Reduction in fat intake is not associated with weight loss in most women after breast cancer diagnosis

Evidence from a randomized controlled trial

Authors

  • Cheryl L. Rock Ph.D., R.D.,

    Corresponding author
    1. Department of Family and Preventive Medicine and Cancer Prevention and Control Program, University of California at San Diego, La Jolla, California
    • UCSD Cancer Prevention and Control Program, 9500 Gilman Drive, Dept. 0901, La Jolla, CA 92093-0901
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    • Fax: 858-822-1497

  • Cynthia Thomson Ph.D., R.D.,

    1. College of Public Health and Cancer Prevention and Control Program, Arizona Cancer Center, University of Arizona, Tucson, Arizona
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  • Bette J. Caan Dr.P.H.,

    1. Division of Research, Kaiser Foundation Research Institute, Kaiser Permanente Northern California, Oakland, California
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  • Shirley W. Flatt M.S.,

    1. Cancer Prevention and Control Program, University of California at San Diego, La Jolla, California
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  • Vicky Newman M.S., R.D.,

    1. Department of Family and Preventive Medicine and Cancer Prevention and Control Program, University of California at San Diego, La Jolla, California
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  • Cheryl Ritenbaugh Ph.D.,

    1. Kaiser Center for Health Research, Portland, Oregon
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  • James R. Marshall Ph.D.,

    1. Arizona Cancer Center, University of Arizona, Tucson, Arizona
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  • Kathryn A. Hollenbach Ph.D.,

    1. Department of Family and Preventive Medicine and Cancer Prevention and Control Program, University of California at San Diego, La Jolla, California
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  • Marcia L. Stefanick Ph.D.,

    1. Department of Medicine, Stanford University, Stanford Center for Research in Disease Prevention, Palo Alto, California
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  • John P. Pierce Ph.D.

    1. Department of Family and Preventive Medicine and Cancer Prevention and Control Program, University of California at San Diego, La Jolla, California
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  • Other authors and researchers for the Women”s Healthy Eating and Living (WHEL) Study Group: WHEL Study Coordinating Center: University of California at San Diego, Cancer Prevention and Control Program, La Jolla, CA: John P. Pierce, Ph.D. (Principal Investigator); Cheryl L. Rock, Ph.D., R.D.; Vicky E. Jones, M.D.; Susan Faerber, B.A.; Vicky Newman, M.S., R.D.; Shirley W. Flatt, M.S.; Sheila Kealey, M.P.H.; Elizabeth Gilpin, M.S., Linda Wasserman, M.D., Ph.D. WHEL Study Clinical Sites: Kaiser Permanente Northern California, Oakland, CA: Bette J. Caan, Dr.P.H.; Lou Ferenbacher, M.D.; Northern California Cancer Center, Union City, CA: Marcia L. Stefanick, Ph.D.; Robert Carlson, M.D.; University of Arizona, Tucson & Phoenix, AZ: James R. Marshall, Ph.D.; Cynthia Thomson, Ph.D., R.D.; James Warnecke, M.D.; University of California at Davis, Davis, CA: Mary N. Haan, Dr.P.H.; Sidney Scudder, M.D.; University of California at San Diego, Cancer Center, La Jolla, CA: Vicky E. Jones, M.D.; Kathryn A. Hollenbach, Ph.D.; University of Texas M. D. Anderson Cancer Center, Houston, TX: Lovell A. Jones, Ph.D.; Richard Theriault, D.O.; Center for Health Research Portland, Portland, OR: Cheryl Ritenbaugh, Ph.D., Mark Rarick, M.D.

Abstract

BACKGROUND

A reduction in dietary fat intake has been suggested as a method to promote weight loss in women at risk for breast cancer recurrence.

METHODS

Weight change in response to diet intervention was examined in 1010 women who had completed treatment for Stage I, Stage II, or Stage IIIA (American Joint Committee on Cancer staging system) primary operable breast cancer during their first year of participation in a randomized, controlled, diet intervention trial to reduce risk of recurrence. Diet intervention was performed by telephone counseling and promoted a low fat diet that also was high in fiber, vegetables, and fruit. The comparison group was provided with general dietary guidelines to reduce disease risk. Multiple linear regression models were used to examine the relations among demographic and personal characteristics, changes in diet composition and exercise level, and change in body weight or body mass index.

RESULTS

The average weight change in the 1-year period was 0.04 kg for the intervention group and 0.46 kg for the comparison group. For the total group, body weight was stable (± 5% baseline weight) for 743 women (74%), whereas 114 (11%) lost weight, and 153 (15%) gained weight. These distributions were similar in the two study groups inclusive of all study participants and for only those women with a baseline body mass index of ≥ 25 kg/m2. Initial body mass index and changes in fiber and vegetable intakes, but not change in percent of energy obtained from fat, were associated independently with change in weight or body mass index.

CONCLUSIONS

For most women at risk for breast cancer recurrence, diet intervention to promote a reduction in fat intake was not associated with significant weight loss. Testing the effect of a substantial change in diet composition on risk for breast cancer recurrence is unlikely to be confounded by weight loss in subjects who were the recipients of intensive intervention efforts. Cancer 2001;91:25–34. © 2001 American Cancer Society.

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