Abstract
Workplace health interventions are essential to improve the health and well-being of workers and promote healthy lifestyle behaviours. We carried out a systematic review, meta-analysis and meta-regression of articles measuring the association between workplace dietary interventions and MetS risk. We recovered potentially eligible studies by searching MEDLINE, the Cochrane Library, Embase, Scopus and Web of Science, using the terms “Metabolic syndrome” and “Occupational Health”. A total of 311 references were retrieved and 13 documents were selected after applying the inclusion and exclusion criteria. Dietary interventions were grouped into six main types: basic education/counselling; specific diet/changes in diet and food intake; behavioural change/coaching; physical exercise; stress management; and internet/social networks. Most programmes included several components. The interventions considered together are beneficial, but the clinical results reflect only a minimal impact on MetS risk. According to the metaregression, the interventions with the greatest impact were those that used coaching techniques and those that promoted physical activity, leading to increased HDL (effect size = 1.58, sig = 0.043; and 2.02, 0.015, respectively) and decreased BMI (effect size = −0.79, sig = −0.009; and −0.77, 0.034, respectively). In contrast, interventions offering information on healthy habits and lifestyle had the contrary effect, leading to increased BMI (effect size = 0.78, sig = 0.006), systolic blood pressure (effect size = 4.85, sig = 0.038) and diastolic blood pressure (effect size = 3.34, sig = 0.001). It is necessary to improve the efficiency of dietary interventions aimed at lowering MetS risk in workers.
Highlights
Metabolic syndrome (MetS) constitutes a major public health problem, because of its increasing prevalence—currently estimated at 25% worldwide [1]—and because of its clinical, economic and humanistic impact.The WHO defines MetS as a pathological condition characterised by abdominal obesity, insulin resistance, hypertension and hyperlipidaemia
Of the articles excluded during the screening stage, 16 were not related to MetS, 8 did not measure the relationship between occupational health and MetS, 14 did not include a dietary intervention, 7 had no available full text, and 11 were published in other languages (Chinese, Japanese, Korean) (Figure 1)
Of the articles excluded during the screening stage, 16 w to MetS, 8 did not measure the relationship between occupational health a not include a dietary intervention, 7 had no available full text, 6aonf 3d1 11 we other languages (Chinese, Japanese, Korean) (Figure 1)
Summary
The WHO defines MetS as a pathological condition characterised by abdominal obesity, insulin resistance, hypertension and hyperlipidaemia. Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity [2] defined MetS as the presence of three or more of the following five risk factors for cardiovascular disease (CVD): (1) abdominal obesity (determined by waist circumference), (2) low levels of high-density lipoprotein cholesterol (HDL-c), (3) elevated blood pressure or use of medication for blood pressure, (4) elevated fasting glucose levels or use of medication to control blood glucose, and (5) elevated triglyceride levels. Multifaceted lifestyle interventions, including diet and physical exercise, are recommended as the first line treatment for MetS [4]. Weight loss has a positive impact on all MetS factors, whereas physical activity reduces insulin resistance, increases fitness, and improves energy balance, reducing cardiovascular disease risk [4]. A healthy lifestyle, centred on appropriate diet and nutritional habits, together with supervised or unsupervised exercise, is critical for preventing or delaying the onset of MetS in susceptible individuals and preventing CVD in those with MetS [5]
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