Effect of a Low-Calorie Diet and/or Exercise Program on Risk Factors for Developing Breast Cancer in Overweight or Obese Postmenopausal Women

NCT ID: NCT00470119

Last Updated: 2012-09-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

439 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-12-31

Study Completion Date

2010-02-28

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

RATIONALE: A low-calorie diet and/or exercise program may help lower an overweight or obese postmenopausal woman's risk of developing breast cancer. It is not yet known whether a low-calorie diet and/or exercise program are more effective than no diet or exercise program in lowering an overweight or obese postmenopausal woman's risk of developing breast cancer.

PURPOSE: This randomized clinical trial is studying the effect of a low-calorie diet and/or exercise program on risk factors for developing breast cancer compared with no diet or exercise program in overweight or obese postmenopausal women.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

OBJECTIVES:

Primary

* Compare the effects of a 1-year exercise intervention, reduced-calorie diet intervention, or a combined exercise and reduced-calorie diet intervention vs no intervention on serum estrone concentrations in overweight or obese postmenopausal women.

Secondary

* Compare the effects of these interventions on serum levels of estradiol and free estradiol in these participants.
* Compare the effects of these interventions on serum levels of testosterone and free testosterone in these participants.
* Compare the effects of these interventions on serum levels of sex hormone binding globulin in these participants.
* Compare the effects of these interventions on serum levels of insulin in these participants.
* Compare the effects of these interventions on serum levels of glucose in these participants.
* Compare the effects of these interventions on serum levels of c-peptide in these participants.
* Compare the effects of these interventions on serum levels of insulin-like growth factor I (IGF-1) in these participants.
* Compare the effects of these interventions on serum levels of insulin-like growth factor binding-protein-3 (IGFBP-3) in these participants.
* Compare the effects of these interventions on serum levels of c-reactive protein (CRP) in these participants.
* Compare the effects of these interventions on serum levels of serum amyloid protein A (SAA) in these participants.
* Compare the effects of these interventions on serum levels of interleukin-6 (IL-6) in these participants.
* Compare the effects of these interventions on serum levels of adiponectin in these participants.
* Compare the effects of these interventions on serum levels of leptin in these participants.
* Compare the effects of these interventions on serum levels of ghrelin in these participants.
* Compare the effects of these interventions on serum levels of Vitamin D in these participants.
* Compare the effects of these interventions on mammographic density in these participants.
* Compare the effects of these interventions on anthropometrics and body composition (i.e., weight, body mass index, total and percentage body fat, and waist and hip circumferences) in these participants.
* Compare the effects of these interventions on quality of life in these participants.
* Compare the effects of these interventions on numbers of leukocytes and neutrophiles in these participants.
* Compare the effects of these interventions on VO2max in these participants.

OUTLINE: This is a randomized study. Participants are stratified according to body mass index (\< 30 vs ≥ 30). Participants are randomized to 1 of 4 intervention arms.

* Arm I (exercise program): Participants exercise 3 days per week under the supervision of a physiologist and 2 days per week independently at home, for a total of 5 exercise sessions (at least 45 minutes of moderate-intensity exercise per session) weekly over 12 months.
* Arm II (reduced-calorie diet): Participants meet with a nutritionist individually and in small groups. Participants receive general information about diet and behavior strategies such as self-monitoring, goal-setting, stimulus-control, problem-solving, and relapse-prevention training. Participants learn to set a calorie goal and a fat gram goal and how to achieve the goal calorie reduction. Meetings are held weekly during the first 6 months of the diet program but taper off over the course of the study.
* Arm III (exercise program and reduced-calorie diet): Participants meet with a physiologist and a nutritionist, as in arms I and II, and exercise and diet accordingly.
* Arm IV (control: delayed diet and exercise): Participants receive study materials on healthy diet and exercise at the end of the 12-month study period. In addition, participants are offered 2 months of group exercise training with a study physiologist and 4 group meetings with a nutritionist to learn about weight loss techniques and behavioral principles for achieving weight loss.

All participants undergo testing at baseline and periodically during study. Participants undergo blood collection for evaluation of serum levels of sex and metabolic hormones (e.g., estrone, estradiol, testosterone, free testosterone, and sex hormone binding globulin, radioimmunoassay and other immunoassays. Participants also undergo anthropometrics and body composition measurements and mammographic density assessment.

Participants complete questionnaires at baseline and at 6 and 12 months for assessment of diet and exercise. Quality of life (QOL) is measured at baseline and at 6 and 12 months using the Medical Outcomes Study 36-Item Short Form and the Impact of Weight on QOL questionnaire. Information on health habits, medical history, family history of breast cancer, and reproductive and menstrual history is also collected.

