Recruiting

Exercise & Diet

Sponsor:

University of Toronto

Code:

NCT06454864

Conditions

Metabolic Disturbance

Sedentary Behavior

Breast Cancer Female

Eligibility Criteria

Sex: Female

Age: 0+

Healthy Volunteers: Not accepted

Interventions

Guidelines-based healthy eating

Guidelines-based physical activity

Stretching exercise

Study Details

Brief summary:

This study aims to produce new evidence on the efficacy of exercise and diet for cardiometabolic risk reduction in BC survivors. Using a 3-arm RCT with to 6 months of 1) exercise following Health Canada guidelines; 2) the same exercise plus counselling to follow Canada's Dietary Guidelines to improve diet quality; or 3) stretching group, this study will answer the following questions:

  • What is the impact of exercise on cardiometabolic health and body composition in BC survivors?
  • What is the effect modification of adding a diet quality intervention to exercise on cardiometabolic health and body composition?
  • Is there a link between the capacity of skeletal muscle adaptation to exercise (and diet) and insulin resistance in BC survivors?

The investigators hypothesize that: 1) exercise will improve cardiometabolic and body composition outcomes 2) improvements in cardiometabolic outcomes will be enhanced by the addition of diet quality, which will be essential or additive for Matsuda index, metabolic syndrome, Framingham CVD risk, thigh myosteatosis, muscle mass, VO2peak, 3) skeletal muscle insulin signalling transduction will be impaired in BC survivors via dampened expression of insulin-responsive proteins (e.g. GLUT4) and co-occur with impaired muscle quality (e.g., higher rates of fat depots, presence of fibrous tissue) negatively impacting insulin signalling.

Conditions

Metabolic Disturbance

Sedentary Behavior

Breast Cancer Female

Study ID

NCT06454864

Start date

Jul 1, 2024

Status verified date

Sep, 2025

Completion date

Apr 1, 2027

Anticipated

Primary completion date

Oct 1, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: Female

Age: 0+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Biologically female
  • Diagnosis of stage I, II, or III breast cancer, post-menopausal at the time of diagnosis (haven't had a menstrual cycle within 12 months or greater)
  • Receipt of aromatase inhibitors for 12 months or more in the past, but do not have to be currently on aromatase inhibitors.
  • Willing and able to complete all study assessments
  • BMI ≥ 25 kg/m2
  • Able to commit to come to the University once per week for 24 weeks.

Exclusion Criteria:

  • Received chemotherapy within the past 11 months
  • Diagnosed with metastatic cancer
  • Currently taking tamoxifen
  • Currently receiving chemotherapy, targeted therapy or radiation treatment
  • Distant recurrence or diagnosis of metastatic cancer since early-stage breast cancer diagnosis
  • Diagnosed cardiovascular diseases, type 2 diabetes, non-alcoholic fatty liver disease, uncontrolled thyroid condition, or respiratory disease (e.g., COPD or severe or uncontrolled asthma).
  • Major signs or symptoms of cardiovascular diseases, diabetes, or renal disease (taken from the American College of Sports Medicine's Guidelines for Exercise Testing and Prescription 11th edition Table 2.1: pain or discomfort in the chest, neck, jaw, arms with rest or exercise, shortness of breath at rest or with mild exertion, dizziness or syncope, loss of balance or passing out, ankle edema, palpitations or tachycardia, intermittent claudication, known heart murmur, unusual fatigue with usual activities.)
  • American Heart Association's absolute or relative contraindications for symptom-limited maximal exercise testing (myocardial infarction, aortic or coronary artery stenosis, heart failure, pulmonary embolism or deep vein thrombosis, inflammation of the heart (myocarditis, pericarditis, and/or endocarditis), uncontrolled cardiac arrhythmia, advanced or complete electrical heart block, stroke or transient ischemia attack, blood pressure >200mmHg/100mmHg, a cancer diagnosis other than skin cancer)
  • Unable to provide informed consent or communicate in English
  • Pregnant or breast-feeding currently or in the past 3 months
  • Mobility limitations to aerobic exercise (i.e., wheelchair, walker use, limp impeding walking)
  • Smoking cigarettes or marijuana within the past 3 months
  • Taking exogenous hormones in any format currently or in the past 3 months
  • Contraindications to research MRI (e.g., pacemaker, magnetic implants)
  • BMI exceeding 40 kg/m2
  • Extreme claustrophobia
  • Self-report >30 min/week of moderate-to-vigorous intensity aerobic physical activity
  • Following a diet that largely restricts entire food groups or time of eating (e.g., vegan, ketogenic, carnivore, one meal a day) in last 3 months
  • Experienced significant weight loss (i.e., >5 kg) in past 3 months
  • Currently taking weight loss medications
  • Diagnosed history of an eating disorder or self-report of potential undiagnosed eating disorder
  • Plans to be away/unavailable for a substantial period of the intervention overall (i.e., >4 weeks throughout the 6 months or >2 weeks within the first 12 weeks of the intervention).
  • Allergies to local anesthetics

Study Design

Enrollment

45 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Prevention

Interventions and Outcome Measures

Arms

experimental: Guidelines-based physical activity

150 weekly minutes of moderate-intensity aerobic activity and twice weekly whole-body muscle strengthening.

experimental: Guidelines-based physical activity and healthy eating

Arm Description: 150 weekly minutes of moderate-intensity aerobic activity and twice weekly whole-body muscle strengthening + counselling to follow Canada's Food Guide.

placebo comparator: Stretching exercise

Whole-body stretching.

Interventions

Guidelines-based healthy eating

One-on-one phone/virtual counselling from a registered dietitian to change dietary habits to be in line with Canada's Food Guide.

Guidelines-based physical activity

Through a combination of exercise trainer-led in-person and virtual sessions, as well as counselling for independent aerobic exercise, participants will be guided to achieve 150 weekly minutes of moderate-intensity aerobic activity and twice weekly whole-body muscle strengthening.

Stretching exercise

Twice weekly virtual instructor-led whole-body stretching.

Primary outcome measure

  • Insulin resistance [ Time Frame: 6 months ]

Central Contacts and Locations

Central contacts

Amy A Kirkham, PhD

416-946-4069amy.kirkham@utoronto.ca

Jenna B Gillen, PhD

416-978-3244jenna.gillen@mail.utoronto.ca

Locations

University of Toronto

Recruiting

Toronto, Ontario, Canada, M5S 2C9

Contacts

Amy A. Kirkham, PhD

416-946-4069amy.kirkham@utoronto.ca

Jenna B. Gillen, PhD

416-978-3244jenna.gillen@utoronto.ca

More Information

Sponsor

University of Toronto

Last update posted

Oct 1, 2025

Last verified

Sep, 2025

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by University of Toronto on 2025-10-01.