Randomized Trial Comparing Telephone Versus In-Person Weight Loss Counseling on Body Composition and Circulating Biomarkers in Women Treated for Breast Cancer: The Lifestyle, Exercise, and Nutrition (LEAN) Study

Abstract

Obesity is associated with a higher risk of breast cancer mortality. The gold standard approach to weight loss is in-person counseling, but telephone counseling may be more feasible. We examined the effect of in-person versus telephone weight loss counseling versus usual care on 6-month changes in body composition, physical activity, diet, and serum biomarkers. MethodsOne hundred breast cancer survivors with a body mass index $ 25 kg/m 2 were randomly assigned to in-person counseling (n = 33), telephone counseling (n = 34), or usual care (UC) (n = 33). In-person and telephone counseling included 11 30-minute counseling sessions over 6 months. These focused on reducing caloric intake, increasing physical activity, and behavioral therapy. Body composition, physical activity, diet, and serum biomarkers were measured at baseline and 6 months. ResultsThe mean age of participants was 59 6 7.5 years old, with a mean BMI of 33.1 6 6.6 kg/m 2 , and the mean time from diagnosis was 2.9 6 2.1 years. Fifty-one percent of the participants had stage I breast cancer. Average 6-month weight loss was 6.4%, 5.4%, and 2.0% for in-person, telephone, and UC groups, respectively (P = .004, P = .009, and P = .46 comparing in-person with UC, telephone with UC, and in-person with telephone, respectively). A significant 30% decrease in C-reactive protein levels was observed among women randomly assigned to the combined weight loss intervention groups compared with a 1% decrease among women randomly assigned to UC (P = .05). ConclusionBoth in-person and telephone counseling were effective weight loss strategies, with favorable effects on C-reactive protein levels. Our findings may help guide the incorporation of weight loss counseling into breast cancer treatment and care.

Ćwiczenia fizyczne jako czynnik zapobiegający nowotworom i poprawiający rokowanie: dobrze udokumentowana czy niepotwierdzona metoda?

“…W badaniach randomizowanych oceniających wpływ różnych interwencji (dieta, aktywność fizyczna, dieta i aktywność fizyczna) stwierdzono, że zmiana sposobu odżywiania oraz zwiększenie aktywności korzystnie wpływa na szereg wskaźników zarówno u osób zdrowych, jak u chorych [11][12][13]. Jednak ocena biomarkerów może nie odzwierciedlać działania przeciwnowotworowego interwencji.…”

eHealth and behavioral weight loss interventions for female cancer survivors: A review

“…The dose of the interventions was also variable; yet across the first 6 months, Harrigan, 30 Harris, 35 and Goodwin 33 each provided between 11 and 16 individual calls over a 6-month period, and each obtained approximately equal weight losses of 4.8, 4.0 and 4.3 kg, respectively. This is about half of what would be expected with an in-person behavioral intervention, yet the dose of 11-16 calls is lower than the 24 in-person meetings that are typically scheduled over 6 months in an in-person program.…”

“…The majority of studies started with front-loading calls by providing weekly contact for the first 3-6 months, then tapering calls to bi-weekly or monthly as time progressed. The dose of contact ranged from 11 calls planned in a 6-month period 30 to a high of 30 scheduled in a 12-month intervention. 35 All of the studies, save two, 31,34 provided individual phone calls to women.…”

“…30,32,33,35 Women had body mass indices (BMIs) at baseline ⩾24 kg/m 2 , were within 10 years of diagnosis and, at a minimum, had been finished with treatment for at least 4 weeks. Intervention length ranged from 12 weeks to 24 months with the intervention dose (number of phone calls planned) being much more variable.…”

“…[25][26][27][28][29] Six additional papers that used telephone counseling to deliver intervention distantly were identified. [30][31][32][33][34][35] All telephonebased intervention papers are described in Table 1. All eHealth/mHealth papers are presented in Table 2.…”