Open Access, Peer-reviewed
eISSN 2093-758X
    J Korean Acad Nurs. 2015 Aug;45(4):483-494. Korean.
    Published online Aug 31, 2015.
    https://doi.org/10.4040/jkan.2015.45.4.483
    © 2015 Korean Society of Nursing Science
    Review

    Effects of Dietary and Physical Activity Interventions on Metabolic Syndrome: A Meta-analysis

    Guna Lee,1 Hye-Young Choi,2 and Sook-Ja Yang2
      • 1Division of Nursing Science, Ewha Womans University, Seoul, Korea.
      • 2Department of Nursing, Tongmyong University, Busan, Korea.
    • Address reprint requests to: Yang, Sook-Ja. Helen Hall 203-3, Division of Nursing Science, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea. Tel: +82-2-3277-4652, Fax: +82-2-3277-2850, Email: yangsj@ewha.ac.kr
    Received January 15, 2015; Revised January 31, 2015; Accepted May 26, 2015.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

    Abstract

    Purpose

    This study identified effects of dietary and physical activity interventions including dietary interventions or physical activity interventions alone or combined dietary-physical activity interventions to improve symptoms in metabolic syndrome including abdominal obesity, high triglycerides, low high density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose through meta-analysis.

    Methods

    Articles on metabolic syndrome X published from 1988 to 2013 were searched through electronic databases, Google Scholar, and reference reviews. Methodological quality was assessed by the checklist, SIGN (Scottish Intercollegiate Guidelines Network).

    Results

    In the meta-analysis, there were 9 articles reporting 13 interventions with 736 participants. Using random effect models, the dietary and/or physical activity interventions showed a lower mean difference in waist circumference ( - 1.30 cm, 95% CI: - 2.44~ - 0.15, p =.027). The combined dietary-physical activity interventions showed a lower mean difference in waist circumference ( - 2.77 cm, 95% CI: - 4.77~ - 0.76, p =.007) and systolic blood pressure ( - 5.44 mmHg, 95% CI: - 10.76~ - 0.12, p =.044). Additionally, interventions of over 24 weeks yielded a lower mean difference in waist circumference ( - 2.78 cm, 95% CI: - 4.69~ - 0.87, p =.004) and diastolic blood pressure ( - 1.93 mmHg, 95% CI: - 3.63~ - 0.22, p =.026).

    Conclusion

    The findings indicate that dietary and/or physical activity interventions for metabolic syndrome reduce central obesity with no adverse effects. This finding provides objective evidences for dietary and physical activity management on metabolic syndrome as an efficient intervention.

    Keywords
    Metabolic syndrome X; Meta-analysis; Physical activity; Diet therapy; Health behavior

    Figures

    Figure 1
    The flow diagram of study selection for the meta-analysis.

    Figure 2
    Forest plot of the effect of dietary and/or physical activity interventions and funnel plot of the effect sizes by standard error on metabolic syndrome criteria.
    Pooled effect estimates are shown as diamonds, one each for trials conducted in waist circumference, triglycerides, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, and fasting glucose. Data are expressed as mean difference with 95% confidence interval, using fixed effects models(waist circumference, triglycerides, high-density lipoprotein cholesterol, diastolic blood pressure and fasting glucose) and random effects model(systolic blood pressure). Inter-study heterogeneity was tested by using the Q statistic(Chi2) at significance level of p<.10 and quantified by the Higgins' I2 statistic (I2>50%).

    Tables

    Table 1
    Characteristics of Studies Included in the Meta-analysis

    Table 2
    Quality Assessment of Studies Included in the Meta-analysis

    Table 3
    Subgroup Analysis of Studies Included in the Meta-analysis

    Appendix 1

    9 Selected Studies in Meta-analysis

    Appendix 2

    Search Strategy Utilized for PubMed

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    MeSH Terms
    Diet*
    Exercise*
    Blood Glucose/analysis
    Blood Pressure
    Cholesterol, HDL/blood
    Databases, Factual
    Health Behavior
    Humans
    Metabolic Syndrome X/metabolism
    Metabolic Syndrome X/pathology*
    Triglycerides/blood
    Waist Circumference
    Metrics
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