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.
Study Goal
The researchers aimed to evaluate the effectiveness of a lifestyle intervention, including increased walking, in improving diet, physical activity, and cardiovascular risk factors among residents of the southeastern US.
Results Summary
The intervention led to substantial improvements in walking (64 min/week increase) and systolic blood pressure (-6.4 mmHg), which were generally maintained over 24 months, though weight loss was modest.
Population
Residents of the southeastern US, predominantly female (77%), African American (65%), with a mean age of 56 years and mean BMI of 36 kg/m².
Effective Dosage
Not specified
Duration
24 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Phase I (months 1-6), individually-tailored intervention promoting a Mediterranean-style dietary pattern and increased walking | increase | diet score | 251 (74 %) that returned for 6 month follow-up | 4.3 units [95 % CI 3.7 to 5.0] | substantial improvements | #1 |
Phase I (months 1-6), individually-tailored intervention promoting a Mediterranean-style dietary pattern and increased walking | increase | walking | 251 (74 %) that returned for 6 month follow-up | 64 min/week [19 to 109] | substantial improvements | #2 |
Phase I (months 1-6), individually-tailored intervention promoting a Mediterranean-style dietary pattern and increased walking | decrease | systolic blood pressure | 251 (74 %) that returned for 6 month follow-up | -6.4 mmHg [-8.7 to -4.1] | substantial improvements | #3 |
Phase II weight loss intervention (16 weekly group sessions) | decrease | weight | group (N = 50) | -3.1 kg (-4.9 to -1.3) | weight change | #4 |
Phase II weight loss intervention (5 group sessions and 10 phone calls) | decrease | weight | group/phone combination (N = 75) | -2.1 kg (-3.2 to -1.0) | weight change | #5 |
Phase III weight loss maintenance RCT | decrease | weight | group (N = 51) | -2.1 kg (-4.3 to 0.0) | weight loss | #6 |
Phase III weight loss maintenance RCT | decrease | weight | combination (N = 72) | -1.1 kg (-2.7 to 0.4) | weight loss | #7 |
The intervention | increase | diet | - | - | yielded substantial improvement | #8 |
The intervention | increase | PA | - | - | yielded substantial improvement | #9 |
The intervention | decrease | blood pressure | - | - | yielded substantial improvement | #10 |
The intervention | decrease | weight loss | - | modest | weight loss was modest | #11 |
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/m(2) 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/m(2). 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 Identifier: NCT01433484.