Effectiveness of a 12-Day Residential Wellness Program: A Pilot Study

Abstract

Intensive Therapeutic Lifestyle Change Programs have shown promise in improving cardiometabolic risk factors over short durations. This pilot study evaluated the effectiveness of a 12-day residential wellness program in rapidly improving selected cardiovascular disease risk factors. Eighteen participants attended a 12-day residential wellness camp emphasizing plant-based nutrition, structured physical activity, and lifestyle education. Baseline and post-intervention measurements included anthropometrics, blood pressure, lipid profiles, fasting glucose, and fitness assessments. HbA1c was measured at baseline. Paired t-tests evaluated changes in biomarkers, and Hedges’ g effect sizes were calculated. Sixteen participants completed the program. Significant reductions (P < 0.05) occurred in systolic and diastolic blood pressure, body mass index, and total cholesterol, with medium to large effect sizes. Triglycerides and LDL-C demonstrated nonsignificant reductions. One-mile walk time improved significantly. Three participants reduced/discontinued diabetes medications, and four adjusted hypertension medications. Participation in a 12-day residential wellness program resulted in meaningful improvements in selected cardiovascular risk factors and functional fitness outcomes. Medication reductions highlight the potential of short-term intensive lifestyle interventions to rapidly improve cardiometabolic health. Larger, controlled studies with follow-up to assess sustainability of outcomes are warranted to confirm these findings.

Keywords

intensive therapeutic lifestyle change plant-based nutrition physical activity cardiometabolic risk residential wellness program pilot study

“The 12-day residential wellness program led to significant improvements in multiple selected CVD risk factors, even as some participants reduced their medications for diabetes and hypertension.”

Introduction

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide. Intensive Therapeutic Lifestyle Change Programs (ITLCPs), including residential and community programs focusing on diet and physical activity, significantly reduce CVD risk factors in both the short and long term.¹ McDougall et al reported that a 12-day program emphasizing a very low-fat vegan diet and exercise resulted in significant reductions in body mass index (BMI), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels in participants.² Recent research by Davis et al highlighted the effectiveness of a 14-day lifestyle intervention program in reducing biomarkers for metabolic syndrome in a high-risk population.³ DeRose et al observed a significant drop in homocysteine levels after just 1 week on a vegan diet.⁴

Longer-duration residential ITLCPs have demonstrated more substantial results. Ornish et al found that a 24-day program incorporating stress management and dietary changes improved ischemic heart disease biomarkers.⁵ Similarly, Bloomer et al showed a 21-day “Daniel Fast,” which included ad libitum intake of plant-based foods, improved multiple biomarkers, including TC, systolic blood pressure (SBP), and diastolic blood pressure (DBP).⁶

Despite evidence supporting the effectiveness of short-term ITLCPs, there are no programs with recently published data in peer-reviewed journals. This pilot study aimed to evaluate the effectiveness of a 12-day residential wellness program in rapidly improving selected CVD risk factors.

Methods

Study Approval

This study was approved by the Ohio University Institutional Review Board (Protocol 22-X-77).

Recruitment of Participants

During orientation of the 12-day residential wellness camp (August 7-18, 2022), participants were invited to consent to the use of their data for this study. The research team explained the study and answered questions during the initial educational session. Participation was voluntary, and individuals were assured that their decision to participate would not affect their camp experience. Written consent forms were provided and collected anonymously. Opportunities for questions were offered both in group settings and individually.

Program Description

The wellness program was conducted in Huttonsville, West Virginia, by the Mountain View Conference of the Seventh-day Adventist (SDA) Church. The program cost was $999, with discounts and scholarships available for those with limited finances.

Schedule . Eighteen participants arrived on day 1 for registration and baseline assessments, which included blood analysis, blood pressure (BP) measurement, height, and weight measurements, and a one-mile timed walk. Individual medical intake evaluations were conducted within 24 hours of arrival. Days 2-6 and 8-12 included three lecture-based presentations, two exercise sessions, and a cooking class. Day 7 involved observance of the Sabbath in accordance with SDA tradition, including worship sessions and a lighter schedule.

Food . Meals consisted of plant-based, whole foods with low-fat content. Added oils were limited to bread recipes. The program followed the principle of “breakfast like a king, lunch like a prince, and dinner like a pauper.” Breakfast typically included legumes, whole grains, fruits, nuts, and berries. Lunch normally featured legumes, whole grains, and salads. Dinner consisted of green smoothies and herbal teas. Participants sometimes prepared an entree of selected meals during cooking classes. Participants were permitted to have a second serving if desired.

