The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial

Abstract

Objective To evaluate the impact of a diet and physical activity intervention (BeWEL) on weight change in people with a body mass index >25 weight (kg)/height (m) 2 at increased risk of colorectal cancer and other obesity related comorbidities.Design Multicentre, parallel group, randomised controlled trial.Setting Four Scottish National Health Service health boards.Participants 329 overweight or obese adults (aged 50 to 74 years) who had undergone colonoscopy after a positive faecal occult blood test result, as part of the national bowel screening programme, and had a diagnosis of adenoma confirmed by histopathology. 163 were randomised to intervention and 166 to control.Intervention Participants were randomised to a control group (weight loss booklet only) or 12 month intervention group (three face to face visits with a lifestyle counsellor plus monthly 15 minute telephone calls).A goal of 7% reduction in body weight was set and participants received a personalised energy prescription (2508 kJ (600 kcal) below that required for weight maintenance) and bodyweight scales. Motivational interviewing techniques explored self assessed confidence, ambivalence, and personal values concerning weight. Behavioural strategies included goal setting, identifying intentions of implementation, self monitoring of body weight, and counsellor feedback about reported diet, physical activity, and weight change. Main outcome measuresThe primary outcome was weight change over 12 months. Secondary outcomes included changes in waist circumference, blood pressure, fasting cardiovascular biomarkers, and glucose metabolism variables, physical activity, diet, and alcohol consumption.Results At 12 months, data on the primary outcome were available for 148 (91%) participants in the intervention group and 157 (95%) in the control group. Mean weight loss was 3.50 kg (SD 4.91) (95% confidence 3.67). Differences between groups were significant for waist circumference, body mass index, blood pressure, blood glucose level, diet, and physical activity. No reported adverse events were considered to be related to trial participation. ConclusionsSignificant weight loss can be achieved by a diet and physical activity intervention initiated within a national colorectal cancer screening programme, offering considerable potential for risk reduction of disease in older adults.Trial registration Current Controlled Trials ISRCTN53033856. IntroductionColorectal cancer is the third most common cancer and cause of cancer related death in the United Kingdom. 1 Most cases (95%) occur in people aged over 50, who often have other lifestyle related comorbidities, such as obesity, type 2 diabetes mellitus, and cardiovascular disease.2 3 These diseases share common risk factors, including increased waist circumference, altered glucose metabolism, and abnormal lipid levels. Consistent with findings for cardiovascular disease and type 2 diabetes mellitus, 6 7 high levels of body fat (body mass index >23 (weight (kg)/height (m)2 )) or a large waist circumferenc...

Health and Economic Costs of Physical Inactivity

“…The recent research on physical activity and health often focuses on impact of high volumes of time that people spend sitting during waking hours on body physiology and health care costs (Garret et al, 2004;Warburton et al, 2006;Autenrieth et al, 2009;Brown et al, 2009;Juneau and Potvin, 2010;Owen et al, 2009Owen et al, , 2010Rishiraj, 2013, Anderson et al, 2014. According to the data reported by Owen et al (2010) adults, on average, spend 9.3h per day in sedentary activities, i.e.…”

Diet-induced weight loss leads to a switch in gene regulatory network control in the rectal mucosa

“…It has been hypothesized that since weight loss decreases systemic inflammation [3], weight loss may mediate anti-cancer effects in the colorectum. Weight loss interventions have been successful among individuals with high colorectal cancer risk [4]. However, there is no defined mechanism of action for this commonly prescribed cancer prevention and lifestyle intervention.…”

Long-term weight loss following a randomised controlled trial of a weight management programme for men delivered through professional football clubs: the Football Fans in Training follow-up study

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