Complete Health Improvement Program Research Articles

Comparative Effectiveness of Delivery Methods of the Complete Health Improvement Program (CHIP)

The Complete Health Improvement Program (CHIP) is effective in improving cardiovascular disease risk via the original live recorded DVD (DIS) and a revised studio recorded video versions (VIS), both presented in-person synchronously. The studio version was also presented in-person asynchronously (VIA) and virtually asynchronously (VVA). Assess the comparative effectiveness of four delivery methods of CHIP. Participants had biomarkers measured at baseline and after the 11th session: blood pressure (SBP, DBP), body mass index (BMI), fasting blood glucose (FBG), and lipid panel (TC, TG, LDL-c, HDL-c). ANCOVA was utilized to evaluate the interaction over time by group. Of 792 participants, the majority female in all groups (71.2-80.7%), mean age ranged 47.0–55.8 years. All methods showed significant changes in all biomarkers measured over time except for TG and SBP in VIA, TG in VVA and DBP in VIS. The time by delivery method interaction was significant for HDL-c (F value = 6.33, P = .0003), BMI (F value = 4.04, P = .007), systolic BP (F value = 4.33, P = .004). DIS was most effective in reducing HDL-c, BMI and systolic BP. While all four methods yielded significant changes in biomarkers, the in-person, synchronous delivery method produced the largest improvements.

Effectiveness of a Teaching Kitchen Intervention on Dietary Intake, Cooking Self-Efficacy, and Psychosocial Health

ABSTRACT Background The consumption of fruits, vegetables, and whole grains (FVWG) has been associated with decreased risk of chronic disease, yet over 80% of U.S. adults do not meet dietary recommendations for FVWG. Purpose This study explored the effectiveness of a teaching kitchen intervention upon consumption of FVWG and overall dietary patterns. Cooking self-efficacy, comfort in the kitchen, and elements of psychosocial health were also assessed. Methods Participants were recruited to the 5-week Complete Health Improvement Program–Teaching Kitchen (CHIP-TK) through a worksite wellness initiative. The program, based upon elements of the social cognitive theory, included cooking classes, health education, and horticulture activities. Pre- and post-surveys were administered and evaluated. Results CHIP-TK led to significant increases in FVWG intake. Cooking self-efficacy, comfort in the kitchen, and general well-being scores also improved, with medium-to-large effect sizes. Participant feedback indicated weekly meetings, hands-on cooking classes, facilitator expertise, and group camaraderie were keys to success in the program. Discussion Teaching kitchens are well-received within a worksite setting and have the potential to improve dietary intake patterns and psychosocial health.Translation to Health Education Practice: Health educators should design and implement integrative, theory-driven programs to improve nutritional status, well-being, and overall health.

The Complete Health Improvement Program and Physical Activity

Background: The Complete Health Improvement Program (CHIP) has demonstrated effectiveness in improving multiple cardiovascular disease risk factors. CHIP promotes physical activity, as well as a plant-based whole-food diet. The study objective is to evaluate the effectiveness of CHIP on improving levels of physical activity. Methods: CHIP participants had biomarkers measured at baseline and after the 11th session, consisting of level of physical activity, blood pressure (BP), body mass index (BMI), fasting blood sugar (FBS), and lipid panel. Pre and post data were analyzed using paired t-tests. Results. CHIP demonstrated significant increase in level of physical activity ( P < .001) and decreased BMI, FBS, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides (all P < .001). Increased levels of physical activity correlated with decreased BMI ( P < .001), but not with other biomarkers. Conclusion: CHIP is effective in producing increased level of physical activity and improvement in multiple biomarkers. The increase in physical activity is correlated with decreased BMI.

Volunteers: An Effective Medium for Delivering Therapeutic Lifestyle Interventions.

