title: The effects of a lifestyle intervention program on physical outcomes, depression, and quality of life in adults with metabolic syndrome: A randomized clinical trial.
abstract: OBJECTIVE
  Lifestyle modification is recommended as the primary intervention for metabolic syndrome (MetS). The study was to examine the effects of a lifestyle intervention program (LIP) on physical outcomes, depression, and quality of life (QoL) in Chinese adults with MetS.
  
  
  METHODS
  A randomized control trial design was used. A three-month LIP guided by the Health Promotion Model was developed, including a lifestyle modification booklet, one session of discharge education, and six telephone follow-ups. Patients with MetS were recruited from the inpatient departments of a hospital and were randomized to receive either the LIP or usual care. The physical outcomes, depression (Depression subscale of Hospital Anxiety and Depression Scale), and QoL (Medical Outcome Study Short Form-12, SF-12) were measured at baseline, one-month (T1) and three-month (T2). The effects of the LIP were examined by the generalized estimating equation (GEE) model.
  
  
  RESULTS
  The study recruited 173 participants, with 86 in the intervention group and 87 in the control. Continuous improvements were observed in all the study outcomes in the intervention group. The GEE model revealed significant improvements in body weight (T1: p=0.017, T2: p=0.007), body mass index (T1: p=0.015, T2: p=0.009), depression (T1: p=0.027, T2: p<0.001), and physical aspects of QoL at T2 (p=0.02).
  
  
  CONCLUSIONS
  The current LIP was effective in losing body weight, improving depression and QoL of MetS populations in three-month observation. Considering its low-cost and convenience, the LIP could be applied in clinical practice to improve patient outcomes.
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong. Electronic address: qunwang@cuhk.edu.hk.
authors.forename: Qun
authors.initials: Q
authors.lastname: Wang
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
authors.forename: Sek Ying
authors.initials: SY
authors.lastname: Chair
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
authors.forename: Eliza Mi-Ling
authors.initials: EM
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003866:Depressive Disorder / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000523:psychology* / Q000534:rehabilitation*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life
keywords: Body weight; Depression; Lifestyle intervention; Metabolic syndrome; Quality of life