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.

Conclusion:

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

Exercise, nutrition, cancer, bone, muscle, androgen deprivation therapy

Document Type

Journal Article

Date of Publication

10-31-2021

Publication Title

Medicine & Science in Sports & Exercise

Publisher

Wolters Kluwer

School

School of Medical and Health Sciences / Institute for Nutrition Research

RAS ID

39720

Funders

YMCA Victoria

Ostelin and Omniblend Deakin University

Primary Growth Partnership grant Ministry of Primary Industries in New Zealand

Fonterra Co-operative Group Ltd.

Comments

This is a non-final version of an article published in final form in Via, J. D., Owen, P. J., Daly, R. M., Mundell, N. L., Livingston, P. M., Rantalainen, T., . . . Fraser, S. F. (2021). Musculoskeletal responses to exercise plus nutrition in men with prostate cancer on androgen deprivation: A 12-month RCT. Medicine & Science in Sports & Exercise, 53(10), 2054-2065. https://doi.org/10.1249/MSS.0000000000002682

Via, J. D., Owen, P. J., Daly, R. M., Mundell, N. L., Livingston, P. M., Rantalainen, T., . . . Fraser, S. F. (2021). Musculoskeletal responses to exercise plus nutrition in men with prostate cancer on androgen deprivation: A 12-month RCT. Medicine & Science in Sports & Exercise, 53(10), 2054-2065.

https://doi.org/10.1249/MSS.0000000000002682

https://cdn-tp2.mozu.com/16833-m1/cms/files/Author-Document.pdf?_mzts=636519775710000000

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Link to publisher version (DOI)

10.1249/MSS.0000000000002682