Introduction
For women with an increased breast cancer risk, reducing excess weight and increasing
physical activity are believed to be important approaches for reducing their risk.
This study tested a weight loss intervention that combined commercially available
technology-based self-monitoring tools with individualized phone calls.
Design
Women were randomized to a weight loss intervention arm (n=36) or a usual care arm
(n=18).
Setting/Participants
Participants were women with a BMI ≥ 27.5 kg/m2 and elevated breast cancer risk recruited from the mammography clinic at the Moores
Cancer Center at the University of California San Diego.
Intervention
Intervention participants used the MyFitnessPal website and phone app to monitor diet
and a Fitbit to monitor physical activity. Participants received 12 standardized coaching
calls with trained counselors over 6 months. Usual care participants received the
U.S. Dietary Guidelines for Americans at baseline and two brief calls over the 6 months.
Main outcome measures
Weight and accelerometer-measured physical activity were assessed at baseline and
6 months. Data were collected in San Diego, CA, from 2012 to 2014 and analyzed in
2015.
Results
Participants (n=54) had a mean age of 59.5 (SD=5.6) years, BMI of 31.9 (SD=3.5), and a mean Gail
Model score of 2.5 (SD=1.4). At 6 months, intervention participants had lost significantly
more weight (4.4 kg vs 0.8 kg, p=0.004) and a greater percentage of starting weight (5.3% vs 1.0%, p=0.005) than usual care participants. Across arms, greater increases in moderate-to-vigorous
physical activity resulted in greater weight loss (p=0.01).
Conclusions
Combining technology-based self-monitoring tools with phone counseling supported weight
loss over 6 months in women at increased risk for breast cancer.
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References
- Cancer Facts & Figures 2015.American Cancer Society, Atlanta, GA2015
- Overweight, obesity, and postmenopausal invasive breast cancer risk: a secondary analysis of the Women’s Health Initiative Randomized Clinical Trials.JAMA Oncol. 2015; 1: 611-621https://doi.org/10.1001/jamaoncol.2015.1546
- Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis.Breast Cancer Res Treat. 2010; 123: 641-649https://doi.org/10.1007/s10549-010-1116-4
- Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status—a meta-analysis.Int J Cancer. 2009; 124: 698-712https://doi.org/10.1002/ijc.23943
- Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.Lancet. 2008; 371: 569-578https://doi.org/10.1016/S0140-6736(08)60269-X
- Physical activity and risk of breast cancer: a meta-analysis of prospective studies.Breast Cancer Res Treat. 2013; 137: 869-882https://doi.org/10.1007/s10549-012-2396-7
- Behavioral risk factors in breast cancer: can risk be modified?.Oncologist. 2003; 8: 326-334https://doi.org/10.1634/theoncologist.8-4-326
- The interactions of obesity, inflammation and insulin resistance in breast cancer..Cancers (Basel). 2015; 7: 2147-2168https://doi.org/10.3390/cancers7040883
- eHealth interventions for the prevention and treatment of overweight and obesity in adults: a systematic review with meta-analysis.Obes Rev. 2015; 16: 376-392https://doi.org/10.1111/obr.12268
- Self-monitoring in weight loss: a systematic review of the literature.J Am Diet Assoc. 2011; 111: 92-102https://doi.org/10.1016/j.jada.2010.10.008
- Adherence and weight loss outcomes associated with food-exercise diary preference in a military weight management program.Eat Behav. 2009; 10: 220-227https://doi.org/10.1016/j.eatbeh.2009.07.004
- A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an Internet weight loss program.Arch Intern Med. 2006; 166: 1620-1625https://doi.org/10.1001/archinte.166.15.1620
- Using Internet technology to deliver a behavioral weight loss program.JAMA. 2001; 285: 1172-1177https://doi.org/10.1001/jama.285.9.1172
- CONSORT-EHEALTH: improving and standardizing evaluation reports of web-based and mobile health interventions.J Med Internet Res. 2011; 13: e126https://doi.org/10.2196/jmir.1923
- Dietary self-monitoring, but not dietary quality, improves with use of smartphone app technology in an 8-week weight loss trial.J Nutr Educ Behav. 2014; 46: 440-444https://doi.org/10.1016/j.jneb.2014.04.291
- Effectiveness of a smartphone application for weight loss compared with usual care in overweight primary care patients: a randomized, controlled trial.Ann Intern Med. 2014; 161: S5-S12https://doi.org/10.7326/M13-3005
- Projecting individualized probabilities of developing breast cancer for white females who are being examined annually.J Natl Cancer Inst. 1989; 81: 1879-1886https://doi.org/10.1093/jnci/81.24.1879
- Projecting individualized absolute invasive breast cancer risk in African American women.J Natl Cancer Inst. 2007; 99: 1782-1792https://doi.org/10.1093/jnci/djm223
- Achieving substantial changes in eating behavior among women previously treated for breast cancer—an overview of the intervention.J Am Diet Assoc. 2005; 105 (quiz 488. http://dx.doi.org/10.1016/j.jada.2004.12.008): 382-391
- Timing of dietary change in response to a telephone counseling intervention: evidence from the WHEL study.Health Psychol. 2008; 27: 539-547https://doi.org/10.1037/0278-6133.27.5.539
- Telephone counseling helps maintain long-term adherence to a high-vegetable dietary pattern.J Nutr. 2007; 137: 2291-2296
- Web-based self-monitoring for weight loss among overweight/obese women at increased risk for breast cancer: the HELP pilot study.Psychooncology. 2013; 22: 1821-1828https://doi.org/10.1002/pon.3219
- Social Foundations of Thought and Action: A Social Cognitive Theory.Prentice Hall, Englewood Cliffs, NJ1986
- Calibration of the Computer Science and Applications, Inc. accelerometer.Med Sci Sports Exerc. 1998; 30: 777-781https://doi.org/10.1097/00005768-199805000-00021
- Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa women’s health study.Cancer Epidemiol Biomarkers Prev. 2005; 14: 656-661https://doi.org/10.1158/1055-9965.EPI-04-0001
- Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes.Diabetes Care. 2011; 34: 1481-1486https://doi.org/10.2337/dc10-2415
- Executive summary: Guidelines (2013) for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society published by the Obesity Society and American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Based on a systematic review from the The Obesity Expert Panel, 2013.Obesity (Silver Spring). 2014; 22: S5-S39
- Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons.J Acad Nutr Diet. 2014; 114: 1557-1568https://doi.org/10.1016/j.jand.2014.07.005
- Technology-assisted weight loss interventions in primary care: a systematic review.J Gen Intern Med. 2015; 30: 107-117https://doi.org/10.1007/s11606-014-2987-6
- Using mHealth technology to enhance self-monitoring for weight loss: a randomized trial.Am J Prev Med. 2012; 43: 20-26https://doi.org/10.1016/j.amepre.2012.03.016
- Dietary assessment and self-monitoring with nutrition applications for mobile devices.Can J Diet Pract Res. 2012; 73: e253-e260https://doi.org/10.3148/73.3.2012.e253
Article Info
Publication History
Published online: September 01, 2016
Identification
Copyright
© 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
