title: The long-term effect of screening and lifestyle counseling on changes in physical activity and diet: the Inter99 Study - a randomized controlled trial.
abstract: BACKGROUND
  Multi-factorial intervention studies have been found to be successful in the initiation of lifestyle changes. However, little is known about the longer-term maintenance of health behavior improvements. The purpose of this study was to investigate whether improvements in physical activity and dietary habits achieved in a population-based multi-factorial lifestyle intervention of five years duration were maintained five years after intervention activities have ended.
  
  
  METHODS
  The study was a population-based randomized controlled trial, Inter99 (1999-2006), Copenhagen, Denmark. Over five years, all participants in the intervention group (n = 6,091) received individual lifestyle counseling; participants at high risk of ischemic heart disease - according to pre-specified criteria - were also offered group-based counseling. The control group (n = 3,324) was followed by questionnaires. Both groups were followed one, three, five, and ten years after baseline. Changes in physical activity and dietary habits (intake of vegetables, fruit, fish, and saturated fat) during and after the intervention were investigated using random-coefficient models.
  
  
  RESULTS
  Five years after the intervention, women in the intervention group reported greater improvements in the intake of fruit (M Δ = 90.2 g/week, p = 0.041) and less intake of saturated fat (OR = 0.30, 95% CI: 0.17-0.54) than the control group. Men in the intervention group reported greater improvements in physical activity (M Δ = 19.6 min/week, p = 0.003) and less intake of saturated fat (OR = 0.31, 95% CI: 0.17-0.56) than the control group. Improvements in the intake of vegetables and fish achieved during the intervention were not maintained in the longer-term.
  
  
  CONCLUSIONS
  Screening and lifestyle counseling had sustained effects on physical activity and dietary habits five years after its discontinuation. The patterns of long-term changes in lifestyle differed across behaviors and between men and women.
  
  
  BACKGROUND
  ClinicalTrials.gov ( NCT00289237 ).
authors.affiliation: University Medicine Greifswald, Institute of Social Medicine and Prevention, Walther-Rathenau-Str. 48, DE-17475, Greifswald, Germany. sophie.baumann@uni-greifswald.de.|Research Centre for Prevention and Health, Building 84/85, Glostrup Hospital, Ndr, Ringvej, DK-2600, Glostrup, Denmark. sophie.baumann@uni-greifswald.de.
authors.forename: Sophie
authors.initials: S
authors.lastname: Baumann
authors.affiliation: Research Centre for Prevention and Health, Building 84/85, Glostrup Hospital, Ndr, Ringvej, DK-2600, Glostrup, Denmark. ulla.toft@regionh.dk.
authors.forename: Ulla
authors.initials: U
authors.lastname: Toft
authors.affiliation: Research Centre for Prevention and Health, Building 84/85, Glostrup Hospital, Ndr, Ringvej, DK-2600, Glostrup, Denmark. mette.aadahl@regionh.dk.
authors.forename: Mette
authors.initials: M
authors.lastname: Aadahl
authors.affiliation: Research Centre for Prevention and Health, Building 84/85, Glostrup Hospital, Ndr, Ringvej, DK-2600, Glostrup, Denmark. torben.joergensen@regionh.dk.|Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. torben.joergensen@regionh.dk.|Faculty of Medicine, University of Aalborg, Aalborg, Denmark. torben.joergensen@regionh.dk.
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
authors.affiliation: Research Centre for Prevention and Health, Building 84/85, Glostrup Hospital, Ndr, Ringvej, DK-2600, Glostrup, Denmark. charlotta.pisinger@regionh.dk.|Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. charlotta.pisinger@regionh.dk.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Pisinger
mesh_terms: D000328:Adult; D003376:Counseling; D003718:Denmark; D004032:Diet / Q000592:standards; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D016017:Odds Ratio; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013995:Time