@inproceedings{KranzEnglert2019, author = {Kranz, Ragna-Marie and Englert, Heike}, title = {Potenzial eines community-basierten Lebensstilprogramms zur Verbesserung gesundheits{\"o}konomischer Parameter am Beispiel des LDL-Cholesterinspiegels und der Einnahme cholesterinsenkender Medikamente}, series = {Lebensjahre in Gesundheit - was leistet die Ern{\"a}hrung? Abstractband zum 56. Wissenschaftlichen Kongress}, booktitle = {Lebensjahre in Gesundheit - was leistet die Ern{\"a}hrung? Abstractband zum 56. Wissenschaftlichen Kongress}, publisher = {DGE}, address = {Bonn}, isbn = {978-3-88749-260-1}, pages = {51}, year = {2019}, abstract = {Potenzial eines community-basierten Lebensstilprogramms zur Verbesserung gesundheits{\"o}konomischer Parameter am Beispiel des LDL-Cholesterinspiegels und der Einnahme cholesterinsenkender Medikamente Hintergrund: Nicht-{\"u}bertragbare Zivilisationserkrankungen (NCDs) stellen eine enorme finanzielle Belastung f{\"u}r unser Gesundheitssystem dar. Erh{\"o}hte Lipidwerte, insbesondere der LDL-Cholesterinspiegel, gelten u. a. als Hauptrisikofaktoren f{\"u}r die Entstehung lebensstilabh{\"a}ngiger Erkrankungen und gehen nicht selten mit einer dauerhaften und kostenintensiven Medikation einher. Zahlreiche Studien konnten jedoch belegen, dass sich ein gesunder Lebensstil (gesunde Ern{\"a}hrung, Bewegung etc.) positiv auf den Verlauf kardiovaskul{\"a}rer Risikofaktoren auswirkt. Vor diesem Hintergrund besteht ein gesundheits politisch großes Interesse an der Implementierung von nachhaltigen Lebensstilinterventionen mit dem Ziel, langfristig eine Reduktion der Medikamenteneinnahme und konsekutiv eine Senkung der Gesundheitsausgaben zu erreichen. Methoden: Die kontrollierte Interventionsstudie umfasst 6 Messzeitpunkte {\"u}ber einen Zeitraum von 24 Monaten. F{\"u}r die Interventionsgruppe (n = 112) fanden individuelle Coachings und ein 10-w{\"o}chiges intensives Lebensstilprogramm mit anschließenden monatlichen Alumni-Treffen statt. Die Kontrollgruppe (n = 87) nahm an keinem Programm teil. In beiden Gruppen wurden, neben anthropometrischen, Vitalund Laborparametern (u. a. LDL-Cholesterin), gesundheits{\"o}konomische Parameter mithilfe von Frageb{\"o}gen erfasst. Ergebnisse: In der Interventionsgruppe zeigte sich bisher eine Verbesserung des LDL-Cholesterinspiegels nach 10 Wochen, wobei sich gleichzeitig eine Tendenz zu einer reduzierten Einnahme von cholesterinsenkenden Medikamenten abzeichnete. In der Kontrollgruppe wurden weder Ver{\"a}nderungen des LDLCholesterinspiegels noch Anpassungen der Medikamenteneinnahme beobachtet. Schlussfolgerung: Das community-basierte Lebens - stil programm eignet sich, um den LDL-Cholesterinspiegel im Blut zu senken und zeigt ein Potenzial zur verringerten Einnahme von cholesterinsenkenden Medikamenten auf. Zuk{\"u}nftig sollten die langfristigen Auswirkungen von Lebensstilinterventionen auf die Verbesserung des Lipid profils, die Reduktion der Medikamenteneinnahme sowie weitere gesundheits{\"o}konomische Parameter fokussiert werden.}, language = {de} } @inproceedings{KranzEnglert2019, author = {Kranz, Ragna-Marie and Englert, Heike}, title = {Effekt eines community-basierten Lebensstilprogramms auf Vitalparameter und gesundheits{\"o}konomische Parameter}, series = {Nieren- und Hochdruckkrankheiten. Hrsg. Deutsche Hochdruckliga e.V. DHL, Deutsche Gesellschaft f{\"u}r Hypertonie und Pr{\"a}vention}, booktitle = {Nieren- und Hochdruckkrankheiten. Hrsg. Deutsche Hochdruckliga e.V. DHL, Deutsche Gesellschaft f{\"u}r Hypertonie und Pr{\"a}vention}, publisher = {Dustri-Verlag}, address = {M{\"u}nchen-Deisenhofen}, issn = {0300-5224}, pages = {564}, year = {2019}, abstract = {Einleitung: Der globale Anstieg von Nicht-{\"u}bertragbaren