Comparative effectiveness of lifestyle interventions on cardiovascular risk factors among a Dutch overweight working population: A randomized controlled trial

Background: Overweight (Body Mass Index [BMI] >= 25 kg/m(2)) and obesity (BMI >= 30 kg/m(2)) are associated with increased cardiovascular risk, posing a considerable burden to public health. The main aim of this study was to investigate lifestyle intervention effects on cardiovascular risk factors in healthy overweight employees. Methods: Participants were 276 healthy overweight employees (69.2% male; mean age 44.0 years [SD 9.2]; mean BMI 29.7 kg/m(2) [SD 3.1]). They were randomized to one of two intervention groups receiving a six month lifestyle intervention with behavior counseling by phone (phone group) or e-mail (Internet group), or to a control group receiving usual care. Body weight, height, waist circumference, sum of skinfolds, blood pressure, total cholesterol level and predicted aerobic fitness were measured at baseline, at 6 and at 24 months. Regression analyses included the 141 participants with complete data. Results: At 6 months a significant favorable effect on total cholesterol level (-0.2 mmol/l, 95% CI -0.5 to -0.0) was observed in the phone group and a trend for improved aerobic fitness (1.9 ml/kg/min, 95% CI -0.2 to 3.9) in the Internet group. At two years, favorable trends for body weight (-2.1 kg, 95% CI -4.4 to 0.2) and aerobic fitness (2.3 ml/kg/min, 95% CI -0.2 to 4.8) were observed in the Internet group. Conclusions: The intervention effects were independent of the used communication mode. However short-term results were in favor of the phone group and long-term results in favor of the internet group. Thus, we found limited evidence for our lifestyle intervention to be effective in reducing cardiovascular risk in a group of apparently healthy overweight workers.