Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial: A Behavioral Weight Loss Intervention in Overweight or Obese Breast Cancer Survivors

Purpose Obesity increases risk for all-cause and breast cancer mortality and comorbidities in women who have been diagnosed and treated for breast cancer. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is the largest weight loss intervention trial among survivors of breast cancer to date. Methods In this multicenter trial, 692 overweight/obese women who were, on average, 2 years since primary treatment for early-stage breast cancer were randomly assigned to either a group-based behavioral intervention, supplemented with telephone counseling and tailored newsletters, to support weight loss or a less intensive control intervention and observed for 2 years. Weight and blood pressure were measured at 6, 12, 18, and 24 months. Longitudinal mixed models were used to analyze change over time. Results At 12 months, mean weight loss was 6.0% of initial weight in the intervention group and 1.5% in the control group (P < .001). At 24 months, mean weight loss in the intervention and control groups was 3.7% and 1.3%, respectively (P < .001). Favorable effects of the intervention on physical activity and blood pressure were observed. The weight loss intervention was more effective among women older than 55 years than among younger women. Conclusion A behavioral weight loss intervention can lead to clinically meaningful weight loss in overweight/obese survivors of breast cancer. These findings support the need to conduct additional studies to test methods that support sustained weight loss and to examine the potential benefit of intentional weight loss on breast cancer recurrence and survival.

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Results of the exercise and nutrition to enhance recovery and good health for you (ENERGY) trial: A behavioral weight loss intervention in overweight or obese breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.15_suppl.9506 ◽

2015 ◽

Vol 33 (15_suppl) ◽

pp. 9506-9506

Author(s):

Cheryl L Rock ◽

Shirley Flatt ◽

Tim Byers ◽

Graham A. Colditz ◽

Wendy Demark-Wahnefried ◽

...

Keyword(s):

Breast Cancer ◽

Weight Loss ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Good Health ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Abstract MP27: Cellphone Intervention for You (CITY): A Randomized, Controlled Trial of Behavioral Weight Loss Intervention by Cellphone or Personal Coaching for Young Adults

Circulation ◽

10.1161/circ.131.suppl_1.mp27 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Laura P Svetkey ◽

Stephen S Intille ◽

Bryan C Batch ◽

Leonor Corsino ◽

Crystal C Tyson ◽

...

Keyword(s):

Weight Loss ◽

Young Adults ◽

Controlled Trial ◽

Personal Contact ◽

Control Group ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

National Guidelines ◽

Personal Coaching ◽

Behavioral Weight Loss Intervention

Background: Obesity affects young adults, leading to future morbidity and mortality. Early behavioral intervention may promote long-term weight control. Mobile technology-based (mHealth) interventions may be particularly effective in young adults. We compared both an mHealth behavioral weight loss intervention and a personal coaching weight loss intervention to no intervention (and to each other) in overweight/obese young adults. Methods: We randomized 365 generally healthy adults age 18-35 years with BMI > 25 kg/m2 (overweight or obese) to 24-months of intervention delivered primarily via investigator-designed cell phone (CP) or intervention delivered primarily via in-person (6 weekly) and by phone (23 monthly) coaching (PC), compared to usual care control group (Control). Primary outcome was weight change from baseline to 24 months. This study was conducted as part of the Early Adult Reduction of weight through LifestYle (EARLY) cooperative trials. Results: Randomized participants (N=365) had mean BMI 35 kg/m2, mean age 29yrs, were 70% women, 36% African American, 6% Latino. Final weight was obtained in 86%; missing weight was multiply imputed. At 24 months, weight loss was not different in either PC or CP vs Control (see Figure). Weight loss in PC was significantly greater than Control at 6 months. From baseline to 24 months, clinically significant weight loss (> 3% per national guidelines) occurred in 40% of PC, 34% of CP, and 30% of Control. Conclusions: mHealth alone may not be sufficient for weight loss in young adults but mHealth-enhanced contact with an interventionist has a modest short-term effect. Future interventions should maximize the complementarity of mHealth and personal contact to achieve larger and more sustained effect.

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Effectiveness of an Internet Delivered Behavioral Weight Loss Intervention Provided to Breast Cancer Survivors

Advances in Obesity Weight Management & Control ◽

10.15406/aowmc.2015.02.00021 ◽

2015 ◽

Vol 2 (3) ◽

Cited By ~ 1

Author(s):

Kim Dittus L

Keyword(s):

Breast Cancer ◽

Weight Loss ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Effects of Pistachio Consumption in a Behavioral Weight Loss Intervention on Weight Change, Cardiometabolic Factors, and Dietary Intake

Nutrients ◽

10.3390/nu12072155 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2155

Author(s):

Cheryl L. Rock ◽

Elizabeth Zunshine ◽

Huong Thien Nguyen ◽

Annemarie O. Perez ◽

Christine Zoumas ◽

...

