Commercially available lifestyle modification program: randomized controlled trial addressing heart and bone health in BRCA1/2+ breast cancer survivors after risk-reducing salpingo-oophorectomy

Abstract

Purpose: The goal of this RCT was to examine the efficacy and safety of a web-based program to improve cardiovascular and bone health outcomes, among 35 BRCA1/2+ breast cancer survivors who underwent prophylactic oophorectomy and thus experienced premature surgical menopause.

Methods: A 12-month commercially available web-based lifestyle modification program (Precision Nutrition Coaching) was utilized. Cardiovascular fitness, dietary intake, leisure time activity, body composition, bone mineral density, bone structure, and muscle strength were assessed.

Results: Average adherence to all program components was 74.8 %. Women in the intervention group maintained their cardiovascular fitness level over the 12 months (1.1 ± 7.9 %), while the control group significantly decreased fitness capacity (-4.0 ± 7.5 %). There was a significant difference between groups in percent change of whole body bone area (-0.8 ± 2.5 control and 0.5 ± 1.30 intervention). We also observed decreased BMI (-4.7 ± 6.2 %) and fat mass (-8.6 ± 12.7 %) in the intervention group due to significant concomitant decreases in caloric intake and increases in caloric expenditure. The control group demonstrated decreased caloric intake and decreased lean tissue mass.

Conclusions: In this population at high risk for detrimental cardiovascular and bone outcomes, a commercially available lifestyle intervention program mitigated a decline in cardiovascular health, improved bone health, and decreased weight through fat loss.

Implications for cancer survivors: Precision Nutrition Coaching has shown benefit in breast cancer survivors for reduced risk of deleterious cardiovascular and bone outcomes.

Keywords: BRCA1/2; Bone; Exercise; Heart; Neoplasm; Weight loss.

Fig. 1

CONSORT diagram. Project HOPE enrolled 35 women into the trial and 32 completed final testing.

Fig. 1

CONSORT diagram. Project HOPE enrolled 35 women into the trial and 32 completed final testing.

Fig. 2

Aerobic fitness capacity. Total time on the treadmill during a modified Bruce protocol is presented at baseline and at 12 month follow up for the control (n=16) and intervention (n=16) groups. The control group demonstrated a significant decrease in aerobic fitness between baseline and follow up (^aP < 0.05) and there was a trend (P = 0.07) for differences between groups in the percent change of aerobic capacity; values are presented as mean ± SEM.