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Lifestyle intervention based on aerobic exercise and Mediterranean diet modulates IGF-1 and its binding proteins in breast cancer survivors

Annibalini G, Sisti D, De Santi M, Natalucci V, Imperio M, Ferri Marini C, Lucertini F, Vallorani L et al.

Breast cancer research : BCR, 2026

26 participants

Abstract

BACKGROUND: Obesity-related biomarkers such as insulin-like growth factor-1 (IGF-1) may help identify high-risk breast cancer survivors (BCS) who could benefit from lifestyle interventions (LIs). However, the effect of LIs on modulation of IGF-1 levels in BCS remains inconclusive. METHODS: Fifty inactive BCS were randomized into a control group (CG, n = 26) and an intervention group (IG, n = 24). Both groups received recommendations on exercise and the Mediterranean diet; the IG additionally followed a supervised 3-month aerobic exercise program (MoviS trial, NCT04818359). Associations between baseline and LI-induced changes (∆) in IGF-1, IGF binding protein-1 (IGFBP1) and IGFBP3 levels, along with anthropometric, metabolic, and fitness parameters, were assessed using linear and quadratic models. RESULTS: Both groups increased physical activity (MET min/week) and Mediterranean diet adherence (MeDiet score) after the LI, while maximal oxygen uptake (V̇O2max) increased only in the IG. Reductions in BMI, fat mass, insulin levels, HOMA-IR index, total and LDL cholesterol were observed in both groups and were associated with increased IGFBP1 and decreased IGFBP3 levels. Mean IGF-1 levels remained unchanged in both groups. Baseline IGFBP1 was inversely correlated with IGF-1, LDL, BMI, fat mass, and insulin, while baseline IGFBP3 was positively correlated with IGF-1, insulin, and HOMA-IR. Baseline IGF-1 levels were negatively correlated with ∆ IGF-1: participants with IGF-1 ≤ 94.7…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 26 participants or records.

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