1. QOL surveys every 2 months for 2 years.
Improved Quality of Life for Early Stage Estrogen Positive Cancer Survivors on a Low Carbohydrate, Calorie Restricted Dietary Intervention L.A. Rojas-Espaillat1,2,3, A. K. Krie2, H.M. Nickles1,2 , K. N. Bohlen1,2,3,Y. Hu,3,4 M.S. Fagerness1,2, N.L. Flier1,2, J. Kittelsrud1,2, Z.M. Weber4 and E.A. Ehli4
1Avera Research Institute, Sioux Falls, SD, 2Avera Cancer Institute, Sioux Falls, SD, 3 University of South Dakota, Sioux Falls, SD 4 Avera Institute for Human Genetics, Sioux Falls, SD, 5 University of South Dakota, Vermillion, SD
Background
Results
Discussion
Weight reduction
The mean total body weight reduction after dietary intervention was 21.9% (p=4.4x10-13), equivalent to 48.4 pounds per individual at the diet termination.
Obesity and weight gain have significant implication for endometrial and breast cancer development and survivorship.1, 3 Weight gain may also develop after an endometrial or breast cancer diagnosis, often attributed to adjuvant chemotherapy and the onset of menopause.2 Weight loss globally correlates with improved overall quality of life.4 The effect of weight loss on functional health and well being in endometrial and breast cancer survivors is not well studied. The purpose of our study was to evaluate the quality of life implications of weight loss in overweight endometrial and breast cancer survivors undergoing a low carbohydrate, calorie restricted dietary intervention.
QOL scores did not decrease at the beginning of the intervention when patients experienced slight fatigue due to the restrictions.
The majority of QOL scores were maintained or increased throughout the active weight loss and into maintenance, reflecting the positive effects the dietary intervention had on mental and physical health.
All mental health QOL scores were above US average at the termination of the diet.
In the future we feel it would be beneficial to include behavior modification education along with the dietary intervention.
Quality of live
Objectives
Conclusions
Evaluate the change in quality of life measures in overweight endometrial and breast cancer survivors during an intensive dietary intervention.
Overall physical and mental health quality of life scores were significantly improved as a result of the low carbohydrate, calorie restricted dietary intervention in estrogen-receptor positive postmenopausal cancer survivors.
Additional research with a larger sample size may confirm the positive influence of weight loss through a low carbohydrate dietary intervention.
Methods
Physical health scores improved by 19.7% from baseline to intervention completion (p=7.43x10-8).
Eligibility Criteria
Early Stage ER+ endometrial & breast cancer survivors
Postmenopausal
BMI >28
Completed surgery & adjuvant chemotherapy
No underlying inflammatory condition
No treatment for diabetes
Demographics
N= 31
Mean (range)
Age
57 years (42-68)
Weight (pre-diet)
220.5 lbs ( )
BMI (pre-diet)
37.5 kg/m2 ( )
Endocrine Therapy
71% on AI or Tamoxifen
Weight Loss Period
25 weeks (7-59)
References
Nickles-Fader A, Nieves-Arriba L, Frasure H, et al: Endometrial cancer and obesity: Epidemiology, biomarkers, preventions and survivorship. Gynecol Oncol 114(2009)
Demark-Wahnefried W, Peterson BL, Winer EP, et al: Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol 19: , 2001.
Ewertz, M, M-B Jensen, K Gunnarsdottir, et al. Effect of obesity on prognosis after early-stage breast cancer. J Clin Oncol 29:25-31, 2011.
Rothberg, A E, McEwen, LN, Kraftson, AT et al. The impact of weight loss on health-related quality-of-life: implications for cost-effectiveness analyses. Qual Life Res. Oct 16, 2013.
Dietary Intervention
30-50g Carbohydrate
0.5g protein/pound
calories/day
35 Patients Enrolled
27 Breast
8 Endometrial
31 Patients
Completed the dietary intervention
SF-36 survey used
QOL surveys every 2 months for 2 years.
Mental health scores improved by 7% from baseline to intervention completion (p=0.0134).