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Diet and Exercise in the Prevention and Management of the Metabolic Syndrome

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Book cover Nutrition and Metabolism

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Key Points

  • The metabolic syndrome (MetSyn) encompasses a constellation of metabolic abnormalities that are thought to place patients at higher risk for cardiovascular morbidity.

  • Many definitions have been proposed, and although the exact mechanisms underlying the syndrome remain unclear, increased abdominal fat correlated with dyslipidemia, insulin resistance, and hyperinsulinemia are believed to be the core of its pathophysiology.

  • Its increasing prevalence urged the need for preventing and managing strategies. Prevention of the syndrome includes keeping body weight within the normal range, exercise training, and consumption of a moderate carbohydrate diet, with moderate consumption of mono or polyunsaturated fatty acids (omega-3 polyunsaturated fatty acids).

  • Current guidelines for the clinical management propose lifestyle changes (diet and physical activity) as a first-line intervention. However, research in this area is limited.

  • Weight loss has been recognized as an important issue in the management of MetSyn, in addition to exercise training and diet quality.

  • Short-term success of lifestyle intervention programs has been observed, though they failed to sustain long-term effectiveness.

  • Multiple follow-up booster sessions proved more effective in maintaining lifestyle changes than one counseling session at the end of follow-up.

  • In conclusion, diet and physical activity have a pivotal role in the prevention and management of the MetSyn. Hence, it is of major importance to explore strategies to improve adherence and ensure that patients achieve and maintain lifestyle changes.

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References

  1. Levantesi G, Macchia A, Marfisi R, et al. Metabolic syndrome and risk of cardiovascular events after myocardial infarction. J Am Coll Cardiol 2005;46:277–83.

    Article  PubMed  Google Scholar 

  2. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002;287:356–9.

    Article  PubMed  Google Scholar 

  3. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988;37:1595–607.

    Article  PubMed  CAS  Google Scholar 

  4. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15:539–53.

    Article  PubMed  CAS  Google Scholar 

  5. Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999;16:442–3.

    Article  PubMed  CAS  Google Scholar 

  6. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA 2001;285:2486–97.

    Google Scholar 

  7. Bloomgarden ZT. American Association of Clinical Endocrinologists (AACE) consensus conference on the insulin resistance syndrome: 25–26 August 2002, Washington, DC. Diabetes Care 2003;26:1297–303.

    Article  PubMed  Google Scholar 

  8. Moller DE, Kaufman KD. Metabolic syndrome: a clinical and molecular perspective. Annu Rev Med 2005;56:45–62.

    Article  PubMed  CAS  Google Scholar 

  9. Avramoglu RK, Basciano H, Adeli K. Lipid and lipoprotein dysregulation in insulin resistant states. Clin Chim Acta 2006;368:1–19.

    Article  PubMed  CAS  Google Scholar 

  10. Balasubramanyam A, Sekhar RV, Jahoor F, Jones PH, Pownall HJ. Pathophysiology of dyslipidemia and increased cardiovascular risk in HIV lipodystrophy: a model of ‘systemic steatosis’. Curr Opin Lipidol 2004;15:59–67.

    Article  PubMed  CAS  Google Scholar 

  11. Grundy SM. Atherogenic dyslipidemia associated with metabolic syndrome and insulin resistance. Clin Cornerstone 2006;8 Suppl 1:S21–7.

    Article  PubMed  Google Scholar 

  12. Lewis GF, Carpentier A, Adeli K, Giacca A. Disordered fat storage and mobilization in the pathogenesis of insulin resistance and type 2 diabetes. Endocr Rev 2002;23:201–29.

    Article  PubMed  CAS  Google Scholar 

  13. Schondorf T, Maiworm A, Emmison N, Forst T, Pfutzner A. Biological background and role of adiponectin as marker for insulin resistance and cardiovascular risk. Clin Lab 2005;51:489–94.

    PubMed  Google Scholar 

  14. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation 2002;106:3143–421.

