Effects of diet and exercise on weight-related outcomes for breast cancer survivors and their adult daughters: an analysis of the DAMES trial

Abstract

Purpose: Few trials have aimed to promote diet and exercise behaviors in both cancer survivors and their family members and examine their associations with weight-related outcomes. We conducted a secondary analysis to examine associations between change in diet and exercise behaviors and weight-related outcomes for overweight breast cancer survivors and their overweight adult daughters in the Daughters And MothErS Against Breast Cancer (DAMES) randomized trial.

Methods: The DAMES trial assessed the impact of two iteratively tailored, mailed print diet and exercise interventions against standard brochures over a 12-month period. This analysis examined change in diet and exercise behaviors and weight-related variables from baseline to post-intervention for the 50 breast cancer survivors and their adult daughters randomized to the intervention arms. To reduce the potential for type II error in this pilot, p values <0.10 were considered statistically significant.

Results: For mothers, change in diet quality was uniquely related to change in BMI (β = -0.12, p = 0.082), weight (β = -0.12, p = 0.060), and waist circumference (β = -0.38, p = 0.001), whereas change in caloric intake was related to waist circumference (β = 0.21, p = 0.002). For daughters, change in caloric intake was related to change in waist circumference (β = 0.12, p = 0.055). However, change in diet quality was not associated with weight-related outcomes in daughters. Additionally, change in exercise was not associated with weight-related outcomes in mothers or daughters.

Conclusions: Findings support mail-based and other tailored interventions for weight loss in this population, with an emphasis on diet quality for breast cancer survivors and caloric intake for their adult daughters.

Keywords: Breast neoplasms; Diet; Exercise; First-degree relatives; Interventions; Weight loss.

Fig. 1

Model of the effects of change in exercise and diet quality on change in body mass index (BMI) Standardized regression coefficients are presented. Paths represented with solid lines and * are significant at p < 0.05, solid lines and † are significant at p < 0.10, and dashed lines are non-significant

Fig. 2

Fig. 2a Model of the effects of change in exercise and diet quality on change in weight Fig. 2b Model of the effects of change in caloric intake and diet quality on change in weight Standardized regression coefficients are presented. Paths represented with solid lines and * are significant at p < 0.05, solid lines and † are significant at p < 0.10, and dashed lines are non-significant

Fig. 2

Fig. 2a Model of the effects of change in exercise and diet quality on change in weight Fig. 2b Model of the effects of change in caloric intake and diet quality on change in weight Standardized regression coefficients are presented. Paths represented with solid lines and * are significant at p < 0.05, solid lines and † are significant at p < 0.10, and dashed lines are non-significant

Fig. 3

Fig. 3a Model of the effects of change in exercise and diet quality on change in waist circumference Fig. 3b Model of the effects of change in caloric intake and diet quality on change in waist circumference Fig. 3c Model of the effects of change in exercise and caloric intake on change in waist circumference Standardized regression coefficients are presented. Paths represented with solid lines and * are significant at p < 0.05, solid lines and † are significant at p < 0.10, and dashed lines are non-significant

Fig. 3

Fig. 3a Model of the effects of change in exercise and diet quality on change in waist circumference Fig. 3b Model of the effects of change in caloric intake and diet quality on change in waist circumference Fig. 3c Model of the effects of change in exercise and caloric intake on change in waist circumference Standardized regression coefficients are presented. Paths represented with solid lines and * are significant at p < 0.05, solid lines and † are significant at p < 0.10, and dashed lines are non-significant

Fig. 3

Fig. 3a Model of the effects of change in exercise and diet quality on change in waist circumference Fig. 3b Model of the effects of change in caloric intake and diet quality on change in waist circumference Fig. 3c Model of the effects of change in exercise and caloric intake on change in waist circumference Standardized regression coefficients are presented. Paths represented with solid lines and * are significant at p < 0.05, solid lines and † are significant at p < 0.10, and dashed lines are non-significant