [Royaume-Uni] ; Hilary J. Powers [Royaume-Uni] ; Robert E. Coleman [Royaume-Uni]Source :
- Breast Cancer Research : BCR [ 1465-5411 ] ; 2014.
Abstract
Many women experience emotional distress, depression and anxiety after a diagnosis of breast cancer. Psychological stress and depression have been associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation that may adversely affect immune system functioning and impact upon survival. This study investigated the effects of a lifestyle intervention on indices of psychological health status, HPA axis regulation and immune function in overweight women recovering from early-stage breast cancer treatment.
A total of 85 women treated for breast cancer 3 to 18 months previously were randomly allocated to a 6-month exercise and hypocaloric healthy eating program plus usual care or usual care alone (control group). Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice, supplemented by weekly nutrition seminars. Depressive symptoms (Beck Depression Inventory version II: BDI-II), perceived stress (Perceived Stress Scale: PSS), salivary diurnal cortisol rhythms; inflammatory cytokines (IL-6 and Tumor necrosis factor-α), leukocyte phenotype counts, natural killer (NK) cell cytotoxicity and lymphocyte proliferation following mitogenic stimulation were assessed at baseline and 6-month follow up.
Compared with the control group, the intervention group exhibited a reduction in depressive symptoms (adjusted mean difference, 95% confidence intervals (95% CI): −3.12, −1.03 to −5.26;
Our results show that the lifestyle intervention resulted in a reduction in depressive symptoms and a normalisation of HPA axis regulation. Such changes could have important implications for long-term survival in women recovering from early-breast cancer treatment.
Current Controlled Trials:
Url:
DOI: 10.1186/bcr3643
PubMed: 24731917
PubMed Central: 4052984
Affiliations:
- Royaume-Uni
- Angleterre, Midlands de l'Ouest, Écosse
- Birmingham, Édimbourg
- Université d'Édimbourg, Université de Birmingham
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Saxton</name><affiliation wicri:level="1"><nlm:aff id="I1">School of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Room 2–8 Queen’s Building, University of East Anglia, Norwich NR4 7TJ, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Room 2–8 Queen’s Building, University of East Anglia, Norwich NR4 7TJ</wicri:regionArea><wicri:noRegion>Norwich NR4 7TJ</wicri:noRegion></affiliation></author><author><name sortKey="Scott, Emma J" sort="Scott, Emma J" uniqKey="Scott E" first="Emma J" last="Scott">Emma J. 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Coleman</name><affiliation wicri:level="1"><nlm:aff id="I8">CR-UK/YCR Sheffield Cancer Research Centre, Weston Park Hospital, University of Sheffield, Sheffield, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>CR-UK/YCR Sheffield Cancer Research Centre, Weston Park Hospital, University of Sheffield, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24731917</idno><idno type="pmc">4052984</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052984</idno><idno type="RBID">PMC:4052984</idno><idno type="doi">10.1186/bcr3643</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">002A92</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002A92</idno><idno type="wicri:Area/Pmc/Curation">002A91</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002A91</idno><idno type="wicri:Area/Pmc/Checkpoint">001B99</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001B99</idno><idno type="wicri:Area/Ncbi/Merge">006571</idno><idno type="wicri:Area/Ncbi/Curation">006571</idno><idno type="wicri:Area/Ncbi/Checkpoint">006571</idno><idno type="wicri:doubleKey">1465-5411:2014:Saxton J:effects:of:an</idno><idno type="wicri:Area/Main/Merge">002B41</idno><idno type="wicri:Area/Main/Curation">002B37</idno><idno type="wicri:Area/Main/Exploration">002B37</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effects of an exercise and hypocaloric healthy eating intervention on indices of psychological health status, hypothalamic-pituitary-adrenal axis regulation and immune function after early-stage breast cancer: a randomised controlled trial</title><author><name sortKey="Saxton, John M" sort="Saxton, John M" uniqKey="Saxton J" first="John M" last="Saxton">John M. Saxton</name><affiliation wicri:level="1"><nlm:aff id="I1">School of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Room 2–8 Queen’s Building, University of East Anglia, Norwich NR4 7TJ, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Room 