A lifestyle intervention of weight loss via a low-carbohydrate diet plus walking to reduce metabolic disturbances caused by androgen deprivation therapy among prostate cancer patients: carbohydrate and prostate study 1 (CAPS1) randomized controlled trial.
| dc.contributor.author | Freedland, Stephen J | |
| dc.contributor.author | Howard, Lauren | |
| dc.contributor.author | Allen, Jenifer | |
| dc.contributor.author | Smith, Jordan | |
| dc.contributor.author | Stout, Jennifer | |
| dc.contributor.author | Aronson, William | |
| dc.contributor.author | Inman, Brant A | |
| dc.contributor.author | Armstrong, Andrew J | |
| dc.contributor.author | George, Daniel | |
| dc.contributor.author | Westman, Eric | |
| dc.contributor.author | Lin, Pao-Hwa | |
| dc.date.accessioned | 2022-02-01T01:32:42Z | |
| dc.date.available | 2022-02-01T01:32:42Z | |
| dc.date.issued | 2019-09 | |
| dc.date.updated | 2022-02-01T01:32:42Z | |
| dc.description.abstract | PurposeThe objective of this study was to test a low-carbohydrate diet (LCD) plus walking to reduce androgen deprivation therapy (ADT)-induced metabolic disturbances.Materials and methodsThis randomized multi-center trial of prostate cancer (PCa) patients initiating ADT was designed to compare an LCD (≤20g carbohydrate/day) plus walking (≥30 min for ≥5 days/week) intervention vs. control advised to maintain usual diet and exercise patterns. Primary outcome was change in insulin resistance by homeostatic model assessment at 6 months. To detect 20% reduction in insulin resistance, 100 men were required. The study was stopped early after randomizing 42 men due to slow accrual. Secondary outcomes included weight, body composition, lipids, and prostate-specific antigen (PSA). Changes from baseline were compared between arms using rank-sum tests.ResultsAt 6 months, LCD/walking reduced insulin resistance by 4% vs. 36% increase in control (p = 0.13). At 3 months, vs. control, LCD/walking arm significantly lost weight (7.8kg; p<0.001), improved insulin resistance (↑36%; p = 0.015), hemoglobin A1c (↓3.3%; p = 0.01), high-density lipoprotein (HDL) (↑13%; p = 0.004), and triglyceride (↓37%; p = 0.036). At 6 months, weight loss (10.6kg; p<0.001) and HDL (↑27%; p = 0.003) remained significant. LCD/walking preserved total body bone mineral count (p = 0.025), reduced fat mass (p = 0.002), lean mass (p = 0.036), and percent body fat (p = 0.004). There were no differences in PSA. Limitations include the effect of LCD, weight loss vs. walking instruction are indistinguishable, and small sample size.ConclusionsIn an underpowered study, LCD/walking did not improve insulin sensitivity at 6 months. Given most secondary outcomes were improved at 3 months with some remaining improved at 6 months and a secondary analysis showed that LCD/walking reduced insulin resistance over the study, supporting future larger studies of LCD/walking intervention to reduce ADT-induced disturbances. | |
| dc.identifier | 10.1038/s41391-019-0126-5 | |
| dc.identifier.issn | 1365-7852 | |
| dc.identifier.issn | 1476-5608 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Springer Science and Business Media LLC | |
| dc.relation.ispartof | Prostate cancer and prostatic diseases | |
| dc.relation.isversionof | 10.1038/s41391-019-0126-5 | |
| dc.subject | Humans | |
| dc.subject | Prostatic Neoplasms | |
| dc.subject | Body Weight | |
| dc.subject | Weight Loss | |
| dc.subject | Androgen Antagonists | |
| dc.subject | Treatment Outcome | |
| dc.subject | Walking | |
| dc.subject | Body Composition | |
| dc.subject | Aged | |
| dc.subject | Middle Aged | |
| dc.subject | Male | |
| dc.subject | Diet, Carbohydrate-Restricted | |
| dc.subject | Healthy Lifestyle | |
| dc.subject | Metabolic Syndrome | |
| dc.title | A lifestyle intervention of weight loss via a low-carbohydrate diet plus walking to reduce metabolic disturbances caused by androgen deprivation therapy among prostate cancer patients: carbohydrate and prostate study 1 (CAPS1) randomized controlled trial. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Howard, Lauren|0000-0003-3355-4483 | |
| duke.contributor.orcid | Inman, Brant A|0000-0002-6060-4485 | |
| duke.contributor.orcid | Armstrong, Andrew J|0000-0001-7012-1754 | |
| duke.contributor.orcid | Lin, Pao-Hwa|0000-0001-5982-9241 | |
| pubs.begin-page | 428 | |
| pubs.end-page | 437 | |
| pubs.issue | 3 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Staff | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Biostatistics & Bioinformatics | |
| pubs.organisational-group | Pharmacology & Cancer Biology | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Surgery | |
| pubs.organisational-group | Medicine, General Internal Medicine | |
| pubs.organisational-group | Medicine, Medical Oncology | |
| pubs.organisational-group | Medicine, Nephrology | |
| pubs.organisational-group | Surgery, Urology | |
| pubs.organisational-group | Duke Cancer Institute | |
| pubs.organisational-group | Duke Molecular Physiology Institute | |
| pubs.publication-status | Published | |
| pubs.volume | 22 |