1
|
Bruns A, Greupner T, Nebl J, Hahn A. Plant-based diets and cardiovascular risk factors: a comparison of flexitarians, vegans and omnivores in a cross-sectional study. BMC Nutr 2024; 10:29. [PMID: 38347653 PMCID: PMC10860304 DOI: 10.1186/s40795-024-00839-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The growing trend towards conscious and sustainable dietary choices has led to increased adoption of flexitarian diets, characterised by plant-based eating habits with occasional consumption of meat and processed meat products. However, the cardiovascular disease (CVD) risk factors associated with flexitarian diets compared to both vegans and omnivores remain underexplored. METHODS In this cross-sectional study, 94 healthy participants aged 25-45 years, categorized into long-term flexitarians (FXs ≤ 50 g/day of meat and meat products, n = 32), vegans (Vs, no animal products, n = 33), and omnivores (OMNs ≥ 170 g/day of meat and meat products, n = 29) were included. Various CVD risk factors were measured, including fasting blood samples for metabolic biomarkers, body composition analysis via bioimpedance, blood pressure measurements, arterial stiffness evaluated through pulse wave velocity (PWV) and metabolic syndrome (MetS) severity was determined using browser-based calculations (MetS-scores). Dietary intake was assessed using a Food Frequency Questionnaire (FFQ), diet quality was calculated with the Healthy Eating Index-flexible (HEI-Flex), while physical activity levels were recorded using the validated Freiburger questionnaire. RESULTS The data showed that FXs and Vs had more beneficial levels of insulin, triglycerides, total cholesterol, and LDL cholesterol compared to OMNs. Notably, FXs revealed the most favorable MetS-score results based on both BMI and waistline, and better PWV values than Vs and OMNs. In addition, FXs and Vs reported higher intake rates of vegetables, fruit, nuts/seeds and plant-based milk alternatives. CONCLUSION The flexitarian diet appears to confer cardiovascular benefits. While Vs had the most favorable results overall, this study supports that reducing meat and processed meat products intake, as in flexitarianism, may contribute to CVD risk factor advantages.
Collapse
Affiliation(s)
- Anja Bruns
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, 30159, Germany
| | - Theresa Greupner
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, 30159, Germany
| | - Josefine Nebl
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, 30159, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, 30159, Germany.
| |
Collapse
|
2
|
Kranz RM, Kettler C, Koeder C, Husain S, Anand C, Schoch N, Englert H. Health Economic Evaluation of a Controlled Lifestyle Intervention: The Healthy Lifestyle Community Program (Cohort 2; HLCP-2). Nutrients 2023; 15:5045. [PMID: 38140304 PMCID: PMC10745766 DOI: 10.3390/nu15245045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Non-communicable diseases (NCD) are associated with high costs for healthcare systems. We evaluated changes in total costs, comprising direct and indirect costs, due to a 24-month non-randomized, controlled lifestyle intervention trial with six measurement time points aiming to improve the risk profile for NCDs. Overall, 187 individuals from the general population aged ≥18 years were assigned to either the intervention group (IG; n = 112), receiving a 10-week intensive lifestyle intervention focusing on a healthy, plant-based diet; physical activity; stress management; and community support, followed by a 22-month follow-up phase including monthly seminars, or a control group (CG; n = 75) without intervention. The complete data sets of 118 participants (IG: n = 79; CG: n = 39) were analyzed. At baseline, total costs per person amounted to 67.80 ± 69.17 EUR in the IG and 48.73 ± 54.41 EUR in the CG per week. The reduction in total costs was significantly greater in the IG compared to the CG after 10 weeks (p = 0.012) and 6 months (p = 0.004), whereas direct costs differed significantly after 10 weeks (p = 0.017), 6 months (p = 0.041) and 12 months (p = 0.012) between the groups. The HLCP-2 was able to reduce health-related economic costs, primarily due to the reduction in direct costs.
