Diet and Physical Activity Interventions to Improve Outcomes in Colorectal Cancer Survivors: A Multicenter Randomized Controlled Trial in North Africa.

The combined diet and physical activity intervention resulted in a 75% reduction in recurrence risk compared with usual care at 24 months.

• Hazard ratio of 0.25 (95% CI, 0.08 to 0.78; P = .01) for recurrence in the combined diet + PA group versus usual care
• Outcomes were assessed at 24 months following a 12-month intervention period
• Diet-only and PA-only arms showed favorable but nonsignificant trends for recurrence risk

The combined diet and physical activity intervention resulted in an 82% reduction in mortality compared with usual care at 24 months.

• Hazard ratio of 0.18 (95% CI, 0.04 to 0.78; P = .01) for mortality in the combined diet + PA group versus usual care
• Diet-only and PA-only arms showed favorable but nonsignificant trends for overall survival
• The combined intervention demonstrated the greatest and most sustained effects among all intervention arms

All intervention groups demonstrated significant improvements in moderate-to-vigorous physical activity and dietary behaviors compared with usual care at 12 and 24 months.

• Primary endpoints were improvements in dietary behaviors and physical activity levels
• Improvements were statistically significant (P < .001) across all intervention groups compared with usual care
• The greatest and most sustained effects were observed in the combined diet and PA arm
• Effects were maintained at both 12 and 24 months

Quality-of-life scores measured by FACT-G improved across all intervention groups, with the greatest gains in the combined intervention arm.

• Quality of life was measured using the FACT-G instrument
• Quality of life was a secondary endpoint assessed at 24 months
• All intervention groups (combined, diet-only, PA-only) showed improvement in FACT-G scores compared with usual care
• The combined diet and PA intervention produced the largest improvements in quality-of-life scores

The trial enrolled 300 nonmetastatic colorectal cancer survivors in remission using a 2×2 factorial randomized controlled design across three oncology centers in North Africa.

• Phase II multicenter randomized controlled trial with a 2×2 factorial design
• 300 participants were randomly assigned into four groups: combined diet + PA, diet-only, PA-only, or usual care
• Participants were nonmetastatic CRC survivors in remission
• The study was conducted across three oncology centers in North Africa
• Interventions were delivered for 12 months with outcomes assessed at 24 months

Subgroup analyses revealed consistent effects of the interventions across age, sex, comorbidity status, tumor site, and cancer stage.

• Subgroup analyses were conducted examining age, sex, comorbidity status, tumor site, and cancer stage
• Effects were described as consistent across all examined subgroups
• This suggests the intervention benefits were not limited to specific patient subpopulations

The intervention was culturally adapted for a North African population of colorectal cancer survivors.

• The study aimed to evaluate the effectiveness of a 'culturally adapted lifestyle intervention'
• This represents a multicenter trial specifically designed for and conducted in North Africa
• The cultural adaptation addressed both dietary behaviors and physical activity components