Changes in Emerging Cardiac Biomarkers After an Intensive Lifestyle Intervention

The present study evaluated the changes in emerging cardiac biomarkers, cognitive function, and social support measures after a comprehensive lifestyle intervention that included a low-fat, whole-foods, plant-based diet, exercise, stress management, and group support meetings. We conducted a prospective cohort study of 131 participants (59.2% women and 43.1% with diabetes mellitus), 56 with coronary heart disease (CHD) (37.5% women and 27.3% diabetes mellitus), and 75 at high risk with >= 3 CHD risk factors and/or diabetes mellitus (76% women and 54.7% diabetes mellitus). The measurements were taken at baseline and 3 months after the intervention. Improvement in all targeted health behaviors was seen in both high-risk and CHD groups (all p <0.001) at 3 months, with reductions in body mass index, systolic and diastolic blood pressure, waist/hip ratio, C-reactive protein, insulin, low-density lipoprotein, high-density and total cholesterol, apolipoproteins A1 and B (all p <0.009) were observed. Nuclear magnetic resonance spectroscopy analysis of lipoprotein subclass particle concentrations and diameters showed a reduction in large very-low-density lipoprotein particles, size of the very-low-density lipoprotein particles, total low-density lipoprotein particles; total, large, and small high-density lipoprotein particles (all p <0.009) and small very-low-density lipoprotein particles (p <0.02). Increases in fibrinogen (p <0.03) and B-type natriuretic peptide (p <0.001) were seen, and these changes correlated inversely with the changes in the body mass index. The observed increase in B-type natriuretic peptide can be explained by the metabolic changes related to adipose tissue lipolysis. The quality of life, cognitive functioning, and social support measures significantly improved. In conclusion, lifestyle changes can be followed by favorable changes in traditional and emerging coronary heart disease biomarkers, quality of life, social support, and cognitive function among those with, or at high risk, of CHD. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:498-507)