Effect Of Lifestyle Health Coaching On Risk Factors In Normal Weight, Overweight And Obese Participants

Abstract

Lifestyle health coaching (LHC) has gained increased popularity as a strategy to facilitate behavior change. Scarce comprehensive data are available on the effect of LHC on multiple cardiovascular disease (CVD) risk factors in normal weight, overweight and obese adults. PURPOSE: In this study, we evaluated the effect of LHC on multiple CVD risk factors in 7,281 adults, of whom 3,784 were obese (Group I, baseline body mass index [BMI] >30 kg/m2), 2,134 were overweight (Group II, baseline BMI = 25-29.9 kg/m2) and 1,363 were normal weight (Group III, baseline BMI <25 kg/m2). METHODS: Outcome measures were assessed at baseline and after approximately 1 year of LHC. LHC included individualized coaching on exercise, nutrition, weight management, stress management and smoking cessation. RESULTS: Weight (Group I, -6.9 lbs; Group II, -2.3 lbs; Group III, 0.1 lbs) and BMI (Group I, -1.1 kg/m2; Group II, -0.4 kg/m2; Group III, 0 kg/m2) decreased significantly (p <0.05) in the overweight and obese participants (p <0.05 for Group I versus Groups II and III; p <0.05 for Group II versus Group III). For participants with abnormal baseline risk factors, significant improvements (p <0.05) were observed for multiple additional variables in all 3 groups, as follows: blood pressure (Group I, -8/7 mmHg; Group II, -8/7 mmHg; Group III, -11/8 mmHg); LDL cholesterol (Group I, -19 mg/dl; Group II, -21 mg/dl; Group III, -21 mg/dl); HDL cholesterol (Group I, 4 mg/dl; Group II, 4 mg/dl; Group III, 6 mg/dl); triglycerides (Group I, -39 mg/dl; Group II, -46 mg/dl; Group III, -58 mg/dl); and fasting glucose (Group I, -9 mg/dl; Group II, -6 mg/dl; Group III, -14 mg/dl). In participants with a baseline Framingham 10-year coronary heart disease risk score >10%, the score decreased significantly (p <0.05) in participants in all 3 groups (Group I, -20.8%; Group II, -21.3%; Group III, -17.2%; p=NS for the differences among groups). CONCLUSIONS: These data serve to document the magnitude of improvement in multiple CVD risk factors in normal weight, overweight and obese individuals in response to participation in 1 year of LHC. Although weight loss is greatest for obese participants, the magnitude of improvement in the Framingham 10-year coronary heart disease risk score is similar for all participants.