Lifestyle modification programs have been shown to effectively treat chronic disease. The Coronary Health Improvement Program has been delivered by both paid professional and unpaid volunteer facilitators. This study compared participant outcomes of each mode in the United States. Pre-/post-analysis of CHIP interventions delivered between 1999 and 2012. Professional-delivered programs in Rockford Illinois 1999-2004 and volunteer-delivered programs across North America 2005-2012. Adults ≥21 years (professional programs N = 3158 34.3% men, mean age = 54.0 ± 11.4 years; volunteer programs N = 7115 33.4% men, mean age = 57.4 ± 13.0 years). Body mass index, blood pressure (systolic and diastolic), blood lipid profile (total cholesterol, high-density lipoprotein, triglycerides, low-density lipoprotein), and fasting plasma glucose. Analysis of Covariance, with adjustment for age, gender, BMI change and baseline biometric and effect sizes. The professional-delivered programs achieved significantly greater reductions in BMI (.4%, P < .001) and HDL (1.9%, P < .001) and the volunteer-delivered programs achieved greater reductions in SBP (1.4%, P < .001), DBP (1.1%, P < .001), TC (1.4%, P = .004), LDL (2.3%, P < .001), TG (4.0%, P = .006), and FPG (2.7%, P < .001). However, the effect size differences between the groups were minimal (Cohen's d .1-.2). Lifestyle modification programs have been shown to effectively treat chronic disease. The Complete Health Improvement Program (CHIP) lifestyle intervention has been delivered by both paid professional and unpaid volunteer facilitators. This study compared selected chronic disease biometric outcomes of participants in each mode in the United States. It found volunteer-delivered programs do not appear to be any less effective than programs delivered by paid professionals, which is noteworthy as volunteers may provide important social capital in the combat of chronic disease.

Effectiveness of the Complete Health Improvement Program in a Geriatric Population.

The Complete Health Improvement Program (CHIP) is an intensive therapeutic lifestyle modification program (ITLMP) with well-documented success in decreasing risk factors for cardiovascular disease (CVD). Plant-based diets and physical activity are components of the program that contribute to these improvements. Yet, there are few studies on how ITLMPs affect risk factors specifically for the geriatric population. The goal of this study was to examine results of CHIP participants with a focus on the older (greater than 65years) population in Athens, Ohio. Retrospective data from 2011 to 2017 were analyzed for 26 CHIP classes. Recorded variables included body mass index (BMI), blood pressure (BP), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), blood glucose (BG), and exercise level. Among geriatric participants, significant changes were found in BMI, BP, TC, LDL, HDL, BG, and exercise level (P < .001). As compared to the younger population, changes in variables were equivalent in the geriatric population in all variables (P > .05). These improvements in CVD risk factors among the elderly support the hypothesis that CHIP should be considered for CVD prevention and treatment in the geriatric population.

Evaluating the Influence of the Complete Health Improvement Program (CHIP) on Blood Glucose, Blood Pressure, and Weight.

BackgroundDiabetes, hypertension, and obesity are vastly prevalent in the United States. Lifestyle modification programs can aid in controlling chronic disease. The aim of the study was to evaluate the health outcomes of the Complete Health Improvement Program (CHIP) concerning blood glucose, blood pressure, and weight. CHIP is a lifestyle medicine education program involving diet modification and increased physical activity.MethodsA quantitative, summative program evaluation was performed to measure the outcomes of CHIP. Pre and post data sets were collected on 73 individuals who completed the 12-week CHIP program. Pre and post program blood glucose levels, blood pressure readings, and weight measurements were analyzed using a paired t-test with a 95% confidence level. Analysis determined influence of the intervention on the biomarkers.ResultsThe post-intervention group means showed decreases in blood glucose, blood pressure, and weight. Statistical analysis revealed significant decreases in blood glucose (p = 0.008) and weight (p = 0.000). Blood pressure readings did not have statistically significant decreases (p = 0.403); however, the pre-intervention blood pressure readings were in the normotensive range.ConclusionResults indicated that the Complete Health Improvement Program decreased participants’ blood glucose levels, blood pressure readings, and weight measurements. Statistically significant decreases in blood glucose and weight suggest enhanced control of diabetes and obesity through utilization of CHIP.

Lifestyle Intervention's Effect and Predictive Value on Weight Loss for University Employees.

Obesity is a costly and pervasive risk factor that requires attention to reduce chronic disease rates. This study evaluated the effect of a lifestyle medicine intervention, Complete Health Improvement Program (CHIP), on reducing weight, blood pressure, lipid levels, and hemoglobin A1c. A secondary aim was to build a preliminary predictive model for computing new participants' potential weight change from CHIP. We evaluated pre- and post-intervention biometric data of 68 individuals who completed a 10-week CHIP intervention at a Midwestern university clinic. Significant reductions (p < 0.05) were observed in weight, diastolic blood pressure, total cholesterol, low-density lipoprotein, and A1c. Regression analyses indicated that the best linear model for predicting change in weight was a one-predictor model with systolic blood pressure. The CHIP intervention effectively promoted weight loss and meaningful reductions in chronic disease risk factors. Larger samples are needed for future regression analyses to create a more robust linear model.

