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Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Study protocol

Study protocol for BeWEL: The impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas

Authors: Angela M Craigie, Stephen Caswell, Caron Paterson, Shaun Treweek, Jill JF Belch, Fergus Daly, Jackie Rodger, Joyce Thompson, Alison Kirk, Anne Ludbrook, Martine Stead, Jane Wardle, Robert JC Steele, Annie S Anderson

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second highest cause of cancer death in the UK. Most cases occur in people over 50 years and CRC often co-exists with other lifestyle related disorders including obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). These diseases share risk factors related to the metabolic syndrome including large body size, abnormal lipids and markers of insulin resistance indicating common aetiological pathways.

Methods/Design

This 3 year study will be a two-arm, multicentre, randomised controlled trial comparing the BeWEL lifestyle (diet, physical activity and behaviour change) programme against usual care. The pre-trial development will take 6 months and participants will be recruited over a 12 month period and undertake the intervention and follow up for 12 months (total 24 months recruitment and intervention implementation) with a further 6 months for data collection, analysis and interpretation.
Four hundred and fifty two participants who have had a colorectal adenoma detected and removed (through the national colorectal screening programme) will provide 80% power to detect a weight loss of 7% over 12 months.
Primary outcomes are changes in body weight and waist circumference. Secondary outcomes will include cardiovascular risk factors, psycho-social measures and intervention costs.

