Browsing by Person "Howell, A."

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Adherence to a Diet and Exercise Weight Loss Intervention amongst Women at Increased Risk of Breast Cancer
(Bentham Open, 2010) Harvie, M.; Cohen, H.; Mason, C.; Mercer, Tom; Malik, R.; Adams, J.; Evans, D. G. R.; Hopwood, P.; Cuzick, J.; Howell, A.
Maintained weight loss of five percent or more may reduce risk of breast cancer. We conducted a feasibility pilot study to assess adherence to an intensive 12 month diet and exercise weight control intervention aimed to achieve and maintain a five percent or greater weight loss as compared to a usual care group receiving written advice only. Overweight premenopausal women at increased risk of breast cancer were enrolled in a 12 month diet and exercise weight loss programme (n = 40) or a comparison group receiving usual care (n = 39). Changes in weight, general (DXA, bioelectrical impedance) and central adiposity (intra abdominal fat; MRI, waist), dietary intake, physical activity, cancer worry (Lerman score) and quality of life (SF-36) were assessed at 6 and 12 months, as well as long-term changes in weight and adiposity 12 and 42 months after the end of the intervention. Target weight loss (5%) was achieved by 55% of the intervention group at the end of the 12 month intervention but maintained by fewer at 24 (39%) and 54 months -(21%). Overall the intervention group achieved significant reductions in weight (mean [95% CI] -4.6 [-6.4 to -2.8] %), body fat (-4.0 [-5.2 to -2.7] ) kg, intra abdominal fat (-25.0 [-39.0 to -8.0])% and waist circumference (-4.0 [-6.8 to -2.0] cm) during the 12 month intervention and reported large reductions in intake of energy (-24.3 [-33.2 to -15.1] %), fat (-32 [-44 to -20] %), and alcohol (-35 [-52 to -13] %), and increased moderate activity (27 [7 to 44] minutes/day). These parameters did not change in the usual care group (all P < 0.05). A small proportion of the usual care group lost and maintained > 5% of their weight at 6 (16%), 12 (11%), 24 (11%) and 54 (13%) months (P < 0.05 at all time points). The intervention increased physical well being (SF-36; P < 0.05) but had no measurable effect on mental well being or cancer worry. Weight loss is achievable within our high risk women but not more so than in previous studies in the general population. Further studies are required to better understand factors which can promote compliance in women at increased risk of breast cancer.
Increase in Serum Total IGF-I and Maintenance of Free IGF-I Following Intentional Weight Loss in Pre-menopausal Women at Increased Risk of Breast Cancer
(Bentham Open, 2010) Harvie, M.; Renehan, A. G.; Frystyk, J.; Flyvbjerg, A.; Mercer, Tom; Malik, R.; Adams, J.; Cuzick, J.; Howell, A.; Howell, A.
Intentional weight loss may reduce breast cancer risk through lowering levels of circulating free IGF-I but few studies have measured this longitudinally. We determined the effect of weight loss (=5% body weight) over 12 months, using an energy restriction and exercise programme, on an expanded panel of IGF-related peptides amongst 23 weight losing and 46 weight stable or gaining pre-menopausal women at increased risk of breast cancer, BMI (mean ± SD) 29.2 ± 6.2 kg/m2. Fasting measures of total and free IGF-I (ultra-filtration), and IGFBP-1, -2 and -3, body weight, body fat (DXA), intra-abdominal fat (MRI) were assessed at 6 and 12 months. After 12 months, women who lost ≥ 5% of body weight had a significant increase in serum total IGF-I; mean (95% CI difference) 17 (2.3 to 34.0) μg/l, P < 0.05, and IGFBP-2; mean (95% CI ratio) 1.24 (1.06 to 1.46) P < 0.001, compared to weight stable/gaining women. Serum IGFBP-1 tended to increase in weight losers compared to the weight stable/gaining women; mean (95% CI ratio) 1.19 (0.97 to 1.45) P=0.09, whereas IGFBP-3 remained unchanged; mean (95% CI ratio) 1.02 (0.94 to 1.20] P=0.99. Weight loss did not significantly alter serum levels of free IGF-I; mean difference 0.1 (-0.1 to 3.4) μg/l, P=0.21. Increased serum total IGF-I levels, and maintenance of free IGF-I despite increased concentrations of serum IGFBP-1 and -2 with weight loss, does not suggest intentional weight loss with diet and exercise mediates reduced risk through the circulating IGF-axis.
The effects of weight loss and exercise on biomarkers of breast cancer risk.
(Research Signpost, 2002) Harvie, M.; Mercer, Tom; Humphries, G.; Hopwood, P.; Adams, J.; Evans, G.; Sumner, H.; Astley, S.; Hayes, L.; Cooley, J.; Ashcroft, L.; Howell, A.; Gandalai, S.