Musculoskeletal Responses to Exercise Plus Nutrition in Men with Prostate Cancer on Androgen Deprivation: A 12-Month RCT

Dalla Via, J; Owen, PJ; Daly, RM; Mundell, NL; Livingston, PM; Rantalainen, T; Foulkes, SJ; Millar, JL; Murphy, DG; Fraser, SF

Author(s): Dalla Via, J; Owen, PJ; Daly, RM; Mundell, NL; Livingston, PM; Rantalainen, T; Foulkes, SJ; Millar, JL; Murphy, DG; Fraser, SF;
Details: Publication Year 2021,Volume 53,Issue #10,Page 2054-2065
Journal Title: Medicine & Science in Sports & Exercise
Publication Type: Research article
Abstract: PURPOSE: Androgen deprivation therapy (ADT) for prostate cancer has multiple adverse effects on musculoskeletal health. This 12-month randomized controlled trial aimed to assess the effects of multicomponent exercise training combined with whey protein, calcium and vitamin D supplementation on bone mineral density (BMD), structure and strength, body composition, muscle strength, and physical function in ADT-treated men. METHODS: Seventy ADT-treated men were randomized to exercise plus supplementation (Ex + Suppl; n = 34) or usual care (control; n = 36). Ex + Suppl involved thrice weekly progressive resistance training plus weight-bearing impact exercise with daily multinutrient supplementation. Primary outcomes were DXA hip and spine areal BMD. Secondary outcomes included the following: tibia and radius pQCT volumetric BMD, bone structure and strength, DXA body composition, pQCT muscle and fat cross-sectional area and muscle density, and muscle strength and physical function. RESULTS: Sixty men (86%) completed the study. Mean exercise and supplement adherence were 56% and 77%, respectively. There were no effects of the intervention on bone or body composition outcomes. Ex + Suppl improved leg muscle strength (net difference, (95% confidence interval, or CI), 14.5% (-0.2 to 29.2); P = 0.007) and dynamic mobility (four-square-step test time, -9.3% (-17.3 to -1.3), P = 0.014) relative to controls. Per-protocol analysis of adherent participants (>/=66% exercise, >/=80% supplement) showed Ex + Suppl preserved femoral neck aBMD (1.9% (0.1 to 3.8), P = 0.026) and improved total body lean mass (1.0 kg (-0.23 to 2.22), P = 0.044) relative to controls. CONCLUSIONS: Exercise training combined with multinutrient supplementation had a limited effect on ameliorating the adverse musculoskeletal consequences of ADT, likely related to the modest intervention adherence.
Keywords: Aged; Androgen Antagonists/*adverse effects; Biomarkers/blood; Body Composition/*drug effects; Bone Density/*drug effects; Calcium, Dietary/administration & dosage; *Dietary Supplements; *Exercise Therapy; Humans; Male; Muscle Strength/*drug effects; Patient Compliance; Prostatic Neoplasms/*drug therapy/physiopathology; Vitamin D/administration & dosage; Whey Proteins/administration & dosage
Department(s): Surgical Oncology
PubMed ID: 33867499
Publisher's Version: https://doi.org/10.1249/MSS.0000000000002682
Terms of Use/Rights Notice: Refer to copyright notice on published article.

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