For the first time in Australia, evidence now shows that lifestyle change programs that address weight-loss, exercise and nutrition for cancer survivors and their carers are working.
The results from a randomised controlled trial (RCT) of Cancer Council NSW’s ENRICH (Exercise and Nutrition Routine Improving Cancer Health) program, in partnership with the University of Newcastle and the Hunter Medical Research Institute, show that those who participated in the face-to-face program had increased their physical activity, reduced weight and body mass index, and increased vegetable consumption.
Compared with the control group of cancer survivors and carers, ENRICH participants were more active, walking 1761 more steps in their day, while the control groups’ daily steps decreased. Further, ENRICH participants weighed on average 1.5kg less, and were consuming 3.5 more serves of vegetables each week.
Importantly, these trends were still apparent 3 months after the program finished, with 95 per cent of ENRICH participants reporting that the program helped them to set their own goals in relation to nutrition and physical activity.
Kathy Chapman, Director of Cancer Programs at Cancer Council NSW, said that with cancer survival on the increase, the analysis of ENRICH as an effective behaviour change program is vital to improving the long-term health of those affected by cancer:
“There is growing evidence that weight management and physical activity can improve the quality of life of cancer survivors, reduce the risk of cancer recurrence, and extend cancer survival.
“The results of the ENRICH RCT are extremely encouraging and show that the program is helping to instil better physical activity and dietary habits amongst cancer survivors and their carers.
“Previous lifestyle habits can be hard to change on your own, and with the added fatigue experienced by many cancer survivors, people can easily slip back into their old ways post-treatment, with few meeting recommendations for healthy eating and physical activity on their own.
“It is extremely encouraging to see that ENRICH participants from the study reported that the program was an enjoyable way to share experiences with other cancer survivors. Almost all of them reported that the program helped them to get back on track and set their own goals, so they can continue to take control of their personal health on a long-term basis.”
Recent research has shown that overweight and obesity is associated with recurrence of breast cancer, bowel cancer, prostate cancer and an increased risk of cancer death. Studies show that pre-menopausal breast cancer survivors who are obese have up to 75 per cent higher risk of mortality than those of a normal weight, while obese post-menopausal breast cancer survivors have up to 34 per cent higher risk.
Another study has suggested that physical activity after diagnosis reduces bowel cancer mortality by up to 30 per cent.
“We hope that through further analysis of survivorship programs we can continue to show the medical and broader communities the importance of evidence-based interventions which ultimately improve lifestyle behaviours of cancer survivors – and their carers – and reduce their risk of cancer recurrence, and improve overall survival,” continued Ms Chapman.
To learn more about ENRICH, please visit: https://www.cancercouncil.com.au/ENRICH
Acknowledgement: The ENRICH trial was supported by funding from the Australian Better Health Initiative: A joint Australian, State and Territory government initiative with additional infrastructure support from the Hunter Medical Research Institute.
Media contact details:
Laura Cairnduff, PR Officer, Cancer Council NSW
firstname.lastname@example.org, 02 9334 1408, 0423 421 382
Notes to editor
The full ENRICH randomised controlled trial (RCT) report can be accessed here: http://www.biomedcentral.com/1471-2407/15/710
About the study
The ENRICH program has been evaluated using a two-group pragmatic randomised controlled trial (RCT); the gold standard for measuring the effectiveness of an intervention. Cancer survivors and carers (n=174) were randomly allocated to the face-to-face, group-based intervention or wait-list control (who attend ENRICH after completion of 20-week data collection). Participants completed assessments at baseline, 8-weeks (completion of program), and 20 weeks (3 months post-program).
At the completion of the RCT, ENRICH has been shown to be successful and effective in improving:
- Pedometer-assessed physical activity (i.e. increased step counts)
- Weight and body mass index
- Vegetable consumption.
ENRICH is the first Australian cancer survivor trial that included carers and was able to show positive results on both physical activity and a dietary outcome. Achieving improvements in at least one component of both diet and physical activity behaviours is an important finding, and has the potential to improve health outcomes of cancer survivors. The health behaviour changes resulting from the ENRICH program were sustained for three months after the intervention, and the magnitude of behaviour changes was significant and clinically relevant, and likely to result in health improvements.
ENRICH (Exercise and Nutrition Routine Improving Cancer Health) is a free group-based, face-to-face multiple health behaviour change program for cancer survivors and their carers.
An informative and interactive program, ENRICH motivates and encourages participants to move towards, and maintain, a healthier lifestyle.
The ENRICH program consists of six two-hour sessions held weekly. Each session covers:
- Information about healthy eating;
- a home-based walking program (using a pedometer); and
- home based-resistance training program (i.e muscle strength training using a Gymstick™ or body weight exercises).
Sessions include a mix of didactic information delivery and practical activities (e.g., label reading, recipe modification, demonstration and practice of resistance exercises, setting step goals for the home-based walking program). At the final session, to encourage maintenance of behaviour change, participants receive information about other community-based programs and support services.
To register interest in attending ENRICH, visit www.cancercouncil.com.au/ENRICH
 EL James, FG Stacey, K Chapman, AW Boyes, T Burrows, A Girgis, G Asprey, A Bisquera, DR Lubans. Impact of a nutrition and physical activity intervention (ENRICH: Exercise and Nutrition Routine Improving Cancer Health) on health behaviours of cancer survivors and carers: A pragmatic randomized controlled trial. BMC Cancer. October 2015. [Abstract available at http://www.biomedcentral.com/1471-2407/15/710/abstract ]
 This difference is clinically important as differences of this size have been associated with decreased blood pressure, BMI and cardiovascular event rates. (Bravata et al 2007; Yates et al 2014)
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 Je Y, Jeon JY, Giovannucci EL, Meyerhardt JA. Association between physical activity and mortality in colorectal cancer: a meta-analysis of prospective cohort studies. Int J Cancer 2013 Oct 15;133(8):1905-13 [Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23580314].