Could primary care dietary intervention combined with lifestyle changes be effective in the cardiovascular prevention?

Móczár, Cs. and Borgulya, G. and Kovács, E. and Rurik, I. (2012) Could primary care dietary intervention combined with lifestyle changes be effective in the cardiovascular prevention? Acta Alimentaria, 41 (2). pp. 248-256. ISSN 0139-3006

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Abstract

Obesity is an important risk factor of cardiovascular diseases. Dietary intervention combined with life style changes were implemented in other countries and proved to be effective. Previously, there were no similar Hungarian experiences.The aim of our study was to screen overweight and obese patients in primary care settings, to involve them in an interventional program and to analyse the expected changes in the laboratory and anthropometric parameters.From 29 primary care practices, 2489 overweight or obese patients were recruited between April of 2004 and 2006.The characteristics of living circumstances, life style, eating and exercise habits were explored by questionnaire. Regular energy intake was counted and compared to estimated requirements. Metabolic and anthropometric parameters were measured. Experienced multi-disciplinary staff was involved, including internist, family physicians, dietetitian, experienced nurses and physical instructors. The interventions were: dietary (recommendation of low calorie diet) and increasing physical activity.One year later the body mass index decreased significantly by 0.56 kg m−2 average and remained about the same by the end of the second year. There was only a small decrease in waist circumference. The rest systolic blood pressure decreased significantly on average 5.9 mmHg by the end of the first year, while decrease in resting diastolic blood pressure was less. All metabolic parameters, except HDL-cholesterol decreased significantly: total cholesterol: by 0.23 mmol l−1, trigliceride: by 0.18 mmol l−1, blood glucose: by 0.15 mmol l−1. Primary care intervention proved to be effective. Better outcomes would be expected, when more resources, more focus in the media, more support from health authorities and sufficient manpower was available.

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