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Background: Sedentary behavior is associated with increased risk of poor outcomes in breast cancer survivors, but underlying mechanisms are not well understood. This pilot study explored associations between different aspects of sedentary behaviors (sitting, prolonged sitting, sit-to-stand transitions, and standing) and breast cancer risk-related biomarkers in breast cancer survivors (n = 30). Methods: Sedentary behavior variables were objectively measured with thigh-worn activPALs. Breast cancer risk-related biomarkers assessed were C-reactive protein (CRP), insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) and were measured in fasting plasma samples. Linear regression models were used to investigate associations between sedentary behavior variables and biomarkers (log CRP, insulin, and HOMA-IR). Results: Sit-to-stand transitions were significantly associated with insulin resistance biomarkers (P < .05). Specifically, each 10 additional sit-to-stand transitions per day was associated with a lower fasting insulin concentration (β = −5.52; 95% CI, −9.79 to −1.24) and a lower HOMA-IR value (β = −0.22; 95% CI, −0.42 to −0.03). Sit-to-stand transitions were not significantly associated with CRP concentration (P = .08). Total sitting time, long sitting bouts, and standing time were not significantly associated with CRP, insulin, or HOMA-IR (P > .05). Conclusions: Sit-to-stand transitions may be an intervention target for reducing insulin resistance in breast cancer survivors, which may have favorable downstream effects on cancer prognosis.

Hartman, Kerr, Natarajan, and Patterson are with the Dept of Family Medicine and Public Health, Moores UCSD Cancer Center, UC San Diego, La Jolla, CA. Marinac is with the Dept. of Family Medicine and Public Health, Moores UCSD Cancer Center, UC San Diego, La Jolla, CA; Dana-Farber Cancer Institute, Boston, MA; and Harvard T.H. Chan School of Public Health, Boston, MA. Cadmus-Bertram is with the Dept of Kinesiology, University of Wisconsin, Madison, WI. Godbole is with the Dept of Family Medicine and Public Health, UC San Diego, La Jolla, CA. Morey is with the Dept of Family Medicine and Public Health, Moores UCSD Cancer Center, UC San Diego, La Jolla, CA. Sears is with the Division of Endocrinology and Metabolism, Dept of Family Medicine and Public Health, Moores UCSD Cancer Center, UC San Diego, La Jolla, CA.

Hartman (sjhartman@ucsd.edu) is the corresponding author.
  • 1.

    Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271–289. PubMed doi:10.3322/caac.21349

  • 2.

    Meeske K, Smith AW, Alfano CM, et al. Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report. Qual Life Res. 2007;16(6):947–960. PubMed doi:10.1007/s11136-007-9215-3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Gerber LH, Stout N, McGarvey C, et al. Factors predicting clinically significant fatigue in women following treatment for primary breast cancer. Support Care Cancer. 2011;19(10):1581–1591. PubMed doi:10.1007/s00520-010-0986-7

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Nelson SH, Marinac CR, Patterson RE, et al. Impact of very low physical activity, BMI, and comorbidities on mortality among breast cancer survivors. Breast Cancer Res Treat. 2016;155(3):551–557. PubMed doi:10.1007/s10549-016-3694-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Demark-Wahnefried W, Colditz GA, Rock CL, et al. Quality of life outcomes from the Exercise and Nutrition Enhance Recovery and Good Health for You (ENERGY)-randomized weight loss trial among breast cancer survivors. Breast Cancer Res Treat. 2015;154(2):329–337. PubMed doi:10.1007/s10549-015-3627-5

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100. PubMed doi:10.1007/s11764-009-0110-5

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Schmitz KH, Courneya KS, Matthews C, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–1426. PubMed doi:10.1249/MSS.0b013e3181e0c112

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Fong DY, Ho JW, Hui BP, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012;344:70. PubMed doi:10.1136/bmj.e70

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Biswas A, Oh PI, Faulkner GE, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162(2):123–132. PubMed doi:10.7326/M14-1651

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Phillips SM, Lloyd GR, Awick EA, McAuley E. Correlates of objectively measured sedentary behavior in breast cancer survivors. Cancer Causes Control. 2016;27(6):787–795. PubMed doi:10.1007/s10552-016-0756-z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E. Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer. 2015;121(22):4044–4052. PubMed doi:10.1002/cncr.29620

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    George SM, Alfano CM, Wilder Smith A, et al. Sedentary behavior, health-related quality of life, and fatigue among breast cancer survivors. J Phys Act Health. 2013;10(3):350–358. PubMed doi:10.1123/jpah.10.3.350

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Sardinha LB, Santos DA, Silva AM, Baptista F, Owen N. Breaking-up sedentary time is associated with physical function in older adults. J Gerontol A Biol Sci Med Sci. 2015;70(1):119–124. PubMed doi:10.1093/gerona/glu193

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Davis MG, Fox KR, Stathi A, Trayers T, Thompson JL, Cooper AR. Objectively measured sedentary time and its association with physical function in older adults. J Aging Phys Act. 2014;22(4):474–481. PubMed doi:10.1123/JAPA.2013-0042

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Dunstan DW, Kingwell BA, Larsen R, et al. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care. 2012;35(5):976–983. PubMed doi:10.2337/dc11-1931

