***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Overweight and obesity affects more than 66 % of the adult population and is associated with a variety of chronic diseases . Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies . Guidelines of the National Heart , Lung , and Blood Institute ( NHLBI ) encourage a 10 % reduction in weight , although considerable literature indicates reduction in health risk with 3 % to 5 % reduction in weight . Physical activity ( PA ) is recommended as a component of weight management for prevention of weight gain , for weight loss , and for prevention of weight regain after weight loss . In 2001 , the American College of Sports Medicine ( ACSM ) published a Position St and that recommended a minimum of 150 min wk(-1 ) of moderate-intensity PA for overweight and obese adults to improve health ; however , 200 - 300 min wk(-1 ) was recommended for long-term weight loss . More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss . To this end , we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain , for weight loss , and prevention of weight regain . Evidence supports moderate-intensity PA between 150 and 250 min wk(-1 ) to be effective to prevent weight gain .  Moderate-intensity PA between 150 and 250 min wk(-1 ) will provide only modest weight loss . Greater amounts of PA ( > 250 min wk(-1 ) ) have been associated with clinical ly significant weight loss .  Moderate-intensity PA between 150 and 250 min wk(-1 ) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction . Cross-sectional and prospect i ve studies indicate that after weight loss , weight maintenance is improved with PA > 250 min wk(-1 ) . However , no evidence from well- design ed r and omized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss .  Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk . Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk . There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain 512 Background : Obesity is an adverse prognostic factor in early BC . We conducted a r and omized clinical trial ( RCT ) to evaluate a 2-year , central ly delivered , telephone-based weight loss intervention ( WLI ) compared to a mailed educational intervention ( EI ) on recurrence , weight loss and QOL in postmenopausal women receiving adjuvant Letrozole . The trial was terminated after 338 of a planned 2,150 women were enrolled due to loss of funding . METHODS 338 women with stage I-IIIa BC were r and omized to WLI ( n%171 ) or EI alone ( n%167 ) at 20 centers in Canada and USA . Eligibility included BMI ≥24 kg/m2 and <3 years of definitive surgery .  WLI involved 19 calls , mailings and a participant manual . Weight loss goal was 10 % of baseline via reduction of caloric and fat intake ( 500 - 1000 kcal/day , 20 % calories fat ) and increased physical activity ( 150 - 200 minutes/week ) .  RESULTS Mean age and BMI were 61 years and 31.3 kg/m2 . Baseline BMI , adjuvant chemotherapy , and tumor characteristics were balanced between arms . 87.5 % of protocol m and ated WLI calls took place . Mean weight change is shown in the table . Results were similar for baseline BMI ≥/<30 kg/m2 and adjuvant chemotherapy ( yes/no ) . Mean SF 36 normalized physical component score was improved in WLI vs. EI at 6 ( + 4.1 WLI vs. + 2.1 C , p%0.046 ) and 12 months ( + 3.9 WLI vs. + 2.7 EI , p%0.33 ) . CONCLUSIONS A 2-year , telephone-based WLI result ed in significant weight loss at 6 , 12 , and 18 months in early BC . Results were similar with BMI < 30 or 30 + and with or without adjuvant chemotherapy . Follow-up continues to evaluate longer term effects . Funded by Novartis Pharmaceuticals Inc. Sponsored by the Ontario Clinical Oncology Group . [ Table : see text ] A continuing challenge in weight loss treatment is attaining maintenance of weight loss . The goal of this study was to develop a counseling method that would assist African American breast cancer survivors with weight loss maintenance . In this pilot study , 31 obese breast cancer survivors were recruited .  Individualized , dietitian-led counseling by telephone and free Weight Watchers coupons were provided to all participants for 18 months . At the 6-month time point , women were r and omized to receive spirituality counseling or not in addition to the st and ard program . The spirituality counseling was delivered via telephone using an 8-step framework . Subjects were asked to utilize  daily meditation or prayer , daily readings  , and the recording of thoughts in a journal . Mean weight loss from baseline to 6 months was a modest 2.0 % of baseline weight . From 6 to 18 months , there was no further weight change in the spirituality arm and a gain of 0.7 % in the dietitian-only arm . Despite little effect on weight loss , it did appear that spirituality counseling positively affected spiritual well-being ( FACIT-Sp ) scores and dietary quality . The spirituality counseling framework therefore may be further refined and useful for other health promotion studies with African American population Excess body weight at diagnosis and weight gain after breast cancer are associated with poorer long-term prognosis . This study investigated the effects of a lifestyle intervention on body weight and other health outcomes influencing long-term prognosis in overweight women ( BMI > 25.0 kg/m2 ) recovering from early-stage ( stage I – III ) breast cancer . A total of 90 women treated 3–18 months previously were r and omly allocated to a 6-month exercise and hypocaloric healthy eating program ( n = 47 , aged 55.6 ± 10.2 year ) or  control group ( n = 43 , aged 55.9 ± 8.9 year ) . Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice , supplemented by weekly nutrition seminars . Body weight , waist circumference , waist/hip ratio [ WHR ] , cardiorespiratory fitness , blood biomarkers associated with breast cancer recurrence and cardiovascular disease risk , and quality of life ( FACT-B ) were assessed at baseline and 6 months . Three-day diet diaries were used to assess macronutrient and energy intakes . A moderate reduction in body weight in the intervention group ( median difference from baseline of −1.09 kg ; IQR −0.15 to −2.90 kg ; p = 0.07 ) was accompanied by significant reductions in waist circumference ( p < 0.001 ) , WHR ( p = 0.005 ) , total ( p = 0.021 ) and saturated fat ( p = 0.006 ) intakes , leptin ( p = 0.005 ) , total cholesterol ( p = 0.046 ) , and resting diastolic blood pressure ( p = 0.03 ) . Cardiopulmonary fitness ( p < 0.001 ) and FACT-B quality of life ( p = 0.004 ) also showed significant improvements in the intervention group . These findings suggest that an individualized exercise and a hypocaloric healthy eating program can positively impact upon health outcomes influencing long-term prognosis in overweight women recovering from early-stage breast cancer Obese breast cancer survivors have increased risk of recurrence and death compared to their normal weight counterparts . Rural women have significantly higher obesity rates , thus weight control intervention may be a key strategy for prevention of breast cancer recurrence in this population . This one-arm treatment study examined the impact of a group-based weight control intervention delivered through conference call technology to obese breast cancer survivors living in remote rural locations . The intervention included a reduced calorie diet incorporating prepackaged entrees and shakes , physical activity gradually increased to 225 min/week of moderate intensity exercise , and weekly group phone sessions . Outcomes included anthropomorphic , diet , physical activity , serum biomarker , and quality of life changes .  Ninety-one percent of participants ( 31 of 34 ) attended > 75 % of intervention sessions and completed post-treatment data collection visits . At 6 months , significant changes were observed for weight ( −12.5 ± 5.8 kg , 13.9 % of baseline weight ) , waist circumference ( −9.4 ± 6.3 cm ) , daily energy intake ( −349 ± 550 kcal/day ) , fruits , and vegetables ( + 3.7 ± 4.3 servings/day ) , percent kcal from fat ( −12.6 ± 8.6 % ) , physical activity ( + 1235 ± 832 kcal/week ; all P values < 0.001 ) , as well as significant reductions in fasting insulin ( 16.7 % reduction , P = 0.006 ) , and leptin ( 37.1 % reduction , P < 0.001 ) . Significant improvements were also seen for quality of life domains including mood , body image , and sexuality . In conclusion , the intervention produced > 10 % weight loss as well as significant improvements across multiple endpoints . The group phone-based treatment delivery approach may help disseminate effective weight control intervention to hard-to-reach breast cancer survivors OBJECTIVE Obesity is associated with poorer breast cancer outcomes and losing weight postdiagnosis may improve survival . As Hispanic and black women have poorer breast cancer prognosis than non-Hispanic whites diagnosed at similar age and stage , and have higher rates of obesity , effective weight loss strategies are needed . We piloted a r and omized , waitlist-controlled , crossover study to examine the effects and feasibility of the commercial Curves weight loss program among Hispanic , African American and Afro-Caribbean breast cancer survivors . DESIGN AND METHODS Women with stage 0-IIIa breast cancer ≥ 6 months posttreatment , sedentary , and BMI ≥ 25 kg/m(2 ) were r and omized to the immediate arm ( IA ) : 6 months of the Curves program followed by 6 months of observation ; or the waitlist control arm ( WCA ) : 6 months of observation followed by 6 months of the Curves program . The Curves program uses a 30-min exercise circuit and a high-vegetable/low-fat/calorie-restricted diet . RESULTS A total of 42 women enrolled ( 79 % Hispanic , 21 % black ) , mean age 51 ( range 32 - 69 ) and mean BMI 33.2(± 5.9 ) kg/m(2 ) ; 91 % were retained at month 12 . At month 6 , women in the IA lost an average 3.3 % ( ± 3.5 % ) of body weight ( range : 1.7 % gain to 10.6 % loss ) , as compared with 1.8 % ( ± 2.9 % ) weight loss in the WCA ( P = 0.04 ) . At month 12 , on average women in the IA regained some but not all of the weight lost during the first 6 months ( P = 0.02 ) . CONCLUSIONS Minority breast cancer survivors were recruited and retained in a weight loss study . Six months of the Curves program result ed in moderate weight loss , but weight loss was not maintained postintervention . Future interventions should identify methods to increase uptake and maintenance of weight loss behaviors Background Obesity is characterized by chronic mild inflammation and may influence the risk and progression of cancer . Purpose The current study is an exploratory analysis of the effect of a weight loss intervention that emphasized increased physical activity on inflammatory cytokines ( tumor necrosis factor-α [ TNF-α ] , interleukin-6 [ IL-6 ] , interleukin-8 [ IL-8 ] , and vascular endothelial growth factor [ VEGF ] ) at the end of the 16-week intervention period in overweight breast cancer survivors . Methods Study participants averaged 56 years of age ( N = 68 ) . Intervention participants ( n = 44 vs. 24 controls ) participated in a cognitive behavioral therapy-based weight management program as part of an exploratory r and omized trial . The intervention incorporated strategies to promote increased physical activity and diet modification . Baseline and 16-week data included height , weight , body composition , physical activity level , and biomarkers IL-6 , IL-8 , TNF-α , and VEGF . Results Weight loss was significantly greater in the intervention group than controls ( −5.7 [ 3.5 ] vs. 0.2 [ 4.1 ] kg , P < 0.001 ) . Paired t tests noted favorable changes in physical activity level ( P < 0.001 intervention , P = 0.70 control ) , marginally lower IL-6 levels ( P = 0.06 intervention , P = 0.25 control ) at 16 weeks for participants in the intervention group , and lower TNF-α levels for participants in the intervention ( P < 0.05 ) and control groups ( P < 0.001 ) . Increased physical activity was associated with favorable changes in IL-6 for participants in the intervention group ( R2 = 0. 
    Output:
    
The studies included in this review suggest that weight loss is feasible to achieve and is safe in women following treatment for breast cancer .