Physical Activity . The first exercise session began before breakfast, with a dynamic warm-up session to prepare participants for a one-mile timed walk. Participants were grouped according to performance capacity and introduced to Galloway’s walk-run technique, an unvalidated fitness training method called “Jeffing,” which incorporates intense and moderate intervals during a standard time walk/run, resembling high-intensity interval training (HIIT).⁷

Participants with physical limitations were provided with personalized exercise programs to suit their individual needs. Daily afternoon pool aerobics sessions were available, and gentle post-meal walks were encouraged to promote physical activity and well-being.

Education . Educational content focused on the SDA health message summarized by the acronym NEWSTART (Nutrition, Exercise, Water, Sunshine, Temperance, Air, Rest, Trust in God).⁸ Additionally, the “Fresh Start!” series was presented, a proprietary ITLCP created by 1 of the authors (Drozek) based on the six pillars of lifestyle medicine outlined by the American College of Lifestyle Medicine (predominantly plant-based diet, physical activity, avoidance of unhealthy substances, stress management, restorative sleep, and nurturing relationships).⁹

Lodging . Accommodation consisted of rooms in cabins or the main lodge, furnished with bunk and queen-size beds. Some individuals had private rooms. Communal, gender-specific bathroom facilities were available.

Data Collection

Baseline History and Vital Signs . Demographics, medical history, medication use, and baseline biometrics were collected within 24 hours of arrival. Measurements included height, weight (measured using a high-capacity digital scale), and blood pressure (measured using an automatic sphygmomanometer with interchangeable cuffs).

Laboratory Tests . Venous blood samples were collected on days 2 and 12 by certified phlebotomists and analyzed at a local hospital laboratory. Tests included lipid profiles and fasting glucose levels (FBS). Glycosylated hemoglobin (HbA1c) was measured only at baseline.

Physical Fitness Assessments . On days 1 and 12, participants performed a one-mile timed walk.¹⁰ They were instructed to complete the walk as quickly as possible and time to completion was recorded.

Medical Monitoring

Medical Consultation . Medical providers held private consultations with participants to discuss personal information, including health history and medication use, and made recommendations on medication use during the program.

Daily Check-in . Medical providers made daily formal or informal “rounds” on participants, ranging from conversations at the dinner table to private sessions as needed.

Data Analysis

Descriptive statistics were calculated for each dependent variable at baseline and post-intervention. Paired sample t-tests were conducted to assess changes over time, with an alpha level set at 0.05. Hedges’ g effect size was calculated for each variable and interpreted as small (≤0.39), medium (0.40-0.69), or large (≥0.70).

Results

Participant Characteristics

Out of 18 consenting participants that attended the camp, 16 completed both baseline and post-intervention assessments. The mean age was 68.2 years (range 50-83). The cohort included 9 females and 7 males; 8 identified as African American and 8 as Caucasian. Fourteen participants were SDA. Dietary habits varied: 4 were vegan, 2 mostly vegan, 7 vegetarian, and 3 omnivorous (Table 1).

Table 1.

Baseline Demographic, Faith, and Dietary Practice Characteristics of Participants

Demographics
Age	Mean: 68.2 yrs	Range: 50–83 yrs
Gender	Female: 9 (56%)	Male: 7 (44%)
Faith	Seventh-day Adventist: 14	Other: 2
Diet	Vegan: 4	Ovo-lacto vegetarian: 9	Omnivores: 3

Twelve (75%) out of the 16 participants who completed both blood draws had baseline HbA1c levels of 5.7% or higher, with a mean of 7.1%. Six (38%) had an HbA1c of 6.5% or higher; six (38%) had an HbA1c of 5.7% to 6.4%. Among the 16 participants, the combined mean baseline HbA1c was 6.7% (Table 2).

Table 2.

Medication changes and fasting blood sugar outcomes by baseline HbA1c category.

