Pilot Study on the Effects of a Whole-Food, Plant-Strong Diet on Cardiovascular Risk Factors in Veterans: Part 3

OBJECTIVES: The purpose of this study was to conduct a preliminary test of the effectiveness of two on-line nutrition programs to promote adoption of a whole-food, plant-strong diet (PSD), and reduce specific cardiovascular risk factors, and plaque inflammation in Veterans. METHODS: A 12 month prospective randomized trial design was used to pilot this comparison. Veterans with diabetes, hyperlipidemia, hypertension, or overweight/obesity, and an interest and desire to make a lifestyle change were recruited. Veterans were randomized 2:1 into treatment (Culinary Rx: CRx) and control (TeleMOVE! : TM) arms. Baseline anthropometrics, biochemistries, and dietary patterns were measured. Dietary patterns were collected using 3-day food records and the 4Leaf survey (developed specifically for estimating the percentage of calories from whole, plant-based foods). Measures were repeated at 3, 6 and 12 months. RESULTS: Data are reported as mean and standard deviation, unless otherwise stated. Ninety-two Veterans, 66 males and 26 females (77% Caucasian, 15% African American) were randomized; 49 completed the entire study. There was no significant difference in age (60 ± 13 vs. 64 ± 11, P = 0.168) or baseline values (e.g., BMI: 35 ± 5 vs 35 ± 4, P = 0.899; HbA1c: 6.3 ± 1.0 vs. 6.4 ± 1.0, P = 0.564) between Veterans enrolled in CRx vs. TM, respectively. More females were enrolled in the CRx vs. TM (34% vs. 8%, P = 0.01). Veterans enrolled in CRx lost an average of 3.5% of body weight compared to a 1.7% loss for those enrolled in TM (P = 0.014) over 1 year. Both groups reported a significant increase in the % calories ingested from whole plant foods over time (p < 0.0001), but this increase was greater in the CRx group (p = .0015). The baseline % consumption of whole plant foods was 10–19%. This changed to 40–59% in CRx and 20–39% in TM. LDL, HDL, triglycerides and HbA1c were similar at baseline in both groups, and did not change over time. CONCLUSIONS: The Culinary Rx program was more effective in promoting adoption of a whole-food, plant-strong diet and greater weight loss over 12 months in Veterans than the current VA standard of care on-line program, TeleMOVE! . Although there was no significant change in LDL, baseline levels were already low due to most Veterans’ receiving lipid lowering medications. FUNDING SOURCES: Rouxbe Online Cooking School.