Browsing by Author "Rankin, Paul"

Lifestyle interventions can effectively reduce chronic disease risk factors. This study examined the effectiveness of an established lifestyle intervention contextualized for low-literacy communities in Fiji. Ninety-six adults from four villages, with waist circumference (WC) indicative of risk of chronic disease, were randomly selected to an intervention or control group. Process evaluation indicated one intervention and one control village fulfilled the study protocol. There were no differences between intervention and control for body mass index BMI (P = 0.696), WC (P = 0.662), total cholesterol (TC) (P = 0.386), and TC:high-density lipoprotein (HDL) ratio (P = 0.485). The intervention village achieved greater reductions than the control village at 30 and 90 days for systolic blood pressure (30 days: −11.1% vs. −2.5%, P = 0.006; 90 days: −14.5% vs. −6.7%, P = 0.019); pulse rate (30 days: −7.0% vs. −1.1%, P = 0.866; 90 days: −7.1% vs. 4.3%, P = 0.027), and HDL (30 days: −13.9% vs. 1.7%, P = 0.206; 90 days: −18.9% vs. 2.2%, P = 0.001); at 90 days only for diastolic blood pressure (−14.4% vs. −0.2%, P = 0.010); at 30 days only for low-density lipoprotein (−11.6% vs. 8.0%, P = 0.009); and fasting plasma glucose (−10.2% vs. 4.3%, P = 0.032). However, for triglycerides, the control achieved greater reductions than the intervention village at 30 days (35.4% vs. −12.3%, P = 0.008; marginal at 90 days 16.4% vs. −23.5%, P = 0.054). This study provides preliminary evidence of the feasibility and potential effectiveness of the intervention to lower several risk factors for chronic disease over 30 days in rural settings in Fiji and supports consideration of larger studies.

Objectives: To examine the responsiveness of an Aboriginal cohort to a community-based lifestyle intervention targeting risk factors for type II diabetes.

Methods: A Pre-test/post-test cohort study conducted in two rural Australian locations: Port Augusta, South Australia and Drouin, Victoria. The cohort consisted of 25 individuals of Aboriginal descent (mean age = 44.4 ± 12.3 yrs, age range = 25-70 yrs, 7 males/18 females). The intervention used was the Complete Health Improvement Program, involving 11 group sessions conducted over a one-month period, which promoted a low-fat plant-based diet and physical activity. The main outcomes measured were changes in body weight, fasting plasma glucose (FPG), lipid profile and blood pressure (BP).

Results: Over the 4 week intervention mean body weight decreased by 3.1 kg (95% CI 2.26 to 4.06), a 3.5% reduction from baseline (p 5.5 mmol/L at baseline showed a 23.6% reduction in mean FPG (7.82 mmol/L to 5.97 mmol/L, p=0.005) and a 4.12% reduction in body weight (98.85 kg to 94.78 kg, p

Conclusion: This feasibility study showed that a lifestyle intervention promoting a low-fat eating pattern combined with physical activity reduced risk factors associated with type II diabetes in a rural Aboriginal cohort when conducted in their usual living environment.

Implications: There is potential for committee-based lifestyle interventions to improve the health risk profile of Aboriginal participants.

Lifestyle modification has been demonstrated to effectively reduce the risk factors associated with cardiovascular disease, but there is a perception that it is costly to administer and resource. The present study examined the results achieved by a 30-day lifestyle modification program (Coronary Health Improvement Project) delivered by volunteers in a community setting. Changes in selected biometric measures of 5,070 participants in the Coronary Health Improvement Project programs delivered throughout North America (January 2006 to October 2009), were assessed. Overall, significant reductions (p280 mg/dl recorded an average reduction of 19.8%. A mean decrease of 16.1% in low-density lipoprotein levels was observed among those who entered the program with a low-density lipoprotein level >190 mg/dl. Individuals who presented with triglycerides >500 mg/dl recorded a mean reduction of 44.1%. The Framingham assessment forecast that approximately 70 cardiac events would be averted during the subsequent decade in the cohort because of the program. In conclusion, significant reductions in cardiovascular disease risk factors can be achieved in a 30-day lifestyle intervention delivered by volunteers, providing a cost-effective mode of administering lifestyle medicine.[from publisher's website].

Background: Affective disorders are becoming more pervasive worldwide, including in Southern Africa, where treating patients with these conditions is challenging due to social and financial constraints. A variety of non-pharmacological approaches including lifestyle medicine (e.g., exercise, nutrition, sleep) and positive psychology practices (e.g., gratitude, service), are effective for treating mental health (MH) conditions.

