People really can commit to diet and lifestyle
changes for the long haul, and the benefit shows
up in their blood pressure, researchers reported.
In a study of 810 adults with elevated blood pressure,
investigators found that those who were given a
lifestyle overhaul were generally able to stick
with the plan for the 18 months they were followed.
Moreover, their risk of having full-blown high
blood pressure was about one-fifth lower than that
of study participants who received only advice on
lifestyle changes.
The findings, published in the Annals of Internal
Medicine, show that people can change their behavior
for the long term, according to study co-author
Dr. William Vollmer, of Kaiser Permanente Northwest
in Portland, Oregon.
"That's the bottom line," he stated. "People were
able to maintain multiple lifestyle modifications."
Those modifications were slightly different depending
on which group study volunteers were in. One group
was given goals of exercising for at least 3 hours
per week, cutting sodium and alcohol intake, and,
if overweight, shedding 15 pounds.
A second group had all of those goals, plus instructions
to follow the National Heart, Lung and Blood Institute's
DASH diet, which calls for boosting fruit, vegetable
and low-fat dairy intake, while cutting down on
saturated fat.
Both groups attended regular counseling sessions
to help them work these lifestyle changes into their
daily routine.
A third group received only advice on diet, exercise
and weight loss.
After 18 months, men and women in both counseling
groups were eating less fat and sodium, and had
shed some pounds; one-quarter had met the goal of
losing 15 pounds. Those in the more intensive DASH
diet group had also increased their fruit, vegetable
and low-fat dairy intake.
These changes, the researchers found, were reflected
in their blood pressure. At the outset, all of the
study volunteers were either on the verge of high
blood pressure or in the earliest stage of the condition,
and nearly all were overweight.
After 18 months, rates of full-blown high blood
pressure were lower in all three groups, but lowest
in the DASH group -- where it fell from 38 percent
to 22 percent.
In the other counseling group, the hypertension
rate slid from 36 percent to 24 percent.
"This is very encouraging news," said Vollmer,
noting that there had been some concern that having
people make multiple diet and exercise changes at
the same time might "overwhelm" them.
In real life, he acknowledged, few people would
have the support of group and individual counseling,
as his study volunteers did. In fact, Vollmer said,
the advice-only group, where participants had two
30-minute discussions with a health educator, got
more support than would the average American battling
excess pounds and elevated blood pressure.
But, Vollmer added, any kind of support can help
a person stick to lifestyle changes, even if it's
simply a friend who will take a regular walk with
you.
"People love to have social support," he said.
SOURCE: Annals of Internal Medicine, April 4,
2006.