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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.
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.
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.
Background: Stress and cortisol dysregulation are linked to NCDs. Moreover, stress favours unhealthy lifestyle patterns, which increase the risk for NCDs. The role of the Cortisol Awakening Response (CAR) and the effect of lifestyle interventions on the same remain unclear. Methods: The impact of the intensive 8-week phase of the Healthy Lifestyle Community Programme (HLCP, cohort 1) on parameters of the CAR, ie cortisol values 0 (sample [S]1), 30), 45 and 60 minutes post-awakening, average peak, S1-peak delta and area under the increase curve (AUCI), and perceived stress levels (PSL) was evaluated in a non-randomized, controlled trial. Covariates of the CAR (eg sleep measures) and irregularities in sampling were assessed. The intervention focussed on stress management, a healthy diet, regular exercise, and social support. Participants were recruited from the general population. Multiple linear regression analyses were conducted. Results: 97 participants (age: 56 ± 10 years; 71% female), with 68 in the intervention group (IG; age: 55 ± 8, 77% female) and 29 participants in the control group (CG; age: 59 ± 12, 59% female), were included in the analysis. The baseline characteristics of both groups were comparable, except participants of IG were younger. On average, the PSL at baseline was low in both groups (IG: 9.7 ± 5.4 points; CG: 8.5 ± 6.9 points; p = .165), but 22% (n = 15) in the IG and 20% (n = 6) in the CG reported a high PSL. Most participants reported irregularities in CAR sampling, eg interruption of sleep (IG: 80% CG: 81%). After 8 weeks, most CAR parameters and the PSL decreased in the IG and CG, resulting in no differences of change between the groups. In the IG only, a decrease of PSL was linked to an increase of CAR parameters, eg AUCI (correlation coefficient = −0.307; p = .017). Conclusion: The HLCP may potentially reduce PSL and change the CAR, but results cannot be clearly attributed to the programme. Methodological challenges and multiple confounders, limit suitability of the CAR in the context of lifestyle interventions. Other measures (eg hair-cortisol) may give further insights. Trial registration: German Clinical Trials Register (DRKS); DRKS00018821; www.drks.de
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.
Hintergrund.ZurQualitätssicherungund
WeiterentwicklungvonBGF-Maßnahmen
(betrieblicheGesundheitsförderung) istes
vonInteresse,einenÜberblicküberwissen
schaftlichuntersuchteBGF-Maßnahmenin
denletztenzweiJahrzehntenzuerlangen.
Zielsetzung.WissenschaftlichevaluierteBGF
MaßnahmenausdenJahren2000–2020wer
denmithilfederinderPraxisdurchdenGKV
SpitzenverbandeingesetztenThemenfelder
aufdiethematischenEntwicklungen,den
Nutzen,aberauchdieSchwächenfürdie
ÜbertragbarkeitindiePraxishinanalysiert.
Methode.EinesystematischeLiteraturrecher
chefürdenPublikationszeitraumzwischen
2000und2020wurdeinzweielektronischen
Datenbankendurchgeführt.
Ergebnisse.DieEinschlusskriterienerfüllten
41Artikel.DiemeistenderindenStudien
durchgeführtenundevaluiertenBGF
MaßnahmenwarenkeineEinzelmaßnahmen,
sondernstelltenProgrammedar. Inihnen
wurdenmehrereThemenfeldergleichzeitig
adressiert.Insgesamtzeigtensichdieinden
StudienuntersuchtenBGF-Maßnahmensehr
heterogen.ZumEndedesUntersuchungszeit
raumesnahmdieAnzahlanPublikationen
zu.
Schlussfolgerung.DieimLeitfadenPräventi
onvorgegebenenBGF-Themenfeldersindbis
aufeinThemenfeldausgewogenvertreten.
DieStudienzudenBGF-Maßnahmen
sindbezogenaufdieVerständlichkeitder
angewendetenDidaktikundMethodikoft
nureingeschränktnachvollziehbarund
somitschwerindieorganisationalePraxis
übertragbar.
Zusammenfassung
Hintergrund. Zur qualitätsbasierten
Weiterentwicklungeffizienter und bedarfs
orientierter Maßnahmen der betrieblichen
Gesundheitsförderung (BGF) ist es von
Interesse, einen Einblick in Ihren Aufbau,
die Ausgestaltung und den Ablauf der
Maßnahmender letztenzwei Jahrzehntezu
erlangen.
Zielsetzung. Auf Basis der arbeitsschutzori
entierten Leitliniendes GKV-Spitzenverbands
wird untersucht, ob vor der Umsetzung
von BGF-Maßnahmen Bedarfserhebungen
mittels Ist-Analysen durchgeführt wurden.
Zusätzlich wird betrachtet,ob die Analysen
„weiche“ Faktoren wie Kultur, Führung und
Beziehungsklima beinhalten. Weiter wird
analysiert, welche wissenschaftlichenTheori
en undModelle denMaßnahmenzugrunde
liegen. Zudem führt die Untersuchungeine
Wirksamkeitsbetrachtungdurch, um zu
ermitteln, welche Effekte die Maßnahmen
erzielten.
Methode. Das vorliegende Literatur-Review
untersucht wissenschaftlichevaluierte BGF
Maßnahmenaus den Jahren 2000–2020.
Hierzu wurde eine systematischeLitera
turrecherche in den zwei elektronischen
DatenbankenScopus und Web of Science
für den benannten Publikationszeitraum
durchgeführt.
Ergebnisse. Die Einschlusskriterienerfüllten
41Artikel.Nur4derStudienführteneine
Ist-Analyse zur Bedarfsbestimmung von
BGF-Maßnahmendurch. 25 Studien führten
Ist-Analysen im Rahmen der Maßnahmen
durch, alle waren arbeitsschutzorientiert.Vier
Studien inkludierten in ihrer Erhebung zu
Beginn Teilaspektevon weichen Faktoren. In
12 Studienwurdenden evaluiertenInterven
tionen unterschiedliche wissenschaftliche
Theorien und Modelle zugrunde gelegt. Alle
Studien berichtetenmindestensfür einzelne
Untersuchungsparametervon positiven
Effekten.
Schlussfolgerung. Vor dem Hintergrund
des Strukturwandels der Wirtschaft und der
beständig zunehmenden Humanisierung
der Arbeit spielen wissenschaftsbasierte
Analyseinstrumentezur Bedarfsbestimmung
eine große Rolle. Zukünftige Analyseinstru
mentesolltenvon derWissenschaftkonzipiert
und erprobt werden und zusätzlich zur
Arbeitsschutzorientierung die immateriellen,
weichen Faktoren Kultur, Führung und
Beziehungsklima beinhalten. Trotz der
Empfehlungen, Maßnahmenauf Grundlage
von Theorien und Modellen zu konzipieren,
wurde dieses Potenzial von nur wenigen
wissenschaftlichevaluiertenStudien genutzt.
Die Wirksamkeitsbetrachtungzeigt, dass alle
Studien mindestensfür Teile Ihrer Evaluation
von positiven Effekten berichten. Dieses
Untersuchungsergebnisdes Reviewsweist auf
ein Publikationsbiashin