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Cited by 2Cancer survivorship and carePhysical Activity and HealthCancer Risks and Factors

Aerobic Training-Induced Changes in Sedentary Time, Non-Exercise Physical Activity, and Sleep Among Breast Cancer Survivors and Postmenopausal Women Without Cancer

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Sartor, Francesco, Ditali, Leandro, Sirtori, Giacomo, Morano, Teresa, Lancia, Federica, Di Marco, Alessandra, Izzicupo, Pascal, Di Baldassarre, Angela, Gallina, Sabina, Pesce, Mirko, Grossi, Simona, Grassadonia, Antonino, Vamvakis, Anastasios, Bucci, Ines, Napolitano, Giorgio, Di Blasio, Andrea·2025·Healthcare
DOI 10.3390/healthcare13192471PMC PMC12524753
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Abstract

Background/Objectives: The 24 h activity cycle highlights the need to consider sedentary behavior (SED), non-exercise physical activity (NEPA), and sleep when introducing aerobic exercise. This study assessed changes in these components among breast cancer survivors (BCS) and non-oncologic menopausal women after a 3-month walking (W) or Nordic walking (NW) program. Methods: A total of 324 menopausal women participated: 156 non-oncologic (Meno), 102 BCS with natural menopause (BCS_Meno), and 66 BCS with medically induced menopause (BCS_Ind_Meno). Linear Mixed Effects (LME) modeling was applied. Age, BMI, hormonal therapy, cancer treatments, hypertension, sleep, and METs were included as covariates. Results: BCS_Meno and BCS_Ind_Meno had longer sleep durations at baseline (adj. diff.: +26.5 min/day, 95% CI 10.1 to 43.0; p = 0.002 and +25.7, 95% CI 6.7 to 44.6; p = 0.008). Sleep improved across all groups post-intervention (overall adj. effect = +17.4 min/day, 95% CI 4.8 to 30.0; p = 0.007). Higher sleep and METs were associated with reduced SED (sleep: β = −43.7 min/day per unit increase, −52.6 to −34.8; METs: β = −115.4, −126.4 to −104.4; both p < 0.001). A significant group × time interaction showed a decrease in SED in the BCS_Ind_Meno group (adj. diff. = −65.1 min/day, −102.8 to −27.4; p = 0.001). NEPA was negatively influenced by sleep (β = −8.7 min/day, −16.2 to −1.1, p = 0.024) and positively by METs (β = +121.1, 111.8 to 130.3; p < 0.001). NEPA increased only in BCS_Ind_Meno (adj. diff.: +70.6 min/day, 38.4 to 102.7; p < 0.001), not in BCS_Meno (+9.87, −18.7 to 38.4; p = 0.497). Conclusions: BCS_Ind_Meno showed the greatest benefits, with reduced SED, increased NEPA, and improved sleep. Sleep improved across all groups following aerobic interventions.

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  • Resistance exercise improves insulin sensitivity.

    “Furthermore, resistance exercise improves insulin sensitivity, which is essential for managing obesity, diabetes, and metabolic syndrome [66].”

    From A Narrative Review on GLP-1 Receptor Agonists for Obesity in Older Women: Maximizing Weight Loss While Preserving Lean Mass (2026) · cites this paper as [66]

    The Interventions section describes supervised aerobic walking, and the Outcomes section focuses on sedentary time, non-exercise physical activity, and sleep; no page numbers are available in our copy. Searches for resistance exercise, insulin sensitivity, and related metabolic terms found no passage addressing whether resistance exercise improves insulin sensitivity. (LLM, conf=0.75)

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Authors
Sartor, F., Ditali, L., Sirtori, G., Morano, T., Lancia, F., Di Marco, A., Izzicupo, P., Di Baldassarre, A., Gallina, S., Pesce, M., Grossi, S., Grassadonia, A., Vamvakis, A., Bucci, I., Napolitano, G., & Di Blasio, A.
Affiliations
  • Bangor University (GB)
  • University of Chieti-Pescara (IT)
  • Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy
  • ASL Lanciano Vasto Chieti (IT)
  • Hellenic Mediterranean University (GR)
Corresponding author
Ditali, Leandro
ORCID
Venue
Healthcare
Publisher
MDPI AG
Published
2025-09-29
Volume
13
Issue
19
Pages
2471
ISSN
2227-9032 (ISSN-L)
DOI
10.3390/healthcare13192471
PMC
PMC12524753
OpenAlex
W4414628589
Cited by
2
References
62
Citations by year
2026: 1 · 2025: 1
FWCI
0.83
Type
journal article
Language
en
Open access
Licence
Locations
  • Healthcare (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Department of Medicine and Aging Sciences of the “G. d’Annunzio” University of Chieti-Pescara (D.D. n. 810, D.D. n. 224)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Keywords
breast cancer survivors, postmenopausal women, sedentary behavior, non-exercise physical activity, sleep duration, aerobic exercise, walking, Nordic walking, hormone replacement therapy, cancer survivorship, exercise intervention outcomes

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