Effect of a 6-Month Controlled Lifestyle Intervention on Common Carotid Intima-Media Thickness

Abstract

Objectives The intima-media thickness of the common carotid artery (ccIMT) is an established risk marker for cardiovascular disease (CVD). However, it is unclear whether lifestyle interventions can easily demonstrate an improvement in ccIMT. The objective was to test if our intervention would beneficially affect ccIMT (among other CVD markers). Design Non-randomized controlled trial Setting Rural northwest Germany Participants Middle-aged and elderly participants from the general population (intervention: n = 114; control: n = 87) Intervention A community-based, 6-month controlled lifestyle intervention focusing on four areas of lifestyle change: a plant-based diet, physical activity, stress management, and an improved social life. A strong emphasis was on dietary change. Measurements We tested whether ccIMT change from baseline to 6 months was different between groups. Results With all participants included, no significant difference in mean ccIMT change between groups was observed (p = 0.708). However, in a subgroup analysis with participants with high baseline mean ccIMT (≥0.800 mm) a significant difference in mean ccIMT change between intervention (−0.023 [95% CI −0.052, 0.007] mm; n = 22; baseline mean ccIMT: 0.884 ± 0.015 mm) and control (0.041 [95% CI 0.009, 0.073] mm; n = 13; baseline mean ccIMT: 0.881 ± 0.022 mm) was observed (p = 0.004). Adjusting for potential confounders did not substantially alter the results. Conclusion The results indicate that healthy lifestyle changes can beneficially affect ccIMT within 6 months and that such a beneficial effect may be more easily demonstrated if participants with high baseline ccIMT are recruited. The observed effect is of relevance for the prevention of CVD events, including myocardial infarction and stroke.

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

“…Participants with a UD lost more weight (up to −5.7±3.5 kg after18 months), suggesting that knowledge transfer was emphasised too strongly for participants of lower educational status. Therefore, we suggest even more practical units and simplified dietary rules-as we modified in subsequent HLCPs (cohort 2 17 and 3 (unpublished data)). The HLCP reached mainly women-as it is typical for health education interventions, but those men who did participate, benefited the most regarding weight change.…”

“…We conducted a non-randomised, controlled intervention trial with a duration of 24 months (see figure 1). As with all lifestyle interventions, blinding of participants or instructors was not possible (as described previously 17 ). Staff performing laboratory assessments were unaware of group allocation.…”

“…Participants of the IG and CG were recruited from the general population in rural Germany and to ensure that they came from different communities, they were recruited separately from a ‘intervention municipality’ and a ‘control municipality’. However, due to our complex real-world approach, which requires involvement of local stakeholders16 in the planning stage and before recruitment was initiated, it was not possible to cluster randomise 17. Notably, we included not only participants at a high risk for NCDs but also health-conscious persons.…”

“…However, due to our complex real-world approach, which requires involvement of local stakeholders 16 in the planning stage and before recruitment was initiated, it was not possible to cluster randomise. 17 Notably, we included not only participants at a high risk for NCDs but also healthconscious persons. In the IG, they were desirable role models (ie, peer support).…”

Effect of a 1-Year Controlled Lifestyle Intervention on Body Weight and Other Risk Markers (the Healthy Lifestyle Community Programme, Cohort 2)

“…material, see www.karger.com/doi/10.1159/000521164]; 2-year time point: intervention: July 2020; no assessment in the control group). Participants were recruited from the general population in rural northwest Germany (intervention group: February 2018; control group: September 2018; as described previously [40]).…”