title: Association of nutrition club membership with markers of health: a cross sectional study.
abstract: Nutrition clubs (NC) operate in community settings and provide members with nutrition education and meal replacements for weight management. NC are owned and operated by distributors of Herbalife products. There are over 6200 NC in the US, but there has been no independent assessment of the association of these NC with biomarkers of health.
  
  
  
  We conducted a cross-sectional pilot study to compare the health status of 100 NC members to 100 community-matched controls (CC) in the greater Boston area. Each CC was matched to a NC member for community of residence (zip code), age category, gender, BMI category, race/ethnicity, education level (category), and readiness to make health changes. Measures obtained included cardio-metabolic risk factors, body composition, markers of nutritional status, reported health status, dietary intake, physical activity, sleep and depression.
  
  
  
  Participants were predominantly female (64%) and Hispanic (73%). NC members had significantly lower fasting insulin (P < 0.001) and lower HbA1c (P = 0.008), higher levels of 25 hydroxy-vitamin D (P = 0.001), and vitamin E:cholesterol ratio (P < 0.001), and lower prevalence of metabolic syndrome (P = 0.02) compared to CC. In addition, most of the NC members (99%) were satisfied with Herbalife NC membership for themselves and their families. A higher percentage of NC members (86%) compared to CC (32%) reported being in much better or somewhat better health compared to a year ago (P < 0.001); and they reported significantly better physical health (P = 0.03), and fewer sleep problems (P = 0.03).
  
  
  
  Herbalife NC membership was positively associated with perceived health and measured cardiometabolic benefits. However, causality cannot be inferred from these findings.
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA. Sai.das@tufts.edu.|Gerald J., Dorothy R., Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. Sai.das@tufts.edu.
authors.forename: Sai Krupa
authors.identifier: 0000-0003-0788-0461
authors.initials: SK
authors.lastname: Das
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA.|Gerald J., Dorothy R., Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
authors.forename: Taylor A
authors.initials: TA
authors.lastname: Vail
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA.|Gerald J., Dorothy R., Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
authors.forename: Namibia
authors.initials: N
authors.lastname: Lebrón-Torres
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA.
authors.forename: Kara A
authors.initials: KA
authors.lastname: Livingston
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA.|Gerald J., Dorothy R., Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Roberts
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA.
authors.forename: Gail T
authors.initials: GT
authors.lastname: Rogers
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA.|Gerald J., Dorothy R., Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
authors.forename: Cheryl H
authors.initials: CH
authors.lastname: Gilhooly
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA.
authors.forename: Lorien E
authors.initials: LE
authors.lastname: Urban
authors.affiliation: Gerald J., Dorothy R., Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Saltzman
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA.|Gerald J., Dorothy R., Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
authors.forename: Nicola M
authors.initials: NM
authors.lastname: McKeown
authors.affiliation: Gerald J., Dorothy R., Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Folta
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers; D001823:Body Composition; D015992:Body Mass Index; D001900:Boston; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006304:Health Status; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010865:Pilot Projects; D012737:Sex Factors; D012890:Sleep; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids
keywords: Health promotion; Metabolic syndrome; Nutrition assessment; Obesity; Program evaluation