Bridging the gap between science and society: long-term effects of the Healthy Lifestyle Community Programme (HLCP, cohort 1) on weight and the metabolic risk profile: a controlled study

Abstract

BackgroundThe 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.Methods24-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.Results143 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.ConclusionThe 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 numberDRKS00018821.

Eight Weeks of Lifestyle Change: What are the Effects of the Healthy Lifestyle Community Programme (Cohort 1) on Cortisol Awakening Response (CAR) and Perceived Stress?

“…A primary report on the effect of the HLCP regarding the metabolic risk profile of NCDs in the long-term is reported elsewhere. 55…”

“…55 In short, the 8-week intensive phase of the comprehensive HLCP consisted of 14 consecutive seminars (2x/week for 2 hours each) with a strong emphasis on salutogenesis and how to use personal health resources . Stress management was one of four main topics, next to a healthy, predominantly plant-based diet, physical activity and social health, 55 and one of the seminars was exclusively about stress as a health factor. Mini-mindfulness exercises (eg ‘take one minute to think about what would make you feel good’) were integrated into all sessions.…”

“…While comprehensive lifestyle intervention programs, including our own, 54,55 are suitable to induce weight loss, to improve metabolic parameters (eg reduce total- and LDL cholesterol) and meet the complexity of sustainable behaviour change, 56,57 little is known about the effect of such programmes on the CAR and their potential to reduce stress and its immense burden on health. 45 Given the complex interaction of direct and indirect influences of stress on health, and considering, that health behaviour change is challenging, especially against the background of chronic stress, 45 holistic approaches are needed to design interventions for the prevention and treatment of NCDs.…”

“…The holistic Healthy Lifestyle Community Program (HLCP) has been shown to significantly reduce weight and parameters of the metabolic risk profile. 54,55…”

“…Here, we examined the effects of the intensive and most effective 55 8-week phase of the HLCP (cohort 1) on the CAR and the PSL through the adoption a healthy lifestyle, characterized by 1) a good stress management and healthy coping mechanisms, 6,38 2) a healthy diet, rich in essential nutrients, 41,63 3) regular physical activity 66 and 4) social support. 67…”