title: Effects of the "PreveDi" lifestyle modiﬁcation trial on metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is a cluster of metabolic disorders that includes central obesity, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia and high blood pressure (BP). Statistical reports suggest that the prevalence of MetS has dramatically increased during the recent years and is considered a worldwide epidemic. MetS has been found to be associated with increased risk of all-cause mortality, cardiovascular diseases (CVD), type 2 diabetes mellitus, chronic kidney disease and some types of cancer. MetS has a high socioeconomic cost and it is therefore extremely important that MetS is prevented and treated by simple and feasible methods.
  
  
  METHODS
  The PreveDi study is a pilot before/after preventive trial aimed at the evaluation of the impact of a brief lifestyle intervention on changes in metabolic syndrome (MetS) risk factors. Recruitment was carried out in two community (council-run) pharmacies in the province of Perugia, Italy and the sample population consisted of 186 adults aged 45 or more who volunteered to participate. At enrolment the participants received a booklet illustrating general recommendations for MetS. During the 6-months follow-up period, participants were invited (by brochures and text messaging on cellular phones) to attend five conferences, five cooking classes, and twelve physical activity sessions. The conferences and the kitchen course were aimed to disseminate a healthy diet strategy focused primarily on reducing glycemic and insulinemic response. At baseline and follow-up MetS parameters were evaluated using medical equipments available in community pharmacies.
  
  
  RESULTS
  At baseline, MetS was observed approximately in 52.2% of the PreveDi population, the MetS prevalence decreased with a higher education level in women, but not in men. Attendance to intervention programs was low and there was no significant difference between physical activity recorded at baseline and at follow-up. A slightly increased adherence to the healthy diet recommendations was observed for males. Waist circumference, systolic and diastolic blood pressure, fasting glucose and triglycerides did not change signiﬁcantly, whereas weight, BMI and total cholesterol did. At follow-up the prevalence of MetS decreased, though not significantly, only in women (from 54,1 to 45.2%). Moreover, in women the negative correlation with education level was lost.
  
  
  CONCLUSIONS
  This pilot study, even if with some limitations, suggests that MetS can be prevented and/or treated by simple and sustainable methods.
authors.affiliation: Department of Pharmaceutical Sciences, Unit of Public Health, University of Perugia, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Villarini
authors.affiliation: Department of Pharmaceutical Sciences, Unit of Public Health, University of Perugia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lanari
authors.affiliation: Department of Pharmaceutical Sciences, Unit of Public Health, University of Perugia, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Barchiesi
authors.affiliation: Department of Pharmaceutical Sciences, Unit of Public Health, University of Perugia, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Casciari
authors.affiliation: Farmacia Comunale, Comune di Bastia Umbra, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tabascio
authors.affiliation: Farmacia Istituti Riuniti, Cannara, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Castellini
authors.affiliation: Department of Pharmaceutical Sciences, Unit of Public Health, University of Perugia, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Levorato
authors.affiliation: Department of Pharmaceutical Sciences, Unit of Public Health, University of Perugia, Italy.
authors.forename: Samuele
authors.initials: S
authors.lastname: Vannini
authors.affiliation: Department of Predictive and Preventive Medicine, National Cancer Institute, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Fornaciari
authors.affiliation: Department of Pharmaceutical Sciences, Unit of Public Health, University of Perugia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Moretti
authors.affiliation: Department of Predictive and Preventive Medicine, National Cancer Institute, Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Villarini
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002784:Cholesterol / Q000097:blood*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D055105:Waist Circumference / Q000502:physiology
chemical_list: D002784:Cholesterol
keywords: Community pharmacy; Metabolic syndrome (MetS); Prevention