This review synthesized and appraised the evidence for an effect of inflammation on breast cancer risk. Systematic searches identified prospective cohort and Mendelian randomization studies relevant ...to this review. Meta-analysis of 13 biomarkers of inflammation were conducted to appraise the evidence for an effect breast cancer risk; we examined the dose-response of these associations. Risk of bias was evaluated using the ROBINS-E tool and the quality of evidence was appraised with Grading of Recommendations Assessment, Development, and Evaluation. Thirty-four observational studies and three Mendelian randomization studies were included. Meta-analysis suggested that women with the highest levels of C-reactive protein (CRP) had a higher risk of developing breast cancer risk ratio (RR) = 1.13; 95% confidence interval (CI), 1.01-1.26 compared with women with the lowest levels. Women with highest levels of adipokines, particularly adiponectin (RR = 0.76; 95% CI, 0.61-0.91) had a reduced breast cancer risk, although this finding was not supported by Mendelian randomization analysis. There was little evidence of an effect of cytokines, including TNFα and IL6, on breast cancer risk. The quality of evidence for each biomarker ranged from very low to moderate. Beyond CRP, the published data do not clearly support the role of inflammation in the development of breast cancer.
Purpose
Growing recognition of the gut microbiome as an influential modulator of cancer treatment efficacy and toxicity has led to the emergence of clinical interventions targeting the microbiome to ...enhance cancer and health outcomes. The highly modifiable nature of microbiota to endogenous, exogenous, and environmental inputs enables interventions to promote resilience of the gut microbiome that have rapid effects on host health, or response to cancer treatment. While diet, probiotics, and faecal microbiota transplant are primary avenues of therapy focused on restoring or protecting gut function in people undergoing cancer treatment, the role of physical activity and exercise has scarcely been examined in this population.
Methods
A narrative review was conducted to explore the nexus between cancer care and the gut microbiome in the context of physical activity and exercise as a widely available and clinically effective supportive care strategy used by cancer survivors.
Results
Exercise can facilitate a more diverse gut microbiome and functional metabolome in humans; however, most physical activity and exercise studies have been conducted in healthy or athletic populations, primarily using aerobic exercise modalities. A scarcity of exercise and microbiome studies in cancer exists.
Conclusions
Exercise remains an attractive avenue to promote microbiome health in cancer survivors. Future research should elucidate the various influences of exercise modalities, intensities, frequencies, durations, and volumes to explore dose-response relationships between exercise and the gut microbiome among cancer survivors, as well as multifaceted approaches (such as diet and probiotics), and examine the influences of exercise on the gut microbiome and associated symptom burden prior to, during, and following cancer treatment.
•Exercise is safe for people with multiple myeloma at low risk of pathological fracture.•Participation in exercise programs is feasible for people with multiple myeloma.•Attendance may be limited ...during active treatment, particularly stem cell transplantation.•There is insufficient evidence to confirm the effect of exercise on disease- and treatment- related side effects.
Bone lesions and other disease- and treatment-related side effects commonly experienced by people with multiple myeloma (MM) may impede their ability to exercise. This systematic review evaluated the safety, feasibility, and efficacy of exercise program participation on the physiological and/or psychological health of people with MM. Literature searches were conducted through five electronic databases and appraised using the Delphi list of criteria. Controlled trials that assessed the safety and feasibility of an exercise intervention and its effects on disease- or treatment-related symptoms in people with MM were included. Seven studies of varying quality involving 563 participants were included. All studies concluded that exercise was safe, reporting zero serious and 4 adverse events attributable to exercise testing or training. Attendance ranged from 58% to 96%, however no study reported adherence to the exercise prescription. Compared to a control group, exercise did not appear to affect fatigue, depression, anxiety, body composition, quality of life, or sleep. Isolated studies identified between-group differences favoring exercise in lower limb strength (+8.4 kg, 95% CI 0.5, 16.3, P= .04), peak oxygen uptake (+1.2 mL/kg/min, 95% CI 0.3, 3.7, P= .02), physical activity (+6.5MET-hs/wk, P< .001), stem cell collection attempts (1.1 ± 0.2 vs. 1.5 ± 0.9, P< .01), and red blood cell (1.8 ± 2.2 vs. 2.4 ± 2.6, P< .05) and platelet transfusions (2.3 ± 1.6 vs. 3.5 ± 3.4, P < .05) during transplantation. Exercise interventions appear safe and well attended by people with MM. The lack of improvements in disease- and treatment-related symptoms requires further exploration to determine whether exercise is a sufficient stimulus to elicit benefits in this unique population.
