Personalisation of the Dutch combined lifestyle intervention SLIMMER improves participant retention and weight loss in people at risk for cardiometabolic disease.

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• Tailoring programmes to meet the individual needs of the participants may increase engagement, improve retention and yield better results.

Introduction

This study aimed to evaluate the effects of a personalised SLIMMER programme (the Dutch combined lifestyle intervention)  on adherence to lifestyle recommendations using questionnaires assessing lifestyle behaviour, self efficacy and quality of life.  Secondary aims included health status measured by: well-being, anthropometrics, clinical metabolic parameters, and inflammation biomarkers.

Method

This was a cluster-allocated, controlled, open-label, parallel study with two arms: the intervention (personalised SLIMMER programme, n=61) and control (standard SLIMMER programme, n=60) groups. The study enrolled adult patients at risk of cardiometabolic disease who were allocated to one of the groups depending on their primary care centre and were followed during the first six months of the two-year programme.

Results

• The intervention group demonstrated significant programme adherence, with a dropout rate of 11%. Whereas the control group had a higher dropout rate of 23% (p < 0.001).

• Both groups improved their adherence to physical and dietary guidelines at 3 and 6 months compared to baseline (p < 0.001). However, the control group showed greater improvement in physical activity adherence (p < 0.05).

• Both groups showed improvements in diet quality (p < 0.05), with no significant differences between groups at 3 and 6 months.

• Quality of life improved in both groups, however, the control group demonstrated a significantly higher overall improvement (p < 0.05) from baseline to 6 months..

• Both groups showed weight loss, with the intervention group achieving greater reductions (p=0.006) at 6 months and greater improvements in body fat percentage (p < 0.001) and waist-hip ratio (p = 0.025).

• Systolic blood pressure decreased in both groups, but only the control group had a significant reduction in diastolic blood pressure (p < 0.001).

• Fasting glucose was lower in the intervention group (p = 0.003), whereas insulin was lower in the control group (p = 0.002).

• HbA1c levels remained stable in the intervention group, whereas they slightly increased in the control group.

• The intervention group showed favourable changes in several inflammatory biomarkers, namely decreases in leptin, high-sensitive C-reactive protein, alpha-1-antitrypsin, and E-selectin, together with increases in adiponectin.

Conclusion

These findings suggest that tailoring an already effective combined lifestyle intervention to meet participants' needs may help increase their engagement and also improve their cardiometabolic health status.

• A one-size-fits-all approach may not address the diverse needs, preferences and barriers to change of each individual at risk of cardiometabolic diseases. Thus, tailoring lifestyle interventions may improve engagement and programme adherence.

• Regular follow-up and personalised goal setting may help individuals at risk of cardiometabolic disease to achieve greater improvements in weight management and overall cardiometabolic health status.

• Longer-term follow-up studies are needed to validate the outcomes and ensure they are sustained over a longer period of time.

• Future research designs should use randomised controlled trials with standardised inclusion criteria to minimise the risk of selection bias between healthcare sites.

• Future studies should include compliance tracking criteria to help identify which components of the personalised intervention led to the observed results.