The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial

Annie S Anderson, Angela M Craigie, Stephen Caswell, Shaun Treweek, Martine Stead, Maureen Macleod, Fergus Daly, Jill Belch, Jackie Rodger, Alison Kirk, Anne Ludbrook, Petra Rauchhaus, Patricia Norwood, Joyce Thompson, Jane Wardle, Robert J C Steele

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Abstract

Objective: To evaluate the impact of a diet and physical activity intervention (BeWEL) on weight change in people with a body mass index >25 weight (kg)/height (m)2 at increased risk of colorectal cancer and other obesity related comorbidities. Design: Multicentre, parallel group, randomised controlled trial. Setting: Four Scottish National Health Service health boards. Participants 329 overweight or obese adults (aged 50 to 74 years) who had undergone colonoscopy after a positive faecal occult blood test result, as part of the national bowel screening programme, and had a diagnosis of adenoma confirmed by histopathology. 163 were randomised to intervention and 166 to control. Intervention: Participants were randomised to a control group (weight loss booklet only) or 12 month intervention group (three face to face visits with a lifestyle counsellor plus monthly 15 minute telephone calls). A goal of 7% reduction in body weight was set and participants received a personalised energy prescription (2508 kJ (600 kcal) below that required for weight maintenance) and bodyweight scales. Motivational interviewing techniques explored self assessed confidence, ambivalence, and personal values concerning weight. Behavioural strategies included goal setting, identifying intentions of implementation, self monitoring of body weight, and counsellor feedback about reported diet, physical activity, and weight change. Main outcome measures: The primary outcome was weight change over 12 months. Secondary outcomes included changes in waist circumference, blood pressure, fasting cardiovascular biomarkers, and glucose metabolism variables, physical activity, diet, and alcohol consumption. Results: At 12 months, data on the primary outcome were available for 148 (91%) participants in the intervention group and 157 (95%) in the control group. Mean weight loss was 3.50 kg (SD 4.91) (95% confidence interval 2.70 to 4.30) in the intervention group compared with 0.78 kg (SD 3.77) (0.19 to 1.38) in the control group. The group difference was 2.69 kg (95% confidence interval 1.70 to 3.67). Differences between groups were significant for waist circumference, body mass index, blood pressure, blood glucose level, diet, and physical activity. No reported adverse events were considered to be related to trial participation. Conclusions: Significant weight loss can be achieved by a diet and physical activity intervention initiated within a national colorectal cancer screening programme, offering considerable potential for risk reduction of disease in older adults.

LanguageEnglish
Article numberg1823
Number of pages13
JournalBMJ
Volume348
DOIs
Publication statusPublished - 7 Mar 2014

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Early Detection of Cancer
Colorectal Neoplasms
Randomized Controlled Trials
Exercise
Weights and Measures
Diet
Weight Loss
Ego
Waist Circumference
Control Groups
Body Mass Index
Body Weight
Confidence Intervals
Motivational Interviewing
Blood Pressure
Occult Blood
Pamphlets
National Health Programs
Hematologic Tests
Risk Reduction Behavior

Keywords

  • BeWEL
  • cancer screening
  • weight loss
  • physical activity intervention
  • weight change

Cite this

Anderson, Annie S ; Craigie, Angela M ; Caswell, Stephen ; Treweek, Shaun ; Stead, Martine ; Macleod, Maureen ; Daly, Fergus ; Belch, Jill ; Rodger, Jackie ; Kirk, Alison ; Ludbrook, Anne ; Rauchhaus, Petra ; Norwood, Patricia ; Thompson, Joyce ; Wardle, Jane ; Steele, Robert J C. / The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme : randomised controlled trial. In: BMJ. 2014 ; Vol. 348.
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Anderson, AS, Craigie, AM, Caswell, S, Treweek, S, Stead, M, Macleod, M, Daly, F, Belch, J, Rodger, J, Kirk, A, Ludbrook, A, Rauchhaus, P, Norwood, P, Thompson, J, Wardle, J & Steele, RJC 2014, 'The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial' BMJ, vol. 348, g1823. https://doi.org/10.1136/bmj.g1823

The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme : randomised controlled trial. / Anderson, Annie S; Craigie, Angela M; Caswell, Stephen; Treweek, Shaun; Stead, Martine; Macleod, Maureen; Daly, Fergus; Belch, Jill; Rodger, Jackie; Kirk, Alison; Ludbrook, Anne; Rauchhaus, Petra; Norwood, Patricia; Thompson, Joyce; Wardle, Jane; Steele, Robert J C.

