J Korean Acad Nurs.  2015 Aug;45(4):483-494. 10.4040/jkan.2015.45.4.483.

Effects of Dietary and Physical Activity Interventions on Metabolic Syndrome: A Meta-analysis

Affiliations
  • 1Division of Nursing Science, Ewha Womans University, Seoul, Korea.
  • 2Department of Nursing, Tongmyong University, Busan, Korea. yangsj@ewha.ac.kr

Abstract

PURPOSE
This study identified effects of dietary and physical activity interventions including dietary interventions or physical activity interventions alone or combined dietary-physical activity interventions to improve symptoms in metabolic syndrome including abdominal obesity, high triglycerides, low high density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose through meta-analysis.
METHODS
Articles on metabolic syndrome X published from 1988 to 2013 were searched through electronic databases, Google Scholar, and reference reviews. Methodological quality was assessed by the checklist, SIGN (Scottish Intercollegiate Guidelines Network).
RESULTS
In the meta-analysis, there were 9 articles reporting 13 interventions with 736 participants. Using random effect models, the dietary and/or physical activity interventions showed a lower mean difference in waist circumference ( - 1.30 cm, 95% CI: - 2.44~ - 0.15, p =.027). The combined dietary-physical activity interventions showed a lower mean difference in waist circumference ( - 2.77 cm, 95% CI: - 4.77~ - 0.76, p =.007) and systolic blood pressure ( - 5.44 mmHg, 95% CI: - 10.76~ - 0.12, p =.044). Additionally, interventions of over 24 weeks yielded a lower mean difference in waist circumference ( - 2.78 cm, 95% CI: - 4.69~ - 0.87, p =.004) and diastolic blood pressure ( - 1.93 mmHg, 95% CI: - 3.63~ - 0.22, p =.026).
CONCLUSION
The findings indicate that dietary and/or physical activity interventions for metabolic syndrome reduce central obesity with no adverse effects. This finding provides objective evidences for dietary and physical activity management on metabolic syndrome as an efficient intervention.

Keyword

Metabolic syndrome X; Meta-analysis; Physical activity; Diet therapy; Health behavior

MeSH Terms

Blood Glucose/analysis
Blood Pressure
Cholesterol, HDL/blood
Databases, Factual
*Diet
*Exercise
Health Behavior
Humans
Metabolic Syndrome X/metabolism/*pathology
Triglycerides/blood
Waist Circumference
Blood Glucose
Cholesterol, HDL
Triglycerides

Figure

  • Figure 1 The flow diagram of study selection for the meta-analysis.

  • Figure 2 Forest plot of the effect of dietary and/or physical activity interventions and funnel plot of the effect sizes by standard error on metabolic syndrome criteria. Pooled effect estimates are shown as diamonds, one each for trials conducted in waist circumference, triglycerides, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, and fasting glucose. Data are expressed as mean difference with 95% confidence interval, using fixed effects models(waist circumference, triglycerides, high-density lipoprotein cholesterol, diastolic blood pressure and fasting glucose) and random effects model(systolic blood pressure). Inter-study heterogeneity was tested by using the Q statistic(Chi2) at significance level of p<.10 and quantified by the Higgins' I2 statistic (I2>50%).


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