Abstract and Introduction
Abstract
Context: The Pritikin Program, which provides intensive lifestyle therapy, has been shown to improve cardiometabolic outcomes when provided as a residential program.
Objective: The purpose of the present study was to conduct a short-term, randomized, controlled trial to evaluate the feasibility and clinical efficacy of treatment with the Pritikin Program in an outpatient worksite setting.
Methods: Cardiometabolic outcomes were evaluated in people with overweight/obesity and ≥2 metabolic abnormalities (high triglycerides, low high-density lipoprotein (HDL) cholesterol, high blood pressure, HbA1c > 5.7%), before and after they were randomized to 6 weeks of standard care (n = 26) or intensive lifestyle therapy, based on the Pritikin Program (n = 28). Participants in the lifestyle intervention group were provided all food as packed-out meals and participated in group nutrition, behavioral education, cooking classes, and exercise sessions 3 times per week at a worksite location.
Results: Compared with standard care, intensive lifestyle therapy decreased body weight (−5.0% vs −0.5%), HbA1c (−15.5% vs +2.3%), plasma total cholesterol (−9.8% vs +7.7%), low-density lipoprotein cholesterol (−10.3% vs +9.3%) and triglyceride (−21.7% vs +3.0%) concentrations, and systolic blood pressure (−7.0% vs 0%) (all P values < .02), and increased exercise tolerance (time to exhaustion walking on a treadmill by +23.7% vs +4.5%; P < .001).
Conclusion: This study demonstrates the feasibility and clinical effectiveness of short-term, intensive outpatient lifestyle therapy in people with overweight/obesity and increased risk of coronary heart disease when all food is provided and the intervention is conducted at a convenient worksite setting.
Introduction
Obesity is associated with a constellation of metabolic comorbidities, including hypertension, dyslipidemia, metabolic syndrome, and type 2 diabetes, which are major risk factors for coronary heart disease.[1–3] The cornerstone of therapy for people with obesity is lifestyle modification that involves decreasing energy intake and increasing physical activity to induce weight loss and improve metabolic health. The Pritikin Program is an intensive lifestyle intervention that combines diet therapy (comprising a diet that is low in fat, sodium, and refined carbohydrates, and high in whole grains, fruits, and vegetables) with multimodal exercise (comprising endurance, strength, and flexibility training).[4,5] An analysis of 4587 subjects who participated in the Pritikin Program for 3 weeks in a residential facility found this program decreased body weight and plasma total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride concentrations.[6] Providing this rigorous program in a residential setting enhances compliance because all meals are prepared and served on site and daily exercise is supervised, but decreases patient convenience and markedly increases program cost. We are not aware of any randomized controlled trials that evaluated the efficacy of the Pritikin Program provided in an outpatient setting on body weight and cardiometabolic outcomes.
The purpose of the present study was to conduct a short-term (6-week), randomized controlled trial to evaluate the feasibility and clinical efficacy of treatment with the Pritikin Program in an outpatient worksite setting in employees or their spouses who are overweight or obese with 2 or more components of the metabolic syndrome. To enhance compliance with the lifestyle intervention, group nutrition/behavioral educations sessions and supervised exercise sessions were provided 3 times per week and all food was provided as packed-out meals.
J Endo Soc. 2023;7(6) © 2023 Endocrine Society