Relationships Between Exercise-Induced Changes In Dietary Intake And Physiological Fitness In Adults With Chronic Lymphocytic Leukaemia

PURPOSE: Although the risk of chronic lymphocytic leukaemia (CLL) is influenced in part by dietary choices, there is insufficient evidence of how dietary intake affects the health and well-being of adults with CLL. We aimed to determine the relationships between diet and physiological fitness before and after an exercise intervention in treatment naïve (TN) and treated (Td) adults with CLL. METHODS: Fifteen adults [5F/10M: aged 66.4 years (range: 51-79 years)] with TN (N = 8) or Td (N = 7) CLL completed a randomised control trial of a 12-week aerobic and resistance training intervention (EXE) or no exercise (CON). Alongside high-resolution physiological assessments and disease activity measures (e.g., white blood cell counts), we determined in-depth 7-day nutritional intake using food diaries. We calculated average nutritional intake and intervention changes in levels of total energy, total carbohydrate, protein, fibre, total fat, saturated fat, monounsaturated fat, and polyunsaturated fat for each participant. We used repeated measures ANOVA and correlations to determine changes and relationships, respectively. RESULTS: Compared to CON, EXE groups increased upper (17.5 ± 12.1%, p < 0.05) and lower body (21.3 ± 12.0%, p < 0.05) muscle strength. EXE groups' exhibited increased time to exhaustion (11.0 ± 5.2%, p = 0.05) and anaerobic threshold (19.5 ± 11.3%, p = 0.001), with trends for increased relative (7.3 ± 8.19%, p < 0.09) and absolute VO2peak (5.8 ± 6.6%, p < 0.09). Nutritional intake did not change from baseline to 12-weeks (p > 0.05). Larger reduced total energy intake and total fat intake were associated with increased absolute (r = -1.00, p < 0.001) and relative (r = -.995, p = 0.005) VO2peak. Reduced saturated fat intake (r = -.988, p = 0.012) drove the associations with increased VO2peak. Reduced carbohydrate (r = -.979, p = 0.021) and saturated fat intake (r = -.983, p = 0.017) were associated with increased maximal upper body strength. Reduced total fat intake was associated with larger reductions in total white blood cell numbers (r = -.956, p = 0.044). CONCLUSION: Reduced fat intake is associated with better fitness responses in CLL. Given CLL cells' energy requirements are lipid-dependent, this data may reflect the possible mechanisms of how exercise benefits CLL by redirecting lipids to healthy tissue. Funded by the American Society of Hematology