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The effect of intermittent versus chronic energy restriction on breast cancer risk biomarkers in premenopausal women: a randomised pilot trial
Breast Cancer Research volume 10, Article number: P53 (2008)
Background
Postmenopausal breast cancer risk increases twofold in women who gain significant amounts of weight [1] and there is evidence that energy restriction may reduce risk [2]. Animal studies indicate that intermittent energy restriction (IER) reduces risk and may be superior to continuous energy restriction (CER) [3]. We have shown that CER reduces breast cancer risk biomarkers in women but is hard to maintain. We hypothesise that IER may be superior to CER in reducing biomarkers of breast cancer risk and may also be more acceptable to women.
Methods
One hundred and eight premenopausal women, mean age 40.0 years (SD = 4.0), mean adult weight gain 20.1 kg (SD = 11.0), were randomised to either CER (75% estimated energy requirements: ~1,500 kcal 7 days/week) or IER (75% estimated energy requirements: 650 kcal for 2 days and ~1,800 kcal 5 days/week) over 6 months. The study endpoints are weight and body composition (waist/hip circumference, fat free and total fat mass by bioelectrical impedence), measures of insulin sensitivity (HOMA, SHBG, testosterone), potential breast cancer growth factors (IGF axis, leptin adiponectin), inflammatory markers (C-reactive protein and sialic acid) and oxidative stress markers (serum isoprostane). The relative acceptability of IER and CER will be assessed using a quality of life questionnaire (RAND SF-36) and scales of behaviour change and adherence.
Results
Nineteen participants (17.6%) have withdrawn from the study (IER = 12, CER = 7; main reasons: stress = 4, pregnancy = 3, change in employment = 3, could not stick to diet = 3). Baseline to 6-month results for weight and body composition are reported in Table 1.
Conclusion
Significant decreases in weight, fat and waist occurred in both groups over 6 months, with the IER group doing slightly better. Greater proportions of the IER group achieved 5% weight loss (IER 79% cf. CER 66%, P = 0.19) and 10% weight loss (IER 43% cf. CER 28%, P = 0.13). We await results for biochemistry and relative acceptability, which will be presented at the meeting.
References
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Huang Z, Hankinson SE, Colditz GA, Stampfer MJ, Hunter DJ, Manson JE, Hennekens CH, Rosner B, Speizer FE, Willett WC: Dual effects of weight and weight gain on breast cancer risk. JAMA. 1997, 278: 1407-1411. 10.1001/jama.278.17.1407.
- 2.
Harvie M, Howell A, Vierkant RA, Kumar N, Cerhan JR, Kelemen LE, Folsom AR, Sellers TA: Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa women's health study. Cancer Epidemiol Biomarkers Prev. 2005, 14: 656-661. 10.1158/1055-9965.EPI-04-0001.
- 3.
Cleary MP, Jacobson MK, Phillips FC, Getzin SC, Grande JP, Maihle NJ: Weight-cycling decreases incidence and increases latency of mammary tumors to a greater extent than does chronic caloric restriction in mouse mammary tumor virus-transforming growth factor-alpha female mice. Cancer Epidemiol Biomarkers Prev. 2002, 11: 836-843.
Acknowledgements
Study funded by Breast Cancer Campaign, World Cancer Research Fund and Genesis.
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Harvie, M., Chapman, M., Cuzick, J. et al. The effect of intermittent versus chronic energy restriction on breast cancer risk biomarkers in premenopausal women: a randomised pilot trial. Breast Cancer Res 10, P53 (2008). https://doi.org/10.1186/bcr1937
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Keywords
- Breast Cancer Risk
- Sialic Acid
- Premenopausal Woman
- Postmenopausal Breast Cancer
- Reduce Breast Cancer Risk
