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RCT·oncology, nutrition, endocrinology, cardiology, preventive_medicine, public_health·PMC10000640

Results of DUET: A Web-Based Weight Loss Randomized Controlled Feasibility Trial among Cancer Survivors and Their Chosen Partners

Cancers · 11 authors, 8 centres

AI SUMMARY

FIDELITY 74%

POPULATIONCancer survivors of obesity-related cancers and their chosen partners (n=112 participants, 56 dyads), both with overweight/obesity (BMI ≥25 kg/m²), insufficient physical activity (<150 min/week MVPA), and suboptimal diets.

INTERVENTIONDUET: a 6-month web-based diet and exercise weight loss intervention incorporating Fitbits, Aria scales, tailored feedback, weekly interactive sessions, SMS text messages, and dyadic support strategies grounded in Social Cognitive Theory.

COMPARISONWaitlist control (received all DUET resources after 6-month follow-up).

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

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TL;DR

The DUET trial tested a 6-month online weight loss intervention for cancer survivors and their chosen partners. The intervention was feasible, with 100% retention in the intervention arm, and produced significantly greater weight loss (−2.8 kg vs. −1.1 kg in controls) along with improvements in caloric intake, physical activity, blood glucose, and inflammation markers. This scalable, dyadic web-based approach shows promise for cancer prevention and control.

Full summary

4,569 CHARS

**Background:** Obesity is a risk factor for 13 cancers and is linked to poorer prognosis after diagnosis. Social support enhances lifestyle change, yet scalable dyadic weight loss interventions for cancer survivors and their partners are limited. Prior dyadic programs (DAMES, Healthy Moves) showed feasibility but had narrow eligibility (mother-daughter or spouse dyads) and used mailed print materials. The DUET trial expanded eligibility to any chosen partner and used a web-based platform with wearable technology.

**Methods:** DUET was a single-blinded, 2-arm RCT conducted at the University of Alabama at Birmingham. Fifty-six dyads (n=112 participants) comprising survivors of obesity-related cancers (breast, colorectal, prostate, endometrial, ovarian, renal) and their chosen partners were recruited from October 2020 to July 2021. Both members had BMI ≥25 kg/m², MVPA <150 min/week, and suboptimal diets. Dyads were randomized 1:1 to the DUET intervention or waitlist control using permuted blocks (size=4). The 24-week web-based intervention included tailored guidance based on WCRF-AICR guidelines, Fitbits, Aria scales, Portion Doctor tableware, 24 weekly interactive sessions (~15 min each), thrice-weekly SMS texts, and dyadic support tools. Outcomes were assessed at baseline and 6 months (and 3 months for surveys). Weight was measured remotely via Zoom. Dietary intake used two 24-hour recalls (ASA-24). Physical activity was measured by Actigraph accelerometry and Godin LEQ. Physical performance tests (30-s chair stand, 8′ get-up-and-go, sit-and-reach, back scratch, 2-min step test) were adapted for remote delivery. Circulating biomarkers (glucose, insulin, HDL/total cholesterol, triglycerides, leptin, adiponectin, CRP) were assayed from dried blood spots. Analyses used general linear mixed models with intent-to-treat approach (α<0.05).

**Key Results:** Enrollment rate was ~5.5% (61/1114). Retention was 89% in waitlist and 100% in intervention arms (p=0.027). Three post-randomization exclusions occurred in the waitlist arm. Adverse events were similar between arms (14 vs. 16, all non-attributable). For the primary outcome, dyad weight loss averaged −1.1 kg (waitlist) vs. −2.8 kg (intervention) (between-arm p=0.044; time-by-arm interaction p=0.033). Intervention dyads lost 3.2% of body weight vs. 1.2% in controls. Waist circumference changes favored intervention but were not significant (time-by-arm p=0.339). Caloric intake decreased significantly more in intervention survivors vs. controls (p=0.027). Diet quality (HEI-2015) improved in intervention but between-arm differences were not significant. Self-reported MVPA increased from 43.1 to 92.7 min/week in intervention dyads vs. 45.6 to 57.9 in controls (time-by-arm p=0.229). Accelerometry showed similar patterns. Physical performance improved in both arms; the sit-and-reach showed significant time-by-arm interaction for survivors (p=0.015) and dyads (p=0.043). For biomarkers, glucose decreased significantly over time in both arms (within-arm p<0.001 for dyads) with no between-arm difference. HDL cholesterol decreased significantly in both arms, with significantly greater decrease in intervention dyads (between-arm p=0.017). CRP decreased significantly over time in survivors and dyads (within-arm p=0.041 and 0.025, respectively) with no between-arm difference. Leptin increased in intervention partners (between-arm p=0.017). No significant between-arm differences were found for insulin, triglycerides, total cholesterol, or adiponectin. Dyadic terms were significant for body weight (p=0.009), waist circumference (p=0.023), diet quality (p=0.009), PA (p<0.001), most physical performance tests (p<0.007), HDL (p=0.038), CRP (p=0.002), and mental health (p<0.001).

