Open Access Open Badges Research article

Comparative effectiveness of lifestyle interventions on cardiovascular risk factors among a Dutch overweight working population: A randomized controlled trial

Johanna C Dekkers123, Marieke F van Wier12, Geertje AM Ariëns123, Ingrid JM Hendriksen24, Nico P Pronk5, Tjabe Smid16 and Willem van Mechelen12*

Author Affiliations

1 EMGO+ Institute and Department of Public and Occupational Health, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands

2 Body@Work, Research Center Physical Activity, Work and Health, TNO-VUmc, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands

3 Municipal Health Service The Hague, PO Box 12652, 2500 DP, The Hague, The Netherlands

4 TNO Quality of Life, P.O. Box 2215, 2301 CE Leiden, The Netherlands

5 HealthPartners, JourneyWell, 8170 33rd Avenue South, Minneapolis, MN 55425, USA

6 KLM Strategic Human Resources, AMS/SH, PO Box 7700, 1117 ZL Schiphol, The Netherlands

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BMC Public Health 2011, 11:49  doi:10.1186/1471-2458-11-49

Published: 24 January 2011



Overweight (Body Mass Index [BMI] ≥ 25 kg/m2) and obesity (BMI≥ 30 kg/m2) are associated with increased cardiovascular risk, posing a considerable burden to public health. The main aim of this study was to investigate lifestyle intervention effects on cardiovascular risk factors in healthy overweight employees.


Participants were 276 healthy overweight employees (69.2% male; mean age 44.0 years [SD 9.2]; mean BMI 29.7 kg/m2 [SD 3.1]). They were randomized to one of two intervention groups receiving a six month lifestyle intervention with behavior counseling by phone (phone group) or e-mail (Internet group), or to a control group receiving usual care. Body weight, height, waist circumference, sum of skinfolds, blood pressure, total cholesterol level and predicted aerobic fitness were measured at baseline, at 6 and at 24 months. Regression analyses included the 141 participants with complete data.


At 6 months a significant favorable effect on total cholesterol level (-0.2 mmol/l, 95%CI -0.5 to -0.0) was observed in the phone group and a trend for improved aerobic fitness (1.9 ml/kg/min, 95%CI -0.2 to 3.9) in the Internet group. At two years, favorable trends for body weight (-2.1 kg, 95%CI -4.4 to 0.2) and aerobic fitness (2.3 ml/kg/min, 95%CI -0.2 to 4.8) were observed in the Internet group.


The intervention effects were independent of the used communication mode. However short-term results were in favor of the phone group and long-term results in favor of the internet group. Thus, we found limited evidence for our lifestyle intervention to be effective in reducing cardiovascular risk in a group of apparently healthy overweight workers.

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