Diet and Physical Activity as Mediators of Weight Loss in a Digital Prostate Cancer Survivorship Intervention for Men: Secondary Analysis of the PC-PEP Randomized Trial
In brief
Digital prostate cancer program cuts weight, diet and activity mediate 21% and 16%
In a 6-month home-based digital trial, men receiving the PC-PEP intervention lost weight, with improvements in diet accounting for about one-fifth and increased physical activity for about one-sixth of the total effect. The intervention still had a strong direct impact, suggesting other components also drive weight loss.
- Journal
- American journal of men's health (Q2)
- Published
- 5 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Becky Power, Nathan K Smith, Gabriela Ilie, Ricardo A Rendon, Ross Mason, Andrea Kokorovic, et al.
- PMID
- 42552876
- DOI
- 10.1177/15579883261457532
Why clinicians should know about it
- Picked for Urology (top studies of the week, 9 August 2026): Digital PCa survivorship trial, diet/PA mediation
Abstract
Weight gain during prostate cancer treatment can worsen treatment-related side effects, impair quality of life, and increase risks of recurrence and prostate cancer-specific mortality. The Prostate Cancer Patient Empowerment Program (PC-PEP), a comprehensive, home-based 6-month digital intervention, has demonstrated improvements in diet, physical activity, and weight. This secondary analysis examined whether changes in diet and physical activity mediated weight loss among participants receiving PC-PEP. In a randomized clinical trial, 128 men with localized prostate cancer were assigned to PC-PEP (n=66) or standard care (n=62) for six months. Diet quality was assessed using a 12-item summary score reflecting weekly frequency of key food groups. Physical activity level was self-reported as not very active, moderately active, or very active. Mediation models were adjusted for age, comorbidity, treatment modality, time from randomization to treatment, relationship status, medication for anxiety or depression, and baseline weight, diet, and physical activity. The results show that weight loss in the PC-PEP group was significantly mediated by both diet and physical activity, accounting for 21% and 16% of the total effect, respectively. The direct effect of the intervention remained significant. These results indicate that improvements in diet and physical activity partially mediated weight loss in men receiving PC-PEP, while a substantial direct effect suggests that additional components of the intervention contribute to outcomes. Findings highlight the value of comprehensive, multi-faceted digital survivorship interventions for men with prostate cancer and suggest that observed mediation effects are conservative estimates given the use of brief self-reported behavioral measures.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.