TY - JOUR
T1 - A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina
T2 - The Heart Healthy Lenoir Project
AU - Keyserling, Thomas C.
AU - Samuel-Hodge, Carmen D.
AU - Pitts, Stephanie Jilcott
AU - Garcia, Beverly A.
AU - Johnston, Larry F.
AU - Gizlice, Ziya
AU - Miller, Cassandra L.
AU - Braxton, Danielle F.
AU - Evenson, Kelly R.
AU - Smith, Janice C.
AU - Davis, Gwen B.
AU - Quenum, Emmanuelle L.
AU - Elliott, Nadya T.Majette
AU - Gross, Myron D.
AU - Donahue, Katrina E.
AU - Halladay, Jacqueline R.
AU - Ammerman, Alice S.
N1 - Publisher Copyright:
© 2016 The Author(s).
PY - 2016/8/5
Y1 - 2016/8/5
N2 - Background: Because 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. Methods: The 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. Results: Baseline 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. Conclusions: The intervention yielded substantial improvement in diet, PA, and blood pressure, but weight loss was modest. Trial registration: clinicaltrials.gov
AB - Background: Because 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. Methods: The 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. Results: Baseline 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. Conclusions: The intervention yielded substantial improvement in diet, PA, and blood pressure, but weight loss was modest. Trial registration: clinicaltrials.gov
KW - Cardiovascular disease
KW - Dietary intervention
KW - Disparities
KW - Lifestyle intervention
KW - Low-income participants
KW - Mediterranean diet
KW - Prevention
KW - Weight loss intervention
UR - http://www.scopus.com/inward/record.url?scp=84982830394&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84982830394&partnerID=8YFLogxK
U2 - 10.1186/s12889-016-3370-9
DO - 10.1186/s12889-016-3370-9
M3 - Article
C2 - 27495295
AN - SCOPUS:84982830394
SN - 1471-2458
VL - 16
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 732
ER -
