Department of Physical Therapy, University of British Columbia, 2177Wesbrook Mall, Vancouver, BC, Canada.
J Acad Nutr Diet. 2012 Apr;112(4):559-67. doi: 10.1016/j.jada.2011.10.022. Epub 2012 Feb 10.
Physical inactivity and being overweight or obese are lifestyle factors that put breast cancer survivors at a higher risk for a cancer recurrence and/or development of other chronic diseases. Despite this, there is limited research that has identified effective lifestyle interventions aimed specifically at weight loss in breast cancer survivors. This pilot study is a single-arm experimental pre-post test design, conducted from November 2009 to July 2010, that tested the efficacy of a 24-week group-based lifestyle intervention modeled on the Diabetes Prevention Program in early stage breast cancer survivors (N=14). The intervention included 16 diet sessions led by a registered dietitian and 150 min/wk of moderate-to-vigorous exercise. Study outcome measures were completed at baseline, 24, and 36 weeks (nonintervention follow-up). The primary outcome was change in body weight, and secondary outcomes were change in body composition, aerobic fitness, dietary intake, and blood biomarkers. Overall, participants were postmenopausal women aged 54.6±8.3 years with obesity (body mass index 30.1±3.6), and had completed adjuvant cancer treatment 2 years prior. Results showed an average weight loss of 3.8±5.0 kg and a decrease in body mass index, percent body fat, and waist and hip circumferences at 24 weeks and an additional mean weight loss of 0.8±1.2 kg at 36 weeks. In exploratory analysis, participants who lost >7% body weight were older and attended a greater percentage of diet and supervised exercise sessions. There were no significant changes in any of the blood biomarkers at 24 and 36 weeks; however, the results provide a measure of expected effect size for future research studies. This pilot study demonstrated the efficacy of a lifestyle intervention based on the Diabetes Prevention Program in early stage breast cancer survivors and represents an innovative clinical intervention for dietetics practitioners to address the unmet need for programs.
身体活动不足和超重或肥胖是导致乳腺癌幸存者癌症复发和/或发展为其他慢性疾病风险增加的生活方式因素。尽管如此，针对乳腺癌幸存者的减肥，目前仅有有限的研究确定了有效的生活方式干预措施。这项初步研究是一项单臂实验前后测试设计，于 2009 年 11 月至 2010 年 7 月进行，旨在测试基于糖尿病预防计划的 24 周小组生活方式干预对早期乳腺癌幸存者（N=14）的疗效。该干预措施包括由注册营养师进行的 16 次饮食课程和每周 150 分钟的中等至剧烈运动。研究结果测量在基线、24 周和 36 周（非干预随访）完成。主要结果是体重变化，次要结果是身体成分、有氧健身、饮食摄入和血液生物标志物的变化。总体而言，参与者是绝经后年龄为 54.6±8.3 岁、肥胖（体重指数 30.1±3.6）的女性，并且在 2 年前完成了辅助癌症治疗。结果显示，24 周时平均体重减轻 3.8±5.0 公斤，体重指数、体脂百分比、腰围和臀围减少，36 周时平均体重再减轻 0.8±1.2 公斤。在探索性分析中，体重减轻超过 7%的参与者年龄较大，参加的饮食和监督运动课程比例更高。在 24 周和 36 周时，所有血液生物标志物均无显著变化；然而，这些结果为未来的研究提供了预期的效应大小的衡量标准。这项初步研究表明，基于糖尿病预防计划的生活方式干预对早期乳腺癌幸存者有效，代表了饮食学从业者满足未满足需求的创新临床干预措施。
