Program led by health coaches at primary care clinics helped reduce heart risk

February 09, 2021

DALLAS, Feb. 9, 2021 -- Participants in a two-year, lifestyle intervention/weight-loss program provided through health coaches at their primary care center were able to lower their blood sugar and improve their cholesterol levels, according to new research published today in the American Heart Association's flagship journal Circulation Journal. Researchers with the PROmoting Successful Weight Loss in Primary CarE in Louisiana (PROPEL) Trial reported previously that participants also reduced body weight by an average of 5% and note that patients who lost more weight experienced greater improvements in their heart disease risk factors.

"Our results demonstrate lifestyle intervention and weight-loss programs can be successful for people in underserved, low-income communities if you bring the program to where they are, removing barriers to participation," said PROPEL principal investigator Peter T. Katzmarzyk, Ph.D., FAHA, a professor and the Marie Edana Corcoran Endowed Chair in Pediatric Obesity and Diabetes and associate executive director for population health sciences at the Pennington Biomedical Research Center of Louisiana State University in Baton Rouge, Louisiana.

Obesity is associated with numerous serious chronic health risks, including heart attacks and strokes. Between 2017 and 2018, researchers estimated the prevalence of obesity among adults in the United States was more than 40%. Food insecurity and lower levels of education and income increase the risk of obesity and its complications. Intensive lifestyle interventions are an effective treatment for obesity, however, access to these programs is often limited, particularly in low-income communities. The PROPEL trial examines the effectiveness of these actions when incorporated into primary care medical clinics.

The PROPEL Trial was conducted between 2016 and 2019 at 18 clinics across Louisiana that serve low-income patients. Clinics were randomly allocated to either usual care or a program, enrolling more than 800 participants who were between ages 20 and 75 years old and with obesity, which is defined as body mass index (BMI) ?30 kg/m2.

The usual care group received normal primary care and printed newsletters about healthy lifestyle habits. Those in the study group received 24 months of a high-intensity, lifestyle-based intervention/weight-loss program delivered by health coaches in the clinic. The program consisted of weekly sessions for the first six months and monthly sessions for the following 18 months. National guidelines set in the 2013 American Heart Association, American College of Cardiology and Task Force for the Management of Overweight and Obesity in Adults served as the basis for the PROPEL program.

Findings include: The researchers suggest the collaborative care approach of the PROPEL model likely offers more successful obesity treatment than the existing Centers for Medicare and Medicaid Services model, which relies solely on the primary care practitioner.

"A broader implementation of the PROPEL model could better allow people in under-resourced communities to receive effective treatment and, thus, help to reduce the prevalence of obesity and related health conditions and risks," said Katzmarzyk.

Because the PROPEL trial included a significant proportion of Black participants, the majority of whom were female, the authors suggest more research is needed to specifically address this issue among men including Black men. Additionally, they believe more study is needed on the dissemination and implementation of lifestyle intervention programs in other types of clinic settings.
-end-
Co-authors are Christoph Höchsmann, Ph.D.; James L. Dorling, Ph.D.; Corby K. Martin; Ph.D.; Robert L. Newton, Jr., Ph.D.; John W. Apolzan, Ph.D.; Candice A. Myers, Ph.D.; Kara D. Denstel, M.P.H.; Emily F. Mire, M.S.; William D. Johnson, Ph.D.; Dachuan Zhang, M.App.Stat.; Connie L. Arnold, Ph.D.; Terry C. Davis, Ph.D.; Vivian Fonseca, M.D.; Carl J. Lavie, M.D.; and Eboni G. Price-Haywood, M.D. The authors' disclosures are listed in the manuscript.

The research was funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Award. Additional support was provided by the National Institute of General Medical Sciences of the National Institutes of Health.

Additional Resources:

Available multimedia is on right column of release link
https://newsroom.heart.org/news/program-led-by-health-coaches-at-primary-care-clinics-helped-reduce-heart-risk?preview=f3acb7d0e4a1b5fa14c984fa928c214c
After 4 a.m. CT/5 a.m. ET Tuesday, Feb. 9, 2021, view the manuscript online.

Why lose weight?
Healthy living resources
Environment, culture, other social determinants play big role in heart health

Follow AHA/ASA news on Twitter @HeartNews
Follow news from the AHA's flagship journal Circulation @CircAHA

Statements and conclusions of studies published in the American Heart Association's scientific journals are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association's overall financial information is available here.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Obesity Articles from Brightsurf:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.

Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.

New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191707.

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.

Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.

Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?

Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.

Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.

Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.

Read More: Obesity News and Obesity Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.