Health

Home-Based Diet and Exercise Program Improves Physical Function in Older Cancer Survivors

While cancer and its treatments take a heavy physical toll on individuals of any age, older adult cancer survivors are more susceptible than younger people to a decline in physical function as a result of the disease and related treatments. A two-year study completed by investigators at UAB and Duke University Medical Center — called RENEW — has shown that a home-based diet and exercise program improved physical function in 641 overweight, older adult cancer survivors from 21 U.S. states, as well as survivors in Canada and United Kingdom. “Some older adults view cancer as a death sentence, but this usually isn’t the case anymore,” observes UAB Nutrition Sciences Chair and Professor of Nutrition Wendy Demark-Wahnefried, Ph.D., R.D., who is also the study’s lead investigator. “A cancer diagnosis represents an opportunity to reevaluate your life and make meaningful changes. The older adults in our study realize there is a great deal they can do to improve the quality of their lives through nutrition and exercise.”

The Exercise and Diet Program

The RENEW study (which is an acronym for Reach out to Enhance Wellness) is a two-year randomized controlled trial that tested the effectiveness of a home-based diet and exercise program in improving physical function among a group of older, overweight survivors of breast, prostate, and colorectal cancer. The study’s one-year results were published in the May 14, 2009 issue of JAMA (Vol. 301, No. 18). “We recruited overweight and obese cancer survivors because of the increase of obesity in older adults and the fact that obesity has been shown to contribute to a decline in physical function,” explains Dr. Demark-Wahnefried.

The study participants were divided into two groups – an intervention group and a delayed intervention control group. As part of the study, participants received a personalized workbook with information comparing their current lifestyle behaviors and weight with recommended levels. “The workbooks also recommended 15 minutes of strength training exercise every other day as well as 30 minutes of endurance exercise each day,” adds Dr. Demark-Wahnefried. “In addition, the workbooks provided detailed information about how to make health dietary changes, such as increasing intake of fruits and vegetables and limiting saturated fat. We also encouraged a slow rate of weight loss of up to one pound per week until a healthy weight was met.” Study participants were also assigned a health counselor who provided regular telephone guidance in monitoring progress, providing reinforcement, overcoming barriers, and establishing future health goals. Every two weeks, participants also received a personalized two-page progress report newsletter to provide motivation and reinforce goals.

Improvements in Physical Function and Quality of Life

Even with the modest changes in diet and exercise that were implemented as part of the RENEW study, the participants experienced clinically significant improvements in both physical function and health-related quality of life. “Our results showed that the group that received the diet and exercise intervention made significant improvements in all of the targeted behaviors as compared to the control group,” explains Dr. Demark-Wahnefried. “In addition, we found that the improvements that participants made with the intervention were durable — they experienced no significant relapse or decline.”

Dr. Demark-Wahnefried says the RENEW study results show that home-based diet and exercise programs hold promise in helping older adult cancer survivors make meaningful health improvements. “Because cancer is an attention-grabber for most people, a cancer diagnosis represents a window of opportunity in which people become very receptive to making meaningful lifestyle changes that will have a positive impact on their health and quality of life.”