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Physical activity levels of overweight or obese breast cancer survivors: correlates at entry into a weight loss intervention study

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Abstract

Purpose

Physical activity is associated with reduced risk and progression of breast cancer, and exercise can improve physical function, quality of life, and fatigue in cancer survivors. Evidence on factors associated with cancer survivors’ adherence to physical activity guidelines from the American Cancer Society and the U.S. Department of Health and Human Services is mixed. This study seeks to help fill this gap in knowledge by examining correlates with physical activity among breast cancer survivors.

Methods

Overweight or obese breast cancer survivors (N = 692) were examined at enrollment into a weight loss intervention study. Questionnaires and medical record review ascertained data on education, race, ethnicity, menopausal status, physical activity, and medical history. Measures of anthropometrics and fitness level were conducted. Regression analysis examined associations between physical activity and demographic, clinical, and lifestyle factors.

Results

Overall, 23 % of women met current guidelines. Multivariate analysis revealed that body mass index (p = 0.03), emergency room visits in the past year (p = 0.04), and number of comorbidities (p = 0.02) were associated with less physical activity. Geographic region also was associated with level of physical activity (p = 0.02), with women in Alabama reporting significantly less activity than those in other participating regions.

Conclusions

The majority of overweight/obese breast cancer survivors did not meet physical activity recommendations. Physical activity levels were associated with degree of adiposity, geographic location, and number of comorbidities. The majority of overweight breast cancer survivors should be encouraged to increase their level of physical activity. Individualizing exercise prescriptions according to medical comorbidities may improve adherence.

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Acknowledgments

This ENERGY study was supported by National Cancer Institute Grant CA148791. The ENERGY Trial Group investigators: University of California, San Diego: Cheryl Rock, PhD, RD, Bilgé Pakiz, EdD, Barbara Parker, MD; University of California, Los Angeles: Patricia Ganz, MD; University of Colorado Anschutz Medical Campus, Aurora: Tim Byers, MD, MPH, Rebecca Sedjo, PhD, Holly Wyatt, MD, Anthony Elias, MD, James Hill, PhD; Washington University in St. Louis: Graham Colditz, MD, Kathleen Wolin, ScD, Jingxia Liu, PhD, Michael Naughton, MD; and University of Alabama at Birmingham: Wendy Demark-Wahnefried, PhD, RD, Helen Krontiras, MD, Maria Azrad, PhD, RD, Cindy Blair, PhD.

This project was also partially supported by the National Institutes of Health, grants TL1TR00098, CA23100, TR001082, and RR024992. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Conflict of interest

Kathleen Wolin has equity in a digital health company whose products include weight management tools. All other authors declare that they have no conflict of interest. Cheryl Rock (corresponding author) and Shirley Flatt have full control of all primary data.

Author information

Authors and Affiliations

  1. Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA, USA

    Fred X. Liu, Shirley W. Flatt, Bilgé Pakiz & Cheryl L. Rock

  2. Department of Community and Behavioral Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Rebecca L. Sedjo

  3. Coeus Health, LLC, Scale Down, LLC, and Department of Preventive Medicine, Northwestern University School of Medicine, Chicago, IL, USA

    Kathleen Y. Wolin

  4. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA

    Cindy K. Blair

  5. Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA

    Wendy Demark-Wahnefried

  6. UC San Diego Moores Cancer Center, 3855 Health Sciences Dr, La Jolla, CA, 92093-0901, USA

    Cheryl L. Rock

Authors
  1. Fred X. Liu
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  2. Shirley W. Flatt
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  3. Bilgé Pakiz
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  4. Rebecca L. Sedjo
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  5. Kathleen Y. Wolin
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  6. Cindy K. Blair
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  7. Wendy Demark-Wahnefried
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  8. Cheryl L. Rock
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Corresponding author

Correspondence to Cheryl L. Rock.

Additional information

The American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors has concluded that exercise training is safe during and after cancer treatment and results in improvements in physical function, quality of life, and cancer-related fatigue in several cancer survivor groups. Evidence on factors associated with cancer survivors’ adherence to physical activity guidelines is mixed. Results from this study may help oncologists and primary care physicians develop educational and intervention programs and to prescribe exercise based on specific patient characteristics, including individualized exercise prescriptions according to medical comorbidities.

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Liu, F.X., Flatt, S.W., Pakiz, B. et al. Physical activity levels of overweight or obese breast cancer survivors: correlates at entry into a weight loss intervention study. Support Care Cancer 24, 173–180 (2016). https://doi.org/10.1007/s00520-015-2761-2

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  • DOI: https://doi.org/10.1007/s00520-015-2761-2

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