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BACKGROUND: Hypertension, hyperlipidemia, and obesity most commonly result from poor diet and lack of physical activity. Lifestyle measures for risk factor modification and cardiovascular disease (CVD) prevention include exercise and dietary changes but most people are not successful at initiating and/or maintaining meaningful changes. We propose that such changes can be initiated using a short-term, intensive “immersion” support approach. METHODS: Moderate to high atherosclerotic CVD (ASCVD) risk individuals completed a 1-week, lifestyle-based immersion program, including daily nutrition education, 100% plant-based food consumption, exercise, and stress management classes. Beginning and end anthropomorphic measurements such as blood pressure and lipid measurements were collected. A dietary survey (14-point Mediterranean diet survey), functional capacity survey (Duke Activity Status Index [DASI] survey), and quality of life (QOL) survey (Sf-36), were administered on Day 0 and 3 months post-immersion. RESULTS: Eighty participants completed the program; 64% women, mean age 47 years (range 21-71), mean weight 88.43 kg (range 45.4-131.3 kg) and mean body mass index (BMI) 30.47 kg/m2 (range 18.6-44.8 kg/m2). Of the participants, 71% had hypertension (HtN), 39% had HbA1c ≥ 5.7%, 35% were former smokers, and 7.5% were active smokers. Average ASCVD risk was 6.84% (range 0.3-39%). After 1 week of the immersion program, BMI decreased on average 0.5 ± 0.38 kg/m2, weight decreased on average 11.49±1.19 kg (both p<0.001). Systolic blood pressures (SBP) decreased on average 6.76±15.17 mmHg and diastolic blood pressure (DBP) decreased on average 5.00±9.82 mmHg (both p<0.001). total cholesterol decreased on average 20.40 ± 15.44 mg/dL, triglycerides decreased on average 31.78 ± 44.06 mg/dL, LDL decreased on average 11.71 ± 15.92 mg/dL (all p < 0.001). High-density lipoprotein (HDL) also decreased on average 3.13 ± 5.83 mg/dL (p < 0.001). Sixty participants with diagnosed HtN or prescribed antihypertensive medications saw decreases in both SBP and DBP. In the majority of participants, improvements in functional capacity, QOL, and dietary compliance were noted. CONCLUSIONS: Short-term, intensive lifestyle intervention is feasible, can lead to immediate improvements in risk profiles, and, importantly, can have longer-lasting effects on exercise capacity, dietary compliance, and QOL.

Background Hypertension (HTN), hyperlipidemia (HLD) and obesity are traditional risk factors for cardiovascular disease (CVD). Lifestyle measures for prevention of CVD include exercise, dietary changes such as reducing saturated fats, increasing fruits and vegetables, and limiting sugar intake but most people are not successful at making meaningful changes without support. Purpose To demonstrate the feasibility of a short-term lifestyle-based immersion in improving anthropomorphic measurements, blood pressure (BP) and lipids after one week, and its ability to create sustainable change in a high risk cohort. Methods This was a one-week lifestyle immersion for employees of their company and a significant other who were considered high risk for CVD. Eighty participants went through a one-week, in-house, lifestyle-based program that included daily nutrition education, 100% plant-based food that was sugar, salt and oil free, exercise classes and stress management. Anthropomorphic measurements, BP and lipids were checked at onset and on day 6. Dietary survey (validated 14-point Mediterranean diet survey), functional capacity survey (DASI survey) and quality of life (QOL) survey (SF-36) were administered at day 0 and 3-months post immersion. Results Of the 80 participants, 64% were female, mean age was 47 years (range 21–71), mean weight was 194.95 lbs. and average BMI was 30.47 kg/m2. Risk factors for CVD were prevalent as 71.25% of the participants had HTN, 27.5% had HbA1c >6%, and there were 35% former and 7.5% active smokers. After one-week lifestyle immersion, average BMI improved by 0.50±0.38 kg/m2 (p<0.001), average weight improved by 3.28±2.62 lbs. (p<0.001) and average waist size improved with a loss of 0.73±1.20 inches (p<0.001). Average systolic BP (SBP) decreased by 6.67±15.17 mmHg (p<0.001) and diastolic BP (DBP) by 5.00±9.82 mmHg (p<0.001). Average total cholesterol improved by 20.40±15.44 mg/dL (p<0.001), triglycerides by 31.78±44.06 mg/dL (p<0.001), HDL by 3.13±5.83 mg/dL (p<0.001) and LDL by 11.71±15.92 mg/dL (p<0.001). In participants who had HTN at the start of the study, average SBP dropped by 10.91±14.30 mmHg (p<0.001) and average DBP by 8.02±8.84 mmHg (p<0.001). DASI and Mediterranean diet surveys were completed by 66% at day 0 and three months. Over the 3 months, there was a significant improvement in both functional capacity (7.03±11.17 points, p<0.001) and average diet score (1.38±2.40 points, p<0.001). The QOL survey was completed by 56% participants with an improvement in quality of life score of 22.02±17.68 points (p<0.001). Conclusion Short term intensive lifestyle interventions can lead to immediate and significant improvements in BP, weight and lipid profiles and importantly can have longer lasting effects on exercise capacity, dietary compliance and QOL. Further research to assess benefits of immersion programs with access to larger populations and for longer durations is warranted. Acknowledgement/Funding Whole Foods, Inc via Total Health Immersions, LLC