1.
Short- and long-term impact of adapted physical activity and diet counseling during adjuvant breast cancer therapy: the "APAD1" randomized controlled trial.
Carayol, M, Ninot, G, Senesse, P, Bleuse, JP, Gourgou, S, Sancho-Garnier, H, Sari, C, Romieu, I, Romieu, G, Jacot, W
BMC cancer. 2019;19(1):737
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Breast cancer is the most common cancer in women, and fatigue reported as the most distressing and common symptom by cancer patients undergoing adjuvant cancer therapy. The aim of this randomised controlled trial was to evaluate the effects of the Adapted Physical Activity and Diet (APAD) intervention, a diet and exercise programme, on fatigue and other side effects, in early stage breast cancer patients undergoing chemo- and radiotherapy. The APAD intervention was compared to Usual Care (UC) without exercise or diet counselling. 143 breast cancer patients were enrolled into this study and followed for 1.5 years. The exercise part of the programme consisted of one resistance and two moderate intensity aerobic exercise sessions per week. Participants in the APAD group also attended nine face-to-face dietary counselling sessions which were based on recommendations by the World Cancer Research Fund (WCRF). Cancer-related fatigue and quality of life were significantly improved in the APAD group compared to UC, with sustainable effects seen at the 1-year follow-up post-intervention. There was no significant effect of the intervention on nutritional intakes. Beneficial effects of the APAD intervention was also seen in BMI, fat mass, muscle endurance, cognitive flexibility, anxiety and depression, and declared physical activity at the end of chemotherapy/radiotherapy but these were not sustained over the following year
Abstract
BACKGROUND Patients with breast cancer undergoing chemotherapy and radiotherapy experience fatigue and other treatment side effects. Integrative therapies combining physical activity and dietary counseling are recommended; however to date no large randomized controlled trial has been conducted during adjuvant therapy. The Adapted Physical Activity and Diet (APAD) intervention was evaluated for its ability to decrease fatigue (primary outcome), anxiety, depression, body mass index (BMI), and fat mass, and enhance muscular and cognitive performances, and quality-of-life (QoL). METHODS Women diagnosed with early breast cancer (N = 143, mean age = 52 ± 10 years) were randomized to APAD or usual care (UC). APAD included thrice-weekly moderate-intensity mixed aerobic and resistance exercise sessions and 9 dietetic consultations. Patient-reported outcomes (PROs) and anthropometric, muscular, and cognitive variables were measured at baseline, 18 weeks (end of chemotherapy), and 26 weeks (end of radiotherapy and intervention), and at 6- and 12-month post-intervention follow-ups. Multi-adjusted linear mixed-effects models were used to compare groups over time. RESULTS Significant beneficial effects of the APAD intervention were observed on all PROs (i.e., fatigue, QoL, anxiety, depression) at 18 and 26 weeks. The significant effect on fatigue and QoL persisted up to 12-month follow-up. Significant decreases in BMI, fat mass, and increased muscle endurance and cognitive flexibility were observed at 26 weeks, but did not persist afterward. Leisure physical activity was enhanced in the APAD group vs UC group at 18 and 26 weeks. No significant effect of the intervention was found on major macronutrients intake. CONCLUSIONS A combined diet and exercise intervention during chemotherapy and radiotherapy in patients with early breast cancer led to positive changes in a range of psychological, physiological and behavioral outcomes at the end of intervention. A beneficial effect persisted on fatigue and QoL at long term, i.e., 1 year post-intervention. Diet-exercise supportive care should be integrated into the management of early breast cancer patients. TRIAL REGISTRATION The APAD study was prospectively registered on ClinicalTrials.gov (NCT01495650; date of registration: December 20, 2011).
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Oral Curcumin (Meriva) Is Effective as an Adjuvant Treatment and Is Able to Reduce IL-22 Serum Levels in Patients with Psoriasis Vulgaris.
Antiga, E, Bonciolini, V, Volpi, W, Del Bianco, E, Caproni, M
BioMed research international. 2015;2015:283634
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Psoriasis is an immune-mediated inflammatory condition affecting the skin, nails, and joints. Turmeric contains curcumin, a yellow-pigmented polyphenol with anti-inflammatory properties. Several diseases, including psoriasis, have been treated with turmeric in Asian countries since ancient times as a topical application and dietary supplement. This phase 3, single-dose, randomised, double-blind, placebo-controlled clinical trial evaluated the efficacy of curcumin as a complementary therapy for the treatment of mild-to-moderate psoriasis. This study used Meriva, a curcumin supplement that contains lecithin to boost the bioavailability and absorption of curcumin. The study assessed the effect of curcumin supplementation on inflammatory cytokine secretion by the immune cells. For 12 weeks, sixty-three patients with mild-to-moderate psoriasis were randomly assigned to either receive 2 grams of oral curcumin supplement, Meriva, along with topical steroid cream (Methylprednisolone aceponate 0.1%), or topical steroid cream alone. Treatment with 2 grams of oral curcumin supplementation and topical steroid cream application for 12 weeks significantly reduced the secretion of inflammatory cytokine, IL-22, in the serum of psoriatic patients. Additionally, the treatment reduced the proliferation of outer skin cells. Further robust studies are required to analyse the beneficial effects of curcumin on other pathogenic pathways of psoriasis. The study can help healthcare professionals learn more about the benefits of curcumin supplements for treating psoriasis in conjunction with conventional medicine.
Abstract
Curcumin is a complementary therapy that may be helpful for the treatment of psoriasis due to its anti-inflammatory, antiangiogenic, antioxidant, and antiproliferative effects. In the present study we performed a randomized, double-blind, placebo-controlled clinical trial to assess the effectiveness of a bioavailable oral curcumin in the treatment of psoriasis. Sixty-three patients with mild-to-moderate psoriasis vulgaris (PASI < 10) were randomly divided into two groups treated with topical steroids and Meriva, a commercially available lecithin based delivery system of curcumin, at 2 g per day (arm 1), or with topical steroids alone (arm 2), both for 12 weeks. At the beginning (T0) and at the end of the therapy (T12), clinical assessment and immunoenzymatic analysis of the serum levels of IL-17 and IL-22 were performed. At T12, both groups achieved a significant reduction of PASI values that, however, was higher in patients treated with both topical steroids and oral curcumin than in patients treated only with topical steroids. Moreover, IL-22 serum levels were significantly reduced in patients treated with oral curcumin. In conclusion, curcumin was demonstrated to be effective as an adjuvant therapy for the treatment of psoriasis vulgaris and to significantly reduce serum levels of IL-22.