Diet and Exercise in the Prevention and Management of the Metabolic Syndrome

Abstract

KEY POINTS The metabolic syndrome (MetSyn) encompasses a constellation of metabolic abnormalities that are thought to place patients at higher risk for cardiovascular morbidity. Many definitions have been proposed, and although the exact mechanisms underlying the syndrome remain unclear, increased abdominal fat correlated with dyslipidemia, insulin resistance, and hyperinsulinemia are believed to be the core of its pathophysiology. Its increasing prevalence urged the need for preventing and managing strategies. Prevention of the syndrome includes keeping body weight within the normal range, exercise training, and consumption of a moderate carbohydrate diet, with moderate consumption of mono or polyunsaturated fatty acids (omega-3 polyunsaturated fatty acids). Current guidelines for the clinical management propose lifestyle changes (diet and physical activity) as a first-line intervention. However, research in this area is limited. Weight loss has been recognized as an important issue in the management of MetSyn, in addition to exercise training and diet quality. Short-term success of lifestyle intervention programs has been observed, though they failed to sustain long-term effectiveness. Multiple follow-up booster sessions proved more effective in maintaining lifestyle changes than one counseling session at the end of follow-up. In conclusion, diet and physical activity have a pivotal role in the prevention and management of the MetSyn. Hence, it is of major importance to explore strategies to improve adherence and ensure that patients achieve and maintain lifestyle changes.