Impact of Adherence to a Plant-Based Residential Lifestyle Medicine Program on Cardiometabolic Disease Risk Factors

Abstract

Background: Residential lifestyle medicine programs have documented immediate and long-term improvements in cardiometabolic risk factors. Despite this, adherence among participants varies in such programs, limiting the positive outcomes that can be achieved. This study aimed to assess how adherence to positive lifestyle behaviors correlates with cardiometabolic risk factors at the end of a residential lifestyle medicine program and at three or more months of follow-up. Methods: Patients enrolled in a NEWSTART® lifestyle medicine program were invited to participate in this prospective chart review. Outcomes included changes in BMI, blood pressure, medication and supplement use, cardiometabolic disease biomarkers, Mediterranean eating pattern, meat intake, and other lifestyle behaviors. Results: Among 109 adults (78% female; 62% overweight or obese) enrolled in a 6- to 39-day (mean 14.5-day) residential intervention, meat intake reduced by 3.2 servings/week, MEPA III scores increased by 2.3, water intake increased by 2.1 glasses/day, and exercise increased by 193 min/week (all p < 0.01). From baseline to end of program, reductions were noted in blood glucose (−5.3 mg/dL, p = 0.01), total cholesterol (−16.0 mg/dL, p < 0.01), LDL cholesterol (−11.0 mg/dL, p < 0.01), HDL cholesterol (−2.0 mg/dL, p < 0.01), triglycerides (−13 mg/dL, p < 0.01), serum creatinine (−0.03 mg/dL, p = 0.049), systolic blood pressure (−6.0 mmHg, p < 0.01), diastolic blood pressure (−3.0 mmHg, p = 0.01), and weight (−3.2 kg, p < 0.01). At a mean of 8.6 months follow-up, reductions in triglycerides (14.9 mg/dL, p = 0.03) and weight (2.8 kg, p < 0.01) from baseline were sustained, and water intake increased 20% from baseline (1.1 glasses/day, p = 0.01). Improved adherence to a Mediterranean eating pattern score, increase in water intake and reductions in meat intake and BMI predicted favorable health outcomes. Conclusions: Participation in the lifestyle medicine program was associated with improvements in cardiometabolic risk factors during intervention and at follow-up. These outcomes correlated with adherence to positive lifestyle behaviors. Sustained weight reduction as well as dietary and cardiometabolic improvements in our participants suggest the NEWSTART® intervention may hold promise for maintaining cardiometabolic health.