    Google Scholar 

  15. Boden G. Role of fatty acids in the pathogenesis of insulin resistance and NIDDM. Diabetes 1997;46:3–10.

    Article  PubMed  CAS  Google Scholar 

  16. Boden G, Shulman GI. Free fatty acids in obesity and type 2 diabetes: defining their role in the development of insulin resistance and beta-cell dysfunction. Eur J Clin Invest 2002;32 Suppl 3:14–23.

    Article  PubMed  CAS  Google Scholar 

  17. Berg AH, Combs TP, Du X, Brownlee M, Scherer PE. The adipocyte-secreted protein Acrp30 enhances hepatic insulin action. Nat Med 2001;7:947–53.

    Article  PubMed  CAS  Google Scholar 

  18. Berg AH, Combs TP, Scherer PE. ACRP30/adiponectin: an adipokine regulating glucose and lipid metabolism. Trends Endocrinol Metab 2002;13:84–9.

    Article  PubMed  CAS  Google Scholar 

  19. Combs TP, Berg AH, Obici S, Scherer PE, Rossetti L. Endogenous glucose production is inhibited by the adipose-derived protein Acrp30. J Clin Invest 2001;108:1875–81.

    PubMed  CAS  Google Scholar 

  20. Yamauchi T, Hara K, Kubota N, et al. Dual roles of adiponectin/Acrp30 in vivo as an anti-diabetic and anti-atherogenic adipokine. Curr Drug Targets Immune Endocr Metabol Disord 2003;3:243–54.

    Article  PubMed  CAS  Google Scholar 

  21. Yamauchi T, Kamon J, Ito Y, et al. Cloning of adiponectin receptors that mediate antidiabetic metabolic effects. Nature 2003;423:762–9.

    Article  PubMed  CAS  Google Scholar 

  22. Banerjee RR, Rangwala SM, Shapiro JS, et al. Regulation of fasted blood glucose by resistin. Science 2004;303:1195–8.

    Article  PubMed  CAS  Google Scholar 

  23. Rajala MW, Qi Y, Patel HR, et al. Regulation of resistin expression and circulating levels in obesity, diabetes, and fasting. Diabetes 2004;53:1671–9.

    Article  PubMed  CAS  Google Scholar 

  24. Steppan CM, Bailey ST, Bhat S, et al. The hormone resistin links obesity to diabetes. Nature 2001;409:307–12.

    Article  PubMed  CAS  Google Scholar 

  25. Chu NF, Chang JB, Shieh SM. Plasma leptin, fatty acids, and tumor necrosis factor-receptor and insulin resistance in children. Obes Res 2003;11:532–40.

    Article  PubMed  CAS  Google Scholar 

  26. Lee JH, Chan JL, Sourlas E, Raptopoulos V, Mantzoros CS. Recombinant methionyl human leptin therapy in replacement doses improves insulin resistance and metabolic profile in patients with lipoatrophy and metabolic syndrome induced by the highly active antiretroviral therapy. J Clin Endocrinol Metab 2006;91:2605–11.

    Article  PubMed  CAS  Google Scholar 

  27. Lichnovska R, Gwozdziewiczova S, Chlup R, Hrebicek J. Serum leptin in the development of insulin resistance and other disorders in the metabolic syndrome. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2005;149:119–26.

    PubMed  CAS  Google Scholar 

  28. Zimmet P, Boyko EJ, Collier GR, de Courten M. Etiology of the metabolic syndrome: potential role of insulin resistance, leptin resistance, and other players. Ann N Y Acad Sci 1999;892:25–44.

    Article  PubMed  CAS  Google Scholar 

  29. Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science 1993;259:87–91.

    Article  PubMed  CAS  Google Scholar 

  30. Spiegelman BM, Hotamisligil GS. Through thick and thin: wasting, obesity, and TNF alpha. Cell 1993;73:625–7.

    Article  PubMed  CAS  Google Scholar 

  31. Moller DE, Chang PY, Yaspelkis BB, III, Flier JS, Wallberg-Henriksson H, Ivy JL. Transgenic mice with muscle-specific insulin resistance develop increased adiposity, impaired glucose tolerance, and dyslipidemia. Endocrinology 1996;137:2397–405.

