Elsevier

Atherosclerosis

Volume 197, Issue 2, April 2008, Pages 784-790
Atherosclerosis

Effect of a 4-year workplace-based physical activity intervention program on the blood lipid profiles of participating employees: The high-risk and population strategy for occupational health promotion (HIPOP-OHP) study

https://doi.org/10.1016/j.atherosclerosis.2007.07.026Get rights and content

Abstract

Individuals who are physically fit or engage in regular physical activity have a lower incidence of cardiovascular disease and risk of mortality. We conducted a large-scale controlled trial of interventions to decrease cardiovascular risk factors, during which we assessed the effect of a workplace-based intervention program, which was part of a population strategy for promoting long-term increases in physical activity, on the blood lipid profiles of participating employees. Data were collected from 2929 participants and this report presents the results of a survey conducted in five factories for the intervention group and five factories for the control group at baseline and year 5. The absolute/proportional changes in HDL-cholesterol were 2.7 mg/dL (4.8%) in the intervention group and −0.6 mg/dL (−1.0%) in the control group. The differences between the two groups in the change in serum levels of HDL-cholesterol were highly significant (p < 0.001) in each analysis of covariance, in which the number of cigarettes smoked was included or excluded. In the intervention group, the daily walking time increased significantly (p < 0.001) when compared between baseline and year 5, whereas no significant difference was observed in daily walking time in the control group over the identical period. Our results show that an intervention program promoting physical activity raises serum HDL-cholesterol levels of middle-aged employees. Increased awareness of the benefits of physical activity, using environmental rearrangement and health promotion campaigns, which especially target walking, may have contributed to a beneficial change in serum HDL-cholesterol levels in the participants.

Introduction

Elevated circulating levels of high-density lipoprotein cholesterol (HDL-C) lower the risk for developing coronary artery disease [1] and are inversely associated with mortality from all causes [2]. Low levels of circulating HDL-C are related significantly and independently to an increased risk of stroke of all types, including ischemic stroke [3].

Regular physical exercise is frequently recommended to prevent coronary artery disease [4]. Improving physical fitness and increasing physical activity are associated with a lower incidence of cardiovascular disease and a reduced risk of mortality [5]. The main mechanism by which regular physical activity mitigates the risk for developing coronary artery disease is its impact on HDL metabolism [6]. Several authors have explored the effect of exercise on changes in HDL-C levels [7], and the collective results of these studies have shown that modifications in lifestyle are thought to be beneficial in increasing serum HDL-C levels [2], [8].

Given that most of the adult population is employed, the workplace presents an ideal opportunity to reach large numbers of people for the purpose of promoting good health and preventing disease [9]. However, there are only a few published reports of controlled trials that were conducted in the workplace and whose aim was to increase the physical activity of the employees. Shimizu et al. [10] investigated the relationship between an interview-based health promotion program and the risk for developing cardiovascular disease in the workplace. From their findings, they suggested that changes in health-related behavior of the participants, including increases in physical activity, were the basis for increased levels of HDL-C in middle-aged participants. However, it remains unclear how a population strategy that promotes good health by increasing physical activity can influence participants in the workplace [11].

In the current study, we assessed the effect of a workplace-based intervention program on the blood lipid profiles of participating employees as part of a population strategy for promoting long-term increases in physical activity.

Section snippets

Study population

A large intervention trial, the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study, was conducted; its details have been published elsewhere [12], [13]. For this purpose, companies throughout Japan were recruited to participate in the study. The first allocation was modified with the hope that each company would comply with the aims and conditions of the study. Twelve participating companies, which consisted of two non-factory companies and 10 factories, were

Results

The average age at baseline was 42.7 ± 8.9 (males, 42.2 ± 9.1; females, 44.2 ± 8.0) and 39.8 ± 8.7 (males, 39.9 ± 8.9; females, 39.5 ± 7.6) years for the intervention and control groups, respectively. The clinical characteristics of the participants in the two groups at baseline and at year 5 are summarized in Table 2. At baseline, there were significant differences in age, serum HDL-C levels, and serum non-HDL-C levels between the two groups of participants. For female participants, the BMI was

Discussion

We explored the effect of a 4-year intervention program on the employees in five factories in an effort to promote physical activity, irrespective of the employee's serum lipid status. We observed that increasing physical activity raised serum HDL-C levels. Our intervention for physical activity was not of high intensity and was conducted as part of a population strategy in an attempt to induce individuals to change their behavior by increasing their interest and motivation. Therefore, the

Acknowledgments

This study was funded by research grants from the Ministry of Health and Welfare of Japan (H10-12, No. 063, Research on Health Services, Health Sciences Research Grants and H13, No. 010, Medical Frontier Strategy Research, Health Sciences Research Grants), the Ministry of Health, Labor, and Welfare of Japan (H14-15, No. 010, Clinical Research for Evidence-Based Medicine, Health, and Labor Sciences Research Grants), and the Japan Arteriosclerosis Prevention Fund 2004 (seikatsu9). We thank

References (29)

  • Y. Soyama et al.

    High-density lipoprotein cholesterol and risk of stroke in Japanese men and women: the Oyabe Study

    Stroke

    (2003)
  • R.R. Pate et al.

    A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine

    JAMA

    (1995)
  • D.A. Leaf et al.

    Changes in VO2max, physical activity, and body fat with chronic exercise: effects on plasma lipids

    Med Sci Sports Exerc

    (1997)
  • J.L. Durstine et al.

    Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis

    Sports Med

    (2001)
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    Investigators and members of the research group are listed in the Appendix A.

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