Analysis of the effects of individualized nutrition and physical activities on body composition during the treatment of breast cancer patients.

BACKGROUND: Malnutrition and loss of skeletal muscle mass are common in breast cancer patients and represent negative prognostic factors. Combined nutrition and exercise interventions may help preserve body composition during treatment. The aim of this study was to evaluate the effects of a targeted nutritional and exercise intervention on body composition, assessed by Bioelectrical Impedance Analysis (BIA), in breast cancer patients undergoing treatment, stratified by baseline nutritional status according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. PATIENTS AND METHODS: In this retrospective analysis of the OREH pilot study, 287 patients were included in the intervention group and 194 in the control group. All patients underwent BIA measurements at baseline, 6 months, and 12 months. Malnourished patients (GLIM-positive) in both groups received individualized nutritional counseling as standard care. GLIM-negative patients in the intervention group received preventive nutritional counseling via online lectures. All intervention group patients participated in supervised group exercise. Differences in BIA parameters (fat-free mass index, phase angle, fat mass, total body water, and body mass index) between the 3rd and 1st measurements were compared using Welch's t-test, with p-values adjusted by the Bonferroni-Holm method. RESULTS: No statistically significant differences in body composition parameters were observed between the intervention and control groups over the 12-month follow-up period. The adjusted p-value for fat-free mass index (FFMI) was 0.2 in GLIM-positive patients and 1.0 in GLIM-negative patients. A trend toward greater FFMI increase was observed in GLIM-positive patients in the intervention group compared to controls (mean difference 0.30; 95% CI 0.05-0.54; unadjusted p = 0.017), but this did not remain significant after correction for multiple comparisons. CONCLUSIONS: The combined nutritional and exercise intervention did not significantly improve BIA-derived body composition parameters. However, the trend toward FFMI improvement in GLIM-positive patients receiving individualized nutritional counseling suggests that personalized approaches may be more effective than group-based interventions. Future studies should incorporate individualized nutrition and resistance training programs to optimize body composition outcomes in breast cancer patients.