Collapse
Affiliation(s)
- Ragna-Marie Kranz
- Department of Food, Nutrition, Facilities, University of Applied Sciences Münster, 48149 Münster, Germany; (C.K.); (C.K.); (S.H.); (C.A.); (N.S.); (H.E.)
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Carmen Kettler
- Department of Food, Nutrition, Facilities, University of Applied Sciences Münster, 48149 Münster, Germany; (C.K.); (C.K.); (S.H.); (C.A.); (N.S.); (H.E.)
| | - Christian Koeder
- Department of Food, Nutrition, Facilities, University of Applied Sciences Münster, 48149 Münster, Germany; (C.K.); (C.K.); (S.H.); (C.A.); (N.S.); (H.E.)
| | - Sarah Husain
- Department of Food, Nutrition, Facilities, University of Applied Sciences Münster, 48149 Münster, Germany; (C.K.); (C.K.); (S.H.); (C.A.); (N.S.); (H.E.)
| | - Corinna Anand
- Department of Food, Nutrition, Facilities, University of Applied Sciences Münster, 48149 Münster, Germany; (C.K.); (C.K.); (S.H.); (C.A.); (N.S.); (H.E.)
| | - Nora Schoch
- Department of Food, Nutrition, Facilities, University of Applied Sciences Münster, 48149 Münster, Germany; (C.K.); (C.K.); (S.H.); (C.A.); (N.S.); (H.E.)
| | - Heike Englert
- Department of Food, Nutrition, Facilities, University of Applied Sciences Münster, 48149 Münster, Germany; (C.K.); (C.K.); (S.H.); (C.A.); (N.S.); (H.E.)
| |
Collapse
|
3
|
Noto S. Perspectives on Aging and Quality of Life. Healthcare (Basel) 2023; 11:2131. [PMID: 37570372 PMCID: PMC10418952 DOI: 10.3390/healthcare11152131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The aging of the world's population and the health problems accompanying it are becoming increasingly severe. Healthcare policies in developed countries focus on how to prevent and treat diseases associated with aging and how to maintain quality of life. Typical age-related diseases include deafness, cataracts, osteoarthritis, chronic obstructive pulmonary disease, diabetes mellitus, and dementia. Although the mechanisms by which these diseases develop differ, they are all caused by the accumulation of molecular and cellular damage over time. In addition, age-related diseases can cause a decline in physical and mental functions and the ability to perform activities of daily living, as well as the loss of roles in society and a sense of fulfillment in life. Therefore, there is a need for treatment and measures to accurately grasp and maintain quality of life. This review aims to introduce areas and representative papers expected to be contributed to the special issue of "Aging and Quality of Life".
Collapse
Affiliation(s)
- Shinichi Noto
- Department of Rehabilitation, Niigata University of Health and Welfare, Niigata 9503198, Japan
| |
Collapse
|
4
|
Koeder C, Alzughayyar D, Anand C, Kranz R, Husain S, Schoch N, Hahn A, Englert H. The healthful plant-based diet index as a tool for obesity prevention-The healthy lifestyle community program cohort 3 study. Obes Sci Pract 2023; 9:296-304. [PMID: 37287519 PMCID: PMC10242251 DOI: 10.1002/osp4.649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/13/2022] [Accepted: 12/11/2022] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND World-wide the prevalence of obesity is high, and promoting a shift toward more healthful and more plant-based dietary patterns appears to be one promising strategy to address this issue. A dietary score to assess adherence to a healthy plant-based diet is the healthful plant-based diet index. While there is evidence from cohort studies that an increased healthful plant-based diet index is associated with improved risk markers, evidence from intervention studies is still lacking. METHODS A lifestyle intervention was conducted with mostly middle-aged and elderly participants from the general population (n = 115). The intervention consisted of a 16-month lifestyle program focusing on a healthy plant-based diet, physical activity, stress management, and community support. RESULTS After 10 weeks, significant improvements were seen in dietary quality, body weight, body mass index, waist circumference, total cholesterol, measured and calculated low-density lipoprotein (LDL) cholesterol, oxidized LDL particles, non-high-density lipoprotein cholesterol, remnant cholesterol, glucose, insulin, blood pressure, and pulse pressure. After 16 months, significant decreases were seen in body weight (-1.8 kg), body mass index (-0.6 kg/m2), and measured LDL cholesterol (-12 mg/dl). Increases in the healthful plant-based diet index were associated with risk marker improvements. CONCLUSIONS The recommendation of moving toward a plant-based diet appears acceptable and actionable and may improve body weight. The healthful plant-based diet index can be a useful parameter for intervention studies.