**Clinical Implications:** DUET demonstrates that a scalable, web-based, dyadic weight loss intervention is feasible, safe, and effective for cancer survivors and their chosen partners. The 3.2% weight loss is clinically significant per AHA/ACC/TOS guidelines and was accompanied by favorable trends in glucose, CRP, and physical function. The expansion beyond family dyads improved accrual (56 dyads in 9 months vs. 68 dyads over 2 years in DAMES). The significant dyadic terms across multiple outcomes support the partner-based approach. Limitations include modest sample size, low enrollment rate (especially for non-breast cancers), lack of long-term follow-up, and multiple comparisons without adjustment. Larger, longer-term studies are needed to confirm durability and generalizability.

PICO

PPOPULATION

Cancer survivors of obesity-related cancers and their chosen partners (n=112 participants, 56 dyads), both with overweight/obesity (BMI ≥25 kg/m²), insufficient physical activity (<150 min/week MVPA), and suboptimal diets.

IINTERVENTION

DUET: a 6-month web-based diet and exercise weight loss intervention incorporating Fitbits, Aria scales, tailored feedback, weekly interactive sessions, SMS text messages, and dyadic support strategies grounded in Social Cognitive Theory.

OOUTCOME

Primary: weight loss at 6 months. Secondary: waist circumference, caloric intake, diet quality (HEI-2015), physical activity (self-report and accelerometry), physical performance, circulating biomarkers (glucose, insulin, lipids, leptin, adiponectin, CRP), quality of life, self-efficacy, social support, and barriers.

STUDY TYPE

RCT

SPECIALTY

oncology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

74% · C

ORIGINAL PAPER

PMC10000640

Results of DUET: A Web-Based Weight Loss Randomized Controlled Feasibility Trial among Cancer Survivors and Their Chosen Partners

Cancers

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ABSTRACT

Abstract Simple Summary Effective and scalable diet, exercise, and weight management interventions are needed for primary cancer prevention in the general public, as well as for cancer control and tertiary prevention among the growing population of cancer survivors. A 6-month online intervention, entitled “Daughters, dUdes, moth E rs, and others T ogether” (DUET), was designed to promote weight loss, a healthful diet, and increased physical activity among cancer survivors and their chosen partners. Fifty-six cancer survivor-partner dyads ( n = 112 participants in total) were recruited into a randomized controlled trial that compared DUET to a waitlist control. The trial surpassed all feasibility endpoints with regard to uptake, retention, and safety; the DUET intervention also resulted in significant weight loss and reductions in caloric intake, as well as having a promising impact on physical activity and performance, blood glucose, and indicators of inflammation. Abstract (1) Background: A healthful diet, regular physical activity, and weight management are cornerstones for cancer prevention and control. Yet, adherence is low in cancer survivors and others, calling for innovative solutions. D aughters, d U des, mothers, and othErs fighting cancer Together (DUET) is a 6-month, online, diet-and-exercise, weight-loss intervention to improve health behaviors and outcomes among cancer survivor-partner dyads. (2) Methods: DUET was tested in 56 dyads (survivors of obesity-related cancers and chosen partners) ( n = 112), both with overweight/obesity, sedentary behavior, and suboptimal diets. After baseline assessment, dyads were randomized to DUET intervention or waitlist control arms; data were collected at 3- and 6-months and analyzed using chi-square, t -tests, and mixed linear models (α < 0.05). (3) Results: Retention was 89% and 100% in waitlisted and intervention arms, respectively. Dyad weight loss (primary outcome) averaged −1.1 (waitlist) vs. −2.8 kg (intervention) ( p = 0.044/time-by-arm interaction p = 0.033). Caloric intake decreased significantly in DUET survivors versus controls ( p = 0.027). Evidence of benefit was observed for physical activity and function, blood glucose, and c-reactive protein. Dyadic terms were significant across outcomes, suggesting that the partner-based approach contributed to intervention-associated improvements. (4) Conclusions: DUET represents a pioneering effort in scalable, multi-behavior weight management interventions to promote cancer prevention and control, calling for studies that are larger in size, scope, and duration. Keywords: neoplasms, survivors, diet, exercise, weight reduction programs, internet, randomized controlled trial

CITATION EXPORT

Wendy Demark-Wahnefried, Robert A Oster, Tracy E Crane et al.. Results of DUET: A Web-Based Weight Loss Randomized Controlled Feasibility Trial among Cancer Survivors and Their Chosen Partners. Cancers. (2023). https://doi.org/10.3390/cancers15051577

AUTHORS

11 · 8 CENTRES

Wendy Demark-Wahnefried, Robert A Oster, Tracy E Crane, Laura Q Rogers, W Walker Cole, Harleen Kaur, David Farrell, Kelsey B Parrish, Hoda J Badr, Kathleen Y Wolin, Dori W Pekmezi

1Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
2O’Neal Comprehensive Cancer Center at UAB, Birmingham, AL 35233, USA
3Department of Preventive Medicine, UAB, Birmingham, AL 35233, USA
4Department of Medical Oncology, University of Miami, Miami, FL 33124, USA
5Department of Health Behavior, UAB, Birmingham, AL 35294, USA
6People Designs, Inc., Durham, NC 27705, USA
7Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
8Coeus Health, LLC, Chicago, IL 60657, USA