Methods: Twenty-six individuals from South Africa with a diagnosed MH condition participated in a 10-week multimodal intervention incorporating a diverse range of non-pharmacological strategies for improving MH. MH metrics were assessed pre-and post-intervention, including general MH, vitality/energy (VIT), depression, anxiety, stress, and satisfaction with life. MH and VIT were also measured weekly.

Results: Improvements were observed in all mental metrics from pre-to post-intervention: MH (59%, p < 0.001, Cohen’s D = 1.36), VIT (110%, p < 0.001, Cohen’s D = 1.71), depression (−46%, p < 0.001, Cohen’s D = −1.06), anxiety (−48%, p < 0.001, Cohen’s D = −1.21), stress (−36%, p < 0.001, Cohen’s D = −1.08) and life satisfaction (23%, p < 0.001, Cohen’s D = 0.66). Significant improvements in MH and VIT were observed after only 1 week of the intervention and progressively increased until the seventh week, after which further improvements were not statistically significant.

Conclusion: The findings of this cohort study indicate that a multimodal intervention that incorporates lifestyle and positive psychology practices may benefit individuals living with an affective disorder. Non-pharmacological, multimodal interventions might offer a stigma-free way of providing MH promotion and treatment at a population level.

Structural equation modeling was used to explore the direct and indirect association of childhood experiences, attitudes, subjective norms, and intentions on the alcohol consumption of adolescents attending faith-based Seventh-day Adventist schools in Australia. Data were collected on 1,266 adolescents and the structural model developed explained 48% of the variance for alcohol consumption. Intentions had the highest degree of association with Alcohol Consumption Status (ACS) (b.0.52). Attitudes were more strongly associated to ACS (btotal . 0.36) than subjective norms (btotal . 0.17). Adverse Childhood Experiences (ACEs) were associated with every variable in the model and had a combined direct and indirect association with ACS of btotal . 0.14.

Multigroup analysis found significant pathway differences in the model for gender and age with regards to the association of intentions, attitudes, ACEs, and Childhood Family Dynamics with alcohol consumption status. The study fills a gap in the alcohol literature by presenting a model describing the complex network of factors that predict alcohol consumption in a low-ACS population. The outcomes of the study highlight the importance of early intervention for children and their families to delay or minimize alcohol consumption in adolescents.

Background: Adolescents attending Seventh-day Adventist schools (Adventist) in Australia tend to experience good health and exhibit better health behaviors than national norms, however few studies have investigated factors predicting their mental health.

Aims: The aim of this study was to explore the complex network of factors that predict the mental health status (MHS) of adolescents attending Adventist schools in Australia.

Methods: A survey instrument was used to collect data from 1527 secondary school students attending Adventist schools across Australia. Structural equation modeling was employed to examine concomitantly the direct and indirect effects of childhood experiences, present attitudes and selected health behaviors on MHS.

Results: Childhood family dynamics had the strongest association with MHS (β_total = 0.33) followed by a sense of meaning and purpose (β_total = 0.27), perceived social misfit status (β_total = –0.19), and school academic performance (β_total = 0.18). Multi-group analysis found significant pathway differences in the model for gender with regards to the association of meaning and purpose, physical activity and sleep quantity with MHS.

Conclusions: The outcomes of the study highlight the importance of early positive childhood family dynamics and the discovery of meaning and purpose during adolescence to promote positive mental health among adolescents.

Objective: To determine the differential effect of gender on outcomes of the Complete Health Improvement Program, a chronic disease lifestyle intervention program.

Design: Thirty-day cohort study.

Setting: One hundred thirty-six venues around North America, 2006 to 2009.

Participants: A total of 5,046 participants (33.5% men, aged 57.9 ± 13.0 years; 66.5% women, aged 57.0 ± 12.9 years).

Intervention: Diet, exercise, and stress management.

Main Outcome Measures: Body mass index, diastolic blood pressure, systolic blood pressure, lipids, and fasting plasma glucose (FPG).

Analysis: The researchers used t test and McNemar chi-square test of proportions, at P < .05.

Results: Reductions 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 Implications: The 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.

Issue addressed: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Background and Objectives: 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. Methods and Study Design: 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. Results: HDL significantly decreased (10.6%, pConclusions: 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.

Objective: To examine the long-term (three or more years) effectiveness of the volunteer-delivered CHIP intervention.

