The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis: a randomised controlled trial

Abstract

BACKGROUND: Breast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women. METHODS: Overweight or obese (n = 243) and normal weight (n = 166) women were randomised to a three-month unsupervised home (home), a supervised community weight control programme (community) or to standard written advice (control). Primary end points were change in weight and body fat at 12 months. Secondary end points included change in insulin, cardiovascular risk markers, quality of life and cost-effectiveness of the programmes. RESULTS: Forty-three percent of eligible women were recruited. Both programmes reduced weight and body fat: home vs. control mean (95% CI); weight −2.3 (−3.5, −1.0) kg, body fat −1.6 (−2.6, −0.7) kg, community vs. control; weight −2.4 (−3.6, −1.1) kg, body fat −1.4 (−2.4, −0.5) kg (all p < 0.001). The community group increased physical activity, reduced insulin, cardiovascular disease risk markers, increased QOL and was cost-effective. CONCLUSIONS: The programmes were equally effective for weight control, but the community programme had additional benefits. CLINICAL TRIAL REGISTRATION: ISRCTN68576140

Evidence-Based Exercise Recommendations to Improve Mental Wellbeing in Women with Breast Cancer during Active Treatment: A Systematic Review and Meta-Analysis

“…The characteristics of study populations, intervention protocols and outcome measures and tools of measure are briefly described. All 57 selected studies, all RCTs in their design and published between 2001 and 2020 [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , …”

A national survey of oncology survivors examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey

“…However, our results suggest that survivors are highly concerned by weight gain, therefore, it should be discussed in a patient-centred manner. The majority of respondents (57%) reported following HE advice and the desire to lose weight in order to reduce recurrence risk was commonly mentioned, in line with the World Cancer Research Fund recommendations for secondary prevention [36], however, while WL may be safe in select groups during active treatment, this should be conducted under dietetic supervision [37,38].…”

Nutrition and cancer: evidence gaps and opportunities for improving knowledge

“…Communication barriers are further compounded and contradicted by the obesogenic environment individuals who attempt to act on advice are faced with (19) . Scientific understanding of behaviour change and communication methods is still evolving (20)(21)(22) and there are likely to be improvements in how advice is presented as these fields develop (23) . An important consideration raised during the course of the meeting was how should researchers communicate the robust and evidenced-based advice for cancer prevention with the people who need it and translate research findings into bona fide behaviour change?…”