Abstract
Background: Obesity was declared by the World Health Organization as one of the 21st century pandemics. In Portugal, about 53% of the population are overweight (BMI > 27 kg/m²), and around 1.5 million are obese (1).
Approach: At a more local scale, Odemira (Alentejo), is estimated that 24.3% of the population aged ≥18 years is obese(2). Moreover, among patients registered at Odemira UCSP, between the ages of 40 and 64, there were in 2023, 1,175 people (12.2% of this population)(3), with obesity and either Hypertension or Diabetes Mellitus.
In response to this scenario, ULSLA EPE (UCSP Odemira), in partnership with Municipio de Odemira, launched an integrated municipal primary prevention program for individuals with obesity and high cardiovascular disease risk (CVD), named Living More, Living Better. The program aims to reduce CVD risk, promote healthy behaviors, and empower individuals to effectively manage their health/disease.
People between 40 to 64 years old with obesity and another CVD risk factor – Diabetes Mellitus, Hypertension, and/or Dyslipidemia – were identified and recruted by their health team.
Exclusion criteria include: pregnancy, uncontrolled psychiatric illness or conditions that prevent moderate-intensity physical exercise.
A multidisciplinary team composed by a doctor, nurse, nutritionist, psychologist and physical education teacher was assembled to follow the patients.
A closed group of 10 people received personalized care over 12 months, with periodic biometric, analytical, and psychological evaluations by the multidisciplinary team every 3 months. Participants received weekly personalized physical training from a physical education teacher and weekly/biweekly dietary consultations with a nutritionist. Monthly educational/capacity-building sessions were held in a mutual aid group format.
Results: Regarding the first group of the project, we could observe that half of the participants moved from obesity to overweight. All increased their HDL levels and reduced baseline systolic blood pressure, resulting in a reduced CVD risk. All improved their aerobic endurance.
Implications: Health should increasingly occupy a central place in the territorial and community policies of each municipality, as community development is limited without health.