Lifestyle Interventions and Carotid Plaque Burden: A Comparative Analysis of Two Lifestyle Intervention Programs in Patients with Coronary Artery Disease

The cardioprotective effects of intensive lifestyle regimens in primary prevention have been elucidated; however, there is a paucity of data comparing the effects of different lifestyle regimens in patients with established coronary artery disease (CAD) or CAD equivalent, specifically vis-à-vis carotid plaque regression. We performed a randomized, single-center, single-blind study in 120 patients with established CAD. Patients were randomly assigned to either 9 months of the Complete Health Improvement Program (CHIP), an outpatient lifestyle enrichment program that focuses on improving dietary choices, enhancing daily exercise, increasing support systems, and decreasing stress; or to 9 months of an ad hoc, nonsequential combination of various healthy living classes offered separately through a health maintenance organization and referred to as the Healthy Heart program. Baseline and 9-month change in carotid intima-media thickness (CIMT) were measured. Among 120 participants, data were analyzed for 79, of which 68 (86%) completed the study. Both average CIMT and average maximum CIMT increased over 9 months, but the changes between groups were insignificant. There were marked differences in the mean body mass index favoring the CHIP group (-1.9 [standard deviation = 1.9]; p < 0.001) and statistically significant within-group improvements in blood pressure, triglyceride level, 6-minute walk test result, self-assessment well-being score, and Patient Health Questionnaire-9 score that were not observed between groups. Neither the CHIP nor Healthy Heart was effective in inducing plaque regression in patients with established CAD after a 9-month period. However, both were effective in improving several CAD risk factors, which shows that the nonsequential offering of healthy lifestyle programs can lead to similar outcomes as a formal, sequential, established program (CHIP) in many aspects. These results have important implications as to how lifestyle changes will be implemented as tertiary prevention measures in the future.

Being a Bad Vegan

Being a Bad Vegan

Body Mass Index Change as a Predictor of Biometric Changes following an Intensive Lifestyle Modification Program.

The initial benefits of lifestyle modification programs such as reduction in chronic and cardiovascular diseases (CVD) risk factors have been well documented. However, such positive effects may deteriorate over time following relapse into inactivity. Timely detection of weight regain leading to the deterioration of the accrued benefits could trigger early resumption of intensive lifestyle intervention. To date, no known cost-effective, noninvasive approach for monitoring long-term outcomes has yet been established. The purpose of this study was to determine if body mass index (BMI) change predicted changes in other CVD biometric markers during an intensive lifestyle modification program. This study was an observational, retrospective review of records of participants from the Complete Health Improvement Program (CHIP). Biomarker changes of participants in this community-based Intensive Therapeutic Lifestyle Modification Program (ITLMP) offered in Athens, Ohio, a rural Appalachian college town, between April 2011 and June 2017 were reviewed retrospectively. BMI, heart rate (Pulse), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), and glucose (FBS) were monitored before and after program completion. Data were analyzed using a multivariate general linear model. The sample analyzed consisted of 620 participants (mean age of 52.3±13.0 years, 74.5% female). Controlling for age and gender, BMI change significantly predicted 5 out of the 8 biomarker changes measured [Wilk's λ = 0.939, F(8,526) = 4.29, p <.0001]. Specifically, a 1-point BMI decrease was associated with 4.4 units decrease in TC, 3.2 units in LDL, 5.3 units in TG, 2 units in SBP, and 1 unit in DBP (all p values < .05). These results suggest that change in BMI may be a useful predictor of change in other CVD biomarkers' outcomes during and after an ITLMP participation. Tracking BMI, therefore, could serve as a proxy measure for identifying regressing biomarker changes following participation in an ITLMP leading to a timelier reassessment and intervention. Future studies evaluating the value of BMI as a surrogate for highlighting overall cardiovascular health are warranted.

Effect of Participation with Accompanying Household Member in the Complete Health Improvement Program in Appalachia.

