Weight gain associated with breast cancer survivorship

Expert Guidelines

The National Comprehensive Cancer Network and the American Cancer Society have recommendations for physical activity for cancer survivors:

• Physical activity and exercise recommendations should be tailored to each person's abilities and preferences. 
• People should try to engage in some physical activity daily; this may include:
  • taking the stairs.
  • walking more.
• Each week, people should try to achieve the following: 
  • At least 150 minutes of moderate-intensity exercise, with an ideal goal of 300 minutes, 75 minutes of vigorous activity or a combination of the two.
  • Two to three sessions of strength/resistance training that include all of the major muscle groups (chest, shoulders, arms, back, core and legs). 
  • Stretch major muscle groups at least two days per week.  

• Avoid sitting or lying down for long periods and other prolonged sedentary behavior. 

Nutrition for people diagnosed with cancer

The National Comprehensive Cancer Network (NCCN) recommends the following for cancer survivors: 

• Think about your food choices and amount of fruits, vegetables and unrefined grains you eat compared with red and processed meats, alcohol, and foods or drinks with added fat or sugar. 
• Think about your eating habits, including portion size, snacking, how often you eat out and use of added fats or sugars.
• All survivors should be encouraged to:
  • Make informed choices about food to ensure variety and adequate nutrient intake.
  • Limit refined sugars.
  • Eat a diet that is at least 50% plant-based, consisting mostly of vegetables, fruit and whole grains.
  • Track calorie intake; monitoring of calories is an effective way to manage weight.
  • Minimize alcohol intake to no more than one drink per day for a woman and two drinks per day for a man.
• For patients desiring further dietary guidelines, the USDA approximate food plate volumes are:
  • Vegetables and fruits should comprise half the volume of food on the plate
  • Vegetables: 30% of plate; Fruits 20% of plate
  • Whole grains: 30% of plate
  • Protein: 20% of plate
• Recommended sources of nutrients:
  • Fat: plant sources such as olive or canola oil, avocados, seeds and nuts, and fatty fish.
  • Carbohydrates: fruits, vegetables, whole grains and legumes.
  • Protein: poultry, fish, legumes, low-fat dairy foods, and nuts.

The Academy of Nutrition and Dietetics, the United States Office of Disease Prevention and Health Promotion  and the American Institute for Cancer Research also publish expert guidelines on nutrition and health. 

Questions To Ask Your Health Care Provider

• How can I manage my weight?
• Cancer treatment is hard on my body—how do I exercise when I don’t feel like I can/want to?
• My weight fluctuates—should I be worried if I gain a few pounds?
• What are the current guidelines for weight management for cancer survivors?
• Can you refer me to a registered dietitian who specializes in oncology nutrition? 

Open Clinical Trials

The following are studies focused on exercise for people diagnosed with breast cancer. 

• NCT04000880: AMPLIFY: An Online Weight Loss Study Specifically for Cancer Survivors. AMPLIFY is a nation-wide, web-based diet and exercise study recruiting overweight survivors of early stage breast, prostate, ovarian, renal, colorectal, endometrial cancer and multiple myeloma age 50 and older who are interested in becoming more active, eating better and losing weight.
• NCT04621721: Physical Activity at Home for Relief from Neuropathy Caused by Taxanes in People with Breast Cancer. This study will look at the effects of gain and balance training and resistance exercise (using bands) on gait, balance, and lower extremity muscle strength after a 16-week home-based exercise program compared to educational materials without an exercise program.
• NCT04298086: A Study of the Body's Response to Exercise and a Plant-Based Diet in Overweight Postmenopausal Women With Breast Cancer. This study is looking to find out what effects exercise and a plant-based diet have on aromatase levels in postmenopausal women who are overweight and being treated with an aromatase inhibitor for their HR+ breast cancer. 
• NCT05327452: Testing Home-based Exercise Strategies in Underserved Minority Cancer Patients Undergoing Chemotherapy: the THRIVE Study. The purpose of this research is to determine whether a 16 week, home-based, aerobic and resistance exercise intervention will increase physical activity levels in Black and Hispanic breast, colorectal, or prostate cancer patients.
• NCT03761706: Impact of Home-based Aerobic and Strength Exercises During Chemotherapy for Early Breast Cancer on Biomarkers of Aging. To determine if engagement in physical activity during chemotherapy will have a moderating effect on increases in p16 levels during chemotherapy.
• NCT03824145: Every Day Counts: A Lifestyle Program for Women With Metastatic Breast Cancer (EDC).This study will examine dietary and activity patterns, body composition, blood and quality of life in breast cancer patients. The study will recruit 176 women with MBC in Milwaukee and Chicago.

• NCT04298086: A Study of the Body's Response to Exercise and a Plant-Based Diet in Overweight Postmenopausal Women With Breast Cancer. This study is looking at the effects exercise and a plant-based diet have on aromatase levels in postmenopausal women who are overweight and being treated with an aromatase inhibitor. 

Visit our Featured Research Page and Research Search and Enroll Tool to find additional studies enrolling people with, or at high risk for cancer.

The following are studies focused on nutrition for people diagnosed with breast cancer. 

• NCT04000880: AMPLIFY: An Online Weight Loss Study Specifically for Cancer Survivors. AMPLIFY is a nation-wide, web-based diet and exercise study recruiting overweight survivors of early-stage breast, prostate, ovarian, renal, colorectal, endometrial cancer and multiple myeloma in people age 50 and older who are interested in becoming more active, eating better and losing weight.
• NCT04298086: A Study of the Body's Response to Exercise and a Plant-Based Diet in Overweight Postmenopausal Women With Breast Cancer. This study is looking to find out what effects exercise and a plant-based diet have on aromatase levels in postmenopausal women who are overweight and being treated with an aromatase inhibitor for their HR+ breast cancer. 
• NCT04365569 Evaluating the Effectiveness of an Individualized Nutrition and Physical Activity Counseling Program. This pilot study looks at whether a tailored in-person and telephone-based nutrition and exercise counseling program can help breast cancer patients improve weight and fitness and thus improve cancer outcomes.

Visit our Featured Research Page and Research Search and Enroll Tool to find additional studies enrolling people with, or at high risk for cancer.