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Peddie MC, Bone JL, Rehrer NJ, Skeaff CM, Gray AR, Perry TL. Breaking prolonged sitting reduces postprandial glycemia in healthy, normal-weight adults: a randomized crossover trial. Am J Clin Nutr. 2013;98(2):358–366. PubMed doi:10.3945/ajcn.112.051763

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Renehan AG, Roberts DL, Dive C. Obesity and cancer: pathophysiological and biological mechanisms. Arch Physiol Biochem. 2008;114(1):71–83. PubMed doi:10.1080/13813450801954303

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Pierce BL, Ballard-Barbash R, Bernstein L, et al. Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients. J Clin Oncol. 2009;27(21):3437–3444. PubMed doi:10.1200/JCO.2008.18.9068

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Lynch BM, Friedenreich CM, Winkler EA, et al. Associations of objectively assessed physical activity and sedentary time with biomarkers of breast cancer risk in postmenopausal women: findings from NHANES (2003–2006). Breast Cancer Res Treat. 2011;130(1):183–194. PubMed doi:10.1007/s10549-011-1559-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Wiseman AJ, Lynch BM, Cameron AJ, Dunstan DW. Associations of change in television viewing time with biomarkers of postmenopausal breast cancer risk: the Australian Diabetes, Obesity and Lifestyle Study. Cancer Causes Control. 2014;25(10):1309–1319. PubMed doi:10.1007/s10552-014-0433-z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Barreira TV, Zderic TW, Schuna JM Jr, Hamilton MT, Tudor-Locke C. Free-living activity counts-derived breaks in sedentary time: are they real transitions from sitting to standing? Gait Posture. 2015;42(1):70–72. PubMed doi:10.1016/j.gaitpost.2015.04.008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Healy GN, Matthews CE, Dunstan DW, Winkler EA, Owen N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06. Eur Heart J. 2011;32(5):590–597. PubMed doi:10.1093/eurheartj/ehq451

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Henson J, Davies MJ, Bodicoat DH, et al. Breaking up prolonged sitting with standing or walking attenuates the postprandial metabolic response in postmenopausal women: a randomized acute study. Diabetes Care. 2016;39(1):130–138. PubMed doi:10.2337/dc15-1240

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Thorp AA, Kingwell BA, Sethi P, Hammond L,Owen N, Dunstan DW. Alternating bouts of sitting and standing attenuate postprandial glucose responses. Med Sci Sports Exerc. 2014;46(11):2053–2061. doi:10.1249/MSS.0000000000000337

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Lyden K, Kozey Keadle SL, Staudenmayer JW, Freedson PS. Validity of two wearable monitors to estimate breaks from sedentary time. Med Sci Sports Exerc. 2012;44(11):2243–2252. PubMed doi:10.1249/MSS.0b013e318260c477

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Kim Y, Barry VW, Kang M. Validation of the ActiGraph GT3X and activPAL accelerometers for the assessment of sedentary behavior. Meas Phys Educ Exerc Sci. 2015;19:125–137. doi:10.1080/1091367X.2015.1054390

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Grant PM, Ryan CG, Tigbe WW, Granat MH. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med. 2006;40(12):992–997. PubMed doi:10.1136/bjsm.2006.030262

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Kozey-Keadle S, Libertine A, Lyden K, Staudenmayer J, Freedson PS. Validation of wearable monitors for assessing sedentary behavior. Med Sci Sports Exerc. 2011;43(8):1561–1567. PubMed doi:10.1249/MSS.0b013e31820ce174

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–419. PubMed doi:10.1007/BF00280883

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Kelly LA, McMillan DG, Anderson A, Fippinger M, Fillerup G, Rider J. Validity of actigraphs uniaxial and triaxial accelerometers for assessment of physical activity in adults in laboratory conditions. BMC Med Phys. 2013;13(1):5. PubMed doi:10.1186/1756-6649-13-5

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Choi L, Liu Z, Matthews CE, Buchowski MS. Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc. 2011;43(2):357–364. PubMed doi:10.1249/MSS.0b013e3181ed61a3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30(5):777–781. PubMed doi:10.1097/00005768-199805000-00021

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Benatti FB, Ried-Larsen M. The effects of breaking up prolonged sitting time: a review of experimental studies. Med Sci Sports Exerc. 2015;47(10):2053–2061. PubMed doi:10.1249/MSS.0000000000000654

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Bailey DP, Locke CD. Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not. J Sci Med Sport. 2015;18(3):294–298. PubMed doi:10.1016/j.jsams.2014.03.008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Brocklebank LA, Falconer CL, Page AS, Perry R, Cooper AR. Accelerometer-measured sedentary time and cardiometabolic biomarkers: a systematic review. Prev Med. 2015;76:92–102. PubMed doi:10.1016/j.ypmed.2015.04.013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Lyden K, Keadle SK, Staudenmayer J, Braun B, Freedson PS. Discrete features of sedentary behavior impact cardiometabolic risk factors. Med Sci Sports Exerc. 2015;47(5):1079–1086. PubMed doi:10.1249/MSS.0000000000000499

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Healy GN, Winkler EA, Owen N, Anuradha S, Dunstan DW. Replacing sitting time with standing or stepping: associations with cardio-metabolic risk biomarkers. Eur Heart J. 2015;36(39):2643–2649. PubMed doi:10.1093/eurheartj/ehv308

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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