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The long-term effect of screening and lifestyle counseling on changes in physical activity and diet: the Inter99 Study - a randomized controlled trial.

Baumann S, Toft U, Aadahl M, Jørgensen T, Pisinger C - Int J Behav Nutr Phys Act (2015)

Bottom Line: Multi-factorial intervention studies have been found to be successful in the initiation of lifestyle changes.Five years after the intervention, women in the intervention group reported greater improvements in the intake of fruit (M Δ = 90.2 g/week, p = 0.041) and less intake of saturated fat (OR = 0.30, 95% CI: 0.17-0.54) than the control group.Men in the intervention group reported greater improvements in physical activity (M Δ = 19.6 min/week, p = 0.003) and less intake of saturated fat (OR = 0.31, 95% CI: 0.17-0.56) than the control group.

View Article: PubMed Central - PubMed

Affiliation: University Medicine Greifswald, Institute of Social Medicine and Prevention, Walther-Rathenau-Str. 48, DE-17475, Greifswald, Germany. sophie.baumann@uni-greifswald.de.

ABSTRACT

Background: Multi-factorial intervention studies have been found to be successful in the initiation of lifestyle changes. However, little is known about the longer-term maintenance of health behavior improvements. The purpose of this study was to investigate whether improvements in physical activity and dietary habits achieved in a population-based multi-factorial lifestyle intervention of five years duration were maintained five years after intervention activities have ended.

Methods: The study was a population-based randomized controlled trial, Inter99 (1999-2006), Copenhagen, Denmark. Over five years, all participants in the intervention group (n = 6,091) received individual lifestyle counseling; participants at high risk of ischemic heart disease - according to pre-specified criteria - were also offered group-based counseling. The control group (n = 3,324) was followed by questionnaires. Both groups were followed one, three, five, and ten years after baseline. Changes in physical activity and dietary habits (intake of vegetables, fruit, fish, and saturated fat) during and after the intervention were investigated using random-coefficient models.

Results: Five years after the intervention, women in the intervention group reported greater improvements in the intake of fruit (M Δ = 90.2 g/week, p = 0.041) and less intake of saturated fat (OR = 0.30, 95% CI: 0.17-0.54) than the control group. Men in the intervention group reported greater improvements in physical activity (M Δ = 19.6 min/week, p = 0.003) and less intake of saturated fat (OR = 0.31, 95% CI: 0.17-0.56) than the control group. Improvements in the intake of vegetables and fish achieved during the intervention were not maintained in the longer-term.

Conclusions: Screening and lifestyle counseling had sustained effects on physical activity and dietary habits five years after its discontinuation. The patterns of long-term changes in lifestyle differed across behaviors and between men and women.

Trial registration: ClinicalTrials.gov ( NCT00289237 ).

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Related in: MedlinePlus

Flow of participants.Note: Asterisk (*) indicates individual lifestyle counseling and group-based counseling offered to all persons at high risk.
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Fig1: Flow of participants.Note: Asterisk (*) indicates individual lifestyle counseling and group-based counseling offered to all persons at high risk.

Mentions: As described elsewhere [18], the study population comprised all 61,301 persons born in 1939–40, 1944–45, 1949–50, 1954–55, 1959–60, 1964–65, and 1969–70 living in the south-western part of Copenhagen County (Figure 1). An age- and sex-stratified random sample of 13,016 persons was drawn from the study population from the Civil Registration System and apriori randomized into two groups comprising 90% (group A: high-intensity intervention, n = 11,708) and 10% (group B: low-intensity intervention, n = 1,308). The persons randomized to group A and B were invited for a health examination, risk assessment, and individual lifestyle counseling via ordinary mail. The invitation included a questionnaire to be completed in advance. Those not responding received up to two reminder mails. Participants did not receive any incentives. From the remaining 48,285 persons in the study population, a random sample of 5,264 persons equally distributed on sex and age was drawn and followed by questionnaires (group C – control group).Figure 1


The long-term effect of screening and lifestyle counseling on changes in physical activity and diet: the Inter99 Study - a randomized controlled trial.

