title: Cardiometabolic risk factor response to a lifestyle intervention: a randomized trial.
abstract: BACKGROUND
  Strategies to increase adherence to national dietary and physical activity (PA) guidelines to improve the health in regions such as the Lower Mississippi Delta (LMD) of the United States are needed. Here we explore the cardiometabolic responses to an education and behavior change intervention among overweight and obese adults that adapted the 2010 Dietary Guidelines (DG), with and without a PA component.
  
  
  METHODS
  White and African American overweight and obese adults were randomized to a DG group (n=61) or a DG+PA group (n=60). Both groups received a 12-week dietary education and behavior change intervention, and the DG+PA group also received a PA education and behavior change intervention with a pedometer. Changes in individual risk factors (blood pressure, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol) and a continuous cardiometabolic risk score were determined. General linear models compared mean changes between groups, adjusting for covariates.
  
  
  RESULTS
  No main effect of intervention group was found in completers (n=99) and those who engaged with ≥80% of the intervention (n=83) for individual risk factors or the continuous risk score. Pooling both groups, those with higher baseline risk factor values realized greater improvements in individual risk factors.
  
  
  CONCLUSIONS
  Adapting DG did not produce any cardiometabolic benefits, even with a PA component. Although the sample was ostensibly healthy, they were all overweight to mildly obese (body mass index of 25-34.9 kg/m(2)) and participants with higher baseline risk factor values showed more improvements. Adherence to longer-term behavior change may elicit changes in risk profile, so this should be explored.
authors.affiliation: 1 Diabetes Research Centre, University of Leicester , Leicester, United Kingdom .
authors.forename: Deirdre M
authors.initials: DM
authors.lastname: Harrington
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Champagne
authors.forename: Stephanie T
authors.initials: ST
authors.lastname: Broyles
authors.forename: William D
authors.initials: WD
authors.lastname: Johnson
authors.forename: Catrine
authors.initials: C
authors.lastname: Tudor-Locke
authors.forename: Peter T
authors.initials: PT
authors.lastname: Katzmarzyk
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D004032:Diet; D004038:Diet, Reducing; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D008922:Mississippi; D009043:Motor Activity; D009765:Obesity / Q000628:therapy; D050177:Overweight / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D008076:Cholesterol, HDL