Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomised Non-pharmacological Intervention Study for Prevention of Ischaemic Heart Disease Inter99
Brief Summary: In spite of declining trend coronary heart disease (CHD) is still a leading cause of morbidity and mortality. Many years of epidemiological research have identified several risk factors for CHD. The main causes are physical inactivity and inappropriate diet (mediated through high blood pressure, high cholesterol and fatness) and smoking. So far intervention studies on lifestyle factors have shown disappointing results, most probably due to insufficient interventions and methodology.

Inter99 is a randomized non-pharmacological intervention study comprising 61,301 persons representing a well-defined population. About 13,000 are invited for a health examination and assessment of risk for CHD. Those at high risk are offered lifestyle intervention in three waves over a five year period. A priori the group is divided into a high intensive and low intensive intervention group. The remaining 48.285 individuals serve as control.

After five years all individuals who attended the base-line examination are re-invited to assess the effect of the intervention on intermediate end-points as lifestyle, absolute risk of CHD and biological risk factors. The total cohort (61.301) is followed through central registers to evaluate the effect of the intervention on use of the health care system and the long term effect on incidence of CHD.

The status for the project is that the four waves of intervention have been performed, the last follow-up was in March 2006.

Data collection finalized with 10 years follow-up via Central National Registries and a questionnaire. No further follow-up is scheduled for the main purposes of the study.

Analyses as regard the primary effect (on incidence of cardiovascular diseases) and secondary effect (on incidence of type 2 diabetes) are on-going. Analyses for a large number of spin off project are on-going.

More than 25 Ph.d. studies and more than 200 peer-review publication have so far been produced.

Summary of results, links to articles and theses at: www.Inter99.dk


Options:
A: Inclusion Criteria:

* All citizens in a predefined area

Exclusion Criteria:

* Drug abuse
* Language problem
B: Inclusion Criteria:

The investigators will recruit 315 non-diabetic Veterans receiving primary care at the Ann Arbor VA Medical Center who meet the following inclusion criteria:

* willing to complete a HIPAA authorization form
* no HbA1c results in previous 12 months
* due for VA Primary Care appointment approximately 12 weeks of sending a recruitment letter and who have a body-mass index (BMI) 30 kg/m2
* or BMI 25 kg/m2 with \> 1 obesity-related condition such as:

  * hypertension
  * hyperlipidemia
  * Hypoalphalipoproteinemia
  * Coronary Artery Disease
  * Peripheral Vascular Disease
  * Hypertriglyceridemia
  * past hemoglobin A1c (HbA1c) of 5.7 - 6.4
  * past diagnosis of Impaired Fasting Glucose (IFG)
  * or Impaired Glucose Tolerance (IGT)
  * or Polycystic Ovary Syndrome (PCOS)

Exclusion Criteria:

* The investigators will exclude patients who are \> 75 years of age
* are receiving chemotherapy for cancer, or have:

  * dementia
  * diabetes
  * dementia
  * New York Heart Association Class III or IV congestive heart failure
  * pregnancy
  * Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 4 Chronic Obstructive Pulmonary Disease (COPD)
  * end-stage renal disease (ESRD)
  * cirrhosis
  * or have been hospitalized or received rehab for stroke or myocardial infarction within the past 6 months
C: Inclusion Criteria:

* 34-69 years-of-age with diagnosed IGT
* Informed consent given.

Exclusion Criteria:

* Patients with pharmacologically-treated diabetes
* Hypertriglyceridaemia under drug treatment
* History of life-limiting diseases or events
* Unwillingness to sign the informed consent.
D: Inclusion Criteria:

* 18+
* High risk of developing type 2 diabetes as identified through a risk score

Exclusion Criteria:

* Diagnosed diabetes
* Taking steroid medication
* Serious chronic illness preventing participation in trial
* Unable to speak English

Answer: A