TY - JOUR A1 - Kranz, Ragna-Marie A1 - Kettler, Carmen A1 - Koeder, Christian A1 - Husain, Sarah A1 - Anand, Corinna A1 - Schoch, Nora A1 - Englert, Heike T1 - Health Economic Evaluation of a Controlled Lifestyle Intervention: The Healthy Lifestyle Community Program (Cohort 2; HLCP-2) JF - Nutrients N2 - 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. Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:hbz:836-opus-174544 ER - TY - JOUR A1 - Koeder, Christian A1 - Kranz, Ragna-Marie A1 - Anand, Corinna A1 - Husain, Sarah A1 - Alzughayyar, Dima A1 - Schoch, Nora A1 - Hahn, Andreas A1 - Englert, Heike T1 - Effect of a 1-year controlled lifestyle intervention on body weight and other risk markers (the Healthy Lifestyle Community Programme, cohort 2) JF - Obesity Facts KW - Adipositas KW - Lebensstil KW - pflanzenbasierte Ernährung Y1 - 2021 U6 - http://dx.doi.org/10.1159/000521164 ER - TY - CHAP A1 - Koeder, Christian A1 - Husain, Sarah A1 - Kranz, Ragna-Marie A1 - Hahn, Andreas A1 - Englert, Heike T1 - How to achieve sustainable eating in the general population? T2 - The 9th World Sustainability Forum Program and Abstract Book N2 - 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. KW - plant-based diet KW - sustainability Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:hbz:836-opus-140455 UR - https://wsf-9.sciforum.net/ SP - 57 EP - 57 PB - MDPI ER - TY - JOUR A1 - Koeder, Christian A1 - Husain, Sarah A1 - Kranz, Ragna-Marie A1 - Anand, Corinna A1 - Alzughayyar, Dima A1 - Schoch, Nora A1 - Hahn, Andrea A1 - Englert, Heike T1 - Healthy lifestyle changes favourably affect common carotid intima-media thickness: the Healthy Lifestyle Community Programme (cohort 2) JF - Journal of Nutritional Science N2 - 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. KW - plant-based diet KW - carotid intima-media thickness KW - cardiovascular disease KW - atherosclerosis KW - lifestyle Y1 - 2022 UR - https://www.cambridge.org/core/journals/journal-of-nutritional-science/article/healthy-lifestyle-changes-favourably-affect-common-carotid-intimamedia-thickness-the-healthy-lifestyle-community-programme-cohort-2/DD29870A14031B1EB3DF112B2A381695#article U6 - http://dx.doi.org/10.1017/jns.2022.46 VL - 11 ER - TY - CHAP A1 - Koeder, Christian A1 - Hahn, Andreas A1 - Englert, Heike T1 - A plant-based diet and healthy lifestyle lower C-reactive protein levels T2 - Complement Med Res N2 - 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. KW - plant-based diet KW - inflammation KW - cardiovascular disease KW - cancer Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:hbz:836-opus-131847 UR - https://pubmed.ncbi.nlm.nih.gov/33631741/ SP - 6 EP - 7 ER - TY - JOUR A1 - Koeder, Christian A1 - Hahn, Andreas A1 - Englert, Heike T1 - Effect of a 6-Month Controlled Lifestyle Intervention on Common Carotid Intima-Media Thickness JF - The journal of nutrition, health & aging KW - plant-based diet KW - cardiovascular disease KW - kardiovaskuläre Erkrankungen KW - Prävention Y1 - 2021 U6 - http://dx.doi.org/10.1007/s12603-021-1628-0 ER - TY - JOUR A1 - Koeder, Christian A1 - Hahn, Andreas A1 - Englert, Heike T1 - No clear association of sleep duration or bedtime with common carotid intima-media thickness JF - Atherosclerosis KW - intima-media thickness, atherosclerosis, cardiovascular disease, sleep, lifestyle medicine Y1 - 2021 U6 - http://dx.doi.org/10.1016/j.atherosclerosis.2021.06.452 SP - e150 EP - e151 ER - TY - JOUR A1 - Koeder, Christian A1 - Hahn, Andreas A1 - Englert, Heike T1 - Is fruit intake associated with common carotid intima-media thickness? JF - European Journal of Public Health N2 - Background Common carotid intima-media thickness (ccIMT) is an established risk marker for cardiovascular events, including myocardial infarction and stroke, which are of high public health relevance. While a higher fruit intake is generally considered beneficial for cardiovascular health, recent studies have shown that a fruit intake of > 2 portions per day may be harmful. Therefore, we tested if there is an association between categories of fruit intake and mean ccIMT. Methods We conducted an exploratory, non-prespecified, cross-sectional analysis of baseline values of 167 mostly middle-aged participants of a controlled lifestyle intervention, recruited from the general population in rural northwest Germany (male: n = 58; female: n = 109). Fruit intake was classified into low (<1 portion of fruit/day), intermediate (1-2 portions of fruit/day), and high (>2 portions of fruit/day). Mean ccIMT was measured in accordance with the Mannheim consensus. Between-group differences in mean ccIMT were assessed with analysis of covariance. Results Mean age was 57.3 ± 0.7 years (mean ± SEM). Mean fruit intake was 1.6 ± 0.1 portions/day. Average mean ccIMT was 0.679 ± 0.010 mm. There was a significant difference in mean ccIMT between subjects with low (0.676 ± 0.020 mm; n = 50), intermediate (0.653 ± 0.014 mm; n = 72), and high fruit intake (0.724 ± 0.019 mm; n = 45; p = 0.016). But this difference was attenuated when adjusting for age, sex, and homocysteine (p = 0.418). Conclusions We found only a non-significant association between consuming >2 portions of fruit per day and ccIMT. Thus, our study could not confirm a negative effect of fruit intake on ccIMT. Age, sex, and homocysteine may confound this association. Key messages Current recommendations of 2 portions of fruit per day seem adequate and do not negatively influence carotid intima-media thickness. Future studies should address confounding of the association between fruit intake and cardiovascular risk markers. KW - plant-based diet KW - carotid intima-media thickness KW - fruit Y1 - 2021 U6 - http://dx.doi.org/10.1093/eurpub/ckab165.391 ER - TY - CHAP A1 - Koeder, Christian A1 - Englert, Heike T1 - Nutrient recommendations for vegans – what should we recommend? T2 - Kessler, C.: Complementary Medicine Research, Vol. 25, Suppl. 1 Y1 - 2018 U6 - http://dx.doi.org/10.1159/000488417 PB - S. Karger CY - Basel ER - TY - JOUR A1 - Koeder, Christian A1 - Anand, Corinna A1 - Husain, Sarah A1 - Kranz, Ragna-Marie A1 - Schoch, Nora A1 - Alzughayyar, Dima A1 - Bitterlich, Norman A1 - Hahn, Andreas A1 - Englert, Heike T1 - Exploratory analysis of the effect of a controlled lifestyle intervention on inflammatory markers – the Healthy Lifestyle Community Programme (cohort 2) JF - BMC Nutrition N2 - 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). Y1 - 2023 U6 - http://dx.doi.org/10.1186/s40795-023-00684-2 SN - 2055-0928 VL - 9 IS - 25 ER -