2–8 Queen’s Building, University of East Anglia, Norwich NR4 7TJ</wicri:regionArea><wicri:noRegion>Norwich NR4 7TJ</wicri:noRegion></affiliation></author><author><name sortKey="Scott, Emma J" sort="Scott, Emma J" uniqKey="Scott E" first="Emma J" last="Scott">Emma J. Scott</name><affiliation wicri:level="1"><nlm:aff id="I2">Warwick Medical School, University of Warwick, Coventry, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Warwick Medical School, University of Warwick, Coventry</wicri:regionArea><wicri:noRegion>Coventry</wicri:noRegion></affiliation></author><author><name sortKey="Daley, Amanda J" sort="Daley, Amanda J" uniqKey="Daley A" first="Amanda J" last="Daley">Amanda J. Daley</name><affiliation wicri:level="4"><nlm:aff id="I3">Department of Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Primary Care Clinical Sciences, University of Birmingham, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region><settlement type="city">Birmingham</settlement></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Woodroofe, M Nicola" sort="Woodroofe, M Nicola" uniqKey="Woodroofe M" first="M Nicola" last="Woodroofe">M Nicola Woodroofe</name><affiliation wicri:level="1"><nlm:aff id="I4">Biomedical Research Centre, Sheffield Hallam University, Sheffield, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Biomedical Research Centre, Sheffield Hallam University, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author><author><name sortKey="Mutrie, Nanette" sort="Mutrie, Nanette" uniqKey="Mutrie N" first="Nanette" last="Mutrie">Nanette Mutrie</name><affiliation wicri:level="4"><nlm:aff id="I5">Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh</wicri:regionArea><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region><settlement type="city">Édimbourg</settlement></placeName><orgName type="university">Université d'Édimbourg</orgName></affiliation></author><author><name sortKey="Crank, Helen" sort="Crank, Helen" uniqKey="Crank H" first="Helen" last="Crank">Helen Crank</name><affiliation wicri:level="1"><nlm:aff id="I6">Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author><author><name sortKey="Powers, Hilary J" sort="Powers, Hilary J" uniqKey="Powers H" first="Hilary J" last="Powers">Hilary J. Powers</name><affiliation wicri:level="1"><nlm:aff id="I7">Human Nutrition Unit, Department of Oncology, University of Sheffield, Sheffield, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Human Nutrition Unit, Department of Oncology, University of Sheffield, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author><author><name sortKey="Coleman, Robert E" sort="Coleman, Robert E" uniqKey="Coleman R" first="Robert E" last="Coleman">Robert E. Coleman</name><affiliation wicri:level="1"><nlm:aff id="I8">CR-UK/YCR Sheffield Cancer Research Centre, Weston Park Hospital, University of Sheffield, Sheffield, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>CR-UK/YCR Sheffield Cancer Research Centre, Weston Park Hospital, University of Sheffield, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author></analytic><series><title level="j">Breast Cancer Research : BCR</title><idno type="ISSN">1465-5411</idno><idno type="eISSN">1465-542X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Many women experience emotional distress, depression and anxiety after a diagnosis of breast cancer. Psychological stress and depression have been associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation that may adversely affect immune system functioning and impact upon survival. This study investigated the effects of a lifestyle intervention on indices of psychological health status, HPA axis regulation and immune function in overweight women recovering from early-stage breast cancer treatment.</p></sec><sec><title>Methods</title><p>A total of 85 women treated for breast cancer 3 to 18 months previously were randomly allocated to a 6-month exercise and hypocaloric healthy eating program plus usual care or usual care alone (control group). Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice, supplemented by weekly nutrition seminars. Depressive symptoms (Beck Depression Inventory version II: BDI-II), perceived stress (Perceived Stress Scale: PSS), salivary diurnal cortisol rhythms; inflammatory cytokines (IL-6 and Tumor necrosis factor-α), leukocyte phenotype counts, natural killer (NK) cell cytotoxicity and lymphocyte proliferation following mitogenic stimulation were assessed at baseline and 6-month follow up.