A Dietary and Physical Activity Interventions for Colorectal Cancer Survivors: A Randomized Controlled Trial

Abstract

Background: Physical activity (PA), dietary fibre, and low intake of red/processed meat are protective factors of colorectal cancer (CRC). There have been few randomized controlled trials (RCTs) on lifestyle interventions of CRC survivors. We conducted the first RCT in an Asian population to assess the acceptability and feasibility of lifestyle interventions in Chinese CRC survivors. Methods: A 2x2 factorial RCT of 12-month theory-based PA and dietary interventions was conducted. CRC survivors within one year after completing main cancer treatment were randomized to receive PA and/or dietary interventions or usual care. Subjects underwent interventions received individual consultation, fortnightly motivational phone calls, monthly stage-of-change matched educational pamphlets and quarterly newsletters, and attended quarterly group meetings. All subjects were assessed at baseline, 6, 12, 18 and 24 months. Intervention effects were assessed by linear mixed effects models wth multiple imputation. Results: Two hundred and twenty-three subjects [mean age 65 years (range: 25-88); 92 (37%) female] were randomized and received their assigned interventions. Fifty-six subjects received PA interventions only, 56 received dietary interventions only, 55 received both interventions, and 56 received usual care. Thirty-one (14%) subjects dropped out due to recurrence, death or lost-to-follow-up. PA by dietary interactions were insignificant. At 24 months, dietary interventions reduced weekly red meat intake by 2.1 servings (95% confidence interval [CI]=1.1 to 3.2, p<0.001), increased daily whole grain intake by 0.21 servings (95% CI=0.04 to 0.38, p=0.017), and reduced daily refined grain intake by 0.36 servings (95% CI=0.14 to 0.58, p=0.001). PA interventions increased the duration of weekly vigorous/moderate intensity PA by 63 minutes (95% CI=18 to 144, 0.126) despite its insignificance. Conclusions: Our lifestyle interventions effectively improved dietary intakes and possessed potential in enhancing PA levels in Chinese CRC survivors. Acknowledgement: The study was supported by a grant from the World Cancer Research Fund International.