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The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the Multisite Cardiac Lifestyle Intervention Program

  • Original Articles
  • Published:
Annals of Behavioral Medicine

Abstract

Background: The relative contribution of health behaviors to coronary risk factors in multicomponent secondary coronary heart disease (CHD) prevention programs is largely unknown.Purpose: Our purpose is to evaluate the additive and interactive effects of 3-month changes in health behaviors (dietary fat intake, exercise, and stress management) on 3-month changes in coronary risk and psychosocial factors among 869 nonsmoking CHD patients (34% female) enrolled in the health insurance-based Multisite Cardiac Lifestyle Intervention Program.Methods: Analyses of variance for repeated measures were used to analyze health behaviors, coronary risk factors, and psychosocial factors at baseline and 3 months. Multiple regression analyses evaluated changes in dietary fat intake and hours per week of exercise and stress management as predictors of changes in coronary risk and psychosocial factors.Results: Significant overall improvement in coronary risk was observed. Reductions in dietary fat intake predicted reductions in weight, total cholesterol, low-density lipoprotein cholesterol, and interacted with increased exercise to predict reductions in perceived stress. Increases in exercise predicted improvements in total cholesterol and exercise capacity (for women). Increased stress management was related to reductions in weight, total cholesterol/high-density lipoprotein cholesterol (for men), triglycerides, hemoglobin A1c (in patients with diabetes), and hostility.Conclusions: Improvements in dietary fat intake, exercise, and stress management were individually, additively and interactively related to coronary risk and psychosocial factors, suggesting that multicomponent programs focusing on diet, exercise, and stress management may benefit patients with CHD.

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Author information

Author notes

  1. Michael D. Sumner Ph.D.

    Present address: Discrimination Research Center, USA

  2. Jennifer J. Daubenmier PH.D.

    Present address: Preventive Medicine Research Institute, 900 Bridgeway, 94965, Sausalito, CA

Authors and Affiliations

  1. Department of Applied Mathematics and Statistics, State University of New York, Stony Brook

    Nancy Mendell Ph.D.

  2. Preventive Medicine Research Institute, University of California, San Francisco

    Terri Merritt-Worden M.S.

  3. Highmark, Inc., USA

    Joli Studley M.S.

  4. Preventive Medicine Research Institute and Department of Medicine, University of California, San Francisco

    Dean Ornish M.D.

  5. Preventive Medicine Research Institute, 900 Bridgeway, 94965, Sausalito, CA

    Gerdi Weidner Ph.D. & Michael D. Sumner Ph.D.

Authors
  1. Jennifer J. Daubenmier PH.D.
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  2. Gerdi Weidner Ph.D.
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  7. Dean Ornish M.D.
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Corresponding author

Correspondence to Gerdi Weidner Ph.D..

Additional information

This study was supported in part by a grant from the Department of the Army (U.S. Army Medical Research Acquisition Activity W81XWH-06-2-0565) and the Department of Health and Human Services (Health Resources and Services Administration #4C76HF00803-01-01) and does not reflect the position or the policy of the government; Highmark, Inc.; Safeway, Inc.; and the PepsiCo Foundation.

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Daubenmier, J.J., Weidner, G., Sumner, M.D. et al. The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the Multisite Cardiac Lifestyle Intervention Program. ann. behav. med. 33, 57–68 (2007). https://doi.org/10.1207/s15324796abm3301_7

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