Promoting weight loss through diet and exercise in overweight women with breast cancer

ISRCTN ISRCTN53325751
DOI https://doi.org/10.1186/ISRCTN53325751
Secondary identifying numbers IEO-0244
Submission date
29/09/2015
Registration date
16/10/2015
Last edited
19/02/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Being overweight or obese puts you at a higher risk for health problems such as heart disease, stroke, high blood pressure and diabetes, and is also associated with an increased risk of developing many forms of cancer, including breast cancer. There is also evidence that being overweight increases the risk of recurrence and death in patients diagnosed with breast cancer. We think that diet and/or exercise counseling could help overweight or obese breast cancer patients to lose weight, which could in turn improve their quality of life and general health status, and in the long term reduce the risk of breast cancer recurrence. We aim to find out about the effects of 6 months of counseling focused on weight loss in a group of overweight or obese women previously treated for early breast cancer. The counseling is designed to promote a healthy diet or/and to increase exercise and decrease sedentary (sitting) time.

Who can participate?
Breast cancer patients aged 18 or older who are overweight or obese.

What does the study involve?
Participant are randomly allocated to one of four groups: diet counseling, exercise counseling, both diet and exercise counseling, or minimal counseling. Women allocated to the diet and/or exercise counseling groups are offered individual counseling consisting of face-to face contact, group meetings, motivational phone calls and information pamphlets. Participants are given a pedometer device (wrist band) in order to monitor their physical activity and sedentary time. Diet, quality of life, health status and participants' anxiety are assessed with questionnaires. Blood samples are collected at the start of the study and follow-up visits.

What are the possible benefits and risks of participating?
The expected result is weight loss in any of the diet or physical activity groups. Other expected long-term results include long-term weight control, increased physical fitness, increased physical activity, reduced sedentary time, healthier diet, improved health status and quality of life. We do not foresee any serious side effects. However, if participants will experience side effects, this will be reported immediately to the attention of the clinical staff. All participants will be monitored to prevent any possible deficiency or inadequate nutrient and/or calorie intake by evaluating their dietary intake. Participants will also be monitored for injuries or problems associated with the increased physical activity.

Where is the study run from?
European Institute of Oncology (IEO), Milan, Italy

When is the study starting and how long is it expected to run for?
March 2014 to June 2019

Who is funding the study?
The Italian Association for Cancer Research (Associazione Italiana per la Ricerca sul Cancro [AIRC]) (Italy)

Who is the main contact?
1. Patrick Maisonnevue (public)
2. Patrizia Gnagnarella (scientific)

Contact information

Dr Patrizia Gnagnarella
Public

European Institute of Oncology
Division of Epidemiology and Biostatistics
Via Adamello, 6
Milan
20139
Italy

ORCiD logoORCID ID 0000-0002-0560-4706
Dr Patrick Maisonneuve
Scientific

European Institute of Oncology
Division of Epidemiology and Biostatistics
Via Adamello, 6
Milan
20139
Italy

Study information

Study designMono-institutional randomized controlled four-arm parallel-group trial
Primary study designInterventional
Secondary study designRandomised parallel trial
Study setting(s)Hospital
Study typePrevention
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titlePromoting weight loss through diet and exercise in overweight women with breast cancer: a four-arm randomized trial - InForma study
Study acronymInForma
Study hypothesisWe hypothesized that individual dietary and/or exercise counseling could help overweight or obese breast cancer patients to lose weight, which could in turn improve their hormonal status, quality of life and general health status, and at long term limit their risk of developing breast cancer recurrence.
Ethics approval(s)Ethical Committee of the European Institute of Oncology, 01/04/2015 , ref: n. R233/15 –IEO 244
ConditionOverweight or obese breast cancer patients
InterventionWe will randomize overweight or obese patients into four intervention arms:
1. Dietary Intervention (DI)
2. Physical Activity Intervention (PAI)
3. Physical Activity And Dietary Intervention (PADI)
4. Less Intensive Intervention (LII)

Women allocated to the dietary intervention and/or physical activity intervention arms will be offered an individualized dietary and/or physical activity counseling consisting of face-to face contacts, group meetings, motivational phone calls and information pamphlets. All participants will be given a pedometer device (wrist band) in order to monitor (in the two physical activity arms) participants’ physical activity and sedentary time. Dietary intake for all participants will be repeatedly assessed with validated food frequency questionnaires. Quality of life, health status and participants' anxiety will be assessed with self-administered questionnaires including FACT-B and the State-Trait Anxiety Inventory (STAI) questionnaires. Blood samples will be collected at baseline and follow-up visit to assess glucose, insulin, lipid and hormone profile. Women allocated to the less intensive intervention (or minimal counseling) arm will be considered as control group.

