Long-term effects of a preconception lifestyle intervention on cardiometabolic health of overweight and obese women

Vincent Wekker; Emilia Huvinen; Lotte Van Dammen; Kristiina Rono; Rebecca C. Painter; Aeilko H. Zwinderman; Cornelieke Van De Beek; Taisto Sarkola; Ben Willem J. Mol; Henk Groen; Annemieke Hoek; Saila B. Koivusalo; Tessa J. Roseboom; Johan G. Eriksson

doi:10.1093/eurpub/cky222

Long-term effects of a preconception lifestyle intervention on cardiometabolic health of overweight and obese women

Vincent Wekker^* (Corresponding Author), Emilia Huvinen, Lotte Van Dammen, Kristiina Rono, Rebecca C. Painter, Aeilko H. Zwinderman, Cornelieke Van De Beek, Taisto Sarkola, Ben Willem J. Mol, Henk Groen, Annemieke Hoek, Saila B. Koivusalo, Tessa J. Roseboom, Johan G. Eriksson

^*Corresponding author for this work

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Abstract

Background The global prevalence of obesity in women keeps increasing. The preconception period may be a window of opportunity to improve lifestyle, reduce obesity and improve cardiometabolic health. This study assessed the effect of a preconception lifestyle intervention on long-term cardiometabolic health in two randomized controlled trials (RCTs). Methods Participants of the LIFEstyle and RADIEL preconception lifestyle intervention studies with a baseline body mass index (BMI) ≥29 kg/m 2 were eligible for this follow-up study. Both studies randomized between a lifestyle intervention targeting physical activity, diet and behaviour modification or usual care. We assessed cardiometabolic health 6 years after randomization. Results In the LIFEstyle study (n = 111) and RADIEL study (n = 39), no statistically significant differences between the intervention and control groups were found for body composition, blood pressure, arterial stiffness, fasting glucose, homeostasis model assessment of insulin resistance, HbA1c, lipids and high sensitive C-reactive protein levels 6 years after randomization. Participants of the LIFEstyle study who successfully lost ≥5% bodyweight or reached a BMI <29 kg/m 2 during the intervention (n = 22, [44%]) had lower weight (-8.1 kg; 99% CI [-16.6 to -0.9]), BMI (-3.3 kg/m 2; [-6.5 to -0.8]), waist circumference (-8.2 cm; [-15.3 to -1.3]), fasting glucose (-0.5 mmol/L; [-1.1 to -0.0]), HbA1c (-4.1 mmol/mol; [-9.1 to -0.8]), and higher HDL-C (0.3 mmol/L; [0.1-0.5]) compared with controls. Conclusion We found no evidence of improved cardiometabolic health 6 years after a preconception lifestyle intervention among overweight and obese women in two RCTs. Women who successfully lost weight during the intervention had better cardiometabolic health 6 years later, emphasizing the potential of successful preconception lifestyle improvement.

Original language	English
Pages (from-to)	308-314
Number of pages	7
Journal	European Journal of Public Health
Volume	29
Issue number	2
Early online date	30 Oct 2018
DOIs	https://doi.org/10.1093/eurpub/cky222
Publication status	Published - 1 Apr 2019

Bibliographical note

The LIFEstyle study has been conducted with the support of a grant [50-50110-96-518] from the Netherlands Organization for Health Research and Development and the Dutch Heart Foundation grant [2013T085]. Ben Willem J Mol is supported by a NHMRC Practitioner Fellowship [GNT1082548]. The RADIEL study was funded by Ahokas Foundation, the Finnish Foundation for Cardiovascular Disease, Academy of Finland, Special state subsidy for health science research of Helsinki University Hospital (HUH), Samfundet Folkhälsan, Finska Läkaresällskapet, Juho Vainio Foundation, Viipuri Tuberculosis Foundation, The Finnish Diabetes Research Foundation, State Provincial Office of Southern Finland, Health Promotion Grant (Ministry of Social Affairs and Health) EU H2020-PHC-2014-DynaHealth [633595] and The Social Insurance Institution of Finland.

