Hypotheses. Sleep disorders are associated with an increased risk of cancer, including breast cancer (BC). Physical activity (PA) can produce beneficial effects on sleep. Study design. We designed a randomized controlled trial to test the effect of 3 months of physical activity on sleep and circadian rhythm activity level evaluated by actigraphy. Methods. 40 BC women, aged 35-70 years, were randomized into an intervention (IG) and a control group (CG). IG performed a 3 month of aerobic exercise. At baseline and after 3 months, the following parameters were evaluated both for IG and CG: anthropometric and body composition measurements, energy expenditure and motion level; sleep parameters (Actual Sleep Time-AST, Actual Wake Time-AWT, Sleep Efficiency-SE, Sleep Latency-SL, Mean Activity Score-MAS, Movement and Fragmentation Index-MFI and Immobility Time-IT) and activity level circadian rhythm using the Actigraph Actiwatch. Results. The CG showed a deterioration of sleep, whereas the IG showed a stable pattern. In the CG the SE, AST and IT decreased and the AWT, SL, MAS and MFI increased. In the IG, the SE, IT, AWT, SL, and MAS showed no changes and AST and MFI showed a less pronounced change in the IG than in the CG. The rhythmometric analysis revealed a significant circadian rhythm in two groups. After 3 months of PA, IG showed reduced fat mass %, while CG had improved weight and BMI. Conclusion. Physical activity may be beneficial against sleep disruption. Indeed, PA prevented sleep worsening in IG. PA can represent an integrative intervention therapy able to modify sleep behaviour.

Recent findings suggest that altered rest-activity circadian rhythms (RARs) are associated with a compromised health status. RARs abnormalities have been observed also in several pathological conditions, such as cardiovascular, neurological, and cancer diseases. Binge eating disorder (BED) is the most common eating disorder, with a prevalence of 3.5% in women and 2% in men. BED and its associate obesity and motor inactivity could induce RARs disruption and have negative consequences on health-related quality of life. However, the circadian RARs and sleep behavior in patients with BED has been so far assessed only by questionnaires. Therefore, the purpose of this study was to determine RARs and sleep parameters by actigraphy in patients with BED compared to a body mass index-matched control group (Ctrl). Sixteen participants (eight obese women with and eight obese women without BED diagnosis) were recruited to undergo 5-day monitoring period by actigraphy (MotionWatch 8®, CamNtech, Cambridge, UK) to evaluate RARs and sleep parameters. In order to determine the RARs, the actigraphic data were analyzed using the single cosinor method. The rhythmometric parameters of activity levels (MESOR, amplitude and acrophase) were then processed with the population mean cosinor. The Actiwatch Sleep Analysis Software (Cambridge Neurotecnology, Cambridge, UK) evaluated the sleep patterns. In each participant, we considered seven sleep parameters (sleep onset: S-on; sleep offset: S-off; sleep duration: SD; sleep latency: SL; movement and fragmentation index: MFI; immobility time: IT; sleep efficiency: SE) calculated over a period of five nights. The population mean cosinor applied to BED and Ctrl revealed the presence of a significant circadian rhythm in both groups (p < 0.001). The MESOR (170.0 vs 301.6 a.c., in BED and Ctrl, respectively; p < 0.01) and amplitude (157.66 vs 238.19 a.c., in BED and Ctrl, respectively p < 0.05) differed significantly between the two groups. Acrophase was not different between BED and Ctrl, as well as all sleep parameters. Both groups displayed a low level of sleep quality (SE 80.7% and 75.7% in BED and Ctrl, respectively). These data provided the first actigraphy-based evidence of RARs disruption and sleep behavior disorder in patients with BED. However, while sleep disorders could be reasonably ascribed to overweight/obesity and the related lower daily physical activity, RARs disruption in this pathology should be ascribed to factors other than reduced physical activity. The circadian timing approach can represent a novel potential tool in the treatment of patients with eating disorders. These data provide exploratory evidence of behavioral association in a small population of patients that, if confirmed in a wider number of subjects and across different populations, may lead to a revision and enhancement of interventions in BED patients.

Circadian rhythms play an important role in biological function; their expression differs across individuals; three chronotypes are distinguished: Morning- [MT], Evening- [ET], and Neither- [NT] type. MT achieve peak activation in the first part of the day and are generally more conscientious and achievement-oriented than ET, which reach their best during the second half of the day and express a higher intelligence. University class schedules can sometimes conflict with ET circadian preferences, compromising their academic performance compared with their MT classmates. Conversely, MT students, being more aligned with their daily schedule, might be more advantaged in their mental performance. The attitudes and performance of NT students are little considered. No studies to date have investigated academic achievement in relation to chronotype in an Italian student population. To fill this gap, this study examined the relationship between chronotype and academic performance in a population of Motor Science Faculty in Milan, differentiating achievement in theoretical and practical subjects by chronotype. The study population was 423 university students (290 males and 133 females) and categorized by chronotype according to Morningness-Eveningness Questionnaire (MEQ) scores. Student transcripts were reviewed to obtain exam grades on three practical and three theoretical subjects. The interaction between MEQ score or chronotypes and mean exam grade was evaluated using one-way ANOVA. The mean grades on the theoretical and practical exams were higher for the MT than for either the ET or the NT students. The NT students (24.8 ± 0.1) had lower mean grades for the theoretical subjects than either the MT (26.3 ± 0.4) or the ET (25.3 ± 0.2) students, while the ET (26.6 ± 0.2) performed worse than either the MT (27.8 ± 0.2) or the NT students (26.9 ± 0.1) on the practical exams. The same trend was observed for the total sample and when subdivided by sex. In the total sample, significant differences in theoretical and practical exam grades were noted between chronotypes: MT vs ET (p < .002, p < .0006) and MT vs NT (p < .04, p < .003). The differences between the males were significant for the theoretical (p < .006, MT vs NT, p < .002) and the practical subjects (MT vs ET p < .004, MT vs NT, p < .01), but no significant differences were noted between the females. Our findings indicate overall better academic achievement by the MT students, whereas the NT had lower exam grades for the theoretical subjects and the ET performed worse on the practical exams. We speculate that the higher intelligence expressed by the ET students might have helped them compensate the disadvantage on the theoretical but not on practical exams, in which the effect of misalignment between circadian preferences and university class schedule was more evident.

Adjuvant chemotherapy significantly decreases recurrences and improves survival in women with early breast cancer (BC). However, the side effects of chemotherapy include weight gain, which is associated with poorer prognosis. We have previously demonstrated that by means of a comprehensive dietary modification which aims at lowering insulin levels it is possible to reduce body weight and decrease the bioavailability of insulin, sex hormones and the growth factors linked to BC risk and prognosis. We are now going to present a randomized controlled study of adjuvant diet in BC patients undergoing chemotherapy. The diet was designed to prevent weight gain during chemotherapy treatment. Women of any age, operated for invasive BC, scheduled for adjuvant chemotherapy and without evidence of distant metastases, were randomized into a dietary intervention group and a control group. The intervention implied changing their usual diet for the whole duration of chemotherapy, following cooking classes and having lunch or dinner at the study centre at least twice per week. 96 BC patients were included in the study. The women in the intervention group showed a significant reduction in their body weight (2.9 kg on average), compared with the controls. They also significantly reduced body fat mass, waist and hip circumferences, biceps, underscapular and suprailiac skinfolds, compared with the women in the control group. Our results support the hypothesis that dietary intervention during adjuvant chemotherapy for BC is feasible and may prevent weight gain.