Mediterranean Diet Intervention Among World Trade Center Responders with Post-Traumatic Stress Disorder: Feasibility and Outcomes of a Pilot Randomized Controlled Trial

Details

• Personal Author:
  Arcan C ; Bromet EJ ; Clouston SAP ; Hoffman K ; Hou W ; Luft B ; Reichardt A ; Yang X
• Description:
  Objective: Responders of the World Trade Center (WTC) disaster suffer from co-morbidities. A Mediterranean Diet (MedDiet) nutrition intervention with physical activity was implemented among WTC responders with overweight/obesity and post-traumatic stress disorder (PTSD). Methods: WTC Health Program members (N = 62), 45-65 years, males 87%, body mass index (BMI) 27-45 kg/m2 randomized to MedDiet (n = 31) or usual nutrition counseling (n = 31). The 10-week intervention included online nutrition education, text messages, and group experiential cooking; both groups had three in-person individual nutrition counseling. Anthropometrics, serum biomarkers, psychosocial factors, MedDiet score, and PTSD symptoms were assessed at baseline, post-intervention, and 3-months (follow-up). The primary outcome was intervention feasibility and secondary outcomes were within- and between-group changes of all measures at post-intervention and follow-up. Nonparametric Wilcoxon rank sum tests for between-group comparisons and Wilcoxon signed rank tests for pre-post within-group comparisons. Results: A total of 58(94%) and 46(74%) participants completed the post-intervention and follow-up measurements, respectively. Both groups experienced significant improvements in anthropometrics, MedDiet score, oxidized low-density lipoprotein, and PTSD symptoms. Baseline median (range) were weight 100.42 (73.66-135.17) kg, BMI 33.20 (27.50-41.75) kg/m2, and Waist circumference (WC) 109.22 (90.17-150.62) cm. Median % weight loss at post-intervention was MedDiet: -3% (-11%-7%), p = 0.0002; Control: -1% (-13%-4%), p = 0.008 and at follow-up MedDiet: -2% (-14%-12%), p = 0.07; Control: -2% (-20%-3%), p = 0.006. The overall BMI was reduced by -0.68 kg/m2 (-4.61-2.09) kg/m2 p < 0.0001 at post-intervention and by -0.60 kg/m2 (-6.91-3.39) kg/m2, p < 0.0009 at follow-up. Overall, median WC was reduced (p < 0.0001); post-intervention -3.81 cm (-33.00-3.30)cm and follow-up -4.45(-38.10-4.57)cm. There were group differences in HbA1c (p = 0.019) and serum ω6/ω3 (p = 0.029) at post-intervention. Conclusion: Online intervention with personal counseling was feasible in this population. Improvements in anthropometrics, MedDiet score, selected serum biomarkers and PTSD symptoms were found in both groups; group differences in HbA1c and serum ω6/ω3. A larger study with a delayed control is needed to better assess intervention effects. [Description provided by NIOSH]
• Subjects:
  Diet Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Body Mass Index BMI Body Mass Index Chronic Inflammation Intervention Effectiveness Mediterranean Diet Nutrition Obesity Post-traumatic Stress Disorder Post Traumatic Stress Disorder PTSD Systemic Inflammation Waist Circumference World Trade Center WTC WTC Responders

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• ISSN:
  2055-2238
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; New York ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  10
• Issue:
  1
• NIOSHTIC Number:
  nn:20069244
• Citation:
  Obes Sci Pract 2024 Feb; 10(1):e725
• Contact Point Address:
  Chrisa Arcan, Department of Epidemiology, School of Population Health, Virginia Commonwealth University, Capitol Square Building 830 E Main Street, 8th floor Richmond, Richmond, VA 23219, USA
• Email:
  arcanh@vcu.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  State University New York Stony Brook
• Peer Reviewed:
  True
• Start Date:
  20201201
• Source Full Name:
  Obesity Science & Practice
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7f04448d6ba71f76ae0ffa6ce04bdd7e691edae971dae443bc6a0ed4e264c0b47570dd695e3eb49f2200ae7b166e910895e0c9691ad722855dd09684e73ab8c7
• Download URL:
  https://stacks.cdc.gov/view/cdc/207753/cdc_207753_DS1.pdf
• File Type:
  [PDF - 1.18 MB ]