Daughters and Mothers Against Breast Cancer (DAMES): Main outcomes of a randomized controlled trial of weight loss in overweight mothers with breast cancer and their overweight daughters

Abstract

BACKGROUNDFew studies to date have used the cancer diagnosis as a teachable moment to promote healthy behavior changes in survivors of cancer and their family members. Given the role of obesity in the primary and tertiary prevention of breast cancer, the authors explored the feasibility of a mother-daughter weight loss intervention.METHODSA randomized controlled trial of a mailed weight loss intervention was undertaken among 68 mother-daughter dyads (n = 136), each comprised of a survivor of breast cancer (AJCC stage 0-III) and her adult biological daughter. All women had body mass indices ≥ 25 kg/m2 and underwent in-person assessments at baseline, 6 months, and 12 months, with accelerometry and exercise capacity performed on a subset of individuals. All women received a personalized workbook and 6 newsletters over a 1-year period that promoted weight loss; exercise; and a nutrient-rich, low-energy density diet. A total of 25 dyads received individually tailored instruction (INDIVIDUAL), 25 dyads received team-tailored instruction (TEAM), and 18 dyads received standardized brochures (CONTROL).RESULTSThe trial met its accrual target, experienced 90% retention, and caused no serious adverse events. Significant differences in baseline to 12-month changes were observed between INDIVIDUAL versus CONTROL mothers for body mass index, weight, and waist circumference (WC); significant differences also were observed in the WC of corresponding daughters (P < .05). Significant differences were found between INDIVIDUAL versus CONTROL and TEAM versus CONTROL dyads for WC (P = .0002 and .018, respectively), minutes per week of physical activity (P = .031 and .036, respectively), and exercise capacity (P = .047 for both).CONCLUSIONSSignificant improvements in lifestyle behaviors and health outcomes are possible with tailored print interventions directed toward survivors of cancer and their family members. For greater impact, more research is needed to expand this work beyond the mother-daughter dyad. Cancer 2014;120:2522–2534. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.Obesity is a major risk factor for the incidence and mortality of several cancers. The results of this randomized controlled trial of weight loss among 136 women diagnosed with breast cancer and their biological daughters suggests that the diagnosis of cancer can be used to motivate healthy diet and exercise behaviors among survivors of cancer and their family members using mailed print interventions.

Effect of a six-month yoga exercise intervention on fitness outcomes for breast cancer survivors

“…Most exercise studies that involve exercise and cancer survivorship to date do not include the comprehensive array of fitness and physical functioning assessments that we employed in our study (Galvao and Newton, 2005; Schmitz et al, 2010b). Moreover, though some exercise studies with breast cancer survivors have employed some of the fitness assessments we did, such as body composition, VO2 uptake with respiratory gases, and strength (Demark-Wahnefried et al, 2014; Friedenreich et al, 2011; Schmitz et al, 2009; Schmitz et al, 2010a); ours is the only study we are aware of to simultaneously compare three different exercise modalities over a six-month randomized trial that includes yoga-based exercise specifically designed for post-treatment breast cancer survivors.…”

Family-based Breast Cancer Prevention Efforts in Adolescence

“…For example, a mother-adult daughter intervention on weight loss supported improvements in behavioral interventions targeting those at higher risk but also demonstrated some of the challenges of the mother-adult daughter dyad for behavioral interventions. 6 We suggest that a major difference that needs to be considered between cardiovascular family-based interventions and cancer interventions is the induction time of the disease. With diseases of shorter induction times, interventions later in life can be more effective at reducing risk.…”

Effects of diet and exercise on weight-related outcomes for breast cancer survivors and their adult daughters: an analysis of the DAMES trial

“…Participant recruitment, consent, and randomization procedures were described in a previous report [24]. Ultimately, 68 mother-daughter dyads were randomized to one of three year-long study conditions: the individually tailored intervention ( n =25), team tailored intervention ( n =25), or attention control group ( n =18).…”

“…This approach has been successfully used in non-cancer samples with mothers and their child or adolescent daughters [14, 20–23]. To our knowledge, the first lifestyle intervention trial to focus on mothers with a cancer history and their daughters was the Daughters And MothErS Against Breast Cancer (DAMES) study [24]. The DAMES trial assessed the feasibility of two tailored mailed print weight loss interventions against a standardized control in overweight or obese female breast cancer survivors and their overweight or obese daughters.…”