Fifteen-Month Lifestyle Intervention Program to Improve Cardiovascular Risk Factors in a Community Population in Japan

Morbidity and mortality associated with cardiovascular disease remain primary public health problems in Japan. We developed a large-scale community-based 15-month intervention program, and evaluated its long-term effects on improving lifestyle and cardiovascular risk. Of 549 participants, 436 (46 males and 186 females in intervention group and 72 males and 132 females in control group) completed the study. The intervention program consisted of a 6-month program including 15 sessions, with one lecture and individual counseling, two workshops and nutrition educations, and nine exercises (total 29 hours) and a 9-month maintenance program including 4 sessions of individual counseling, workshop, nutrition, and exercise (total 7 hours). Changes from the baseline to 15 months were significantly different between intervention and control groups by gender: the proportion of subjects who walked more than 6,000 steps/day (+39% vs. +2% for males; +17% vs. +1% for females), exercised more than 20 min/day and 3 times/week (+22% vs. +1% for males; +22% vs. +8% for females), ate vegetables at every meal (+18% vs. +4% for females), and consumed less salt (+9% vs. +3% for females); and the changes in body weight (-1.0 vs. -0.1 kg for males; -1.8 vs. -0.6 kg for females). Other changes detected only in females were body mass index (-0.8 vs. -0.3 kg/m(2)), systolic blood pressure (-6.6 vs. -2.4 mmHg), total cholesterol (-2.2 vs. +1.5 mg/dl), and the total risk scores (-0.5 vs. -0.1 points). The 15-month intervention program effectively improves and maintains lifestyle and cardiovascular risk, with greater effects of the long-term intervention in females.