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

Abstract

Purpose Few trials have aimed to promote diet and exercise behaviors in both cancer survivors and their family members and examine their associations with weight-related outcomes. We conducted a secondary analysis to examine associations between change in diet and exercise behaviors and weight-related outcomes for overweight breast cancer survivors and their overweight adult daughters in the DAMES (Daughters And MothErS Against Breast Cancer) randomized trial. Methods The DAMES trial assessed the impact of two iteratively tailored, mailed print diet and exercise interventions against standard brochures over a 12-month period. This analysis examined change in diet and exercise behaviors and weight-related variables from baseline to post-intervention for the 50 breast cancer survivors and their adult daughters randomized to the intervention arms. To reduce the potential for Type II error in this pilot, p-values < 0.10 were considered statistically significant. Results For mothers, change in diet quality was uniquely related to change in BMI (β=−0.12, p=0.082), weight (β=−0.12, p=0.060), and waist circumference (β=−0.38, p=0.001), whereas change in caloric intake was related to waist circumference (β=0.21, p=0.002). For daughters, change in caloric intake was related to change in waist circumference (β=0.12, p=0.055). However, change in diet quality was not associated with weight-related outcomes in daughters. Additionally, change in exercise was not associated with weight-related outcomes in mothers or daughters. Conclusions Findings support mail-based and other tailored interventions for weight loss in this population, with an emphasis on diet quality for breast cancer survivors and caloric intake for their adult daughters.

Rural breast cancer survivors are able to maintain diet quality improvements during a weight loss maintenance intervention

“…Many successful weight loss and weight loss maintenance (WLM) interventions include dietary education that promotes a high-quality diet. Previous work within our group and others has shown that higher DQ was associated with greater weight loss in female rural breast cancer survivors [29][30][31]. However, there are no published evaluations of DQ during maintenance of weight loss in rural breast cancer survivors.…”

Effect of an mHealth weight loss intervention on Healthy Eating Index diet quality: the SMARTER randomised controlled trial

“…In a small pilot study with a 16-week intervention period, women who achieved clinically meaningful weight loss improved HEI-2005 total scores by 8•3 points (39) . In both the Weight Optimization Revamping Lifestyle using the Dietary Guidelines (WORLD) (35) and Daughters and Mothers Against Breast Cancer (DAMES) (8) studies, which used the HEI-2005, relationships between change in diet quality and weight loss were also observed. Additionally, among rural breast cancer survivors who maintained lost weight (≥ 5 % of baseline weight) v. those who did not, there was a 4•6-point difference in Alternate Healthy Eating Index (AHEI) scores at 18 months (9) .…”

“…Poor diet quality is a major correlate of prevalent overweight and obesity (4) as well as weight gain over time (5,6) . In randomised controlled trials, improvements in diet quality have been shown to relate to weight loss separate from the effect of energy restriction (7,8) . Diet quality has also been shown to relate to weight loss maintenance postintervention (9,10) .…”

Mothers’ Diet and Family Income Predict Daughters’ Healthy Eating

“…Incidence of breast cancer, the most common cancer in women, is on the rise globally (1). Adult daughters in families with a history of the disease are at greater risk of breast cancer than women without a family history (2).…”

“…Incidence of breast cancer, the most common cancer in women, is on the rise globally ( 1 ). Adult daughters in families with a history of the disease are at greater risk of breast cancer than women without a family history ( 2 ). Increasing evidence suggests that early lifestyle behaviors can affect a woman’s breast cancer risk ( 3 ).…”