Diet, exercise slow functional decline in older cancer survivors

NEW YORK (Reuters Health) - Among older, overweight cancer patients, a home-based diet and exercise program increases strength and endurance and decreases weight, investigators with the RENEW (Reach out to Enhance Wellness) trial report in the May 13 issue of the Journal of the American Medical Association.

"The intensity of strength training was probably low-to-moderate rather than high," Dr. Miriam C. Morey commented to Reuters Health. "However, we were very pleased with our results because this low/moderate dose of strength training was easily performed in the home and contributed to the positive functional outcomes we observed."

Dr. Morey of Duke University and the Veterans Affairs Medical Center in Durham, North Carolina, randomized 641 male and female cancer survivors to a 12-month, home-based individualized program of telephone counseling and instructions on exercise, diet and modest weight loss, or to a control group that was wait-listed for 12 months.

The subjects were between 65 and 91 years of age, with a body mass index ranging from 25-40 and were at least five-year survivors of cancer. The mean baseline Short-Form 36 physical function score was 75.7.

After 12 months of intervention, the mean function scores declined less in the intervention group (-2.15) compared with the control group (-4.84). The mean changes in basic lower extremity function were a gain of 0.34 in the intervention group compared with a decline of -1.89 in the control group.

"Physical activity, dietary behaviors and overall quality of life increased significantly in the intervention group compared with the control group, and weight loss also was greater (2.06 kg vs 0.92 kg, respectively)," the researchers report.

"Our counseling goals encouraged individuals to perform 30 minutes or more of moderate endurance exercise on five or more days of the week and 15 minutes of leg strength training every other day," Dr. Morey explained. "Our study participants were given exercise bands or simply did weight bearing leg strengthening exercises."

Looking at the combined duration of both strength and endurance exercises, "the counseling group increased from an average baseline of 30 minutes of exercise per week to an average of 85 minutes per week at 12 months (an almost three-fold improvement)," Dr. Morey said, "while the control group went from an average baseline of 30 minutes of exercise per week to an average of 53 minutes per week at 12 months."

She commented, "For older, overweight adults with multiple chronic conditions, a three-fold increase in physical activity would be considered clinically meaningful, even though many are not physically capable of reaching the guideline goals established for healthy older adults."

Furthermore, Dr. Morey and her colleagues feel confident "that the observed results are indicative of adoption of the recommended behaviors," and will continue to be practiced long-term.

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