||5R21CA215415-02 Interpret this number
||University Of Tx Md Anderson Can Ctr
||Using Hunger Training to Enhance Weight Loss and Modulate Cancer-Related Biomarkers in Women at High Risk for Breast Cancer: a Pilot Study
Research has shown that a weight loss of >10% favorably modulates biomarkers of breast cancer risk. The
most effective behavioral weight loss programs, such as the Diabetes Prevention Program (DPP), yield weight
losses of only 4-7%. As a result, many people resort to weight-loss surgery, which is costly, drastic, and an
often irreversible choice that, when successful, results in weight losses of 25-50%, which far exceed that
necessary for risk reduction. New behavioral strategies that enhance the weight-loss outcomes of existing
interventions are needed. One recently introduced and innovative weight-loss strategy is `Hunger Training'.
Hunger Training uses real-time blood glucose monitoring as biological feedback to help users self-regulate
meal initiation to promote sustained weight loss that may have indirect and direct effects on breast cancer risk
reduction. Evidence demonstrates that Hunger Training alone—without any additional dietary restrictions or
increased physical activity—produces weight losses of >7% and significantly improves insulin sensitivity. In the
proposed pilot study, we will combine Hunger Training with the DPP using a two-arm approach. We will
randomize 50 non-diabetic, postmenopausal obese women, identified as being at high risk for breast cancer
and enrolled in the MD Anderson Longitudinal High Risk Breast Cohort for ≥1 year, to receive either the DPP
only or the DPP-plus-Hunger Training for 16 weeks. Aim 1 is to evaluate the feasibility of adding Hunger
Training to the DPP. Feasibility criteria will include accrual rates >50%, attrition rates <20%, and protocol
adherence rates >75% for both study groups. Aim 2 is to estimate the magnitude of the effect sizes and
variation in the outcome variables for the DPP-only and DPP-plus-Hunger Training interventions on changes in
weight; metabolic and breast cancer risk biomarkers (e.g., fasting insulin and glucose levels, levels of
glycosylated hemoglobin, insulin resistance, adiponectin, interleukin-6, and c-reactive protein); and proposed
behavioral mediators (e.g., reduction in total energy intake, overall eating frequency, percent of eating events
occurring at or below the average fasting blood glucose concentration). This study will be the first to assess the
synergistic effect of adding Hunger Training to a highly disseminated weight-loss intervention. We expect to
find that the addition of Hunger Training to the DPP is feasible and that the combined intervention has an
additive effect on promoting weight losses of >10% in obese women at risk for postmenopausal breast cancer.
The successful completion of this pilot study will support a larger randomized controlled trial that will
additionally enable us to compare the DPP's long-term impact on weight loss and weight loss maintenance to
that of the DPP-plus-Hunger Training.
Using pre-prandial blood glucose to assess eating in the absence of hunger in free-living individuals.
, Liao Y.
, Huh J.
, Keller S.
Eating behaviors, 2020 08; 38, p. 101411.
Using Continuous Glucose Monitoring to Motivate Physical Activity in Overweight and Obese Adults: A Pilot Study.
, Basen-Engquist K.M.
, Urbauer D.L.
, Bevers T.B.
, Hawk E.
, Schembre S.M.
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2020 04; 29(4), p. 761-768.
Just-in-Time Feedback in Diet and Physical Activity Interventions: Systematic Review and Practical Design Framework.
, Liao Y.
, Robertson M.C.
, Dunton G.F.
, Kerr J.
, Haffey M.E.
, Burnett T.
, Basen-Engquist K.
, Hicklen R.S.
Journal of medical Internet research, 2018-03-22; 20(3), p. e106.