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The morbidity and mortality of the cardiovascular diseases is high in the developed countries. The lifestyle changes are capable to decrease it by 50%. The aim of the present study was to measure the parameters of some risk factors before and after a one-week NEW START rehabilitative retreat. 1,349 volunteers, 320 men, 1,029 woman, mean age 51±14.5 (SD) years participated in 30 rehabilitative retreats from 1999–2006 in the Czech Republic, using a low-fat, low-energy, lacto-ovo-vegetarian diet and exercise, in a stress-free environment. Body weight, height, BMI, blood pressure, heart rate, serum cholesterol and blood glucose were measured. Body weight decreased in 1,223 measured persons from 71.2±14.38 (SD) to 70.6±14.02 kg (p<0.0001), BMI (1,046 measured persons) from 25.1±4.60 (SD) to 24.8±4.49 (SD) kg/m2 (p<0.0001), systolic blood pressure (1,218 persons) from 129.8±23.02 (SD) to 123.8±21.52 (SD) mmHg (p<0.0001), diastolic blood pressure (1,210 persons) from 79.8±12.7 (SD) to 77.5±11.6 (SD) mmHg (p<0.0001), serum cholesterol (998 persons) from 4.86±0.95 (SD) to 4.32±0.77 (SD) mmol (p<0.0001), blood glucose (544 persons) from 4.31±1.59 (SD) to 3.88±1.33 (SD) mmol (p<0.0001). Heart rate was not significantly decreased. The parameters were lower in lacto-ovo vegetarians and Seventh-day Adventists than in controls who never observed the diet and avail the lifestyle programs. The parameters were nonsignificantly changed one year after finishing the retreat in the sample of 68 persons showing the positive effect of retreats. Our results showed, that the intake of a low-fat, low-energy diet, over the course of one week in a stress-free environment, had positive impact on the risk factors of cardiovascular diseases.
Some studies have shown that the application of lifestyle changes without pharmacotherapy may decrease the risk factors for cardiovascular diseases (1–8). Our previous studies have proven that the 10 day rehabilitative retreats, combined with the consumption of low-energy, low-fat diet, a stress-free environment and a small amount of physical training (the Loma Linda University lifestyle NEW START), may significantly decrease serum cholesterol, blood glucose, and blood pressure in 50-year-old volunteers of the Czech population (9, 10).
The study group consisted of 1,349 volunteers, mean age 51.5±14.7 (SD) years comprising 320 men, 51.4±15.1 (SD) years, and 1,029 women, 51.5±14.5 (SD) years, who participated in one of 30 one-week SDA-NEW START retreats in the Czech Republic from 1999–2006. The volunteers were informed about the retreats during the “Days of Health”, organized by Country Life International, when tents are erected in public areas in several towns throughout the Czech Republic to promote healthy lifestyles and offer the preventive examinations for the risk factors of civilization diseases. In this way a large number of the population was addressed. In addition, the programme was advertised to visitors of vegetarian restaurants and in the shops of Country Life International. The participants of the retreats were either vegetarians and Adventists, or controls (Table 1). The Czech Republic Seventh-day Adventists are the members of the Seventh-day Advent Church of more than 5 years using the Loma Linda University (California), NEW START lifestyle. The vegetarians are the Czech lacto-ovo-vegetarians practicing it for more than 5 years and participating on the retreats. The control group comprised persons who never practised the diet or the lifestyle programmes. The cardiovascular disease risk factor parameters during 30 one-week lasting NEW START retreats in 1999–2006 were compared in all participants including controls, vegetarians and Adventists, men and women.
The retreats took place at higher quality hotels in the Czech and Moravian mountains, 600–800 meters above sea level, in the spring, summer and autumn (60 volunteers per retreat). A typical day's schedule: 07:00 wake; 07:20–07:45 morning exercise near hotel; 07:45–08:30 breakfast; 08:30–09:15 lifestyle study; 09:15–11:00 group activities: physiotherapy, balneotherapy, medical consultation, nature walk; 11:00–13:00 practical education in nutrition, exercise program; 13:00–13:30 lunch; 13:30–14:15 rest; 14:15–16:30 walk; 16:30–18:00 group activities (similar to morning). 18:00–18:30 dinner; 19:00–21:00 lectures about lifestyle, cultural programmes, discussions etc.; 21:00 rest. The participants paid 4,000,- Kč for the programme (200–250 USD, 130 €).
There are about ten thousand members of the Seventh-day Adventist Church in the Czech Republic. Their NEW START lifestyle has been practiced in the population since the end of the 19th century.