Discussion

The results from this study will enhance the evidence base for lifestyle change in patients at higher risk of chronic disease including obesity related cancers.
International Standard Randomised Controlled Trials No: ISRCTN53033856
Appendix
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Literature
2.
go back to reference Baade PD, Fritschi L, Eakin EG: Non-cancer mortality among people diagnosed with cancer (Australia). Cancer Causes Control. 2006, 17 (3): 287-97. 10.1007/s10552-005-0530-0.CrossRefPubMed Baade PD, Fritschi L, Eakin EG: Non-cancer mortality among people diagnosed with cancer (Australia). Cancer Causes Control. 2006, 17 (3): 287-97. 10.1007/s10552-005-0530-0.CrossRefPubMed
3.
go back to reference Brown BW, Brauner C, Minnotte MC: Noncancer deaths in white adult cancer patients. J Natl Cancer Inst. 1993, 85 (12): 979-87. 10.1093/jnci/85.12.979. 16CrossRefPubMed Brown BW, Brauner C, Minnotte MC: Noncancer deaths in white adult cancer patients. J Natl Cancer Inst. 1993, 85 (12): 979-87. 10.1093/jnci/85.12.979. 16CrossRefPubMed
4.
go back to reference World Health Organization: Global strategy on diet, physical activity and health (Resolution 57.17). 2004, Geneva World Health Organization: Global strategy on diet, physical activity and health (Resolution 57.17). 2004, Geneva
5.
go back to reference World Cancer Research Fund/American Institute for Cancer Research: Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. 2007, Washington World Cancer Research Fund/American Institute for Cancer Research: Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. 2007, Washington
6.
go back to reference Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002, 346 (6): 393-403. 10.1056/NEJMoa012512.CrossRefPubMedCentral Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002, 346 (6): 393-403. 10.1056/NEJMoa012512.CrossRefPubMedCentral
7.
go back to reference Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M: Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001, 344 (18): 1343-50. 10.1056/NEJM200105033441801. 3CrossRefPubMed Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M: Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001, 344 (18): 1343-50. 10.1056/NEJM200105033441801. 3CrossRefPubMed
8.
go back to reference Torjesen PA, Birkeland KI, Anderssen SA, Hjermann I, Holme I, Urdal P: Lifestyle changes may reverse development of the insulin resistance syndrome. The Oslo Diet and Exercise Study: a randomized trial. Diabetes Care. 1997, 20 (1): 26-31. 10.2337/diacare.20.1.26.CrossRefPubMed Torjesen PA, Birkeland KI, Anderssen SA, Hjermann I, Holme I, Urdal P: Lifestyle changes may reverse development of the insulin resistance syndrome. The Oslo Diet and Exercise Study: a randomized trial. Diabetes Care. 1997, 20 (1): 26-31. 10.2337/diacare.20.1.26.CrossRefPubMed
9.
go back to reference Ratner R, Goldberg R, Haffner S, Marcovina S, Orchard T, Fowler S, Temprosa M: Diabetes Prevention Program Research Group. Impact of intensive lifestyle and metformin therapy on cardiovascular disease risk factors in the diabetes prevention program. Diabetes Care. 2005, 28 (4): 888-94. 10.2337/diacare.28.4.888.CrossRefPubMed Ratner R, Goldberg R, Haffner S, Marcovina S, Orchard T, Fowler S, Temprosa M: Diabetes Prevention Program Research Group. Impact of intensive lifestyle and metformin therapy on cardiovascular disease risk factors in the diabetes prevention program. Diabetes Care. 2005, 28 (4): 888-94. 10.2337/diacare.28.4.888.CrossRefPubMed
10.
go back to reference Jacobs ET, Martínez ME, Alberts DS, Jiang R, Lance P, Lowe KA, Thompson PA: Association between body size and colorectal adenoma recurrence. Clin Gastroenterol Hepatol. 2007, 5 (8): 982-90. 10.1016/j.cgh.2007.03.022.CrossRefPubMedPubMedCentral Jacobs ET, Martínez ME, Alberts DS, Jiang R, Lance P, Lowe KA, Thompson PA: Association between body size and colorectal adenoma recurrence. Clin Gastroenterol Hepatol. 2007, 5 (8): 982-90. 10.1016/j.cgh.2007.03.022.CrossRefPubMedPubMedCentral
11.