Collapse
Affiliation(s)
- Christian Koeder
- Institute of Food Science and Human NutritionLeibniz University HannoverHannoverGermany
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Dima Alzughayyar
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Corinna Anand
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Ragna‐Marie Kranz
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Sarah Husain
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Nora Schoch
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Andreas Hahn
- Institute of Food Science and Human NutritionLeibniz University HannoverHannoverGermany
| | - Heike Englert
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| |
Collapse
|
5
|
Kranz RM, Kettler C, Anand C, Koeder C, Husain S, Schoch N, Buyken A, Englert H. Effect of a controlled lifestyle intervention on medication use and costs: The Healthy Lifestyle Community Program (cohort 2). Nutr Health 2023:2601060231164665. [PMID: 36938591 DOI: 10.1177/02601060231164665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
TRIAL REGISTRATION German Clinical Trials Register DRKS (www.drks.de; reference: DRKS00018775).
Collapse
Affiliation(s)
- Ragna-Marie Kranz
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, 26578Paderborn University, Paderborn, Germany.,Department of Food Nutrition Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Carmen Kettler
- Department of Food Nutrition Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Corinna Anand
- Department of Food Nutrition Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Christian Koeder
- Department of Food Nutrition Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Sarah Husain
- Department of Food Nutrition Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Nora Schoch
- Department of Food Nutrition Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Anette Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, 26578Paderborn University, Paderborn, Germany
| | - Heike Englert
- Department of Food Nutrition Facilities, University of Applied Sciences Muenster, Muenster, Germany
| |
Collapse
|
6
|
Effects of the healthy lifestyle community program (cohort 1) on stress-eating and weight change after 8 weeks: a controlled study. Sci Rep 2023; 13:3486. [PMID: 36859448 PMCID: PMC9977731 DOI: 10.1038/s41598-022-27063-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 12/23/2022] [Indexed: 03/03/2023] Open
Abstract
Stress-eating (eating more or more unhealthily in order to accommodate to stress), contributes to the development and maintenance of obesity. The effect of comprehensive weight loss interventions on changes in stress-eating as well as the contributing role of stress-eating on weight reduction has not been examined. The impact of the 8-week intensive phase of the Healthy Lifestyle Community Programme (HLCP, cohort 1) on emotional, external and restrained eating, as expressions of stress-eating was evaluated in a non-randomized controlled trial. Intervention: 14 seminars (twice per week, including practical units), complemented by stress-regulation and cooking workshops and coaching sessions empowering participants to change their behaviour towards a healthy plant-based diet (ad libitum), stress regulation, regular exercise and to focus on social support. Participants were recruited from the general population. In the intervention group, 91 participants (IG; age: 56 ± 10, 77% female) and in the control group, 52 (CG; age: 62 ± 14, 57% female) were enrolled. At baseline, participants of the IG reported higher levels of stress (9.7 ± 5.4 points [P] vs. 7.6 ± 6.2; p < 0.011), and of emotional eating (27.9 ± 9.4 vs. 20.0 ± 7.1; p < 0.001) and external eating (29.1 ± 4.9 vs. 25.5 ± 5.6; p < 0.001) than participants of the CG. Within 8 weeks, in the IG, scores of emotional eating (- 3.5 ± 5.4 P) and external eating significantly decreased (= - 2.0 ± 3.8 P), while restrained eating increased (2.7 ± 5.0 P; p for all < 0.001). Weight change was negatively correlated with change of external eating (R2 = 0.045; CC = - 0.285; p = 0.014), indicating that a greater weight change was associated with a smaller change of external eating. This is the first study to prospectively investigate the role of stress-eating on the weight reduction effect of comprehensive lifestyle interventions. Our data confirm that overweight is associated with EE and external eating and suggest that the HLCP is capable to reduce both, weight and stress-eating.Trial registration: German Clinical Trials Register (DRKS; reference: DRKS00018821; September 18th 2019; retrospectively registered).