Data Availability Statement

Supplementary data are available at EURPUB online

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Wekker, V., Huvinen, E., Van Dammen, L., Rono, K., Painter, R. C., Zwinderman, A. H., Van De Beek, C., Sarkola, T., Mol, B. W. J., Groen, H., Hoek, A., Koivusalo, S. B., Roseboom, T. J., & Eriksson, J. G. (2019). Long-term effects of a preconception lifestyle intervention on cardiometabolic health of overweight and obese women. European Journal of Public Health, 29(2), 308-314. https://doi.org/10.1093/eurpub/cky222

Wekker, V, Huvinen, E, Van Dammen, L, Rono, K, Painter, RC, Zwinderman, AH, Van De Beek, C, Sarkola, T, Mol, BWJ, Groen, H, Hoek, A, Koivusalo, SB, Roseboom, TJ & Eriksson, JG 2019, 'Long-term effects of a preconception lifestyle intervention on cardiometabolic health of overweight and obese women', European Journal of Public Health, vol. 29, no. 2, pp. 308-314. https://doi.org/10.1093/eurpub/cky222

@article{100370ee1a884625b9c22223e013520e,

title = "Long-term effects of a preconception lifestyle intervention on cardiometabolic health of overweight and obese women",

abstract = "Background The global prevalence of obesity in women keeps increasing. The preconception period may be a window of opportunity to improve lifestyle, reduce obesity and improve cardiometabolic health. This study assessed the effect of a preconception lifestyle intervention on long-term cardiometabolic health in two randomized controlled trials (RCTs). Methods Participants of the LIFEstyle and RADIEL preconception lifestyle intervention studies with a baseline body mass index (BMI) ≥29 kg/m 2 were eligible for this follow-up study. Both studies randomized between a lifestyle intervention targeting physical activity, diet and behaviour modification or usual care. We assessed cardiometabolic health 6 years after randomization. Results In the LIFEstyle study (n = 111) and RADIEL study (n = 39), no statistically significant differences between the intervention and control groups were found for body composition, blood pressure, arterial stiffness, fasting glucose, homeostasis model assessment of insulin resistance, HbA1c, lipids and high sensitive C-reactive protein levels 6 years after randomization. Participants of the LIFEstyle study who successfully lost ≥5% bodyweight or reached a BMI <29 kg/m 2 during the intervention (n = 22, [44%]) had lower weight (-8.1 kg; 99% CI [-16.6 to -0.9]), BMI (-3.3 kg/m 2; [-6.5 to -0.8]), waist circumference (-8.2 cm; [-15.3 to -1.3]), fasting glucose (-0.5 mmol/L; [-1.1 to -0.0]), HbA1c (-4.1 mmol/mol; [-9.1 to -0.8]), and higher HDL-C (0.3 mmol/L; [0.1-0.5]) compared with controls. Conclusion We found no evidence of improved cardiometabolic health 6 years after a preconception lifestyle intervention among overweight and obese women in two RCTs. Women who successfully lost weight during the intervention had better cardiometabolic health 6 years later, emphasizing the potential of successful preconception lifestyle improvement.",

author = "Vincent Wekker and Emilia Huvinen and {Van Dammen}, Lotte and Kristiina Rono and Painter, {Rebecca C.} and Zwinderman, {Aeilko H.} and {Van De Beek}, Cornelieke and Taisto Sarkola and Mol, {Ben Willem J.} and Henk Groen and Annemieke Hoek and Koivusalo, {Saila B.} and Roseboom, {Tessa J.} and Eriksson, {Johan G.}",

note = "The LIFEstyle study has been conducted with the support of a grant [50-50110-96-518] from the Netherlands Organization for Health Research and Development and the Dutch Heart Foundation grant [2013T085]. Ben Willem J Mol is supported by a NHMRC Practitioner Fellowship [GNT1082548]. The RADIEL study was funded by Ahokas Foundation, the Finnish Foundation for Cardiovascular Disease, Academy of Finland, Special state subsidy for health science research of Helsinki University Hospital (HUH), Samfundet Folkh{\"a}lsan, Finska L{\"a}kares{\"a}llskapet, Juho Vainio Foundation, Viipuri Tuberculosis Foundation, The Finnish Diabetes Research Foundation, State Provincial Office of Southern Finland, Health Promotion Grant (Ministry of Social Affairs and Health) EU H2020-PHC-2014-DynaHealth [633595] and The Social Insurance Institution of Finland.",

year = "2019",

month = apr,

day = "1",

doi = "10.1093/eurpub/cky222",

language = "English",

volume = "29",

pages = "308--314",

journal = "European Journal of Public Health",

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number = "2",

}

TY - JOUR

T1 - Long-term effects of a preconception lifestyle intervention on cardiometabolic health of overweight and obese women

AU - Wekker, Vincent

AU - Huvinen, Emilia

AU - Van Dammen, Lotte

AU - Rono, Kristiina

AU - Painter, Rebecca C.

AU - Zwinderman, Aeilko H.

AU - Van De Beek, Cornelieke

AU - Sarkola, Taisto

AU - Mol, Ben Willem J.

AU - Groen, Henk

AU - Hoek, Annemieke

AU - Koivusalo, Saila B.

AU - Roseboom, Tessa J.

AU - Eriksson, Johan G.

