760. Impact of a nutrition and physical activity intervention (ENRICH: Exercise and Nutrition Routine Improving Cancer Health) on health behaviors of cancer survivors and carers: a pragmatic randomized controlled trial
Commentary by Laurien Buffart, Human Movement Scientist and Epidemiologist, VU University Medical Center, The Netherlands
Erica James and colleagues have examined the effects of a group-based multiple health behaviour change intervention (ENRICH) on physical activity, sedentary behaviour, dietary intake and body weight in cancer survivors who completed cancer treatment and carers. International guidelines for prevention and management of cancer recommend sufficient levels of physical activity, consuming a healthy diet, and maintaining a heathy body weight. A healthy lifestyle has been associated with fewer disease and treatment related physical and psychosocial symptoms, reduced risk of recurrence and reduced mortality.
In this study, 133 cancer survivors and carers were randomly assigned to the ENRICH intervention or a wait-list control group. The 8-week ENRICH intervention was delivered by qualified exercise physiologists/physiotherapists, and a dietician, and included 6 face-to-face group sessions that delivered simultaneous multiple health behaviour content, covering a home-based walking program using a pedometer, a home-based resistance exercise program using a Gymstick and information about healthy eating using the Australian Guide to Healthy eating, fruit and vegetables, maintaining a healthy weight fat, meat, salt, dietary supplements, alcohol and food labels. Behaviour change theory and strategies were incorporated in the content and delivery of the sessions. Participants completed assessments at baseline, 8 weeks (after completion of the intervention), and 20 weeks. Participants from the wait-list control group were offered the ENRICH intervention after 20 weeks. Outcomes measures included step counts assessed with sealed pedometers, diet and alcohol intake assessed with the Food Frequency Questionnaire, self-reported physical activity and sedentary behaviour as well as measures of body composition.
Results indicated a significant difference in the number of steps per day in favour of participants who received the ENRICH intervention compared to the control group. More specifically, the average increase in the number of daily steps was 800 in the intervention group whereas the participants in the control group decreased their daily steps by almost 1300. This difference between groups of 2000 steps per day may have important clinical implications. In addition, participants who received the ENRICH intervention increased their daily vegetable consumption with 0.3 to 0.5 serves per day, reduced their body weight with 1.5 kg and their body mass index with 0.5 kg/m2 compared to patients from the control group, and effects were sustained for three months. There were no significant between group differences in time spent in sitting, moderate –to-vigorous exercise and resistance exercise, or other dietary changes.
This study showed that a theory-based multiple health-behaviour intervention is feasible and can improve physical activity, body weight and composition, and vegetable consumption in cancer survivors. The trial was developed and conduced with a major charity allowing rapid routine implementation. As a consequence, the evidence-based ENRICH intervention has currently been adopted as a Cancer Council NSW program and is being delivered state-wide.
Source: BMC Cancer 2015, 15: 710. Access the whole article.