Abstract 4365737: Intensive Lifestyle Intervention Strategies for Improving Atherogenic Profile and Estimated Cardiovascular Risk in Indian Adults with Obesity

Abstract

Introduction: Obesity-related cardiovascular (CV) risk is a growing concern in India, even in the absence of diabetes. Lifestyle intervention strategies may play a role in improving cardiovascular risk in the Indian population. Research Question: Does a structured, multidisciplinary lifestyle intervention improve CV risk factors—including the Atherogenic Index of Plasma (AIP) and estimated 10-year cardiovascular risk using the Framingham Risk Score (FRS)—in metabolically at-risk individuals with obesity? Methods: This study involved 271 adults, aged 30 to 75 years, with obesity (BMI ≥ 25 kg/m^2 according to the WHO Asia Pacific Guidelines) and no history of heart disease. These individuals participated in a one-year online intensive lifestyle intervention program at an obesity management clinic in Pune, India, between 2021 and 2023. The intervention comprised a personalized plant-based diet, physical activity, stress management, and medical management. Baseline and endline assessments were conducted to measure anthropometric and biochemical parameters related to cardiovascular risk. Results: The mean age of the cohort was 48.1±9.1 years, with 73.1% being female. Initially, 25.5% and 27.3% of the participants were receiving pharmacological treatment for dyslipidemia and hypertension, respectively. Post-intervention, there was a statistically significant improvement in weight loss (-6.5%, p<0.005), with 14% of individuals transitioning to an overweight or normal BMI category. Notable improvements were observed in traditional risk factors: the prevalence of high triglycerides (≥150 mg/dl) decreased from 30% to 23.6%, high non-HDL cholesterol (≥130 mg/dl) from 67.2% to 60.5%, low HDL cholesterol in females (≤50 mg/dl) from 61.1% to 53.0%, and a high TG/HDL ratio (≥3) from 38.0% to 31.4% (p<0.05). Among non-traditional risk factors, the proportion of individuals with high-sensitivity C-reactive protein (hs-CRP >3 mg/L) decreased from 57.9% to 41.7% (p<0.05). The intervention led to a significant reduction in the AIP, with the percentage of individuals exceeding the risk threshold (>0.11) decreasing from 40.0% to 33.6%. Furthermore, the estimated 10-year cardiovascular risk, as assessed by the FRS, demonstrated a significant improvement (-7.6%, p<0.001). Conclusion: A one-year online lifestyle intervention significantly improved traditional and non-traditional CV risk factors, reducing AIP and FRS scores in obese Indian adults.