NAP Challenge as a Tool and Inspiration for a Cancer Survivors Group

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While helping survivors, I searched for an online program to complement my instruction.  I wanted an evidence-based program that aligned with my teaching on a healthy lifestyle.  I discovered the NAP (New American Plate) Challenge from the American Institute for Cancer Research (AICR) and signed up to give it a try. I found it to be an effective tool to help my patients with their journey.  

As a registered dietitian working with cancer survivors I see many experience unwanted weight gain during and after their treatment. For some, this is new, so they welcome my help with navigating changes in diet, exercise and other health behaviors. Cancer survivors are often open to change and motivated to live a healthier life to reduce risk of reoccurrence.

The NAP Challenge is a dietitian-led approach to use for those interested in healthier habits and weight management. Each week, participants receive a diet or physical activity challenge. The website provides tips on diet, exercise, mindful eating and many resources like recipes, menus and cooking tips. 

“I have enjoyed trying new recipes and preparing them for my family…learning to include more plant-based foods in my diet has been helpful”

The New American Plate for Weight Loss

My patients using NAP Challenge on their own asked me for in-person support, including weekly follow up meetings. As the only dietitian in a busy outpatient setting, this was not practical, so I decided to try a weekly class. This became our “Weight Management Class for Cancer Survivors”.

The group meets one week before the 12-week NAP Challenge begins and then meets every Thursday. This first gathering allows me to introduce the NAP Challenge and how it works, and participants can sign up on the spot to begin receiving emails for the weekly challenges. 

With a Tanita Body Composition Analyzer we measure weight, BMI, fat% and fat mass for each participant.  We also offer optional waist circumference measurements at the beginning and at the end of the program.  

We encourage everyone to keep a close record of what they eat and drink and to bring the recorded diary back with them the following week.

One participant summed up a key reason for using a food diary – “Keeping a food diary has helped me think about what I am eating.”

Sharing Tips and Building Community

Our weekly one hour meetings include recording repeat measurements and a short presentation on the week’s challenge. I ask participants how they managed the challenge and share any tips or suggestions they have for the rest of the group.  We encourage sharing and support – this is such an important way to build a bond and foster trust and community. It was fun to see how they could include their families in changes they were making.

One challenger said, “I have learned to enjoy exercise again and my daughter enjoys walking with me too.”

One of our favorite activities is a hands on cooking demonstration of a weekly recipe. This recipe may be from the AICR site or one of my recipes that can be easily prepared with limited time in our demo kitchen. We introduced new ideas for adding fruits and vegetables, some of which they had never tried! 

A favorite AICR handout was the “Phytochemicals: the Cancer Fighters in Your Food”, which I shared on the day we made personalized Mason Jar Salads. Many were excited to have new ideas for meals that are easy and different for their families.

I hear things like, “I have enjoyed trying new recipes and preparing them for my family…learning to include more plant-based foods in my diet has been helpful,” and “Even my grandchildren liked many of the recipes.”

We also make it convenient for those survivors who attend our center’s exercise program. They are able to go directly from the NAP Challenge Weight Class to the physical activity program. This reinforces the message of overall healthy lifestyle during survivorship.

“I have learned to enjoy exercise again and my daughter enjoys walking with me too.”

Reviewing Food Diary

After each class, I review participant’s food diary and add any notes or suggestions to give them at the next class. If someone misses a class, they receive a phone call to see how they are doing and encouragement to continue the program.

The Weight Management Program for Cancer Survivors in combination with the free online NAP Challenge has been offered twice at our facility (the spring and fall of 2018).   We do not charge a fee for this program and it is available to any cancer survivor in our area.  The class is one hour and meets weekly for 13 consecutive weeks.  

The program had 6 participants this past spring and 5 participants for the fall session.  Every participant lost some weight, but those who attended weekly and followed guidelines closely were most successful with weight loss. 

 One participant who attended every class and consistently exercised with the Exercise Program for Cancer Patients lost 25.5 pounds in the 13 week program.

She continues to work toward her goal and plans to participate in the next Weight Management Program for Cancer Survivors which will begin on February 21, 2019, with NAP Challenge kicking off on February 25th.

I encourage anyone working with survivors to incorporate the NAP Challenge into their work. For those not able to attend a weekly class, I helped them sign up and start the challenge and did some follow-up support via email. I also introduced a cancer support group that meets monthly to the challenge and they enjoyed learning more and participating on their own.

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    Author: Judy Fehlenberg

    Judy Fehlenberg, RD, MS, LD is an Oncology Dietitian with AdventHealth Gordon, Calhoun, Georgia.

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