Effects of a cardioprotective nutritional program (BALANCE program) on diet quality, anthropometric features and cardiovascular risk factors in primary cardiovascular prevention: A workplace feasibility study

Abstract

The Cardioprotective Nutritional Program (BALANCE Program) was created for the secondary cardiovascular prevention setting, shown to be effective in improving the diet quality, body weight and cardiovascular risk factor in individuals with previous cardiovascular disease. However, it has been not tested among employees at primary cardiovascular prevention conditions. The aim of this study was to evaluate the feasibility of the BALANCE Program in a workplace, and its possible effects on diet quality, body composition and cardiovascular risk factors. This was a before-after feasibility study conducted in an Occupational Medicine Service at a tertiary hospital. The nutritional-education program intervention comprised a ludic nutritional counselling about healthy and affordable foods, and individual/group counselling sessions as well. One hundred twenty-one workers with cardiovascular risk factors were enrolled to follow the BALANCE Program for 6 months. In addition to the dietary intake, glycemic and blood lipids profile, blood pressure and body composition features were evaluated. Feasibility was measured by participant's adherence to a specific diet quality index (the BALANCE index) and to the protocol sessions. Mean data differences from baseline to 3 and 6 months were compared using a paired Student's t -test or Wilcoxon test. The BALANCE Program improved diet quality by increasing BALANCE Index ( P = 0.001). 80% of participants attended the individual visits with dietitian. There was a significant reduction at 6 months in anthropometric indexes [body mass index ( P = 0.034), waist and neck circumferences ( P = 0.003 and P < 0.001, respectively)], body fat percentage ( P = 0.014) and metabolic parameters [total cholesterol ( P = 0.02), high density lipoprotein-cholesterol ( P = 0.011), fasting glucose (P = 0.021), glycated hemoglobin ( P = 0.039) and diastolic blood pressure ( P < 0.001)] after intervention. The BALANCE Program might be implemented in Occupational Medicine Services aiming to improve employee's diet and cardiovascular risk factors. • BALANCE Program was created aiming at secondary cardiovascular prevention. • It comprises ludic nutritional counselling about healthy and affordable food. • BALANCE Program seems to be applied to primary cardiovascular prevention in hospital workers. • The Program improved diet quality in primary prevention and reduced both anthropometric indexes and metabolic parameters.