A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina: the Heart Healthy Lenoir Project

BMC Public Health

Research Article

Cassandra L. Miller¹  Larry F. Johnston¹  Ziya Gizlice¹  Janice C. Smith¹  Beverly A. Garcia¹  Gwen B. Davis¹  Danielle F. Braxton²  Alice S. Ammerman²  Carmen D. Samuel-Hodge²  Kelly R. Evenson³  Katrina E. Donahue⁴  Jacqueline R. Halladay⁵  Myron D. Gross⁶  Stephanie Jilcott Pitts⁷  Thomas C. Keyserling⁸  Emmanuelle L. Quenum⁹  Nadya T. Majette Elliott^1,10 

[1] Center for Health Promotion and Disease Prevention (a CDC Prevention Research Center), CB 7426, University of North Carolina, 27599, Chapel Hill, NC, USA;Center for Health Promotion and Disease Prevention (a CDC Prevention Research Center), CB 7426, University of North Carolina, 27599, Chapel Hill, NC, USA;Department of Nutrition, Gillings School of Global Public Health, CB 7461, University of North Carolina, 27599, Chapel Hill, NC, USA;Department of Epidemiology, Gillings School of Global Public Health, CB 8050, University of North Carolina, 27599, Chapel Hill, NC, USA;Department of Family Medicine, School of Medicine, CB 7595, University of North Carolina, 27599, Chapel Hill, NC, USA;Department of Family Medicine, School of Medicine, CB 7595, University of North Carolina, 27599, Chapel Hill, NC, USA;Cecil G. Sheps Center for Health Services Research, School of Medicine, CB 7590, University of North Carolina, 27599, Chapel Hill, NC, USA;Department of Laboratory Medicine and Pathology, University of Minnesota, 55455, Minneapolis, MN, USA;Department of Public Health, Brody School of Medicine, East Carolina University, Lakeside Annex 8, 600 Moye Blvd, MS 660, 27834, Greenville, NC, USA;Division of General Medicine and Clinical Epidemiology, Department of Medicine, School of Medicine, CB 7110, University of North Carolina, 5039 Old Clinic Building, 27599, Chapel Hill, NC, USA;Center for Health Promotion and Disease Prevention (a CDC Prevention Research Center), CB 7426, University of North Carolina, 27599, Chapel Hill, NC, USA;Greene County Health Department, 225 Kingold Blvd, Suite B, 28580, Snow Hill, North Carolina, USA;Student Health Services, East Carolina University, 1000 East 5th St, MS 408, 27858, Greenville, NC, USA;

关键词: Mediterranean diet;    Dietary intervention;    Lifestyle intervention;    Weight loss intervention;    Low-income participants;    Disparities;    Cardiovascular disease;    Prevention;   

DOI  :  10.1186/s12889-016-3370-9

 received in 2016-02-10, accepted in 2016-07-23,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundBecause residents of the southeastern United States experience disproportionally high rates of cardiovascular disease (CVD), it is important to develop effective lifestyle interventions for this population.MethodsThe primary objective was to develop and evaluate a dietary, physical activity (PA) and weight loss intervention for residents of the southeastern US. The intervention, given in eastern North Carolina, was evaluated in a 2 year prospective cohort study with an embedded randomized controlled trial (RCT) of a weight loss maintenance intervention. The intervention included: Phase I (months 1–6), individually-tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7–12), option of a 16-week weight loss intervention for those with BMI ≥ 25 kg/m2 offered in 2 formats (16 weekly group sessions or 5 group sessions and 10 phone calls) or a lifestyle maintenance intervention; and Phase III (months 13–24), weight loss maintenance RCT for those losing ≥ 8 lb with all other participants receiving a lifestyle maintenance intervention. Change in diet and PA behaviors, CVD risk factors, and weight were assessed at 6, 12, and 24 month follow-up.ResultsBaseline characteristics (N = 339) were: 260 (77 %) females, 219 (65 %) African Americans, mean age 56 years, and mean body mass index 36 kg/m2. In Phase I, among 251 (74 %) that returned for 6 month follow-up, there were substantial improvements in diet score (4.3 units [95 % CI 3.7 to 5.0]), walking (64 min/week [19 to 109]), and systolic blood pressure (−6.4 mmHg [−8.7 to −4.1]) that were generally maintained through 24 month follow-up. In Phase II, 138 (57 group only, 81 group/phone) chose the weight loss intervention and at 12 months, weight change was: −3.1 kg (−4.9 to −1.3) for group (N = 50) and −2.1 kg (−3.2 to −1.0) for group/phone combination (N = 75). In Phase III, 27 participants took part in the RCT. At 24 months, weight loss was −2.1 kg (−4.3 to 0.0) for group (N = 51) and −1.1 kg (−2.7 to 0.4) for combination (N = 72). Outcomes for African American and whites were similar.ConclusionsThe intervention yielded substantial improvement in diet, PA, and blood pressure, but weight loss was modest.Trial registrationclinicaltrials.gov Identifier: NCT01433484

【 授权许可】

CC BY   
© The Author(s). 2016