title: Family physician-led, team-based, lifestyle intervention in patients with metabolic syndrome: results of a multicentre feasibility project.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is a medical condition with major complications and health care costs. Previous research has shown that diet and exercise can improve and reverse this condition. The goal of this study was to test the feasibility and effectiveness of implementing the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program into diverse family medicine practices to improve MetS.
  
  
  METHODS
  In this longitudinal before-after study, 305 adult patients with MetS were recruited from 3 diverse family medicine team-based organizations to the CHANGE personalized diet and exercise program. Participants were followed for 12 months. Primary outcomes included feasibility and reversal of MetS. Secondary outcomes included improvement in MetS components, changes in diet quality, aerobic fitness and cardiovascular risk.
  
  
  RESULTS
  Participants attended 76% and 90% of the kinesiologist and dietitian visits, respectively. At 12 months, 19% of patients (95% confidence interval [CI] 14%-24%) showed reversal of MetS, VO2max increased by 16% (95% CI 13%-18%), and Healthy Eating Index and Mediterranean Diet Scores improved by 9.6% (95% CI 7.6%-11.6%) and 1.4% (1.1%-1.6%), respectively. In addition, the Prospective Cardiovascular Munster (PROCAM) 10-year risk of acute coronary event decreased by 1.4%, from a baseline of 8.6%.
  
  
  CONCLUSIONS
  A team-based program led by the family physician that educates patients about the risks of MetS, and with a dietitian and kinesiologist, empowers them to undertake an individualized supervised program of diet modification and exercise, is feasible, improves aerobic capacity and diet quality, reverses MetS and improves MetS components at 12 months.
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Khursheed
authors.initials: K
authors.lastname: Jeejeebhoy
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Rupinder
authors.initials: R
authors.lastname: Dhaliwal
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Daren K
authors.initials: DK
authors.lastname: Heyland
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Roger
authors.initials: R
authors.lastname: Leung
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Day
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Paula
authors.initials: P
authors.lastname: Brauer
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Dawna
authors.initials: D
authors.lastname: Royall
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Angelo
authors.initials: A
authors.lastname: Tremblay
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: David M
authors.initials: DM
authors.lastname: Mutch
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Lew
authors.initials: L
authors.lastname: Pliamm
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Caroline
authors.initials: C
authors.lastname: Rhéaume
authors.affiliation: Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization.
authors.forename: Doug
authors.initials: D
authors.lastname: Klein