Effectiveness of lifestyle intervention on metabolic syndrome

Effectiveness of a Lifestyle Intervention on Metabolic Syndrome. A Randomized Controlled Trial
Simona Bo, MD1, Giovannino Ciccone, MD, PhD 2, Carla Baldi, MD3, Lorenzo Benini, MD3, Ferruccio Dusio, MD3, Giuseppe Forastiere, MD3, Claudio Lucia, MD3, Claudio Nuti, MD3, Marilena Durazzo, MD1, Maurizio Cassader, MD1, Luigi Gentile, MD4, and Gianfranco Pagano, MD1
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Department of Internal Medicine, University of Turin, Turin, Italy; 2Unit of Epidemiology, S. Giovanni Battista Hospital, Turin, Italy; Sanitary Districts of Asti, Asti, Italy; 4 Diabetic Clinic, Hospital of Asti, Asti, Italy.

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BACKGROUND: Intensive lifestyle intervention significantly reduces the progression to diabetes in high-risk individuals. OBJECTIVE: It is not known whether a program of moderate intervention might effectively reduce metabolic abnormalities in the general population. DESIGN: Two-arm randomized controlled 1-year trial. PATIENTS: Three hundred and thirty-five patients participated from a dysmetabolic population-based cohort of 375 adults aged 45–64 years in northwestern Italy. MEASUREMENTS: We compared the effectiveness of a general recommendation-based program of lifestyle intervention carried out by trained professionals versus standard unstructured information given by family physicians at reducing the prevalence of multiple metabolic and inflammatory abnormalities. RESULTS: At baseline, clinical/anthropometric/laboratory and lifestyle characteristics of the intervention (n=169) and control (n=166) groups were not significantly different. The former significantly reduced total/ saturated fat intake and increased polyunsaturated fat/fiber intake and exercise level compared to the controls. Weight, waist circumference, high-sensitivity C-reactive protein, and most of the metabolic syndrome components decreased in the intervention group and increased in the controls after 12 months. Lifestyle intervention significantly reduced metabolic syndrome (odds ratio [OR]=0.28; 95%