title: Effects of a long-term lifestyle intervention program with Mediterranean diet and exercise for the management of patients with metabolic syndrome in a primary care setting.
abstract: BACKGROUND
  The impact of a lifestyle intervention (LSI) program for the long-term management of subjects with metabolic syndrome in a primary care setting is not known.
  
  
  METHODS
  This 3-year prospective controlled trial randomized adult subjects with metabolic syndrome to receive intensive LSI or to usual care in a community health centre in Malaga, Spain. LSI subjects received instruction on Mediterranean diet and a regular aerobic exercise program by their primary care professionals. Primary outcome included changes from baseline on different components of metabolic syndrome (abdominal circumference, blood pressure, HDL-cholesterol, fasting plasma glucose and triglycerides).
  
  
  RESULTS
  Among the 2,492 subjects screened, 601 subjects with metabolic syndrome (24.1%) were randomized to LSI (n = 298) or to usual care (n = 303); of them, a 77% and a 58%, respectively, completed the study. At the end of the study period, LSI resulted in significant differences vs. usual care in abdominal circumference (-0.4 ± 6 cm vs. + 2.1 ± 6.7 cm, p < 0.001), systolic blood pressure (-5.5 ± 15 mmHg vs. -0.6 ± 19 mmHg, p = 0.004), diastolic blood pressure (-4.6 ± 10 mmHg vs. -0.2 ± 13 mmHg, p < 0.001) and HDL-cholesterol (+4 ± 12 mg/dL vs. + 2 ± 12 mg/dL, p = 0.05); however, there were no differences in fasting plasma glucose and triglyceride concentration (-4 ± 35 mg/dl vs. -1 ± 32 mg/dl, p = 0.43 and -0.4 ± 83 mg/dl vs. +6 ± 113 mg/dl, p = 0.28).
  
  
  CONCLUSIONS
  Intensive LSI counseling provided by primary care professionals resulted in significant improvements in abdominal circumference, blood pressure and HDL-cholesterol but had limited effects on glucose and triglyceride levels in patients with metabolic syndrome.
authors.affiliation: Internal Medicine Department, Hospital Regional de Malaga, Spain; Biomedical Institute of Malaga (IBIMA), Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain. Electronic address: ricardogomezhuelgas@hotmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Gomez-Huelgas
authors.affiliation: Internal Medicine Department, Hospital Regional de Malaga, Spain; Biomedical Institute of Malaga (IBIMA), Spain.
authors.forename: S
authors.initials: S
authors.lastname: Jansen-Chaparro
authors.affiliation: Health Center Ciudad Jardín, Distrito Malaga, Málaga, Spain.
authors.forename: A J
authors.initials: AJ
authors.lastname: Baca-Osorio
authors.affiliation: Health Center Ciudad Jardín, Distrito Malaga, Málaga, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Mancera-Romero
authors.affiliation: Biomedical Institute of Malaga (IBIMA), Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Endocrinology and Nutrition Department, Hospital Regional y Clinico Universitario Virgen de la Victoria de Malaga, Spain.
authors.forename: F J
authors.initials: FJ
authors.lastname: Tinahones
authors.affiliation: Internal Medicine Department, Hospital Regional de Malaga, Spain; Biomedical Institute of Malaga (IBIMA), Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain. Electronic address: robelopajiju@yahoo.es.
authors.forename: M R
authors.initials: MR
authors.lastname: Bernal-López
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood; D038441:Diet, Mediterranean; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000628:therapy*; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008076:Cholesterol, HDL
keywords: Intervention; Lifestyle; Metabolic syndrome