title: Randomized Trial Comparing Telephone Versus In-Person Weight Loss Counseling on Body Composition and Circulating Biomarkers in Women Treated for Breast Cancer: The Lifestyle, Exercise, and Nutrition (LEAN) Study.
abstract: OBJECTIVE
  Obesity is associated with a higher risk of breast cancer mortality. The gold standard approach to weight loss is in-person counseling, but telephone counseling may be more feasible. We examined the effect of in-person versus telephone weight loss counseling versus usual care on 6-month changes in body composition, physical activity, diet, and serum biomarkers.
  
  
  METHODS
  One hundred breast cancer survivors with a body mass index ≥ 25 kg/m(2) were randomly assigned to in-person counseling (n = 33), telephone counseling (n = 34), or usual care (UC) (n = 33). In-person and telephone counseling included 11 30-minute counseling sessions over 6 months. These focused on reducing caloric intake, increasing physical activity, and behavioral therapy. Body composition, physical activity, diet, and serum biomarkers were measured at baseline and 6 months.
  
  
  RESULTS
  The mean age of participants was 59 ± 7.5 years old, with a mean BMI of 33.1 ± 6.6 kg/m(2), and the mean time from diagnosis was 2.9 ± 2.1 years. Fifty-one percent of the participants had stage I breast cancer. Average 6-month weight loss was 6.4%, 5.4%, and 2.0% for in-person, telephone, and UC groups, respectively (P = .004, P = .009, and P = .46 comparing in-person with UC, telephone with UC, and in-person with telephone, respectively). A significant 30% decrease in C-reactive protein levels was observed among women randomly assigned to the combined weight loss intervention groups compared with a 1% decrease among women randomly assigned to UC (P = .05).
  
  
  CONCLUSIONS
  Both in-person and telephone counseling were effective weight loss strategies, with favorable effects on C-reactive protein levels. Our findings may help guide the incorporation of weight loss counseling into breast cancer treatment and care.
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD.
authors.forename: Maura
authors.initials: M
authors.lastname: Harrigan
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD.
authors.forename: Brenda
authors.initials: B
authors.lastname: Cartmel
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD.
authors.forename: Erikka
authors.initials: E
authors.lastname: Loftfield
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD.
authors.forename: Tara
authors.initials: T
authors.lastname: Sanft
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD.
authors.forename: Anees B
authors.initials: AB
authors.lastname: Chagpar
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD.
authors.forename: Mary
authors.initials: M
authors.lastname: Playdon
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD.
authors.forename: Fangyong
authors.initials: F
authors.lastname: Li
authors.affiliation: Maura Harrigan, Brenda Cartmel, Erikka Loftfield, Tara Sanft, Anees B. Chagpar, Yang Zhou, Mary Playdon, Fangyong Li, and Melinda L. Irwin, Yale University; Brenda Cartmel, Tara Sanft, Anees B. Chagpar, Yang Zhou, Fangyong Li, and Melinda L. Irwin, Yale Cancer Center, New Haven, CT; and Erikka Loftfield and Mary Playdon, National Cancer Institute, Bethesda, MD. melinda.irwin@yale.edu.
authors.forename: Melinda L
authors.initials: ML
authors.lastname: Irwin
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001823:Body Composition; D001943:Breast Neoplasms / Q000401:mortality* / Q000628:therapy; D003376:Counseling / Q000379:methods*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000401:mortality / Q000517:prevention & control*; D017741:Survivors; D013689:Telephone; D015431:Weight Loss
chemical_list: D014408:Biomarkers, Tumor