Effect of body composition change on markers of metabolic syndrome in breast cancer survivors on either fat or carbohydrate restricted diets.

A21

Women previously treated for breast cancer are at risk for post-treatment morbidity including obesity, cardiovascular disease, diabetes, and sarcopenia or sarcopenic obesity. The encouragement of weight loss for the management of comorbidities and metabolic disturbance, without consideration of protein content or physical activity, may exacerbate sarcopenia, compromise functional status and lead to increasing risk of future fractures. The purpose of this study is to evaluate the relationship between changes in body composition and metabolic status in the survivor population.
 >In an ongoing, randomized, weight loss intervention of low fat or low carbohydrate diets in breast cancer survivors (N=37; Age 55.4 ± 9.7 yrs; BMI >25 kg/m²) on adjuvant hormonal therapies, standard anthropometry (height, weight, waist, and hip circumferences) and total and region body fat, lean, and bone mass measures were performed (dual X-ray absorptiometry). Total cholesterol, triglycerides (TG), high density lipoprotein cholesterol (HDL), insulin, glycosylated hemoglobin, and glucose were also measured by the clinical diagnostic laboratory.
 >At baseline, we found that 32% of participants had elevated (>3.5) TG/HDL values, a sensitive and specific surrogate measure for insulin resistant, dyslipidemic individuals. In intervention completers thus far (N=14), using the new ATP III criterion, cases of metabolic syndrome were cut by 56% following intervention (metabolic syndrome by ATP III 64% at baseline, 29% at 24weeks) in this survivor group.
 >At 24 weeks, completers also demonstrated significant improvements in weight and body fat, with suggested loss in lean mass. Although measures of glucose were not altered, fasting insulin and glycosylated hemoglobin were significantly reduced, consistent with improved insulin sensitivity.
 >Investigations of high protein diets in cancer survivors for the preservation of lean mass during weight loss are limited. This preliminary analysis indicates that markers of metabolic syndrome can be improved by diet in breast cancer survivors, but there is a trend toward loss of lean mass accompanying loss of fat.
 >Variable Change; p-value
 >Weight (kg) -8.46 ± 4.08; <0.001
 >BMI (kg/m2) -3.05 ± 1.6; <0.001
 >%Total Body Fat -4.8 ± 3.0; <0.001
 >Trunk Fat (kg) -3.4 ± 1.8; <0.001
 >Lean Mass (kg) -0.86 ± 1.6; 0.06
 >Fasting Plasma Glucose (mg/dl) -3.00 ± 8.99; 0.18
 >2hr-Post-Load Glucose (mg/dl) 8.70 ± 28.39; 0.36
 >Fasting Insulin (uU/ml) -3.56 ± 5.83; 0.02
 >Glycosylated Hemoglobin (%) -0.17 ± 0.34; 0.05
 >Total Cholesterol (mg/dl) -8.61 ± 29.95; 0.24
 >Triglycerides (mg/dl) 0.06 ± 77.26; 1.0
 >High-density lipoprotein cholesterol (mg/dl) 1.56 ± 9.08; 0.48