Can a telehealth delivered exercise program with nutritional advice be as effective as a supervised clinic-based exercise and nutrition program for weight loss and health enhancement in overweight and obese men with prostate cancer?

The interventions will consist of a similar resistance and aerobic exercise program performed over 3 sessions per week for 6 months delivered face-to-face (CENUT) in an exercise clinic or via telehealth (TENUT) by Accredited Exercise Physiologists (AEP). Both TENUT and CENUT groups will undertake resistance training comprising 6-12 repetition maximum (RM; i.e. the maximal weight that can be lifted 6 to 12 times which is equivalent to ~60-85% of 1RM) using 1-4 sets per exercise for 6 exercises targeting the major upper and lower body muscle groups performed using different equipment such as exercise machines, dumbbells, Gymsticks™ and elastic bands. Participants will exercise in a group setting of 6-8 people. The aerobic exercise component will involve 15 to 20 minutes of moderate to vigorous intensity cardiovascular exercise using a variety of modes such as walking, jogging or cycling and will be self-directed and undertaken daily. The total duration of the exercise session will be 60 minutes. In addition, participants will also be instructed to perform the general recommendations of 30 min of moderate/vigorous physical activity in the remaining 4 days of the week (a total of 120 minutes per week of moderate physical activity) to achieve at least 300 min of moderate to vigorous physical activity per week. These exercises are up to the participant's choice. For the telehealth intervention we will implement the latest digital platforms and related technological advancements in wearable sensors, online monitoring, cloud-based platforms, and video chat. Participants will receive their exercise program via their smart device or computer, communicate with the AEP and fellow participants by video chat, and be monitored in real-time through the Internet. For the nutrition intervention, all participants will receive a total of 5 face-to-face or online consultations between 30-60 mins over the first 6 months of intervention (baseline, 2, 12, 18, 24 weeks) with an Accredited Practising Dietitian aiming to: 1) achieve an energy deficit of 2100-4200 kJ/day (500-1000 kcal/day); 2) reducing discretionary items including alcoholic drinks and foods containing refined sugars; and 3) maintain protein intake, as well as the consumption of a 40 g whey protein supplement 3 times per week immediately after the resistance exercise sessions. Safety and monitoring will be assessed by recording the incidence and severity of any adverse events. The TENUT group will have their consultations online while the CENUT group will have face-to-face sessions. At the end of the first 6-month period, participants from CENUT will receive a booklet created for the study based on previous exercise oncology guidelines (Hayes et al. 2019, Schmitz et al. 2010) with detailed information about a home exercise prescription, while the telehealth program will be maintained without supervision for participants from TENUT. Instructions on performing the home-based exercises and diet will be provided by the AEP and APD.