Martijn J L Bours1, Eline H van Roekel1, Marlou-Floor Kenkhuis2, Mo Klingestijn3, Anne-Marie Fanshawe3, Stéphanie O Breukink4, Maryska L G Janssen-Heijnen1,5, Eric T P Keulen6, Sabina Rinaldi7, Paolo Vineis8,9, Marc J Gunter7, Michael F Leitzmann10, Augustin Scalbert7, Matty P Weijenberg1. 1. Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands. 2. Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands. m.kenkhuis@maastrichtuniversity.nl. 3. Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University as Part of an Internship, Maastricht University, Maastricht, The Netherlands. 4. Department of Surgery, GROW School for Oncology and Reproduction, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands. 5. Department of Clinical Epidemiology, Viecuri Medical Center, Venlo, The Netherlands. 6. Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands. 7. Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), Lyon, France. 8. MRC Centre for Environment and Health, School of Public Health, Imperial College, London, UK. 9. Italian Institute of Technology, Genoa, Italy. 10. Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Abstract
PURPOSE: We investigated longitudinal associations of sedentary behavior, light-intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) with body composition in colorectal cancer (CRC) survivors, between 6 weeks and 24 months post treatment. In addition, we explored whether body composition mediated associations of sedentary behavior and MVPA with fatigue. METHODS: A prospective cohort study was conducted in 459 stage I-III CRC patients recruited at diagnosis. Measurements were performed of accelerometer-assessed sedentary time (hours/day), self-reported LPA and MVPA (hours/week), anthropometric assessment of body mass index (BMI), waist circumference and fat percentage (measures of adiposity), and muscle circumference and handgrip strength (measures of muscle mass/function) repeated at 6 weeks, and 6, 12 and 24 months post treatment. Longitudinal associations of sedentary time and physical activity with body composition were analyzed using confounder-adjusted linear mixed models. Mediation analyses were performed to explore the role of body mass index (BMI) and handgrip strength as mediators in associations of sedentary time and MVPA with fatigue. RESULTS: Less sedentary time and LPA were, independent of MVPA, longitudinally associated with increased handgrip strength, but not with measures of adiposity. More MVPA was associated with increased adiposity and increased handgrip strength. Higher BMI partly mediated associations between higher sedentary time and more fatigue. CONCLUSION: Within the first two years after CRC treatment, changes in sedentary behavior, physical activity and body composition are interrelated and associated with fatigue. Intervention studies are warranted to investigate causality. TRIAL REGISTRATION: The EnCoRe study is registered at trialregister.nl as NL6904 (former ID: NTR7099).
PURPOSE: We investigated longitudinal associations of sedentary behavior, light-intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) with body composition in colorectal cancer (CRC) survivors, between 6 weeks and 24 months post treatment. In addition, we explored whether body composition mediated associations of sedentary behavior and MVPA with fatigue. METHODS: A prospective cohort study was conducted in 459 stage I-III CRC patients recruited at diagnosis. Measurements were performed of accelerometer-assessed sedentary time (hours/day), self-reported LPA and MVPA (hours/week), anthropometric assessment of body mass index (BMI), waist circumference and fat percentage (measures of adiposity), and muscle circumference and handgrip strength (measures of muscle mass/function) repeated at 6 weeks, and 6, 12 and 24 months post treatment. Longitudinal associations of sedentary time and physical activity with body composition were analyzed using confounder-adjusted linear mixed models. Mediation analyses were performed to explore the role of body mass index (BMI) and handgrip strength as mediators in associations of sedentary time and MVPA with fatigue. RESULTS: Less sedentary time and LPA were, independent of MVPA, longitudinally associated with increased handgrip strength, but not with measures of adiposity. More MVPA was associated with increased adiposity and increased handgrip strength. Higher BMI partly mediated associations between higher sedentary time and more fatigue. CONCLUSION: Within the first two years after CRC treatment, changes in sedentary behavior, physical activity and body composition are interrelated and associated with fatigue. Intervention studies are warranted to investigate causality. TRIAL REGISTRATION: The EnCoRe study is registered at trialregister.nl as NL6904 (former ID: NTR7099).
Authors: Jose J L Breedveld-Peters; Janna L Koole; Eloise Müller-Schulte; Bernadette W A van der Linden; Cherelle Windhausen; Martijn J L Bours; Eline H van Roekel; Matty P Weijenberg Journal: Br J Nutr Date: 2018-04-16 Impact factor: 3.718
Authors: Janneke Annegarn; Martijn A Spruit; Nicole H M K Uszko-Lencer; Sophie Vanbelle; Hans H C M Savelberg; Annemie M W J Schols; Emiel F M Wouters; Kenneth Meijer Journal: Arch Phys Med Rehabil Date: 2011-11 Impact factor: 3.966
Authors: B E Ainsworth; W L Haskell; A S Leon; D R Jacobs; H J Montoye; J F Sallis; R S Paffenbarger Journal: Med Sci Sports Exerc Date: 1993-01 Impact factor: 5.411
Authors: Alfonso J Cruz-Jentoft; Jean Pierre Baeyens; Jürgen M Bauer; Yves Boirie; Tommy Cederholm; Francesco Landi; Finbarr C Martin; Jean-Pierre Michel; Yves Rolland; Stéphane M Schneider; Eva Topinková; Maurits Vandewoude; Mauro Zamboni Journal: Age Ageing Date: 2010-04-13 Impact factor: 10.668
Authors: N K Aaronson; S Ahmedzai; B Bergman; M Bullinger; A Cull; N J Duez; A Filiberti; H Flechtner; S B Fleishman; J C de Haes Journal: J Natl Cancer Inst Date: 1993-03-03 Impact factor: 13.506
Authors: Justin C Brown; Babette S Zemel; Andrea B Troxel; Michael R Rickels; Nevena Damjanov; Bonnie Ky; Andrew D Rhim; Anil K Rustgi; Kerry S Courneya; Kathryn H Schmitz Journal: Br J Cancer Date: 2017-09-21 Impact factor: 7.640
Authors: Brenda A J Berendsen; Marike R C Hendriks; Kenneth Meijer; Guy Plasqui; Nicolaas C Schaper; Hans H C M Savelberg Journal: BMC Public Health Date: 2014-07-24 Impact factor: 3.295