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The effect of prescribed exercise volume on biomarkers of chronic stress in postmenopausal women: results from the breast cancer and exercise trial in Alberta (BETA) [with consumer summary]
Friedenreich CM, Wang Q, Shaw E, Heer EV, Zhou R, Brenner DR, Courneya KS, Wynne-Edwards KE
Preventive Medicine Reports 2019 Sep;15:100960
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

There is epidemiologic and biologic evidence for a role of stress in breast cancer etiology and physical activity mitigates the negative effects of stress. We examined the potential for a dose-response relationship between two volumes of aerobic exercise and biomarkers of chronic stress in post-menopausal women. The breast cancer and exercise trial in Alberta is a randomized controlled trial with post-menopausal women randomized to either a moderate (150 min per week) or high (300 min per week) volume of exercise over a one year intervention period. Fasting serum concentrations of cortisol, cortisone, corticosterone and 11-deoxycortisol at baseline, 12 months (the end of the intervention), and 24 months. Intention-to-treat analyses were performed using general linear models, adjusted for baseline biomarker concentrations. There were modest but non-statistically significant decreases in cortisol (high -4%, 95% CI -7% to 2%; moderate -1%, 95%: CI -14% to 4%) and corticosterone (high -4%, 95% CI -12% to 6%; moderate -5%, 95% CI -14% to 4%) concentrations for both exercise groups between baseline and 12 months, and no difference in cortisone concentrations. Intention-to-treat analysis of 386 (97%) participants showed no statistically significant group differences for changes in biomarker levels at 12 months. Between baseline and 12 months, there were no differences in cortisol or cortisone and, at 24 months all stress hormone levels increased to near-baseline levels with no significant differences between the two intervention groups.

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