The effect of dietary changes on distinct components of the metabolic syndrome in a young Sri Lankan population at high risk of CVD

Abstract

South Asian populations are predisposed to early onset of the metabolic syndrome. Lifestyle intervention programmes have demonstrated a reduction in the metabolic syndrome and CVD risk; however, the most effective components of the multi-faceted lifestyle interventions are unknown. We studied 2637 Sri Lankan males (n 1237) and females (n 1380), with a mean BMI of 23·9 (SD 4·2) kg/m 2 , aged 22·5 (SD 10·0) years, who had participated in a 5-year lifestyle-modification programme to examine the effect of dietary changes on distinct components of the metabolic syndrome. The dietary intervention comprised advice to replace polished starches with unpolished starches, high-fat meat and dairy products with low-fat products and high-sugar beverages and snacks with low-sugar varieties. For the purposes of this analysis, data from the control and intensive lifestyle groups were combined. Anthropometric and biochemical data were recorded, and a FFQ was completed annually. Multiple regression was used to determine the effect of the dietary changes on distinct components of the metabolic syndrome. The ratio unpolished:polished rice was inversely related to change in fasting glucose (β = − 0·084, P = 0·007) and TAG (β = − 0·084, P = 0·005) and positively associated with change in HDL-cholesterol (β = 0·066, P = 0·031) at the 5-year follow-up after controlling for relevant confounders. Red meat intake was positively associated with fasting glucose concentrations (β = 0·05, P = 0·017), whereas low-fat (β = − 0·046, P = 0·018) but not high-fat dairy products (β = 0·003, P = 0·853) was inversely related to glucose tolerance at the follow-up visit. Replacement of polished with unpolished rice may be a particularly effective dietary advice in this and similar populations. The metabolic syndrome (MetS) constitutes a cluster of cardiovascular risk factors, which double the risk for CHD and increase the risk for type 2 diabetes mellitus (T2DM) 5-fold (1) . Although the MetS is a growing epidemic worldwide, the prevalence reaches 25-50 % in some urban areas of South Asia, and the prevalence of individual risk factors is even greater, with obesity and low HDL-cholesterol reaching 68 and 81 %, respectively (2) . These risk factors are also growing in prevalence among children and young adults (2) .The risk of the MetS can be reduced through diet and lifestyle changes (3,4) . In particular, approaches including weight loss (4,5) , increasing whole-grain sources of carbohydrates (6,7) and increasing dairy products intake (8) have a demonstrable effect on components of the MetS. However, the majority of studies on the MetS have been carried out in older, Western populations or Southern Asians who have migrated to Western countries (4)(5)(6)(7)(8)(9) .There are differences in the presentation of the MetS in Southern Asians, who are at higher risk of MetS risk factors such as increased waist circumference (WC) and hyperglycaemia at a given BMI along with lower HDL-cholesterol and higher levels of small, dense LDL-cholesterol compared w...

Effectiveness of the I2AO2 interdisciplinary programme led by nurses on metabolic syndrome and cardiovascular risk: a randomized, controlled trial

“…Failure attributed to conservative treatment of MS is due to development of programmes based on unidirectional therapies, which are promoted and carried out by a single professional group. 4 Different professionals in isolation have found some beneficial short-term results of treating MS, 22 – 24 among them nursing. 25 , 26 However, recent published tendencies maintain that the approach to achieve long-term efficiency and efficacy for treating MS must be interdisciplinary.…”

“…10 A recent study suggested that nursing is important for treating this metabolic disorder, with nurses as the leaders of coordination between health teams and community resources and estates. 23 Our research team aimed to work with the patient, and to understand their social, family, and personal reality. Under the philosophy of empowerment, we made the patient responsible for his/her illness, with an interdisciplinary basis, but without nursing as an element of leadership, showed beneficial results in reduction of MS at 12 months.…”