Real-World Outcomes of a Traffic-Light Approach to Lifestyle Modification in Chronic Disease: Evidence from an Integrative Health Clinic

*Background*: Non-communicable diseases driven by unhealthy lifestyles are a growing and largely avoidable burden among industrial workers. Patient-level evidence on the effectiveness of structured lifestyle programmes delivered alongside standard care - such as a traffic-light dietary guideline, a Yoga protocol and a daily four-spice culinary extract - remains limited. The Integrative Health Clinic (IHC) at ESIC Medical College & Hospital, Faridabad, India, is a family-medicine-style outpatient clinic that follows the 21-item Health Building Lifestyle Guideline and delivers care through a 7-step COM-B-based protocol. We therefore estimated patient-reported relief and compliance with three lifestyle practices in patients attending the IHC. *Methods*: We conducted a retrospective single-arm cohort of patients first seen between February 2025 and 30 September 2026, with follow-up through 4 November 2026. All patients received the three-component lifestyle intervention (advice on spice extract, diet and Yoga) and were offered follow-up; the 1,466 patients with a usable telephone contact were called for feedback and reinforcement of practices. A physical visit with a coded diagnosis was treated as a valid record. Each patient called was coded once for relief and for spice, diet and Yoga compliance using the most recent definitive answer (YES/NO); calls without a definitive answer ("no response", "not interested") were skipped, and patients with no definitive answer on any call were classified as such. Disease burden, including the screening-detected diagnoses, was counted as patient-condition pairs and classed into 14 systems. *Results*: There were 4,047 valid visit records from 1,737 unique patients (904 female [52.0%]; mean age 40.3 +/- 14.6 years; 833 male [48.0%]; mean age 44.8 +/- 15.1 years). Of these, there were 1,035 single-visit [59.6%] and 702 revisit patients [40.4%], i.e. 2.33 visits per patient. The 1,466 analysed patients (763 female [52.1%] and 703 male [47.9%]) comprised 666 revisit and 800 single-visit patients. Their most frequent patient-condition pairs were hypertension (511), obesity (397) and arthritis (268); objective-evidence screening contributed 246 pairs in 233 patients (obesity 161, hypertension 39, anaemia 44, diabetes 2). Of the 1,466 (84.4% of 1,737) patients with a usable telephone contact who were called, 1,016 had a definitive relief answer: 850 (83.7%; 95% CI 81.3-85.8) reported relief and 166 reported no relief. The remaining 450 had no definitive answer. Among the 1,016 patients with a definitive answer, relief was 87.2% (395/453) in revisit versus 80.8% (455/563) in single-visit patients. Treating all 450 patients without a definitive relief answer as no relief, the conservative lower bound of patients reporting relief was 58.0% overall (850/1,466), 59.3% in revisit (395/666) and 56.9% in single-visit patients (455/800). Among the 1,016 patients with practice data, compliance with the spice extract, diet and Yoga was 77.1%, 83.3% and 81.2%, respectively; counting all 450 non-responders as non-compliant gave conservative estimates of 53.4%, 57.7% and 56.3% for the three practices (n = 1,466). In the responding cohort, relief rose with the five-level compliance dose, from 5.2% (6/115) at dose 0 to 98.2% (326/332) at dose 4 (all three practices plus a repeat visit). *Conclusions*: In this exploratory single-arm cohort, patient-reported relief was more frequent at higher levels of a composite measure that combined the three practices and repeat visits. Because there was no comparison group and all lifestyle components were delivered jointly alongside continuing pharmacotherapy, causality cannot be inferred. The findings support feasibility and justify prospective, controlled, disease-specific studies. The efficacy of the four-spice extract remains under study and is not yet a proven treatment.