MA LONERGAN1,2, K MURALI1,2 , LC TAPSELL2, MJ BATTERHAM2, EP NEALE2, A MARTIN2, R THORNE2, F DEANE2, G PEOPLES2
1Illawarra Shoalhaven Local Health District; 2Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW.
Aim: The HealthTrack study was undertaken to determine the effectiveness of an intervention focused on the impact of interdisciplinary care, interdisciplinary care plus a healthy food supplement versus usual care in overweight and obese adult volunteers in Illawarra Shoalhaven.
Background: Obesity is a leading cause of morbidity and mortality. Many weight loss studies are only short term and do not provide 12 month follow up.
Methods: 377 were randomised into Control – (generalised guideline-based diet and exercise) (n=126), Intervention Group 1 with interdisciplinary protocol (n=125) or intervention Group 2 with interdisciplinary protocol and healthy food supplement (30 grams walnuts per day) (n=126). 298 completed the three month intensive phase and 178 the 12 months.
Participants were assessed at 0, 1, 2, 3, 6, 9 and 12 months.
The primary outcome was difference in weight between baseline and 12 months (clinically relevant target 5% loss). Secondary outcomes were systolic blood pressure, lipids, glucose, 24 hour urine sodium was measured at 0, 3 and 12 months.
Psychological assessments (Physical and Mental Health SF-12, Depression Anxiety Scale and Acceptance and Action Questionnaire for Weight-related problems were undertaken at 0,3 and 12 months.
Results: At 12 months, all groups had lost weight with 20% control, 38% Group1 and 33% Group 2 achieving 5% weight loss.
Systolic blood pressure decreased between baseline and 3 months, then remained unchanged. Urine sodium excretion also decreased from baseline to 3 months.
Conclusions: Multi-disciplinary care achieved more weight loss compared to usual care but walnut supplementation did not provide additional benefits. Maintaining weight loss is difficult. Changes in diet and physical activity are accompanied by increases in positive psychological parameters and decreases in negative.