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Nutrition and Exercise Trial: Improving Diet and Physical Activity Patterns in Overweight Cancer Survivors

Not Applicable
Completed
Conditions
Cancer Survivor
Overweight
Interventions
Other: Dietary Intervention
Behavioral: Exercise Intervention
Other: Laboratory Biomarker Analysis
Dietary Supplement: Nutritional Intervention
Other: Questionnaire Administration
Registration Number
NCT03489213
Lead Sponsor
Ohio State University Comprehensive Cancer Center
Brief Summary

This randomized phase II trial will enroll overweight cancer survivors. Subjects in both groups will be educated to follow a diet pattern similar to what is recommended by the Dietary Guidelines for Americans and the American Institute for Cancer Research (DGA/AICR) but one group will also receive 18 ounces of lean beef for incorporation into a healthy diet. Subjects will be encouraged to exercise regularly and activity will be monitored throughout the study. Nutrition and exercise may help cancer survivors successfully maintain improved dietary patterns, body composition, and physical activity efforts and consumption of beef may favorably impact lean body mass and specific nutritional outcomes.

Detailed Description

PRIMARY OBJECTIVES:

I. To determine the feasibility and compliance with a the Dietary Guidelines for Americans/American Institute for Cancer Research (DGA/AICR) healthy dietary pattern and a beef + DGA/AICR healthy dietary pattern in cancer survivors.

II. To determine the impact of dietary interventions on body composition, clinical outcomes, and physical performance.

III. To quantify the impact of the two dietary interventions on cardiometabolic biomarkers of health.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive DGA/AICR-based dietary intervention for 6 months consisting of 12 education sessions over 60 minutes every other week, fruit, vegetable, and herb harvesting 1-2 times per week for 2 hours, wearing a FitBit during physical activity, and remote health coaching over 10 minutes for 12 weeks.

ARM II: Patients receive DGA/AICR-based dietary intervention as in Arm I and consume 11-18 ounces of lean beef each week for 6 months.

