title: Lifestyle guidelines for managing adverse effects on bone health and body composition in men treated with androgen deprivation therapy for prostate cancer: an update.
abstract: Men treated with androgen deprivation therapy (ADT) for prostate cancer are prone to multiple treatment-induced adverse effects, particularly with regard to a deterioration in bone health and altered body composition including decreased lean tissue mass and increased fat mass. These alterations may partially explain the marked increased risk in osteoporosis, falls, fracture and cardiometabolic risk that has been observed in this population.
  
  
  
  A review was conducted that assessed standard clinical guidelines for the management of ADT-induced adverse effects on bone health and body composition in men with prostate cancer.
  
  
  
  Currently, standard clinical guidelines exist for the management of various bone and metabolic ADT-induced adverse effects in men with prostate cancer. However, an evaluation of the effectiveness of these guidelines into routine practice revealed that men continued to experience increased central adiposity, and, unless pharmacotherapy was instituted, accelerated bone loss and worsening glycaemia occurred.
  
  
  
  This review discusses the current guidelines and some of the limitations, and proposes new recommendations based on emerging evidence regarding the efficacy of lifestyle interventions, particularly with regard to exercise and nutritional factors, to manage ADT-related adverse effects on bone health and body composition in men with prostate cancer.
authors.affiliation: Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
authors.forename: P J
authors.initials: PJ
authors.lastname: Owen
authors.affiliation: Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
authors.forename: R M
authors.initials: RM
authors.lastname: Daly
authors.affiliation: Faculty of Health, Deakin University, Geelong, VIC, Australia.
authors.forename: P M
authors.initials: PM
authors.lastname: Livingston
authors.affiliation: Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
authors.forename: S F
authors.initials: SF
authors.lastname: Fraser
mesh_terms: D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000728:Androgens / Q000378:metabolism* / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D001851:Bone Diseases, Metabolic / Q000139:chemically induced / Q000473:pathology; D015444:Exercise; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced / Q000150:complications / Q000378:metabolism / Q000473:pathology; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors
chemical_list: D000726:Androgen Antagonists; D000728:Androgens; D018931:Antineoplastic Agents, Hormonal