Effects of a Combined Physical Activity and Dietary Change Intervention on Weight Loss in Minority Breast Cancer Survivors.

Abstract

Background: Hispanic and black women with breast cancer have poorer survival and are more likely to be obese and sedentary than non-Hispanic whites. Regular physical activity, high intake of fruits and vegetables, and lean body mass may improve survival. We report the initial results of a randomized wait-list controlled pilot study to test the effects of 6 months of the community-based Curves® exercise and nutrition program on weight loss among minority BC survivors.Methods: Hispanic/black women with stage 0-IIIa breast cancer who were ≥6 months post-treatment, sedentary and had a BMI≥25kg/m2 were enrolled. Eligible participants were randomized to the Immediate Arm (IA): 6 months of the Curves® exercise and dietary change weight loss program, followed by 6 months of observation; or the Delayed Arm (DA): 6 months of a waitlist control period, followed by 6 months of the Curves® program. The intervention entailed recommending exercise 5 times/wk using the 30-minute Curves® circuit-based exercise program and attending a series of 6 weekly nutrition sessions that promoted a high-vegetable/low-fat diet. All study materials were available in Spanish and English. Participants underwent clinic visits at baseline, 3, 6, 9, and 12 months and were followed with monthly telephone calls during the intervention. Month 6 results are reported here.Results: Forty-two women enrolled in the study (IA, n=22; DA, n=20). Baseline characteristics: mean (±SD) age, 50.7 (±8.9) years; 78.6% Hispanic/21.4% black; breast cancer stage, stage 0 9.5%, stage I 42.9%, stage II 33.3%, stage III 14.2%; mean body mass index (BMI), 33.2 (±5.9) kg/m2; mean % body fat as measured by DEXA, 41.6 (±4.9) %; and mean VO2 max, 18.4 (±3.6). Six month data were collected from 39 women; 2 women were removed from the study due to medical conditions (1 recurrent disease, 1 previously undiagnosed cardiac condition) and 1 women dropped from the study due to being too busy. In the IA, the average number of exercise sessions attended over the 6 month period was 1.1(±0.8) per week (range: 0.04 to 2.9/wk), and all participants attended all 6 nutrition classes either in-person or via phone make-up sessions. After 6 months, women in the IA lost an average of 2.7 (±3.2) kg (range: loss of 9.9 kg to gain of 1.7 kg), had a decrease in percent body fat of 1.5 (±1.5)% (range: loss of 5.9% to gain of 0.2%), and a decrease in VO2max of 1.0 (±3.4) ml/kg/min (range: decrease of 8.6 ml/kg/min to increase of 2.5 ml/kg/min) (within-subject measures p<0.05 for change in weight and percent body fat; all between-arm measures p>0.05). Twelve month data collection will be completed in July 2009 and will be presented at the conference.Conclusions: This 6 month pilot physical activity and dietary change intervention resulted in decreased in body weight and percent body fat among Hispanic and black BC survivors, although this decline was not significantly different than the wait-list control group. Though adherence to the exercise intervention was less than the targeted 5 exercise sessions per week, those that did adhere lost up to 9.9 kg. Further research on barriers to participation, optimal dose, and duration are necessary for future intervention trials. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1038.