Health benefits of a 4-month group-based diet and lifestyle modification program for individuals with metabolic syndrome

Abstract

Individualised highly prescriptive lifestyle programs for obesity management tend to be limited by resource constraints and difficulty with uptake. To evaluate the health benefits of a minimally prescriptive group-based lifestyle intervention in participants with the metabolic syndrome (MetS). 153 obese adults with MetS were randomised to intervention (INT) or control (CON) for 16 weeks. INT was provided with education, practical strategies and group-based support to achieve diet and physical activity (PA) modifications based on Australian national guidelines. Anthropometric, cardio-metabolic, physical fitness and diet assessments were undertaken at baseline and 16 weeks. Compared with CON, INT demonstrated greater improvements in weight, BMI, body fat mass and percent, abdominal fat mass (AbdoFat) and waist circumference; systolic, diastolic and mean arterial blood pressure; total cholesterol and low-density lipoprotein cholesterol; physical work capacity (PWC) and handgrip strength (p < 0.01, group × time for all). Energy intake and % energy from saturated fat (%Sfat) decreased in both groups (p < 0.05 for time). Dietary glycemic index (GI) decreased more in INT (p < 0.01, group × time). Reductions in weight, waist and AbdoFat were associated with reductions in %Sfat (r = 0.379, 0.306, 0.319, respectively; p < 0.01) and GI (r = 0.308, 0.411, 0.296, respectively; p < 0.01). Reductions in AbdoFat were inversely related to increased PWC (r = -0.385; p < 0.001). Withdrawals were similar in INT (6%) and CON (14%) (p = 0.48). A group-based minimally prescriptive lifestyle modification program with a high retention rate achieved significant improvements in body composition, physical and cardio-metabolic fitness. Group-based programs may provide an achievable and effective, but less resource intensive, method for obesity and MetS management than individualised approaches.