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Submitted: 10 June 2011 Modified: 20 August 2018
HERDIN Record #: PCHRD06101112061539

Dietary and lifestyle intervention in metabolic syndrome: Recent evidence.

Rosa Allyn G. Sy

Metabolic syndrome is clustering of cardiovascular disease (CVD) risk factors, including abdominal obesity, elevated blood glucose, dyslipidemia, and high blood presure that increase risk type of 2 diabetes and CVD. In 2004, the Centers for Disease Control and Prevention (CDC) estimated that as many as 64 million Americans, or 27% of the United State population, have metabolic syndrome. In the Philippines, based on the NCEP/ATPIII criteria modified by the AHA/NHLBI criteria it is estimated that 18.6% of Filipinos have metabolic syndrome. In recent years, with the increasing workers involved in night shifts, it is predicted that this number will further increase on the basis of unfavorable effects of sleep deprivation on the main components of the syndrome such as visceral obesity, blood pressure and insulin sensitivity. In this session, recent evidence on the influence of lifestyle modification on the different components of metabolic syndrome will be presented and discussed. Lifestyle changes such as diet, weight loss, and exercise are the first line of treatment for metabolic syndrome. Insulin sensitivity (Si) is improved by weight loss and exercise; however, the optimal diet composition is debated. Current nutritional approaches to metabolic syndrome and type 2 diabetes generally rely on reductions in dietary fat. The success of such approaches has been limited and the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain. Hence, therapy more generally relies on pharmacology. Recently, re-evaluation of the role of carbohydrates restriction as an alternative and possibly superior dietary strategy in the management of metabolic syndrome is suggested. The rationale is that carbohydrate restriction improves glycemic control and reduces insulin fluctuations, which are primary targets. The effects of a whole grain-enriched hypocaloric diet on cardiovascular disease risk factors in men and women with metabolic syndrome showed favorable results. In a separate study, high-carbohydrate diet showed a significant decrease in LDL cholesterol concentrations while the low-carbohydrate diet was associated with a greater decrease in the prevalence of hypertension (P<0.05) and of hypertricylglycerolemia (P<0.001). However, the extent of the resolution of the metabolic syndrome was not different between groups. In contrast, the Mediterranean diet has been shown to have beneficial effects on cardiovascular risk factors. In individuals with hypertension and with metabolic syndrome, the combination of established recommendations and DASH (Dietary Approached to Stop Hypertension) showed potential benefits in both SBP and DBP as well as reduction in total cholesterol and insulin resistance. In a study that compared calorie restriction (CR) with and without exercise showed that despite similar effect on fat losses, combining CR with exercise increased aerobic fitness in parallel with improved insulin sensitivity, LDL cholesterol, and diastolic BP. The results lend support for inclusion of an exercise component in weight loss programs to improve metabolic fitness. Present evidence supports the promotion of lifestyle modification-diet and exercise as an important and efficacious strategy for the treatment of metabolic syndrome.

Publication Type
Publication Sub Type
The Philippine Society of Endocrinology and Metabolism : 4th Congress
March 15, 2011
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Philippine Council for Health Research and Development Library Pro 385 Abstract pdf (Request Document)