Impact of Digital Health Methods for Weight Management on Atherosclerotic Cardiovascular Disease Risk in “at-risk” Women

The LEARN (Lifestyle-Exercise-Attitudes-Relationships-Nutrition) program is an established weight loss program that may have positive impact on atherosclerotic cardiovascular disease (ASCVD) risk, but can be limited in application due to requirement of weekly meetings. We examine the changes in lipid profiles and 10-year ASCVD risk score in a prospective study of a novel format of the LEARN program utilizing digital health (DH) tools compared to a traditional meeting format. Eighty-nine women (age: 55.5±9.3 years, BMI: 34.3±5.2 kg/m2) with ≥ 2 CVD risk factors were prospectively randomized to a 3-month duration LEARN program delivered either through a DH approach using internet-based podcasts with an online interactive message board and FitBit (San Francisco, CA) activity trackers (DH group), or traditional weekly meetings (Control group=C). Lipids (total cholesterol, LDL, HDL, triglycerides, NMR lipoprofile patterns) were analyzed at baseline and 3 months (LabCorp, Burlington, NC). Statistical analysis was performed (ANOVA and matched pairs). Fifty-eight women (DH=30, C=28) completed baseline and 3-month testing. At baseline there were no differences in hypertension (52%), fasting glucose impairment (29%), or smoking history (31%). However, DH women were younger than C (52 vs 59 years, p=0.007), and had lower 10-year ASCVD risk scores (6.2±5.1% vs 3.7±3.7, p=0.042). Upon LEARN program completion, mean weight loss (2.9±4.1 kg), was similar in both groups (p=0.773), and there was no change in SBP or ASCVD risk scores for either group. Lipid profile parameters showed favorable trends for both groups. A significant reduction was seen only for triglycerides in DH group (119±40 at baseline vs 98±26 at 3 months, p=0.0009). Similarly, NMR lipoprofile analysis showed a significant reduction in large VLDL particles for DH group (5.3±3.6 at baseline vs 3.4±2.2 at 3 months, p=0.0188). In women with ASCVD risk completing a 3 month LEARN program, Digital Health administration resulted in similar decreases in weight loss as traditional methods, but more favorable cardiometabolic results. This study demonstrates the feasibility and effectiveness of novel Digital Health methods for a weight loss program with immediate beneficial impact on weight loss and triglyceride levels.