Sapporo lifestyle study is a community-based, prospective, randomized controlled study to improve coronary risk profile by therapeutic lifestyle change (TLC) consisting of exercise and dietary modification for 12 months. Three hundred and sixteen (316) eligible residents (male 111, female 205) aged 40 to 69 years without symptom were recruited with informed consent, and allocated into 3 groups such as 105 control (A), 106 exercise intervention (B), and 105 exercise with dietary intervention group. Brisk walking (near 3 METs) for 150 minutes a week was introduced for B and C groups, and a nutritional intervention consisting of appropriate energy intake for ideal body weight, increased n-3 polyunsaturated fatty acid (PUFA) up to 2.9g a day and additional 2.0 g increase of fiber intake a day, was instructed for C group in training sessions. All participants were estimated body composition, lipid profile, physical fitness, and nutritional status (by diet history questionnaire made in Japan NIH) at the beginning and end of the study, and monitored on daily physical activity by pedometer during the study. Computerized randomization by minimization method was successful, resulting in no significant differences of major risk factors. Total of 249 residents (A: 87, B: 78, C: 84) were followed up for 12 months (follow-up rate 79%). B and C group had significant increased brisk walking than that of A group. Lipid profile was improved in all groups. Above all, HDL-C levels increased by 0.31, 2.47 and 3.62 mg/dl in A, B and C groups (P<0.05), respectively. Although intakes of total energy and cholesterol per 1,000 kcal a day were reduced in all groups, n-3 PUFA per 1,000 kcal is significantly increased in only C groups (P<0.05).

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