Valerie J. Hoover

A Multicomponent Intervention Reduces Body Weight and Cardiovascular Risk at a GEICO Corporate Site

Purpose. To determine whether a multicomponent nutrition intervention program at a corporate site reduces body weight and improves other cardiovascular risk factors in overweight individuals. Design. Prospective clinical intervention study. Subjects/Setting. Employees of the Government Employees Insurance Company (GEICO) (N = 113), aged 21 to 65 years, with a body mass index ≥ 25 kg/m2 and/or previous diagnosis of type 2 diabetes. Intervention. A 22-week intervention including a low-fat, vegan diet. Measures. Changes in body weight, anthropometric measures, blood pressure, lipid profile, and dietary intake. Analysis. Multivariate analyses of variance were calculated for clinical and nutrient measures, followed by univariate analyses of variance, to determine the significance of differences between groups in changes over time. Results. Intervention-group participants experienced greater weight changes compared with control-group participants (mean, – 5.1 [SE, .6] kg vs. + .1 [SE, .6] kg, p < .0001), as well as greater changes in waist circumference (mean, – 4.7 [SE, .6] cm vs. + .8 [SE, .6] cm, p < .0001) and waist:hip ratio (mean, – .006 [SE, .003] vs. + .014 [SE, .005], p = .0007). Weight loss of 5% of body weight was more frequently observed in the intervention group (48.5%) compared with the control group (11.1%) (χ2[1, N= 113] = 16.99, p < .0001). Conclusions. Among individuals volunteering for a 22-week worksite research study, an intervention using a low-fat, vegan diet effectively reduced body weight and waist circumference.

A Worksite Vegan Nutrition Program Is Well-Accepted and Improves Health-Related Quality of Life and Work Productivity

Background/Aims: Vegetarian and vegan diets are effective in preventing and treating several chronic diseases. However, their acceptability outside a clinical trial setting has not been extensively studied. The aim of this study was to determine the acceptability of a worksite vegan nutrition program and its effects on health-related quality of life and work productivity. Methods: Employees of a major insurance corporation with a body mass index ≧25 kg/m2 and/or a previous diagnosis of type 2 diabetes received either weekly group instruction on a low-fat vegan diet (n = 68) or received no diet instruction (n = 45) for 22 weeks. Results: The vegan group reported improvements in general health (p = 0.002), physical functioning (p = 0.001), mental health (p = 0.03), vitality (p = 0.004), and overall diet satisfaction (p < 0.001) compared with the control group. The vegan group also reported a decrease in food costs (p = 0.003), and increased difficulty finding foods when eating out (p = 0.04) compared with the control group. The vegan group reported a 40–46% decrease in health-related productivity impairments at work (p = 0.03) and in regular daily activities (p = 0.004). Conclusions: A worksite vegan nutrition program is well-accepted and can be implemented by employers to improve the health, quality of life, and work productivity of employees.

A worksite programme significantly alters nutrient intakes

OBJECTIVE To examine whether a worksite nutrition programme using a low-fat vegan diet could significantly improve nutritional intake. DESIGN At two corporate sites of the Government Employees Insurance Company, employees who were either overweight (BMI > or = 25 kg/m2) and/or had type 2 diabetes participated in a 22-week worksite-based dietary intervention study. SETTING At the intervention site, participants were asked to follow a low-fat vegan diet and participate in weekly group meetings that included instruction and group support (intervention group). At the control site, participants received no instruction (control group). At weeks 0 and 22, participants completed 3 d dietary records to assess energy and nutrient intake. SUBJECTS A total of 109 participants (sixty-five intervention and forty-four control). RESULTS In the intervention group, reported intake of total fat, trans fat, saturated fat and cholesterol decreased significantly (P < or = 0.001), as did energy and protein (P = 0.01), and vitamin B12 (P = 0.002), compared with the control group. Intake (exclusive of any use of nutritional supplements) of carbohydrate, fibre, vitamin C, magnesium and potassium increased significantly (P < or = 0.0001), as did that for beta-carotene (P = 0.0004), total vitamin A activity (P = 0.004), vitamin K (P = 0.01) and sodium (P = 0.04) in the intervention group, compared with the control group. CONCLUSIONS The present study suggests that a worksite vegan nutrition programme increases intakes of protective nutrients, such as fibre, folate and vitamin C, and decreases intakes of total fat, saturated fat and cholesterol.