HbA1c	FBS1	FBS2	Meds	Change in Meds
12.1	253	246	Oral meds
8.7	148	176	Oral meds	Stopped
8.5	218	185	Insulin and oral meds	Stopped insulin and sulfonylurea
8.2	164	104	Metformin
7.3	112	113	Rybelsus	Was on steroid dose pack for 2nd draw
6.5	103	91
6.4	120	122	Metformin	Stopped
5.8	81	76
5.7	91	84
5.7	91	83
5.7	91	81
5.7	87	86
5.5	93	88
5.4	106	100
5.4	73	126
5.2	114	112
Mean:	121.6	117.1

Table 2 summarizes medication changes and nonsignificant trends in change in fasting blood sugar stratified by baseline HbA1c status. Shading represents glycemic categories: red = diabetes, yellow = prediabetes, green = normal. Participants with elevated HbA1c showed reductions in fasting blood sugar and medication use, indicating possible early metabolic improvements. The isolated FBS2 value of 126 mg/dL occurred in a participant with a previously normal fasting glucose (FBS1) and no baseline impaired glucose regulation. This value possibly reflects transient physiological variation (eg, stress response, sleep disruption, or dawn phenomenon) or measurement variability, rather than a sustained change in glycemic status.

Biomarker Outcomes

Significant improvements (P < 0.05) were observed in SBP (13.1 mmHg/9.0%), BMI (0.5/1.6%), and TC (15.4 mg/dL/8.5%), all with a large effect size, and DBP (9.6 mmHg/11.4%), with a medium effect size. The one-mile timed walk improved significantly with a large effect size (Table 3).

Table 3.

Pre–post Changes in Clinical and Functional Outcomes With Effect Sizes.

Variable	n	Pre	Post	Dif	% Dif	t-stat	P	g	Effect Size
SBP (mmHg)	16	146.00 ± 26.82	132.88 ± 23.06	13.1	9.0	3.11	0.007*	0.74	Large
DBP (mmHg)	16	84.12 ± 14.82	74.56 ± 16.07	9.6	11.4	2.48	0.03*	0.59	Medium
BMI (kg/m ²)	16	31.93 ± 9.51	31.42 ± 9.14	0.5	1.6	3.54	0.003*	0.84	Large
FBS (mg/dL)	16	121.56 ± 50.75	117.06 ± 46.94	4.5	3.7	0.26	0.46	0.09	Small
TC (mg/dL)	16	182.69 ± 29.31	167.25 ± 25.14	15.4	8.5	3.24	0.005*	0.77	Large
TG (mg/dL)	16	116.19 ± 48.34	92.69 ± 29.32	23.5	20.2	1.66	0.11	0.58	Medium
LDL (mg/dL)	16	111.81 ± 25.78	102.00 ± 22.34	9.8	8.8	1.64	0.06	0.47	Medium
One mile time (minute)	11	1276.36 ± 208.51	1090.64 ± 156.13	185.7	14.6	8.5	<0.001*	2.35	Large

Results comparing baseline and post-intervention variables. SBP: systolic blood pressure (mmHg); DBP: diastolic blood pressure (mmHg); BMI: body mass index (kg/m²); FBS: fasting blood sugar (mg/dL); TC: total cholesterol (mg/dL); TG: triglycerides (mg/dL); LDL: low-density lipoprotein cholesterol (mg/dL); One Mile Time: time to walk one mile (minutes); Pre: baseline measurement and standard deviation; Post: post-intervention measurement and standard deviation; Dif: difference in pre and post values; % Dif: percent change from pre to post values; t-stat: t-value for associated paired-test; p: p-value for associated paired t-test; g: Hedge’s g effect size; *signifies significant changes (P < 0.05).

Nonsignificant reductions in triglycerides and LDL-C were observed, each with a medium effect size. No significant change was observed in FBS. There was a nonsignificant trend in improvement of diabetes status (Table 2).

Changes in Medications

By the program’s end, at least three participants had reduced or ceased diabetes medications (Table 2), and four had adjusted anti-hypertension medications due to hypotension.

Some participants reported poor sleep quality due to the lack of air conditioning or heating and uncomfortable beds, which may have impacted their overall experience and potentially mitigated some of the health improvements.

Discussion

Summary of Results

The 12-day residential wellness program led to significant improvements in multiple selected CVD risk factors, even as some participants reduced their medications for diabetes and hypertension.

Comparison with Previous Studies

The significant reductions in SBP, DBP, BMI, and TC align with findings from other ITLCPs. Similar to McDougall’s findings of an 11% reduction in TC and a 6% decrease in BP over 12 days, our study observed significant improvements in a comparable timeframe.² DeRose et al found a 13% decrease in homocysteine levels after a 10-day vegan diet.⁴ These results suggest that short-term, intensive lifestyle interventions can rapidly improve selected CVD risk factors.

