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
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
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DOI：
10.1200/jco.2015.61.6375
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发表时间：
2016-03-01
影响因子：
45.3
通讯作者：
Irwin, Melinda L.
中科院分区：
文献类型：
--
作者：
Harrigan, Maura;Cartmel, Brenda;Irwin, Melinda L.
肥胖与乳腺癌死亡率的高风险相关。减肥的金标准方法是面对面的咨询，但电话咨询可能更可行。我们研究了面对面与电话减肥咨询与常规护理对6个月内身体成分、体力活动、饮食和血清生物标志物变化的影响。方法将100名体重指数>= 25 kg/m2的乳腺癌幸存者随机分为面对面咨询组（n = 33）、电话咨询组（n = 34）和常规护理组（n = 33）。面对面和电话咨询包括11个30分钟的咨询会议超过6个月。这些措施集中在减少热量摄入，增加体力活动和行为治疗。结果参与者的平均年龄为59 +/- 7.5岁，平均BMI为33.1 +/- 6.6 kg/m2，平均诊断时间为2.9 +/- 2.1年。51%的参与者患有I期乳腺癌。面对面、电话和UC组的平均6个月体重减轻分别为6.4%、5.4%和2.0%（分别比较面对面与UC、电话与UC和面对面与电话）。一个显着的30%的C-反应蛋白水平下降，观察妇女随机分配到联合减肥干预组相比，减少1%的妇女随机分配到UC（P = 0.05）。我们的研究结果可能有助于指导将减肥咨询纳入乳腺癌治疗和护理。(C)2015年美国临床肿瘤学会
PurposeObesity 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.MethodsOne 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.ResultsThe 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).ConclusionBoth 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. (C) 2015 by American Society of Clinical Oncology