In: BMJ, Vol. 348, g1823, 07.03.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme

T2 - BMJ

AU - Anderson, Annie S

AU - Craigie, Angela M

AU - Caswell, Stephen

AU - Treweek, Shaun

AU - Stead, Martine

AU - Macleod, Maureen

AU - Daly, Fergus

AU - Belch, Jill

AU - Rodger, Jackie

AU - Kirk, Alison

AU - Ludbrook, Anne

AU - Rauchhaus, Petra

AU - Norwood, Patricia

AU - Thompson, Joyce

AU - Wardle, Jane

AU - Steele, Robert J C

PY - 2014/3/7

Y1 - 2014/3/7

N2 - Objective: To evaluate the impact of a diet and physical activity intervention (BeWEL) on weight change in people with a body mass index >25 weight (kg)/height (m)2 at increased risk of colorectal cancer and other obesity related comorbidities. Design: Multicentre, parallel group, randomised controlled trial. Setting: Four Scottish National Health Service health boards. Participants 329 overweight or obese adults (aged 50 to 74 years) who had undergone colonoscopy after a positive faecal occult blood test result, as part of the national bowel screening programme, and had a diagnosis of adenoma confirmed by histopathology. 163 were randomised to intervention and 166 to control. Intervention: Participants were randomised to a control group (weight loss booklet only) or 12 month intervention group (three face to face visits with a lifestyle counsellor plus monthly 15 minute telephone calls). A goal of 7% reduction in body weight was set and participants received a personalised energy prescription (2508 kJ (600 kcal) below that required for weight maintenance) and bodyweight scales. Motivational interviewing techniques explored self assessed confidence, ambivalence, and personal values concerning weight. Behavioural strategies included goal setting, identifying intentions of implementation, self monitoring of body weight, and counsellor feedback about reported diet, physical activity, and weight change. Main outcome measures: The primary outcome was weight change over 12 months. Secondary outcomes included changes in waist circumference, blood pressure, fasting cardiovascular biomarkers, and glucose metabolism variables, physical activity, diet, and alcohol consumption. Results: At 12 months, data on the primary outcome were available for 148 (91%) participants in the intervention group and 157 (95%) in the control group. Mean weight loss was 3.50 kg (SD 4.91) (95% confidence interval 2.70 to 4.30) in the intervention group compared with 0.78 kg (SD 3.77) (0.19 to 1.38) in the control group. The group difference was 2.69 kg (95% confidence interval 1.70 to 3.67). Differences between groups were significant for waist circumference, body mass index, blood pressure, blood glucose level, diet, and physical activity. No reported adverse events were considered to be related to trial participation. Conclusions: Significant weight loss can be achieved by a diet and physical activity intervention initiated within a national colorectal cancer screening programme, offering considerable potential for risk reduction of disease in older adults.

AB - Objective: To evaluate the impact of a diet and physical activity intervention (BeWEL) on weight change in people with a body mass index >25 weight (kg)/height (m)2 at increased risk of colorectal cancer and other obesity related comorbidities. Design: Multicentre, parallel group, randomised controlled trial. Setting: Four Scottish National Health Service health boards. Participants 329 overweight or obese adults (aged 50 to 74 years) who had undergone colonoscopy after a positive faecal occult blood test result, as part of the national bowel screening programme, and had a diagnosis of adenoma confirmed by histopathology. 163 were randomised to intervention and 166 to control. Intervention: Participants were randomised to a control group (weight loss booklet only) or 12 month intervention group (three face to face visits with a lifestyle counsellor plus monthly 15 minute telephone calls). A goal of 7% reduction in body weight was set and participants received a personalised energy prescription (2508 kJ (600 kcal) below that required for weight maintenance) and bodyweight scales. Motivational interviewing techniques explored self assessed confidence, ambivalence, and personal values concerning weight. Behavioural strategies included goal setting, identifying intentions of implementation, self monitoring of body weight, and counsellor feedback about reported diet, physical activity, and weight change. Main outcome measures: The primary outcome was weight change over 12 months. Secondary outcomes included changes in waist circumference, blood pressure, fasting cardiovascular biomarkers, and glucose metabolism variables, physical activity, diet, and alcohol consumption. Results: At 12 months, data on the primary outcome were available for 148 (91%) participants in the intervention group and 157 (95%) in the control group. Mean weight loss was 3.50 kg (SD 4.91) (95% confidence interval 2.70 to 4.30) in the intervention group compared with 0.78 kg (SD 3.77) (0.19 to 1.38) in the control group. The group difference was 2.69 kg (95% confidence interval 1.70 to 3.67). Differences between groups were significant for waist circumference, body mass index, blood pressure, blood glucose level, diet, and physical activity. No reported adverse events were considered to be related to trial participation. Conclusions: Significant weight loss can be achieved by a diet and physical activity intervention initiated within a national colorectal cancer screening programme, offering considerable potential for risk reduction of disease in older adults.

KW - BeWEL

KW - cancer screening

KW - weight loss

KW - physical activity intervention

KW - weight change

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DO - 10.1136/bmj.g1823

M3 - Article

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JO - BMJ

JF - BMJ

SN - 0959-8138

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