Effects of Lifestyle Intervention on Inflammatory Markers and Waist Circumference in Overweight/Obese Adults With Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Physical inactivity and an imbalanced diet could lead to some cardio metabolic risk factors. Objective: The objective of this meta-analysis was to investigate the effects of lifestyle modification on inflammatory indicators and waist circumference (WC) in overweight/obese subjects with metabolic syndrome (MS) Data sources: A systematic search was conducted in PubMed, CINAHL, MEDLINE, Cochrane, Google Scholar, and Web of Science. Study selection: The selection criteria were randomized controlled trials (RCTs) investigating the effects of lifestyle interventions on inflammation and WC from inception to 20 December 2020. The weighted mean difference (WMD) and 95% confidence interval (CI) between interventions were computed using a random or fixed-effects model. Results: Six RCTs (including 1246 MS patients who had, on average, overweight/obesity) met all inclusion criteria. Interventions lasted 6 to 12 months (2–5 sessions per week). Lifestyle intervention significantly reduced C-reactive protein (WMD: −0.52 mg/ml, 95% CI: −0.72, −0.33), IL-6 (WMD: −0.50 pg/ml, 95% CI: −0.56, −0.45), and increased adiponectin (WMD: 0.81 µg/ml, 95% CI, 0.64, 0.98). Moreover, lifestyle modification significantly decreased WC (WMD: −3.12 cm, 95% CI, −4.61, −1.62). Conclusion: Our findings provide evidence that lifestyle alterations, including physical activity and diet, can lead to significant improvement in abdominal obesity, measured by WC and some inflammation markers among overweight/obese individuals with MS. Further high-quality research is needed to clarify the mechanisms underlying the effect of such interventions on this population’s inflammatory markers.

Exploratory analysis of the effect of a controlled lifestyle intervention on inflammatory markers – the Healthy Lifestyle Community Programme (cohort 2)

“…In participants with metabolic syndrome, some lifestyle interventions have resulted in significant [ 32 ] (or non-significant [ 43 ]) Apn increases. However, apart from our study, no other controlled trials could be identified which have assessed the effect of a dietary or lifestyle intervention including a strong focus on a predominantly plant-based diet on Apn levels in mostly clinically healthy participants from the general population [ 31 , 32 ]. Thus, our results cannot be compared to highly similar studies.…”

“…Like in the case of Hcy, the potential effect of plant-based diets on Apn levels are unclear [ 31 ]. To date, controlled trials assessing the effect of healthy lifestyle changes including a predominantly plant-based diet on Apn levels in clinically healthy participants from the general population are lacking [ 31 , 32 ].…”

Prevalence of Metabolic Syndrome and Insulin Resistance in a Sample of Adult ADHD Outpatients

“…To reduce atherosclerotic cardiovascular disease risk in MS, lifestyle interventions are the first-choice, regardless of age ( 65 ). Non-pharmacological approaches are recommended to all patients, including quit smoking, follow healthy diet and practice physical activity ( 66 , 67 ). Pharmacological strategies such as statins and antihypertensive medications should be reserved to patients with specific risk profile based on previous history of cardiovascular disease, and Framingham-based 10-year risk score ( 65 , 68 ).…”

Obesity and recurrent miscarriage: The interconnections between adipose tissue and the immune system

“…121,122 A recent extensive systematic review and meta-analysis found that lifestyle changes in patients with obesity improve anthropometric measurements and levels of inflammatory markers, such as C-reactive protein (CRP) and IL-6. 123 Nutritional interventions and pharmacotherapy can also alleviate the inflammatory status in individuals with and without obesity. [124][125][126] Additionally, the surgical treatment of obesity can reduce BMI and inflammatory marker levels.…”