Short-term effectiveness of a lifestyle intervention program for reducing selected chronic disease risk factors in individuals living in rural appalachia: a pilot cohort study

David Drozek, Hans Diehl, Masato Nakazawa, Tom Kostohryz, Darren Morton, Jay H Shubrook, David Drozek, Hans Diehl, Masato Nakazawa, Tom Kostohryz, Darren Morton, Jay H Shubrook

Abstract

Most Western chronic diseases are closely tied to lifestyle behaviors, and many are preventable. Despite the well-distributed knowledge of these detrimental behaviors, effective efforts in disease prevention have been lacking. Many of these chronic diseases are related to obesity and type 2 diabetes, which have doubled in incidence during the last 35 years. The Complete Health Improvement Program (CHIP) is a community-based, comprehensive lifestyle modification approach to health that has shown success in addressing this problem. This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population. Two hundred fourteen participants in CHIP collectively demonstrated significant reductions in body mass index, systolic and diastolic blood pressure, and fasting blood levels of total cholesterol, low-density lipoprotein, and glucose. If these results can be repeated in other at-risk populations, CHIP has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively.

References

    1. Anderson G. Chronic Care: Making the Case for Ongoing Care. Robert Wood Johnson Foundation; 2010. .
    1. National health expenditures, aggregate and per capita amounts, annual percent change and percent distribution: selected calendar years 1960–2011. .
    1. Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. The Lancet. 2010;376(9754):1775–1784.
    1. Aldana S. The Culprit & The Cure: Why Lifestyle Is the Culprit Behind America's Poor Health and How Transforming That Lifestyle Can Be the Cure. Maple Mountain Press; 2005.
    1. Complete health improvement program sponsored by lifestyle medicine institute LLC.
    1. Diehl HA. Coronary risk reduction through intensive community-based lifestyle intervention: the Coronary Health Improvement Project (CHIP) experience. American Journal of Cardiology B. 1998;82(10):83T–87T.
    1. Englert HS, Diehl HA, Greenlaw RL, Willich SN, Aldana S. The effect of a community-based coronary risk reduction: the Rockford CHIP. Preventive Medicine. 2007;44(6):513–519.
    1. Rankin P, Morton DP, Diehl H, Gobble J, Morey P, Chang E. Effectiveness of a volunteer-delivered lifestyle modification program for reducing cardiovascular disease risk factors. American Journal of Cardiology. 2012;109(1):82–86.
    1. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New England Journal of Medicine. 2001;344(18):1343–1350.
    1. Englert HS, Diehl HA, Greenlaw RL, Aldana S. The effects of lifestyle modification on glycemic levels and medication intake: the Rockford CHIP. In: Capelli O, editor. Primary Care at a Glance–Hot Topics and New Insights. InTech; 2012. pp. 323–336.
    1. Merrill RM, Taylor P, Aldana SG. Coronary Health Improvement Project (CHIP) is associated with improved nutrient intake and decreased depression. Nutrition. 2008;24(4):314–321.
    1. Thieszen CL, Merrill RM, Aldana SG, et al. The coronary health improvement project (CHIP) for lowering weight and improving psychosocial health. Psychological Reports. 2011;109(1):338–352.
    1. Small area income and poverty estimates.
    1. Small area health insurance estimates.
    1. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine. 2002;346(6):393–403.
    1. Wing RR, Bolin P, Brancati FL, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. The New England Journal of Medicine. 2013;369(2):145–154.
    1. Ornish D. Serum lipids after a low-fat diet. Journal of the American Medical Association. 1998;279(17):1345–1346.
    1. Barnard RJ. Effects of life-style modification on serum lipids. Archives of Internal Medicine. 1991;151(7):1389–1394.
    1. Briel M, Ferreira-Gonzalez I, You JJ, et al. Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis. British Medical Journal. 2009;338(7693, article b92)
    1. Navab M, Anantharamaiah GM, Reddy ST, Van Lenten BJ, Ansell BJ, Fogelman AM. Mechanisms of disease: proatherogenic HDL: an evolving field. Nature Clinical Practice Endocrinology and Metabolism. 2006;2(9):504–511.
    1. Ansell BJ, Fonarow GC, Fogelman AM. High-density lipoprotein: is it always atheroprotective? Current Atherosclerosis Reports. 2006;8(5):405–411.
    1. Roberts CK, Ng C, Hama S, Eliseo AJ, Barnard RJ. Effect of a short-term diet and exercise intervention on inflammatory/antiinflammatory properties of HDL in overweight/obese men with cardiovascular risk factors. Journal of Applied Physiology. 2006;101(6):1727–1732.
    1. Esselstyn CB., Jr. Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology) American Journal of Cardiology. 1999;84(3):339–341.
    1. Gould AL, Davies GM, Alemao E, Yin DD, Cook JR. Cholesterol reduction yields clinical benefits: meta-analysis including recent trials. Clinical Therapeutics. 2007;29(5):778–794.
    1. Navab M, Reddy ST, Van Lenten BJ, Fogelman AM. HDL and cardiovascular disease: atherogenic and atheroprotective mechanisms. Nature Reviews Cardiology. 2011;8(4):222–232.
    1. Khera AV, Cuchel M, de la Llera-Moya M, et al. Cholesterol efflux capacity, high-density lipoprotein function, and atherosclerosis. The New England Journal of Medicine. 2011;364(2):127–135.
    1. Fleming RM. The effect of high-protein diets on coronary blood flow. Angiology. 2000;51(10):817–826.
    1. Kottler BM, Ferdowsian HR, Barnard ND. Effects of plant-based diets on plasma lipids. American Journal of Cardiology. 2009;104(7):947–956.
    1. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lancet. 1990;336(8708):129–133.
    1. Shurney D, Hyde S, Hulsey K, Elam R, Cooper A, Groves J. CHIP lifestyle program at Vanderbilt University demonstrates an early ROI for a diabetic cohort in a workplace setting: a case study. Journal of Managed Care Medicine. 2012;15(4):5–15.
    1. Hughes M. WEA trust-ThedaCare CHIP collaborative. 2012, .
    1. Prevention for a healthier America: investments in disease prevention yield significant savings, stronger communities. 2009, .
    1. Garcia A, Boufford J, Finkelstein R. A Compendium of Proven Community-Based Prevention Programs. New York Academy of Medicine; 2009.
    1. Aldana SG, Greenlaw RL, Diehl HA, et al. Effects of an intensive diet and physical activity modification program on the health risks of adults. Journal of the American Dietetic Association. 2005;105(3):371–381.
    1. Merrill RM, Aldana SG, Greenlaw RL, Diehl HA, Salberg A, Englert H. Can newly acquired healthy behaviors persist? An analysis of health behavior decay. Preventing Chronic Disease. 2008;5(1, article A13)

Source: PubMed

3
Abonnere