Design: Cohort study

Setting: Hawera, New Zealand

Participants: Of the total cohort of 284 individuals who self-selected to complete the CHIP lifestyle intervention between 2007 and 2009, 106 (37% of the original cohort, mean age = 64.9±7.4 years, range 42-87 years; 35% males, 65% female) returned in 2012 for a complimentary follow-up health assessment (mean follow-up duration = 49.2+10.4 months).

Intervention: 30-day lifestyle modification program (diet, physical activity, substance use and stress management) delivered by volunteers in a community setting.

Main outcome measures: Changes in body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG).

Results: After approximately 4 years, participants with elevated biometrics at program entry maintained significantly lowered BMI (-3.2%; 34.8±5.4 versus 33.7±5.3 kg/m², p=0.02), DBP (-9.4%; 89.1±4.1 versus 80.8±12.6 mmHg, p=0.005), TC (-5.5%; 6.1±0.7 versus 5.8±1.0 mmol/L, p=0.04) and TG (-27.5%; 2.4±0.8 versus 1.7±0.7 mmol/L, p=0.002). SBP, HDL, LDL and FPG were not significantly different from baseline. Participants with elevated baseline biometrics who reported being compliant to the lifestyle principles promoted in the intervention (N=71, 67% of follow-up participants) recorded further reductions in BMI (-4.2%; 34.8±4.5 versus 33.4±4.8 kg/m², p=0.02), DBP (-13.3%; 88.3±3.2 versus 77.1±12.1 mmHg, p=0.005) and FPG (-10.4%; 7.0±1.5 versus 6.3±1.3 mmol/L, p=0.02).

Conclusions: Individuals who returned for follow-up assessment and entered the CHIP lifestyle intervention with elevated risk factors were able to maintain improvements in most biometrics for more than three years. The results suggest that the community-based CHIP lifestyle intervention can be effective in the longer-term, even when delivered by volunteers.

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.

While a sedentary lifestyle is a one of the most pressing health concern in western society, there appears to be a minority of individuals who exercise compulsively and in excess. Relatively little research has examined the factors leading exercise to transition from a healthy and sociable habit to one that is potentially pathological, addictive, and physically damaging. The present study examined the possible impact ofearly maladaptive schema (EMS) and implicit self-esteem on exercise dependence (EXD) in a cohort ofAustralian cyclists. A total of136 cyclists completed the Young Schema Questionnaire Short-Form Revised, Self-esteem Implicit Association Test and Exercise Dependence Scale Revised to assess EMS, implicit self-esteem and for EXD symptomology. Early maladaptive schema, specifically the domains Bother directedness^ and Bimpaired limits^, accounted for a significant proportion of the variability in self-reported EXD symptomology. Additionally, a significant proportion of this cohort exhibited EXD symptomology irrespective of socio-demographic characteristics. These findings indicate that individuals who have an excessive external focus on the desires and needs of others, and/or are unable to set appropriate internal limits, may be at higher risk of developing EXD symptomology than individuals with lower levels of specific EMS. Therefore, understanding the relationship between EMS and EXD may aid in understanding the etiology ofEXD and the development of intervention strategies.

Students attending Seventh-day Adventist (Adventist) schools in Australia have been shown to have better health status and behaviours compared to secular norms, yet these schools cater for a high percentage of non-Adventist students. The purpose of this study was to investigate the influence of religious affiliation (Adventist/non-Adventist) on the health status and behaviours of students attending Adventist secondary schools in Australia. The sample included 1734 students who responded to a health and lifestyle survey that captured demographic details, self-reported height and weight, self-reported health status, mental health and select health behaviours. Students who identified themselves as Adventist reported significantly better health behaviours than the non-Adventist students in several behavioural domains, especially among the male students. However, this did not translate to a difference in health status. Further research is needed to understand the causal mechanisms responsible for the potential health advantage of Adventist students, which may include family or church religious influences.

Background

The factors shaping the health of the current generation of adolescents are multi-dimensional and complex. The purpose of this study was to explore the determinants of self-rated health (SRH) of adolescents attending a faith-based school system in Australia.

Methods

A total of 788 students attending 21 Seventh-day Adventist schools in Australia responded to a health and lifestyle survey that assessed SRH as well as potential determinants of SRH including the health outcomes mental health, vitality, body mass index (BMI), select health behaviors, social factors and personal demographics. Structural equation modeling was used to analyze the data and examine the direct and indirect effects of these factors on SRH.

