Long-term cardio-metabolic effects of lifestyle intervention among obese Arab women: a 12-year follow-up of a randomized trial

Background: Information on the long-term effects of lifestyle interventions after withdrawal among ethnic minority groups is sparse. Objective: To study the long-term cardio-metabolic effects of a 12-month intensive versus moderate culturally congruent lifestyle intervention after program termination. Methods: This is a long-term follow-up of a randomized controlled trial conducted between 2006 and 2008 in a primary care setting. Obese, non-diabetic Arab women aged 35-54 years were included (n=201). Both interventions promoted a calorie-restricted diet and regular physical exercise. The intensive intervention consisted of two monthly physical activity sessions and two monthly meetings with a dietitian. The moderate intervention, designed to follow usual care, consisted of five sessions/year with a dietitian. The main outcome measures were cardio-metabolic risk factors, measured during the trial and after its termination. Results: during follow-up, but this effect diminished over time; hazard ratios (95% confidence intervals) for the intensive vs. moderate intervention were 4.11 (2.17, 7.76) at the intervention end; 2.42 (1.47, 4.01) after 3 years, and 1.43 (0.81, 2.53) after 5 years. Among women with impaired fasting plasma glucose levels at baseline, the intensive intervention was associated with a more favorable glucose trajectory during follow-up. Nevertheless, the lifestyle intervention had no long-term effect on glucose levels among women with normal fasting glucose at baseline. No long-term effects were observed regarding blood pressure, plasma lipid levels, or the incidence of type 2 diabetes. Conclusion: diminished over time. It was also associated with an improvement in plasma glucose levels, observed only in women with impaired fasting glucose at baseline. The intervention did not produce sustained long-term improvements in other cardio-metabolic risk factors.