R Gomez-Huelgas1, S Jansen-Chaparro2, A J Baca-Osorio3, J Mancera-Romero3, F J Tinahones4, M R Bernal-López5. 1. Internal Medicine Department, Hospital Regional de Malaga, Spain; Biomedical Institute of Malaga (IBIMA), Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain. Electronic address: ricardogomezhuelgas@hotmail.com. 2. Internal Medicine Department, Hospital Regional de Malaga, Spain; Biomedical Institute of Malaga (IBIMA), Spain. 3. Health Center Ciudad Jardín, Distrito Malaga, Málaga, Spain. 4. Biomedical Institute of Malaga (IBIMA), Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Endocrinology and Nutrition Department, Hospital Regional y Clinico Universitario Virgen de la Victoria de Malaga, Spain. 5. Internal Medicine Department, Hospital Regional de Malaga, Spain; Biomedical Institute of Malaga (IBIMA), Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain. Electronic address: robelopajiju@yahoo.es.
Abstract
BACKGROUND: The impact of a lifestyle intervention (LSI) program for the long-term management of subjects with metabolic syndrome in a primary care setting is not known. METHODS: This 3-year prospective controlled trial randomized adult subjects with metabolic syndrome to receive intensive LSI or to usual care in a community health centre in Malaga, Spain. LSI subjects receivedinstruction on Mediterranean diet and a regular aerobic exercise program by their primary care professionals. Primary outcome included changes from baseline on different components of metabolic syndrome (abdominal circumference, blood pressure, HDL-cholesterol, fasting plasma glucose and triglycerides). RESULTS: Among the 2,492 subjects screened, 601 subjects with metabolic syndrome (24.1%) were randomized to LSI (n = 298) or to usual care (n = 303); of them, a 77% and a 58%, respectively, completed the study. At the end of the study period, LSI resulted in significant differences vs. usual care in abdominal circumference (-0.4 ± 6 cm vs. + 2.1 ± 6.7 cm, p < 0.001), systolic blood pressure (-5.5 ± 15 mmHg vs. -0.6 ± 19 mmHg, p = 0.004), diastolic blood pressure (-4.6 ± 10 mmHg vs. -0.2 ± 13 mmHg, p < 0.001) and HDL-cholesterol (+4 ± 12 mg/dL vs. + 2 ± 12 mg/dL, p = 0.05); however, there were no differences in fasting plasma glucose and triglyceride concentration (-4 ± 35 mg/dl vs. -1 ± 32 mg/dl, p = 0.43 and -0.4 ± 83 mg/dl vs. +6 ± 113 mg/dl, p = 0.28). CONCLUSION:Intensive LSI counseling provided by primary care professionals resulted in significant improvements in abdominal circumference, blood pressure and HDL-cholesterol but had limited effects on glucose and triglyceride levels in patients with metabolic syndrome.
RCT Entities:
BACKGROUND: The impact of a lifestyle intervention (LSI) program for the long-term management of subjects with metabolic syndrome in a primary care setting is not known. METHODS: This 3-year prospective controlled trial randomized adult subjects with metabolic syndrome to receive intensive LSI or to usual care in a community health centre in Malaga, Spain. LSI subjects received instruction on Mediterranean diet and a regular aerobic exercise program by their primary care professionals. Primary outcome included changes from baseline on different components of metabolic syndrome (abdominal circumference, blood pressure, HDL-cholesterol, fasting plasma glucose and triglycerides). RESULTS: Among the 2,492 subjects screened, 601 subjects with metabolic syndrome (24.1%) were randomized to LSI (n = 298) or to usual care (n = 303); of them, a 77% and a 58%, respectively, completed the study. At the end of the study period, LSI resulted in significant differences vs. usual care in abdominal circumference (-0.4 ± 6 cm vs. + 2.1 ± 6.7 cm, p < 0.001), systolic blood pressure (-5.5 ± 15 mmHg vs. -0.6 ± 19 mmHg, p = 0.004), diastolic blood pressure (-4.6 ± 10 mmHg vs. -0.2 ± 13 mmHg, p < 0.001) and HDL-cholesterol (+4 ± 12 mg/dL vs. + 2 ± 12 mg/dL, p = 0.05); however, there were no differences in fasting plasma glucose and triglyceride concentration (-4 ± 35 mg/dl vs. -1 ± 32 mg/dl, p = 0.43 and -0.4 ± 83 mg/dl vs. +6 ± 113 mg/dl, p = 0.28). CONCLUSION: Intensive LSI counseling provided by primary care professionals resulted in significant improvements in abdominal circumference, blood pressure and HDL-cholesterol but had limited effects on glucose and triglyceride levels in patients with metabolic syndrome.
Authors: Khursheed Jeejeebhoy; Rupinder Dhaliwal; Daren K Heyland; Roger Leung; Andrew G Day; Paula Brauer; Dawna Royall; Angelo Tremblay; David M Mutch; Lew Pliamm; Caroline Rhéaume; Doug Klein Journal: CMAJ Open Date: 2017-03-14
Authors: Yan Ping Duan; Wei Liang; Lan Guo; Julian Wienert; Gang Yan Si; Sonia Lippke Journal: J Med Internet Res Date: 2018-11-19 Impact factor: 5.428