Effect of a 15-Week Whole Foods, Plant-Based Diet, Physical Activity, and Stress Management Intervention on Cardiometabolic Risk Factors in a Population of US Veterans: A Retrospective Analysis

Themis A Yiaslas; Tara S Rogers-Soeder; Gregory Ono; Rachel E Kitazono; Ajay Sood

doi:10.1177/15598276241267932

Effect of a 15-Week Whole Foods, Plant-Based Diet, Physical Activity, and Stress Management Intervention on Cardiometabolic Risk Factors in a Population of US Veterans: A Retrospective Analysis

Am J Lifestyle Med. 2024 Aug 2:15598276241267932. doi: 10.1177/15598276241267932. Online ahead of print.

Authors

Themis A Yiaslas^{1

2

3}, Tara S Rogers-Soeder⁴, Gregory Ono⁵, Rachel E Kitazono⁶, Ajay Sood^{7

8}

Affiliations

¹ Behavioral Medicine Clinic, VA Northern California Health Care System, Mather, CA, USA (TAY).
² Division of Cardiovascular Medicine, Department of Internal Medicine, UC Davis School of Medicine, Sacramento, CA, USA (TAY).
³ Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Sacramento, CA, USA (TAY).
⁴ Nutrition and Food Service, VA Northern California Health Care System, Mather, CA, USA (TSRS).
⁵ Pharmacy Service, VA Northern California Health Care System, Mather, CA, USA (GO).
⁶ Behavioral Medicine Services, Kaiser Permanente South Sacramento Medical Center, Sacramento, CA, USA (REK).
⁷ Endocrine Section, Medical Service, VA Northern California Health Care System, Mather, CA, USA (AS).
⁸ Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of California, Davis Medical Center, Sacramento, CA, USA (AS).

Abstract

Military Veterans have a higher risk of incident atherosclerotic cardiovascular disease (ASCVD) than the general population and are often clinically complex. We studied the changes in cardiovascular risk factors with a lifestyle intervention in this population. We retrospectively analyzed data from 67 participants (mean age 69.2 (SD 7.9) years; 97% male) with atherosclerotic heart disease and/or type 2 diabetes in a 15-week, multiple health behavior change (MHBC) intervention implemented in a Veterans Affairs (VA) Behavioral Medicine Clinic. The intervention promoted a whole foods, plant-based (WFPB) diet, physical activity, and cognitive-behavioral stress management. We assessed cardiometabolic risk factors at baseline, 1 month into the intervention, and at 15 weeks (post-treatment). Among intervention completers (n = 67), we observed statistically significant improvements in waist circumference (-2.8 inches, P = .03), systolic blood pressure (-7.9 mmHg, P = .03), LDL cholesterol (-11.27 mg/dL, P = .04), fasting glucose (-15.10 mg/dL, P = .03), and hemoglobin A1c (-0.55%, P = .017) at post-treatment. Participants with type 2 diabetes (n = 34) achieved improvements in hemoglobin A1c (-0.80%, P = .007), systolic blood pressure (-10.98 mmHg, P = .01), and diastolic blood pressure (-6.65 mmHg, P = .03) at post-treatment. Medication usage did not significantly change. Veterans who completed the MHBC intervention achieved significant improvements in cardiometabolic risk in a routine VA clinical practice setting.

Keywords: cardiovascular risk reduction; lifestyle medicine; military veterans; multiple health behavior change intervention; plant-based diet.