Abstract
Lifestyle modification programs (LMP) represent a new approach to cardiometabolic/oncologic risk reduction. Successful LMP in clinical practice must be feasible, cost effective, efficacious and consider home-based exercise. Likewise, multiple mechanisms implied in cardiometabolic risk reduction such as cardiac autonomic regulation (CAR) should be easily evidenced, in spite of the computational complexity involved. This goal could be facilitated by employing novel, friendlier, simpler techniques, such as the Autonomic Nervous System Index (ANSI), which can be treated as a proxy of CAR. In this observational study, we introduce a simple LMP (based on cognitive behavioral strategies and patient-tailored prescription of nutrition and home-based exercise, managed by a single physician) into the currently existing clinical practice of secondary cardiometabolic prevention. In 26 subjects, we assessed CAR (autoregressive spectral analysis of cardiovascular variabilities), body mass composition (bioelectrical impedance analysis) and stress perception (questionnaires). After LMP, ANSI and lipid profile were improved; % of fat mass, waist circumference and stress perception were reduced. We conclude that this preliminary, proof of concept study provides significant evidence in favor of the hypothesis that it is possible to introduce a convenient, cost effective LMP into the currently existing clinical practice of secondary cardiometabolic prevention. Findings suggest a successful comprehensive behavioral change, possibly facilitated by the simplified approach employed in this study, capable of improving cardiac autonomic regulation in addition to body mass composition and stress perception.
Highlights
Lifestyle medicine [1] represents a new approach to cardiometabolic/oncologic risk reduction, aiming to reduce risk factors but primarily to ameliorate healthy lifestyles such as improvement in physical activity habits, healthy nutrition, cessation of smoking and stress management strategies
The proof of concept nature of this study could not, by design, consider a control untreated group, since it was based on self-selected patients who consulted our clinic in order to change their normal lifestyle introducing Lifestyle modification programs (LMP). We conclude that this preliminary, proof of concept study supports the hypothesis that it is possible to introduce a convenient time and cost effective LMP into the currently existing clinical practice of secondary cardiometabolic prevention
Findings suggest that a successful comprehensive behavior change, possibly facilitated by the simplified approach employed in this study, is capable of improving cardiac autonomic regulation in addition to body mass composition and stress perception
Summary
Lifestyle medicine [1] represents a new approach to cardiometabolic/oncologic risk reduction, aiming to reduce risk factors but primarily to ameliorate healthy lifestyles such as improvement in physical activity habits, healthy nutrition, cessation of smoking and stress management strategies. The programs that appear to be most effective, in secondary prevention, are characterized by multifactorial interventions and are designed for individuals or groups according to specific characteristics and needs [6,7,8,9,10]. These complex programs are expensive, are time consuming and require that the different healthcare professionals work in truly collaborative and goal-oriented teams in order to achieve positive results [10,11,12,13,14]. Home-based exercise programs are welcomed by patients, being convenient from an economical point of view and representing a bridge toward introducing exercise into everyday routine
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