Implementing Evidence-Based Practices in Community Treatment Programs: Initial Feasibility of a Counselor “Toolkit”

ABSTRACT Community substance abuse treatment programs face many barriers to adopting “evidence-based” therapies. Training budgets are inadequate to permit acquisition of complex skills, there is little clinical supervision available, and almost all counseling is done in group sessions. The authors adopted an approach widely used in the teaching field—developing a resource “toolkit” for a specific topic, in this case, a Decisional Balance exercise often used in the evidence-based treatment approach of Motivational Interviewing. This trial toolkit was comprised of a DVD (televised during group to illustrate the clinical concept), a laminated counselor guide (to provide guidance and talking points for the counselor during group), and some worksheets and wallet cards for patients to retain key points (see Table 1). A feasibility trial assessed the acceptability, and sustainability of the “Decisional Balance” concept toolkit among 26 counselors and 210 of their patients, from 6 community-based substance abuse treatment programs. The great majority of patients (97%) and all counselors (100%) reported they were satisfied with the toolkit session; 84% of patients said they would like more groups like the toolkit session. Almost all counselors (96%) were still using at least one component of the toolkit 3 months after their initial exposure with no prompting. The toolkit curriculum–based approach may be a viable and attractive way of translating core concepts from sophisticated evidence-based therapies into use by counselors within contemporary, community-based treatment programs with minimal training.

Preventing Breast Cancer Recurrence through a Tailored Lifestyle Intervention: The MyLIFE (My Lifestyle Intervention with Food and Exercise) Trial Rationale and Study Design

Breast cancer risk, and risk of associated co-morbidities such as cardiovascular disease, is highest among overweight or obese women with a previous history of breast cancer. The objective of this study is to test the effectiveness of a tailored nutrition, physical activity, and behavioral weight management intervention for breast cancer survivors against a widely available commercial weight management program. We hypothesize that an intervention tailored to the unique psychological, nutritional, and physical needs of breast cancer survivors will provide superior physiological and psychological benefits compared to an existing commercial program for the general population. To test our hypothesis, we initially conducted a focus group with both breast cancer survivors and oncology affiliated health care providers in order to illicit feedback to develop an intervention customized specifically to breast cancer survivors. Subsequently, in a randomized, multicenter trial, we are studying the effect of the tailored program on overweight/obese women (N=120) with a history of breast cancer (3 months to 5 years post-primary treatment) on body weight and composition, markers of systemic inflammation related to cancer and associated chronic diseases, physical activity habits, dietary intake, health-related quality of life, and program adherence and satisfaction. Assessments will be taken prior to study initiation immediately following the intervention and at 6 months post-intervention to assess long-term maintenance of weight, lifestyle behaviors, and impact on physiological markers of disease risk. This project is unique in that it addresses weight issues in a high risk, understudied population using a tailored approach.

Contents Vol. 56, 2010

F. Azizi, Tehran A. Berg, Freiburg F. Branca, Rome R. Brigelius-Flohé, Nuthetal P.C. Calder, Southampton N. Chang, Seoul T. Decsi, Pécs K. Eder, Halle/Saale A. El-Sohemy, Toronto, Ont. H. Goldenberg, Vienna R. Hakkak, Little Rock, Ark. H. Hauner, Munich S. Hercberg, Paris H. Heseker, Paderborn N. Houalla, Beirut A. Kafatos, Heraklion M.-H. Kang, Daejeon E.T. Kennedy, Boston, Mass. M. Krawinkel, Giessen G. Krejs, Graz A.V. Kurpad, Bangalore W. Langhans, Zurich M. Lawrence, Burwood, Vic. D. Li, Hangzhou X. Lin, Shanghai J. Linseisen, Heidelberg J.A. Martinez, Pamplona Y. Naito, Kyoto H.Y. Paik, Seoul M. Panagiotidis, Reno, Nev. J.M. Pettifor, Johannesburg L.A. Réthy, Budapest G. Rimbach, Kiel J. Sabaté, Loma Linda, Calif. W.H.M. Saris, Maastricht L. Serra-Majem, Las Palmas de Gran Canaria A.P. Simopoulos, Washington, D.C. P. Stehle, Bonn J.J. Strain, Coleraine I. Th orsdottir, Reykjavik K. Tontisirin, Nakhon Pathom R. Uauy, Santiago H. Vannucchi, Ribeirão Preto A. von Rücker, Bonn M. Wahlqvist, Clayton W. Waldhäusl, Vienna E. Wasantwisut, Salaya B. Watzl, Karlsruhe W.M. Windisch, Vienna T. Yoshikawa, Kyoto J. Zempleni, Lincoln, Nebr. A. Zittermann, Bad Oeynhausen Journal of Nutrition, Metabolic Diseases and Dietetics