N1 - The LIFEstyle study has been conducted with the support of a grant [50-50110-96-518] from the Netherlands Organization for Health Research and Development and the Dutch Heart Foundation grant [2013T085]. Ben Willem J Mol is supported by a NHMRC Practitioner Fellowship [GNT1082548]. The RADIEL study was funded by Ahokas Foundation, the Finnish Foundation for Cardiovascular Disease, Academy of Finland, Special state subsidy for health science research of Helsinki University Hospital (HUH), Samfundet Folkhälsan, Finska Läkaresällskapet, Juho Vainio Foundation, Viipuri Tuberculosis Foundation, The Finnish Diabetes Research Foundation, State Provincial Office of Southern Finland, Health Promotion Grant (Ministry of Social Affairs and Health) EU H2020-PHC-2014-DynaHealth [633595] and The Social Insurance Institution of Finland.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background The global prevalence of obesity in women keeps increasing. The preconception period may be a window of opportunity to improve lifestyle, reduce obesity and improve cardiometabolic health. This study assessed the effect of a preconception lifestyle intervention on long-term cardiometabolic health in two randomized controlled trials (RCTs). Methods Participants of the LIFEstyle and RADIEL preconception lifestyle intervention studies with a baseline body mass index (BMI) ≥29 kg/m 2 were eligible for this follow-up study. Both studies randomized between a lifestyle intervention targeting physical activity, diet and behaviour modification or usual care. We assessed cardiometabolic health 6 years after randomization. Results In the LIFEstyle study (n = 111) and RADIEL study (n = 39), no statistically significant differences between the intervention and control groups were found for body composition, blood pressure, arterial stiffness, fasting glucose, homeostasis model assessment of insulin resistance, HbA1c, lipids and high sensitive C-reactive protein levels 6 years after randomization. Participants of the LIFEstyle study who successfully lost ≥5% bodyweight or reached a BMI <29 kg/m 2 during the intervention (n = 22, [44%]) had lower weight (-8.1 kg; 99% CI [-16.6 to -0.9]), BMI (-3.3 kg/m 2; [-6.5 to -0.8]), waist circumference (-8.2 cm; [-15.3 to -1.3]), fasting glucose (-0.5 mmol/L; [-1.1 to -0.0]), HbA1c (-4.1 mmol/mol; [-9.1 to -0.8]), and higher HDL-C (0.3 mmol/L; [0.1-0.5]) compared with controls. Conclusion We found no evidence of improved cardiometabolic health 6 years after a preconception lifestyle intervention among overweight and obese women in two RCTs. Women who successfully lost weight during the intervention had better cardiometabolic health 6 years later, emphasizing the potential of successful preconception lifestyle improvement.

AB - Background The global prevalence of obesity in women keeps increasing. The preconception period may be a window of opportunity to improve lifestyle, reduce obesity and improve cardiometabolic health. This study assessed the effect of a preconception lifestyle intervention on long-term cardiometabolic health in two randomized controlled trials (RCTs). Methods Participants of the LIFEstyle and RADIEL preconception lifestyle intervention studies with a baseline body mass index (BMI) ≥29 kg/m 2 were eligible for this follow-up study. Both studies randomized between a lifestyle intervention targeting physical activity, diet and behaviour modification or usual care. We assessed cardiometabolic health 6 years after randomization. Results In the LIFEstyle study (n = 111) and RADIEL study (n = 39), no statistically significant differences between the intervention and control groups were found for body composition, blood pressure, arterial stiffness, fasting glucose, homeostasis model assessment of insulin resistance, HbA1c, lipids and high sensitive C-reactive protein levels 6 years after randomization. Participants of the LIFEstyle study who successfully lost ≥5% bodyweight or reached a BMI <29 kg/m 2 during the intervention (n = 22, [44%]) had lower weight (-8.1 kg; 99% CI [-16.6 to -0.9]), BMI (-3.3 kg/m 2; [-6.5 to -0.8]), waist circumference (-8.2 cm; [-15.3 to -1.3]), fasting glucose (-0.5 mmol/L; [-1.1 to -0.0]), HbA1c (-4.1 mmol/mol; [-9.1 to -0.8]), and higher HDL-C (0.3 mmol/L; [0.1-0.5]) compared with controls. Conclusion We found no evidence of improved cardiometabolic health 6 years after a preconception lifestyle intervention among overweight and obese women in two RCTs. Women who successfully lost weight during the intervention had better cardiometabolic health 6 years later, emphasizing the potential of successful preconception lifestyle improvement.

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EP - 314

JO - European Journal of Public Health

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Long-term effects of a preconception lifestyle intervention on cardiometabolic health of overweight and obese women

Abstract

Bibliographical note

Data Availability Statement

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