About ALPHA
Previously, a study was done that tested the likelihood of breast cancer risk in postmenopausal women who exercised against those who didn’t. The ALPHA (Alberta Physical Activity and Breast Cancer Prevention) trial studied how one year of aerobic exercise for at least 45 minutes, five days a week, influenced sex hormone concentrations, body composition, mammographic density, insulin-like growth factors, insulin resistance and markers of obesity and inflammation. Dr. Christine Friedenreich, principal investigator of the ALPHA trial, explains that “the more exercise [participants] did, the more they adhered to the program, the greater the impact on those biomarkers.”
As in the BETA trial, the eligibility requirements were extensive. The participants had to be English-speaking residents of Edmonton or Calgary, between the ages of 50 and 74 and postmenopausal for a minimum of 24 months. They could have no previous cancer diagnosis, had to be healthy, physician-approved for an exercise program, have a body mass index between 22 (normal) and 40 (obese) and could not be on hormone replacement therapy. Smokers, heavy drinkers or snowbirds need not apply.
The researchers for the ALPHA trial concluded that there was a decrease in body fat and some estrogen levels, and less insulin resistance and inflammation in the exercise group compared to the control group who did not exercise during this year-long study. These positive results are what led to the BETA trial.
Meeting new people, getting in shape and boosting your body’s production of happy endorphins are no longer the only benefits to hanging out at the gym. Researchers have found that exercise can help reduce breast cancer risk. Studies, like the ALPHA trial, have shown evidence of this in postmenopausal women, but the new question to be answered is just how much exercise is necessary?
To test the accurate amount of exercise, principal investigators Dr. Christine Friedenreich of Alberta Health Services-Cancer Care and Dr. Kerry Courneya, professor and Canada research chair at the University of Alberta, have come up with a new trial. The Breast Cancer and Exercise Trial in Alberta (BETA) will ultimately determine what amount of exercise can reduce breast cancer risk as measured by changes in biomarkers linked to this cancer.
Participants in the trial will be randomly assigned to either a high-volume exercise group (one hour, five days a week) or a moderate group (30 minutes, five days a week). They will be followed for an entire year and are expected to complete a series of assessments throughout. They will provide blood samples at the beginning, midpoint and end of the study, complete fitness tests every three months and have CT and DXA scans to measure their body fat levels. They will also be asked to complete several questionnaires to provide the researchers with as much information as possible. The participants will wear accelerometers three times during the study for a one-week period to measure the amount of activity they do throughout the day.
Friedenreich and Courneya are looking for any changes in sex hormones, insulin resistance, inflammatory markers and body fat measures. They are also interested in psychological factors such as perceived stress, quality of sleep, general well-being and any other barriers that people might experience.
The participants in this trial are postmenopausal women between the ages of 50 and 74 who currently lead sedentary lifestyles. The screening process is extensive and many women have to be screened to find sufficient numbers of those who are eligible. The women must not be actively exercising but still be healthy and physician-cleared for an exercise program. They cannot smoke, have had any form of cancer, be on hormone-replacement therapy or have diabetes or other metabolic conditions. Participants have to commit to being around for an entire year of the trial (no snowbirds) and must be residents of either Edmonton or Calgary. They also cannot be on any sort of weight-loss program since changes in diet may also affect the test result; this study is meant only to focus on the impact of exercise.
The women who make it through the screening process will meet with a personal trainer who will guide them through the exercise program, keeping them motivated and able to meet their exercise goals. They also receive a free membership to a health facility (Westside Recreation Centre in Calgary and the University of Alberta Exercise Oncology Lab in Edmonton), a gift certificate for new running shoes, running shirt, water bottle, journal and exercise manual, as well as other incentives throughout the year.
The trial and “rolling enrolment” began in June and will take about five years to complete. Each participant is on the exercise program for one year and all participants will be contacted 12 months after completing the study to determine if they have maintained their activity. The results are expected to be released in 2015.
The BETA researchers are excited to see the results. Friedenreich points out that although studies like this are extremely complicated, they are definitely worthwhile. “It’ll be interesting because basically what we’ll be able to come up with is much better guidelines for women … on how much exercise you need to do – what intensity, what kind, what volume is necessary – to reduce their risk of breast cancer.
To learn more about the beta trial or find out how to participate, visit www.beta-trial.com.
