title: Daughters and Mothers Against Breast Cancer (DAMES): main outcomes of a randomized controlled trial of weight loss in overweight mothers with breast cancer and their overweight daughters.
abstract: BACKGROUND
  Few studies to date have used the cancer diagnosis as a teachable moment to promote healthy behavior changes in survivors of cancer and their family members. Given the role of obesity in the primary and tertiary prevention of breast cancer, the authors explored the feasibility of a mother-daughter weight loss intervention.
  
  
  METHODS
  A randomized controlled trial of a mailed weight loss intervention was undertaken among 68 mother-daughter dyads (n = 136), each comprised of a survivor of breast cancer (AJCC stage 0-III) and her adult biological daughter. All women had body mass indices ≥ 25 kg/m(2) and underwent in-person assessments at baseline, 6 months, and 12 months, with accelerometry and exercise capacity performed on a subset of individuals. All women received a personalized workbook and 6 newsletters over a 1-year period that promoted weight loss; exercise; and a nutrient-rich, low-energy density diet. A total of 25 dyads received individually tailored instruction (individual), 25 dyads received team-tailored instruction (TEAM), and 18 dyads received standardized brochures (control).
  
  
  RESULTS
  The trial met its accrual target, experienced 90% retention, and caused no serious adverse events. Significant differences in baseline to 12-month changes were observed between individual versus control mothers for body mass index, weight, and waist circumference (WC); significant differences also were observed in the WC of corresponding daughters (P < .05). Significant differences were found between individual versus control and team versus control dyads for WC (P = .0002 and .018, respectively), minutes per week of physical activity (P = .031 and .036, respectively), and exercise capacity (P = .047 for both).
  
  
  CONCLUSIONS
  Significant improvements in lifestyle behaviors and health outcomes are possible with tailored print interventions directed toward survivors of cancer and their family members. For greater impact, more research is needed to expand this work beyond the mother-daughter dyad.
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas; Duke University School of Nursing, Durham, North Carolina.
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
authors.forename: Denise C
authors.initials: DC
authors.lastname: Snyder
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Sloane
authors.forename: Gretchen G
authors.initials: GG
authors.lastname: Kimmick
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Hughes
authors.forename: Hoda J
authors.initials: HJ
authors.lastname: Badr
authors.forename: Paige E
authors.initials: PE
authors.lastname: Miller
authors.forename: Lora E
authors.initials: LE
authors.lastname: Burke
authors.forename: Isaac M
authors.initials: IM
authors.lastname: Lipkus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000150:complications / Q000628:therapy*; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D009035:Mothers; D009679:Nuclear Family; D009765:Obesity / Q000150:complications / Q000628:therapy*; D017741:Survivors; D015431:Weight Loss
keywords: breast neoplasms; diet; exercise; intervention studies; obesity; survivors; weight loss