Qi Wu, Li Huang, Jie Yang, Liyang Zhang, Cheng Cheng, Xukun Chen, Tongtong Li, Huilian Duan, Zehao Wang, Qinghan Ren, Tongyang Wu, Yue Wang (65477), Shanshan Bian, Zhenshu Li, Huan Liu, Jing Yan (312090), Yue Du, Yongjie Chen, Huichao Qu, Ya Su, Baoguo Gao, Wei Liu, Lichun Cao, Wen Li, Fei Ma, Guowei Huang
OBJECTIVE: To assess the efficacy of the reducing cardiometabolic disease risk (RCMDR) dietary pattern health education intervention on cardiometabolic disease (CMD) risk and carotid atherosclerosis in the Chinese older population. DESIGN: The cluster randomized clinical trial was conducted from April 2023 to December 2024. Participants according to residential areas were randomized to the intervention group (2 clusters) or control group (2 clusters). SETTING: Single-center in Tianjin, China. PARTICIPANTS: 694 community older residents (61-80 years): intervention group (n = 349) and control group (n = 345). INTERVENTION: Participants in the intervention group received the RCMDR dietary pattern health education intervention, while those in the control group received general health education. The intervention period lasted 12 months. MEASUREMENTS: The primary outcome was clustered cardiometabolic risk score (CMRS). The secondary outcomes included common carotid artery ultrasound parameters and cardiometabolic risk indicators. Analysis was intention-to-treat principle. RESULTS: Of 694 participants, 411 (59.2%) were female; mean (SD) age was 68.2 (5.1) years. Compared with the control group, the RCMDR dietary pattern health education intervention resulted in a significantly lower CMRS (β = -0.25; 95% CI -0.31, -0.19); lower intima-media thickness (β = -0.05, 95% CI -0.08, -0.02); lower serum total cholesterol, triglyceride and low-density lipoprotein cholesterol, higher high-density lipoprotein cholesterol; lower fasting blood glucose, fasting insulin, fasting C-peptide and HOMA-IR, higher HOMA-β; lower serum homocysteine; lower systolic blood pressure and diastolic blood pressure; lower weight, body mass index, waist circumference, waist-to-hip ratio, body fat percentage, body fat mass and Chinese visceral adiposity index, higher lean body mass (all P < 0.05). CONCLUSION: The RCMDR dietary pattern health education intervention could reduce the CMD risk, delayed the progression of carotid atherosclerosis and improved cardiometabolic factors among Chinese older population.