An interactive web-based intervention on nutritional status, physical activity and health-related quality of life in patient with metabolic syndrome: a randomized-controlled trial (The Red Ruby Study)

L Jahangiry,M Najafi,A Montazeri,M A Farhangi,M Yaseri

doi:10.1038/nutd.2016.35

Abstract

Background/Objectives:Physical inactivity and unhealthy nutritional behaviors are recognized as the key factors in the cause and management of metabolic syndrome (MetS). The effectiveness of interactive web-based interventions on dietary intakes, physical activity and health-related quality of life (HRQOL) among people with MetS is currently unknown.Methods:The two-arm randomized-controlled trial was conducted for patients with MetS from June through December 2012 in Tehran, Iran. Participants (n=160) were recruited through online registration on the study website. After free clinical assessments of eligible participants for MetS, they were randomly assigned to intervention and control groups (n=80). All participants received general information about cardiovascular diseases and MetS risk factors via the website. The intervention group logged in to interactive part including My Healthy Heart Profile, received tailored calorie-restricted diet and used all parts of the interactive prevention program. Anthropometric measures, glycemic status, lipid profile, physical activity and food intake were evaluated at the beginning and after 6-month follow-up. HRQOL was assessed at beginning, 3- and 6-month follow-up.Results:There were no significant differences between the intervention and control groups on age, gender, education and MetS factors. In comparison with control group, the intervention group showed significant changes in moderate physical activity 260.3±473.6 vs 101.6±213.1 MET-min/week, walking 505.2±505.3 vs 321±884 MET-min per week, cholesterol intake −88.4±158.7 vs −8.3±6 mg per day, total calories −430.2±957.5 vs −392.9±34.7 kcal per day and sodium 1336.9±2467 vs 1342±3200.4 mmol per day. With regard to HRQOL, the intervention group showed greater improvement in general health and vitality (P<0.05 for all).Conclusion:These results indicate the positive impact of a lifestyle intervention by a web-based program on physical activity, dietary intake and several dimension of QoL. The use of web-based approaches is a great interest to manage patients at high cardiovascular risk, especially where the prevalence of obesity, MetS and diabetes is increasing.

Highlights

Metabolic syndrome (MetS) is becoming a worldwide epidemic disorder that increases the risk of cardiovascular diseases.[1]
Earlier distribution of age, gender, education and cardio-metabolic risk factors do not show any significant differences between two groups
This study showed that interactive web-based program with feedback and monitoring produced significant relatively improvement in adopting a healthy diet and physical activity habits, these can lead to more improvement in MetS indicators over time

Summary

Introduction

Metabolic syndrome (MetS) is becoming a worldwide epidemic disorder that increases the risk of cardiovascular diseases.[1]. Recent evidence from Lipid and Glucose study among adult population in Tehran indicated that MetS appears to affect ~ 34.7% of Iranian population.[4,5] Third report of the National Cholesterol Education Program (NCEP) adult treatment panel (ATP III) declared that the presence of the MetS was identified by three or more of the following components: waist circumference 4102 cm in men and 488 cm in women (for Iranian, 490 cm for both genders6,7), triglyceride level of at least 150 mg dl − 1, HDL level o 40 mg dl − 1 in men and o 50 mg dl − 1 in women, systolic/diastolic blood pressure 130/85 mmHg or higher and fasting blood glucose level 110 mg dl − 1 or higher.[8] Lifestyle modification strategies are foremost in the management of MetS.[9] Lifestyle interventions that mainly consist of increasing physical activity and improving dietary habits have been demonstrated to improve MetS. Lifestyle programs with increased physical activity and focused on healthy dietary help people for weight loss, raises HDL cholesterol, lowers serum cholesterol, triglycerides, glucose and blood pressure.[10,11]

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