Lifestyle intervention: Prevention of complications to the metabolic syndrome

Abstract

Metabolic syndrome is characterised by insulin resistance and a clustering of risk factors for both type 2 diabetes and cardiovascular diseases (CVD). Metabolic syndrome and type 2 diabetes show rising prevalence worldwide. The most important modifiable risk factors for the metabolic syndrome and type 2 diabetes are overweight, abdominal obesity and physical inactivity, as well as dietary factors. Prevention, early identification and treatment of the metabolic syndrome serve for the primary and secondary prevention of type 2 diabetes and CVD. Besides being a major challenge for health care, prevention and treatment of the metabolic syndrome is also a challenge for predisposed individuals. Recent recommendations promote lifestyle changes, e.g. increased physical activity, a healthy diet and weight loss (Grundy et al., Circulation 112:2735-2752, 2005; Alberti et al., Diabet Med 23:469-480, 2006; Eckel et al., Lancet 375:181, 2010). There are now several studies supporting the possibility of preventing type 2 diabetes through changes in lifestyle (Tuomilehto et al., N Engl J Med 344: 1343-1350, 2001; Knowler et al., N Engl J Med 346: 393-403, 2002), but only a few studies on the treatment of the metabolic syndrome have been published. Post hoc analyses of the Finnish Diabetes Prevention Study (DPS) and the USA Diabetes Prevention Program (DPP) data of the effects of intensive and individual lifestyle counselling, weight loss and exercise on the metabolic syndrome have shown that lifestyle intervention is effective in preventing metabolic syndrome in people at high risk of type 2 diabetes The intervention also resulted in resolution of the metabolic syndrome in those participants who had metabolic syndrome at baseline.