Individual advice on lifestyle and three years of counselling by a nurse practitioner have a positive effect: people are able to stabilize their weight and their fasting blood sugar levels show improvement. This is a significant indication of improvement in their health. The Groningen Overweight and Lifestyle (GOAL) study is the first large-scale high-quality lifestyle intervention in this field in the Netherlands. Researcher Nancy ter Bogt from the University Medical Center Groningen (UMCG) carried out the study in association with the National Institute for Public Health and the Environment (RIVM). On 30 March 2011 she will be awarded a PhD by the University of Groningen for her research.
People taking part in the study carried were given a step counter and received a diary in which they were asked to keep a note of everything they ate and drank for three days and were given a tailor-made lifestyle advice. The nurse practitioner was guided by a software program based in which guidelines and techniques for changing behaviour were embedded. As most people have difficulty maintaining long-term changes in their lifestyle, counselling was offered for three years for the purposes of this study.
A total of 457 overweight people took part in the study. They had a body mass index (BMI) of between 25 and 40, high blood pressure and/or high cholesterol. Losing weight was not the primary aim of the study; the main aim was to prevent the participants from further weight gain. This is important in terms of reducing the risk of diabetes and cardiovascular disease.
In the long term, the participants counselled by the nurse practitioner showed more positive results than those receiving regular care from their GP. Although 60% of participants in both groups maintained their weight, the group that had regular meetings with the nurse practitioner showed better fasting blood sugar levels. This difference became evident after three years and indicates a positive long-term effect from the lifestyle advice.
The researchers claim that nurse practitioners can help people to take small steps to change their lifestyle in a way that works for them. The advice is designed to be fit in daily life for each individual. Participants were satisfied with the nurse practitioner. They also thought that they had learned a lot.
The lifestyle advice had little impact on people who already had attemps to lose weight before taking part in the study. The researchers conclude from this that this lifestyle intervention is not suitable for experienced dieters.
Nancy ter Bogt (Doetinchem, 1975) studied nutrition and health at Wageningen University. She conducted her research at the Department of General Practice at the UMCG. The research was funded by ZonMw and the Stichting Fonds de Gavere. Her thesis is entitled ‘Preventing weight gain in general practice. Lifestyle counselling by nurse practitioners compared with usual care by general practitioners’. Supervisor: K. van der Meer. Co-supervisors: W.J.E. Bemelmans, F.W. Beltman.
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