Baumann S, Toft U, Aadahl M, Jørgensen T, Pisinger C - Int J Behav Nutr Phys Act (2015)

Flow of participants.Note: Asterisk (*) indicates individual lifestyle counseling and group-based counseling offered to all persons at high risk.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4352560&req=5

Fig1: Flow of participants.Note: Asterisk (*) indicates individual lifestyle counseling and group-based counseling offered to all persons at high risk.
Mentions: As described elsewhere [18], the study population comprised all 61,301 persons born in 1939–40, 1944–45, 1949–50, 1954–55, 1959–60, 1964–65, and 1969–70 living in the south-western part of Copenhagen County (Figure 1). An age- and sex-stratified random sample of 13,016 persons was drawn from the study population from the Civil Registration System and apriori randomized into two groups comprising 90% (group A: high-intensity intervention, n = 11,708) and 10% (group B: low-intensity intervention, n = 1,308). The persons randomized to group A and B were invited for a health examination, risk assessment, and individual lifestyle counseling via ordinary mail. The invitation included a questionnaire to be completed in advance. Those not responding received up to two reminder mails. Participants did not receive any incentives. From the remaining 48,285 persons in the study population, a random sample of 5,264 persons equally distributed on sex and age was drawn and followed by questionnaires (group C – control group).Figure 1

Bottom Line: Multi-factorial intervention studies have been found to be successful in the initiation of lifestyle changes.Five years after the intervention, women in the intervention group reported greater improvements in the intake of fruit (M Δ = 90.2 g/week, p = 0.041) and less intake of saturated fat (OR = 0.30, 95% CI: 0.17-0.54) than the control group.Men in the intervention group reported greater improvements in physical activity (M Δ = 19.6 min/week, p = 0.003) and less intake of saturated fat (OR = 0.31, 95% CI: 0.17-0.56) than the control group.

View Article: PubMed Central - PubMed

Affiliation: University Medicine Greifswald, Institute of Social Medicine and Prevention, Walther-Rathenau-Str. 48, DE-17475, Greifswald, Germany. sophie.baumann@uni-greifswald.de.

ABSTRACT

Background: Multi-factorial intervention studies have been found to be successful in the initiation of lifestyle changes. However, little is known about the longer-term maintenance of health behavior improvements. The purpose of this study was to investigate whether improvements in physical activity and dietary habits achieved in a population-based multi-factorial lifestyle intervention of five years duration were maintained five years after intervention activities have ended.

Methods: The study was a population-based randomized controlled trial, Inter99 (1999-2006), Copenhagen, Denmark. Over five years, all participants in the intervention group (n = 6,091) received individual lifestyle counseling; participants at high risk of ischemic heart disease - according to pre-specified criteria - were also offered group-based counseling. The control group (n = 3,324) was followed by questionnaires. Both groups were followed one, three, five, and ten years after baseline. Changes in physical activity and dietary habits (intake of vegetables, fruit, fish, and saturated fat) during and after the intervention were investigated using random-coefficient models.

Results: Five years after the intervention, women in the intervention group reported greater improvements in the intake of fruit (M Δ = 90.2 g/week, p = 0.041) and less intake of saturated fat (OR = 0.30, 95% CI: 0.17-0.54) than the control group. Men in the intervention group reported greater improvements in physical activity (M Δ = 19.6 min/week, p = 0.003) and less intake of saturated fat (OR = 0.31, 95% CI: 0.17-0.56) than the control group. Improvements in the intake of vegetables and fish achieved during the intervention were not maintained in the longer-term.

Conclusions: Screening and lifestyle counseling had sustained effects on physical activity and dietary habits five years after its discontinuation. The patterns of long-term changes in lifestyle differed across behaviors and between men and women.

Trial registration: ClinicalTrials.gov ( NCT00289237 ).

Show MeSH
Related in: MedlinePlus