Effectiveness of a community-based individualized lifestyle intervention among older adults with diabetes and hypertension, Tianjin, China, 2008-2009.
BACKGROUND
Though diet and exercise modification is effective in preventing diabetes and hypertension, community-based models for lifestyle intervention for managing these conditions that are practical and effective are few.


METHODS
A community-based lifestyle intervention trial was conducted in 5 community clinics in Tianjin, China. Trained physicians used energy monitors and software as tools to provide eight individualized lifestyle consultation sessions (zhiji management) to 273 residents with mild hypertension (including prehypertension) or diabetes (including prediabetes). The recruitment was based on a waitlist control design. The early group (n = 175) received the 3-month intervention and the late group served as controls; afterward, the early group was followed up while the late group received the 3-month intervention. Selected characteristics between the 2 groups were compared by χ(2) tests, continuous variables paired t tests, and independent t tests.


RESULTS
Compared with baseline, the intervention significantly increased effective (3-6 metabolic equivalents and >6 minutes) physical activity by 54.6 kilocalories per day (P < .01) and decreased total dietary intake by 328.5 kilocalories per day (P < .01). The net differences between early group (intervention) and late group (control phase) were significant (P < .01) for weight, waist circumference, systolic and diastolic blood pressure, 2-hour postprandial glucose, and hemoglobin A1c.


CONCLUSIONS
This community-based lifestyle zhiji management program produced short-term beneficial changes in activity, diet, and clinical parameters in patients with mild diabetes or hypertension. Larger and longer trials are needed to fully evaluate the effectiveness and feasibility of this model.
Tianjin Health Insurance Research Association, Tianjin, China.
Ruijun
R
Yu
The George Institute for Global Health at Peking University Health Science Center, Beijing, China, and Northwestern University, Chicago, Illinois.
Lijing L
LL
Yan
Health Promotion Working Committee, National Center for Medical Education Development, Beijing, China.
Hanliang
H
Wang
The George Institute for Global Health at Peking University Health Science Center, Beijing, China.
Liang
L
Ke
Health Promotion Working Committee, National Center for Medical Education Development, Beijing, China.
Zhou
Z
Yang
The George Institute for Global Health at Peking University Health Science Center, Beijing, China.
Enying
E
Gong
The George Institute for Global Health at Peking University Health Science Center, Beijing, China.
Hui
H
Guo
Tianjin Health Insurance Research Association, Tianjin, China.
Jun
J
Liu
Department of Rehabilitation, The First Affiliated Hospital of Tianjin Chinese Traditional Medicine University, Tianjin, China.
Yuting
Y
Gu
The George Institute for Global Health at Peking University Health Science Center, Floor 18, Tower B, Horizon Tower, No. 6 Zhichun Road, Haidian, Beijing, 100088 China. E-mail: ywu@georgeinstitute.org.cn.
Yangfeng
Y
Wu
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D004038:Diet, Reducing; D002149:Energy Intake; D015444:Exercise / Q000502:physiology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000628:therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000517:prevention & control; D015397:Program Evaluation; D012959:Socioeconomic Factors; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology