Abstract
Introduction: Obesity is a global epidemic contributing to CVD, the leading cause of death worldwide. Diet, exercise, and lifestyle are crucial to CVD prevention and treatment. The Healthy Eating Index (HEI) is a 13-component dietary analysis tool based on the Dietary Guidelines for Americans, with higher scores associated with lower CVD risk. Calculating the HEI involves a 24-hour food recall and complex scoring. The Diet Risk Score (DRS), a 9-question, efficient alternative screening tool, has been validated against the HEI. JeffWLP, a unique low-cost, long-term student-delivered nutrition education program, evaluates improvement in DRS. Hypothesis: JeffWLP participants in JeffWLP would demonstrate significant weight loss, increased physical activity, and improved DRS in urban at-risk patients. Methods: In this randomized controlled trial, 30 obese adults from an underserved urban population were randomized to intervention (n=18) or control/usual care (n=12) groups. Mean age was 46 +/- 13 years. 80% were African American, and 90% were female; mean baseline BMI was 38 +/- 5. Mean socioeconomic status, self-assessed using the MacArthur Scale, was 6 (maximum 10). JeffWLP includes 12 core weekly group and individual nutrition education counseling sessions, meal replacements, and an exercise component, followed by unlimited bimonthly maintenance counseling. Vitals were obtained pre, mid, and post-core intervention. Results: JeffWLP participants achieved mean weight loss of 6.1 +/- 7.8 lbs (p=0.01), or 2.7 +/- 3.3% body weight (p < 0.01) in 12 weeks. Mean DRS improved by 7 +/- 6 points (p <0.001). Number of weekend steps walked increased by 3500 +/- 3150 (p = 0.016). Pilot JeffWLP patients (n=7), sustained weight loss of 4.8 +/- 8.1 lbs, 285 days after enrollment (p = 0.17). Conclusions: Our study demonstrates the cost-effectiveness of JeffWLP for improving weight loss, exercise, and dietary risk in 12 weeks. We anticipate additional sustained improvements in this ongoing study with double the sample size; this additional data will be available at the AHA meeting. JeffWLP empowers medical students to improve health outcomes in disadvantaged, at-risk underserved populations affordably, addressing critical health disparities.
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