Zivilisationserkrankungen (NCDs) sowie die damit h{\"a}ufig verbundenen langfristigen Medikationen, f{\"u}hren zu einer enormen medizinischen und finanziellen Belastung f{\"u}r unser Gesundheitssystem. Erh{\"o}hte Ruhepuls- und Blutdruckwerte gelten als zentrale Risikofaktoren f{\"u}r NCDs, die sich jedoch u.a. durch ein gesundes Ern{\"a}hrungsverhalten und k{\"o}rperliche Aktivit{\"a}t positiv beeinflussen lassen. Dabei stellt sich die Frage, inwiefern eine nachhaltige Lebensstilintervention zu einer Verbesserung dieser Vitalparameter sowie zu einer verringerten Medikamenteneinnahme f{\"u}hren kann, um den individuellen Gesundheitszustand verbessern und potenzielle Kosteneinsparungen im Bereich der Gesundheits{\"o}konomie erzielen zu k{\"o}nnen. Methode: Im Rahmen einer 24-monatigen, kontrollierten Interventionsstudie wurden zu sechs Messzeitpunkten umfangreiche Gesundheitsdaten von erwachsenen Personen in zwei im M{\"u}nsterland lokalisierten Kommunen erfasst. In der Interventionsgruppe (n=112) wurden individuelle Coachings und ein 10-w{\"o}chiges intensives Lebensstilprogramm mit anschließenden monatlichen Alumni-Treffen angeboten. Das Lebensstilprogramm fokussierte die Bereiche "Ern{\"a}hrung", "Bewegung", "Stressmanagement" und "Gemeinschaft". Die Kontrollgruppe (n=87) erhielt keine Interventionsmaßnahmen. Zu Beginn (t0) und zum Ende der Interventionsphase (t1) sowie nach 6, 12, 18 und 24 Monaten (t2 - t5) wurden in beiden Gruppen Gesundheitschecks durchgef{\"u}hrt. Dabei wurden gesundheits{\"o}konomische Parameter, wie Medikamenteneinnahmen und Erkrankungen, erfasst sowie der Blutdruck, der Ruhepuls und u.a. anthropometrische Daten und Laborparameter erhoben. Die Datenauswertung erfolgte mithilfe von IBM SPSS Statistics. Ergebnisse: In der Interventionsgruppe zeigten sich im Durchschnitt Verbesserungen des systolischen und diastolischen Blutdrucks sowie eine Senkung der Ruhepulswerte nach 10 Wochen (t1). Zu Beginn der Studie nahmen ca. 37\% der Teilnehmer blutdrucksenkende Medikamente ein, wobei sich bereits zum zweiten Messzeitpunkt (t1) eine Tendenz zu einer verminderten Medikamentendosierung abzeichnete. In der Kontrollgruppe wurden ebenfalls Verbesserungen des systolischen und diastolischen Blutdrucks, jedoch keine Verbesserungen der Ruhepulswerte beobachtet. Etwa 31\% der Teilnehmer in der Kontrollgruppe nahmen zur Baseline-Untersuchung (t0) blutdrucksenkende Medikamente ein, wobei kein R{\"u}ckgang der Medikation in dieser Gruppe abgebildet werden konnte. Diskussion: Das community-basierte Lebensstilprogramm konnte zu einer Senkung der Ruhepuls- und Blutdruckwerte innerhalb von 10 Wochen (t0 - t1) beitragen. Gleichzeitig wurde ein Potenzial zur verringerten Einnahme von blutdrucksenkenden Medikamenten gezeigt, wodurch sich Kosteneinsparungen ergeben k{\"o}nnten. Im weiteren Studienverlauf k{\"o}nnen langfristige Ver{\"a}nderungen der Vitalparameter sowie Anpassungen der Medikamenteneinnahme und weiteren gesundheits{\"o}konomischen Parametern aufgezeigt werden.}, language = {de} } @article{KranzEnglert2020, author = {Kranz, Ragna-Marie and Englert, Heike}, title = {Entwicklung des Lebensstilprogramms „Gemeinsam Gesund"}, series = {Pr{\"a}vention und Gesundheitsf{\"o}rderung}, journal = {Pr{\"a}vention und Gesundheitsf{\"o}rderung}, doi = {10.1007/s11553-020-00759-z}, pages = {1 -- 7}, year = {2020}, abstract = {Zusammenfassung Hintergrund. Zivilisationserkrankungen (NCD) werden in Deutschland mit nahezu allen Sterbef{\"a}llen assoziiert. Durch einen gesunden Lebensstil l{\"a}sst sich das Erkran-kungsrisiko jedoch maßgeblich beeinflussen. Daraus leitet sich ein großes Potenzial f{\"u}r Lebensstilinterventionen zur Pr{\"a}vention und Gesundheitsf{\"o}rderung