Abstract
Purpose
Among breast cancer (BC) survivors, overweight and obesity increase the risk of recurrence, underscoring the importance of dietary strategies for weight management. The Mediterranean diet (MD) can promote weight loss and reduce lipid levels. Analyzing alterations at the lipid species level can provide more detailed insights into the metabolic benefits associated with the MD. This study aimed to explore lipid remodeling associated with MD adherence in BC survivors through comprehensive lipidomic analysis.Methods
This exploratory ancillary study was conducted as non-randomized, non-controlled pre-post intervention analysis of serum samples collected before and after an 8-week MD intervention from 12 overweight or obese BC survivors. Fasting paired serum samples (n = 24) were used to profile lipid species using ultra-high-performance liquid chromatography-tandem mass spectrometry in both positive and negative ionization modes. Multivariate and correlation analyses were used to assess overall lipidomic alterations. Participants were further classified into maintainer or improver subgroups based on changes in their Mediterranean diet score (MDS), and subgroup-specific lipidomic responses to the MD intervention were examined.Results
Participants showed significant reductions in body weight, waist circumference, and clinical triglyceride levels, along with increased quantitative insulin sensitivity check index and MDS following the MD intervention. Forty-three putative lipid species were identified, predominantly characterized by reductions in triacylglycerols (TGs) enriched with saturated fatty acids. TG 16:0_18:0_18:0 and TG 16:0_18:1_24:0 exhibited strong negative correlations with MDS and positive correlations with insulin resistance markers. Significant lipid remodeling was observed only in the maintainer group.Conclusion
In this exploratory study, adherence to an 8-week MD was associated with changes in body composition, metabolic markers, and the serum lipidomic profile in overweight and obese BC survivors. These findings provide preliminary evidence that MD adherence may be associated with lipidomic and metabolic changes in BC survivors, warranting confirmation in larger, controlled studies.Clinical trial registry
http://clinicaltrials.gov , NCT03581630.