Hsin-Chieh Yeh1, John P Bantle2, Maria Cassidy-Begay3, George Blackburn4, George A Bray5, Tim Byers6, Jeanne M Clark7, Mace Coday8, Caitlin Egan9, Mark A Espeland10, John P Foreyt11, Katelyn Garcia10, Valerie Goldman12, Edward W Gregg13, Helen P Hazuda14, Louise Hesson15, James O Hill16, Edward S Horton17, John M Jakicic18, Robert W Jeffery19, Karen C Johnson8, Steven E Kahn20, William C Knowler3, Mary Korytkowski21, Anne Kure20, Cora E Lewis22, Christos Mantzoros4, Maria Meacham3, Maria G Montez14, David M Nathan12, Nicholas Pajewski10, Jennifer Patricio23, Anne Peters24, F Xavier Pi-Sunyer23, Henry Pownall25, Donna H Ryan5, Monika Safford26, Rebecca L Sedjo27, Helmut Steinburg28, Mara Vitolins29, Thomas A Wadden15, Lynne E Wagenknecht30, Rena R Wing9, Antonio C Wolff31, Holly Wyatt32, Susan Z Yanovski33. 1. Departments of Medicine, Epidemiology, and Oncology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA. 2. Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA. 3. National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix Epidemiology and Clinical Research Branch, Phoenix, Arizona, USA. 4. Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. 5. Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA. 6. Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 7. Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. 8. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA. 9. Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. 10. Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 11. Department of Medicine, Baylor College of Medicine, Houston, Texas, USA. 12. Diabetes Clinical Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA. 13. Department of Epidemiology and Biostatistics, Imperial College London, London, UK. 14. Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. 15. Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. 16. Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA. 17. Department of Medicine, Joslin Diabetes Center, Boston, Massachusetts, USA. 18. Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 19. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA. 20. Department of Medicine, VA Puget Sound Health Care System / University of Washington, Seattle, Washington, USA. 21. Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 22. Division of Preventive Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA. 23. Columbia University Medical Center, New York, New York, USA. 24. Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 25. Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA. 26. Department of Medicine, Weill Cornell Medical College of Cornell University, New York, New York, USA. 27. Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 28. Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA. 29. Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 30. Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 31. Department of Oncology, The Johns Hopkins Sydney Kimmel Cancer Center, Baltimore, Maryland, USA. 32. Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 33. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Abstract
OBJECTIVE: This study was designed to determine whether intensive lifestyle intervention (ILI) aimed at weight loss lowers cancer incidence and mortality. METHODS: Data from the Look AHEAD trial were examined to investigate whether participants randomized to ILI designed for weight loss would have reduced overall cancer incidence, obesity-related cancer incidence, and cancer mortality, as compared with the diabetes support and education (DSE) comparison group. This analysis included 4,859 participants without a cancer diagnosis at baseline except for nonmelanoma skin cancer. RESULTS: After a median follow-up of 11 years, 684 participants (332 in ILI and 352 in DSE) were diagnosed with cancer. The incidence rates of obesity-related cancers were 6.1 and 7.3 per 1,000 person-years in ILI and DSE, respectively, with a hazard ratio (HR) of 0.84 (95% CI: 0.68-1.04). There was no significant difference between the two groups in total cancer incidence (HR, 0.93; 95% CI: 0.80-1.08), incidence of nonobesity-related cancers (HR, 1.02; 95% CI: 0.83-1.27), or total cancer mortality (HR, 0.92; 95% CI: 0.68-1.25). CONCLUSIONS: An ILI aimed at weight loss lowered incidence of obesity-related cancers by 16% in adults with overweight or obesity and type 2 diabetes. The study sample size likely lacked power to determine effect sizes of this magnitude and smaller.
OBJECTIVE: This study was designed to determine whether intensive lifestyle intervention (ILI) aimed at weight loss lowers cancer incidence and mortality. METHODS: Data from the Look AHEAD trial were examined to investigate whether participants randomized to ILI designed for weight loss would have reduced overall cancer incidence, obesity-related cancer incidence, and cancer mortality, as compared with the diabetes support and education (DSE) comparison group. This analysis included 4,859 participants without a cancer diagnosis at baseline except for nonmelanoma skin cancer. RESULTS: After a median follow-up of 11 years, 684 participants (332 in ILI and 352 in DSE) were diagnosed with cancer. The incidence rates of obesity-related cancers were 6.1 and 7.3 per 1,000 person-years in ILI and DSE, respectively, with a hazard ratio (HR) of 0.84 (95% CI: 0.68-1.04). There was no significant difference between the two groups in total cancer incidence (HR, 0.93; 95% CI: 0.80-1.08), incidence of nonobesity-related cancers (HR, 1.02; 95% CI: 0.83-1.27), or total cancer mortality (HR, 0.92; 95% CI: 0.68-1.25). CONCLUSIONS: An ILI aimed at weight loss lowered incidence of obesity-related cancers by 16% in adults with overweight or obesity and type 2 diabetes. The study sample size likely lacked power to determine effect sizes of this magnitude and smaller.