FINAL ACCRUAL: A total of 439 participants (118 in the caloric restriction arm, and 117 in both the CR+Exercise, and exercise only arm; and 87 in control arm) were accrued for this study.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Breast Cancer Obesity Weight Changes

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

breast cancer obesity weight changes

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Investigators

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Control

Group Type NO_INTERVENTION

No interventions assigned to this group

Caloric Restriction

Nutritionist-delivered weight loss intervention though diet modification with an aim of 10% weightloss over a year long intervention based on the DPP and LookAHEAD interventions. Participants meet with a nutritionist individually and in small groups. Participants receive general information about diet and behavior strategies such as self-monitoring, goal-setting, stimulus-control, problem-solving, and relapse-prevention training. Participants learn to set a calorie goal and a fat gram goal and how to achieve the goal calorie reduction. Meetings are held weekly during the first 6 months of the diet program but taper off over the course of the study.

Group Type OTHER

behavioral dietary intervention

Intervention Type BEHAVIORAL

A group based modification of the DPP and LookAHEAD lifestyle programs with a goal of 10% weight loss

Exercise Intervention

Participants exercise 3 days per week under the supervision of a physiologist and 2 days per week independently at home, for a total of 5 exercise sessions (at least 45 minutes of moderate-intensity exercise per session) weekly over 12 months

Group Type OTHER

Exercise intervention

Intervention Type BEHAVIORAL

Facility based and home-based exercise designed to increase moderate-to-vigorous aerobic activity in participants to 45 mins/day 5 days/week

Caloric Restriction AND Exercise Intervention

Combined caloric restriction \& exercise intervention

Group Type OTHER

behavioral dietary intervention

Intervention Type BEHAVIORAL

A group based modification of the DPP and LookAHEAD lifestyle programs with a goal of 10% weight loss

Exercise intervention

Intervention Type BEHAVIORAL

Facility based and home-based exercise designed to increase moderate-to-vigorous aerobic activity in participants to 45 mins/day 5 days/week

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

behavioral dietary intervention

A group based modification of the DPP and LookAHEAD lifestyle programs with a goal of 10% weight loss

Intervention Type BEHAVIORAL

Exercise intervention

Facility based and home-based exercise designed to increase moderate-to-vigorous aerobic activity in participants to 45 mins/day 5 days/week

Intervention Type BEHAVIORAL

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Weight Loss interventions

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

DISEASE CHARACTERISTICS:

* At increased risk for developing breast cancer due to any of the following lifestyle risk factors:

* Lack of physical activity
* Excess weight
* Obesity
* Weight gain over lifetime
* Body mass index \> 25.0
* Physically able to undertake a moderate exercise or calorie reduction program
* No history of invasive or in situ breast cancer

PATIENT CHARACTERISTICS:

* Postmenopausal, defined by the absence of periods for the past 12 months
* Able to attend study clinic visits and classes, and undergo study measurements
* Able to fill out questionnaires and logs in English
* No moderate to high alcohol intake (more than 2 drinks per day)
* No concurrent smoking
* No invasive cancer within the past 10 years except simple basal cell or squamous cell carcinoma
* No diabetes mellitus

* Fasting blood sugar \< 126 mg/dL (on 2 occasions)
* Hematocrit 32-48%
* WBC 3,000-15,000/mm³
* Potassium 3.5-5.0 mEq/L
* Creatinine ≤ 2.0 mg/dL
* No abnormalities on screening physical that contraindicate study participation
* No contraindications for treadmill testing or entry into a training program, including any of the following:

* Myocardial infarction within the past 6 months
* Pulmonary edema
* Myocarditis
* Pericarditis
* Unstable angina
* Pulmonary embolism or deep vein thrombosis
* Uncontrolled hypertension (i.e., blood pressure \> 200/100 mm Hg)
* Orthostatic hypotension
* Moderate-to-severe aortic stenosis
* Uncontrolled arrhythmia
* Uncontrolled congestive heart failure
* Third-degree heart block
* Left bundle branch block
* Thrombophlebitis
* ST depression \> 3 mm at rest
* History of cardiac arrest or stroke
* Normal exercise treadmill testing (ETT)

* Negative thallium or echo ETT required for patients with abnormal ETT (defined as ≥ 1.5 mm ST depression in \> 1 lead within 1-minute recovery OR ≥ 1.1 mm ST depression in \> 1 lead after 1-minute recovery OR reading of positive test by study doctor)
* No drug abuse
* No significant mental illness

PRIOR CONCURRENT THERAPY:

* More than 6 months since prior and no concurrent menopausal hormone replacement therapy of any type, including vaginal route
* No concurrent participation in any other organized weight loss or exercise program
* No concurrent appetite suppressant medication
* No concurrent medications (e.g., weight-loss medications) likely to interfere with adherence to interventions or study outcomes
Minimum Eligible Age

50 Years

Maximum Eligible Age

75 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Fred Hutchinson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

FHCRC

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Anne McTiernan, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Fred Hutchinson Cancer Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Fred Hutchinson Cancer Research Center

Seattle, Washington, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Duggan C, Tapsoba JD, Shivappa N, Harris HR, Hebert JR, Wang CY, McTiernan A. Changes in Dietary Inflammatory Index Patterns with Weight Loss in Women: A Randomized Controlled Trial. Cancer Prev Res (Phila). 2021 Jan;14(1):85-94. doi: 10.1158/1940-6207.CAPR-20-0181. Epub 2020 Aug 28.