Collapse
|
7
|
Koeder C, Anand C, Husain S, Kranz RM, Schoch N, Alzughayyar D, Bitterlich N, Hahn A, Englert H. Exploratory analysis of the effect of a controlled lifestyle intervention on inflammatory markers - the Healthy Lifestyle Community Programme (cohort 2). BMC Nutr 2023; 9:25. [PMID: 36747285 PMCID: PMC9900566 DOI: 10.1186/s40795-023-00684-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Chronic low-grade inflammation is associated with an increased risk of chronic disease and mortality. The objective of the study was to test the effect of a healthy lifestyle intervention on biomarkers of inflammation (among other risk markers). METHODS We conducted a non-randomized controlled trial with mostly middle-aged and elderly participants from the general population in rural northwest Germany (intervention: n = 114; control: n = 87). The intervention consisted of a 1-year lifestyle programme focusing on diet (largely plant-based; strongest emphasis), physical activity, stress management, and social support. High-sensitivity C-reactive protein (hs-CRP) was assessed at baseline, 10 weeks, 6 months, and 1 year. Homocysteine (Hcy) was assessed at baseline, 10 weeks, and 1 year. Adiponectin (Apn) was assessed at baseline and 10 weeks. An exploratory analysis of these inflammatory markers assessing the between-group differences with ANCOVA was conducted. RESULTS The 1-year trajectory of hs-CRP was significantly lower in the intervention group compared to control (between-group difference: -0.8 (95% CI -1.2, -0.3) mg/l; p = 0.001; adjusted for baseline). The 1-year trajectory of Hcy was non-significantly higher in the intervention compared to control (between-group difference: 0.2 (95% CI -0.3, 0.7) µmol/l; p = 0.439; adjusted for baseline). From baseline to 10 weeks, Apn decreased significantly more in the intervention group compared to control (between-group difference: -1.6 (95% CI -2.7, -0.5) µg/ml; p = 0.004; adjusted for baseline). CONCLUSIONS Our study shows that healthy lifestyle changes can lower hs-CRP and Apn levels and are unlikely to significantly affect Hcy levels within 1 year. TRIAL REGISTRATION German Clinical Trials Register (DRKS; reference: DRKS00018775 , registered 12 Sept 2019; retrospectively registered; www.drks.de ).
Collapse
Affiliation(s)
- Christian Koeder
- grid.9122.80000 0001 2163 2777Institute of Food Science and Human Nutrition, Leibniz University Hanover, Hanover, Germany ,grid.466058.9Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Corinna Anand
- grid.466058.9Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Sarah Husain
- grid.466058.9Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Ragna-Marie Kranz
- grid.466058.9Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Nora Schoch
- grid.466058.9Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Dima Alzughayyar
- grid.466058.9Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Norman Bitterlich
- Department of Biostatistics, Medizin & Service GmbH, Chemnitz, Germany
| | - Andreas Hahn
- grid.9122.80000 0001 2163 2777Institute of Food Science and Human Nutrition, Leibniz University Hanover, Hanover, Germany
| | - Heike Englert
- grid.466058.9Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| |
Collapse
|
8
|
Effect of Exercise on Carotid Artery Intima-Media Thickness in Adults: A Systematic Review and Meta-Analysis. J Phys Act Health 2022; 19:855-867. [PMID: 36257606 DOI: 10.1123/jpah.2022-0372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/22/2022] [Accepted: 09/01/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Carotid intima-media thickness (cIMT) is a validated surrogate marker of atherosclerosis that is independently associated with the risk for cardiovascular disease. Recent studies on the effect of exercise on cIMT have yielded conflicting results. METHODS Studies that were available up until October 30, 2021 from the PubMed, Cochrane Library, Embase, and Web of Science databases were included in the analysis. Subgroup analyses were performed to determine the effects of the type, intensity, and duration of exercise on cIMT. RESULTS This review included 26 studies with 1370 participants. Compared with control participants, those who engaged in exercise showed a decline in cIMT (weighted mean difference [WMD] -0.02; 95% confidence interval [CI], -0.03 to -0.01; I2 = 90.1%). Participants who engaged in aerobic (WMD -0.02; 95% CI, -0.04 to -0.01; I2 = 52.7%) or resistance (WMD -0.01; 95% CI, -0.02 to -0.00; I2 = 38.5%) exercise showed lower cIMT compared with control participants. An exercise duration of >6 months was associated with a 0.02 mm reduction in cIMT. In participants with low cIMT at baseline (<0.7 mm), exercise alone was not associated with a change in cIMT (WMD -0.01; 95% CI, -0.03 to 0.00; I2 = 93.9%). CONCLUSIONS Exercise was associated with reduced cIMT in adults. Aerobic exercise is associated with a greater decline in cIMT than other forms of exercise. Large, multicenter, randomized controlled trials are required to establish optimal exercise protocols for improving the pathological process of atherosclerosis.
