title: Seasonal variation of lipid-lowering effects of complex spa therapy.
abstract: OBJECTIVE
  It has been shown that spa therapy has a lipid-lowering effect. Also, seasonal variations in spa therapy effects have been found for some outcome measures. The aim of the present study is to investigate whether the lipid-lowering effects of spa therapy as a complex health intervention also are subject to seasonal variation.
  
  
  METHODS
  The effect of 3-week resident spa therapy at the Austrian spa Bad Tatzmannsdorf was studied in 395 patients with moderate musculoskeletal chronic pain over a time of 2 years. Spa therapy included balneotherapy, exercise therapy, and dietary measures. Total cholesterol (CHOL), HDL, LDL, triglycerides (TG), and the CHOL/HDL ratio were assessed at the beginning and end of therapy.
  
  
  RESULTS
  Spa therapy was associated with a decrease of CHOL, HDL, and LDL (p < 0.001). TG and CHOL/HDL did not change. The decrease of lipids was smaller for older patients, females, and normal weight individuals. CHOL decrease showed a seasonal variation independent of weight loss (p = 0.04), being largest in fall (-6.1%) and smallest in spring (-2.4%). CHOL and CHOL/HDL for obese individuals showed the greatest decrease in winter (-10% for CHOL, -9% for CHOL/HDL ratio), whereas corresponding measures increased for normal-weight subjects.
  
  
  CONCLUSIONS
  The lipid-lowering effect of spa therapy could be confirmed; it is partly moderated by season. The results suggest that the effect of some components of spa therapy such as exercise therapy, diet, and relaxation may be subject to seasonal variation.
authors.affiliation: Institut für Physiologie, Universität Wien, Vienna. gerhard.strauss@univie.ac.at
authors.forename: G
authors.initials: G
authors.lastname: Strauss-Blasche
authors.forename: C
authors.initials: C
authors.lastname: Ekmekcioglu
authors.forename: V
authors.initials: V
authors.lastname: Leibetseder
authors.forename: W
authors.initials: W
authors.lastname: Marktl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D001452:Balneology; D002908:Chronic Disease; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D012063:Relaxation; D012621:Seasons; D016896:Treatment Outcome
chemical_list: D008055:Lipids