Intensive therapeutic lifestyle modification programs, such as the Complete Health Improvement Program (CHIP), reduce cardiovascular disease (CVD) risk factors. However, there are little data on how participation in CHIP with a household member can affect CVD biomarkers. This study focuses on the benefit of joint participation of household members in CHIP in order to have a better outcome in improving CVD risk factors compared with lone or individual participation. Data from 20 CHIP classes offered from 2011 to 2015 in Athens, Ohio, where each class was conducted over 2-4 months, consisting of 16-18 sessions, were collected. Body mass index (BMI), blood pressure, fasting glucose, and lipid profiles were measured before and near the completion of each class. A statistically significant greater reduction in BMI (p = 0.003) in those who attended with a household member compared to those who attended as individuals was found. CHIP has some effect on various CVD risk factors for those who attend intensive therapeutic lifestyle modification programs with an accompanying household member. Hence, encouragement of participation with a family member or a “buddy” may be prudent, especially if weight reduction is a key program participation goal. Further evaluation of the “buddy effect” involving both of those residing in the same household and those who do not but nevertheless provide mutual support is warranted.

HDL subfraction changes with a low-fat, plant-based Complete Health Improvement Program (CHIP).

Low HDL concentrations are considered an important risk factor for cardiovascular disease. Interventions promoting a low-fat, plant-based eating pattern appear to reduce CVD risk while paradoxically also reducing HDL concentrations. Recent studies show HDL to comprise a range of subfractions, but the role these play in ameliorating the risk of CVD is unclear. The purpose of this study was to characterise changes in HDL subfractions in participants where HDL decreased following the CHIP intervention which promotes a low-fat, plant-based diet, with physical activity. Individuals (n=22; mean age=55.4±16.3 years; 45.5% men, 54.5% women) participating in a CHIP intervention were assessed at baseline and 30 days for changes in BMI, blood pressure, lipid profile, (including large-, intermediate- and small-HDL subfractions) and fasting glucose. HDL significantly decreased (10.6%, p<0.001) together with BMI (2.5%, p=0.028), systolic blood pressure (7.1%, p=-0.005), total cholesterol (9.5%, p=0.002), LDL (11.2%, p=0.007) and fasting glucose (8.2%, p=0.028). Triglycerides (TG) did not significantly change. Physical activity (22.7%, p=0.016) and consumption of whole plant-foods (13.9%, p=0.003) significantly increased, while nonplant (energy and animal) foods decreased (43.1%, p=0.009). Large-, intermediate- and small-HDL decreased (-10.0%, p=0.003; -8.3%, p=0.013 and 22%, p=0.005, respectively). This paper discusses specific changes in HDL subfractions when overall-HDL decreases as a response to low fat, whole-food, plant-based eating and exercise. Additional research is required to elucidate the reasons through which behavioural therapies remodel the HDL particle and how this impacts the functional properties of HDL and CVD risk.

Employer-Funded Complete Health Improvement Program: Preliminary Results of Biomarker Changes.

Previous studies of the Complete Health Improvement Program (CHIP) have demonstrated short-term improvements in select metabolic and cardiovascular biomarkers in community-based programs. However, less is known about the benefits of an employer-funded lifestyle intervention program. To determine if participation in employer-provided CHIP would result in improvements in short-term metabolic and cardiovascular biomarkers, and to compare the results of the current study to a larger national study. This observational study evaluated metabolic and cardiovascular biomarker changes in employer health insurance beneficiaries enrolled in CHIP between August 2012 and November 2014. Body mass index; blood pressure (systolic and diastolic); total cholesterol, low-density lipoprotein, high-density lipoprotein, fasting plasma glucose, and triglyceride levels; and weight were measured at baseline and after CHIP. Of 160 employees enrolled in CHIP, 115 women and 45 men agreed to participate in the study. Overall, the participants demonstrated significant reductions in body mass index, from a baseline average of 31.5 to a post-CHIP average of 30.5 (P<.001), systolic blood pressure from 124.5 to 119.4 mm Hg (P=.017), diastolic blood pressure from 77.3 to 74.5 mm Hg (P=.046), total cholesterol from 186.0 to 168.8 mg/dL (P<.001), low-density lipoprotein from 112.9 to 99.3 mg/dL (P<.001), high-density lipoprotein from 48.8 to 46.4 mg/dL (P<.001), and fasting plasma glucose from 100.8 to 96.5 mg/dL (P<.001). When funded by an employer, CHIP demonstrated short-term improvements in select metabolic and cardiovascular biomarkers. Future studies will analyze these data to determine whether these findings translate into subsequent decreased employee absenteeism and reduced beneficiary health claims.