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Hoffmann, SM, Skinner, TL, van Rosendal, SP, Osborne, MA, Emmerton, LM, and Jenkins, DG. The efficacy of the lactate threshold: A sex-based comparison. J Strength Cond Res 34(11): 3190-3198, 2020-The ...second lactate threshold (LT2) has previously been associated with endurance performance; however, comparisons between sexes are lacking regarding its efficacy. The aim of this study was to compare LT2 between men and women, specifically regarding its (a) relationship with endurance performance and (b) capacity to establish training and competition intensities. Competitive male (mean ± SD: age, 27.7 ± 4.7 years; VCombining Dot AboveO2max, 59.7 ± 5.2 ml·kg·min; n = 10) and female (mean ± SD: age, 27.3 ± 6.2 years; VCombining Dot AboveO2max, 54.5 ± 5.3 ml·kg·min; n = 12) cyclists and triathletes completed an incremental cycle trial to volitional fatigue (for determination of VCombining Dot AboveO2max and LT2 via the modified D-max method), a constant load (±5%) exercise trial of 30 minutes at LT2 power output, and a 40-km cycle time trial. The LT2 significantly correlated with 40-km cycling performance in both men (r = -0.69 to -0.77; p < 0.01-0.05) and women (r = -0.63 to -0.75; p < 0.01-0.05). All men sustained LT2 power output for 30 minutes, compared with 82% of women. Despite LT2 reflecting a similar heart rate, VCombining Dot AboveO2, and La to those elicited during a 40-km time trial in both men and women, power output at LT2 was 6% higher (p < 0.05) than mean time trial power output in women, with no significant difference in men. Based on these findings, sex-specific recommendations have been suggested in regard to the use of LT2 for establishing performance potential, prescribing endurance training intensities and setting 40-km performance intensity.
People with multiple myeloma (MM) are second only to people with lung cancer for the poorest reported health-related quality of life (HRQoL) of all cancer types. Whether exercise can improve HRQoL in ...MM, where bone pain and lesions are common, requires investigation. This trial aims to evaluate the efficacy of an exercise intervention compared with control on HRQoL in people with MM. Following baseline testing, people with MM (
= 60) will be randomized to an exercise (EX) or waitlist control (WT) group. EX will complete 12-weeks of supervised (24 sessions) and unsupervised (12 sessions) individualized, modular multimodal exercise training. From weeks 12-52, EX continue unsupervised training thrice weekly, with one optional supervised group-based session weekly from weeks 12-24. The WT will be asked to maintain their current activity levels for the first 12-weeks, before completing the same protocol as EX for the following 52 weeks. Primary (patient-reported HRQoL) and secondary (bone health and pain, fatigue, cardiorespiratory fitness, muscle strength, body composition, disease response, and blood biomarkers) outcomes will be assessed at baseline, 12-, 24- and 52-weeks. Adverse events, attendance, and adherence will be recorded and cost-effectiveness analysis performed. The findings will inform whether exercise should be included as part of standard myeloma care to improve the health of this unique population.
Purpose
Following colorectal cancer diagnosis and anti-cancer therapy, declines in cardiorespiratory fitness and body composition lead to significant increases in morbidity and mortality. There is ...increasing interest within the field of exercise oncology surrounding potential strategies to remediate these adverse outcomes. This study compared 4 weeks of moderate-intensity exercise (MIE) and high-intensity exercise (HIE) training on peak oxygen consumption (V̇O
2
peak) and body composition in colorectal cancer survivors.
Methods
Forty seven post-treatment colorectal cancer survivors (HIE = 27 months post-treatment; MIE = 38 months post-treatment) were randomised to either HIE 85–95 % peak heart rate (HR
peak
) or MIE (70 % HR
peak
) in equivalence with current physical activity guidelines and completed 12 training sessions over 4 weeks.
Results
HIE was superior to MIE in improving absolute (
p
= 0.016) and relative (
p
= 0.021) V̇O
2
peak. Absolute (+0.28 L.min
−1
,
p
< 0.001) and relative (+3.5 ml.kg
−1
.min
−1
,
p
< 0.001) V̇O
2
peak were increased in the HIE group but not the MIE group following training. HIE led to significant increases in lean mass (+0.72 kg,
p
= 0.002) and decreases in fat mass (−0.74 kg,
p
< 0.001) and fat percentage (−1.0 %,
p
< 0.001), whereas no changes were observed for the MIE group. There were no severe adverse events.
Conclusions
In response to short-term training, HIE is a safe, feasible and efficacious intervention that offers clinically meaningful improvements in cardiorespiratory fitness and body composition for colorectal cancer survivors.
