Abstract P6-07-12: A physical activity and dietary counseling intervention in breast cancer survivors and changes in known and novel prognostic biomarkers
Authors: Peterson LL , Ford ME , Gregoski MJ , Knight KD , Hilton EJ , Magwood G , Turner DP 
Published: May 2019

High rates of overweight/obesity are commonly seen in breast cancer (BC) survivors. Observational data show an association between post-treatment increased weight and lack of physical activity (PA) and risk of BC recurrence and death. Increases in prognostic inflammatory associated biomarkers (BM) such as interleukin-6 (IL6) and C-reactive protein (CRP), and their downstream effects, are linked to overweight/obesity and provide a potential mechanistic explanation for this increase in recurrence risk, but studies are mixed regarding the effect of lifestyle interventions on these BM. In addition, better BM may exist. The Getting on Board with an Active Lifestyle (GOAL) study tested the feasibility of a PA and dietary counseling (DC) intervention in BC survivors and included known BM (IL6 , CRP) as well as a novel BM (advanced glycation end-products [AGEs]). AGEs are reactive metabolites produced by an uncontrolled reaction between sugars and proteins and were selected because they are seen in chronic diseases including: diabetes, neuro-degenerative disorders, stroke, heart disease and more recently, BC. Further, dietary AGEs are consumed in high fat and highly processed foods that contribute to overweight/obesity.

Methods: Ten overweight/obese women (BMI≥25) within 36 months of BC diagnosis (stage I-III) participated in a 12-week supervised PA and DC intervention consisting of two supervised PA sessions per week and weekly DC sessions. Body mass index (BMI), resting heart rate (HR) and blood pressure (BP) and blood samples were collected at baseline, week 4, 8, 12, 24, 36, 52. IL-6, CRP and AGEs were assessed in serum using commercially available 96-well format ELISAs. Data through week 12 is presented here.

Results: Ten participants (four African American) completed the 12-week intervention. The age range of participants was 50-68 years (mean 56 years). The average number of daily active minutes increased significantly between baseline (45) and week 11 (71). There was a drop off at week 12 due to right-censoring of the data. Dietary AGE intake decreased in 8 of 10 participants from baseline to week 12 (average reduction 53%). Significant reductions in mean serum AGEs were seen (baseline=53 ug/ml, week 12=38ug/ml, p&lt;0.001). No correlating reductions in CRP or IL6 were found. Correlations were seen between AGE levels and AGE intake (r=0.24 at week 12). There were no significant correlations between AGE levels and IL6 or CRP. Decreases in BMI (average change -.54 kg/m2), resting HR and BP corroborated with AGE reductions.

Conclusions: The GOAL intervention has the potential to improve PA and dietary AGE intake among overweight/obese BC patients. Participants improved weight, resting HR, BP, and number of daily active minutes; which are important metrics for overall health. There were no changes in IL6 and CRP, but reductions in AGEs correlated with reductions in dietary AGE levels, indicating that serum AGEs may be reduced through diet and PA. Serum AGEs may represent a better BM than IL6 and CRP in BC survivors. Further investigation of AGEs in BC survivors is warranted.

Citation Format: Peterson LL, Ford ME, Gregoski MJ, Knight KD, Hilton EJ, Magwood G, Turner DP. A physical activity and dietary counseling intervention in breast cancer survivors and changes in known and novel prognostic biomarkers [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-12.