Multi-modal interventions outperform nutritional or exercise interventions alone in reversing metabolic syndrome: a systematic review and network meta-analysis.

IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Bernice S Chan, Doris S F Yu, Cathy W Y Wong, Polly W C Li
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引用次数: 0

Abstract

Aims: This review aimed to evaluate the comparative effectiveness of primary prevention interventions targeting therapeutic lifestyle changes on metabolic syndrome reversal and cardiometabolic outcomes in adults (≥ 18 years) with metabolic syndrome.

Methods: A systematic search was conducted in seven electronic databases from inception to 28 April 2023 to identify randomised controlled trials (RCTs) of primary prevention interventions combating metabolic syndrome. Bayesian network meta-analyses were conducted to evaluate comparative effectiveness of active intervention components.

Results: Total of 98 eligible RCTs involving 12 813 participants were included. The individual interventions were categorised as nutritional or exercise interventions and their combinations as multi-modal interventions. The behavioural change strategies were categorised according to the sources of behaviour (i.e., capability, opportunity and motivation). Pairwise meta-analysis demonstrated that multi-modal interventions outperformed exercise interventions in reversing metabolic syndrome. Network meta-analyses revealed the differences in the optimal active intervention components across outcomes. The consumption of a diet promoting moderate macronutrient intake (caloric restriction, DASH and Mediterranean diets) combined with supervised aerobic exercise training or professional physical activity advice or counselling consistently yielded superior beneficial effects on metabolic syndrome, which was supported by a low certainty of evidence. Between-study differences in body weight and blood pressure were significantly explained by the use of behavioural change strategies.

Conclusion: Combining a moderate macronutrient diet with aerobic exercise training or physical activity advice or counselling demonstrated superior beneficial effects on metabolic syndrome and its defining characteristics. These findings could provide healthcare professionals with critical guidance for implementing lifestyle interventions to manage metabolic syndrome.

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来源期刊
European journal of preventive cardiology
European journal of preventive cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
12.50
自引率
12.00%
发文量
601
审稿时长
3-8 weeks
期刊介绍: European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.
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