Dose-response effects of aerobic exercise on body composition among colon cancer survivors: a randomised controlled trial.

Br J Cancer. 2017 Sep 21. doi: 10.1038/bjc.2017.339. [Epub ahead of print] Brown JC1, Zemel BS2,3, Troxel AB4, Rickels MR5, Damjanov N6, Ky B7, Rhim AD8, Rustgi AK9, Courneya KS10, Schmitz KH11. Author information 1 Division of Population Science &Gastrointestinal Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA. 2 Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. 3 Department of Pediatrics, University of Pennsylvania, Philadelphia, PA 19104, USA. 4 Department of Population Health, NYU School of Medicine, New York, NY 10016, USA. 5 Divsion of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania, PA 19104, USA. 6 Division of Medical Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. 7 Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. 8 Department of Gastroenterology Hepatology &Nutrition, M.D. Anderson Cancer Center, Houston, TX 77230, USA. 9 Division of Gastroenterology, Department of Medicine, University of Pennsylvania, PA 19104, USA. 10 Department of Physical Activity and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada. 11 Department of Public Health Science, College of Medicine, Penn State College of Medicine, Hershey, PA 17033, USA. Abstract BACKGROUND: Physical activity is associated with a lower risk of disease recurrence among colon cancer survivors. Excess visceral adipose tissue is associated with a higher risk of disease recurrence among colon cancer survivors. The pathways through which physical activity may alter disease outcomes are unknown, but may be mediated by changes in visceral adipose tissue. METHODS: Thirty-nine stage I-III colon cancer survivors were randomised to one of three groups: usual-care control, 150 min wk-1 of aerobic exercise (low dose) and 300 min wk-1 of aerobic exercise (high dose) for 6 months. The prespecified key body composition outcome was visceral adipose tissue quantified using dual energy X-ray absorptiometry. RESULTS: Exercise reduced visceral adipose tissue in dose-response fashion (Ptrend=0.008). Compared with the control group, the low- and high-dose exercise groups lost 9.5 cm2 (95% CI: -22.4, 3.5) and 13.6 cm2 (95% CI: -27.0, -0.1) in visceral adipose tissue, respectively. Each 60 min wk-1 increase in exercise predicted a 2.7 cm2 (95% CI: -5.4, -0.1) reduction in visceral adipose tissue. CONCLUSIONS: Aerobic exercise reduces visceral adipose tissue in dose-response fashion among patients with stage I-III colon cancer. Visceral adipose tissue may be a mechanism through which exercise reduces the risk of disease recurrence among colon cancer survivors.British Journal of Cancer advance online publication 21 September 2017; doi:10.1038/bjc.2017.339 www.bjcancer.com. PMID: 28934762 DOI: 10.1038/bjc.2017.339