Introduction Weight gain commonly occurs after the diagnosis of breast cancer. 1,2 Weight gain is associated with decreased qual- ity of life (QOL) and increased risk for several comorbid conditions, such as cardiovascular disease and diabetes. 3 Recently, Kroenke et al found that patients with breast cancer who gained modest amounts of weight (increases in body mass index [BMI] ≥ 0.5 kg/m 2 ) were significantly more likely to experience disease recurrence and die from breast cancer and other causes than those who were weight sta- ble. 4 Recent reports suggest that mean weight gain during chemotherapy ranges from 1-5 kg; however, roughly 20% of women gain 10-20 kg. 1,2,5,6 Weight gain is most prevalent Results of a Diet/Exercise Feasibility Trial to Prevent Adverse Body Composition Change in Breast Cancer Patients on Adjuvant Chemotherapy Purpose: Patients with breast cancer on adjuvant chemotherapy can experience weight gain and concurrent losses in muscle mass. Exercise interventions can prevent these changes, but time and travel pose barriers to participation. The Survivor Training for Enhancing Total Health (STRENGTH) trial assessed the feasibility and impact of 2 home-based interventions. Patients and Methods: Ninety premenopausal patients with breast cancer on adjuvant chemotherapy were randomized to a calcium-rich diet (CA) intervention (attention control) or to 2 experimental arms: a CA + exercise (EX) arm or a CA + EX and high fruit and vegetable, low-fat diet (FVLF) arm. Exercise arms included aerobic and strength-training exercises. Body composition, weight status, waist circumference, dietary intake, physical activity, quality of life, anxiety, depression, serum lipids, sex- hormone binding globulin, insulin, proinsulin, C-reactive protein, interleukin-1B, and tumor-necrosis factor receptor–II were measured at baseline and at 6-month follow-up. Results: Accrual targets were achieved and modest attrition was observed (8.8%). Self-reports suggest increased calcium intakes in all arms, and higher fruit and vegtable and lower fat intake in the CA + EX + FVLF arm; no differences in physical activity were observed. While measures of adiposity were generally lower in the CA + EX + FVLF arm, the only significant difference was in percentage of body fat (arms and legs); change in scores (mean ± standard deviation) were +0.7% ± 2.3% (CA); +1.2% ± 2.7% (CA + EX); and +0.1% ± 2% (CA + EX + FVLF; P = .047). Lean body mass was largely preserved, even in the control arm (net gain of 452 g ± 2395 g). No differences were observed in other endpoints. Conclusion: Diet and exercise interventions can prevent weight gain and adverse body composition changes, but more research is needed to determine optimally effective interventions that can be implemented during active treatment and that promote adherence. Clinical Breast Cancer, Vol. 8, No. 1, 70-79, 2008 Key words: Dual-energy x-ray absorptiometry, Epirubicin, Metabolic equivalent task, Sarcopenia Abstract contribution original Wendy Demark-Wahnefried, 1 L. Douglas Case, 2 Kimberly Blackwell, 3 P. Kelly Marcom, 3 William Kraus, 3 Noreen Aziz, 4 Denise Clutter Snyder, 5 Jeffrey K. Giguere, 6 Edward Shaw 7 Submitted: Mar 23, 2007; Revised: Aug 24, 2007; Accepted: Oct 3, 2007 Address for correspondence: Wendy Demark-Wahnefried, PhD, RD, Department of Behavioral Science, M. D. Anderson Cancer Center, 1155 Pressler St, CPB3.3245, Houston, TX 77030 Fax: 713-794-4730; e-mail: wdemarkw@mdanderson.org 1 Department of Behavioral Sciences, University of Texas, M. D. Anderson Cancer Center, Houston 2 Department of Biostatistical Sciences, Wake Forest University, Winston- Salem, NC 3 Department of Medicine, Duke University Medical Center, Durham, NC 4 Office of Cancer Survivorship, National Cancer Institute, Bethesda, MD 5 School of Nursing, Duke University Medical Center, Durham, NC 6 Cancer Centers of the Carolinas, Greenville, SC 7 Department of Radiation Oncology, Wake Forest University, Winston- Salem, NC Electronic forwarding or copying is a violation of US and International Copyright Laws. Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by CIG Media Group, LP , ISSN #1526-8209, provided the appropriate fee is paid directly to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923 USA 978-750-8400. 70 • Clinical Breast Cancer February 2008