Can lifestyle changes improve markers of metabolic and cardiovascular health in men on ADT?

Although most of us know the health benefits of physical activity and eating well, it can be difficult to implement healthy behaviours and challenging to maintain them over time. Those who’ve participated in the ADT classes and read the ADT book will have learned about strategies, such as using Action Plans, to achieve healthy behavioural change.

In a similar vein, a new study out of Arizona tested the feasibility and impact of a Comprehensive Lifestyle Improvement Program for Prostate Cancer (or CLIPP), which was designed to help men manage the adverse metabolic effects of ADT.

The Program and its Study:  CLIPP is a 24-week comprehensive lifestyle modification intervention, adapted from an evidence-based diabetes prevention program. It involves weekly curricula about nutrition, physical activity, and stress management. Trained health coaches provide ongoing guidance and support, helping participants to work toward their health goals over time.

To investigate the program’s effectiveness, researchers looked at the impacts of the program on weight management and various markers of metabolic syndrome. Thirty-one men enrolled in the program and provided data at baseline, and at 12 and 24 weeks.

Results:  Retention and adherence rates were high. Ninety percent of participants completed the program and attended at least 75% of the education sessions. At the end of the study, statistically significant improvements were found in weight, waist circumference, blood pressure, blood glucose, triglycerides, and high-density lipoprotein (HDL). The proportion of participants identified as having metabolic syndrome dropped from 63% at baseline to 50% at the end of the 24 weeks.

Although this was a pilot study, the results are promising and suggest that a lifestyle modification program can impact in a positive way various markers of cardiovascular and diabetes risk (i.e., metabolic syndrome) for men on ADT. However, certain aspects of the study should be highlighted. First, the sample size was quite small (with 18 researchers contributing to the study and only 31 participants). Moreover, almost all participants were Caucasian and from a relatively small catchment area in Arizona. Lastly, no nutrition or physical activity data were reported. We therefore don’t know what participants actually did in terms of nutrition choices and physical activity.

Importantly, though, the study points to the potential for lifestyle changes —i.e., healthier eating and increased physical activity—to improve the metabolic and cardiovascular health of men on ADT.

To read the study abstract, see:  https://pubmed.ncbi.nlm.nih.gov/33767355/

Algotar, A. M., Hsu, C. H., Chow, H. H., Dougherty, S. T., Babiker, H. M., Marrero, D. G., Abraham, I., Kumar, R., Ligibel, J. A., Courneya, K. S., Smith, T. E., Jones, P. A., Lopez, J. N., Niemiro, G., Ramakumar, S., Hoy, R. D., Mack, C., & Thomson, C. A. (2021). Comprehensive Lifestyle Improvement Program for Prostate Cancer (CLIPP) is associated with improvement in weight and components of metabolic syndrome in men exposed to androgen deprivation therapy for prostate cancer. Prostate cancer and prostatic diseases, 10.1038/s41391-021-00346-z. Advance online publication.