title: Commercially available lifestyle modification program: randomized controlled trial addressing heart and bone health in BRCA1/2+ breast cancer survivors after risk-reducing salpingo-oophorectomy.
abstract: The goal of this RCT was to examine the efficacy and safety of a web-based program to improve cardiovascular and bone health outcomes, among 35 BRCA1/2+ breast cancer survivors who underwent prophylactic oophorectomy and thus experienced premature surgical menopause.
  
  
  
  A 12-month commercially available web-based lifestyle modification program (Precision Nutrition Coaching) was utilized. Cardiovascular fitness, dietary intake, leisure time activity, body composition, bone mineral density, bone structure, and muscle strength were assessed.
  
  
  
  Average adherence to all program components was 74.8 %. Women in the intervention group maintained their cardiovascular fitness level over the 12 months (1.1 ± 7.9 %), while the control group significantly decreased fitness capacity (-4.0 ± 7.5 %). There was a significant difference between groups in percent change of whole body bone area (-0.8 ± 2.5 control and 0.5 ± 1.30 intervention). We also observed decreased BMI (-4.7 ± 6.2 %) and fat mass (-8.6 ± 12.7 %) in the intervention group due to significant concomitant decreases in caloric intake and increases in caloric expenditure. The control group demonstrated decreased caloric intake and decreased lean tissue mass.
  
  
  
  In this population at high risk for detrimental cardiovascular and bone outcomes, a commercially available lifestyle intervention program mitigated a decline in cardiovascular health, improved bone health, and decreased weight through fat loss.
  
  
  
  Precision Nutrition Coaching has shown benefit in breast cancer survivors for reduced risk of deleterious cardiovascular and bone outcomes.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3440 Market St, Suite 440, Office 458, Philadelphia, PA, 19104, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Sturgeon
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3440 Market St, Suite 440, Office 458, Philadelphia, PA, 19104, USA.
authors.forename: Lorraine T
authors.initials: LT
authors.lastname: Dean
authors.affiliation: Precision Nutrition, Toronto, ON, Canada.
authors.forename: Mariane
authors.initials: M
authors.lastname: Heroux
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3440 Market St, Suite 440, Office 458, Philadelphia, PA, 19104, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kane
authors.affiliation: Precision Nutrition, Toronto, ON, Canada.
authors.forename: Toni
authors.initials: T
authors.lastname: Bauer
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3440 Market St, Suite 440, Office 458, Philadelphia, PA, 19104, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Palmer
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3440 Market St, Suite 440, Office 458, Philadelphia, PA, 19104, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Long
authors.affiliation: Fox Chase Cancer Center, Philadelphia, PA, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Lynch
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3440 Market St, Suite 440, Office 458, Philadelphia, PA, 19104, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Jacobs
authors.affiliation: Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
authors.affiliation: Stanford University, Stanford, CA, USA.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Leonard
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3440 Market St, Suite 440, Office 458, Philadelphia, PA, 19104, USA. kschmitz@phs.psu.edu.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Schmitz
mesh_terms: D000293:Adolescent; D000328:Adult; D024682:BRCA2 Protein / Q000378:metabolism*; D001521:Behavior Therapy / Q000379:methods*; D001943:Breast Neoplasms / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D010052:Ovariectomy / Q000379:methods*; D040242:Risk Reduction Behavior; D017741:Survivors; D044767:Ubiquitin-Protein Ligases / Q000378:metabolism*; D055815:Young Adult
chemical_list: D024682:BRCA2 Protein; C551750:BRCA2 protein, human; C111164:BRAP protein, human; D044767:Ubiquitin-Protein Ligases
keywords: BRCA1/2; Bone; Exercise; Heart; Neoplasm; Weight loss