Department of Family and Community Medicine, The University of Arizona, College of Medicine-Tucson, Tucson, Arizona.
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Prev Res (Phila). 2022 Mar 1;15(3):193-201. doi: 10.1158/1940-6207.CAPR-21-0298.
Weight losses >10% favorably modulate biomarkers of breast cancer risk but are not typically achieved by comprehensive weight loss programs, including the Diabetes Prevention Program (DPP). Combining the DPP with hunger training (HT), an evidence-based self-regulation strategy that uses self-monitored glucose levels to guide meal timing, has potential to enhance weight losses and cancer-related biomarkers, if proven feasible. This two-arm randomized controlled trial examined the feasibility of adding HT to the DPP and explored effects on weight and metabolic and breast cancer risk biomarkers. Fifty postmenopausal women [body mass index (BMI) >27 kg/m2)] at risk of breast cancer were randomized to the DPP+HT or DPP-only arm. Both arms followed a 16-week version of the DPP delivered weekly by a trained registered dietitian. Those in the DPP+HT also wore a continuous glucose monitor during weeks 4-6 of the program. Feasibility criteria were accrual rates >50%, retention rates >80%, and adherence to the HT protocol >75%. All a priori feasibility criteria were achieved. The accrual rate was 67%, retention rate was 81%, and adherence to HT was 90%. Weight losses and BMI reductions were significant over time as were changes in metabolic and breast cancer risk biomarkers but did not vary by group. This trial demonstrated that HT was feasible to add to comprehensive weight management program targeted toward postmenopausal women at high risk of breast cancer, though upon preliminary examination it does not appear to enhance weight loss or metabolic changes.
This study found that it was feasible to add a short glucose-guided eating intervention to a comprehensive weight management program targeting postmenopausal women at high risk of breast cancer. However, further development of this novel intervention as a cancer prevention strategy is needed.
目的：体重减轻 >10% 有利于调节乳腺癌风险的生物标志物，但通常无法通过综合减肥计划实现，包括糖尿病预防计划（DPP）。将 DPP 与饥饿训练（HT）相结合，这是一种基于证据的自我调节策略，使用自我监测的血糖水平来指导进餐时间，有可能增强减肥效果和与癌症相关的生物标志物，如果证明是可行的。这项双臂随机对照试验研究了将 HT 添加到 DPP 中的可行性，并探讨了其对体重和代谢及乳腺癌风险生物标志物的影响。
方法：50 名绝经后妇女[体重指数（BMI）>27 kg/m2]有患乳腺癌的风险，被随机分配到 DPP+HT 或 DPP 仅治疗组。两组均遵循经过培训的注册营养师每周提供的 16 周版 DPP。DPP+HT 组的参与者还在该计划的第 4-6 周期间佩戴连续血糖监测仪。可行性标准为入组率>50%，保留率>80%，以及对 HT 方案的依从性>75%。所有预先设定的可行性标准均达到。入组率为 67%，保留率为 81%，对 HT 的依从性为 90%。体重减轻和 BMI 降低随着时间的推移而显著，代谢和乳腺癌风险生物标志物的变化也是如此，但组间无差异。
结论：这项试验表明，将 HT 添加到针对绝经后高危乳腺癌女性的综合体重管理计划中是可行的，尽管初步检查表明，HT 似乎并没有增强减肥效果或代谢变化。
预防相关性：本研究发现，将短期血糖指导的饮食干预添加到针对绝经后高危乳腺癌女性的综合体重管理计划中是可行的。然而，需要进一步开发这种新的干预措施作为癌症预防策略。
