Effects of multicomponent lifestyle interventions on body composition and lipid profiles in Breast cancer: a systematic review and meta-analysis

Abstract

Individuals with breast cancer often experience negative changes in anthropometry, body composition, and lipid profiles, which increase their cardiovascular and metabolic risk. Although exercise, nutrition education, and psychosocial interventions are each beneficial individually, their integrated delivery within multicomponent lifestyle interventions may produce synergistic effects; however, the magnitude and consistency of this combined benefit remain insufficiently established. Therefore, this systematic review and meta-analysis aimed to evaluate the effectiveness of integrated exercise and nutrition education, with or without psychosocial support, on body composition, anthropometric measures, and lipid profiles in breast cancer. This systematic review and meta-analysis followed the PRISMA guidelines and was registered with PROSPERO (CRD420251128849). Scopus, Web of Science, PubMed, and Embase were searched using the Population, Intervention, Comparison, and Outcome (PICOs) framework, supplemented by a manual search. Eligible are RCTs involving breast cancer patients to compare the effect of a multicomponent intervention compared with standard care on anthropometric measurements, body composition, and lipid profiles. Two reviewers conducted study selection, data extraction, and risk-of-bias assessment. Narrative synthesis and meta-analyses were conducted to generate the evidence. Twenty-one RCTs involving 2,849 patients with breast cancer were included. Narrative synthesis did not find any effect of the waist-to-hip ratio. Only two studies reported lipid results, which were limited and inconsistent: decreases in triglyceride, low-density lipoprotein, and total cholesterol levels, with inconsistent high-density lipoprotein results. The meta-analysis showed a significant weight reduction (WMD -2.80 kg [-3.85, -1.77]), BMI (WMD -1.31 kg/m2 [-1.79, -0.65]), waist circumference (WMD -4.1 cm [-5.81, -2.28]), hip circumference (WMD -3.23 cm [-6.12, -0.47]), fat mass (WMD -3.03 kg [-4.41, -1.65]), fat-free mass (WMD -0.3 kg [-0.40, -0.20]), and body fat percentage (WMD -1.46 [-2.53, -0.39]). Multicomponent lifestyle interventions significantly improve anthropometric measures and body composition in breast cancer, with moderate certainty of evidence. This finding supports the integration of comprehensive lifestyle intervention into breast cancer care, indicating the need for further research on long-term outcomes and implementation in low-resource settings.