Participants will be followed up for a further 18 months and outcome assessments will be made at 12 and 24 months.
Intervention typeBehavioural
Primary outcome measureChange in body weight (weight loss ≥5% of the baseline body weight) at the end of the 6-month intervention
Secondary outcome measuresThe secondary outcome measures will be assessed along intervention including:
1. Maintain long-term weight control, measured at baseline, 6 months, 12 months and 24 months
2. Increase physical activity levels and reduce physical inactivity from baseline, measured at baseline, 6 months, 12 months and 24 months
3. Change in dietary intake (increase adherence to healthy diet from baseline), measured at baseline, 6 months and 24 months
4. Evaluate the effect of intervention on long-term breast cancer recurrence
5. Change in health status and quality of life, measured at baseline, 6 months, 12 months and 24 months
6. Evaluate the effect of intervention on blood lipid profile (total cholesterol, LDL and HDL cholesterol, triglycerides), measured at baseline, 6 months and 24 months
7. Evaluate the effect of intervention on biomarkers (estradiol, C-reactive protein (CRP), insulin, glucose), measured at baseline, 6 months and 24 months
Overall study start date01/03/2014
Overall study end date30/06/2019

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participants260
Total final enrolment266
Participant inclusion criteria1. Women aged 18 or older
2. Written informed consent obtained
3. Willing to be randomized to either group
4. Histological breast cancer diagnosis
5. BMI comprised between 25 and 40 kg/m2
6. Within one year/6 months of completion of main cancer treatment
7. Willing to wear the wrist-based activity monitor during the 6-month study period
Participant exclusion criteria1. Unable to find transportation to the study location over the study period
2. Plan to move away from Lombardy or to be out of town for more than 3 weeks during the study period
3. Investigator does not approve participation in the study in case of:
3.1. History of heart condition, stroke, chest pain during activity or rest
3.2. Severe hypertension
3.3. Patient is unable to walk for exercise (self-report)
3.4. Symptoms of alcohol or substance dependence
3.5. Recent hip fracture, hip or knee replacement, spinal surgery or other orthopedic complications that would prevent optimal participation in the physical activities prescribed
4. Any other severe medical condition or advanced age impeding the patient to adhere at the planned study follow-up period
5. Participant already participates to a physical activity or diet intervention trial
6. Participant currently uses an activity monitor device
Recruitment start date01/10/2015
Recruitment end date01/10/2016

Locations

Countries of recruitment

  • Italy

Study participating centre

European Institute of Oncology
Via Ripamonti, 435
Milan
20141
Italy

Sponsor information

European Institute of Oncology (Italy)
Research organisation

Via Ripamonti, 435
Milan
20141
Italy

Website http://www.ieo.it/
ROR logo "ROR" https://ror.org/02vr0ne26

Funders

Funder type

Research organisation

Associazione Italiana per la Ricerca sul Cancro
Private sector organisation / Associations and societies (private and public)
Alternative name(s)
Italian Association for Cancer Research, The Italian Association for Cancer Research, AIRC
Location
Italy

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination plan1. Protocol publication in a international peer-reviewed journal
2. The results will be presented in national and international scientific meetings
2. Publication in national journals and international peer-reviewed journals
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 28/07/2016 Yes No
Basic results 19/02/2020 19/02/2020 No No

Additional files

ISRCTN53325751_BasicResults_19Feb2020.docx
Uploaded 19/02/2020

Editorial Notes

18/02/2020: The following changes have been made:
1. The overall trial end date has been changed from 31/12/2018 to 30/06/2019 and the plain English summary has been updated to reflect this change.
2. The total final enrolment number has been added.
3. The basic results of this trial have been uploaded as an additional file.
29/07/2016: Publication reference added.