Osteoporosis (progressive deterioration of bone) is often referred to as a silent epidemic due to its widespread prevalence but little awareness. It is thought that around 3 million people in the UK have verified osteoporosis – with specific populations more likely to develop the condition. Breast cancer survivors are at particular risk.
Partially due to the initial treatment, bone loss is a problem for individuals who develop and survive breast cancer. The biggest problem is the loss of the hormone estrogen. For many breast cancer survivors estrogen is severely diminished due to early onset-menopause (sometimes purposely induced or as a result of specific treatments) and the use of aromatase inhibitors (aromatase is a key enzyme in the biosynthesis of estrogen) in certain individuals.
Estrogen and bone is a complicated lot, which involves many systems in the body. Although the entire cascade hasn’t been completely mapped out yet, there is sufficient evidence to say that estrogen is a key player in the growth and re-modelling of bone – in the years leading up to menopause and a decade after, women can lose up to 50% of their total bone mass. So anything that can slow down, arrest, or even stimulate accrual of bone is a big boost to the quality of life of breast cancer survivors (BCS).
Although not a novel premise in regards to the average population, researchers have recently studied the effects of resistance training in this specific cohort of individuals (BCS) on the parameters of strength, body composition (Because muscle loss is also a big issue in cancer treatment this study also looked at the potential for lean body mass changes too), blood markers of bone, and inflammation.(1)
As well as resistance training the researchers also looked at the potential of ingesting dried plums (prunes) on bone remodelling. Prunes have previously been shown to improve several indices of bone remodelling, one of which is to inhibit the activity of osteoclasts (specific cells that break down and remove bone tissue).(2)
The combination of the two interventions – resistance training to provide the stress needed to stimulate growth; and the effect of the prunes in modulating the breakdown of bone – may tilt the balance in favour of at least maintaining current bone levels, or preferably, an increase.
In the study 23 BCS (RT, n = 12; RT+DP, n = 11), aged 64 ± 7 years, were evaluated at baseline and after 6 months of intervention on the following: muscular strength; body composition, specifically bone mineral density (BMD) by dual energy X-ray absorptiometry (DEXA); biochemical markers of bone turnover; and inflammation. Resistance training prescription was 2 days/week of 10 exercises. The Resistance training plus dried plums group also consumed 90g (around 10 prunes) of dried plums daily.
At baseline there were no differences between groups. Both groups increased upper and lower body strength over the intervention, with the resistance training plus dried plums group gaining slightly more.
Resistance training was also found to be effective for improving biochemical markers of bone turnover.
Although there were no significant changes noted in body composition and measures of inflammation, the authors did suggest that a longer and higher intensity intervention may be needed to reveal the true effects.
Having viewed the resistance training component I tend to agree, as the workout was fairly poorly designed for purpose. That however is a positive sign, as even with a sub-optimal set-up, positive effects were seen in terms of bone health – with a well designed program I would suggest the results would be markedly superior.
References:
1- Emily Simonavice, Pei-Yang Liu, Jasminka Z. Ilich, Jeong-Su Kim, Bahram Arjmandi, Lynn B. Panton. The effects of a 6-month resistance training and dried plum consumption intervention on strength, body composition, blood markers of bone turnover, and inflammation in breast cancer survivors1. Applied Physiology, Nutrition, and Metabolism, 2013; 1 DOI: 10.1139/apnm-2013-0281
2- Hooshmand S, Chai SC, Saadat RL, Payton ME, Brummel-Smith K, Arjmandi BH. Comparative effects of dried plum and dried apple on bone in postmenopausal women. Br J Nutr. 2011 Sep;106(6):923-30. doi: 10.1017/S000711451100119X. Epub 2011 May 31. PubMed PMID: 21736808.
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