The long-term effect of screening and lifestyle counseling on changes in physical activity and diet: the Inter99 Study - a randomized controlled trial

TY - JOUR

T1 - The long-term effect of screening and lifestyle counseling on changes in physical activity and diet

T2 - the Inter99 Study - a randomized controlled trial

AU - Baumann, Sophie

AU - Toft, Ulla

AU - Aadahl, Mette

AU - Jørgensen, Torben

AU - Pisinger, Charlotta

PY - 2015/3/6

Y1 - 2015/3/6

N2 - Background: Multi-factorial intervention studies have been found to be successful in the initiation of lifestyle changes. However, little is known about the longer-term maintenance of health behavior improvements. The purpose of this study was to investigate whether improvements in physical activity and dietary habits achieved in a population-based multi-factorial lifestyle intervention of five years duration were maintained five years after intervention activities have ended. Methods: The study was a population-based randomized controlled trial, Inter99 (1999-2006), Copenhagen, Denmark. Over five years, all participants in the intervention group (n=6,091) received individual lifestyle counseling; participants at high risk of ischemic heart disease - according to pre-specified criteria - were also offered group-based counseling. The control group (n=3,324) was followed by questionnaires. Both groups were followed one, three, five, and ten years after baseline. Changes in physical activity and dietary habits (intake of vegetables, fruit, fish, and saturated fat) during and after the intervention were investigated using random-coefficient models. Results: Five years after the intervention, women in the intervention group reported greater improvements in the intake of fruit (M Δ=90.2 g/week, p=0.041) and less intake of saturated fat (OR=0.30, 95% CI: 0.17-0.54) than the control group. Men in the intervention group reported greater improvements in physical activity (M Δ=19.6 min/week, p=0.003) and less intake of saturated fat (OR=0.31, 95% CI: 0.17-0.56) than the control group. Improvements in the intake of vegetables and fish achieved during the intervention were not maintained in the longer-term. Conclusions: Screening and lifestyle counseling had sustained effects on physical activity and dietary habits five years after its discontinuation. The patterns of long-term changes in lifestyle differed across behaviors and between men and women.

AB - Background: Multi-factorial intervention studies have been found to be successful in the initiation of lifestyle changes. However, little is known about the longer-term maintenance of health behavior improvements. The purpose of this study was to investigate whether improvements in physical activity and dietary habits achieved in a population-based multi-factorial lifestyle intervention of five years duration were maintained five years after intervention activities have ended. Methods: The study was a population-based randomized controlled trial, Inter99 (1999-2006), Copenhagen, Denmark. Over five years, all participants in the intervention group (n=6,091) received individual lifestyle counseling; participants at high risk of ischemic heart disease - according to pre-specified criteria - were also offered group-based counseling. The control group (n=3,324) was followed by questionnaires. Both groups were followed one, three, five, and ten years after baseline. Changes in physical activity and dietary habits (intake of vegetables, fruit, fish, and saturated fat) during and after the intervention were investigated using random-coefficient models. Results: Five years after the intervention, women in the intervention group reported greater improvements in the intake of fruit (M Δ=90.2 g/week, p=0.041) and less intake of saturated fat (OR=0.30, 95% CI: 0.17-0.54) than the control group. Men in the intervention group reported greater improvements in physical activity (M Δ=19.6 min/week, p=0.003) and less intake of saturated fat (OR=0.31, 95% CI: 0.17-0.56) than the control group. Improvements in the intake of vegetables and fish achieved during the intervention were not maintained in the longer-term. Conclusions: Screening and lifestyle counseling had sustained effects on physical activity and dietary habits five years after its discontinuation. The patterns of long-term changes in lifestyle differed across behaviors and between men and women.

KW - Adult

KW - Counseling

KW - Denmark

KW - Diet

KW - Exercise

KW - Female

KW - Follow-Up Studies

KW - Food Habits

KW - Health Behavior

KW - Health Promotion

KW - Humans

KW - Life Style

KW - Male

KW - Middle Aged

KW - Motor Activity

KW - Odds Ratio

KW - Sex Factors

KW - Surveys and Questionnaires

KW - Time

U2 - 10.1186/s12966-015-0195-3

DO - 10.1186/s12966-015-0195-3

M3 - Journal article

C2 - 25886540

SN - 1479-5868

VL - 12

SP - 1

EP - 10

JO - International Journal of Behavioral Nutrition and Physical Activity

JF - International Journal of Behavioral Nutrition and Physical Activity

M1 - 33

ER -