title: A lifestyle intervention program for successfully addressing major cardiometabolic risks in persons with SCI: a three-subject case series.
abstract: BACKGROUND
  This study is a prospective case series analyzing the effects of a comprehensive lifestyle intervention program in three patients with chronic paraplegia having major risks for the cardiometabolic syndrome (CMS).
  
  
  METHODS
  Individuals underwent an intense 6-month program of circuit resistance exercise, nutrition using a Mediterranean diet and behavioral support, followed by a 6-month extension (maintenance) phase involving minimal support. The primary goal was a 7% reduction of body mass. Other outcomes analyzed insulin resistance using the HOMA-IR model, and plasma levels of fasting triglycerides and high-density lipoprotein cholesterol. All participants achieved the goal for 7% reduction of body mass and maintained the loss after the MP. Improvements were observed in 2/3 subjects for HOMA-IR and high-density lipoprotein cholesterol. All participants improved their risk for plasma triglycerides.
  
  
  CONCLUSIONS
  We conclude, in a three-person case series of persons with chronic paraplegia, a lifestyle intervention program involving circuit resistance training, a calorie-restrictive Mediterranean-style diet and behavioral support, results in clinically significant loss of body mass and effectively reduced component risks for CMS and diabetes. These results were for the most part maintained after a 6-month MP involving minimal supervision.
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Bigford
authors.affiliation: Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Armando J
authors.initials: AJ
authors.lastname: Mendez
authors.affiliation: Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, FL, USA.
authors.forename: Luisa
authors.initials: L
authors.lastname: Betancourt
authors.affiliation: Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, FL, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Burns-Drecq
authors.affiliation: The Crawford Research Institute, Shepherd Center Atlanta, GA, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Backus
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Mark S
authors.identifier: 0000-0003-4205-4130
authors.initials: MS
authors.lastname: Nash
keywords: Cardiovascular diseases; Risk factors