title: Outcomes of a weight loss intervention among rural breast cancer survivors.
abstract: Obese breast cancer survivors have increased risk of recurrence and death compared to their normal weight counterparts. Rural women have significantly higher obesity rates, thus weight control intervention may be a key strategy for prevention of breast cancer recurrence in this population. This one-arm treatment study examined the impact of a group-based weight control intervention delivered through conference call technology to obese breast cancer survivors living in remote rural locations. The intervention included a reduced calorie diet incorporating prepackaged entrees and shakes, physical activity gradually increased to 225 min/week of moderate intensity exercise, and weekly group phone sessions. Outcomes included anthropomorphic, diet, physical activity, serum biomarker, and quality of life changes. Ninety-one percent of participants (31 of 34) attended >75% of intervention sessions and completed post-treatment data collection visits. At 6 months, significant changes were observed for weight (-12.5 ± 5.8 kg, 13.9% of baseline weight), waist circumference (-9.4 ± 6.3 cm), daily energy intake (-349 ± 550 kcal/day), fruits, and vegetables (+3.7 ± 4.3 servings/day), percent kcal from fat (-12.6 ± 8.6%), physical activity (+1235 ± 832 kcal/week; all P values <0.001), as well as significant reductions in fasting insulin (16.7% reduction, P = 0.006), and leptin (37.1% reduction, P < 0.001). Significant improvements were also seen for quality of life domains including mood, body image, and sexuality. In conclusion, the intervention produced >10% weight loss as well as significant improvements across multiple endpoints. The group phone-based treatment delivery approach may help disseminate effective weight control intervention to hard-to-reach breast cancer survivors.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 1008, Kansas City, KS 66160, USA. cbefort@kumc.edu
authors.forename: Christie A
authors.initials: CA
authors.lastname: Befort
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Klemp
authors.forename: Heather L
authors.initials: HL
authors.lastname: Austin
authors.forename: Michael G
authors.initials: MG
authors.lastname: Perri
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Schmitz
authors.forename: Debra K
authors.initials: DK
authors.lastname: Sullivan
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Fabian
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000401:mortality / Q000628:therapy*; D031204:Caloric Restriction; D005081:Exercise Therapy; D005260:Female; D006126:Group Processes; D006801:Humans; D007328:Insulin / Q000097:blood; D007615:Kansas / Q000453:epidemiology; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000178:diet therapy / Q000401:mortality / Q000628:therapy*; D011788:Quality of Life; D019114:Remote Consultation; D019035:Rural Health Services; D011795:Surveys and Questionnaires; D017741:Survivors; D013689:Telephone; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D007328:Insulin; D020738:Leptin