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

Background: The 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.

Methods: 24-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.

Results: 143 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.

Conclusion: The 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 number: DRKS00018821.

Keywords: blood pressure lowering; dietary patterns; lipid lowering; preventive counselling; weight management.

Figure 1

Study design; data collection at six health checks: T0 (baseline), T1 (after 10 weeks), T2 (after 6 months), T3 (after 12 months), T4 (after 18 months) and T5 (after 24 months). In the intervention group (IG), there was an 8-week intensive phase of the Healthy Lifestyle Community Programme (HLCP), which included 14 consecutive seminars about the prevention of non-communicable diseases (NCDs) and a healthy lifestyle, emphasising community support and the chances of behaviour change. Additional workshops and practical sessions were offered. In the subsequent 22-months alumni-phase, monthly meetings of 2 hours each, refreshed the contents of the intensive phase and strengthened group support.

Figure 2

CONSORT structure participants’ flow diagram; in the follow-up-phase, those participants categorised as ‘lost to follow-up’ did not show up to health checks from that time point onwards or withdraw from the study with the given reason. In the IG, additional information is given on how many participants discontinued the intervention (eg, dropped out) and why. CONSORT, Consolidated Standards of Reporting Trials; IG, intervention group.

Figure 3

Boxplots of weight change (kg) in intervention (left, dark grey) and control group (white) after 8 weeks, 6, 12, 18 and 24 months after baseline (baseline values in intervention group: 85±19 kg, in control group: 80±18 kg). Differences to baseline were significant in IG after 8 weeks to 18 months (p<0.001) and 24 months (p<0.05). Differences between IG and CG were significant after 8 weeks (p<0.001), 6 months (p<0.05), 12 months (p<0.05), 18 months (p<0.05). CG, control group; IG, intervention group.

Figure 4

Weight loss after 8 weeks in intervention and control group according to sex and weight status at baseline; adjusted for age, participating with/without family interaction and the group-participating with/without family interaction (R²=0.216, p=0.001).