</p></sec><sec><title>Results</title><p>Compared with the control group, the intervention group exhibited a reduction in depressive symptoms (adjusted mean difference, 95% confidence intervals (95% CI): −3.12, −1.03 to −5.26; <italic>P</italic> = 0.004) at the 6-month follow-up but no significant decrease in PSS scores (−2.07, −4.96 to 0.82; <italic>P</italic> = 0.16). The lifestyle intervention also had a significant impact on diurnal salivary cortisol rhythm compared with usual care alone, as evidenced by an increase in morning salivary cortisol at the 6-month follow-up (<italic>P</italic> <0.04), indicating a change in HPA axis regulation. Women in the control group had higher total leukocyte, neutrophil and lymphocyte counts in comparison to the intervention group at the 6-month follow-up (<italic>P</italic> ≤0.05), whereas there was no difference in NK cell counts (<italic>P</italic> = 0.46), NK cell cytotoxicity (<italic>P</italic> = 0.85) or lymphocyte proliferation responses (<italic>P</italic> = 0.11) between the two groups.</p></sec><sec><title>Conclusion</title><p>Our results show that the lifestyle intervention resulted in a reduction in depressive symptoms and a normalisation of HPA axis regulation. Such changes could have important implications for long-term survival in women recovering from early-breast cancer treatment.</p></sec><sec><title>Trial registration</title><p>Current Controlled Trials: <ext-link ext-link-type="uri" xlink:href="http://www.controlled-trials.com/ISRCTN08045231">ISRCTN08045231</ext-link></p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Burgess, C" uniqKey="Burgess C">C Burgess</name></author><author><name sortKey="Cornelius, V" uniqKey="Cornelius V">V Cornelius</name></author><author><name sortKey="Love, S" uniqKey="Love S">S Love</name></author><author><name sortKey="Graham, J" uniqKey="Graham J">J Graham</name></author><author><name sortKey="Richards, M" uniqKey="Richards M">M Richards</name></author><author><name sortKey="Ramirez, A" uniqKey="Ramirez A">A Ramirez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zainal, Nz" uniqKey="Zainal N">NZ 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S">SS Dickerson</name></author><author><name sortKey="Petersen, L" uniqKey="Petersen L">L Petersen</name></author><author><name sortKey="Aziz, N" uniqKey="Aziz N">N Aziz</name></author><author><name sortKey="Fahey, Jl" uniqKey="Fahey J">JL Fahey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anderson, G" uniqKey="Anderson G">G Anderson</name></author><author><name sortKey="Maes, M" uniqKey="Maes M">M Maes</name></author><author><name sortKey="Berk, M" uniqKey="Berk M">M Berk</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Weber, Mm" uniqKey="Weber M">MM Weber</name></author><author><name sortKey="Michl, P" uniqKey="Michl P">P Michl</name></author><author><name sortKey="Auernhammer, Cj" uniqKey="Auernhammer C">CJ Auernhammer</name></author><author><name sortKey="Engelhardt, D" uniqKey="Engelhardt D">D Engelhardt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pattison, Cw" uniqKey="Pattison C">CW Pattison</name></author><author><name sortKey="Woods, Kl" uniqKey="Woods K">KL Woods</name></author><author><name sortKey="Morrison, Jm" uniqKey="Morrison J">JM Morrison</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Midlands de l'Ouest</li><li>Écosse</li></region><settlement><li>Birmingham</li><li>Édimbourg</li></settlement><orgName><li>Université d'Édimbourg</li><li>Université de Birmingham</li></orgName></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Saxton, John M" sort="Saxton, John M" uniqKey="Saxton J" first="John M" last="Saxton">John M. Saxton</name></noRegion><name sortKey="Coleman, Robert E" sort="Coleman, Robert E" uniqKey="Coleman R" first="Robert E" last="Coleman">Robert E. Coleman</name><name sortKey="Crank, Helen" sort="Crank, Helen" uniqKey="Crank H" first="Helen" last="Crank">Helen Crank</name><name sortKey="Daley, Amanda J" sort="Daley, Amanda J" uniqKey="Daley A" first="Amanda J" last="Daley">Amanda J. Daley</name><name sortKey="Mutrie, Nanette" sort="Mutrie, Nanette" uniqKey="Mutrie N" first="Nanette" last="Mutrie">Nanette Mutrie</name><name sortKey="Powers, Hilary J" sort="Powers, Hilary J" uniqKey="Powers H" first="Hilary J" last="Powers">Hilary J. Powers</name><name sortKey="Scott, Emma J" sort="Scott, Emma J" uniqKey="Scott E" first="Emma J" last="Scott">Emma J. Scott</name><name sortKey="Woodroofe, M Nicola" sort="Woodroofe, M Nicola" uniqKey="Woodroofe M" first="M Nicola" last="Woodroofe">M Nicola Woodroofe</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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