Indirect lifestyle intervention through wives improves metabolic syndrome components in men

Abstract

Objectives: It is well known that body weight loss through a direct (supervised) lifestyle intervention (LSI) improves obesityrelated metabolic disorders. The purpose of this study was to investigate the effects of an indirect LSI on weight loss and metabolic syndrome (MetS) in spouses of LSI participants. Methods: A total of 104 men (abdominal circumference X85 cm; age, 52.1 ± 9.3 years) were assigned to one of three groups: no intervention (NI, n ¼ 34), direct intervention (DI, n ¼ 34) or indirect intervention (II, n ¼ 36), the last of which consisted of subjects who did not participate in the direct LSI but whose wives did. Body weight and MetS components were measured before and after a 14-week intervention. Daily energy intake and activity-related energy expenditure were assessed before and during the intervention. The LSI program was mainly consisted of dietary modifications with a physical activity program. Results: No differences were observed across the three groups in any of the measures at baseline. Significant differences were observed among the groups in weight loss (NI, À0.7 ± 1.4; DI, À6.2 ± 3.3 and II, À4.4 ± 3.7 kg) during the intervention. Along with the body weight reductions, significant improvements were observed in most of MetS components within the DI and II groups. When analyzing the spouse pairs in group II, significant correlations were observed in weight loss (r ¼ 0.57) and decreased total energy intake (r ¼ 0.54) between wives and husbands. Conclusions: Indirect LSI in abdominally obese men whose wives were undergoing LSI led to loss of weight and a decreased incidence of MetS, suggesting that indirect LSI may be an effective program for eliciting beneficial change in health status. one spouse has a significant impact on weight loss in the untreated spouse. They clearly showed 'a ripple effect' on weight loss through spouses. However, the studies did not include examinations of MetS components, which can be greatly affected by changes in body adiposity. To the best of our knowledge, the study by Sexton et al. 17 is the only one to show that a health behavior intervention for one spouse has a ripple effect on cardiovascular risk factors in the other, untreated spouse. Although the study focused on three cardiovascular risk factors (blood pressure, cigarette smoking and serum cholesterol) it did not examine subjects' weight loss and MetS components. Thus, none of the earlier studies focused on the effects of an indirect LSI on weight loss and improved MetS components in the untreated spouse. Therefore, in this study, we examined the effects on weight loss and MetS components in abdominally obese Japanese men of an indirect LSI through their wives. The primary hypothesis of our study was that the indirect LSI through wives would affect weight loss and improve the MetS components of the husbands who did not receive the direct LSI. We also had a secondary hypothesis that the weight loss and lifestyle changes of wives would correlate with those of their husbands.

Significant but weak spousal concordance of metabolic syndrome components in Japanese couples

“…Familial aggregation of MS has been a focus of studies in various populations [10][11][12][13][14][18][19][20][21][22][23][24][25][26][27][28]. The subjects studied in families included parents (i.e., couples), children and relatives.…”

An increase in high-density lipoprotein cholesterol after weight loss intervention is associated with long-term maintenance of reduced visceral abdominal fat

“…3 It is well known that body weight reduction improves metabolic disorders related to obesity, and many studies [4][5][6][7] have indicated that metabolic risk factors, such as blood pressure, lipids and glucose, improve with weight reduction through a short-term weight-loss intervention. However, several studies [8][9][10] have…”

Effect of Six Months Lifestyle Intervention in Japanese Men with Metabolic Syndrome: Randomized Controlled Trial

“…In a US study among 279 adult men and women with MS, only body weight and waist circumference were significantly decreased by a 12-month computer-based intervention of physical activity and diet 13) . Similarly, Japanese studies among subjects who had at least one component of MS have also observed significant decreases in body weight, fasting glucose or glycated hemoglobin in intervention groups; however, a beneficial effect of intervention on blood pressure, total cholesterol or triglyceride has not been observed [5][6][7] . Among persons with MS, lifestyle intervention was focused on weight control, although physical activity and diet may have a favorable effect on body weight, waist circumference and glucose metabolism but have no or limited effect on blood pressure and lipid profile.…”

“…On the other hand, in an Italian study among subjects with MS and those who had two MS components and a high level of high-sensitivity C-reactive protein (hs-CRP) 4) , the intervention group showed a significantly greater reduction in the prevalence of MS than the control group. In some Japanese studies, lifestyle intervention in adults who had an unfavorable profile in terms of cardiometabolic risk factors [5][6][7] has been shown to improve components of MS. To our knowledge, however, no study has examined the effect of intervention among subjects who met the Japanese definition of MS in Japan. …”