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 Rauchaus; Patricia Norwood; Joyce Thompson; Jane Wardle; Robert JC Steele

doi: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

Annie S Anderson^* (Corresponding Author), Angela M Craigie, Stephen Caswell, Shaun Treweek, Martine Stead, Maureen Macleod, Fergus Daly, Jill Belch, Jackie Rodger, Alison Kirk, Anne Ludbrook, Petra Rauchaus, Patricia Norwood, Joyce Thompson, Jane Wardle, Robert JC Steele

^*Corresponding author for this work

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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.

Original language	English
Article number	g1823
Number of pages	13
Journal	BMJ
Volume	348
DOIs	https://doi.org/10.1136/bmj.g1823
Publication status	Published - 7 Mar 2014

Bibliographical note

Funding: This study was funded by the MRC National Prevention
Research Initiative (www.npri.org.uk), grant award No G0802030.

National Prevention Research Initiative is a national research initiative administered by the Medical Research Council made up of the following
funding partners: Alzheimer’s Research Trust; Alzheimer’s Society;
Biotechnology and Biological Sciences Research Council; Cancer Research UK; Chief Scientist Office, Scottish Government Health Directorate; Department of Health; Diabetes UK; Economic and Social Research Council; Engineering and Physical Sciences Research Council; Health and Social Care Research and Development Office for Northern Ireland; Medical Research Council; Welsh Assembly Government; and World Cancer Research Fund. Further financial
support was provided by NHS Research Scotland to carry out this work.
The Health Services Research Unit, University of Aberdeen, is core funded by the Chief Scientist Office of the Scottish Government Health Directorates

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/bmj.g1823Licence: CC BY-NC

Anderson 2014
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
Final published version, 506 KBLicence: CC BY-NC

Patricia Norwood
- School of Medicine, Medical Sciences & Nutrition, Health Economics Research Unit - Advanced Research Fellow
Person: Academic Related - Research
Shaun Treweek
- School of Medicine, Medical Sciences & Nutrition, Health Services Research Unit (HSRU) - Chair in Health Services Research
- Institute of Applied Health Sciences
Person: Academic

Cite this

Anderson, A. S., Craigie, A. M., Caswell, S., Treweek, S., Stead, M., Macleod, M., Daly, F., Belch, J., Rodger, J., Kirk, A., Ludbrook, A., Rauchaus, P., Norwood, P., Thompson, J., Wardle, J., & Steele, R. JC. (2014). The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial. BMJ, 348, Article g1823. https://doi.org/10.1136/bmj.g1823

Anderson, AS, Craigie, AM, Caswell, S, Treweek, S, Stead, M, Macleod, M, Daly, F, Belch, J, Rodger, J, Kirk, A, Ludbrook, A, Rauchaus, 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

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

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.",

author = "Anderson, {Annie S} and Craigie, {Angela M} and Stephen Caswell and Shaun Treweek and Martine Stead and Maureen Macleod and Fergus Daly and Jill Belch and Jackie Rodger and Alison Kirk and Anne Ludbrook and Petra Rauchaus and Patricia Norwood and Joyce Thompson and Jane Wardle and Steele, {Robert JC}",

note = "Funding: This study was funded by the MRC National Prevention Research Initiative (www.npri.org.uk), grant award No G0802030. National Prevention Research Initiative is a national research initiative administered by the Medical Research Council made up of the following funding partners: Alzheimer{\textquoteright}s Research Trust; Alzheimer{\textquoteright}s Society; Biotechnology and Biological Sciences Research Council; Cancer Research UK; Chief Scientist Office, Scottish Government Health Directorate; Department of Health; Diabetes UK; Economic and Social Research Council; Engineering and Physical Sciences Research Council; Health and Social Care Research and Development Office for Northern Ireland; Medical Research Council; Welsh Assembly Government; and World Cancer Research Fund. Further financial support was provided by NHS Research Scotland to carry out this work. The Health Services Research Unit, University of Aberdeen, is core funded by the Chief Scientist Office of the Scottish Government Health Directorates",

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TY - JOUR

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

T2 - randomised controlled trial

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 - Rauchaus, Petra

AU - Norwood, Patricia

AU - Thompson, Joyce

AU - Wardle, Jane

AU - Steele, Robert JC

N1 - Funding: This study was funded by the MRC National Prevention Research Initiative (www.npri.org.uk), grant award No G0802030. National Prevention Research Initiative is a national research initiative administered by the Medical Research Council made up of the following funding partners: Alzheimer’s Research Trust; Alzheimer’s Society; Biotechnology and Biological Sciences Research Council; Cancer Research UK; Chief Scientist Office, Scottish Government Health Directorate; Department of Health; Diabetes UK; Economic and Social Research Council; Engineering and Physical Sciences Research Council; Health and Social Care Research and Development Office for Northern Ireland; Medical Research Council; Welsh Assembly Government; and World Cancer Research Fund. Further financial support was provided by NHS Research Scotland to carry out this work. The Health Services Research Unit, University of Aberdeen, is core funded by the Chief Scientist Office of the Scottish Government Health Directorates

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.

U2 - 10.1136/bmj.g1823

DO - 10.1136/bmj.g1823

M3 - Article

SN - 0959-8146

VL - 348

JO - BMJ

JF - BMJ

M1 - g1823

ER -

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

Abstract

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