Impact of a 24-Week Mobile App-Based Human Coaching Program on Body Composition and Lipid Metabolism in Breast Cancer Survivors With Overweight or Obesity: Single-Arm Prospective Cohort Study.

内容摘要

Overweight or obesity is a prognostic factor for breast cancer recurrence and breast cancer-related deaths. However, weight control is difficult for breast cancer survivors because of menopause, chemotherapy, antihormonal therapy, and psychological issues. This study aimed to develop a 24-week mobile app-based human coaching program using Noom and evaluate its efficacy in breast cancer survivors who are excessively overweight or with obesity, including those who successfully used the program. In this single-arm prospective cohort study, 130 breast cancer survivors with BMI &#x2265;25 were enrolled and received a 24-week program, including diet-, exercise-, and psychology-based content with the trained human coach in Noom between 2019 and 2021. For a hyperactive group who joined for more than 16 weeks, we evaluated weight, BMI, lipid level, bioimpedance, and quality of life at baseline, 6-month, and 12-month follow-up. Among 130 breast cancer survivors, 101 (77.7%) and 93 (71.5%) completed the 6-month and 12-month follow-ups, respectively. The mean age of all participants was 54.90 (SD 7.42) years. At baseline, the median BMI was 27.14 (IQR 25.20-35.36) for the hyperactive group and 27.50 (IQR 25.20-35.50) for the active and inactive group. In the hyperactive group (68/101, 67%), body weight and BMI significantly reduced (mean difference -1.97, 95% CI -2.65 to -1.26 kg; P<.01 and mean difference -0.86, 95% CI -1.15 to -0.56; P<.01, respectively) at 6 months and were maintained at 12 months without the yo-yo effect. Among the lipid panel, triglyceride levels decreased significantly (-34.13, 95% CI -58.09 to-10.17; P<.01) and were maintained at 12 months. With respect to bioimpedance components, skeletal muscle mass (kg), body fat mass (kg), percent body fat (%), waist-to-hip ratio, and visceral fat area (cm2) improved in the first 6 months. However, waist-to-hip ratio and visceral fat area increased during the next 6 months. Based on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ C30) and Breast Cancer Module (23 items), nausea or vomiting, constipation, body image, and arm and breast symptoms significantly improved during the first 6 months. This study demonstrated that a 24-week mobile app-based human coaching program is beneficial for controlling body weight, BMI, triglyceride, and body composition in terms of bioimpedance for breast cancer survivors who are excessively overweight or have obesity.