Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.
College of Education, Health and Human Development, Montana State University, Bozeman, Montana, USA.
Obesity (Silver Spring). 2018 May;26(5):845-853. doi: 10.1002/oby.22158. Epub 2018 Apr 10.
The aim of this study was to evaluate a multilevel cardiovascular disease (CVD) prevention program for rural women.
This 6-month, community-based, randomized trial enrolled 194 sedentary rural women aged 40 or older with BMI ≥ 25 kg/m . Intervention participants attended 6 months of twice-weekly exercise, nutrition, and heart health classes (48 total) that included individual-, social-, and environment-level components. An education-only control program included didactic healthy lifestyle classes once a month (six total). The primary outcome measures were change in BMI and weight.
Within-group and between-group multivariate analyses revealed that only intervention participants decreased BMI (-0.85 units; 95% CI: -1.32 to -0.39; P = 0.001) and weight (-2.24 kg; 95% CI: -3.49 to -0.99; P = 0.002). Compared with controls, intervention participants decreased BMI (difference: -0.71 units; 95% CI: -1.35 to -0.08; P = 0.03) and weight (1.85 kg; 95% CI: -3.55 to -0.16; P = 0.03) and improved C-reactive protein (difference: -1.15 mg/L; 95% CI: -2.16 to -0.15; P = 0.03) and Simple 7, a composite CVD risk score (difference: 0.67; 95% CI: 0.14 to 1.21; P = 0.01). Cholesterol decreased among controls but increased in the intervention group (-7.85 vs. 3.92 mg/dL; difference: 11.77; 95% CI: 0.57 to 22.96; P = 0.04).
The multilevel intervention demonstrated modest but superior and meaningful improvements in BMI and other CVD risk factors compared with the control program.
本研究旨在评估一项针对农村女性的多层次心血管疾病（CVD）预防计划。
这是一项为期 6 个月的基于社区的随机试验，共纳入 194 名年龄在 40 岁或以上、BMI≥25kg/m 的久坐农村女性。干预组参与者参加了 6 个月的每周两次运动、营养和心脏健康课程（共 48 节），其中包括个体、社会和环境层面的内容。对照组为教育仅干预组，每月参加一次健康生活方式课程（共 6 节）。主要结局指标为 BMI 和体重的变化。
组内和组间多元分析显示，只有干预组参与者的 BMI（-0.85 单位；95%CI：-1.32 至-0.39；P=0.001）和体重（-2.24kg；95%CI：-3.49 至-0.99；P=0.002）下降。与对照组相比，干预组参与者的 BMI（差值：-0.71 单位；95%CI：-1.35 至-0.08；P=0.03）和体重（1.85kg；95%CI：-3.55 至-0.16；P=0.03）以及 C 反应蛋白（差值：-1.15mg/L；95%CI：-2.16 至-0.15；P=0.03）和简单 7，一种复合 CVD 风险评分（差值：0.67；95%CI：0.14 至 1.21；P=0.01）有所改善。对照组的胆固醇水平下降，而干预组的胆固醇水平上升（-7.85 与 3.92mg/dL；差值：11.77；95%CI：0.57 至 22.96；P=0.04）。
与对照组相比，多层次干预在 BMI 和其他 CVD 风险因素方面显示出适度但更优且有意义的改善。