Keyword(s):

Body Mass Index ◽

Weight Loss ◽

Waist Circumference ◽

Time Effect ◽

Control Group ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Obese Adults ◽

Behavioral Weight Loss Intervention ◽

Cardiometabolic Factors

Epidemiological studies have linked regular nut consumption with lower body mass index and reduced likelihood of weight gain in adulthood. Nuts can displace other foods in the diet, and thus, promote a healthier dietary pattern. The purpose of this study was to examine the effect of pistachio nut consumption in overweight/obese adults. This randomized controlled study enrolled non-diabetic overweight/obese adults (n = 100) assigned to a 4-month behavioral weight loss intervention only group (controls) or also prescribed 1.5 oz/day (42 g/day) of pistachios (pistachio group). Outcomes were change in body weight, cardiometabolic factors, and dietary intake. Percent weight change was similar in the two groups (−5.1 [0.5] (mean [SE])% in the control group and −4.9 [0.6]% in the pistachio group, and body mass index (BMI) and waist circumference were reduced in both groups (time effect p ≤ 0.05). The pistachio group (but not the control group) exhibited a significant reduction in both systolic and diastolic blood pressure (time effect p = 0.01). Plasma alpha-carotene, beta-carotene, and lutein concentrations increased significantly in the pistachio group (time effect p < 0.05). Pistachio consumption was associated with increased dietary fiber intake and decreased consumption of sweets. Regular consumption of pistachios was associated with a comparable degree of weight loss, and similar reductions in BMI and waist circumference, in overweight/obese men and women compared to controls, and favorable changes in the diet, in the context of a behavioral weight loss intervention.

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Impact of a behavioral weight loss intervention on comorbidities in overweight and obese breast cancer survivors

Supportive Care in Cancer ◽

10.1007/s00520-016-3141-2 ◽

2016 ◽

Vol 24 (8) ◽

pp. 3285-3293 ◽

Cited By ~ 2

Author(s):

Rebecca L. Sedjo ◽

Shirley W. Flatt ◽

Tim Byers ◽

Graham A. Colditz ◽

Wendy Demark-Wahnefried ◽

...

Keyword(s):

Breast Cancer ◽

Weight Loss ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Psychological and behavioral pathways between perceived stress and weight change in a behavioral weight loss intervention

Journal of Behavioral Medicine ◽

10.1007/s10865-021-00231-z ◽

2021 ◽

Author(s):

Kristine Molina ◽

Monica L. Baskin ◽

Dustin Long ◽

Tiffany L. Carson

Keyword(s):

Weight Loss ◽

Perceived Stress ◽

Weight Change ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Abstract P249: A Behavioral Weight Loss Intervention is Effective for Change in CVD Risk Factors in Young Adults: The IDEA Study

Circulation ◽

10.1161/circ.131.suppl_1.p249 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

John M Jakicic ◽

Kelliann K Davis ◽

Bethany Barone Gibbs ◽

Diane Helsel ◽

Wendy C King ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Weight Loss ◽

Young Adults ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

Introduction: Few studies have examined behavioral weight loss interventions with respect to change in cardiovascular disease risk factors in young adults (aged 18 to 35 years). Hypothesis: We tested the hypothesis that a 6 month behavioral weight loss intervention resulted in significant improvements in selective cardiovascular disease risk factors in young adults. Methods: Data are presented as median [25 th , 75 th percentiles]. 470 participants (age: 30.9 [27.8, 33.7] years); BMI: 31.2 [28.4, 34.3] kg/m 2 ) were enrolled in a 6 month behavioral weight loss intervention that included weekly group sessions and prescribed an energy restricted diet and moderate-to-vigorous physical activity. Assessments included weight using a standardized protocol, resting blood pressure, and fasting lipids, glucose, and insulin. Statistical significance of change was according to tests of symmetry or the Wilcoxon matched pairs signed ranks test. Results: The primary outcome (weight) was available for 424 of the 470 participants (90.2%). Weight significantly decreased (-7.8 kg [-12.2, -3.7]) (p<0.0001). Systolic (-4.0 mmHg [-8.5, 0.5] and diastolic blood pressure (-3.0 mmHg [-6.5, 1.0]) decreased (p<0.0001). Total cholesterol (-13 mg/dl [-28.0, 2.0]), LDL cholesterol (-9.5 mg/dl [-21.7, 2.0]), triglycerides (-8.5 mg/dl [-44.0, 9.0]), glucose (-4.0 mg/dl [-8.0, 1.0]), and insulin (-2.6 mIU/L [-5.9, 0.7]) decreased (p<0.0001, n=416). There was not a significant change in HDL cholesterol (p=0.72). Conclusions: In conclusion, after 6 months, weight loss was observed in young adults assigned to this behavioral intervention that focused on physical activity and diet modification. They tended to also have improved cardiovascular disease risk factors. This may demonstrate an approach to reducing cardiovascular disease risk in young adults. Supported by NIH (U01HL096770) and AHA (12BGIA9410032)

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