Effectiveness of the Complete Health Improvement Program in Reducing Risk Factors for Cardiovascular Disease in an Appalachian Population.

In 11 counties in Appalachian Ohio, the self-reported prevalence of diabetes mellitus (11.3%) is higher than the state (7.8%) or national (7.2%) average. Direct medical costs for diabetes in the United States are estimated at $176 billion annually. Indirect costs from disability, work loss, and premature death add up to another $69 billion. To determine the effectiveness of the Complete Health Improvement Program (CHIP) in reducing cardiovascular disease (CVD) risk factors in a sample of Appalachian participants with elevated fasting blood glucose (FBG) levels or a diagnosis of type 2 diabetes mellitus (T2DM). In a retrospective study, data from 6 CHIP cohorts conducted in Appalachian Ohio from 2011 to 2012 were combined and analyzed for short-term changes in CVD risk factors from baseline. This study focused on a subsample of the overall CHIP, whose participants had elevated FBG levels or T2DM. Statistical analysis was completed by calculating means and SDs and using paired t tests to compare differences in variables. After the CHIP intervention, 110 participants with baseline elevated FBG levels showed notable reductions in FBG levels, total cholesterol, low-density lipoprotein cholesterol, body mass index, and systolic blood pressure (all P values <.001). Likewise, participants in the subsample with T2DM experienced reductions in all CVD risk factors (all P values <.05). The CHIP lifestyle intervention was effective in reducing CVD risk factors in this Appalachian population with elevated FBG levels or with T2DM.

Optimizing the Intensity of Lifestyle Medicine Interventions: Similar Outcomes for Half the Sessions.

Lifestyle medicine interventions are typically intensive by design. This study explored the optimal "dosage" of a well-known lifestyle medicine intervention-the Complete Health Improvement Program (CHIP). A total of 2383 individuals (mean age = 61.0 ± 9.2 years; 34% males) participated in either an 8-session (N = 448) or 16-session (N = 1935) version of the CHIP intervention conducted over 4 weeks in community settings throughout North America. Both the 8- and 16-session groups experienced significant improvements in all the chronic disease risk factors measured. There was no difference between the changes experienced by the 8- and 16-session groups in lipid profile, fasting plasma glucose, or systolic blood pressure. The 8-session group experienced a significantly greater reduction in body mass (0.3 percentage points or 0.8 lbs, P < .01), but the 16-session group recorded a significantly greater reduction in diastolic blood pressure (2.8 percentage points or 2.2 mm Hg, P < .01). There was no clear difference between the outcomes achieved in 4 weeks by the 8- and 16-session versions of the CHIP lifestyle medicine intervention. This study suggests that the short-term outcomes achieved by a 16-session CHIP intervention can be achieved in half the number of sessions, which has implications from a resourcing and cost-effectiveness perspective.

The Influence of Religious Affiliation on Participant Responsiveness to the Complete Health Improvement Program (CHIP) Lifestyle Intervention.

Seventh-day Adventist (SDA) and non-SDA (21.3 and 78.7 %, respectively) individuals (n = 7172) participating in the Complete Health Improvement Program, a 30-day diet and lifestyle intervention, in North America (241 programs, 2006–2012) were assessed for changes in selected chronic disease risk factors: body mass index (BMI), blood pressure (BP), pulse, lipid profile and fasting plasma glucose (FPG). Reductions were greater among the non-SDA for BMI, pulse and blood lipids. Furthermore, the majority of non-SDA in the highest risk classifications for BP, lipids and FPG, but only some lipids among SDA, were able to show improvement by 20 % or more.

