title: Impact + resistance training improves bone health and body composition in prematurely menopausal breast cancer survivors: a randomized controlled trial.
abstract: Our randomized controlled trial in prematurely menopausal breast cancer survivors showed that impact + resistance training prevented increases in percentage of body fat compared with controls and also improved BMD at the hip and prevented BMD loss at the spine among exercise-trained women who were menopausal for >1 year.
  
  
  BACKGROUND
  Cancer treatment-related menopause worsens bone health and body composition in breast cancer survivors (BCS). We investigated whether impact + resistance training could improve bone mineral density (BMD), reduce bone turnover, build muscle, and decrease fat mass in BCS with premature menopause.
  
  
  METHODS
  We conducted a randomized controlled trial in 71 BCS (mean age, 46.5 years) within 5 years of treatment-related menopause. Women were randomly assigned to one of two groups: (1) impact + resistance training (prevent osteoporosis with impact + resistance (POWIR)) or (2) exercise placebo (FLEX) 3×/week for 1 year. Outcomes were hip and spine BMD (in grams per square centimeter) and body composition (percent body fat (%BF) and lean and fat mass (in kilograms)) by DXA and bone turnover markers (serum osteocalcin (in nanograms per milliliter) and urinary deoxypryrodinoline (in nanomoles per milliliter).
  
  
  RESULTS
  There were no significant group × time interactions for bone outcomes when using an intent-to-treat approach on the full sample. In analyses restricted to BCS who were menopausal for ≥1 year, POWIR increased BMD at the hip and slowed BMD loss at the spine compared with FLEX (femoral neck-POWIR, 0.004 ± 0.093 g/cm(2) vs. FLEX, -0.010 ± 0.089 g/cm(2); p < 0.01; spine-POWIR, -0.003 ± 0.114 g/cm(2) vs. FLEX, -0.020 ± 0.110 g/cm(2); p = 0.03). POWIR prevented increases in %BF (POWIR, 0.01 % vs. FLEX, 1.3 %; p < 0.04). Women with attendance to POWIR at ≥64 % had better improvements in %BF than women attending less often (p < 0.03).
  
  
  CONCLUSIONS
  Impact + resistance training may effectively combat bone loss and worsening body composition from premature menopause in BCS.
authors.affiliation: School of Nursing, Oregon Health & Science University, Portland, OR, USA. wintersk@ohsu.edu
authors.forename: K M
authors.initials: KM
authors.lastname: Winters-Stone
authors.forename: J
authors.initials: J
authors.lastname: Dobek
authors.forename: L M
authors.initials: LM
authors.lastname: Nail
authors.forename: J A
authors.initials: JA
authors.lastname: Bennett
authors.forename: M C
authors.initials: MC
authors.lastname: Leo
authors.forename: B
authors.initials: B
authors.lastname: Torgrimson-Ojerio
authors.forename: S-W
authors.initials: SW
authors.lastname: Luoh
authors.forename: A
authors.initials: A
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D001823:Body Composition / Q000502:physiology; D015519:Bone Density / Q000502:physiology*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008594:Menopause, Premature / Q000502:physiology*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D010349:Patient Compliance; D055070:Resistance Training / Q000379:methods; D017741:Survivors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents