Dietary and lifestyle modification in metabolic syndrome: a review of randomized control trials in different population groups
DOI:
https://doi.org/10.7175/rhc.v4i4.667Keywords:
Metabolic syndrome, Lifestyle, Intervention studiesAbstract
The emergence of modernization coupled with sedentary lifestyle has resulted in the shift from the prevalence of diseases only due to under nutrition, to those caused by over nutrition. The augmentation of non-communicable diseases, thus, imposes double burden of disease, impeding the health of a nation. This upsurge has led to increase in prevalence and incidence of Metabolic syndrome which is a cluster of inter-related factors characterized by high fasting blood glucose, increased level of triglycerides, low levels of high density cholesterol, elevated blood pressure and abdominal obesity. The best way to combat this syndrome is to reduce the atherosclerotic risk, which can be carried out by modification in the diet and lifestyle – the first line of treatment of the syndrome. Thus, the present review was undertaken to understand the already existing as well as the current scenario specifically regarding the dietary and lifestyle interventions being carried out to overcome Metabolic syndrome. Of the randomized control trials reviewed, all except one reported improvement in Metabolic syndrome following intervention in diet and/or lifestyle modification either in certain components or overall syndrome within a period of 2 weeks–1 year. These interventions to alter diet and lifestyle focus on weight reduction, promotion of regular physical activity, reduction of substance abuse, effectiveness of specific food items along with regulation of genes and various inflammatory markers. They have the potential to succeed only if they are executed early, and thus, offer enough evidence to develop appropriate public policies. However, the issue that is of utmost significance is of sustainability and compliance, which eventually decides the long-term success or failure of an intervention.
References
Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012; 70: 3-21; http://dx.doi.org/10.1111/j.1753-4887.2011.00456.x
Misra A, Singhal N, Sivakumar B, et al. Nutrition transition in India: Secular trends in dietary intake and their relationship to diet-related non-communicable diseases. J Diabetes 2011; 3: 278-92; http://dx.doi.org/10.1111/j.1753-0407.2011.00139.x
Misra A. Overnutrition and nutritional deficiency contribute to metabolic syndrome and atherosclerosis in Asian Indians. Nutrition 2002; 18: 702-3; http://dx.doi.org/10.1016/S0899-9007(02)00818-3
Reddy KS. Cardiovascular diseases in the developing countries: dimensions, determinants, dynamics and directions for public health action. Public Health Nutr 2002; 5: 231-7; http://dx.doi.org/10.1079/PHN2001298
Murray CJL, Lopez AD. The global burden of disease. Boston: Harvard School of Public Health, 1996
World Health Organization. The World Health Report: life in the 21st century: A vision for all. Geneva: World Health Organization, 1998
Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance in India. In: Gan D. Diabetes atlas, 3rd ed. Kortrijik (Hevle), Belgium: International Diabetes Federation 2006; 15-103
Pritchett AM, Foreyt JP, Mann DL. Treatment of the Metabolic Syndrome: The Impact of Lifestyle Modification. Curr Atheroscler Rep 2005; 7: 95-102; http://dx.doi.org/10.1007/s11883-005-0030-4
Modan M, Halkin H, Almog S, et al. Hyperinsulinaemia - A link between hypertension, obesity and glucose intolerance. J Clin Invest 1985; 75: 809-17; http://dx.doi.org/10.1172/JCI111776
Ferrannini E, Haffner M, Mitchell BD, et al. Hyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia 1991; 34: 416-22; http://dx.doi.org/10.1007/BF00403180
Reaven GM. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607; http://dx.doi.org/10.2337/diab.37.12.1595
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143-421; http://circ.ahajournals.org/content/106/25/3143.citation
Do Carmo I, Dos Santos O, Camolas J, et al. Overweight and obesity in Portugal: National prevalence in 2003-2005. Obes Rev 2008; 9: 11-9; http://dx.doi.org/10.1111/j.1467-789X.2007.00422.x
