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Primary Care Lifestyle Intervention Has Cardiometabolic Benefits

TUESDAY, Feb. 9, 2021 -- An intensive lifestyle intervention (ILI) delivered in the primary care setting has cardiometabolic benefits for obese adults, according to a study published online Feb. 9 in Circulation.

Christoph Höchsmann, Ph.D., from the Pennington Biomedical Research Center in Baton Rouge, Louisiana, and colleagues examined the effectiveness of a pragmatic ILI for weight loss delivered in primary care among a racially diverse, low-income population with obesity. The PROPEL trial (Promoting Successful Weight Loss in Primary Care in Louisiana) randomly assigned 18 clinics to offer usual care (351 participants) or an ILI (452 participants), which included a 24-month high-intensity lifestyle-based obesity treatment program embedded in the clinic setting and delivered by health coaches.

The researchers found that compared with those receiving usual care, participants receiving the PROPEL ILI lost significantly more weight over 24 months (mean difference, −4.51 percent). At 12 months, but not at 24 months, fasting glucose decreased more in the ILI versus the usual-care group (mean difference, −7.1 mg/dL). The ILI group had greater increases in high-density lipoprotein cholesterol at both time points (mean difference at 24 months, 4.6 mg/dL). At both time points, the total:high-density lipoprotein cholesterol ratio and metabolic syndrome severity (z score) decreased more in the ILI group versus the usual-care group.

"Our results demonstrate lifestyle intervention and weight-loss programs can be successful for people in underserved, low-income communities if you bring the program to where they are, removing barriers to participation," a coauthor said in a statement.

Several authors disclosed financial ties to the biopharmaceutical industry.

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