The findings also corroborate the results of Davis et al, which demonstrated that a 2-week lifestyle intervention program could reduce metabolic syndrome biomarkers in high-risk populations.³ Modeled after Davis et al, The Fit 4 You Retreat™, a 2-week lifestyle intervention program sponsored by the Allegany East Conference of Seventh-day Adventists, in Boyertown, Pennsylvania, our intervention similarly revealed that significant improvements can consistently occur within a short-term timeframe. This highlights the potential for rapid, impactful changes in health outcomes when evidence-based lifestyle strategies are implemented effectively.

The Complete Health Improvement Program (CHIP), recently rebranded as PIVIO, is one of the most extensively studied ITLCPs. CHIP has demonstrated comparable improvements in biomarkers among free-living participants over 2-3 months.¹¹ In contrast, our program provided a controlled environment with a uniform diet and exercise, potentially enhancing the efficacy and speed of health improvements. Three month measurements would allow for a better comparison with CHIP.

The one-mile timed walk is a practical measure of functional aerobic capacity and provides meaningful insight into cardiovascular fitness within short-term lifestyle interventions. Previous research examining autonomic responses to aerobic activity demonstrates that steady, submaximal exercise elicits predictable shifts in sympathetic and parasympathetic balance. Chiang et al found that regular aerobic exercise enhances parasympathetic activity and improves autonomic regulation, supporting the use of functional walking tests as indicators of cardiovascular health.¹² These findings suggest that the one-mile timed walk serves not only as a performance measure but also as a reflection of underlying physiologic adaptations associated with improved endurance and cardiovascular function.¹²

The “Jeffing” walk-run technique has gained popularity among recreational runners and marathon participants due to its purported ability to enable participants to sustain activity for longer periods while reducing physical strain.⁷ The technique, though not specifically validated, is purported to reduce fatigue, minimize the risk of injury, and improve endurance, making it an accessible training strategy for individuals of varying fitness levels. The interval-based structure of Jeff Galloway’s run-walk method aligns with HIIT and other validated exercise techniques. HIIT demonstrated significant improvements in VO2max and running performance when compared to traditional sprint intervals.¹³ Karstoft et al showed that interval walking training significantly improved cardiovascular health markers, such as VO2max, and reduced risk factors for metabolic syndrome and chronic disease.¹⁴

Limitations

• Sample Size: The small number of participants limits the generalizability of the findings.

• Selection Bias: Participants were self-selected and may have been more motivated or health conscious.

• Lack of Control Group: Without a control group, attributing changes solely to the intervention is challenging.

• Homogeneity: The cohort was relatively homogeneous in faith and practices, potentially affecting applicability to broader populations.

• Sleep Quality: Poor sleep conditions may have attenuated the magnitude of health improvements.

• The comprehensive lifestyle approach, incorporating education, nutrition, and exercise, likely contributed to the significant health improvements observed. It was not possible to isolate the specific factors contributing to observed changes.

• Participants’ prior adherence to plant-based diets may have influenced the degree of improvement observed.

• Reductions in medications for BP and blood sugar could have moderated the extent of biomarker changes, as medication adjustments were made in response to improving health metrics.

• This study did not incorporate long-term follow-up to evaluate recidivism outcomes.

Implications for Practice

The rapid improvements observed suggest that residential short-term ITLCPs may be effective in managing selected CVD risk factors. Additionally, the program’s modest tuition and availability of financial assistance indicate that intensive residential lifestyle interventions can be delivered in a manner that is financially accessible and scalable in real-world settings. Healthcare providers might consider recommending such programs as adjuncts to traditional medical therapies, particularly for patients with cardiometabolic risk factors who may benefit from structured lifestyle support beyond what is feasible in routine clinical practice.

Conclusion

Participation in a 12-day residential wellness program resulted in significant improvements in BP, BMI, and lipid profiles among adults with elevated CVD risk factors. The program also facilitated reductions in medication use for some participants. These findings suggest that short-term, intensive lifestyle interventions can lead to rapid improvement in health outcomes. Further research with larger, more diverse populations and controlled study designs with follow-up to assess sustainability of outcomes is warranted to evaluate the benefits of such programs fully.

Footnotes

Acknowledgments

Special thanks to the Mountain View Conference of the SDA Church, Dr. David Emerson, the camp staff, and volunteers for their contributions. Ohio University provided research oversight and statistical support.

ORCID iDs

LaTaya De Jesus

Ginelle Nelson

David Drozek

Ethical Considerations

This study was reviewed and approved by the Ohio University Institutional Review Board (Protocol 22-X-77). All study procedures adhered to institutional research standards and the ethical principles outlined in the Declaration of Helsinki. Participation was voluntary, and all individuals were informed that their decision to participate or decline would not affect their experience in the wellness program.