Clinical and physical activity assessments will take place at baseline, after the intervention and at 12 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
82
Inclusion Criteria
  • Have a body mass index (BMI) >= 25 kg/m^2
  • Be non-vegetarian/non-vegan, and have no concerns with beef consumption
  • Have completed active curative therapy for cancer within the past 36 months (i.e., surgery, chemotherapy, or radiation); ongoing hormone therapy is acceptable
  • Voluntarily provide consent, Health Insurance Portability and Accountability Act (HIPPA) authorization form, and consent from primary care provider (PCP) or treating oncologist
  • Not be planning to travel for more than 3 consecutive weeks during the intervention period
  • Agree to refrain from all nutritional supplements, herbal supplements, and botanical supplements aside from those prescribed by a physician for the duration of the study
Exclusion Criteria
  • Are cognitively unable to consent or have physical or mental limitations that would prevent full participation in the program
  • Are vegan or those unwilling to consume 11-18 ounces (oz) of beef per week
  • Have pre-existing medical conditions that preclude unsupervised physical activity (i.e., severe orthopedic conditions, impending hip or knee replacement, paralysis, unstable angina, dementia, recent history of myocardial infarction, congestive heart failure, pulmonary conditions requiring oxygen, or hospitalization in past 6 months)
  • Have had cancer treatment that significantly impacts digestion, metabolism, or food intake (e.g., surgical loss of esophagus, stomach, or colon, pancreas dysfunction, or brain surgery that alters cognition, etc.)
  • Report meeting the recommendations for physical activity (> 60 minutes per day, most days per week) and already meet the majority of dietary guidelines as assessed by a telephone screener
  • Are prescribed medication that do not allow for increased intake of fruits and vegetables
  • Have recently (< 3 months) started a statin or other lipid lowering medication; participants who report that they are changing a lipid lowering drug dose or drug type during the recruitment period will also be excluded; participants who have been stable on a lipid-lowering medication for at least 3 months may participate; well-controlled diabetics (type I or II) may participate
  • Have been diagnosed with active metabolic or digestive illnesses (i.e., Celiac disease, irritable bowel syndrome [IBS], renal insufficiency, hepatic insufficiency)
  • Are pregnant or are planning to become pregnant during the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm I (DGA/AICR)Laboratory Biomarker AnalysisPatients receive DGA/AICR-based dietary intervention for 6 months consisting of 12 education sessions (60 minutes each) every other week. Lectures will take place in an urban garden where fruit, vegetable, and herb harvesting 1-2 times per week is encouraged. All participants will be given a FitBit and regular physical activity will be encouraged. Finally, remote health coaching is offered to all study subjects for the duration of the intervention (12 weeks).
Arm I (DGA/AICR)Questionnaire AdministrationPatients receive DGA/AICR-based dietary intervention for 6 months consisting of 12 education sessions (60 minutes each) every other week. Lectures will take place in an urban garden where fruit, vegetable, and herb harvesting 1-2 times per week is encouraged. All participants will be given a FitBit and regular physical activity will be encouraged. Finally, remote health coaching is offered to all study subjects for the duration of the intervention (12 weeks).
Arm II (DGA/AICR plus Beef)Laboratory Biomarker AnalysisPatients receive the same intervention as in Arm I with the addition of 18 ounces of lean beef provided by the study to each subject. Subjects will be encouraged to consume the lean beef and lectures will incorporate healthy beef consumption into each lesson and cooking demonstration.
Arm II (DGA/AICR plus Beef)Nutritional InterventionPatients receive the same intervention as in Arm I with the addition of 18 ounces of lean beef provided by the study to each subject. Subjects will be encouraged to consume the lean beef and lectures will incorporate healthy beef consumption into each lesson and cooking demonstration.
Arm II (DGA/AICR plus Beef)Questionnaire AdministrationPatients receive the same intervention as in Arm I with the addition of 18 ounces of lean beef provided by the study to each subject. Subjects will be encouraged to consume the lean beef and lectures will incorporate healthy beef consumption into each lesson and cooking demonstration.
Arm I (DGA/AICR)Dietary InterventionPatients receive DGA/AICR-based dietary intervention for 6 months consisting of 12 education sessions (60 minutes each) every other week. Lectures will take place in an urban garden where fruit, vegetable, and herb harvesting 1-2 times per week is encouraged. All participants will be given a FitBit and regular physical activity will be encouraged. Finally, remote health coaching is offered to all study subjects for the duration of the intervention (12 weeks).
Arm I (DGA/AICR)Exercise InterventionPatients receive DGA/AICR-based dietary intervention for 6 months consisting of 12 education sessions (60 minutes each) every other week. Lectures will take place in an urban garden where fruit, vegetable, and herb harvesting 1-2 times per week is encouraged. All participants will be given a FitBit and regular physical activity will be encouraged. Finally, remote health coaching is offered to all study subjects for the duration of the intervention (12 weeks).
Arm I (DGA/AICR)Nutritional InterventionPatients receive DGA/AICR-based dietary intervention for 6 months consisting of 12 education sessions (60 minutes each) every other week. Lectures will take place in an urban garden where fruit, vegetable, and herb harvesting 1-2 times per week is encouraged. All participants will be given a FitBit and regular physical activity will be encouraged. Finally, remote health coaching is offered to all study subjects for the duration of the intervention (12 weeks).
Arm II (DGA/AICR plus Beef)Dietary InterventionPatients receive the same intervention as in Arm I with the addition of 18 ounces of lean beef provided by the study to each subject. Subjects will be encouraged to consume the lean beef and lectures will incorporate healthy beef consumption into each lesson and cooking demonstration.
Arm II (DGA/AICR plus Beef)Exercise InterventionPatients receive the same intervention as in Arm I with the addition of 18 ounces of lean beef provided by the study to each subject. Subjects will be encouraged to consume the lean beef and lectures will incorporate healthy beef consumption into each lesson and cooking demonstration.
Primary Outcome Measures
NameTimeMethod
Adherence to either the DGA/AICR group or the DGA/AICR + Beef groupUp to 12 months

Participants will keep both 7 day diet records periodically through out the study as well as a daily log of beef consumption

Change in body compositionUp to 12 months

Change in body composition will be assessed by dual X-ray absorptiometry (iDXA)

Change in blood pressureBaseline up to 12 months

Trained personnel will use a sphygomanometer to assess blood pressure

Change in body mass index (BMI)Baseline up to 12 months

Weight and height will be combined to report BMI in kg/m\^2.

Change in dietary carotenoid intakeBaseline up to 12 months

Assessed by Raman spectroscopy

Change in blood carotenoidsUp to 12 months

Assessed by High Pressure Liquid Chromatography

Change in physical performance assessed by timed performance-related mobility tasksBaseline up to 12 months

Physical performance will be measured using the 40 M walk test

Change in physical performanceUp to 12 months

Assessed by a standardized stair climb test

Dietary intake patternsUp to 6 months

Will be assessed using diet logs maintained throughout the intervention and graphical food frequency questionnaire (FFQ). This FFQ automatically calculates the Healthy Eating Index 2010. Will use previous 30-day intake for all FFQs to assess dietary patterns. To determine protein balance, will use a 7-day diet record prior to a 24-hr urine collection.

Adherence to classesUp to 12 months

Descriptive statistics will be generated using attendance forms

Change in fasting glucoseUp to 12 months

A fasting blood sample will be used to measure glucose at three time points

Change in lipoprotein profilesUp to 12 months

A fasting blood sample will be used to assess serum lipoprotein profile

Daily physical activity (steps per day)up to 12 months

Each participants daily FitBit data will be downloaded to a secure spreadsheet

Secondary Outcome Measures
NameTimeMethod
Health related quality of lifeUp to 12 months

Measured at all three time points using the Health Related Quality of Life (HR-QOL) questionnaire

Trial Locations

Locations (1)

Ohio State University Comprehensive Cancer Center

🇺🇸

Columbus, Ohio, United States

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