Summary

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

Authors: Harrigan, M. et. al.

Source: J Clin Oncol. 2016 Mar 1;34(7): 669-676.

www.ncbi.nlm.nih.gov/pubmed/26598750

The American Cancer Society has provided specific guidelines about exercise and dietary habits following cancer treatment.  Weight loss in obese (body mass index equal to or greater than 24.9 kg/m²) cancer survivors is a key goal. The investigators in this study noted that more than 65% of breast cancer survivors are overweight or obese, and that fewer than 30% of them engage in recommended levels of physical activity. 

In-person counseling programs have shown effectiveness in helping patients achieve their weight loss goals.  However, for many, there is limited access to such programs.  Restricted time and transportation are frequent factors.  This study examined a novel approach to assisting breast cancer patients with their weight loss by using a telephone counseling program. A group of 100 women was fairly evenly split into three groups. One group received in-person weight loss counseling, one received telephone counseling and one group received usual care.  The counseling sessions were identical in number and length of time; they were conducted by experienced and certified dieticians. Participants also received a LEAN journal and guidebook. The patients receiving usual care received no personal counseling.  They were offered two standard weight management sessions as well as standard nutrition and physical activity brochures.

Outcome measures included weight, waist and hip circumference, physical activity, pedometer recordings, dietary intake and serum biomarkers. At six months, the in-person and telephone counseling patients had greater weight reduction than the usual care patients. This pattern was also noted for waist and hip circumference reduction. The reductions were greatest in the in-person counseling group. However, both counseling groups had significantly greater changes than the usual care group. All participants appeared to have persistence of these changes 6 months later — one year after the intervention. Women in both counseling groups had increased physical activity as measured by the pedometers, and they also had more favorable changes in the composition of their diets (i.e., less fat, more fiber).

There were also notable differences in several biomarkers that are associated with inflammation and obesity. These differences favored those receiving personal counseling and those who achieved significant weight loss.

This group summarized that, although in-person counseling is an effective method for weight loss, telephone counseling offered very comparable results and was more effective than standard care. This approach to survivor care may be something that both patients and providers can do with ease.