EVALUATION OF WEIGHT-REDUCTION IN A COMMUNITY INTERVENTION FOR CARDIOVASCULAR-DISEASE RISK - CHANGES IN BODY-MASS-INDEX IN THE MINNESOTA HEART HEALTH-PROGRAM

This paper describes the effectiveness of the Minnesota Heart Health P rogram (MHHP) in modifying mean body mass index (BMI) in whole communi ties, The MHHP is a 13-year research and demonstration project designe d to reduce cardiovascular risk, One member of each of three pairs of matched communities received 7 years of community intervention activit ies that included risk factor screening, mass media education, adult e ducation classes, worksite interventions, home correspondence programs , school-based programs, restaurant programs, and point of-purchase ed ucation in supermarkets, Weight gain prevention was emphasized for all adults and weight loss was encouraged among those who were obese or w ho had elevated risk factors known to be responsive to weight loss (e. g., high blood pressure), A strong upward secular trend in weight was noted in all MHHP communities over time, Intervention effects were eva luated conservatively with community as the unit of analysis, This ana lysis showed no overall effect of the MHHP intervention program on mea n BMI. However, a positive intervention effect was noted early in the intervention among those with elevated cholesterol or a history of obe sity-related disease, Possible reasons for this relatively weak commun ity effect are discussed, including secular forces overwhelming interv ention effects, an intervention effort not sufficiently focused on obe sity, ceiling effects for weight concern in a population that was high ly aware of the issue at baseline, and inherent limitations in educati onal approaches for this recalcitrant public health problem.