go back to reference Sedjo RL, Byers T, Levin TR, Haffner SM, Saad MF, Tooze JA, D'Agostino RB: Change in Body Size and the Risk of Colorectal Adenomas. Cancer Epidemiol Biomarkers Prev. 2007. 2007, 16 (3): 526-31. 10.1158/1055-9965.EPI-06-0229.CrossRef Sedjo RL, Byers T, Levin TR, Haffner SM, Saad MF, Tooze JA, D'Agostino RB: Change in Body Size and the Risk of Colorectal Adenomas. Cancer Epidemiol Biomarkers Prev. 2007. 2007, 16 (3): 526-31. 10.1158/1055-9965.EPI-06-0229.CrossRef
12.
go back to reference Yamaji Yutaka, Okamoto Makoto, Yoshida Haruhiko, Kawabe Takao, Wada Ryoichi, Mitsushima Toru, Masao Omata: The effect of body weight reduction on the incidence of colorectal adenoma. Am J Gastroenterol. 2008, 103 (8): 2061-7. 10.1111/j.1572-0241.2008.01936.x.CrossRefPubMed Yamaji Yutaka, Okamoto Makoto, Yoshida Haruhiko, Kawabe Takao, Wada Ryoichi, Mitsushima Toru, Masao Omata: The effect of body weight reduction on the incidence of colorectal adenoma. Am J Gastroenterol. 2008, 103 (8): 2061-7. 10.1111/j.1572-0241.2008.01936.x.CrossRefPubMed
13.
go back to reference Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC: Long-term mortality after gastric bypass surgery. N Engl J Med. 2007, 357 (8): 753-61. 10.1056/NEJMoa066603. 23CrossRefPubMed Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC: Long-term mortality after gastric bypass surgery. N Engl J Med. 2007, 357 (8): 753-61. 10.1056/NEJMoa066603. 23CrossRefPubMed
14.
go back to reference Byberg L, Melhus H, Gedeborg R, Sundström J, Ahlbom A, Zethelius B, Berglund LG, Wolk A, Michaëlsson K: Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort. BMJ. 2009, 338: b688-10.1136/bmj.b688.CrossRefPubMedPubMedCentral Byberg L, Melhus H, Gedeborg R, Sundström J, Ahlbom A, Zethelius B, Berglund LG, Wolk A, Michaëlsson K: Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort. BMJ. 2009, 338: b688-10.1136/bmj.b688.CrossRefPubMedPubMedCentral
15.
go back to reference Baron JA, Cole BF, Sandler RS, Haile RW, Ahnen D, Bresalier R, McKeown-Eyssen G, Summers RW, Rothstein R, Burke CA, Snover DC, Church TR, Allen JI, Beach M, Beck GJ, Bond JH, Byers T, Greenberg ER, Mandel JS, Marcon N, Mott LA, Pearson L, Saibil F, van Stolk RU: A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med. 2003, 348 (10): 891-9. 10.1056/NEJMoa021735. 6CrossRefPubMed Baron JA, Cole BF, Sandler RS, Haile RW, Ahnen D, Bresalier R, McKeown-Eyssen G, Summers RW, Rothstein R, Burke CA, Snover DC, Church TR, Allen JI, Beach M, Beck GJ, Bond JH, Byers T, Greenberg ER, Mandel JS, Marcon N, Mott LA, Pearson L, Saibil F, van Stolk RU: A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med. 2003, 348 (10): 891-9. 10.1056/NEJMoa021735. 6CrossRefPubMed
16.
go back to reference Laiyemo AO, Murphy G, Albert PS, Sansbury LB, Wang Z, Cross AJ, Marcus PM, Caan B, Marshall JR, Lance P, Paskett ED, Weissfeld J, Slattery ML, Burt R, Iber F, Shike M, Kikendall JW, Lanza E, Schatzkin A: Postpolypectomy colonoscopy surveillance guidelines: predictive accuracy for advanced adenoma at 4 years. Ann Intern Med. 2008, 148 (6): 419-26. 18CrossRefPubMed Laiyemo AO, Murphy G, Albert PS, Sansbury LB, Wang Z, Cross AJ, Marcus PM, Caan B, Marshall JR, Lance P, Paskett ED, Weissfeld J, Slattery ML, Burt R, Iber F, Shike M, Kikendall JW, Lanza E, Schatzkin A: Postpolypectomy colonoscopy surveillance guidelines: predictive accuracy for advanced adenoma at 4 years. Ann Intern Med. 2008, 148 (6): 419-26. 18CrossRefPubMed
18.
go back to reference Vanwormer JJ, French SA, Pereira MA, Welsh EM: The Impact of Regular Self-weighing on Weight Management: A Systematic Literature Review. Int J Behav Nutr Phys Act. 2008, 5: 54-10.1186/1479-5868-5-54.CrossRefPubMedPubMedCentral Vanwormer JJ, French SA, Pereira MA, Welsh EM: The Impact of Regular Self-weighing on Weight Management: A Systematic Literature Review. Int J Behav Nutr Phys Act. 2008, 5: 54-10.1186/1479-5868-5-54.CrossRefPubMedPubMedCentral
19.
go back to reference VanWormer JJ, Martinez AM, Martinson BC, Crain AL, Benson GA, Cosentino DL, Pronk NP: Self-weighing promotes weight loss for obese adults. Am J Prev Med. 2009, 36 (1): 70-3. 10.1016/j.amepre.2008.09.022.CrossRefPubMed VanWormer JJ, Martinez AM, Martinson BC, Crain AL, Benson GA, Cosentino DL, Pronk NP: Self-weighing promotes weight loss for obese adults. Am J Prev Med. 2009, 36 (1): 70-3. 10.1016/j.amepre.2008.09.022.CrossRefPubMed
