A pilot comprehensive lifestyle intervention program (CLIP) – Comparison with qualitative lifestyle advice and simvastatin on cardiovascular risk factors in overweight hypercholesterolaemic individuals

Cleanthous, X.; Noakes, M.; Brinkworth, G.D.; Keogh, J.B.; Williams, G.; Clifton, P.M.

doi:10.1016/j.numecd.2009.09.002

« Previous Next »Nutrition, Metabolism & Cardiovascular Diseases
Volume 21, Issue 3 , Pages 165-172, March 2011

A pilot comprehensive lifestyle intervention program (CLIP) – Comparison with qualitative lifestyle advice and simvastatin on cardiovascular risk factors in overweight hypercholesterolaemic individuals

X. Cleanthous
- Heart Foundation, Level 12, 500 Collins Street, Melbourne, 3000 Victoria, Australia
- Corresponding author. Tel.: +61 (0) 3 9321 1516; fax: +61 (0) 3 9321 1574.
M. Noakes
- Commonwealth Scientific and Industrial Research Organisation – Human Nutrition, PO Box 10041 BC, Adelaide, South Australia 5000, Australia
G.D. Brinkworth
- Commonwealth Scientific and Industrial Research Organisation – Human Nutrition, PO Box 10041 BC, Adelaide, South Australia 5000, Australia
J.B. Keogh
- Commonwealth Scientific and Industrial Research Organisation – Human Nutrition, PO Box 10041 BC, Adelaide, South Australia 5000, Australia
G. Williams
- Commonwealth Scientific and Industrial Research Organisation – Human Nutrition, PO Box 10041 BC, Adelaide, South Australia 5000, Australia
P.M. Clifton
- Commonwealth Scientific and Industrial Research Organisation – Human Nutrition, PO Box 10041 BC, Adelaide, South Australia 5000, Australia

Received 9 April 2009; received in revised form 16 August 2009; accepted 1 September 2009. published online 28 January 2010.

Abstract

Background and Aims

Escalating costs of pharmaceuticals for cardiovascular management highlight the need to develop effective lifestyle intervention programs to reduce reliance on these agents. The aim of this pilot study was to evaluate the efficacy of a Comprehensive Lifestyle Intervention Program (CLIP) compared with qualitative lifestyle advice (L) and Simvastatin plus qualitative lifestyle (S+L) on cardiovascular risk factors.

Methods and Results

Sixty-five overweight adults with hypercholesterolemia were randomised to either L (qualitative advice on diet, exercise), S+L (20mg/day Simvastatin plus L) or CLIP (6500kJ structured menu plan: conventional and functional foods contributing <10% energy from saturated fat, ≥3g soluble fibre, 2.4g plant sterols, oily fish ≥2 times/week at lunch and dinner, plus exercise advice and self monitoring) for 6 weeks. LDL-cholesterol was lowered in CLIP (−0.57±0.67mmol/L, 15%) and S+L (−1.43±0.59mmol/L, 37%), but did not change significantly in L (−0.17±0.59, 4%) (P<0.001 time-by-treatment interaction). Weight and waist circumference were significantly lowered by CLIP (−4.2±2.2 kg; −5.1±2.3 cm) compared to L (−1.0±1.6 kg; −2.7±3.3 cm) and L+S (−0.7±1.4 kg; −2.4±2.3 cm), (P≤0.003 time-by-treatment interactions). B-carotene levels within treatment groups did not change over time and were not lowered by the CLIP diet compared to L (P>0.05, all). Blood pressure changes were not different between groups.

Conclusions

The structured CLIP program was more effective than qualitative lifestyle advice in improving weight, waist circumference and LDL-cholesterol without adverse effects on plasma carotenoids over a 6 week period. This program may therefore assist in comprehensive risk factor management, although the sustainability of these benefits needs confirmation.

Keywords: Weight loss, Lipids, Cardiovascular disease risk, Diet composition, Statin, Lifestyle program