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Accepted for/Published in: JMIR Cardio

Date Submitted: Dec 23, 2021
Date Accepted: Mar 5, 2022

The final, peer-reviewed published version of this preprint can be found here:

Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort

Castela Forte J, Gannamani R, Folkertsma P, Kumaraswamy S, Mount S, van Dam S, Hoogsteen J

Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort

JMIR Cardio 2022;6(1):e34946

DOI: 10.2196/34946

PMID: 35319473

PMCID: 8987960

Changes in blood lipid levels after a digitally-enabled, cardiometabolic preventive health program: a pre-post study in an adult, Dutch general population cohort

  • José Castela Forte; 
  • Rahul Gannamani; 
  • Pytrik Folkertsma; 
  • Sridhar Kumaraswamy; 
  • Sarah Mount; 
  • Sipko van Dam; 
  • Jan Hoogsteen

ABSTRACT

Background:

Despite widespread education, many individuals fail to follow basic health behaviours such as consuming a healthy diet, exercising, and managing stress. Positive changes in lifestyle habits are associated with improvements in multiple cardiometabolic health risk factors, including lipid levels. Digital lifestyle interventions have been suggested as a viable complement or potential alternative to conventional health behaviour change strategies. However, the benefit of digital, preventive interventions on lipid levels in a preventive health context remains unclear.

Objective:

The aim of this observational study was to determine how lipid levels, namely total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-HDL cholesterol, and triglycerides, changed over time in a general Dutch population cohort undergoing a digital, preventive health program. In addition, we looked to establish associations between lifestyle factors at baseline and lipid levels.

Methods:

We included 348 adults from the general Dutch population who underwent a digitally-enabled, preventive health program at Ancora Health between January 2020 and October 2021. Upon enrolment to the program, participants underwent a baseline assessment, where a comprehensive lifestyle questionnaire, a blood biochemistry panel, physical measurements, and cardiopulmonary fitness were measured. Thereafter, users could access the digital application to register and track health behaviours, weight and anthropometrics data at any time during the subsequent intervention. Lipids levels were categorised as normal, elevated, high, and clinical according to accepted international standards. If at least one lipid marker was high or HDL was low, participants received specific coaching and advice for cardiometabolic health. We retrospectively analysed the mean and percent changes in lipid markers in users who were remeasured after a cardiometabolic health focused intervention, and studied the association between baseline user lifestyle characteristics and having normal lipid levels.

Results:

In our cohort, 199 participants (57.2%) had dyslipidemia at baseline, of which 104 participants were advised to follow a cardiometabolic focused intervention due to having at least one relevantly abnormal lipid marker. Eating more of favourable food groups and being more active was associated with normal lipid profiles. Of the participants who got remeasured, 56.7%, 61.3%, 55.6%, 81.8% and 100% showed improvement at remeasurement for total, LDL, HDL, and non-HDL cholesterol, and triglycerides, respectively. In addition, between 35.3% and 77.8% returned to normal levels. In those with high lipids at baseline, total cholesterol decreased by 0.5 mmol/L (7.5%), LDL decreased by 0.39 mmol/L (10%), non-HDL cholesterol decreased by 0.44 mmol/L (8.3%), triglycerides decreased by 0.97 mmol/L (32%), and HDL increased by 0.17 mmol/L (15.6%), after a cardiometabolic-focused intervention.

Conclusions:

A cardiometabolic screening program in a general population cohort identified a significant portion of individuals with sub-clinical and clinical lipid levels. Individuals who, after screening, participated in a cardiometabolic-focused lifestyle program improved their lipid levels over time.


 Citation

Please cite as:

Castela Forte J, Gannamani R, Folkertsma P, Kumaraswamy S, Mount S, van Dam S, Hoogsteen J

Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort

JMIR Cardio 2022;6(1):e34946

DOI: 10.2196/34946

PMID: 35319473

PMCID: 8987960

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