Rowan T Chlebowski1. 1. Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Building J-3, Torrance, CA 90502, USA. Electronic address: rowanchlebowski@gmail.com.
Abstract
INTRODUCTION AND AIMS: To provide a current perspective on nutrition and physical activity influence on breast cancer. METHODS AND RESULTS: A comprehensive literature review was conducted and selective presentation of findings follows. While some observational studies have associated higher dietary fat intake with higher breast cancer incidence, two full-scale randomized, clinical trials of dietary fat intake reduction programs were negative. However, a lifestyle intervention targeting fat intake reduction in the Women's Intervention Nutrition Study (WINS), resulted in weight loss and also reduced breast cancer recurrences in women with early stage disease. Observational studies evaluating specific nutrient intakes and dietary supplements have provided mixed results. Several observational studies find women with early stage breast cancer with lower 25-hydroxyvitamin D levels at higher recurrence risk, a finding requiring cautious interpretation. The lifestyle factor most strongly and consistently associated with both breast cancer incidence and breast cancer recurrence risk is physical activity. A meta-analyses of observational studies supports the concept that moderate recreational physical activity (about 3-4 h walking per week) may reduce breast cancer incidence and that women with early stage breast cancer who increased or maintain their physical activity may have lower recurrence risk as well. Feasibility of achieving increased physical activity and weight loss in women with early-stage breast cancer has been established. Two full-scale randomized clinical trials are evaluating weight loss/maintenance and increased physical activity in relation to recurrence risk in women with early-stage, resected breast cancer. DISCUSSION/ CONCLUSIONS: Dietary intake may influence breast cancer but influence is difficult to separate from influence of body weight. A consistent body of observational study evidence suggests higher physical activity has favorable influence on breast cancer incidence and outcome. While awaiting definitive evidence from ongoing randomized trials, breast cancer patients can reasonably be counseled to avoid weight gain and reduce body weight if overweight or obese and increase or maintain a moderate level of physical activity.
INTRODUCTION AND AIMS: To provide a current perspective on nutrition and physical activity influence on breast cancer. METHODS AND RESULTS: A comprehensive literature review was conducted and selective presentation of findings follows. While some observational studies have associated higher dietary fat intake with higher breast cancer incidence, two full-scale randomized, clinical trials of dietary fat intake reduction programs were negative. However, a lifestyle intervention targeting fat intake reduction in the Women's Intervention Nutrition Study (WINS), resulted in weight loss and also reduced breast cancer recurrences in women with early stage disease. Observational studies evaluating specific nutrient intakes and dietary supplements have provided mixed results. Several observational studies find women with early stage breast cancer with lower 25-hydroxyvitamin D levels at higher recurrence risk, a finding requiring cautious interpretation. The lifestyle factor most strongly and consistently associated with both breast cancer incidence and breast cancer recurrence risk is physical activity. A meta-analyses of observational studies supports the concept that moderate recreational physical activity (about 3-4 h walking per week) may reduce breast cancer incidence and that women with early stage breast cancer who increased or maintain their physical activity may have lower recurrence risk as well. Feasibility of achieving increased physical activity and weight loss in women with early-stage breast cancer has been established. Two full-scale randomized clinical trials are evaluating weight loss/maintenance and increased physical activity in relation to recurrence risk in women with early-stage, resected breast cancer. DISCUSSION/ CONCLUSIONS: Dietary intake may influence breast cancer but influence is difficult to separate from influence of body weight. A consistent body of observational study evidence suggests higher physical activity has favorable influence on breast cancer incidence and outcome. While awaiting definitive evidence from ongoing randomized trials, breast cancerpatients can reasonably be counseled to avoid weight gain and reduce body weight if overweight or obese and increase or maintain a moderate level of physical activity.
Authors: Max Dieterich; Johannes Stubert; Toralf Reimer; Nicole Erickson; Anika Berling Journal: Breast Care (Basel) Date: 2014-12 Impact factor: 2.860
Authors: Rowan T Chlebowski; Aaron K Aragaki; Garnet L Anderson; Michael S Simon; JoAnn E Manson; Marian L Neuhouser; Kathy Pan; Marcia L Stefanic; Thomas E Rohan; Dorothy Lane; Lihong Qi; Linda Snetselaar; Ross L Prentice Journal: JAMA Oncol Date: 2018-10-11 Impact factor: 31.777
Authors: Balazs I Bodai; Therese E Nakata; William T Wong; Dawn R Clark; Steven Lawenda; Christine Tsou; Raymond Liu; Linda Shiue; Neil Cooper; Michael Rehbein; Benjamin P Ha; Anne Mckeirnan; Rajiv Misquitta; Pankaj Vij; Andrew Klonecke; Carmelo S Mejia; Emil Dionysian; Sean Hashmi; Michael Greger; Scott Stoll; Thomas M Campbell Journal: Perm J Date: 2018
Authors: Rowan T Chlebowski; Aaron K Aragaki; Garnet L Anderson; Cynthia A Thomson; JoAnn E Manson; Michael S Simon; Barbara V Howard; Thomas E Rohan; Linda Snetselar; Dorothy Lane; Wendy Barrington; Mara Z Vitolins; Catherine Womack; Lihong Qi; Lifang Hou; Fridtjof Thomas; Ross L Prentice Journal: J Clin Oncol Date: 2017-06-27 Impact factor: 44.544