Collapse
|
9
|
Men J, Wang W, Zhao J, Wen J, Hao Q, Li S, Zou S. Effectiveness of exercise in reducing cerebral stroke risk factors: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31861. [PMID: 36397439 PMCID: PMC9666154 DOI: 10.1097/md.0000000000031861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study aimed to explore the relationship between exercise and cerebral stroke and provide evidence for the prevention of cerebral stroke. MATERIALS/METHODS All clinical trials of exercise intervention for atherosclerosis were systematically reviewed. Five major databases were searched to retrieve relevant studies from their inception to May 2022. According to the magnitude of heterogeneity, the random and fixed-effect models were used to test reasonably. RESULTS According to the inclusion and exclusion criteria, 1341 articles were screened and 13 articles involving 825 patients were identified. The result showed that in the randomized controlled trials carotid intima-media thickness index was lower in the exercise group (-0.04 mm, 95% confidence interval: -0.07 to -0.01). All were statistically significant (P < .005) and subgroup analysis showed that the intervention period and paper quality are sources of heterogeneity. CONCLUSIONS The results of this systematic review suggest that exercise is associated with a slow increase in carotid intima-media thickness, which may provide evidence that exercise helps reduce cerebral stroke.
Collapse
Affiliation(s)
- Jie Men
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Wenjuan Wang
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Jian Zhao
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Jie Wen
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Qingqing Hao
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Shufeng Li
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Shuangling Zou
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| |
Collapse
|
10
|
Healthy lifestyle changes favourably affect common carotid intima-media thickness: the Healthy Lifestyle Community Programme (cohort 2). J Nutr Sci 2022; 11:e47. [PMID: 35754985 PMCID: PMC9201878 DOI: 10.1017/jns.2022.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/05/2022] Open
Abstract
Common carotid intima-media thickness (ccIMT) progression is a risk marker for cardiovascular disease (CVD), whereas healthy lifestyle habits are associated with lower ccIMT. The objective of the present study was to test whether a healthy lifestyle intervention can beneficially affect ccIMT progression. A community-based non-randomised, controlled lifestyle intervention was conducted, focusing on a predominantly plant-based diet (strongest emphasis), physical activity, stress management and social health. Assessments of ccIMT were made at baseline, 6 months and 1 year. Participants had an average age of 57 years and were recruited from the general population in rural northwest Germany (intervention: n 114; control: n 87). From baseline to 1 year, mean ccIMT significantly increased in both the intervention (0⋅026 [95 % CI 0⋅012, 0⋅039] mm) and control group (0⋅045 [95 % CI 0⋅033, 0⋅056] mm). The 1-year trajectory of mean ccIMT was lower in the intervention group (P = 0⋅022; adjusted for baseline). In a subgroup analysis with participants with high baseline mean ccIMT (≥0⋅800 mm), mean ccIMT non-significantly decreased in the intervention group (-0⋅016 [95 % CI -0⋅050, 0⋅017] mm; n 18) and significantly increased in the control group (0⋅065 [95 % CI 0⋅033, 0⋅096] mm; n 12). In the subgroup, the 1-year trajectory of mean ccIMT was significantly lower in the intervention group (between-group difference: -0⋅051 [95 % CI -0⋅075, -0⋅027] mm; P < 0⋅001; adjusted for baseline). The results indicate that healthy lifestyle changes may beneficially affect ccIMT within 1 year, particularly if baseline ccIMT is high.
