The Effect of Aerobic Exercise and Pomegranate Juice Consumption on Serum Enzyme Levels Associated With the Oxidant-Antioxidant System of Women Rescued From Breast Cancer

Document Type : Original Article


1 PhD Candidate in Exercise Physiology, School of Sports Sciences and Physical Education, Science and Research Branch, Islamic Azad University, Tehran, Iran.

2 Assistant Professor, Department of Exercise Physiology, School of Literature, Human and Social Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.

3 Professor, Department of Exercise Physiology, School of Sport Sciences and Physical Education, Tehran Shahid Beheshti University, Tehran, Iran.


Introduction: Increasing oxidative factors and reducing antioxidants is one of the main causes of breast cancer.The purpose of this study was to investigate the effect of eight weeks of aerobic exercise and pomegranate juice on serum enzyme levels related to the Oxidant-Antioxidant system of women saved from breast cancer.
Methods: In this blinded randomized control trial which was conducted in rasht in 2019, 40 women with breast cancer were selected who were randomly were assigned into four equal groups control groups (n=10), pomegranate juice (n=10), aerobic exercise (n=10) and aerobic exercise and pomegranate juice (n=10). The aerobic exercise group and the aerobic exercise and pomegranate juice group, performed training programs including 8 weeks and 3 sessions per week with intensity 50 to 70% of the maximal heart rate for 60 to 90 minutes of training. Two groups of pomegranate juice consumers received 100 cc of pomegranate juice before each training session. In order to investigate the variables of research (MDA, SOD, GPX), blood samples were collected 48 hours before and after the intervention in fasting state. The obtained data was analyzed using of one-way analysis of variance (ANOVA) and bonferroni post hoc test analysis. The significant level was P<0/05
Results: The results showed that 8 weeks of aerobic exercise caused a significantly decreased MDA levels and significantly increased SOD and GPX levels in women with breast cancer (P = 0/0001).aerobic exercise without use of pomegranate juice, only led to a significant decrease in MDA (P=0.0001) level, and pomegranate juice consumption alone, no significant changes were observed at the three variables investigated in women with breast cancer.
Conclusion: According to the results, Aerobic exercise and consumption of pomegranate juice simultaneously, reduce oxidative factors and increase anti-oxidant factors in women Rescued from Breast Cancer


