Department of Human Studies, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Atherotech Diagnostics Lab, Birmingham, Alabama, USA.
Nutr Diet. 2018 Feb;75(1):73-78. doi: 10.1111/1747-0080.12366. Epub 2017 Jul 7.
Derangements in blood lipid and lipoprotein metabolism are one of the leading causes of coronary heart disease (CHD). Therapeutic lifestyle changes such as diet and exercise are often prescribed to improve blood lipid and lipoprotein characteristics, but the efficacy of a telephone-based health coaching program has not been thoroughly explored. Our purpose was to examine effects of the Our Healthy Heart (OHH) Program on blood lipid and lipoprotein characteristics of individuals with mixed dyslipidaemia.
Cholesterol content of serum very low-density lipoprotein (VLDL), low-density lipoprotein (LDL) and high-density (HDL) subfractions and apolipoprotein concentrations were measured by vertical-density ultracentrifugation (Vertical Auto Profile (VAP)) from 1522 individuals with mixed dyslipidaemia (age 18-99 years, body mass index (BMI) 25-40, 62.7% female). Telephone-based health coaching (OHH, n = 722) or standard care (Control, n = 800) was provided for six months followed by VAP to evaluate changes in lipid and lipoprotein concentrations. Controls were obtained from individuals with similar blood lipid/lipoprotein characteristics who did not participate in the OHH Program. Coaches collected baseline self-reported data on anthropometrics, food intake and exercise. Participants in the OHH group were then prescribed a hypocaloric 500 kcal/day caloric deficit with encouragement to participate in physical activity. A two-way ANOVA was used to examine differences between groups over time, with results presented as means ± standard deviation.
Health coaching significantly decreased serum concentrations of apoB100 (104.5 ± 25.8-94.3 ± 24.8 mg/dL), shifted LDL pattern size from B to A or A/B in over 60% of the OHH group and decreased cholesterol content of all VLDL subfractions (P < 0.05) compared to the control.
Telephone-based health coaching recommendations to reduce dietary energy intake and increase physical activity produced significant improvements in cholesterol content of atherogenic lipoproteins, which are known to increase CHD risk.
血脂和脂蛋白代谢紊乱是冠心病（CHD）的主要原因之一。饮食和运动等治疗性生活方式的改变通常被用于改善血脂和脂蛋白特征，但电话健康指导计划的疗效尚未得到充分探索。我们的目的是研究“我们的健康心脏（OHH）计划”对混合性血脂异常个体的血脂和脂蛋白特征的影响。
通过垂直密度超速离心（垂直自动谱（VAP））测量 1522 名混合性血脂异常患者（年龄 18-99 岁，体重指数（BMI）25-40，女性占 62.7%）血清极低密度脂蛋白（VLDL）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）亚组分的胆固醇含量和载脂蛋白浓度。对 6 个月的电话健康指导（OHH，n=722）或标准护理（对照组，n=800）进行健康指导，然后进行 VAP 以评估血脂和脂蛋白浓度的变化。对照组是从具有相似血脂/脂蛋白特征但未参加 OHH 计划的个体中获得的。教练收集了基线自我报告的人体测量、饮食摄入和运动数据。然后，OHH 组的参与者被规定每天摄入 500 卡路里的低热量热量，并鼓励他们参加体育活动。采用双向方差分析比较两组随时间的差异，结果以平均值±标准差表示。
健康指导显著降低了血清 apoB100 浓度（104.5±25.8-94.3±24.8mg/dL），改变了 LDL 模式大小，使超过 60%的 OHH 组的 LDL 模式从 B 转变为 A 或 A/B，并降低了所有 VLDL 亚组分的胆固醇含量（P<0.05）与对照组相比。
减少饮食能量摄入和增加体力活动的电话健康指导建议显著改善了致动脉粥样脂蛋白的胆固醇含量，这已知会增加 CHD 风险。