Consent to Participate

Written informed consent was obtained from all participants before enrollment in the program evaluation. Participants provided written consent both to participate in the 12-day wellness program and to allow the use of their de-identified program evaluation data for publication.

Consent for Publication

Not applicable. This manuscript does not include any identifiable personal data, images, or videos requiring consent for publication.

Author Contributions

LaTaya De Jesus contributed to study planning and program design, drafted portions of the manuscript, and provided critical revisions that enhanced the clarity and overall intellectual content.

Ronda Davis contributed the Fit 4 You Retreat™ research model, which served as the foundation for this study; led conceptualization of the intervention model; drafted portions of the manuscript; and contributed to manuscript revision.

Ginelle Nelson, as Director of Health Ministries for the Mountain View Conference, led the wellness camp, oversaw protocol adherence, coordinated program implementation with coauthors, and provided evidence-based feedback and revisions that shaped the final manuscript.

Janet Simon provided statistical methods and analysis.

David Drozek served as supervising author and provided medical instruction and oversight during the program.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Three of the authors are members of the Seventh-day Adventist Church, the denomination associated with the organization that sponsored the wellness program. This affiliation did not influence the study design, data collection, analysis, interpretation, or the decision to submit the work for publication. The authors declare no financial conflicts of interest and no other potential conflicts with respect to the authorship or publication of this article.

References

Mechley

Dysinger

. Intensive therapeutic lifestyle change programs: a progressive way to successfully manage health care. Am J Lifestyle Med. 2015;9(5):354-360. doi:10.1177/1559827615592344.

McDougall

Litzau

Haver

Saunders

Spiller

. Rapid reduction of serum cholesterol and blood pressure by a twelve-day, very low fat, strictly vegetarian diet. J Am Coll Nutr. 1995;14(5):491-496.

Davis

Hwang

Reid

Han

. Lifestyle intervention program reduces metabolic syndrome in a high-risk population. Toxicol Environ Health Sci. 2022;14(4):389-395. doi:10.1007/s13530-022-00154-5.

DeRose

Charles-Marcel

Jamison

, et al. Vegan diet-based lifestyle program rapidly lowers homocysteine levels. Prev Med. 2000;30(3):225-233. doi:10.1006/pmed.1999.0623.

Ornish

Scherwitz

Doody

, et al. Effects of stress management training and dietary changes in treating ischemic heart disease. JAMA. 1983;249(1):54-59.

Bloomer

Kabir

Trepanowski

Canale

Farney

. A 21 day daniel fast improves selected biomarkers of antioxidant status and oxidative stress in men and women. Nutr Metab. 2011;8:17. doi:10.1186/1743-7075-8-17.

Master Marathons with Galloway’s Run Walk Run™ Method. https://www.jeffgalloway.com/training/. Accessed June 26, 2025.

Ashley

Cort

. The effects of the practice of the NEWSTART health regimen on faculty stress among faculty at Seventh-day Adventist colleges and universities. Christ High Educ. 2007;6:131-142. doi:10.1080/15363750600712300.

American College of Lifestyle Medicine . What is lifestyle medicine? https://www.lifestylemedicine.org/What-is-Lifestyle-Medicine. Accessed 6 May 2016.

10.

Seneli

Ebersole

OʼConnor

Snyder

. Estimated V(O2)max from the rockport walk test on a nonmotorized curved treadmill. J Strength Condit Res. 2013;27(12):3495-3505. doi:10.1519/JSC.0b013e31828f04d8.

11.

Morton

Rankin

Kent

Dysinger

. The Complete Health Improvement Program (CHIP): history, evaluation, and outcomes. Am J Lifestyle Med. 2014;8(6):403-417. doi:10.1177/1559827614531391.

12.

Chiang

J-K

Lin

Y-C

Hung

T-Y

Kao

H-H

Kao

Y-H

. The impact on autonomic nervous system activity during and following exercise in adults: a meta-regression study and trial sequential analysis. Medicina. 2024;60(8):1223. doi:10.3390/medicina60081223.

13.

Hov

Wang

Lim

, et al. Aerobic high-intensity intervals are superior to improve V̇O2max compared with sprint intervals in well-trained men. Scand J Med Sci Sports. 2023;33(2):146-159. doi:10.1111/sms.14251.

14.

Karstoft

Thorsen

Nielsen

, et al. Health benefits of interval walking training. Appl Physiol Nutr Metab. 2024;49(7):1002-1007. doi:10.1139/apnm-2023-0595.