Effect of a remotely delivered weight loss intervention in early-stage breast cancer: Randomized controlled trial

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Reeves, MM
Terranova, CO
Winkler, EAH
McCarthy, N
Hickman, IJ
Ware, RS
Lawler, SP
Eakin, EG
Demark-Wahnefried, W
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2021
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Abstract

Limited evidence exists on the effects of weight loss on chronic disease risk and patientreported outcomes in breast cancer survivors. Breast cancer survivors (stage I-III; body mass index 25–45 kg/m2) were randomized to a 12-month, remotely delivered (22 telephone calls, mailed material, optional text messages) weight loss (diet and physical activity) intervention (n = 79) or usual care (n = 80). Weight loss (primary outcome), body composition, metabolic syndrome risk score and components, quality of life, fatigue, musculoskeletal pain, menopausal symptoms, fear of recurrence, and body image were assessed at baseline, 6 months, 12 months (primary endpoint), and 18 months. Participants were 55 ± 9 years and 10.7 ± 5.0 months post-diagnosis; retention was 81.8% (12 months) and 80.5% (18 months). At 12-months, intervention participants had significantly greater improvements in weight (−4.5% [95%CI: −6.5,−2.5]; p < 0.001), fat mass (−3.3 kg [−4.8,−1.9]; p < 0.001), metabolic syndrome risk score (−0.19 [−0.32,−0.05]; p = 0.006), waist circumference (−3.2 cm [−5.5,−0.9]; p = 0.007), fasting plasma glucose (−0.23 mmol/L [−0.44,−0.02]; p = 0.032), physical quality of life (2.7 [0.7,4.6]; p = 0.007; Cohen’s effect size (d) = 0.40), musculoskeletal pain (−0.5 [−0.8,−0.2]; p = 0.003; d = 0.49), and body image (−0.2 [−0.4,−0.0]; p = 0.030; d = 0.31) than usual care. At 18 months, effects on weight, adiposity, and metabolic syndrome risk scores were sustained; however, significant reductions in lean mass were observed (−1.1 kg [−1.7,−0.4]; p < 0.001). This intervention led to sustained improvements in adiposity and metabolic syndrome risk.

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Nutrients

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13

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11

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© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Food sciences

Nutrition and dietetics

Oncology and carcinogenesis

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Reeves, MM; Terranova, CO; Winkler, EAH; McCarthy, N; Hickman, IJ; Ware, RS; Lawler, SP; Eakin, EG; Demark-Wahnefried, W, Effect of a remotely delivered weight loss intervention in early-stage breast cancer: Randomized controlled trial, Nutrients, 2021, 13 (11), pp. 4091

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