Reduction in neural activation to high-calorie food cues in obese endometrial cancer survivors after a behavioral lifestyle intervention: a pilot study.
BACKGROUND
Obesity increases the risk of endometrial cancer (EC) and obese EC patients have the highest risk of death among all obesity-associated cancers. However, only two lifestyle interventions targeting this high-risk population have been conducted. In one trial, food disinhibition, as determined by the Three-Factor Eating Questionnaire, decreased post-intervention compared to baseline, suggesting an increase in emotional eating and, potentially, an increase in food related reward. Therefore, we evaluated appetitive behavior using functional magnetic resonance imaging (fMRI) and a visual food task in 8 obese, Stage I/II EC patients before and after a lifestyle intervention (Survivors in Uterine Cancer Empowered by Exercise and a Healthy Diet, SUCCEED), which aimed to improve nutritional and exercise behaviors over 16 group sessions in 6 months using social cognitive theory.


RESULTS
Congruent to findings in the general obese population, we found that obese EC patients, at baseline, had increased activation in response to high- vs. low-calorie food cues after eating a meal in brain regions associated with food reward (insula, cingulate gyrus; precentral gyrus; whole brain cluster corrected, p < 0.05). At 6 months post-intervention compared to baseline, we observed decreased activation for the high-calorie vs. non-food contrast, post-meal, in regions involved in food reward and motivation (posterior cingulate, cingulate gyrus, lateral globus pallidus, thalamus; claustrum; whole brain cluster corrected, p < 0.05).


CONCLUSIONS
Our preliminary results suggest behavioral lifestyle interventions may help to reduce high-calorie food reward in obese EC survivors who are at a high-risk of death. To our knowledge, this is the first study to demonstrate such changes.
Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106-7281, USA. nln@case.edu
Nora L
NL
Nock
Anastasia
A
Dimitropolous
Jean
J
Tkach
Heidi
H
Frasure
Vivan
V
von Gruenigen
D001834:Body Water; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D001931:Brain Mapping; D003463:Cues; D016889:Endometrial Neoplasms / Q000209:etiology / Q000473:pathology / Q000523:psychology; D005260:Female; D005502:Food; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008019:Life Style; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000473:pathology / Q000523:psychology; D010100:Oxygen / Q000097:blood; D010775:Photic Stimulation; D010865:Pilot Projects
D010100:Oxygen