Lifestyle management is the cornerstone of both primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) and the importance of lifestyle management is emphasised by all major guidelines. Despite this, actual implementation of lifestyle management is poor. Lifestyle modification includes smoking cessation, weight loss, dietary change, increasing physical inactivity, and stress management. This review summarises evidence-based opportunities and challenges for healthcare professionals to promote healthy lifestyles at an individual level for the prevention of ASCVD.
Unhealthy lifestyle behaviours are common among vocational students and increase their risk of non-communicable diseases later in life. Unfortunately, only a limited number of school-based healthy lifestyle interventions have been developed for vocational students. Moreover, there is no evidence that these interventions are effective. They have often been developed by professionals without involving students and therefore may not align with the target group’s perceptions and needs. We used a participatory design approach to develop an intervention to promote healthy physical activity and dietary behaviours, in co-creation with vocational students. ‘Contextmapping’ was used to assess student conscious and subconscious motivation for a healthy lifestyle (n = 27, ages 17-26 years). All sessions and interviews were recorded and transcribed. The transcripts were analysed using framework analysis. Contextual characteristics that influenced student lives were their peers, family and short-term motives like earning money, being cool and looking good. In addition, they often had a passive attitude towards daily life, were unaware of their health illiteracy and being healthy was a goal for the distant future. These findings led to four design concepts that converged in a peer-led healthy lifestyle intervention that includes a social media campaign and activities to demonstrate and practice specific health behaviours among vocational students.
ObjectiveThe Plants for Joints (PFJ) intervention significantly improved pain, stiffness, and physical function, and metabolic outcomes, in people with metabolic syndrome-associated osteoarthritis (MSOA). This secondary analysis investigated its effects on body composition.MethodIn the randomized PFJ study, people with MSOA followed a 16-week intervention based on a whole-food plant-based diet, physical activity, and stress management, or usual care. For this secondary analysis, fat mass, muscle mass, and bone mineral density were measured using dual-energy X-ray absorptiometry (DEXA) for all participants. Additionally, in a subgroup (n = 32), hepatocellular lipid (HCL) content and composition of visceral adipose tissue (VAT) were measured using magnetic resonance spectroscopy (MRS). An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyse between-group differences.ResultsOf 66 people randomized, 64 (97%) completed the study. The PFJ group experienced significant weight loss (−5.2 kg; 95% CI –6.9, −3.6) compared to controls, primarily from fat mass reduction (−3.9 kg; 95% CI –5.3 to −2.5). No significant differences were found in lean mass, muscle strength, or bone mineral density between groups. In the subgroup who underwent MRI scans, the PFJ group had a greater reduction in HCL (−6.5%; 95% CI –9.9, 3.0) compared to controls, with no observed differences in VAT composition.ConclusionThe PFJ multidisciplinary intervention positively impacted clinical and metabolic outcomes, and appears to significantly reduce body fat, including liver fat, while preserving muscle mass and strength.
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