Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Jul 15;130(14):2440-2452.
doi: 10.1002/cncr.35280. Epub 2024 Mar 12.

Improving lifestyle behaviors during chemotherapy for breast cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis (LEANer) Trial

Leah S Puklin  1 , Leah M Ferrucci  1   2 , Maura Harrigan  1 , Courtney McGowan  1   2 , Michelle Zupa  1 , Brenda Cartmel  1   2 , Fang-Yong Li  1 , Jennifer A Ligibel  3 , Donna Spiegelman  1   2 , Mona Sharifi  1   4 , Tara Sanft  2   4 , Melinda L Irwin  1   2
Affiliations
Randomized Controlled Trial

Improving lifestyle behaviors during chemotherapy for breast cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis (LEANer) Trial

Leah S Puklin et al. Cancer. .

Erratum in

Abstract

Background: Little is known about improving physical activity (PA) and diet during and after chemotherapy for breast cancer. This secondary analysis examines changes in PA and diet quality during a yearlong intervention for patients with breast cancer undergoing chemotherapy and evaluates factors associated with these changes.

Methods: Newly diagnosed patients with breast cancer (N = 173) undergoing chemotherapy were randomized to a year-long nutrition and exercise intervention (n = 87) or usual care (UC, n = 86). Mixed models compared 1-year changes in PA and diet quality via the Healthy Eating Index (HEI)-2015 by study arm. Among the intervention group, baseline factors associated with change in PA and diet were assessed with multivariable linear and logistic regression.

Results: At 1 year, compared with UC, the intervention arm increased PA more (mean difference = 136.1 minutes/week; 95% CI, 90.2-182.0), participated in more strength training (56% vs. 15%; p < .001), and had suggestive improvements in HEI-2015 (mean difference = 2.5; 95% CI, -0.3 to 5.3; p = .08). In the intervention arm, lower fatigue was associated with improved PA (p = .04) and higher education was associated with improved HEI-2015 (p = .001) at 1 year. Higher HEI-2015 (p = .04) and married/living with someone (p = .05) were associated with higher odds of participating in strength training at 1 year.

Conclusions: This year-long lifestyle intervention for patients with breast cancer undergoing chemotherapy resulted in increases in PA and suggestive improvements in diet quality. Behavior change was associated with baseline fatigue, diet quality, education, and married/living with someone. Addressing these factors in interventions may improve uptake of lifestyle behaviors in trials during and after chemotherapy.

Keywords: breast cancer; chemotherapy; diet; exercise; lifestyle intervention; nutrition; physical activity; treatment.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors declare no financial or non-financial competing interests.

Figures

Figure 1.
Figure 1.
Consort diagram of participants in the LEANer study.
Figure 2.
Figure 2.
Changes in physical activity and diet quality across study time points by randomization arm; error bars represent 95% confidence interval.
Figure 3.
Figure 3.
Proportion of women meeting the physical activity and dietary goals across study time points by randomization arm.
See this image and copyright information in PMC

References

    1. Runowicz CD, Leach CR, Henry NL, et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. CA: A Cancer Journal for Clinicians. 2016;66(1):43–73. doi: 10.3322/caac.21319 - DOI - PubMed
    1. Rock CL, Thomson CA, Sullivan KR, et al. American Cancer Society nutrition and physical activity guideline for cancer survivors. CA: A Cancer Journal for Clinicians. 2022;72(3):230–262. doi: 10.3322/caac.21719 - DOI - PubMed
    1. Cifu G, Arem H. Adherence to lifestyle-related cancer prevention guidelines and breast cancer incidence and mortality. Ann Epidemiol Nov 2018;28(11):767–773.e1. doi: 10.1016/j.annepidem.2018.09.002 - DOI - PubMed
    1. Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA: A Cancer Journal for Clinicians. 2012;62(4):242–274. doi: 10.3322/caac.21142 - DOI - PubMed
    1. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. Nov 2019;51(11):2375–2390. doi: 10.1249/mss.0000000000002116 - DOI - PMC - PubMed

Publication types