ab. Das community-basierte Lebensstilprogramm „Gemeinsam Gesund" kombiniert verhaltens- und verh{\"a}ltnispr{\"a}ventive Maßnahmen zur NCD-Pr{\"a}vention. Fragestellung. Wie l{\"a}sst sich das Programm „Gemeinsam Gesund" mithilfe des Interven-tion-Mapping-Ansatzes (IMA) entwickeln und strukturieren? Methodik. Die Planung des Lebensstil-programms erfolgte mithilfe des IMA. Die theoretische Planungsmethode erm{\"o}g-lichte eine in Teilschritte untergliederte Programmentwicklung, die von einer Analyse der Ausgangssituation und Zielfindung {\"u}ber die Maßnahmenfestlegung bis hin zur Evaluationsplanung reichte. Ergebnisse. Die Bedarfs- und Bestandsanalyse (Schritt I) konnte die Bedarfe und bereits eta-blierte Gesundheitsangebote der Community aufzeigen. Daraus konnten konkrete Ziele ent-wickelt (Schritt II) sowie Maßnahmenformate und -inhalte (Schritt III) festgelegt werden. Es wurden Gesundheitschecks und ein 10-w{\"o}chiges intensives Lebensstilprogramm mit anschließenden Alumni-Treffen konzipiert. F{\"u}r alle Interventionsinhalte wurden Materialien entwickelt (Schritt IV) und die Akteure f{\"u}r die Implementierung vor Ort identifiziert (Schritt V). F{\"u}r die Evaluation (Schritt VI) wurde eine Kombination aus einer Effekt- und Prozessevaluation geplant. Diskussion. Der IMA eignet sich gut zur Planung von komplexen Lebensstilprogram-men. Die Anwendung der Methode konnte zu einer sehr zielgruppenorientierten Inter-ventionsentwicklung beitragen, wenngleich einige Abweichungen von der normalen Vorgehensweise des IMA notwendig waren.}, language = {de} } @inproceedings{KranzEnglert2020, author = {Kranz, Ragna-Marie and Englert, Heike}, title = {Potenzial eines Community-basierten Lebensstilprogramms zur Pr{\"a}vention von Diabetes mellitus Typ 2 im gesundheits{\"o}konomischen Kontext}, series = {Proceedings of the German Nutrition Society}, booktitle = {Proceedings of the German Nutrition Society}, isbn = {978-3-88749-267-0}, pages = {73}, year = {2020}, abstract = {Hintergrund: Der globale Anstieg von lebensstilabhängigen Erkrankungen, wie Diabetes mellitus Typ 2 (DMT2), f{\"u}hrt zu enormen Belastungen f{\"u}r das Gesundheitssystem. Dabei er-weist sich insbesondere der DMT2 häufig durch regelmäßige Untersuchungen und Medikationen als sehr kostenintensiv. Vor diesem Hintergrund stellt sich die Frage, inwiefern ein Le-bensstilprogramm (LSP), durch die Senkung der N{\"u}chternglu-cose und des HbA1c-Wertes, das DM2T-Risikoprofil verbessern und dem {\"U}bergang des Prädiabetes in einen DMT2 entgegen-wirken sowie sukzessive Kosteneinsparungen erzielen kann.Methoden: Das LSP umfasst eine 24-monatige, prospektive und kontrollierte Interventionsstudie mit Personen ≥18Jah-ren. Datenerhebungen wurden zur Baseline (t0) sowie nach 10 Wochen (t1) und 6, 12, 18 und 24 Monaten (t2-t5) festge-legt. Dabei werden u.a. Laborparameter (z.B. N{\"u}chternglu-cose und HbA1c) sowie gesundheits{\"o}konomische Parameter (z.B. Behandlungen und Medikationen) erfasst. In der Inter-ventionsgruppe (N=112) wurden individuelle Coachings, ein 10-w{\"o}chiges intensives LSP und monatliche Folgetreffen durchgef{\"u}hrt. Die Kontrollgruppe (N=87) erhielt ein „Treat-ment as usual".Ergebnisse: In der Interventionsgruppe zeigte sich eine kon-tinuierliche Verringerung der N{\"u}chternglucose (p<0,05), bis-her jedoch keine signifikante HbA1c-Reduktion, innerhalb der ersten 3 Messzeitpunkte (t0-t2). In der Kontrollgruppe wurde eine geringere Senkung der N{\"u}chternglucose (p<0,01) sowie ein leichter Anstieg des HbA1c-Wertes (p<0,01) beobachtet (t0-t2).Schlussfolgerung: Das LSP konnte bisher zu einer Verbes-serung des DMT2-Risikoprofils f{\"u}hren (t0-t2) und kann sich präventiv auf die Manifestation und den {\"U}bergang eines Prä-diabetes in einen DMT2 auswirken. Daraus k{\"o}nnen Kosten-einsparungen abgeleitet werden. Die Auswertung weiterer Messzeitpunkte kann die langfristigen Auswirkungen des LSPs auf die Verbesserung von DMT2-assoziierten Parametern und damit verbundenen gesundheits{\"o}konomischen Parame-tern aufzeigen.