@inproceedings{KoederHahnEnglert2021, author = {Koeder, Christian and Hahn, Andreas and Englert, Heike}, title = {A plant-based diet and healthy lifestyle lower C-reactive protein levels}, series = {Complement Med Res}, booktitle = {Complement Med Res}, doi = {10.1159/000514476}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-131847}, pages = {6 -- 7}, year = {2021}, abstract = {Introduction: Many disease processes are accompanied and promoted by increased inflammation in the body. Increased concentrations of high-sensitivity C-reactive protein (hs-CRP) in the blood are an indicator of subclinical inflammation, increased disease risk, and an increased risk of early death. A healthy plant-based diet and increased physical activity have been shown to reduce hs-CRP concentrations. Objectives: Our objective was to test if a healthy lifestyle intervention program can improve hs-CRP levels and other risk factors. Methodology: We are conducting a non-randomized, controlled intervention study with 6 times of measurement (baseline, after 2.5, 6, 12, 18 and 24 months). Participants in the intervention group (n = 104) took part in a 2.5-month intensive lifestyle program focusing on a plant-based diet (PBD), physical activity, stress management and group support. Currently they are in the less intensive phase (monthly seminars) which will be completed after 24 months. The control group (n = 62) did not take part in any program. In both groups hs-CRP was assessed, and participants with an infection/common cold at any of the times of measurement were excluded from the analyses. Results: In the intervention group (n = 97) we observed a reduction in hsCRP from baseline to 2.5 months (p < 0.001). In the control group (n = 46) hs-CRP levels increased non-significantly. The changes from baseline to 2.5 months were significantly different between intervention and control (p < 0.01). Conclusion: Our program led to a clinically relevant reduction in hs-CRP. Continued follow-up will show if this improvement can be maintained in the intervention group. Our study confirms that a PBD and healthier lifestyle choices can lower hs-CRP.}, 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} } @misc{HusainHillmannHengstetal.2023, author = {Husain, Sarah and Hillmann, Katharina and Hengst, Karin and Englert, Heike}, title = {Effects of a lifestyle intervention on the biomarkers of oxidative stress in non-communicable diseases: A systematic review}, series = {Frontiers in Aging}, journal = {Frontiers in Aging}, publisher = {Frontiers Journal}, address = {Germany}, doi = {10.25974/fhms-16082}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-160827}, year = {2023}, abstract = {Oxidative stress plays a critical role in the pathogenesis of chronic diseases. Therefore, improvement of oxidative stress status through lifestyle intervention can play a vital role in preventing and treating chronic diseases. This systematic review aims to provide an overview of articles published in the last decade examining the association between lifestyle intervention and oxidative stress biomarkers in the context of non-communicable diseases. The electronic databases PubMed and Web of Science were searched for relevant studies, following the PRISMA (Preferred Reporting of Systematic Reviews and Meta-Analyses) guidelines. This systematic review focused on the four important oxidative stress biomarkers; glutathione (GSH), superoxide dismutase (SOD), catalase, and malondialdehyde. 671 articles were identified, of which nine met the inclusion criteria. A trend emerged, showing that lifestyle modifications that focus on diet and physical health can improve oxidative stress in the form of an increase in superoxide dismutase and CAT levels and a decrease in Malondialdehyde levels in participants with non-communicable diseases (NCDs), GSH levels were not affected. However, the results are difficult to compare because of the heterogeneity of the methods of the biomarkers studied. Our review indicates that oxidative stress can be influenced by lifestyle modifications and may be an effective tool for the prevention and management of non-communicable diseases. This review also elucidated the importance of analyzing multiple oxidative stress biomarkers to evaluate oxidative stress, it further highlights the need to conduct long-term lifestyle intervention studies on oxidative stress biomarkers to understand the connection between oxidative stress biomarkers, NCDs and Lifestyle intervention.}, language = {en} } @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{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} } @techreport{EnglertMuellerNordhornSeewaldetal.2010, type = {Working Paper}, author = {Englert, Heike and M{\"u}ller-Nordhorn, Jacqueline and Seewald, Sebastian and Sonntag, Frank and V{\"o}ller, Hans and Meyer-Sabellek, Wolfgang and Wegscheider, Karl and Windler, Eberhard and Katus, Hugo and Willich, Stefan N.