Effects of a nutritional intervention in overweight/obese breast cancer patients

Article type: Research Article

Authors: Patella, M.N.^{a; b} | Ghiotto, C.^{b; c} | Pertile, R.^d | Fiduccia, P.^c | Bozza, F.^{b; c} | Pluchinotta, A.^e | Zanetti, L.^b | Zavagno, G.^{b; c; f} | Cavestro, M.^a | Fedele, D.^{a; f}

Affiliations: [a] Clinical Nutrition Unit, District 2, Unità Locale Socio Sanitariaria 16, Via Avanzo 35, 35100 Padua, Italy. e-mail: marinelda.patella@sanita.padova.it | [b] Mammary Oncological Centre (COM), Hospital of Padova, Padua, Italy | [c] Oncological Institute of Veneto (IOV), Padua, Italy | [d] Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy | [e] Department of Surgery, Hospital of Abano Terme, Abano Terme, Italy | [f] Department of Medical and Surgical Sciences, University of Padova, Padua, Italy

Abstract: Introduction: Today breast cancer (BC) patients can expect more prolonged survival than in the past, but obesity at diagnosis and/or weight gain during adjuvant therapies increase the risk of recurrences as well as of weight-related disorders (diabetes, cardiovascular disease … ). Therefore lifestyle intervention might offer a valuable approach to positively influence the prognosis of survivors. Design and objectives: The charts of 189 overweight/obese outpatients with “early-stage BC” were reviewed to evaluate the effects of nutritional intervention on weight, body mass index (BMI), waist circumference and metabolic parameters. After the first clinical evaluation, in 97 subjects (education group), dieting therapy and periodical medical examinations were connected with brief individual sessions of nutritional education. Instead, 92 patients (no-education group) were treated only with diet and routine visits. At baseline and after nearly 1 year of treatment, data (weight, waist circumference, BMI, systolic and diastolic pressure, metabolic parameters and results of a battery of self-administered questionnaires to assess Nutritional Knowledge (NK), Physical Functioning (PF) and Quality Of Life (QOL) of patients) were collected and compared. Results: Ninety-two (48.7%) patients completed a one-year follow-up. The dropout rate was higher (73.2%) in traditionally treated women (no-education group) than in education group patients (22.8%); these data highlight that more educated patients completed the programme than non-educated patients (ODs 9.2, p < 0.000). The low follow-up rate makes any comparison between the 2 types of treatment impossible since the weight and metabolic changes of the vast majority of the non-educated subjects remain unknown. Anyway, the education group patients, in active follow-up at 1 year, showed significant weight loss (−6.6 kg, SD 3.7) and improvements of metabolic parameters and questionnaire scores. Conclusions: Data from the study show the usefulness of this simple nutritional education intervention, which appears to increase the adherence to a weight loss programme. In educated patients who completed a 1-year follow-up, the weight reduction and metabolic changes were significant, but the analysis was carried out on less than half of the subjects and this very high global dropout rate (51.3%) makes it impossible to draw generalised conclusions.

Keywords: Nutritional education, Breast cancer, Body mass index, Obesity

DOI: 10.3233/s12349-009-0040-z

Journal: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 1, pp. 21-28, 2009