Results

The structural model developed was a good fit with the data. The health outcome mental health had the strongest association with SRH (β = 0.17). Several upstream variables were also associated with higher SRH ratings. The health behavior sleep hours had the strongest association with SRH (β_total = 0.178) followed by fruit/vegetable consumption (β_total = 0.144), physical activity (β_total = 0.135) and a vegetarian diet (β_total = 0.103). Of the demographic and social variables measured, adverse childhood experiences (ACEs) had the strongest association with SRH (β_total = − 0.125), negatively influencing SRH, and gender also associated with an increase in SRH (β_total = 0.092), with the influence of these factors being mediated through other variables in the model.

Conclusions

This study presents a conceptual model that illustrates the complex network of factors concomitantly associated with SRH in adolescents. The outcomes of the study provide insights into the determinants of adolescent SRH which may inform priority areas for improving this construct.

BACKGROUND

We examined the body mass index (BMI) of students attending Seventh-day Adventist (Adventist) schools in Australia in 2001 and 2012.

METHODS

A total of 3069 students attending Adventist schools in Australia responded to a health and lifestyle survey in 2001 (N = 1335) and 2012 (N = 1734). The survey captured self-reported height and weight, demographics (age, sex, year level, religion), and select health behaviors.

RESULTS

Compared with national norms, lower rates of overweight and obesity were observed in the study cohort, but higher rates of underweight. There was no change in the mean BMI of the students attending Adventist schools in Australia from 2001 to 2012. Regression analyses indicated that a lower BMI was associated with age, sex, more regularly eating breakfast, consuming less soft drink, and having a regular exercise program. The students reported a high consumption of fruits, vegetables, and whole grains compared with Australian national norms, and 29% claimed to be vegetarian.

CONCLUSIONS

Students attending Adventist schools appear to have a lower prevalence of overweight and obesity than the secular population, but a higher prevalence of underweight. The mechanisms through which Adventist schools may influence student's BMI warrants further investigation.

Purpose: The short-term effectiveness of the nutrition-centred Complete Health Improvement Program (CHIP) lifestyle intervention for improving selected chronic disease risk factors was examined in the Canadian setting.

Methods: A total of 1003 people (aged 56.3 ± 12.1 years, 68% female) were self-selected to participate in one of 27 CHIP interventions hosted in community settings by Seventh-day Adventist churches throughout Canada, between 2005 and 2011. The program centred on the promotion of a whole-food, plant-based eating pattern, and daily physical activity was also encouraged. Biometric measures, including body mass index (BMI), blood pressure (BP), blood lipid profile, and fasting blood sugar (FBS), were determined at program entry and 30 days into the intervention.

Results: Over 30 days, significant overall reductions (P

Conclusions: The CHIP intervention, which centres on a whole-food, plant-based eating pattern, can lead to rapid and meaningful reductions in chronic disease risk factors in the Canadian context.

Lifestyle modification has been demonstrated to effectively reduce the risk factors associated with chronic disease. The Complete Health Improvement Project, a 30-day diet and lifestyle modification program, has been shown to be efficacious in the US, Australasia and Canada. The present study examined the changes in selected biometric measures of 61 participants from six programs delivered in Manila, in the Philippines (May 2013 to November 2014). Overall, significant reductions were recorded in body mass (2.2%, p5.17mmol/l recorded an average reduction of 14.4%. A mean decrease of 17.0% in low-density lipoprotein levels was observed among those who entered the program with a low-density lipoprotein level >3.35 mmol/l. Individuals who presented with triglycerides >2.26 mmol/l recorded a mean reduction of 21.8%. Individuals with systolic blood pressure above 139 mmHg and diastolic blood pressure above 89 mmHg decreased levels by 10.3% and 7.1%, respectively. Finally, fasting plasma glucose decreased on average 24.8% among individuals entering the program with levels above 6.9 mmol/l. In conclusion, significant reductions in chronic disease risk factors can be achieved in a 30-day life style intervention delivered in the Philippines.

Abstract

The Complete Health Improvement Program (CHIP) is a premier lifestyle intervention targeting chronic disease that has been offered for over 25 years. The intervention has been utilized in clinical, corporate and community settings and the short and longer-term clinical benefits of the intervention, as well as its cost-effectiveness, have been documented in over 25 peer-reviewed publications. Being an easily administered intervention, CHIP has been presented not only by health professionals, but also non-health trained volunteers. The benefits of the program have been extensively studied under these two delivery channels, consistently demonstrating positive outcomes. This paper provides a brief history of CHIP and describes the content and structure of the intervention. The published evaluations and outcomes of the intervention are presented and discussed and future directions are highlighted.

