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Review

Dietary Intake and Energy Expenditure in Breast Cancer Survivors: A Review

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Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
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Anschutz Health and Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
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Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
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Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA
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Division of Geriatric Medicine, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paolo Piaggi
Nutrients 2021, 13(10), 3394; https://doi.org/10.3390/nu13103394
Received: 16 July 2021 / Revised: 23 September 2021 / Accepted: 23 September 2021 / Published: 27 September 2021
(This article belongs to the Special Issue Energy Balance and Body Weight)
Many breast cancer survivors (BCS) gain fat mass and lose fat-free mass during treatment (chemotherapy, radiation, surgery) and estrogen suppression therapy, which increases the risk of developing comorbidities. Whether these body composition alterations are a result of changes in dietary intake, energy expenditure, or both is unclear. Thus, we reviewed studies that have measured components of energy balance in BCS who have completed treatment. Longitudinal studies suggest that BCS reduce self-reported energy intake and increase fruit and vegetable consumption. Although some evidence suggests that resting metabolic rate is higher in BCS than in age-matched controls, no study has measured total daily energy expenditure (TDEE) in this population. Whether physical activity levels are altered in BCS is unclear, but evidence suggests that light-intensity physical activity is lower in BCS compared to age-matched controls. We also discuss the mechanisms through which estrogen suppression may impact energy balance and develop a theoretical framework of dietary intake and TDEE interactions in BCS. Preclinical and human experimental studies indicate that estrogen suppression likely elicits increased energy intake and decreased TDEE, although this has not been systematically investigated in BCS specifically. Estrogen suppression may modulate energy balance via alterations in appetite, fat-free mass, resting metabolic rate, and physical activity. There are several potential areas for future mechanistic energetic research in BCS (e.g., characterizing predictors of intervention response, appetite, dynamic changes in energy balance, and differences in cancer sub-types) that would ultimately support the development of more targeted and personalized behavioral interventions. View Full-Text
Keywords: metabolism; obesity; nutrition; exercise; oncology metabolism; obesity; nutrition; exercise; oncology
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MDPI and ACS Style

Purcell, S.A.; Marker, R.J.; Cornier, M.-A.; Melanson, E.L. Dietary Intake and Energy Expenditure in Breast Cancer Survivors: A Review. Nutrients 2021, 13, 3394. https://doi.org/10.3390/nu13103394

AMA Style

Purcell SA, Marker RJ, Cornier M-A, Melanson EL. Dietary Intake and Energy Expenditure in Breast Cancer Survivors: A Review. Nutrients. 2021; 13(10):3394. https://doi.org/10.3390/nu13103394

Chicago/Turabian Style

Purcell, Sarah A., Ryan J. Marker, Marc-Andre Cornier, and Edward L. Melanson. 2021. "Dietary Intake and Energy Expenditure in Breast Cancer Survivors: A Review" Nutrients 13, no. 10: 3394. https://doi.org/10.3390/nu13103394

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