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
{"title":"Multi-modal interventions outperform nutritional or exercise interventions alone in reversing metabolic syndrome: a systematic review and network meta-analysis.","authors":"Bernice S Chan, Doris S F Yu, Cathy W Y Wong, Polly W C Li","doi":"10.1093/eurjpc/zwaf167","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of preventive cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/eurjpc/zwaf167","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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.

多模式干预在逆转代谢综合征方面优于单独的营养或运动干预:一项系统综述和网络荟萃分析。
目的:本综述旨在评估针对治疗性生活方式改变的一级预防干预对代谢综合征成人(≥18岁)逆转和心脏代谢结局的比较有效性。方法:系统检索自成立至2023年4月28日的7个电子数据库,以确定初级预防干预措施对抗代谢综合征的随机对照试验(rct)。采用贝叶斯网络元分析来评估主动干预成分的相对有效性。结果:共纳入98项符合条件的随机对照试验,涉及12 813名受试者。个体干预被归类为营养或运动干预,它们的组合被归类为多模式干预。根据行为来源(即能力、机会和动机)对行为改变策略进行分类。两两荟萃分析表明,多模式干预在逆转代谢综合征方面优于运动干预。网络荟萃分析揭示了不同结果的最佳主动干预成分的差异。促进适度常量营养素摄入的饮食(热量限制、DASH和地中海饮食)与有监督的有氧运动训练或专业的体育活动建议或咨询相结合,始终对代谢综合征产生卓越的有益效果,这得到了低确定性证据的支持。研究间体重和血压的差异可以通过使用行为改变策略来解释。结论:将适度的常量营养素饮食与有氧运动训练或体育活动建议或咨询相结合,对代谢综合征及其定义特征具有卓越的有益效果。这些发现可以为医疗保健专业人员提供实施生活方式干预以控制代谢综合征的关键指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信