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Impact of Lifestyle Intervention on Lost Productivity and Disability: Improving Control With Activity and Nutrition

Wolf, Anne M. MS; Siadaty, Mir S. MD; Crowther, Jayne Q. MSN; Nadler, Jerry L. MD; Wagner, Douglas L. PhD*; Cavalieri, Stephen L. MD; Elward, Kurtis S. MD; Bovbjerg, Viktor E. PhD

Journal of Occupational and Environmental Medicine: February 2009 - Volume 51 - Issue 2 - p 139-145
doi: 10.1097/JOM.0b013e3181965db5
Original Articles

Objective: To evaluate the effectiveness of a lifestyle intervention (LI) in reducing work loss and disability days.

Methods: One year randomized controlled trial of health plan members (n = 147) with type 2 diabetes and obesity. Members were randomized to modest-cost LI or usual care (UC). Outcomes were group differences in cumulative days either missed at work or with disability using Mann-Whitney U-tests and Poisson regression models.

Results: LI reduced the risk of workdays lost by 64.3% (P ≤ 0.001) compared to UC (annual accumulation: UC: 3.49 days vs LI: 0.92 days, P = 0.01). LI decreased the risk of disability days by 87.2% (P = 0.0003) compared to UC (annual accumulation: UC: 5.3 days vs LI: 0.94 days, P ≤ 0.001). Similar trends were observed among the subset of people with depression.

Conclusion: LIs reduce work loss and disability days associated with diabetes and obesity.

From the Department of Public Health Sciences (Ms Wolf, Mr Siadaty, Mr Crowther, Dr Wagner, Dr Bovbjerg), University of Virginia School of Medicine, Charlottesville, Va; Department of Internal Medicine (Mr Nadler), Eastern Virginia Medical School, Norfolk, Va; Southern Health Services, Inc./Coventry Health Care, Inc (Mr Cavalieri, Mr Elward), Richmond, Va; and Department of Family Medicine (Mr Elward), University of Virginia, Charlottesville, Va.

CME Available for this Article at

The authors have no financial interests associated with this research, which was funded by grants from the American Dietetic Association, National Institute of Diabetes and Digestive and Kidney Diseases (R18 DK062942), and a grant to the University of Virginia General Clinical Research Center, MO1 RR00847.

Any opinions, results, or conclusions set forth in this article are those of the authors and do not necessarily reflect the policies or opinions of Southern Health Services, Inc, Coventry Health Care, Inc. or any subsidiaries or affiliate companies.


Address correspondence to: Anne Wolf, MS, Department of Public Health Sciences, Box 800717, Charlottesville, VA 22908-0717; E-mail:

©2009The American College of Occupational and Environmental Medicine