Dietary patterns and change in food consumption in overweight or obese breast cancer survivors: the InForma randomized intervention trial

Oct 23, 2026

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InForma is a randomized controlled trial evaluating whether promoting a healthy diet and/or increased physical activity can drive weight loss in overweight or obese breast cancer survivors, with effects tracked over two years. This secondary analysis examines changes in dietary patterns, nutrient intake, and food group consumption using validated questionnaires and dietary adherence assessments. Among 260 participants, three baseline patterns were identified; follow-up showed reduced dietary factor contributions and improved Mediterranean diet adherence, alongside reductions in energy and key nutrient intakes. Results also highlight predictors of weight loss exceeding 5%.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Article overview

Background and aims

Methods and results

Conclusion and trial registration

Introduction

Context: breast cancer survivorship risks and evidence gap

Nutrition, Metabolism and Cardiovascular Diseases 36 (2026) 104378 Contents lists available at ScienceDirect Nutrition, Metabolism and Cardiovascular Diseases journal [homepage:](homepage: www.elsevier.com/locate/nmcd)[ www.elsevier.com/locate/nmcd](homepage: www.elsevier.com/locate/nmcd) | Research Paper
Dietary patterns and change in food consumption in overweight or obese breast cancer survivors: the InForma randomized intervention trial
Patrizia Gnagnarella a, Giulia Carioni a,b,* , Daniele Drag`a a, Silvia Raja a, Federica Baggic,
Maria C. Simoncinic, Ketti Mazzoccod,e, Marianna Masierod,e, Fabio D. Bassif, Nickolas Peradzef, Laura Zorzinog, Gabriella Pravettonid,e, Sabina Sierih, Patrick Maisonneuve a
a Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
b Department of Medicine-DMED, University of Udine, Via Colugna 50, 33100, Udine, Italy
c Physiotherapy Unit, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy d Department of Oncology and Hemato-oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
e Applied Research Division for Cognitive and Psychological Sciences, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
f Division of Breast Surgery, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
g Division of Laboratory Medicine, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy h Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian, 1, 20133, Milan, Italy | | | | | --- | --- | --- | --- | | A R T I C L E I N F O | | A B S T R A C T | | | Handling Editor: Dr. A. Siani | | Background and aims: InForma is a randomized controlled trial designed to promote weight loss in overweight or obese breast cancer survivors by encouraging adherence to a healthy diet and/or increased physical activity. This secondary analysis evaluated its effects on dietary patterns, nutrients and food groups intake, over a two-year period.
Methods and results: 260 breast cancer survivors with a BMI ≥25 kg/m2 were randomized into four arms: Dietary Intervention (DI), Physical Activity Intervention (PAI), Physical Activity and Dietary Intervention (PADI), and Minimal Intervention (MI). Participants were followed for 24 months and dietary intake and adherence to the Mediterranean diet were assessed throughout validated questionnaires (EPIC-FFQ, QueMD). Principal component analysis identified three baseline dietary patterns explaining 33.6 % of the variance: MEDITERRANEAN loaded heavily on “olive oil” and “vegetables”; SWEET on “cake, sweets”; and WESTERN on “red, processed meat”. Dietary factors contributing predominantly to each pattern decreased over follow-up visits, indicating an overall reduction in food consumption. Enrollment in DI and PADI arms compared to MI arm and being ≥60 years compared to <50 years, significantly predicted weight loss >5 %. Significant nutrient and energy intake reductions were observed, particularly at 6 months. Adherence to the Mediterranean diet improved in the whole study population, with no differences between intervention arms.
Conclusion: A lifestyle intervention can promote significant reductions in energy and nutrient intake, and modifications in dietary patterns. This study provides new insights into the effectiveness of personalized lifestyle interventions in promoting long-term dietary changes among breast cancer survivors.
Trial registration: ISRCTN53325751; [ClinicalTrials.gov](ClinicalTrials.gov) NCT02622711. | | | Keywords:
Breast cancer survivors Randomized controlled trial Diet
Dietary patterns Mediterranean diet Weight loss | | | | 1. Introduction The number of women living with and beyond breast cancer (BC) is increasing [1]. In 2022, BC was the second leading cause of cancer

FAQs

What was the purpose of the InForma trial?

The InForma trial aimed to promote weight loss in overweight or obese breast cancer survivors by encouraging adherence to a healthy diet and/or increased physical activity.

How were participants assigned and followed?

A total of 260 breast cancer survivors with BMI ≥25 kg/m² were randomized into four arms, then followed for 24 months with dietary intake and Mediterranean diet adherence assessed via validated questionnaires.

What dietary patterns were identified, and how did they change over time?

Principal component analysis identified three baseline patterns: Mediterranean, Sweet, and Western. The dietary factors contributing to each pattern decreased over follow-up visits, indicating an overall reduction in food consumption and related intake changes.

Oct 23, 2026

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