RESUMO
PURPOSE: Half of adult cancer survivors under age 50 years are obese. Excess body weight is associated with cancer recurrence, and effective weight loss interventions for younger cancer survivors are needed. Commercially available, online weight loss programmes are readily accessible, but few have been studied in this population. This study employed a single-arm, pre-post intervention (baseline-6 month/baseline-12 month comparisons) to preliminarily explore feasibility, efficacy and safety of an online, commercially available weight loss programme in breast (n = 30) and testicular (n = 16) cancer survivors under age 50 years. METHODS: The intervention included three daily components: exercise, nutritional/behavioural modification strategies and health lessons. Intention-to-treat and completers analyses were conducted. Feasibility was measured by participation (number of participants enrolled/number screened), retention (number of participants attending 6/12 month study visit/number of enrolled) and self-reported adherence rates (average of mean percent adherence to each of the three intervention components). Efficacy was assessed by changes in initial weight (percent weight loss). Safety was assessed by adverse events. RESULTS: The mean participation rate was 42%. The retention rate was 59% at 6 and 49% at 12 months. The adherence rate for all participants (completers/dropouts/lost-to-follow-up) was 50.1% at 6 and 44% at 12 months. Completers reported adherence rates of 68% at 12 months. Study participants lost 5.3% body weight at 12 months; completers lost 9%. Only three unexpected adverse events (unrelated to the intervention) were reported. CONCLUSION: Clinically significant weight loss was observed, although retention rates were low. Findings generally support preliminary feasibility, efficacy and safety of this online weight loss programme, and future randomized control trials should be explored.
RESUMO
The aim of this pilot study was to examine if a personalized web-based multi-platform nutrition, exercise, and lifestyle coaching program, supported weight loss and the reduction of chronic disease risk factors in overweight or obese women. Twenty-eight women completed the program, which represented 50% of those who provided baseline data. The program consisted of a one-year curriculum with daily exercise, nutritional habits, and health behaviour lessons along with access to a one-on-one coach. The workouts, habits, and lessons were available via computer, tablet, and mobile device which, along with coaching, facilitated self-monitoring and accountability. At baseline and 12-months, weight, waist circumference, fat mass, muscle mass, blood pressure, total cholesterol, low density lipoproteins, high density lipoproteins, triglycerides, C reactive protein, and fasting glucose were collected. Over the 12 months, women who completed the program, (average age 49.64 (SD 10.99) years), lost 16.52 (SD 13.63) lbs (P < 0.001), and reduced waist circumference by 3.56 (SD 2.31) in (P < 0.0001). Diastolic blood pressure decreased by 3.77 (SD 7.25) mm Hg (P = 0.02) and high density lipoproteins increased by 0.16 (SD 0.28) mmol/L (P = 0.01). No other risk factors changed significantly. Compliance was a significant predictor of weight loss (P < 0.01). In conclusion, women who completed the web-based program experienced significant weight loss (8.62% of initial body weight) coming predominantly from body fat. Chronic disease risk factors also improved.