CHIP: The Complete Health Improvement Program

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“The best kept secret in medicine is that, given the right [conditions], the body [can sometimes heal] itself.” And: “When it comes to cardiovascular disease, there is no substitute for nutritional excellence.” So, Ornish, Pritikin, Barnard, Esselstyn—all the great names in evidence-based nutrition. But, how many have heard about the CHIP program (the Coronary Health Improvement Project), a volunteer-run community-based education program “educating physicians and patients alike, about the power of nutrition as medicine is perhaps the best investment we can make in the fight against heart disease.” More effective, cheaper, safer. And, what are the side effects? Improved overall health, and not just physical health.

“Lifestyle change programs, such as CHIP, aimed at improving physical health behaviors can likewise have a profound effect on mental health.” Based on studies of thousands of individuals who went through the CHIP program, there were significant improvements in a number of “sleep or stress disorders,” like sleeping restlessly, not sleeping at all, stress, upset, fear, and depression. Here are the numbers; most of these cut in half. All highly significant findings. The question is why?

Well, “[t]he psychological well-being of the CHIP participants might have been positively affected by increasing feelings of empowerment, making strides toward reducing their body weight, and improving other health indicators.” As they start eating better and making strides, feelings of despair and failure “may be replaced by a growing sense of accomplishment, increased social support, and a new sense of hope.” Or, they may just be physically feeling better. If your diabetes goes away, that’s reason enough to perk you up.

While these before-and-after results looked great, what was missing? Right, a control group. Now, you say, “Wait; they each acted as their own control, before and after.” Ah, you’re forgetting about “the Hawthorne effect”. Remember? Just being in a study under observation can affect people’s behavior. So, if they put you on a scale, weigh you, and say they’re going to weigh you again in six months, people may consciously—or unconsciously—just eat better on their own, even if they’re not told to do anything special. So, how much of these improvements would have happened without the CHIP program?

Yeah, it’s great that you can take a thousand people and markedly reduce their risk-factor profiles for our leading killer in just four weeks—regardless. But, to know exactly what role healthy eating and living advice can play, you need to… put it to the test, by performing randomized controlled trials.

And, as expected, there were small improvements even in the control group. But, “[f]or almost all variables, the [CHIP] intervention group showed significantly greater improvements”—so much so as to have “the potential to dramatically reduce the risks associated with common chronic diseases in the long term.” Ironically, CHIP was so successful in this city of Rockford, Illinois that dozens of restaurants started offering special plant-based menu options. So, the control group might have been sneaking in some healthier meals too.

Okay, but what about the mental health improvements? A randomized controlled trial, and…”[t]hose in the [CHIP] group showed significantly greater [improvements] in physical functioning,…pain, general health perceptions, vitality, social functioning, [and] emotional and mental health. For example, significant improvements, particularly in mild to moderate depression, compared to the control group. And, not just right after the program ended, but six months later.

So, the CHIP acronym started out as the Coronary Health Improvement Project, but as study after study “showed the efficacy of the intervention in addressing other chronic diseases, such as type 2 diabetes and even depression,” it [has since been] renamed…the Complete Health Improvement Program.”

As Hans Diehl—the founder of CHIP—explains, “We [as a society] are largely at the mercy of powerful and manipulative marketing forces that basically tell us what to…eat….Everywhere we look, we’re being seduced to the ‘good life’ as marketers define it,…[b]ut this so-called ‘good life’ has produced in this country an avalanche of morbidity and mortality”—disease and death….What [he’d] like to see in America is not this so-called ‘good life,’ but the ‘best life’…a simpler lifestyle…characterized by eating more whole [plant] foods,” in other words, “foods-as-grown.”

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• Kadoch MA. The power of nutrition as medicine. Prev Med. 2012;55(1):80.
• Englert HS, Diehl HA, Greenlaw RL, Willich SN, Aldana S. The effect of a community-based coronary risk reduction: the Rockford CHIP. Prev Med. 2007;44(6):513 - 9.
• Aldana SG, Greenlaw RL, Diehl HA, et al. Effects of an intensive diet and physical activity modification program on the health risks of adults. J Am Diet Assoc. 2005;105(3):371-81.
• The CHIP Prescription for Health. Absolute Advantage. The Workplace Wellness Magazine for Health. Health, Vol. 3, No. 8 .
• Thieszen CL, Aldana SG, Mahoney ML, Vermeersch DA, Merrill RM, Diehl HA, Greenlaw RL, Englert H. The Coronary Health Improvement Project (CHIP) for Lowering Weight and Improving Psychosocial Health.
• Merrill RM, Aldana SG, Greenlaw RL, Diehl HA. The Coronary Health Improvement Projects Impact on Lowering Eating, Sleep, Stress, and Depressive Disorders. Published online: 23 Jan 2013 Pages 337-344.
• Morton D, Rankin P, Kent L, Dysinger W. The Complete Health Improvement Program (CHIP): History, Evaluation, and Outcomes. Am J Lifestyle Med. 2016;10(1):64-73.
• Merrill RM, Aldana SG, Greenlaw RL, Diehl HA, Salberg A. The effects of an intensive lifestyle modification program on sleep and stress disorders. J Nutr Health Aging. 2007;11(3):242-8.

Image credit: chiphealth.com. Image has been modified.

Motion graphics by Avocado Video.

• alternative medicine
• cardiovascular disease
• CHIP program
• chronic diseases
• complementary medicine
• Dr. Caldwell Esselstyn
• Dr. Dean Ornish
• Dr. Neal Barnard
• heart disease
• lifestyle medicine
• Pritikin
• sleep
• workplace wellness