CMAJ April 29, 2013 First published April 29, 2013, doi: 10.1503/cmaj.120567
© 2013 Canadian Medical Association or its licensors
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Naturopathic medicine for the prevention of cardiovascular disease: a randomized clinical trial
- Dugald Seely, Orest Szczurko, Kieran Cooley, Heidi Fritz,Serenity Aberdour, Craig Herrington, Patricia Herman,Philip Rouchotas, David Lescheid, Ryan Bradley, Tara Gignac,Bob Bernhardt, Qi Zhou, Gordon Guyatt
From the Canadian College of Naturopathic Medicine (Seely, Szczurko, Cooley, Fritz, Aberdour, Herrington, Rouchotas, Lescheid, Gignac, Bernhardt), Toronto, Ont.; the Ottawa Hospital Research Institute (Seely), Ottawa, Ont.; the Ottawa Integrative Cancer Centre (Seely), Ottawa, Ont.; the Leslie Dan Faculty of Pharmacy, University of Toronto (Szczurko, Cooley), Toronto, Ont.; the Department of Psychology, University of Arizona (Herman), Tucson, Ariz.; Bastyr University (Bradley), Kenmore, Wash.; and the Department of Clinical Epidemiology and Biostatistics, McMaster University (Zhou, Guyatt), Hamilton, Ont.
Background: Although cardiovascular disease may be partially preventable through dietary and lifestyle-based interventions, few individuals at risk receive intensive dietary and lifestyle counselling. We performed a randomized controlled trial to evaluate the effectiveness of naturopathic care in reducing the risk of cardiovascular disease.
Methods: We performed a multisite randomized controlled trial of enhanced usual care (usual care plus biometric measurement; control) compared with enhanced usual care plus naturopathic care (hereafter called naturopathic care). Postal workers aged 25–65 years in Toronto, Vancouver and Edmonton, Canada, with an increased risk of cardiovascular disease were invited to participate. Participants in both groups received care by their family physicians. Those in the naturopathic group also received individualized care (health promotion counselling, nutritional medicine or dietary supplementation) at 7 preset times in work-site clinics by licensed naturopathic doctors. The body weight, waist circumference, lipid profile, fasting glucose levels and blood pressure of participants in both groups were measured 3 times during a 1-year period. Our primary outcomes were the 10-year risk of having a cardiovascular event (based on the Framingham risk algorithm) and the prevalence of metabolic syndrome (based on the Adult Treatment Panel III diagnostic criteria).
Results: Of 246 participants randomly assigned to a study group, 207 completed the study. The characteristics of participants in both groups were similar at baseline. Compared with participants in the control group, at 52 weeks those in the naturopathic group had a reduced adjusted 10-year cardiovascular risk (control: 10.81%; naturopathic group: 7.74%; risk reduction –3.07% [95% confidence interval (CI) –4.35% to –1.78%], p < 0.001) and a lower adjusted frequency of metabolic syndrome (control group: 48.48%; naturopathic care: 31.58%; risk reduction –16.90% [95% CI–29.55% to –4.25%],p = 0.002).
Interpretation: Our findings support the hypothesis that the addition of naturopathic care to enhanced usual care may reduce the risk of cardiovascular disease among those at high risk. Trial registration: ClinicalTrials.gov, no.NCT0071879.
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