The „NEW START“ Lifestyle is an acronym for:
Daily energy intake of SDA – NEW START lifestyle – vegetarian diet (15): 2073±600 kcal (8500kJ), fat (g) 70.1±35, carbohydrates (g) 300±102, proteins (g) 80±30, fiber (g) 26.9±3.3, saturated fatty acids (g) 23.5±11.5, unsaturated fatty acids (g) 24.4±13.4, ratio unsatur./satur. FA 1.09±0.4, cholesterol (mg) 0–80, calcium (mg) 993±408, iron (mg) 16±5, vitamin A (μg) 1794±370, vitamin C (mg) 182±10, thiamin (mg) 2±1.2, riboflavin (mg) 2±0.7, niacin (mg) 17.6±6.2, vitamin B6 (mg) 2±0.8. The diet was determined from recipes. The meals were supplied to participants.
The volunteers were informed about conditions on the retreat and their consent was acquired. Screening examinations were made at the beginning and near the end of the stay. The questionnaire was completed, then body weight, BMI, blood pressure, heart rate, serum cholesterol and blood glucose were measured. The data protocol was maintained for every person in the retreat. In some persons subcutaneous fat was measured by the bioimpedance method (Omron), and the percentage of body weight and the weight of fat in kilograms was recorded. Blood sugar and serum cholesterol were measured by Accutrend GC (Roche, Boehringer Mannheim) test strips. In some persons with high serum cholesterol levels, routine biochemical laboratory methods vere used to evaluate the lipid spectrum.
The measurement of risk factors was not obligatory, but voluntary. This is the reason why many variables were not recorded in all subjects.
In Table 2 there is a comparison of some risk factors in Seventh-day Adventists (SDA) and in controls who took part in the retreats for the first time and who never used the diet and the lifestyle programmes. In Table 3, the same risk factors are compared in vegetarians and in controls who participated in the NEW START retreats in 2001–2003.
Similar results have been obtained in comparison of lacto-ovo-vegetarians and controls, i.e. the decrease in 7 cardiovascular risk factors parameters in lacto-ovo-vegetarians when compared with controls (p>0.01).
Table 4 shows a decrease in some cardiovascular disease risk factor parameters in both men and women of the Czech population, measured at the beginning and at the end of 30 one-week NEW START retreats in 1999–2006. The results showed that 6 measured cardiovascular disease risk factor parameters decreased during 30 one-week NEW START retreats in all participating persons (p<0.000l).
The efficiency of retreats was determined in 68 persons repeatedly visiting the retreats (Table 5) by measuring the investigated parameters after one year. The parameters were nonsignificantly increased after one year except of the systolic blood pressure (increased significantly, p<0.001) thus documenting positive effect of the retreat.
The presented results confirmed more favourable values for risk factors of cardiovascular diseases in lacto-ovo-vegetarians (1, 4) and in SDAs (12, 13) of the Czech population. The SDAs and lacto-ovo-vegetarians were selected from the retreats group in 2001–2003. The ability of a one-week retreat [a relatively short stay in comparison with the literature (16)] to decrease the parameters is due to the vegetarian diet and other conditions of the NEW START lifestyle, i.e., no stress, light physical training, abstinence from smoking, alcohol, coffee and spicy meals. Some parameters such as BMI and serum cholesterol were lower in our participants (Table 4) than in Czech participants of the MONICA study (17), 2000–2001 (1,012 men, BMI 28.1±4.4 kg/m2, serum cholesterol 5.88±1.08 mmol/l, 1,066 women, BMI 27.3±5.7 kg/m2, serum cholesterol 5.82±1.13 mmol/l) (17) due to the consumption of a low-energy diet and the presence of SDAs and lacto-ovo-vegetarians in our group. However the systolic and diastolic blood pressure in the MONICA study did not differ from our present results. In SDAs and vegetarians, the risk factor parameters for cardiovascular diseases were low before the retreat.
Some persons visited the retreats repeatedly. In 68 persons the cardiovascular diseases risk factors were measured one year after the end of the previous retreat and compared with the previous ones to determine the effectivness of the retreat (Table 5). The mean number of visits in these 68 persons was 2. Comparing Table 5 and Table 4, the returnees were in general in better health than the average at the end of the programme. We did not measure the parameters in all participants one year after finishing the retreat, however, the parameters in 68 persons (Table 5) increased insignificantly after one year except for significant increase of the systolic blood pressure (p<0.001). We have no explanation why this parameter should have been particularly affected by repeated participation in the retreat, but the number of persons repeatedly present there is small when compared with all participants. The results in Table 5 showed that the study was prospective.
A one week rehabilitative retreat, combined with a low-fat, low-energy, lacto-ovo-vegetarian diet and exercise, in a stress-free environment, decreased the cardiovascular disease risk factor parameters in a 50-year-old sample of the Czech population.
The parameters are lower in lacto-ovo-vegetarians and Seventh-day Adventists due to their observation of the healthier lifestyle.
These parameters did not significantly change one year after finishing the retreat proving the positive effect of it.
The present study showed that lifestyle changes without pharmacotherapy can cause at least a decrease in the risk factors for cardiovascular diseases (Table 4).
Authors wish to thank to Mrs. Tereza Vavříková for the preparation and corrections of manuscript and Tables.