Authors: Rena R Wing; Paula Bolin; Frederick L Brancati; George A Bray; Jeanne M Clark; Mace Coday; Richard S Crow; Jeffrey M Curtis; Caitlin M Egan; Mark A Espeland; Mary Evans; John P Foreyt; Siran Ghazarian; Edward W Gregg; Barbara Harrison; Helen P Hazuda; James O Hill; Edward S Horton; Van S Hubbard; John M Jakicic; Robert W Jeffery; Karen C Johnson; Steven E Kahn; Abbas E Kitabchi; William C Knowler; Cora E Lewis; Barbara J Maschak-Carey; Maria G Montez; Anne Murillo; David M Nathan; Jennifer Patricio; Anne Peters; Xavier Pi-Sunyer; Henry Pownall; David Reboussin; Judith G Regensteiner; Amy D Rickman; Donna H Ryan; Monika Safford; Thomas A Wadden; Lynne E Wagenknecht; Delia S West; David F Williamson; Susan Z Yanovski Journal: N Engl J Med Date: 2013-06-24 Impact factor: 91.245
Authors: Daniel P Schauer; Heather Spencer Feigelson; Corinna Koebnick; Bette Caan; Sheila Weinmann; Anthony C Leonard; J David Powers; Panduranga R Yenumula; David E Arterburn Journal: Ann Surg Date: 2019-01 Impact factor: 12.969
Authors: Jeanine M Genkinger; Donna Spiegelman; Kristin E Anderson; Leslie Bernstein; Piet A van den Brandt; Eugenia E Calle; Dallas R English; Aaron R Folsom; Jo L Freudenheim; Charles S Fuchs; Graham G Giles; Edward Giovannucci; Pamela L Horn-Ross; Susanna C Larsson; Michael Leitzmann; Satu Männistö; James R Marshall; Anthony B Miller; Alpa V Patel; Thomas E Rohan; Rachael Z Stolzenberg-Solomon; Bas A J Verhage; Jarmo Virtamo; Bradley J Willcox; Alicja Wolk; Regina G Ziegler; Stephanie A Smith-Warner Journal: Int J Cancer Date: 2011-03-04 Impact factor: 7.396
Authors: Ted D Adams; Antoinette M Stroup; Richard E Gress; Kenneth F Adams; Eugenia E Calle; Sherman C Smith; R Chad Halverson; Steven C Simper; Paul N Hopkins; Steven C Hunt Journal: Obesity (Silver Spring) Date: 2009-01-15 Impact factor: 5.002
Authors: Juhua Luo; Michael Hendryx; JoAnn E Manson; Jane C Figueiredo; Erin S LeBlanc; Wendy Barrington; Thomas E Rohan; Barbara V Howard; Kerryn Reding; Gloria Yf Ho; David O Garcia; Rowan T Chlebowski Journal: JNCI Cancer Spectr Date: 2019-08-09
Authors: Kajsa Sjöholm; Lena M S Carlsson; Per-Arne Svensson; Johanna C Andersson-Assarsson; Felipe Kristensson; Peter Jacobson; Markku Peltonen; Magdalena Taube Journal: Diabetes Care Date: 2022-02-01 Impact factor: 19.112
Authors: Ali Aminian; Rickesha Wilson; Abbas Al-Kurd; Chao Tu; Alex Milinovich; Matthew Kroh; Raul J Rosenthal; Stacy A Brethauer; Philip R Schauer; Michael W Kattan; Justin C Brown; Nathan A Berger; Jame Abraham; Steven E Nissen Journal: JAMA Date: 2022-06-28 Impact factor: 157.335
Authors: Rena R Wing; Rebecca H Neiberg; Judy L Bahnson; Jeanne M Clark; Mark A Espeland; James O Hill; Karen C Johnson; William C Knowler; KayLoni Olson; Helmut Steinburg; Xavier Pi-Sunyer; Thomas A Wadden; Holly Wyatt; Jeanne M Clark; Lee Swartz; Dawn Jiggetts; Jeanne Charleston; Lawrence Cheskin; Nisa M Maruthur; Scott J Pilla; Danielle Diggins; Mia Johnson; George A Bray; Frank L Greenway; Donna H Ryan; Catherine Champagne; Valerie Myers; Jeffrey Keller; Tiffany Stewart; Jennifer Arceneaux; Karen Boley; Greta Fry; Lisa Jones; Kim Landry; Melissa Lingle; Marisa Smith; Cora E Lewis; Sheikilya Thomas; Stephen Glasser; Gareth Dutton; Amy Dobelstein; Sara Hannum; Anne Hubbell; DeLavallade Lee; Phyllis Millhouse; L Christie Oden; Cathy Roche; Jackie Grant; Janet Turman; David M Nathan; Valerie Goldman; Linda Delahanty; Mary Larkin; Kristen Dalton; Roshni Singh; Melanie Ruazol; Medha N Munshi; Sharon D Jackson; Roeland J W Middelbeek; A Enrique