von Gruenigen Vivian E, Courneya Kerry S, Gibbons Heidi E, Kavanagh Mary Beth, Waggoner Steven E, Lerner Edith
University Hospitals Case Medical Center, Division of Gynecologic Oncology, 11100 Euclid Avenue, Room 7128, Cleveland, Ohio 44106, USA.
Gynecol Oncol. 2008 Apr;109(1):19-26. doi: 10.1016/j.ygyno.2007.12.026. Epub 2008 Feb 19.
The majority of endometrial cancer survivors (ECS) are obese and at risk for premature death. The purpose of this study was to assess feasibility of a lifestyle intervention program for promoting weight loss, change in eating behaviors, and increased physical activity in obese ECS.
Early stage ECS (n=45) were randomized to a 6-month lifestyle intervention (LI; n=23) or usual care (UC; n=22). The LI group received group and individual counseling for 6 months. The primary endpoint was weight change. Secondary endpoints were physical activity, [Leisure score index (LSI)] and nutrient intake (3-day food records). Quantitative vitamin C and folate intake were used to assess fruit/vegetable intake.
Recruitment was 29%, adherence (LI group) was 73% and 84% of participants completed follow-up assessments. At 12 months, the intervention group lost 3.5 kg compared to a 1.4 kg gain in the control group [mean difference=-4.9 kg; 95% CI: -9.0 to -0.9 kg; p=.018] and had an increased LSI score of 16.4 versus -1.3 in the control group from baseline [mean group difference=17.8; 95% CI=7.1 to 28.4; p=.002]. There were no differences in vitamin C and folate intake. The LI group had lower intake of kilocalories, although differences were not significant.
CONCLUSION(S): A lifestyle intervention program in obese ECS is feasible and can result in sustained behavior change and weight loss over a 1-year period.
大多数子宫内膜癌幸存者(ECS)肥胖且有过早死亡风险。本研究旨在评估一项生活方式干预计划对促进肥胖ECS体重减轻、饮食行为改变及增加身体活动的可行性。
将早期ECS患者(n = 45)随机分为6个月生活方式干预组(LI;n = 23)或常规护理组(UC;n = 22)。LI组接受为期6个月的团体和个体咨询。主要终点为体重变化。次要终点为身体活动[休闲评分指数(LSI)]和营养摄入(3天食物记录)。采用定量维生素C和叶酸摄入量评估水果/蔬菜摄入量。
招募成功率为29%,依从性(LI组)为73%,84%的参与者完成了随访评估。在12个月时,干预组体重减轻3.5kg,而对照组体重增加1.4kg[平均差异=-4.9kg;95%CI:-9.0至-0.9kg;p = 0.018],且干预组的LSI评分从基线起增加了16.4,而对照组为-1.3[组间平均差异=17.8;95%CI = 7.1至28.4;p = 0.002]。维生素C和叶酸摄入量无差异。LI组的千卡摄入量较低,尽管差异不显著。
针对肥胖ECS的生活方式干预计划是可行的,并且在1年期间可导致持续的行为改变和体重减轻。