}, language = {de} } @inproceedings{KoederHusainKranzetal.2021, author = {Koeder, Christian and Husain, Sarah and Kranz, Ragna-Marie and Hahn, Andreas and Englert, Heike}, title = {How to achieve sustainable eating in the general population?}, series = {The 9th World Sustainability Forum Program and Abstract Book}, booktitle = {The 9th World Sustainability Forum Program and Abstract Book}, publisher = {MDPI}, doi = {10.25974/fhms-14045}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-140455}, pages = {57 -- 57}, year = {2021}, abstract = {Introduction: Moving towards a more plant-based dietary pattern would likely be beneficial in terms of a variety of sustainability dimensions. Methodology: We conducted a 2-year intervention study with six measurement time points (baseline, 10 weeks, 6 months, 1 year, 1½ years, 2 years) in rural northwest Germany. The intervention consisted of a lifestyle programme, and dietary recommendations were to move towards a healthy, plant-based diet. The control group received no intervention. Diet quality was assessed with the healthful plant-based diet index (hPDI). Results: In the intervention group (n = 67), the 2-year trajectory of hPDI was significantly higher compared to control (n = 39; p 0.001; between-group difference: 5.7 (95\% CI 4.0, 7.3) food portions/day; adjusted for baseline). The 2-year trajectory of meat intake was significantly lower in the intervention group (n = 79) compared to control (n = 40; p 0.001; between-group difference: -0.7 (95\% CI -0.9, -0.5) portions/day; adjusted for baseline). Conclusion: Our study confirms that plant-based nutrition education in the general population is likely to result in at least modest dietary improvements in terms of general healthfulness and meat reduction.}, language = {en} } @article{KranzEnglert2021, author = {Kranz, Ragna-Marie and Englert, Heike}, title = {Effect of a community-based lifestyle intervention programme on quality of life among German women}, series = {European Journal of Public Health}, volume = {Volume 31}, journal = {European Journal of Public Health}, doi = {10.1093/eurpub/ckab165.389}, year = {2021}, abstract = {Background Quality of life is an important concept in the field of health, which can be influenced by various lifestyle factors. The objective was to test if a community-based lifestyle programme would beneficially affect the health-related quality of life of German women. Methods The controlled intervention study had a total duration of 24 months. Quality of life (EQ-5D-3L), anthropometrics, vital and blood parameters as well as diagnosed diseases and health economic parameters were collected at baseline (t0), after 10 weeks (t1) and after 6 months (t2). For the intervention group (n = 65) a 10-week intensive lifestyle programme followed by monthly alumni meetings were conducted. The intensive phase consisted of 14 consecutive seminars about a healthy lifestyle, which focused on a plant-based diet, physical activity, stress management and community support. The control group (n = 35) received no intervention. Results The first descriptive health profile results of the subgroup analysis showed that 59\% women of the intervention group at t0 (t1: 37\%; t2: 48\%) and 60\% of the control group at t0 (t1: 54\%; t2: 49\%) reported problems in at least one of the EQ-5D dimensions (mobility, selfcare, activities, pain, and anxiety). A significant difference in