Ahmet N. Sanli1, Kadri Altundag2
1Department of General Surgery, Silivri State Hospital, Istanbul, Turkey.
2MKA Breast Cancer Clinic, Tepe Prime, Ankara, Turkey.
Abstract
Dear Editor,
Adiposity is commonly measured through body mass index (BMI), which represents adipose tissue and lean mass. Higher BMI is associated with increased postmenopausal breast cancer risk. Waist circumference (WC) and waist-tohip ratio (WHR) are often used to measure central obesity, characterized by high levels of visceral adipose tissue (VAT). Central adiposity may be particularly relevant to breast cancer development as VAT may be more metabolically active than subcutaneous adipose tissue (SAT). Houghton et al [1] examined whether WC, hip circumference (HC), or WHR were associated with incident invasive breast cancer (overall and by tumor subtype), independent of BMI according to menopause status. They reported that central adiposity was positively associated with pre- and postmenopausal breast cancers independent of BMI. Therefore, strategies for reducing central adiposity are major concerns. Hula-hooping is an ancient type of dance, which has recently experienced a comeback in the form of aerobic core training. Beneficial metabolic effects in obese subjects is unknown. One study compared the effects of weighted hula-hooping and walking in obese subjects. They found that 6 weeks of hula-hooping for an average duration of 13 min per day sig¬nificantly decreased waist circumference and body fat in the android region and increased trunk muscularity compared to a period of walking in a group of overweight subjects [2]. Furthermore, excess total body fat and abdominal adipose tissue are recognized risk factors for metabolic diseases but also for some types of cancers, including breast cancer. Obesity stimulates cancer progression through chronic, low-grade inflammation in white adipose tissue. One study showed that a 16-week aerobic and resistance exercise in¬tervention attenuates adipose tissue inflammation in obese postmenopausal breast cancer survivors [3]. We previously suggested that weighted Hula-Hooping as an exercise type may decrease breast cancer recurrence by decreasing abdominal fat and in¬creasing trunk muscularity in obese postmenopausal breast cancer survivors [4]. Taken all together, regular daily weighted Hula-Hooping exercise might reduce central adiposity leading to decrased pre- and postmenopausal breast cancers risk. This issue merits further investigation.
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