Stolley Melinda, Sheean Patricia, Gerber Ben, Arroyo Claudia, Schiffer Linda, Banerjee Anjishnu, Visotcky Alexis, Fantuzzi Giamila, Strahan Desmona, Matthews Lauren, Dakers Roxanne, Carridine-Andrews Cynthia, Seligman Katya, Springfield Sparkle, Odoms-Young Angela, Hong Susan, Hoskins Kent, Kaklamani Virginia, Sharp Lisa
Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX.
J Clin Oncol. 2017 Aug 20;35(24):2820-2828. doi: 10.1200/JCO.2016.71.9856. Epub 2017 Jun 19.
Purpose African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior. Patients and Methods Early-stage (I-III) AABCS were randomly assigned to a 6-month interventionist-guided (n = 125) or self-guided (n = 121) weight loss program supporting behavioral changes to promote a 5% weight loss. Anthropometric, body composition, and behavioral data were collected at baseline, postintervention (6 months), and follow-up (12 months). Descriptive statistics and mixed models analyses assessed differences between groups over time. Results Mean (± standard deviation) age, and body mass index were 57.5 (± 10.1) years and 36.1 (± 6.2) kg/m, respectively, and 82% had stage I or II breast cancer. Both groups lost weight. Mean and percentage of weight loss were greater in the guided versus self-guided group (at 6 months: 3.5 kg v 1.3kg; P < .001; 3.6% v 1.4%; P < .001, respectively; at 12 months: 2.7 kg v 1.6 kg; P < .05; 2.6% v 1.6%; P < .05, respectively); 44% in the guided group and 19% in the self-guided group met the 5% goal. Body composition and behavioral changes were also greater in the interventionist-guided group at both time points. Conclusion The study supports the efficacy of a community-based interventionist-guided weight loss program targeting AABCS. Although mean weight loss did not reach the targeted 5%, the mean loss of > 3% at 6 months is associated with improved health outcomes. Affordable, accessible health promotion programs represent a critical resource for AABCS.
目的 患有乳腺癌的非裔美国女性具有较高的癌症特异性死亡率和总体死亡率。肥胖在非裔美国女性中很常见，且会促使乳腺癌病情发展并引发多种慢性疾病。乳腺癌幸存者的体重减轻干预措施对体重、行为、生物标志物和心理社会结果有积极影响，但针对非裔美国人的此类措施却很少。本文探讨了“向前迈进”这一针对非裔美国乳腺癌幸存者（AABCS）的体重减轻干预措施对体重、身体成分和行为的影响。
患者与方法 早期（I - III期）AABCS被随机分配至一个为期6个月的、有干预人员指导的（n = 125）或自我指导的（n = 121）体重减轻计划，该计划支持行为改变以促进体重减轻5%。在基线、干预后（6个月）和随访（12个月）时收集人体测量、身体成分和行为数据。描述性统计和混合模型分析评估了不同组随时间的差异。
结果 平均（±标准差）年龄和体重指数分别为57.5（±10.1）岁和36.1（±6.2）kg/m²，82%的患者患有I期或II期乳腺癌。两组均减轻了体重。有干预人员指导的组与自我指导的组相比，体重减轻的平均值和百分比更高（6个月时：3.5 kg对1.3 kg；P < 0.001；3.6%对1.4%；P < 0.001；12个月时：2.7 kg对1.6 kg；P < 0.05；2.6%对1.6%；P < 0.05）；有干预人员指导的组中44%的人和自我指导的组中19%的人达到了5%的目标。在两个时间点，有干预人员指导的组在身体成分和行为改变方面也更大。
结论 该研究支持了一项针对AABCS的基于社区的、有干预人员指导的体重减轻计划的有效性。尽管平均体重减轻未达到目标的5%，但6个月时平均减轻超过3%与改善健康结果相关。经济实惠、易于获得的健康促进计划是AABCS的一项关键资源。
