Physical activity and nutrition behaviour outcomes of a cluster-randomized controlled trial for adults with metabolic syndrome in Vietnam

Abstract

BackgroundMetabolic syndrome is prevalent among Vietnamese adults, especially those aged 50–65 years. This study evaluated the effectiveness of a 6 month community-based lifestyle intervention to increase physical activity levels and improve dietary behaviours for adults with metabolic syndrome in Vietnam.MethodsTen communes, involving participants aged 50–65 years with metabolic syndrome, were recruited from Hanam province in northern Vietnam. The communes were randomly allocated to either the intervention (five communes, n = 214) or the control group (five communes, n = 203). Intervention group participants received a health promotion package, consisting of an information booklet, education sessions, a walking group, and a resistance band. Control group participants received one session of standard advice during the 6 month period. Data were collected at baseline and after the intervention to evaluate programme effectiveness. The International Physical Activity Questionnaire – Short Form and a modified STEPS questionnaire were used to assess physical activity and dietary behaviours, respectively, in both groups. Pedometers were worn by the intervention participants only for 7 consecutive days at baseline and post-intervention testing. To accommodate the repeated measures and the clustering of individuals within communes, multilevel mixed regression models with random effects were fitted to determine the impacts of intervention on changes in outcome variables over time and between groups.ResultsWith a retention rate of 80.8%, the final sample comprised 175 intervention and 162 control participants. After controlling for demographic and other confounding factors, the intervention participants showed significant increases in moderate intensity activity (P = 0.018), walking (P < 0.001) and total physical activity (P = 0.001), as well as a decrease in mean sitting time (P < 0.001), relative to their control counterparts. Significant improvements in dietary behaviours were also observed, particularly reductions in intake of animal internal organs (P = 0.001) and in using cooking oil for daily meal preparation (P = 0.001).ConclusionsThe prescribed community-based physical activity and nutrition intervention programme successfully improved physical activity and dietary behaviours for adults with metabolic syndrome in Vietnam.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12614000811606. Registered on 31 July 2014Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1771-9) contains supplementary material, which is available to authorized users.

Supervised lifestyle intervention for people with metabolic syndrome improves outcomes and reduces individual risk factors of metabolic syndrome: A systematic review and meta-analysis

“…Two studies reported significant positive behaviour change in relation to physical activity in the intervention group [35,41], with one reporting significant increases in moderate intensity activity, walking and total physical activity, and decreased mean sitting time [35]. Six studies reported significant positive behaviour changes related to food intake in the intervention groups [28,31,35,36,38,41].…”

“…Three studies by Straznicky et al [27][28][29] report data from one trial and two studies by Anderssen et al [30,31], as well as the study by Torjesen et al [32] all report data from the Oslo Diet and Exercise Study (ODES) [33]. Two studies by Tran et al [34,35] also report results from the same trial. Data were only included once in any meta-analysis for participant data reported in multiple trials.…”

“…Dietary interventions included education or behavioural counselling on healthy eating [34,37,38], intensive nutritional education course [37], calorie reduction [28,32,36,[39][40][41], reducing carbohydrates [39,40] and fats [31,36,40,41], daily food diary [40,41], recipes [28,34], supermarket tour and cooking sessions [38]. In general, dietary interventions targeted either calorie restriction [28,32,36,[39][40][41] or healthy eating [35,37,38,42].…”

“…Most studies reported individual tailoring of exercises to suit participant's needs. Three trials included supervised walking or jogging only [35,36,42]. The duration of exercise interventions ranged from 4 weeks [40,41] to 1 year [32].…”

“…7, Table 3). When including only trials that measured glucose in mmol/L [28,32,35,37,38] so that data could be converted to %HbA1c for clinical interpretability, lifestyle intervention reduced fasting glucose by 0.3 mmol/L which is equivalent to a reduction in HbA1c of 1.8%. Significant moderators from the meta-regression analysis were intervention duration, amount of supervised exercise and percentage women.…”