Background

Low levels of high-density lipoproteins (HDL) are considered an important risk factor for cardiovascular disease and constitute one of the criteria for the Metabolic Syndrome (MetS). Lifestyle interventions promoting a low-fat, plant-based eating pattern appear to paradoxically reduce cardiovascular risk but also HDL levels. This study examined the changes in MetS risk factors, in particular HDL, in a large cohort participating in a 30-day lifestyle intervention that promoted a low-fat, plant-based eating pattern.

Methods

Individuals (n = 5,046; mean age = 57.3 ± 12.9 years; 33.5% men, 66.5% women) participating in a in a Complete Health Improvement Program (CHIP) lifestyle intervention within the United States were assessed at baseline and 30 days for changes in body mass index (BMI), blood pressure (BP), lipid profile and fasting plasma glucose (FPG).

Results

HDL levels decreased by 8.7% (p

Conclusions

When people move towards a low-fat, plant-based diet, HDL levels decrease while other indicators of cardiovascular risk improve. This observation raises questions regarding the value of using HDL levels as a predictor of cardiovascular risk in populations who do not consume a typical western diet. As HDL is part of the assemblage of risk factors that constitute MetS, classifying individuals with MetS may not be appropriate in clinical practice or research when applying lifestyle interventions that promote a plant-based eating pattern.[from publisher's website].

In the latter half of the 20th Century increases in the availability of inexpensive, energy-dense foods combined with an estimated 60-70% reduction in daily energy expenditure, created an “obesogenic” environment. The epidemic of obesity that has emerged has been associated with the Metabolic Syndrome (MetS) which is a cluster of risk factors that are precursors to chronic diseases including cardiovascular disease (CVD), type II diabetes (T2D), stroke, and dementia. These chronic diseases are having a significant social and economic impact worldwide with their related morbidity and mortality.
Epidemiological and interventional studies have shown that lifestyle interventions based on a low-fat, plant-based diet are effective for the management of MetS and associated chronic diseases. To date, the research has focused on lifestyle interventions delivered by professional facilitators, mostly in clinical settings. The primary aim of this dissertation was to examine the effectiveness of a lifestyle intervention known as the Coronary Health Improvement Program (CHIP), when delivered by volunteer facilitators to free-living participants in their community. The secondary aim of the dissertation was to examine the impact of selected participant factors including age, gender, religious affiliation, marital status, previous history, family history and body mass index on the participants’ responsiveness to the CHIP intervention.
This study adopted a pre-test post-test design involving, a large cohort of 5070 individuals who participated in one of 178 community-based CHIP interventions delivered by volunteers between 2006 to 2009 in the United States and Canada.
In 30 days, significant reductions (p < 0.001) were recorded in body mass index (3.2%), total cholesterol (11.0%), low-density lipoprotein cholesterol (13.0%), triglycerides (7.7%), fasting plasma glucose (6.1%) and systolic and diastolic blood pressure (4.9% and 5.3%, respectively). Stratification of the data revealed larger reductions in those participants who presented to the program with the greatest risk factor levels.
Regardless of age, gender, marital status, religious affiliation, previous history, family history and body weight, participants in the CHIP intervention achieved significant improvements in the risk factors associated with MetS however these factors influenced the responsiveness of the participants to the program. In general, male participants achieved better results than the females, and males tended to achieve their best outcomes at a younger age than the female participants. Married participants achieved better outcomes than single, divorced or widowed participants. Seventh-day Adventist (SDA) participants had better risk profiles at baseline, however, the non-SDA participants achieved better outcomes during the intervention. Participants who had the highest body mass index (BMI) at baseline achieved the greatest changes in BMI, fasting plasma glucose and blood pressure, however, those participants with a BMI greater than 35 kg/m2 showed significantly less improvement in their lipid profile than those participants with a BMI between 25 and 35 kg/m2.
It was concluded that significant reductions in the risk factors associated with MetS can be achieved in 30 days using the CHIP lifestyle intervention when delivered by volunteers to free-living participants in their local community. Significant reductions in risk factors associated with MetS can be achieved regardless of age, gender, marital status, religious affiliation or baseline biometrics. Utilising volunteers may therefore provide an effective and cost-efficient mode of delivering lifestyle interventions targeting MetS.