Implications for Cancer Survivors
HIE appears to offer superior improvements in cardiorespiratory fitness and body composition in comparison to current physical activity recommendations for colorectal cancer survivors and therefore may be an effective clinical utility following treatment.
The protective effect of physical activity on breast cancer incidence may partially be mediated by inflammation. Systematic searches of Medline, EMBASE, and SPORTDiscus were performed to identify ...intervention studies, Mendelian randomization studies, and prospective cohort studies that examined the effects of physical activity on circulating inflammatory biomarkers in adult women. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the overall quality of the evidence. Thirty-five intervention studies and one observational study met the criteria for inclusion. Meta-analyses of randomized controlled trials (RCT) indicated that, compared with control groups, exercise interventions reduced levels of C-reactive protein (CRP) standardized mean difference (SMD) = -0.27, 95% confidence interval (CI) = -0.62 to 0.08), tumor necrosis factor alpha (TNFα, SMD = -0.63, 95% CI = -1.04 to -0.22), interleukin-6 (IL6, SMD = -0.55, 95% CI = -0.97 to -0.13) and leptin (SMD = -0.50, 95% CI = -1.10 to 0.09). Owing to heterogeneity in effect estimates and imprecision, evidence strength was graded as low (CRP, leptin) or moderate (TNFα and IL6). High-quality evidence indicated that exercise did not change adiponectin levels (SMD = 0.01, 95% CI = -0.14 to 0.17). These findings provide support for the biological plausibility of the first part of the physical activity-inflammation-breast cancer pathway.
Purpose
Stroke rate (SR) has not been considered in previous research examining the relative roles of the limbs in front-crawl performance. This study compared velocity, aerobic power (
V
˙
O
2
) and ...metabolic cost (
C
) between whole body (WB) and arms only (AO) front-crawl swimming across various intensities while controlling SR.
Methods
Twenty Australian national swimmers performed six 200 m front-crawl efforts under two conditions: (1) WB swimming and, (2) AO swimming. Participants completed the 200 m trials under three SR conditions: “low” (22–26 stroke-cycles min
−1
), “moderate” (30–34 stroke-cycles min
−1
and “high” (38–42 stroke-cycles min
−1
).
V
˙
O
2
was continuously measured, with
C
, velocity, SR, and kick rate calculated for each effort.
Results
Regardless of the SR condition and sex, AO velocity was consistently lower than WB velocity by ~11.0 % (
p
< 0.01). AO
V
˙
O
2
was lower than WB
V
˙
O
2
at all SR conditions for females (
p
< 0.01) and at the “high” SR for males (
p
< 0.01).
C
did not differ between WB and AO at any SR for both sexes (
p
> 0.01). When
C
was expressed as a function of velocity, WB and AO regression equations differed for males (
p
= 0.01) but not for females (
p
= 0.087). Kick rate increased as SR increased (
p
< 0.01), though the kick-to-stroke rate ratio remained constant.
Conclusion
Elite swimmers gain ~11 % in velocity from their kick and, when used in conjunction with the arm stroke at the swimmers’ preferred frequency, the metabolic cost of WB and AO swimming is the same. Coaches should consider these results when prescribing AO sets if their intention is to reduce the metabolic load.
This investigation (i) examined changes in tear osmolarity in response to fluid loss that occurs with exercise in a field setting, and (ii) compared tear osmolarity with common field and laboratory ...hydration measures. Sixty-three participants age 27.8 ± 8.4 years, body mass 72.15 ± 10.61 kg completed a self-paced 10 km run outside on a predetermined course. Body mass, tear fluid, venous blood and urine samples were collected immediately before and after exercise. Significant (p < 0.001) reductions in body mass (1.71 ± 0.44%) and increases in tear osmolarity (8 ± 15 mOsm.L
−1
), plasma osmolality (7 ± 8 mOsm.kg
−1
), and urine specific gravity (0.0014 ± 0.0042 g.mL
−1
; p = 0.008) were observed following exercise. Pre- to post-exercise change in tear osmolarity was not significantly correlated (all p > 0.05) with plasma osmolality (r
s
= 0.24), urine osmolality (r
s
= 0.14), urine specific gravity (r
s
= 0.13) or relative body mass loss (r = 0.20). Tear osmolarity is responsive to exercise-induced fluid loss but does not correlate with the changes observed using other common measures of hydration status in the field setting. Practitioners shouldn't directly compare or replace other common hydration measures with tear osmolarity in the field.
Abbreviations: BML: Body Mass Loss; CV: Coefficient of Variation; P
osm
: Plasma osmolality; SD: Standard Deviation; T
osm
: Tear Osmolarity; U
osm
: Urine Osmolality; USG: Urine Specific Gravity; WBGT: Wet bulb globe thermometer
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