Open Access

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.

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 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.