Effects of lifestyle modification on metabolic syndrome: a systematic review and meta-analysis

Table 1 Characteristics of included randomized clinical trials.^a

Country, trial	n	Definition of MetS	Age years	Gender	Type of intervention	Duration, years	Rate, % = number free from MetS/number subjects)		Mean difference (SE)
							Intervention	Control	FBG	Waist	SBP	DBP	TG	HDL
UK, CARMEN trial [23]	46	3+ risk factors	46	M/F	LF-SC	0.5	-	-	-	0.0 (2.02)	-13.0 (5.56)	-0.6 (4.29)	50.7 (19.95)	0.5 (2.42)
UK, CARMEN trial [23]	46	≥3 MetS risk factors	46	M/F	LF-CC	0.5	-	-	-	-4.0 (2.94)	-15.0 (6.33)	-4.2 (4.29)	0.0 (16.62)	-1.5 (2.42)
USA [22]	53	Syndrome X	>29	M/F	EX+WL	0.5	-	-	-8.0 (4.84)	-	-6.0 (4.17)	-9.0 (2.08)	-17.0 (64.11)	4.0 (4.26)
Italy [21]^b	164	ATP III	44	M/F	Med diet	2	20% = 18/90	67% = 60/90	-6.0 (0.35)	-2.0 (0.05)	-3.0 (0.24)	--2.0 (0.15)	-19.0 (0.90)	3.0 (0.24)
Tehran Lipid and Glucose Study [20]^b	116	ATP III	41	M/F	WR	0.5	0% = 0/40	18% = 7/38	-6.0 (5.18)	0.0 (4.31)	-3.0 (5.58)	-1.0 (3.01)	-15.0 (11.34)	-6.0 (2.22)
Tehran Lipid and Glucose Study [20]^b	116	ATP III	41	M/F	DASH	0.5	0% = 0/40	34% = 13/38	3.0 (5.83)	-5.0 (4.48)	-11.0 (3.80)	-6.0 (2.96)	-17.0 (11.34)	1.0 (2.16)
Part of DPPRG Study [19]	1711	ATP III	25-82 M/F	M/F	L	3	18% = 107/592	38% = 209/549	-	-	-	-	-	-
Italy [18]^b	335	ATP III or hs-CRP+2	56	M/F	L	1	34% = 41/120^c	65% = 77/119^c	-5.9 (1.28)	-4.6 (0.64)	-6.8 (1.92)	-2.3 (1.03)	-16.0 (8.95)	3.6 (5.84)
Part of PREDIMED study [17]	499	Med diet	67	M/F	Med diet+nuts	3	16% = 41/250	25% = 63/249	-	-	-	-	-	-
Part of PREDIMED study [17]	502	Med diet	67	M/F	Med diet+V00	3	16% = 41/250	21% = 53/252	-	-	-	-	-	-
Part of Finnish DPS study [16]	502	ATPIII high risk	55	M/F	L	1	15% = 26/177	27% = 49/184	-	-	-	-	-	-

ATP III = The National Cholesterol Education Program's Adult Treatment Panel III; CARMEN = Carbohydrate Ratio Management in European National diets; DASH = The Dietary Approaches to Stop Hypertension; DBP = diastolic blood pressure; DPPRG = Diabetes Prevention Program Research Group; DPS = Diabetes Prevention Study; EX+WL = dietary and behavior modification for weight loss plus exercise; FBG = fasting blood glucose; HDL = high-density lipoprotein; hs-CRP+2 = 2 components of metabolic syndrome plus high-sensitivity CRP serum values ≥3 mg/L; L = lifestyle recommendation; LF-CC = low-fat; high-complex-carbohydrate diet; LF-SC = low-fat; high-simple-carbohydrate diet; Med = Mediterranean; MetS = metabolic syndrome; PREDIMED = Prevención con Dieta Mediterránea; SBP = systolic blood pressure; TG = triglycerides; VOO = virgin olive oil; WR = weight-reducing diet; WR+EX = weight-reducing diet plus exercise.
^aStudies [20–26] were used for the meta-analysis of the metabolic syndrome components.
^bSD was calculated using 95% confidence interval for references [18, 20, 21].
^cCalculated from the proportion

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