  1. Abbasi S, Azimi C, Othman F, Einollahi N, Dashti N, Nabatchian F, et al. Risk factors for breast cancer in Iranian women: A case control study. Int J Cancer Res 2009; 5(1):1-11.
  2. Nouri T, Zahmatkesh T, Molai T. Assessment of breast cancer risk using the Gail model. Breast Disease J Iran 2008; 1:53-7.
  3. Keihanian SH, Ghaffari F, Fotokian Z, Shoormig R, Saravi M. Risk factors of breast cancer in Ramsar and Tonekabon. Journal of Inflammatory Disease 2010; 14(2):12-9.
  4. Nelson NJ. Migrant studies aid the search for factors linked to breast cancer risk. Journal of the National cancer Institute 2006; 98(7):436-8.
  5. Chekachak S, MolanouriShamsi M, Soudi S. Investigating The Effect of Aerobic Interval Training with Selenium Nanoparticles on the Content of IL-6, TNF-α and IL-4 cytokines in spleen tissue of Mice with Breast Cancer. Journal of Fasa University of Medical Sciences 2018; 8(1):608-17.
  6. Pham-Huy LA, He H, Pham-Huy C. Free radicals, antioxidants in disease and health. International journal of biomedical science: IJBS 2008; 4(2):89-96.
  7. Trachootham D, Lu W, Ogasawara MA, Valle NR, Huang P. Redox regulation of cell survival. Antioxidants & redox signaling 2008; 10(8):1343-74.
  8. Aldini G, Yeum KJ, Niki E, Russell RM, editors. Biomarkers for antioxidant defense and oxidative damage: principles and practical applications. John Wiley & Sons; 2011.
  9. Ray G, Batra S, Shukla NK, Deo S, Raina V, Ashok S, et al. Lipid peroxidation, free radical production and antioxidant status in breast cancer. Breast cancer research and treatment 2000; 59(2):163-70.
  10. Didziapetriene J, Smailyte G, Bublevic J, Kazbariene B, Kasiulevicius V, Stukas R. Relationship of MDA plasma concentrations to long-term survival of breast cancer patients. Tumori Journal 2014; 100(3):333-7.
  11. Emadi S, Azamian A, Hemmati S. Effect of 6 Weeks of Low-volume High-intensity Interval Training on Antioxidant Defense and Aerobic Power in Female Survivors of Breast Cancer. Medical Journal of Mashhad University of Medical Sciences 2018; 60(6):779-91.
  12. Qi Y, Min H, Mujeeb A, Zhang Y, Han X, Zhao X, et al. Injectable hexapeptide hydrogel for localized chemotherapy prevents breast cancer recurrence. ACS applied materials & interfaces 2018; 10(8):6972-81.
  13. Akbarpour M, Fathollahi Shoorabeh F, Faraji F. Effect of eight weeks of resistance training with supplementation of pomegranate juice on oxidative. antioxidant factors and lipid profiles in women with type 2 diabetes. Journal of Knowledge & Health 2019; 14(3):52-8.
  14. Shahar S, Salleh RM, Ghazali AR, Koon PB, Mohamud WN. Roles of adiposity, lifetime physical activity and serum adiponectin in occurrence of breast cancer among Malaysian women in Klang Valley. Asian Pac J Cancer Prev 2010; 11(1):61-6.
  15. Fathollahi Shoorabeh F, Tarverdyzadeh B, Aminbaksahayesh S. Effect of 8 weeks resistance training on some antioxidant/oxidative indexes in postmenopausal women with breast cancer. The Horizon of Medical Sciences 2017; 23(4):279-83.
  16. Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD, et al. Influence of pre-and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. Journal of clinical oncology 2008; 26(24):3958-64.
  17. Bayat Ce, Fallahzadeh H, Askari G, Rahavi R, Maghsoudi Z, Nadjarzadeh A. The effect of pomegranate juice supplementation on muscle damage, oxidative stress and inflammation induced by exercise in healthy young men. Journal of Isfahan Medical School 2015; 32(320):2464-2472.
  18. Takemura H, Sakakibara H, Yamazaki S, Shimoi K. Breast cancer and flavonoids-a role in prevention. Current Pharmaceutical Design 2013; 19(34):6125-32.
  19. Zarban A, Malekaneh M, Reza Boghrati M. Antioxidant properties of pomegranate juice and its scavenging effect on free radicals. Journal of Birjand University of Medical Sciences 2007; 14(3):9-15.
  20. Shadmanfar A, Nemati A, Naghizadeh Baghi A, Mazani M. The effect of pomegranate juice supplementation on oxidative stress in young healthy males. Journal of Ardabil University of Medical Sciences 2012; 12(5):77-86.
  21. Costantini S, Rusolo F, De Vito V, Moccia S, Picariello G, Capone F, et al. Potential anti-inflammatory effects of the hydrophilic fraction of pomegranate (Punica granatum L.) seed oil on breast cancer cell lines. Molecules 2014; 19(6):8644-60.
  22. Shirode AB, Kovvuru P, Chittur SV, Henning SM, Heber D, Reliene R. Antiproliferative effects of pomegranate extract in MCF‐7 breast cancer cells are associated with reduced DNA repair gene expression and induction of double strand breaks. Molecular carcinogenesis 2014; 53(6):458-70.
  23. Mandal A, Bhatia D, Bishayee A. Anti-Inflammatory Mechanism Involved in Pomegranate-Mediated Prevention of Breast Cancer: the Role of NF-κB and Nrf2 Signaling Pathways. Nutrients 2017; 9(5):436.
  24. Irwin ML, American College of Sports Medicine. ACSM's guide to exercise and cancer survivorship. Human Kinetics; 2012.
  25. Kent M. Oxford Dictionary of Sports Science and Medicine. 3nd ed. Journal of Sports Science and Medicine 2007; 6(152).
  26. Khoramjah M, Khorshidi D, Karimi M. Effect of moderate-intensity aerobic training on some hormonal and metabolic factors associated with breast cancer in overweight postmenopausal women. Iranian Journal of Ageing 2019; 14(1):74-83.
  27. Akbarpour Bani M, FathollahiShoorabeh F,M.Rmoradpourian3, Mardani M, Khajeh Heydari S.(2020) The effect of eight weeks of resistance training with pomegranate juice supplementation on inflammatory. Anti-inflammatory factors and some lipoproteins in women with type 2diabetes. Pars J Med Sci;18(2):57-64
  28. Shiravand F, Valipour V, Abbasi M. The effect of 8 weeks of HICT training on serum levels of catalase, malondialdehyde and maximal oxygen consumption in breast cancer survivors: Randomized clinical trial. KAUMS Journal (FEYZ) 2019; 23(4):398-406.
  29. Fathi Bayyatiani Z, Dabidi Roshan V, Ayaz A, Hoseinzadeh M. The relationship between the pro-inflammatory markers with lipid peroxidation after water-based regular exercise and ginger supplement in breast cancer. Daneshvar Medicine 2013; 21(1):61-76.
  30. Barrera G. Oxidative stress and lipid peroxidation products in cancer progression and therapy. International Scholarly Research Notices 2012; 2012.
  31. Kitaoka Y, Masuda H, Mukai K, Hiraga A, Takemasa T, Hatta H. Effect of training and detraining on monocarboxylate transporter (MCT) 1 and MCT4 in Thoroughbred horses. Experimental physiology 2011; 96(3):348-55.
  32. Karanth, Jeevaratnam. Oxidative stress and antioxidant status in rat blood, liver and muscle: effect of dietary lipid, carnitine and exercise. International journal for vitamin and nutrition research 2005; 75(5):333-9.
  33. Marsh, Laursen, Coombes. Effects of antioxidant supplementation and exercise training on erythrocyte antioxidant enzymes. International journal for vitamin and nutrition research 2006; 76(5):324-31.
  34. Helmy MM, Elkholy M. In Vitro Study of Pomegranate Seed Extract on GADD45A Gene Expression in (MDA) Breast Cancer Cells. ACTA SCIENTIFIC Cancer Biology 2020; 4(2):10-27.
  35. Rocha A, Wang L, Penichet M, Martins-Green M. Pomegranate juice and specific components inhibit cell and molecular processes critical for metastasis of breast cancer. Breast cancer research and treatment 2012; 136(3):647-58.
  36. Zheng W, Wang SY. Antioxidant activity and phenolic compounds in selected herbs. Journal of Agricultural and Food chemistry 2001; 49(11):5165-70.
  37. Zou CG, Agar NS, Jones GL. Oxidative insult to human red blood cells induced by free radical initiator AAPH and its inhibition by a commercial antioxidant mixture. Life Sciences 2001; 69(1):75-86.