Benefit of One Week Immersion in Lifestyle-based Program for Sustainable Improvements in Cardiovascular Risk Factors Over Time

Abstract

BACKGROUND: Hypertension, hyperlipidemia, and obesity most commonly result from poor diet and lack of physical activity. Lifestyle measures for risk factor modification and cardiovascular disease (CVD) prevention include exercise and dietary changes but most people are not successful at initiating and/or maintaining meaningful changes. We propose that such changes can be initiated using a short-term, intensive “immersion” support approach.
 METHODS: Moderate to high atherosclerotic CVD (ASCVD) risk individuals completed a 1-week, lifestyle-based immersion program, including daily nutrition education, 100% plant-based food consumption, exercise, and stress management classes. Beginning and end anthropomorphic measurements such as blood pressure and lipid measurements were collected. A dietary survey (14-point Mediterranean diet survey), functional capacity survey (Duke Activity Status Index [DASI] survey), and quality of life (QOL) survey (Sf-36), were administered on Day 0 and 3 months post-immersion.
 RESULTS: Eighty participants completed the program; 64% women, mean age 47 years (range 21-71), mean weight 88.43 kg (range 45.4-131.3 kg) and mean body mass index (BMI) 30.47 kg/m2 (range 18.6-44.8 kg/m2). Of the participants, 71% had hypertension (HtN), 39% had HbA1c ≥ 5.7%, 35% were former smokers, and 7.5% were active smokers. Average ASCVD risk was 6.84% (range 0.3-39%). After 1 week of the immersion program, BMI decreased on average 0.5 ± 0.38 kg/m2, weight decreased on average 11.49±1.19 kg (both p<0.001). Systolic blood pressures (SBP) decreased on average 6.76±15.17 mmHg and diastolic blood pressure (DBP) decreased on average 5.00±9.82 mmHg (both p<0.001). total cholesterol decreased on average 20.40 ± 15.44 mg/dL, triglycerides decreased on average 31.78 ± 44.06 mg/dL, LDL decreased on average 11.71 ± 15.92 mg/dL (all p < 0.001). High-density lipoprotein (HDL) also decreased on average 3.13 ± 5.83 mg/dL (p < 0.001). Sixty participants with diagnosed HtN or prescribed antihypertensive medications saw decreases in both SBP and DBP. In the majority of participants, improvements in functional capacity, QOL, and dietary compliance were noted.
 CONCLUSIONS: Short-term, intensive lifestyle intervention is feasible, can lead to immediate improvements in risk profiles, and, importantly, can have longer-lasting effects on exercise capacity, dietary compliance, and QOL.