Mediterranean Diet and Physical Activity in Breast Cancer Patients Under Hormone Therapy

The objective of this interventional study is to evaluate body weight status, lifestyle characteristics, and cardiometabolic risk in women in remission from breast cancer undergoing adjuvant hormone therapy, and to assess the impact of a nutritional intervention based on the Mediterranean diet combined with physical activity promotion.

A total of 150 women treated with adjuvant hormone therapy are recruited from the oncology department of Akid Othmane Hospital in Aïn El Turc, Oran, Algeria. Participants are classified according to the type of endocrine treatment received, including tamoxifen or aromatase inhibitors.

Baseline evaluation includes anthropometric measurements such as body weight, body mass index, waist circumference, and hip circumference. Socioeconomic characteristics and lifestyle habits are documented.

Dietary assessment is conducted using 24-hour dietary recalls and 3-day food records. Nutritional analysis includes total energy intake, macronutrient and micronutrient composition, dietary quality, meal distribution, and adherence to the Mediterranean diet assessed using the MEDAS score. Food group consumption patterns and dietary behaviors are also evaluated.

Physical activity level, sedentary behavior, daily energy expenditure, and energy balance are determined using standardized assessment methods.

Cardiometabolic risk profile is evaluated through measurement of blood pressure, fasting blood glucose, lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides), uric acid, albumin, creatinine, urea, and calculation of atherogenic indices.

Following baseline assessment, participants receive a structured educational program promoting adherence to the Mediterranean dietary pattern and regular physical activity. Follow-up assessments are conducted to monitor changes in anthropometric parameters, dietary habits, lifestyle behaviors, and cardiometabolic markers over time.

Inclusion criteria

• Histologically confirmed hormone receptor-positive breast cancer
• Breast cancer survivors receiving adjuvant endocrine therapy (tamoxifen or aromatase inhibitors) for ≥3 months
• No recurrence or second primary malignancy
• Ability to perform moderate-intensity physical activity
• Consecutively recruited during routine surveillance visits

Exclusion criteria

• Incomplete or discontinued hormone therapy
• Concurrent ovarian suppression
• Use of lipid-lowering medications
• Severe uncontrolled comorbidities (e.g., diabetes, cardiac, or hepatic disease)
• Cognitive or physical impairments preventing informed consent or participation
• Restrictive dietary regimens