Caballero; Anthony Rodriguez; George Blackburn; Christos Mantzoros; Ann McNamara; Holly Wyatt; James O Hill; Jeanne Anne Breen; Marsha Miller; Debbie Bochert; Suzette Bossart; Paulette Cohrs; Susan Green; April Hamilton; Eugene Leshchinskiy; Loretta Rome; John P Foreyt; Molly Gee; Henry Pownall; Ashok Balasubramanyam; Chu-Huang Chen; Peter Jones; Michele Burrington; Allyson Clark Gardner; Sharon Griggs; Michelle Hamilton; Veronica Holley; Sarah Lee; Sarah Lane Liscum; Susan Cantu-Lumbreras; Julieta Palencia; Jennifer Schmidt; Jayne Thomas; Carolyn White; Charlyne Wright; Monica Alvarez; Karen C Johnson; Beate Griffin; Mace Coday; Donna Valenski; Lisa Jones; Karen Johnson; Karen C Johnson; Helmut Steinburg; Robert W Jeffery; Tricia Skarphol; John P Bantle; J Bruce Redmon; Kerrin Brelje; Carolyne Campbell; Mary Ann Forseth; Soni Uccellini; Mary Susan Voeller; Blandine Laferrère; Xavier Pi-Sunyer; Jennifer Patricio; Jose Luchsinger; Priya Palta; Sarah Lyon; Kim Kelly; Thomas A Wadden; Barbara J Maschak-Carey; Robert I Berkowitz; Ariana Chao; Renee Davenport; Katherine Gruber; Sharon Leonard; Olivia Walsh; John M Jakicic; Jacqueline Wesche-Thobaben; Lin Ewing; Andrea Hergenroeder; Mary Korytkowski; Susan Copelli; Rebecca Danchenko; Diane Ives; Juliet Mancino; Lisa Martich; Meghan McGuire; Tracey Y Murray; Linda Semler; Kathy Williams; Rena R Wing; Caitlin Egan; Elissa Jelalian; Jeanne McCaffery; Kathryn Demos McDermott; Jessica Unick; Kirsten Annis; Jose DaCruz; Ariana Rafanelli; Helen P Hazuda; Juan Carlos Isaac; Prepedigna Hernandez; Steven E Kahn; Edward J Boyko; Elaine Tsai; Lorena Wright; Karen Atkinson; Ivy Morgan-Taggart; Jolanta Socha; Heidi Urquhart; William C Knowler; Paula Bolin; Harelda Anderson; Sara Michaels; Ruby Johnson; Patricia Poorthunder; Janelia Smiley; Anne L Peters; Siran Ghazarian; Elizabeth Beale; Edgar Ramirez; Gabriela Rodriguez; Valerie Ruelas; Sara Serafin-Dokhan; Martha Walker; Marina Perez; Mark A Espeland; Lynne E Wagenknecht; Judy L Bahnson; David Reboussin; Mike E Miller; Peter Brubaker; Nicholas Pajewski; Michael Bancks; Jingzhong Ding; Gagan Deep; Kathleen Hayden; Stephen R Rapp; Felicia Simpson; Haiying Chen; Bonnie C Sachs; Denise Houston; Shyh-Huei Chen; Andrea Anderson; Jerry M Barnes; Mary Barr; Tara D Beckner; Delilah R Cook; Carrie C Williams; Joni Evans; Katie Garcia; Sarah A Gaussoin; Carol Kittel; Lea Harvin; Marjorie Howard; James Lovato; Rebecca H Neiberg; June Pierce; Debbie Steinberg; Christopher Webb; Jennifer Walker; Michael P Walkup; Carolyn Watkins; Santica M Marcovina; Jessica Hurting; John J Albers; Vinod Gaur; Michael Nevitt; Ann Schwartz; John Shepherd; Michaela Rahorst; Lisa Palermo; Susan Ewing; Cynthia Hayashi; Jason Maeda Journal: Diabetes Care Date: 2022-04-14 Impact factor: 17.152
Authors: G Craig Wood; Lisa Bailey-Davis; Peter Benotti; Adam Cook; James Dove; Jacob Mowery; Abhilasha Ramasamy; Neeraj Iyer; B Gabriel Smolarz; Neela Kumar; Christopher D Still Journal: PLoS One Date: 2021-11-03 Impact factor: 3.240
Authors: Anie Naqvi; Michelle L MacKintosh; Abigail E Derbyshire; Anna-Maria Tsakiroglou; Thomas D J Walker; Rhona J McVey; James Bolton; Martin Fergie; Steven Bagley; Garry Ashton; Philip W Pemberton; Akheel A Syed; Basil J Ammori; Richard Byers; Emma J Crosbie Journal: Int J Obes (Lond) Date: 2021-12-02 Impact factor: 5.551
Authors: Abigail E Derbyshire; Michelle L MacKintosh; Christina M Pritchard; Arya Pontula; Basil J Ammori; Akheel A Syed; Rebecca J Beeken; Emma J Crosbie Journal: Int J Womens Health Date: 2022-01-28