Effects of a cardiometabolic risk-reducing dietary pattern health education intervention on cardiometabolic disease risk in community-dwelling older adults in China: a cluster-randomized clinical trial.

ObjectiveTo 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.DesignThe 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).SettingSingle-center in Tianjin, China.Participants694 community older residents (61-80 years): intervention group (n = 349) and control group (n = 345).InterventionParticipants 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.MeasurementsThe 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.ResultsOf 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).ConclusionThe 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.