Hollman G, Kristenson M. The prevalence of the metabolic syndrome and its risk factors in a middle-aged Swedish population–mainly a function of overweight? Eur J Cardiovasc Nurs 2008; 7: 21-6; http://dx.doi.org/10.1016/j.ejcnurse.2007.05.003
Hillier TA, Fagot-Campagna A, Eschwege E, et al. Weight change and changes in the metabolic syndrome as the French population moves towards overweight: The D.E.S.I.R. cohort. Int J Epidemiol 2006; 35: 190-6; http://dx.doi.org/10.1093/ije/dyi281
Ervin RB. Prevalence of Metabolic Syndrome among Adults 20 Years of Age and Over, by Sex, Age, Race and Ethnicity, and Body Mass Index: United States, 2003-2006. National Health Statistics Reports. Hyattsville, MD: National Center for Health Statistics 2009, No. 13
Kanjilal S, Shanker J, Rao VS, et al. Prevalence and component analysis of metabolic syndrome: An Indian atherosclerosis research study perspective. Vasc Health Risk Manag 2008; 4: 189-97; http://dx.doi.org/10.2147/VHRM.S2279
Misra A, Khurana L. Obesity and the Metabolic Syndrome in Developing Countries. J Clin Endocrinol Metab 2008; 93: S9-S30; http://dx.doi.org/10.1210/jc.2008-1595
Misra A, Misra R. Asian Indians and insulin resistance syndrome: Global perspective. Metab Syndr Relat Disord 2003; 1: 277-85; http://dx.doi.org/10.1089/1540419031361390
Misra A, Pandey RM, Devi JR, et al. High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India. Int J Obes Relat Metab Disord 2001; 25: 1722-9
Carr DB, Utzschneider KM, Hull RL, et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004; 53: 2087-94; http://dx.doi.org/10.2337/diabetes.53.8.2087
Park YW, Zhu S, Palaniappan L, et al. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 2003; 163: 427-36; http://dx.doi.org/10.1001/archinte.163.4.427
Lemieux I, Pascot A, Couillard C, et al. Hypertriglyceridemic waist: a marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL in men? Circulation 2000; 102: 179-84; http://dx.doi.org/10.1161/01.CIR.102.2.179
Gustat J, Srinivasan SR, Elkasabany A, et al. Relation of self-rated measures of physical activity to multiple risk factors of insulin resistance syndrome in young adults: the Bogalusa Heart Study. J Clin Epidemiol 2002; 55: 997-1006; http://dx.doi.org/10.1016/S0895-4356(02)00427-4
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: Findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356-9; http://dx.doi.org/10.1001/jama.287.3.356
Apridonidze T, Essah PA, Iuorno MJ, et al. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004; 90: 1929-35; http://dx.doi.org/10.1210/jc.2004-1045
Misra A, Vikram NK. Factors, definitions, predictive value & Asian Indian ethnicity: Complexities of the metabolic syndrome. Indian J Med Res 2008; 127: 293-6
Kamble P, Deshmukh PR, Garg N. Metabolic Syndrome in adult population of rural Wardha, Central India. Indian J Med Res 2010; 132: 701-5
Prabhakaran D, Chaturvedi V, Shah P, et al. Differences in the prevalence of metabolic syndrome in urban and rural India: a problem of urbanization. Chronic Illn 2007; 3: 8-19; http://dx.doi.org/10.1177/1742395307079197
Mohan V, Gokulakrishnan K, Deepa R, et al. Association of physical inactivity with components of metabolic syndrome and coronary artery disease; the Chennai Urban Population Study (CUPS no. 15). Diabetic Med 2005; 22: 1206-11; http://dx.doi.org/10.1111/j.1464-5491.2005.01616.x
Yeolekar ME. Coronary artery disease in Asian Indians. J Postgrad Med 1998; 44: 26-8; http://www.jpgmonline.com/text.asp?1998/44/1/26/382
Misra A, Misra R, Wijesuriya M, et al. The metabolic syndrome in South Asians: Continuing escalation & possible solutions. Indian J Med Res 2007; 125: 345-54
Sharifi F, Mousavinasab SN, Saeini M, et al. Prevalence of Metabolic Syndrome in an Adult Urban Population of the West of Iran. Exp Diabetes Res 2009: 5; http://dx.doi.org/10.1155/2009/136501
He Y, Jiang B, Wang J, et al. Prevalence of the metabolic syndrome and its relation to cardiovascular disease in an elderly Chinese population. J Am Coll Cardiol 2006; 47: 1588-94; http://dx.doi.org/10.1016/j.jacc.2005.11.074
Adams RJ, Appleton S, Wilson DH, et al. Population comparison of two clinical approaches to the metabolic syndrome: implications of the new International Diabetes Federation consensus definition. Diabetes Care 2005; 28: 2777-9; http://dx.doi.org/10.2337/diacare.28.11.2777
Gupta R, Sarna M, Thanvi J, et al. High prevalence of multiple coronary risk factors in Punjabi Bhatia community: Jaipur Heart Watch-3. Indian Heart J 2004; 56: 646-52
Hu FB, Meigs JB, Li TY, et al. Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes 2004; 53: 693-700; http://dx.doi.org/10.2337/diabetes.53.3.693
Mangat C, Goel NK, Walia DK, et al. Metabolic Syndrome: a challenging health Issue in highly urbanized Union Territory of North India. Diabetol Metab Syndr 2010; 2: 19
Smith C, Essop MF. Gender differences in metabolic risk factor prevalence in a South African student population. Cardiovasc J Africa 2009; 20: 178-82
Regitz-Zagroek V, Lehmkuhl E, Mahmoodzadeh S. Gender aspects of the role of the metabolic syndrome as a risk factor for cardiovascular disease. Gen Med 2007; 4: S162-77; http://dx.doi.org/10.1016/S1550-8579(07)80056-8
Sarkar S, Das M, Mukhopadhyay B, et al. High prevalence of metabolic syndrome and its correlates in two tribal populations of India and the impact of urbanization. Indian J Med Res 2006; 123: 679-86
Ramachandran A, Snehalatha C, Satyavani K, et al. Metabolic syndrome in urban Asian Indian adults - a population study using modified ATP-III criteria. Diabetes Res Clin Pract 2003; 60: 199-204; http://dx.doi.org/10.1016/S0168-8227(03)00060-3
Perel P, Langenberg C, Ferrie J, et al. Household wealth and the metabolic syndrome in the Whitehall II study. Diabetes Care 2006; 29: 2694-700; http://dx.doi.org/10.2337/dc06-0022
Dallongeville J, Cottel D, Ferrieres J, et al. Household income is associated with the risk of metabolic syndrome in a sex-specific manner. Diabetes Care 2005; 28: 409-15; http://dx.doi.org/10.2337/diacare.28.2.409
Du S, Mroz TA, Zhai F, et al. Rapid income growth adversely affects diet quality in China - Particularly for the poor! Soc Sci Med 2004; 59: 1505-15; http://dx.doi.org/10.1016/j.socscimed.2004.01.021
Brunner EJ, Marmot MG, Nanchahal K, et al. Social inequality in coronary risk: Central obesity and the metabolic syndrome. Evidence from the Whitehall II study. Diabetologia 1997; 40: 1341-49; http://dx.doi.org/10.1007/s001250050830
Deepa M, Farooq S, Datta M, et al. Prevalence of metabolic syndrome using WHO, ATP-III and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES-34). Diabetes 2006; 23: 127-34; http://dx.doi.org/10.1002/dmrr.658
Florez H, Silva E, Fernandez V, et al. Prevalence and risk factors associated with the metabolic syndrome and dyslipidemia in White, Black, Amerindian and Mixed Hispanics in Zulia State, Venezuela. Diabetes Res Clin Pract 2005; 69: 63-77; http://dx.doi.org/10.1016/j.diabres.2004.11.018
Al-Lawati JA, Mohammed AJ, Al-Hinai HQ, et al. Prevalence of the metabolic syndrome among Omani adults. Diabetes Care 2003; 26: 1781-5; http://dx.doi.org/10.2337/diacare.26.6.1781
Reddy KS, Prabhkaran D, Chaturvedi V, et al. Methods for establishing a surveillance system for cardiovascular diseases in Indian industrial populations. Bull World Health Organ 2006; 84: 461-69; http://dx.doi.org/10.1590/S0042-96862006000600015
Rosengren A, Anderson K, Wilhelmsen L. Risk of coronary heart disease in middle-aged male bus and tram drivers compared to men in other occupations: A prospective study. Int J Epidemiol 1991; 20: 82-7; http://dx.doi.org/10.1093/ije/20.1.82
León Latre M, Andrés EM, Cordero A, et al. Relationship between metabolic syndrome and ischemic heart disease mortality in Spain. Rev Esp Cardiol 2009; 62: 1469-72; http://dx.doi.org/10.1016/S1885-5857(09)73544-3
Taraghi Z, Ilali E. Screening of Hypertension in truck drivers in Mazandaran. HAYAT 2004; 10: 63-70
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52; http://dx.doi.org/10.1161/CIRCULATIONAHA.105.169404
AHA Scientific Statement. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement: Executive Summary. Circulation 2005; 112: e285-e90; http://dx.doi.org/10.1161/CIRCULATIONAHA.105.169405
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