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Clinical Research

Dose-response effects of aerobic exercise on adiposity markers in postmenopausal women: pooled analyses from two randomized controlled trials

International Journal of Obesity volume 45, pages 1298–1309 (2021)Cite this article

Subjects

Abstract

Background/objective

Exercise may reduce the risk of breast cancer through adiposity changes, but the dose-response effects of exercise volume on adiposity markers are unknown in postmenopausal women. We aimed to compare the dose-response effects of prescribed aerobic exercise volume on adiposity outcomes.

Participants/methods

Data from the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) and Breast Cancer and Exercise Trial in Alberta (BETA) were pooled for this analysis (N = 720). These were 12-month randomized controlled trials, where participants were randomized to 225 min/week (mid-volume) of aerobic exercise versus usual inactive lifestyle (ALPHA), or 150 min/week (low-volume) versus 300 min/week (high-volume) (BETA). Fat mass and fat-free mass were measured using DXA and intra-abdominal and subcutaneous fat area were assessed with computed tomography.

Results

After 12 months of aerobic exercise, increasing exercise volumes from no exercise/control to 300 min/week resulted in statistically significant reductions in BMI, weight, fat mass, fat percentage, intra-abdominal and subcutaneous fat area (P < 0.001). Compared with controls, fat mass loss was −1.13, −1.98 and −2.09 kg in the low-, mid- and high-volume groups, respectively. Similarly, weight loss was −1.47, −1.83, −2.21 kg in the low-, mid- and high-volume groups, respectively, compared to controls, and intra-abdominal fat area loss was −7.44, −15.56 and −8.76 cm2 in the low-, mid- and high-volume groups, respectively, compared to controls. No evidence for a dose-response effect on fat-free mass was noted.

Conclusion

A dose-response effect of exercise volume on adiposity markers was noted, however, the differences in adiposity markers were smaller when comparing 225 min/week to 300 min/week of exercise. Given the strong positive associations between obesity and postmenopausal breast cancer risk, this study provides evidence on the importance of exercise volume as part of the exercise prescription to reduce adiposity and, ultimately, postmenopausal breast cancer risk.

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Fig. 1: Participant flow diafram for the ALPHA Trial and BETA, Alberta, Canada, 2008–2012.

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Acknowledgements

The ALPHA Trial was funded by a research grant (no. 017468) from the Canadian Breast Cancer Research Alliance. BETA was funded by a research grant from the Alberta Cancer Foundation (#24404). Paola Gonzalo-Encabo is supported by a Predoctoral Fellowship by the Spanish Ministry of Education, Culture and Sports. Dr JM is supported by a Postdoctoral Fellowship Awards from the Canadian Institutes of Health Research and Alberta Innovates-Health Solutions. Dr Kerry Courneya holds a Tier I Canada Research Chair. Dr Christine Friedenreich holds a Health Senior Scholar Award from Alberta Innovates-Health Solutions and the Alberta Cancer Foundation Weekend to End Women’s Cancers Breast Cancer Chair.

Funding

Research Grant No. 017468 from the Canadian Breast Cancer Research Alliance (ALPHA Trial); Research Grant No. 24404 from the Alberta Cancer Foundation (BETA Trial).

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Authors and Affiliations

  1. Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada

    Paola Gonzalo-Encabo, Jessica McNeil & Christine M. Friedenreich

  2. Department of Biomedical Sciences, Area of Sport and Physical Education (GRIGEDE), University of Alcalá, Alcalá de Henares, Madrid, Spain

    Paola Gonzalo-Encabo, Alberto Pérez-López & David Valadés

  3. Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain

    Paola Gonzalo-Encabo

  4. Department of Kinesiology, School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, USA

    Jessica McNeil

  5. Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada

    Kerry S. Courneya

  6. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Christine M. Friedenreich

  7. Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Christine M. Friedenreich

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  1. Paola Gonzalo-Encabo
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Correspondence to Christine M. Friedenreich.

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Gonzalo-Encabo, P., McNeil, J., Pérez-López, A. et al. Dose-response effects of aerobic exercise on adiposity markers in postmenopausal women: pooled analyses from two randomized controlled trials. Int J Obes 45, 1298–1309 (2021). https://doi.org/10.1038/s41366-021-00799-1

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