Optimising weight-loss interventions in cancer patients-A systematic review and network meta-analysis

Excess weight has been associated with increased morbidity and a worse prognosis in adult patients with early-stage cancer. The optimal lifestyle interventions to optimize anthropometric measures amongst cancer patients and survivors remain inconsistent. To conduct a systematic review and network me...

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Bibliographic Details
Published in:PloS one 2021-02, Vol.16 (2), p.e0245794-e0245794
Main Authors: LeVasseur, Nathalie, Cheng, Wei, Mazzarello, Sasha, Clemons, Mark, Vandermeer, Lisa, Jones, Lee, Joy, Anil Abraham, Barbeau, Pauline, Wolfe, Dianna, Ahmadzai, Nadera, Hersi, Mona, Stober, Carol, Shorr, Risa, Hilton, John, Hutton, Brian
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Body mass index
Body measurements
Body weight loss
Cancer
Cancer patients
Cancer therapies
Care and treatment
Clinical trials
Data collection
Diet
Diet therapy
Editing
Epidemiology
Exercise
Exercise therapy
Food and nutrition
Health aspects
Health care facilities
Health services
Hospitals
Intervention
Lifestyles
Measurement
Medical prognosis
Medical research
Medicine and Health Sciences
Meta-analysis
Methodology
Morbidity
Obesity
Oncology
Optimization
Patient outcomes
Patients
Physical activity
Physical fitness
Population studies
Prostate cancer
Public health
Questions
Systematic review
Weight control
Weight loss
Weight loss measurement
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Summary:Excess weight has been associated with increased morbidity and a worse prognosis in adult patients with early-stage cancer. The optimal lifestyle interventions to optimize anthropometric measures amongst cancer patients and survivors remain inconsistent. To conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the effects of exercise and dietary interventions alone or in combination on anthropometric measures of adult cancer patients and survivors. A systematic search of Medline, Embase and the Cochrane Trials Registry was performed. Outcomes of interest included changes in weight, body mass index (BMI), and waist circumference. Screening and data collection were performed by two reviewers. Bayesian NMAs were performed. Overall, 98 RCTs were included; 75 were incorporated in NMAs (n = 12,199). Groups of intervention strategies included: 3 exercise interventions, 8 dietary interventions, 7 combination interventions of diet and exercise and standard care. Median intervention duration was 26 weeks. NMA suggested that diet alone (mean difference [MD] -2.25kg, 95% CrI -3.43 to -0.91kg) and combination strategies (MD -2.52kg, 95% CrI -3.54 to -1.62kg) were associated with more weight loss compared to standard care. All dietary interventions achieved a similar magnitude of weight loss (MD range from -2.03kg to -2.52kg). Both diet alone and combination strategies demonstrated greater BMI reductions versus standard care, and each of diet alone, exercise alone and combination strategies demonstrated greater reductions in waist circumference than standard care. Diet and exercise alone or in combination are effective lifestyle interventions to improve anthropometric measures in cancer patients and survivors. All reputable diets appear to be similarly effective to achieve weight loss.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0245794