Objective
To examine the preliminary effects of an online intervention integrating diet, walking, and mindfulness, compared with diet and walking alone, on weight-related outcomes in breast cancer survivors.
Methods
This pilot randomized controlled trial enrolled women with stage I-III breast cancer and a body mass index ≥ 24 kg/m2. Participants were randomly assigned to a diet, walking, and mindfulness (DWM) group or a diet and walking (DW) group. Both groups completed an 8-week synchronous online program and were followed for 48 weeks. Primary outcomes were body weight, waist circumference, and body fat percentage, assessed at baseline and at Weeks 8, 24, and 48. Secondary outcomes included self-efficacy, dispositional mindfulness, and quality of life. Data were analyzed using generalized estimating equations.
Results
Forty-two participants were enrolled, with 21 assigned to each group. Both groups showed reductions in body weight, waist circumference, and body fat percentage over 12 months. The DWM group showed a more favorable pattern of body weight change over time than the DW group, with a significant overall group × time interaction. For waist circumference and body fat percentage, both groups improved over time, but between-group differences were not consistently supported by the overall interaction tests; exploratory time-specific estimates suggested possible differences at Week 48. Engagement was similar between groups. More frequent dietary recording was associated with greater reductions in body weight and body fat percentage.
Conclusions
This pilot trial provides preliminary evidence that an online intervention integrating diet, walking, and mindfulness may be associated with a more favorable long-term pattern of body weight change in breast cancer survivors. Evidence for differential effects on waist circumference, body fat percentage, and psychosocial outcomes was limited, and the contribution of mindfulness-specific mechanisms remains uncertain. Larger, adequately powered trials with longer follow-up and more targeted process measures are needed.
Trial registration
ClinicalTrials.gov Identifier: NCT06427473.