P5546The benefit of one week immersion in lifestyle-based program for sustainable improvements in cardiovascular risk factors over time
Authors: Schwartz C , George J , Stoll S , Jain A , Desai D , Li Q , Handberg E , Aggarwal M 
Published: October 2019

Abstract

Background
Hypertension (HTN), hyperlipidemia (HLD) and obesity are traditional risk factors for cardiovascular disease (CVD). Lifestyle measures for prevention of CVD include exercise, dietary changes such as reducing saturated fats, increasing fruits and vegetables, and limiting sugar intake but most people are not successful at making meaningful changes without support.

Purpose
To demonstrate the feasibility of a short-term lifestyle-based immersion in improving anthropomorphic measurements, blood pressure (BP) and lipids after one week, and its ability to create sustainable change in a high risk cohort.

Methods
This was a one-week lifestyle immersion for employees of their company and a significant other who were considered high risk for CVD. Eighty participants went through a one-week, in-house, lifestyle-based program that included daily nutrition education, 100% plant-based food that was sugar, salt and oil free, exercise classes and stress management. Anthropomorphic measurements, BP and lipids were checked at onset and on day 6. Dietary survey (validated 14-point Mediterranean diet survey), functional capacity survey (DASI survey) and quality of life (QOL) survey (SF-36) were administered at day 0 and 3-months post immersion.

Results
Of the 80 participants, 64% were female, mean age was 47 years (range 21–71), mean weight was 194.95 lbs. and average BMI was 30.47 kg/m2. Risk factors for CVD were prevalent as 71.25% of the participants had HTN, 27.5% had HbA1c >6%, and there were 35% former and 7.5% active smokers. After one-week lifestyle immersion, average BMI improved by 0.50±0.38 kg/m2 (p<0.001), average weight improved by 3.28±2.62 lbs. (p<0.001) and average waist size improved with a loss of 0.73±1.20 inches (p<0.001). Average systolic BP (SBP) decreased by 6.67±15.17 mmHg (p<0.001) and diastolic BP (DBP) by 5.00±9.82 mmHg (p<0.001). Average total cholesterol improved by 20.40±15.44 mg/dL (p<0.001), triglycerides by 31.78±44.06 mg/dL (p<0.001), HDL by 3.13±5.83 mg/dL (p<0.001) and LDL by 11.71±15.92 mg/dL (p<0.001). In participants who had HTN at the start of the study, average SBP dropped by 10.91±14.30 mmHg (p<0.001) and average DBP by 8.02±8.84 mmHg (p<0.001). DASI and Mediterranean diet surveys were completed by 66% at day 0 and three months. Over the 3 months, there was a significant improvement in both functional capacity (7.03±11.17 points, p<0.001) and average diet score (1.38±2.40 points, p<0.001). The QOL survey was completed by 56% participants with an improvement in quality of life score of 22.02±17.68 points (p<0.001).

Conclusion
Short term intensive lifestyle interventions can lead to immediate and significant improvements in BP, weight and lipid profiles and importantly can have longer lasting effects on exercise capacity, dietary compliance and QOL. Further research to assess benefits of immersion programs with access to larger populations and for longer durations is warranted.

Acknowledgement/Funding
Whole Foods, Inc via Total Health Immersions, LLC