title: Obesity and physical inactivity are related to impaired physical health of breast cancer survivors.
abstract: OBJECTIVE
  The aim of the present study was to examine the impact of obesity and physical activity on the health and wellbeing of patients with breast cancer shortly after the adjuvant treatments.
  
  
  METHODS
  A total of 537 women aged 35 to 68 years with newly-diagnosed breast cancer were enrolled into the exercise intervention study. The physical activity, physical performance (2-km walking test), cardiovascular risk factors, quality of life (EORTC-QoL-C30), co-morbidities and body-mass index (BMI) were measured after the adjuvant treatments.
  
  
  RESULTS
  Overall, 191 (39%) patients were overweight (BMI=25-30) and 85 (17%) obese (BMI ≥ 30). Physical activity and performance (p<0.001 and p<0.001), QoL (p<0.001) and high density lipoprotein (HDL)-cholesterol decreased (p<0.001) whereas age (p=0.009), co-morbidities (p<0.001), hypertension (p=0.011), metabolic syndrome (p<0.001), low density lipoprotein (LDL)-cholesterol (p=0.0043), triglycerides (p<0.001), glucose (p<0.001) and insulin (p<0.001) increased linearly with BMI. Higher waist circumference (p=0.0011), triglyceride (p=0.020), insulin (p=0.0098), rate of metabolic syndrome (p=0.028), and lower HDL-cholesterol (p=0.012) and QoL (p<0.001) were associated with low physical activity. Physical activity and BMI were the most important determinants of physical performance (p<0.001 and p<0.001, respectively).
  
  
  CONCLUSIONS
  Obesity and a sedentary lifestyle are related to poor physical performance, increased risk of cardiovascular diseases and impaired QoL, leading to a vicious circle, which impairs patients' physical health and QoL.
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, HUS, Finland. meri.utriainen@hus.fi
authors.forename: Anneli
authors.initials: A
authors.lastname: Elme
authors.forename: Meri
authors.initials: M
authors.lastname: Utriainen
authors.forename: Pirkko
authors.initials: P
authors.lastname: Kellokumpu-Lehtinen
authors.forename: Tiina
authors.initials: T
authors.lastname: Palva
authors.forename: Riitta
authors.initials: R
authors.lastname: Luoto
authors.forename: Riku
authors.initials: R
authors.lastname: Nikander
authors.forename: Riikka
authors.initials: R
authors.lastname: Huovinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Salme
authors.initials: S
authors.lastname: Järvenpää
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Penttinen
authors.forename: Leena
authors.initials: L
authors.lastname: Vehmanen
authors.forename: Anna-Stina
authors.initials: AS
authors.lastname: Jääskeläinen
authors.forename: Johanna
authors.initials: J
authors.lastname: Ruohola
authors.forename: Carl
authors.initials: C
authors.lastname: Blomqvist
authors.forename: Tiina
authors.initials: T
authors.lastname: Saarto
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000150:complications / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000523:psychology; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D024821:Metabolic Syndrome / Q000209:etiology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000209:etiology* / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*; D055105:Waist Circumference