Discussion
Weight loss, T2D, weight loss
CVD, RECRUITMENT
Weight loss occurred in the BCPP and MDPP programmes and the minimal intervention written group, although the supported programmes resulted in more women achieving clinically significant weight loss of ≥10%. Additional personalised CVD and T2D risk information did not influence weight loss success compared to a programme which just provided personalised BC risk.We have shown good uptake to the trial, particularly from face-to face recruitment. Uptake of 10% with a postal invitation was comparable to previous weight loss studies in our high risk clinic (12%) [Previous randomised controlled trials amongst women at increased risk of BC have involved smaller cohorts (50–80 participants) and reported weight loss at the end of the active weight loss phase at either 3, 4 and 6 months [Weight loss in our written advice group (3.3%) was considerably higher than the 1% previously reported in the literature. This previously reported 1% weight loss in controls is thought to be an effect of trial weigh-ins [Modest weight loss of ≥5% has been associated with reduction in risk of postmenopausal BC within observational studies [There was no difference in retention or weight loss success between the MDPP and BCPP groups which is consistent with our findings in women in the general population attending breast screening [There was no clear benefit of the additional CVD and T2D risk information. Notably 55–70% of the MDPP group had low estimated 10-year and lifetime risks of CVD and T2D. Low CVD risk factors (i.e., lipid and blood pressure) may lead to underestimation of subsequent lifetime risk amongst the relatively young women in the FHRPC. It is not known whether better lifetime CVD risk assessment tools could increase engagement amongst young women [Actual level of BC risk amongst these women at increased risk did not predict retention to the study. Twelve percent of the cohort were taking BC risk reduction medication, i.e. tamoxifen, aromatase inhibitors, or raloxifene which is comparable to figures in our clinic [Most women opted to follow the intermittent diet at baseline. However only half of completers were still following the diet at 12 months. This is consistent with previous reports that intermittent diets are not maintained long term [