}, title = {Is patient self-report an adequate tool for monitoring cardiovascular conditions in patients with hypercholesterolemia?}, publisher = {Oxford University Press}, doi = {10.25974/fhms-576}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-5761}, year = {2010}, abstract = {ABSTRACT Background: To determine the accuracy of patient self-reports of specific cardiovascular diagnoses and to identify individual patient characteristics that influence the accuracy. Methods: This investigation was conducted as a part of the randomized controlled ORBITAL study. Patients with hypercholesterolemia were enrolled in 1961 primary-care centers all over Germany. Self-reported questionnaire data of 7640 patients were compared with patients' case report forms (CRFs) and medical records on cardiovascular diseases, using k statistics and binomial logit models. Results: k values ranged from 0.89 for diabetes to 0.04 for angina. The percentage of overreporting varied from 1 percent for diabetes to 17 percent for angina, whereas the percentage of underreporting varied from 8.0 percent for myocardial infarction to 57 percent for heart failure. Individual characteristics such as choice of individual general practitioner, male gender and age were associated with the accuracy of self-report data. Conclusion: Since the agreement between patient self-report and CRFs/medical records varies with specific cardiovascular diagnoses in patients with hypercholesterolemia, the adequacy of this tool seems to be limited. However, the authors recommend additional data validation for certain patient groups and consideration of individual patient characteristics associated with over- and underreporting. Keywords agreement, cardiovascular disease, case report forms, general practitioner information, medical records, orbital study, overreporting, patient self-report, underreporting}, language = {de} } @incollection{EnglertDiehlGreenlawetal.2012, author = {Englert, Heike and Diehl, H. and Greenlaw, R. and Aldana, S.}, title = {The Effects of Lifestyle Modification on Glycemic Levels and Medication Intake:The Rockford CHIP}, series = {Dr. Oreste Capelli, Primary Care at a Glance - Hot Topics and New Insights}, booktitle = {Dr. Oreste Capelli, Primary Care at a Glance - Hot Topics and New Insights}, publisher = {InTech}, address = {Rijeka, Rum{\"a}nien}, isbn = {979-953-307-556-2}, doi = {10.25974/fhms-571}, pages = {323 -- 336}, year = {2012}, abstract = {Introduction: The high prevalence of cardiovascular disease (CVD) in the past 50 years has led to intense research, resulting in many improvements in treatment. At the same time, type 2 diabetes, with its concomitant increase in vascular complications, has become a serious, exploding and costly public health concern . Diabetes now affects 285 million adults worldwide and 344 million with pre-diabetes. Of these, 25.8 million diabetics and 79 million pre-diabetics are found in the United States alone.The current cost of diabetes in the US is likely to exceed the \$174 billion estimate, which includes 2/3 for direct medical costs and 1/3 for indirect costs, such as disability, work loss, and premature death, but omits the social cost of intangibles (e.g. pain, suffering, lower quality of life). The diabetes epidemic has been accompanied by a similarly drastic increase in obesity. Although the relationship between the two developments is a matter of debate, both are presumably caused by changes in dietary habits and an increasingly sedentary modern lifestyle . Compelling evidence has shown that lifestyle changes can effectively prevent or delay the occurrence of type 2 diabetes. Because individuals at risk for this disease can usually be identified during the pre-diabetic phase of impaired glucose tolerance, early intervention and lifestyle change offer a logical approach to preventing this disease and its devastating vascular complications. Additionally, community-based lifestyle interventions for high risk groups and for the general population are a cost-effective way of curbing the growing burden of the disease. Solidifying the scientific basis for the prevention, treatment and control of this disease and its implementation on a national level, however, remains a difficult challenge. Moreresearch is needed to provide comprehensive and more effective strategies for weight-loss,especially over time. Therefore, the objectives of this study were to identify diabetics and those at risk (prediabetics) out of the total cohort of 1,517 who selected themselves into an intensive community-based lifestyle intervention program, and to assess its clinical efficacy ineffecting medication status as determined and managed by their personal physicians.}, language = {en} }