The Complete Health Improvement Program (CHIP) and Reduction of Chronic Disease Risk Factors in the Philippines

The Complete Health Improvement Program (CHIP) and Reduction of Chronic Disease Risk Factors in the Philippines

English

Currently, heart disease and diabetes dominate society as the leading cause of death for Americans. In this study, we examined the effectiveness of a lifestyle enhancement program on factors related to the development of heart disease. The Wabash Valley Complete Health Improvement Program (CHIP) is a community-based lifestyle change program with the aim to prevent and reverse the effects of all forms of heart disease through educating participants to make more positive choices in regard to their dietary habits, physical activity, stress management, and tobacco use. Fifty-one participants participated in this 8-week study consisting of 16 sessions that included pre– and post–health screenings for comparison. The health screenings included total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, glucose, weight (pounds), body mass index, systolic blood pressure, diastolic blood pressure, and resting heart rate. Aggregate data for the group were used to compare the pre– and post–heart screen data for each category. According to the American Heart Association (2006), approximately 34.3% of deaths in the United States are caused by some form of cardiovascular disease. Most of these cases result from unhealthy lifestyle choices related to poor nutrition, physical activity, stress, and tobacco use. In this study, we examined several factors to look for correlations between healthy lifestyle and risk of heart disease. Results show CHIP was effective in reducing the aforementioned factors from 4.8% to 19.2% from pre- to postscreening. These results suggest that the CHIP program was successful in reducing the participants' overall risk of heart disease.

Gender differences in effectiveness of the Complete Health Improvement Program (CHIP) lifestyle intervention: an Australasian study

Complete Health Improvement Program (CHIP) is a lifestyle modification program that promotes healthy diet, physical activity and stress management techniques. Among US CHIP participants, differences in gender responsiveness to improvements in chronic disease risk factors were demonstrated. This study examined gender differences in outcomes to the CHIP intervention in Australasia. Changes in body weight, blood pressure (BP), blood lipid profile and fasting plasma glucose (FPG) were assessed in 925 participants (34.3% men, mean age=56.0±12.5 years; 65.7% women, mean age=54.4±13.5 years) 30 days after program commencement. Significant reductions (P<0.001) in all biometrics measured were found for men and women but were greater among men for total (TC) and low-density lipoprotein cholesterol (LDL), triglycerides (TG), FPG, body mass index (BMI) and TC/high-density lipoprotein cholesterol (HDL) ratio. Participants with highest baseline classifications of BMI, systolic BP, blood lipids and FPG showed greatest reductions in 30 days. CHIP more effectively reduced chronic disease risk factors among men than women. All participants, but particularly men, entering the program with the greatest risk achieved the largest reductions. Possible physiological or behavioural factors include food preferences, making commitments and differential support modes. SO WHAT?: Developers of lifestyle intervention programs should consider gender differences in physiological and behavioural factors when planning interventions. In particular, developers should manage expectations of people entering lifestyle interventions to increase awareness that men tend to respond better than women. In addition, this is a call for further research to identify the underlying mechanisms responsible for the disproportionate responsiveness of males.

Gender Differences in Effectiveness of the Complete Health Improvement Program (CHIP)

ObjectiveTo determine the differential effect of gender on outcomes of the Complete Health Improvement Program, a chronic disease lifestyle intervention program. DesignThirty-day cohort study. SettingOne hundred thirty-six venues around North America, 2006 to 2009. ParticipantsA total of 5,046 participants (33.5% men, aged 57.9 ± 13.0 years; 66.5% women, aged 57.0 ± 12.9 years). InterventionDiet, exercise, and stress management. Main Outcome MeasuresBody mass index, diastolic blood pressure, systolic blood pressure, lipids, and fasting plasma glucose (FPG). AnalysisThe researchers used t test and McNemar chi-square test of proportions, at P < .05. ResultsReductions were significantly greater for women for high-density lipoprotein (9.1% vs 7.6%) but greater for men for low-density lipoprotein cholesterol (16.3% vs 11.5%), total cholesterol (TC) (13.2% vs 10.1%), triglycerides (11.4% vs 5.6%), FPG (8.2% vs 5.3%), body mass index (3.5% vs 3%), diastolic blood pressure (5.5% vs 5.1%), and TC/high-density lipoprotein (6.3% vs 1.4%) but not different for systolic blood pressure (6% vs 5%). The greatest reductions were in participants with the highest baseline TC, low-density lipoprotein, triglycerides, and FPG classifications. Conclusions and ImplicationsThe Complete Health Improvement Program effectively reduced chronic disease risk factors among both genders, but particularly men, with the largest reductions occurring in individuals at greatest risk. Physiological or behavioral factor explanations, including differences in adiposity and hormones, dietary intake, commitment and social support, are explored. Researchers should consider addressing gender differences in food preferences and eliciting commitment and differential support modes in the development of lifestyle interventions such as the Complete Health Improvement Program.