Effects of Lifestyle Counselling on Cardiometabolic Risk Factors

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Arvo building, auditorium F115, address: Arvo Ylpön katu 34.

Jatta Puhkala

Doctoral defence of M.Sc. (Health Care) Jatta Puhkala

Effects of Lifestyle Counselling on Cardiometabolic Risk Factors : Overweight professional drivers and postpartum women at increased risk for gestational diabetes

The field of science of the dissertation is Occupational Health.

The opponent is docent Marjaana Lahti-Koski (University of Helsinki). Professor Clas-Håkan Nygård acts as the custos.

The language of the dissertation defence is Finnish.

The risk for atherosclerosis and diabetes can be reduced by lifestyle counselling

Diet and physical activity reduces the risk for atherosclerosis and diabetes in overweight professional drivers. In addition, intensified lifestyle counselling during pregnancy improved women’s health and lifestyle. However, counselling during pregnancy was not associated with prevalence of metabolic syndrome one and seven years postpartum. The academic dissertation was based on two lifestyle counselling interventions which aimed to improve health of professional drivers and pregnant women.  

Several factors in the work environment and personal behaviour predispose professional lorry and bus drivers to elevated risk for atherosclerosis and type 2 diabetes. Unhealthy dietary patterns, low physical activity and smoking are typical of many professional drivers’ lifestyles. Obesity and dyslipidemias are more common among them than in general population. Gestational diabetes is a disorder in glucose metabolism diagnosed during pregnancy. Major risk factors for GDM include pre-pregnancy overweight, high maternal age and family history diabetes. Gestational diabetes predisposes to an increased risk for developing type 2 diabetes and metabolic syndrome later in life, but it is not known if lifestyle counselling during pregnancy reduces the postpartum risk. Metabolic syndrome is a clustering of risk factors for atherosclerosis and diabetes.

The Professional Driver weight Reduction Study  is one of the first research projects on lifestyle counselling in professional drivers internationally. Long-distance professional male drivers were offered monthly counselling on diet, physical activity and sleep for one year. The drivers improved their dietary patterns and increased physical activity. Their weight was reduced by four kilograms and risk factors for atherosclerosis and diabetes were reduced. The monthly counselling programme combining face-to-face and telephone contacts seemed appropriate for long-distance male drivers and helped them to improve their lifestyle. In Finland, few of professional drivers are offered occupational health care services, leading to that they lack health monitoring and lifestyle counselling.

- Access to occupational health care with trained nurses to give lifestyle counselling should be ensured for professional drivers, says Jatta Puhkala.
The Gestational Diabetes Prevention Study is one of the first, large studies on prevention of gestational diabetes. The women entering maternal care were offered intensified counselling on diet and physical activity. The dissertation found that even though intensified counselling during pregnancy improved women’s lifestyle, it did not have an effect on the prevalence of metabolic syndrome one and seven years postpartum. The risk for metabolic syndrome were highest among women with a diagnosis of GDM in early pregnancy and among women who were overweight before pregnancy. Pregnancy may be too short a time to achieve permanent changes in lifestyle. Women with GDM diagnosis, and also overweight e women, should be monitored and counselled after delivery.
-  Intensified care in well-baby clinics soon after delivery, and, further, e.g. in occupational health care could have potential to inculcate the lifestyle changes achieved during pregnancy, Puhkala summarises.

Academic dissertation of Puhkala is part of two UKK Institute lifestyle counselling research projects. The Professional Driver Study was conducted between 2009 and 2012 and its’ aim was to improve health of professional drivers by lifestyle counselling. The Gestational Diabetes Prevention Study  was conducted 2007-2016, and its’ aim was to prevent gestational diabetes by intensified lifestyle counselling during pregnancy, and, further, to study the health of mother and child one and seven years postpartum. The study was financially supported by the Academy of Finland, the Finnish Ministry of Education and Culture, the Medical Research Fund of Tampere University Hospital, the Juho Vainio Foundation and the Pirkanmaa Fund of the Finnish Cultural Foundation.


The dissertation is published in the publication series of Acta Universitatis Tamperensis; 2286, Tampere University Press, Tampere 2017. The dissertation is also published in the e-series Acta Electronica Universitatis Tamperensis; 1789, Tampere University Press 2017.

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