EQ VAS change between women in intervention (7,15 [95\% CI 4,32; 9,98]; EQ VAS t0: 75,35 [SD 13,71]) and control group (-2,63 [95\% CI -5,40; 0,15]; EQ VAS t0: 78,80 [SD 18,51]) from t0 to t1 was observed (p < 001; adjusted for baseline). No significant differences in mean EQ VAS change from t0 to t2 and in mean EQ-5D index change from t0 to t1 and t0 to t2 between the groups were observed (p > 0,05; adjusted for baseline). Conclusions The preliminary results suggest that the lifestyle intervention programme can have a positive short-time effect on some aspects of quality of life, such as the health profile and EQ VAS. However, the long-term results will be shown in the future. Key messages - A healthy lifestyle can affect the quality of life in a positive way. - The community-based lifestyle programme had a short-time influence on the descriptive health profile and EQ VAS of German women, whereby the EQ index didńt change significantly between the groups.}, language = {en} } @article{KoederKranzAnandetal.2021, author = {Koeder, Christian and Kranz, Ragna-Marie and Anand, Corinna and Husain, Sarah and Alzughayyar, Dima and Schoch, Nora and Hahn, Andreas and Englert, Heike}, title = {Effect of a 1-year controlled lifestyle intervention on body weight and other risk markers (the Healthy Lifestyle Community Programme, cohort 2)}, series = {Obesity Facts}, journal = {Obesity Facts}, doi = {10.1159/000521164}, year = {2021}, language = {en} } @article{AnandKranzHusainetal.2022, author = {Anand, Corinna and Kranz, Ragna-Marie and Husain, Sarah and Koeder, Christian and Schoch, Nora and Karam Alzughayyar, Dima and Gellner, Reinhold and Hengst, Karin and Englert, Heike}, title = {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}, series = {BMJ Nutrition, Prevention \& Health}, journal = {BMJ Nutrition, Prevention \& Health}, doi = {10.1136/bmjnph-2021-000340}, year = {2022}, 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.}, language = {en} } @article{KoederHusainKranzetal.2022, author = {Koeder, Christian and Husain, Sarah and Kranz, Ragna-Marie and Anand, Corinna and Alzughayyar, Dima and Schoch, Nora and Hahn, Andrea and Englert, Heike}, title = {Healthy lifestyle changes favourably affect common carotid intima-media thickness: the Healthy Lifestyle Community Programme (cohort 2)}, series = {Journal of Nutritional Science}, volume = {11}, journal = {Journal of Nutritional Science}, doi = {10.1017/jns.2022.46}, year = {2022}, 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.}, language = {en} } @article{KranzKettlerAnandetal.2023, author = {Kranz, Ragna-Marie and Kettler, Carmen and Anand, Corinna and Koeder, Christian and Husain, Sarah and Schoch, Nora and Buyken, Anette and Englert, Heike}, title = {Effect of a controlled lifestyle intervention on medication use and costs: The Healthy Lifestyle Community Program (cohort 2)}, series = {Nutrition and Health}, journal = {Nutrition and Health}, publisher = {Sage Publications}, issn = {2047-945X}, doi = {10.25974/fhms-16217}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-162176}, year = {2023}, abstract = {Background: Establishing a healthy lifestyle has a great potential to reduce the prevalence of non-communicable diseases (NCDs) and their risk factors. NCDs contribute immensely to the economic costs of the health care system arising from therapy, medication use, and productivity loss. Aim: The aim of this study was to evaluate the effect of the Healthy Lifestyle Community Program (cohort 2; HLCP-2) on medication use and consequently on medication costs for selected NCDs (diabetes, hypertension, and dyslipidemia). Methods: Data stem from a 24-month non-randomised, controlled intervention trial aiming to improve