20.
go back to reference Caswell S, Anderson AS, Steele RJ: Bowel health to better health: a minimal contact lifestyle intervention for people at increased risk of colorectal cancer. Br J Nutr. 2009, 102 (11): 1541-6. 10.1017/S0007114509990808.CrossRefPubMed Caswell S, Anderson AS, Steele RJ: Bowel health to better health: a minimal contact lifestyle intervention for people at increased risk of colorectal cancer. Br J Nutr. 2009, 102 (11): 1541-6. 10.1017/S0007114509990808.CrossRefPubMed
21.
go back to reference Kelly MP, McDaid D, Ludbrook A, Powell J: Economic appraisal of public health interventions. Edited by: Agency NHD. 2005, HDA Briefing Paper, London Kelly MP, McDaid D, Ludbrook A, Powell J: Economic appraisal of public health interventions. Edited by: Agency NHD. 2005, HDA Briefing Paper, London
22.
go back to reference Roe L, Hunt P, Bradshaw H, Rayner M: Health promotion interventions to promote healthy eating in the general population: a review. 1997, London: The Cromwell Press Roe L, Hunt P, Bradshaw H, Rayner M: Health promotion interventions to promote healthy eating in the general population: a review. 1997, London: The Cromwell Press
23.
go back to reference McBride CM, Clipp E, Peterson BL, Lipkus IM, Demark-Wahnefried W: Psychological impact of diagnosis and risk reduction among cancer survivors. Psychooncology. 2000, 9 (5): 418-27. 10.1002/1099-1611(200009/10)9:5<418::AID-PON474>3.3.CO;2-5.CrossRefPubMed McBride CM, Clipp E, Peterson BL, Lipkus IM, Demark-Wahnefried W: Psychological impact of diagnosis and risk reduction among cancer survivors. Psychooncology. 2000, 9 (5): 418-27. 10.1002/1099-1611(200009/10)9:5<418::AID-PON474>3.3.CO;2-5.CrossRefPubMed
24.
go back to reference Miles A, Wardle J, McCaffery K, Williamson S, Atkin W: The effects of colorectal cancer screening on health attitudes and practices. Cancer Epidemiol Biomarkers Prev. 2003, 12 (7): 651-5.PubMed Miles A, Wardle J, McCaffery K, Williamson S, Atkin W: The effects of colorectal cancer screening on health attitudes and practices. Cancer Epidemiol Biomarkers Prev. 2003, 12 (7): 651-5.PubMed
25.
go back to reference Dyer KJ, Fearon KCH, Buckner K, Richardson RA: Diet and colorectal cancer risk: baseline dietary knowledge of colorectal patients. Health Education Journal. 2004, 63 (3): 242-53. 10.1177/001789690406300305.CrossRef Dyer KJ, Fearon KCH, Buckner K, Richardson RA: Diet and colorectal cancer risk: baseline dietary knowledge of colorectal patients. Health Education Journal. 2004, 63 (3): 242-53. 10.1177/001789690406300305.CrossRef
26.
go back to reference Caswell S, Anderson AS, Steele RJ: Diet and physical activity in patients with colorectal adenomas: directions for intervention programmes. J Hum Nutr Diet. 2008, 21 (5): 494-501. 10.1111/j.1365-277X.2008.00884.x.CrossRefPubMed Caswell S, Anderson AS, Steele RJ: Diet and physical activity in patients with colorectal adenomas: directions for intervention programmes. J Hum Nutr Diet. 2008, 21 (5): 494-501. 10.1111/j.1365-277X.2008.00884.x.CrossRefPubMed
27.
go back to reference Kirk A, Barnett J, Leese G, Mutrie N: A randomized trial investigating the 12-month changes in physical activity and health outcomes following a physical activity consultation delivered by a person or in written form in Type 2 diabetes: Time2Act. Diabet Med. 2009, 26 (3): 293-301. 10.1111/j.1464-5491.2009.02675.x.CrossRefPubMed Kirk A, Barnett J, Leese G, Mutrie N: A randomized trial investigating the 12-month changes in physical activity and health outcomes following a physical activity consultation delivered by a person or in written form in Type 2 diabetes: Time2Act. Diabet Med. 2009, 26 (3): 293-301. 10.1111/j.1464-5491.2009.02675.x.CrossRefPubMed
Metadata
Title
Study protocol for BeWEL: The impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas
Authors
Angela M Craigie
Stephen Caswell
Caron Paterson
Shaun Treweek
Jill JF Belch
Fergus Daly
Jackie Rodger
Joyce Thompson
Alison Kirk
Anne Ludbrook
Martine Stead
Jane Wardle
Robert JC Steele
Annie S Anderson
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-184

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