Overlooked benefit of successful healthy lifestyle programs: Improved quality-of-life

In an analysis published in the August issue of the journal Quality of Life Research, the scientists showed that participation in a community-based behavioral lifestyle intervention program to improve health not only helped people lose weight, increase their physical activity levels, and reduce their risk of diabetes and heart disease, but also increased their health-related quality of life by an average of nearly 10 percent. The research was funded by the National Institutes of Health (NIH).

"These community-based lifestyle intervention programs have additional valuable benefits, beyond the improvement of risk factors for type 2 diabetes and heart disease," said lead author Yvonne L. Eaglehouse, Ph.D., a postdoctoral researcher at Pitt Public Health. "Our study demonstrates that these programs, delivered in diverse community settings such as senior centers and worksites, simultaneously and significantly improved the quality of life of the participants."

Dr. Eaglehouse and her colleagues investigated the impact of the Group Lifestyle Balance program, modified from the lifestyle intervention program used in the highly successful U.S. Diabetes Prevention Program (DPP). The DPP was a national study demonstrating that people at risk for diabetes who lost a modest amount of weight and increased their physical activity levels sharply reduced their chances of developing diabetes and metabolic syndrome and outperformed people who took a diabetes drug instead.

Group Lifestyle Balance is a 22-session program administered over a one-year period aimed at helping people make lifestyle changes to improve their risk for diabetes and heart disease. The goals of the program are to help participants reduce their weight by 7 percent and increase their moderate-intensity physical activity (such as brisk walking) to 150 minutes per week.

As part of the Pitt community intervention effort, a total of 223 participants were enrolled to test the effectiveness of the Group Lifestyle Balance program at a worksite and three community centers in the Pittsburgh area. The participants averaged 58 years of age and had pre-diabetes or metabolic syndrome or both.

Before beginning the program, each participant ranked his or her current health on a scale from 0 "worst imaginable health state" to 100 "best imaginable health state." The U.S. average is 79.2, whereas the participants averaged 71.5 at baseline.

After completing the year-long Group Lifestyle Balance program, the participants increased their average health-related quality-of-life score to 78.2. When looking at only those with baseline health-related quality of life below the U.S. average, there was an even greater magnitude of improvement, from 61.8 at baseline to 74 at the end of the program. Once scores were adjusted for meeting weight loss and physical activity goals, participants who met the program goals were found to have increased their health-related quality-of-life score by nine more points compared to those participants who met neither program goal.

"It is exciting that we were able to document an improvement in health-related quality of life in addition to improvement in risk factors for diabetes and cardiovascular disease," said senior author Andrea Kriska, Ph.D., professor in Pitt Public Health's Department of Epidemiology and principal investigator of the NIH study. "This important benefit was most evident in those who started the intervention program having a relatively lower quality of life--in other words, those who needed to improve the most."