risk factors for NCDs. Participants completed questionnaires at six measurement time points assessing medication use, from which costs were calculated. The following medication groups were included in the analysis as NCD medication: glucose-lowering medications (GLM), antihypertensive drugs (AHD) and lipid-lowering drugs (LLD). Statistical tests for inter- and intra-group comparison and multiple regression analysis were performed. Results: In total, 118 participants (intervention group [IG]: n = 79; control group [CG]: n = 39) were considered. Compared to baseline medication use decreased slightly in the IG and increased in the CG. Costs for NCD medication were significantly lower in the IG than in the CG after 6 (p = 0.004), 12 (p = 0.040), 18 (p = 0.003) and 24 months (p = 0.008). After multiple regression analysis and adjusting for confounders, change of costs differed significantly between the groups in all final models. Conclusion: The HLCP-2 was able to moderately prevent an increase of medication use and thus reduce costs for medication to treat NCDs with the greatest impact on AHD.}, language = {de} } @article{KoederAnandHusainetal.2023, author = {Koeder, Christian and Anand, Corinna and Husain, Sarah and Kranz, Ragna-Marie and Schoch, Nora and Alzughayyar, Dima and Bitterlich, Norman and Hahn, Andreas and Englert, Heike}, title = {Exploratory analysis of the effect of a controlled lifestyle intervention on inflammatory markers - the Healthy Lifestyle Community Programme (cohort 2)}, series = {BMC Nutrition}, volume = {9}, journal = {BMC Nutrition}, number = {25}, issn = {2055-0928}, doi = {10.1186/s40795-023-00684-2}, year = {2023}, 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).}, language = {en} } @article{KoederAlzughayyarAnandetal.2022, author = {Koeder, Christian and Alzughayyar, Dima and Anand, Corinna and Kranz, Ragna-Marie and Husain, Sarah and Schoch, Nora and Hahn, Andreas and Englert, Heike}, title = {The healthful plant-based diet index as a tool for obesity prevention - the Healthy Lifestyle Community Program cohort 3 study}, series = {Obesity Science and Practice}, journal = {Obesity Science and Practice}, doi = {10.1002/osp4.649}, year = {2022}, abstract = {Background Worldwide the prevalence of obesity is high, and promoting a shift towards 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 LDL cholesterol, oxidized LDL particles, non-HDL 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 towards 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.}, language = {de} } @article{KranzKettlerKoederetal.2023, author = {Kranz, Ragna-Marie and Kettler, Carmen and Koeder, Christian and Husain, Sarah and Anand, Corinna and Schoch, Nora and Englert, Heike}, title = {Health Economic Evaluation of a Controlled Lifestyle Intervention: The Healthy Lifestyle Community Program (Cohort 2; HLCP-2)}, series = {Nutrients}, journal = {Nutrients}, doi = {10.25974/fhms-17454}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-174544}, year = {2023}, 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.}, language = {en} } @inproceedings{KettlerKranzAnandetal.2024, author = {Kettler, Carmen and Kranz, Ragna-Marie and Anand, Corinna and Husain, Sarah and K{\"o}der, Christian and Michaelsen, Maren M. and Esch, Tobias and Englert, Heike}, title = {Effekt eines community-basierten Lebensstil-Interventionsprogramms auf die Selbstwirksamkeitserwartung von B{\"u}rger*innen in Bezug auf eine gesunde Ern{\"a}hrung}, series = {Proceedings of the German Nutrition Society}, booktitle = {Proceedings of the German Nutrition Society}, publisher = {Deutsche Gesellschaft f{\"u}r Ern{\"a}hrung e.V. (DGE)}, address = {Bonn}, pages = {93 -- 93}, year = {2024}, language = {de} }