Healthy Eating and Active Lifestyle after Bowel Cancer (HEAL ABC) – Feasibility Randomised Controlled Trial

Abstract

Background: Evidence from cohort studies indicates that a healthy lifestyle can improve cancer survival but evidence from randomised controlled trials (RCT) is lacking. Thus, this study tested the feasibility of conducting a lifestyle intervention in patients after colorectal cancer (CRC) treatment. Methods: An intervention was developed based on World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) recommendations, the Health Action Process Approach and Motivational Interviewing and tested using a feasibility/mixed-methods RCT. Participants were allocated to a three-month telephone-based intervention with printed resources and website versus standard care control group. The follow up period was six months. Data on anthropometry, diet, physical activity were collected and analysed using Stata (V14, StataCorp LLC). Results: In total, 34/35 participants completed the intervention, and 31 (89%) completed follow up. Recruitment was challenging (31 ineligible, 37 declined). There was improvement in WCRF/AICR score in the intervention group compared to control at three months (R2 1.1, 95%CI 0.5;1.6, p=0.0001), and at six months (R2 0.9, 95%CI 0.1;1.7, p=0.03), and in Diet Quality Index-International score (R2 8.9, 95%CI 3.3;14.5, p=0.003) at three months, and at six months (R2 8.2, 95%CI 1.1;15.3, p=0.02). Following WCRF/AICR recommendations led to a 10% reduction in ultra-processed food consumption in the intervention group. Conclusions: The intervention was feasible for 87% of intervention participants, supporting them in healthy lifestyle changes. However, alternative recruitment strategies are needed to provide a large enough sample for a powered RCT to determine the efficacy of the intervention.