title: Physical activity in patients with metabolic syndrome: at screening and three years thereafter.
abstract: BACKGROUND
  Metabolic syndrome is a cluster of risk factors for cardiovascular disease and type 2 diabetes. Physical activity can decrease these risks. Many randomized clinical trials to increase physical activity have demonstrated disappointing results, and implementation in daily practice appeared to be difficult. The aim of this study was to investigate whether 3 years of usual care with available guidelines in a primary care setting result in change in physical activity in patients with screen-detected metabolic syndrome.
  
  
  METHODS
  After a population-based screening, 473 patients were diagnosed with metabolic syndrome and received advice to increase physical activity. Three years later, they were invited for follow-up. Physical activity was measured by means of the validated SQUASH questionnaire. The primary outcome measure was: % of metabolic syndrome patients that fulfill the Dutch Physical Activity Guideline (DPAG) criterion (30 min of moderately intensive physical activity at least 5 days per week) at screening and follow-up.
  
  
  RESULTS
  In the final study population (n=168), the proportion of patients fulfilling the DPAG criterion did not significantly increase between screening (56.0%) and follow-up (60.7%) (P=0.29). Female gender [odds ratio (OR)=3.59; 95% confidence interval (CI) 1.24-10.39] and body mass index (BMI) at baseline (OR=0.82; 95% CI 0.69-0.97) appeared to be independent predictors of increase in physical activity.
  
  
  CONCLUSIONS
  In this real-world setting, despite the advice to increase physical activity, the number of metabolic syndrome patients with sufficient physical activity did not significantly increase after 3 years. This finding confirms the need for an intensified approach to achieve an increase in physical activity in this group, with special attention to men and patients with higher BMI values.
authors: Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. h.jansen-3@umcutrecht.nl
authors: Hanneke
authors: H
authors: Jansen
authors: Corine
authors: C
authors: den Engelsen
authors: Guy E H M
authors: GE
authors: Rutten
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010349:Patient Compliance / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult