The Effect of a 30-Day Outpatient Intensive Lifestyle Intervention on Cardiometabolic Health

Abstract

Background: Lifestyle modifications are a first-line treatment to prevent and reverse chronic disease. Lifestyle interventions with a holistic approach can rapidly address multiple risk factors, although adherence can be challenging. This study examined a 30-day, outpatient, intensive lifestyle intervention and its impact on multiple cardiovascular and metabolic risk factors.

Methods: This retrospective, observational study included patients at a primary care practice who participated in an innovative, 30-day program consisting of a multifaceted approach to intense lifestyle intervention including a whole food, plant-based diet, daily aerobic exercise, sleep hygiene, and mindfulness-based stress reduction education with regular follow-up and guidance from both lifestyle coaches and physicians. Patients’ pre- and post-program vital signs and lab results were retrospectively reviewed and analyzed for individuals who completed the program from September 2015 to June 2022.

Results: Of the 112 participants who met the study criteria, there were a total of 42 males and 70 females with a mean age of 54.8 ± 11.9 years. Participants experienced an average decrease in systolic blood pressure of 11.6 ± 17.4 mmHg (p<0.0001), decrease in diastolic blood pressure of 3.4 ± 10.9 mmHg (p<0.01), and weight loss of 13.6 ± 8.0 lbs (p<0.0001). Lab values showed an average decrease in total cholesterol of 32.2 ± 33.2 mg/dL (p<0.0001), low-density lipoprotein of 19.5 ± 29.3 mg/dL (p<0.0001), A1c of 0.6 ± 0.8% (p<0.01), and high-sensitivity C-reactive protein of 0.9 ± 4.3 mg/L (p = 0.045). Medication deprescribing at onset of intervention occurred in 34 of 41 participants on anti-hypertensives, 14 of 16 participants on lipid-lowering medications, and 12 of 12 participants on anti-diabetic medications. In addition, some participants reported resolution of chronic symptoms including gastroesophageal reflux disease, fatigue, nocturia, and insomnia.

Conclusion: A 30-day, outpatient, intensive lifestyle intervention program for primary care patients was successful at improving numerous health vital signs and metabolic risk factors. The intervention allowed for medication deprescribing in most patients on anti-hypertensive, lipid-lowering, and anti-diabetic medications. Future directions should include longitudinal follow-up of sustained impact.