title: Community-based primary prevention programs decrease the rate of metabolic syndrome among socioeconomically disadvantaged women.
abstract: BACKGROUND
  Metabolic Syndrome (MetSyn) is one of the strongest predictors of type 2 diabetes (DM2) and cardiovascular disease (CVD). It is associated with a 4- to 10-fold increased risk of DM2 and a 2- to 3-fold increased risk of CVD. Low income and minority women have some of the highest rates of MetSyn. This study examines the effect of a unique, community based, primary prevention program on the rates of MetSyn and health habits.
  
  
  METHODS
  Sixty-four low income and minority women were enrolled in the HAPPY (Health Awareness and Primary Prevention in Your neighborhood) Heart Program in an eastern suburb of Boston. Over these 2 years, patients were evaluated by an interdisciplinary medical team: their primary physician, cardiologist, nutritionist, physical therapist, and health coach. The rate of MetSyn was measured at baseline, year 1, and year 2. Comparisons were made either using the paired t test for normally distributed variables or the Wilcoxon Sign test for non-normal variables.
  
  
  RESULTS
  The rate of MetSyn fell from 64.7% at baseline to 34.9% at year 1 (p=0.01) and 28.2% at year 2 (p<0.001). This was driven by increases in high-density lipoprotein (HDL-C) (p<0.001) and decreases in blood pressure (p=0.05). Fasting blood glucose trended down, but the hemoglobin A1c (HbA1c) reached significance (decreasing from 6 to 5.8, p<0.01). Nutrition and exercise habits trended toward improvement. There were significant decreases in anxiety (p<0.001), depression (p=0.006) and stress (p=0.002).
  
  
  CONCLUSIONS
  This lifestyle intervention program is effective at decreasing MetSyn in a socioeconomically disadvantaged, largely minority, female population. This program also decreases anxiety, stress, and depression among participants.
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. lgilstrap@partners.org
authors.forename: Lauren Gray
authors.initials: LG
authors.lastname: Gilstrap
authors.forename: Rajeev
authors.initials: R
authors.lastname: Malhotra
authors.forename: Donna
authors.initials: D
authors.lastname: Peltier-Saxe
authors.forename: Donna
authors.initials: D
authors.lastname: Slicas
authors.forename: Eliana
authors.initials: E
authors.lastname: Pineda
authors.forename: Catherine
authors.initials: C
authors.lastname: Culhane-Hermann
authors.forename: Nakela
authors.initials: N
authors.lastname: Cook
authors.forename: Carina
authors.initials: C
authors.lastname: Fernandez-Golarz
authors.forename: Malissa
authors.initials: M
authors.lastname: Wood
mesh_terms: D000328:Adult; D003153:Community Health Services; D005260:Female; D006801:Humans; D008019:Life Style; D024821:Metabolic Syndrome / Q000517:prevention & control*; D008875:Middle Aged; D011203:Poverty; D011322:Primary Prevention; D035862:Vulnerable Populations