Evaluation of a standardized wellness protocol to improve anthropometric and physiologic function and to reduce health risk factors: a retrospective analysis of outcome

Evaluating the Influence of the Complete Health Improvement Program (CHIP) on Blood Glucose, Blood Pressure, and Weight

Background

Diabetes, hypertension, and obesity are vastly prevalent in the United States. Lifestyle modification programs can aid in controlling chronic disease. The aim of the study was to evaluate the health outcomes of the Complete Health Improvement Program (CHIP) concerning blood glucose, blood pressure, and weight. CHIP is a lifestyle medicine education program involving diet modification and increased physical activity.

Methods

A quantitative, summative program evaluation was performed to measure the outcomes of CHIP. Pre and post data sets were collected on 73 individuals who completed the 12-week CHIP program. Pre and post program blood glucose levels, blood pressure readings, and weight measurements were analyzed using a paired t-test with a 95% confidence level. Analysis determined influence of the intervention on the biomarkers.

Results

The post-intervention group means showed decreases in blood glucose, blood pressure, and weight. Statistical analysis revealed significant decreases in blood glucose (p = 0.008) and weight (p = 0.000). Blood pressure readings did not have statistically significant decreases (p = 0.403); however, the pre-intervention blood pressure readings were in the normotensive range.

Conclusion

Results indicated that the Complete Health Improvement Program decreased participants’ blood glucose levels, blood pressure readings, and weight measurements. Statistically significant decreases in blood glucose and weight suggest enhanced control of diabetes and obesity through utilization of CHIP.

A review and critique of published real-world weight management program studies

BACKGROUND

Beyond the essential but somewhat artificial conditions that typify formal clinical studies, real-world evidence (RWE) of weight loss program effectiveness is paramount for an accurate assessment of such programs and refinement of best practices.

OBJECTIVES

To evaluate the current state of RWE studies and publications on weight loss, identify the range of weight loss components being used in RWE programs, and to provide a general overview of the consistency or lack of consistency with regard to measuring and reporting outcomes.

METHODS

A structured search of PubMed was performed to identify relevant English-language publications from 2006 to December 2017 that reported real-world studies of weight loss among adults. Duplicates, non-relevant publications, articles on weight loss surgery, pediatric studies, randomized controlled trials, studies with self-reported weight loss, no objective weight measures, or that failed to include weight loss results were excluded.

RESULTS

This review included 62 RWE publications. Forty-nine studies included dietary intervention, 37 included exercise, 29 included motivational counseling, and 5 contained some patients who had pharmacologic treatment as part of their weight loss regimen. The numbers of participants per study ranged from 10 to more than 3 million. The interventions reported in the publications included diet, exercise, counseling to promote diet and/or exercise, motivational counseling, and pharmacotherapy, and various combinations of these.

CONCLUSIONS

Despite general acceptance that weight loss programs are capable of facilitating successful outcomes, this review revealed substantial inconsistency in the design and reporting of such programs, making it very difficult to draw conclusions about the comparative merits of different real-world weight loss strategies/components. In addition, there was a marked lack of congruence with current weight loss management guidelines, and notably few studies incorporating anti-obesity medications. There clearly is a need for greater rigor and standardization among designing and reporting RWE weight-loss studies.

A weight loss program in a chiropractic practice: a retrospective analysis

CONTEXT

Obesity is a global problem and places individuals at risk for developing chronic metabolic disorders. The need for investigating simple, effective and sustaining approaches to weight loss cannot be overstated.

METHODS

We performed a retrospective file analysis of patient files attending a 13-week weight loss program. Inclusion for analysis were files of adults (i.e., >18 years) completing the program consisting of chiropractic adjustments/spinal manipulative therapy augmented with diet/nutritional intervention, exercise and one-on-one counseling.

RESULTS

Sixteen of 30 people (i.e., 53.33%) completed the program. Statistically and clinically significant changes were noted in weight and BMI measures based on pre-treatment (average weight = 190.46 lbs. and BMI = 30.94 kg/m(2)) and comparative measurements (average weight = 174.94 lbs. and BMI = 28.50 kg/m(2)).

CONCLUSION

A cohort of patients under enrolled in a weight loss program was described. This provides supporting evidence on the effectiveness of a multi-modal approach to weight loss implemented in a chiropractic clinic.

Five keys to real transformation in health care

Transformation in health care requires a deeply holistic approach. Natural leaders of such a transformation are the complementary and alternative medicine practitioners who already share a vision of wellness, prevention, and optimal human function. Central to this shared vision is lifestyle change for patients and practitioners. Yet, to change a lifestyle is to change a self. Assisting individuals to transform their very sense of self in order to live healthier, more fulfilling lives centered on flourishing requires several important keys. Visionary and unified leaders are the first key. Structural support through coordination of health clinics locally and nationally is the second key. This can be optimized by utilizing initiatives of the new Affordable Health Care Act, because it provides a potential impetus for deep structural changes. An expanded evidence base for multifactorial approaches to wellness lifestyles is the third key. A reorganizational orientation with an emphasis on the right timing of transformation is the fourth key. The fifth key is an Integral map, which brings together the personal, behavioral, cultural, and social domains. By utilizing such a map, one ensures that no aspect of the transformative revolution at hand slips away due to any misplaced focus, such as emphasizing only on the things we can see with our eyes. By embracing the essence of transformation in terms of a wholeness to all reality, an evolutionary unifying field with interior depth and exterior expression, health care is redefined more authentically.