Journal of Food, Agriculture and Environment

Dietary and physical activity counseling in high-risk asymptomatic patients with metabolic syndrome – A primary care intervention

Author(s):

Claudiu Avram ^1*, Mircea Iurciuc ², Laura Craciun ², Adina Avram ², Stela Iurciuc ², Cristian Oancea ², Dan Gaita ²

Recieved Date: 2011-06-03, Accepted Date: 2010-10-10

Abstract:

Metabolic syndrome (MetSyn) is related to cardiometabolic risk factors that appear to promote the development of atherosclerotic cardiovascular disease and insulin resistance associated with visceral obesity. An important role in MetSyn treatment is played by the lifestyle intervention including diet recommendations and increase in physical activity. The EuroAspire III – Primary Care Arm survey showed a high prevalence of uncontrolled cardiometabolic risk factors among high-risk asymptomatic patients (obesity, inadequate control of blood pressure, lipids and glucose). General practitioners (GP) recommendations in regard to diet and physical activity were suboptimal and patients’ adherence to lifestyle counseling was reduced. The aim of the study was to assess the efficacy of intensive dietary and physical activity recommendations, made by primary care physicians, in order to improve the management of patients with MetSyn compared to usual care. Two hundred and fifty-three patients with metabolic syndrome were randomized to an intensive lifestyle counseling intervention or usual care. All patients were evaluated using anthropometric measurements and questionnaires for dietary habits and daily physical activity at baseline and after 18 months. Each subject in the intervention group (Group I) was offered a total of approximately 90 min intervention contacts in 3 consecutive visits (every 6 months) to GP offices, consisting in lifestyle habits in relation to diet, weight control and physical activity. Beside this, once a month the patients received a follow-up phone from their GP, emphasis was placed on weight loss, decreasing fat intake, portion control and healthier food group selection along with increasing in daily physical activity. Due to ethical reasons the patients in the control group (Group C) received minimal intervention consisting in one page written general information about the importance of healthy lifestyle. At baseline, main characteristics of the intervention group (n = 133) and control (n = 120) were not significantly different. After 18 months of intervention, the patients in the Group I significantly reduced fat (p = 0.001), carbohydrate (p = 0.054) and total caloric intake (p = 0.009) and increased physical activity level compared to the controls (p = 0.042). Antropometric parameters significantly decreased in Group I (weight from 83.4±14.5 to 81.8±14.7 kg, p = 0.002; waist circumference from 101.1±11.1 to 98.6±11.1 cm, p<0.001; body mass index from 30.3±4.6 to 29.4±4.4 kg/m², p<0.001) and increased in Group C. The primary care intervention applied in our study improved dietary habits and physical activity level, decreased weight and abdominal obesity, with a positive impact on cardiometabolic risk profile of high-risk asymptomatic patients with metabolic syndrome.

Keywords:

Metabolic syndrome, dietary counseling, physical activity, cardiometabolic risk, primary care

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Journal: Journal of Food, Agriculture and Environment
Year: 2011
Volume: 9
Issue: 3&4
Category: Food and Health
Pages: 16-19

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