Exercise and Lifestyle Programme Improves Weight Maintenance in Young People with Psychosis: a Service Evaluation

Background: Young people with psychosis typically have higher rates of premature cardiovascular disease and metabolic disorders compared to non-psychotic peers due to unhealthy lifestyle habits and higher rates of obesity. This study presents outcomes from a 12 wk exercise and lifestyle intervention entitled Supporting Health and Promoting Exercise (SHAPE) Programme for young people with psychosis. Methods: Participants (n=26) engaged in weekly 45’ healthy lifestyle education sessions (e.g. substance/smoking cessation, nutritional advice) followed by 45’ exercise session (e.g. group aerobic and resistance training, yoga). Anthropometric data were measured at baseline, 12 wks and 12 mos post-intervention. Lifestyle behaviours and clinical measurements (resting heart rate, blood pressure, blood lipids, HbA1c and prolactin) were assessed at baseline and 12 mos. Results: Mean baseline data suggests participants were at an increased health risk with elevated values in mean BMI (70% overweight/obese), waist circumference, resting heart rate, and triglycerides. Over 50% reported smoking daily and 52% of participants were prescribed highly obesogenic antipsychotic medications (Clozapine, Olanzepine). At 12 wks and 12 mos, no changes were observed in mean BMI, waist circumference or any other clinical variable (p > 0.05). Positive impacts on lifestyle behaviours included 7 participants eating ~400g of fruit/vegetables daily, 2 ceased substance use, 2 ceased alcohol use, 4 ceased smoking and 5 were less sedentary. Conclusions: SHAPE supported participants to attenuate their physical health risk following a 12 wk intervention which was sustained at 12 mos follow up. Participants also made positive lifestyle behaviour changes contributing to weight maintenance and physical health

Body composition and lung cancer-associated cachexia in TRACERx

Cancer-associated cachexia (CAC) is a major contributor to morbidity and mortality in individuals with non-small cell lung cancer. Key features of CAC include alterations in body composition and body weight. Here, we explore the association between body composition and body weight with survival and delineate potential biological processes and mediators that contribute to the development of CAC. Computed tomography-based body composition analysis of 651 individuals in the TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy (Rx)) study suggested that individuals in the bottom 20th percentile of the distribution of skeletal muscle or adipose tissue area at the time of lung cancer diagnosis, had significantly shorter lung cancer-specific survival and overall survival. This finding was validated in 420 individuals in the independent Boston Lung Cancer Study. Individuals classified as having developed CAC according to one or more features at relapse encompassing loss of adipose or muscle tissue, or body mass index-adjusted weight loss were found to have distinct tumor genomic and transcriptomic profiles compared with individuals who did not develop such features. Primary non-small cell lung cancers from individuals who developed CAC were characterized by enrichment of inflammatory signaling and epithelial–mesenchymal transitional pathways, and differentially expressed genes upregulated in these tumors included cancer-testis antigen MAGEA6 and matrix metalloproteinases, such as ADAMTS3. In an exploratory proteomic analysis of circulating putative mediators of cachexia performed in a subset of 110 individuals from TRACERx, a significant association between circulating GDF15 and loss of body weight, skeletal muscle and adipose tissue was identified at relapse, supporting the potential therapeutic relevance of targeting GDF15 in the management of CAC