Collapse
|
11
|
Anand C, Kranz RM, Husain S, Koeder C, Schoch N, Alzughayyar DK, Gellner R, Hengst K, Englert H. Bridging the gap between science and society: long-term effects of the Healthy Lifestyle Community Programme (HLCP, cohort 1) on weight and the metabolic risk profile: a controlled study. BMJ Nutr Prev Health 2022; 5:44-54. [PMID: 35814727 PMCID: PMC9237906 DOI: 10.1136/bmjnph-2021-000340] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/22/2021] [Indexed: 11/08/2022] Open
Abstract
Background The potential of adopting a healthy lifestyle to fight non-communicable diseases (NCDs) is not fully used. We hypothesised that the Healthy Lifestyle Community Programme (HLCP, cohort 1) reduces weight and other risk markers compared with baseline and control. Methods 24-month, non-randomised, controlled intervention trial. Intervention: intensive 8-week phase with seminars, workshops and coaching focusing on a healthy lifestyle (eg, plant-based diet, physical activity, stress management) and group support followed by a 22-month alumni phase. Weight reduction as the primary outcome and other NCD risk parameters were assessed at six time points. Participants were recruited from the general population. Multiple linear regression analyses were conducted. Results 143 participants (58±12 years, 71% female) were enrolled (91 in the intervention (IG) and 52 in the control group (CG)). Groups’ baseline characteristics were comparable, except participants of IG were younger, more often females, overweight and reported lower energy intake (kcal/day). Weight significantly decreased in IG at all follow-ups by −1.5 ± 1.9 kg after 8 weeks to −1.9 ± 4.0 kg after 24 months and more than in CG (except after 24 months). Being male, in the IG or overweight at baseline and having a university degree predicted more weight loss. After the intervention, there were more participants in the IG with a ‘high’ adherence (+12%) to plant-based food patterns. The change of other risk parameters was most distinct after 8 weeks and in people at elevated risk. Diabetes-related risk parameters did not improve. Conclusion The HLCP was able to reduce weight and to improve aspects of the NCD risk profile. Weight loss in the IG was moderate but maintained for 24 months. Participants of lower educational status might benefit from even more practical units. Future interventions should aim to include more participants at higher risk. Trial registration number DRKS00018821.
Collapse
Affiliation(s)
- Corinna Anand
- Faculty of Medicine, University of Muenster (WWU), Muenster, Germany
- Department of Food, Nutrition and Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Ragna-Marie Kranz
- Department of Food, Nutrition and Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Sarah Husain
- Department of Food, Nutrition and Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Christian Koeder
- Department of Food, Nutrition and Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Nora Schoch
- Department of Food, Nutrition and Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Dima-Karam Alzughayyar
- Department of Food, Nutrition and Facilities, University of Applied Sciences Muenster, Muenster, Germany
| | - Reinhold Gellner
- Faculty of Medicine, University of Muenster (WWU), Muenster, Germany
| | - Karin Hengst
- Faculty of Medicine, University of Muenster (WWU), Muenster, Germany
| | - Heike Englert
- Department of Food, Nutrition and Facilities, University of Applied Sciences Muenster, Muenster, Germany
| |
Collapse
|