Objective: To evaluate the effectiveness of a lifestyle intervention for male workers in the construction industry at risk of cardiovascular disease (CVD). Methods: In a randomized controlled trial performed in the Netherlands between 2007 and 2009, usual care was compared to 6 months of individual counseling using motivational interviewing techniques, delivered face to face and by telephone. Participants aimed at improving energy balance-related behavior or smoking cessation. Linear regression analyses were performed to determine the effects. Results: Body weight had significantly decreased at 6 (β= -1.9, 95% CI -2.6; -1.2) and 12 months (β= -1.8, 95%CI -2.8; -1.1). The intervention effects were also significant for diastolic blood pressure at 6 months (β = -1.7, 95% CI -3.3; -0.1). Among participants who had aimed at energy balance, the intervention had a significant favorable effect on body weight at 6 (β= -2.1, 95% CI -2.9; -1.3) and 12 months (β= -2.2, 95% CI -3.1; -1.3) and at HDL cholesterol (β=0.05, 95% CI 0.01; 0.10) and HbA1c (β= -0.06, 95%CI -0.12; -0.001) at 12 months, although there was no intervention effect on these variables over time. Conclusion: Individual-based counseling resulted in significant beneficial long-term effects on body weight. This is an important finding for occupational health, considering the rising prevalence of obesity and CVD. © 2010 Elsevier Inc.