Reference Type DERIVED
PMID: 32859616 (View on PubMed)

Mason C, de Dieu Tapsoba J, Duggan C, Wang CY, Alfano CM, McTiernan A. Eating behaviors and weight loss outcomes in a 12-month randomized trial of diet and/or exercise intervention in postmenopausal women. Int J Behav Nutr Phys Act. 2019 Nov 27;16(1):113. doi: 10.1186/s12966-019-0887-1.

Reference Type DERIVED
PMID: 31775800 (View on PubMed)

Duggan C, Tapsoba Jde D, Wang CY, McTiernan A. Dietary Weight Loss and Exercise Effects on Serum Biomarkers of Angiogenesis in Overweight Postmenopausal Women: A Randomized Controlled Trial. Cancer Res. 2016 Jul 15;76(14):4226-35. doi: 10.1158/0008-5472.CAN-16-0399.

Reference Type DERIVED
PMID: 27417562 (View on PubMed)

Habermann N, Makar KW, Abbenhardt C, Xiao L, Wang CY, Utsugi HK, Alfano CM, Campbell KL, Duggan C, Foster-Schubert KE, Mason CE, Imayama I, Blackburn GL, Potter JD, McTiernan A, Ulrich CM. No effect of caloric restriction or exercise on radiation repair capacity. Med Sci Sports Exerc. 2015 May;47(5):896-904. doi: 10.1249/MSS.0000000000000480.

Reference Type DERIVED
PMID: 25160845 (View on PubMed)

Duggan C, Xiao L, Terry MB, McTiernan A. No effect of weight loss on LINE-1 methylation levels in peripheral blood leukocytes from postmenopausal overweight women. Obesity (Silver Spring). 2014 Sep;22(9):2091-6. doi: 10.1002/oby.20806. Epub 2014 Jun 13.

Reference Type DERIVED
PMID: 24930817 (View on PubMed)

Imayama I, Alfano CM, Mason C, Wang C, Duggan C, Campbell KL, Kong A, Foster-Schubert KE, Blackburn GL, Wang CY, McTiernan A. Weight and metabolic effects of dietary weight loss and exercise interventions in postmenopausal antidepressant medication users and non-users: a randomized controlled trial. Prev Med. 2013 Nov;57(5):525-32. doi: 10.1016/j.ypmed.2013.07.006. Epub 2013 Jul 13.

Reference Type DERIVED
PMID: 23859929 (View on PubMed)

Mason C, Xiao L, Imayama I, Duggan CR, Foster-Schubert KE, Kong A, Campbell KL, Wang CY, Villasenor A, Neuhouser ML, Alfano CM, Blackburn GL, McTiernan A. Influence of diet, exercise, and serum vitamin d on sarcopenia in postmenopausal women. Med Sci Sports Exerc. 2013 Apr;45(4):607-14. doi: 10.1249/MSS.0b013e31827aa3fa.

Reference Type DERIVED
PMID: 23190588 (View on PubMed)

Mason C, Foster-Schubert KE, Imayama I, Xiao L, Kong A, Campbell KL, Duggan CR, Wang CY, Alfano CM, Ulrich CM, Blackburn GL, McTiernan A. History of weight cycling does not impede future weight loss or metabolic improvements in postmenopausal women. Metabolism. 2013 Jan;62(1):127-36. doi: 10.1016/j.metabol.2012.06.012. Epub 2012 Aug 14.

Reference Type DERIVED
PMID: 22898251 (View on PubMed)

Mason C, Foster-Schubert KE, Imayama I, Kong A, Xiao L, Bain C, Campbell KL, Wang CY, Duggan CR, Ulrich CM, Alfano CM, Blackburn GL, McTiernan A. Dietary weight loss and exercise effects on insulin resistance in postmenopausal women. Am J Prev Med. 2011 Oct;41(4):366-75. doi: 10.1016/j.amepre.2011.06.042.

Reference Type DERIVED
PMID: 21961463 (View on PubMed)

Mason C, Xiao L, Imayama I, Duggan CR, Bain C, Foster-Schubert KE, Kong A, Campbell KL, Wang CY, Neuhouser ML, Li L, W Jeffery R, Robien K, Alfano CM, Blackburn GL, McTiernan A. Effects of weight loss on serum vitamin D in postmenopausal women. Am J Clin Nutr. 2011 Jul;94(1):95-103. doi: 10.3945/ajcn.111.015552. Epub 2011 May 25.

Reference Type DERIVED
PMID: 21613554 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

U54CA116847

Identifier Type: NIH

Identifier Source: secondary_id

View Link

P50CA083636

Identifier Type: NIH

Identifier Source: secondary_id

View Link

P30CA015704

Identifier Type: NIH

Identifier Source: secondary_id

View Link

FHCRC-PHS-1960.00

Identifier Type: -

Identifier Source: secondary_id

FHCRC-1960

Identifier Type: -

Identifier Source: secondary_id

CDR0000544634

Identifier Type: REGISTRY

Identifier Source: secondary_id

PHS 1960.00

Identifier Type: -

Identifier Source: org_study_id