    Article  PubMed  CAS  Google Scholar 

  32. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 2003;163:427–36.

    Article  PubMed  Google Scholar 

  33. Christ M, Iannello C, Iannello PG, Grimm W. Effects of a weight reduction program with and without aerobic exercise in the metabolic syndrome. Int J Cardiol 2004;97:115–22.

    Article  PubMed  Google Scholar 

  34. Villareal DT, Miller BV, III, Banks M, Fontana L, Sinacore DR, Klein S. Effect of lifestyle intervention on metabolic coronary heart disease risk factors in obese older adults. Am J Clin Nutr 2006;84:1317–23.

    PubMed  CAS  Google Scholar 

  35. Muzio F, Mondazzi L, Sommariva D, Branchi A. Long-term effects of low-calorie diet on the metabolic syndrome in obese nondiabetic patients. Diabetes Care 2005;28:1485–6.

    Article  PubMed  Google Scholar 

  36. Case CC, Jones PH, Nelson K, O’Brian Smith E, Ballantyne CM. Impact of weight loss on the metabolic syndrome. Diabetes Obes Metab 2002;4:407–14.

    Article  PubMed  CAS  Google Scholar 

  37. Watkins LL, Sherwood A, Feinglos M, et al. Effects of exercise and weight loss on cardiac risk factors associated with syndrome X. Arch Intern Med 2003;163:1889–95.

    Article  PubMed  Google Scholar 

  38. Lindahl B, Nilsson TK, Asplund K, Hallmans G. Intense nonpharmacological intervention in subjects with multiple cardiovascular risk factors: decreased fasting insulin levels but only a minor effect on plasma plasminogen activator inhibitor activity. Metabolism 1998;47:384–90.

    Article  PubMed  CAS  Google Scholar 

  39. Anderssen SA, Hjermann I, Urdal P, Torjesen PA, Holme I. Improved carbohydrate metabolism after physical training and dietary intervention in individuals with the “atherothrombogenic syndrome”. Oslo Diet and Exercise Study (ODES). A randomized trial. J Intern Med 1996;240:203–9.

    Article  PubMed  CAS  Google Scholar 

  40. Singh RB, Singh NK, Rastogi SS, Mani UV, Niaz MA. Effects of diet and lifestyle changes on atherosclerotic risk factors after 24 weeks on the Indian Diet Heart Study. Am J Cardiol 1993;71:1283–8.

    Article  PubMed  CAS  Google Scholar 

  41. Niskanen L, Laaksonen DE, Punnonen K, Mustajoki P, Kaukua J, Rissanen A. Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome. Diabetes Obes Metab 2004;6:208–15.

    Article  PubMed  CAS  Google Scholar 

  42. Brook RD, Bard RL, Glazewski L, et al. Effect of short-term weight loss on the metabolic syndrome and conduit vascular endothelial function in overweight adults. Am J Cardiol 2004;93:1012–6.

    Article  PubMed  CAS  Google Scholar 

  43. Esposito K, Marfella R, Ciotola M, et al. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004;292:1440–6.

    Article  PubMed  CAS  Google Scholar 

  44. Poppitt SD, Keogh GF, Prentice AM, et al. Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. Am J Clin Nutr 2002;75:11–20.

    PubMed  CAS  Google Scholar 

  45. Higgins M, Kannel W, Garrison R, Pinsky J, Stokes J, III. Hazards of obesity – the Framingham experience. Acta Med Scand Suppl 1988;723:23–36.

    PubMed  CAS  Google Scholar 

  46. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403.

    Article  PubMed  CAS  Google Scholar 

  47. Hu FB. Sedentary lifestyle and risk of obesity and type 2 diabetes. Lipids 2003;38:103–8.

    Article  PubMed  CAS  Google Scholar 

  48. Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001;345:790–7.

    Article  PubMed  CAS  Google Scholar 

  49. Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med 2000;343:16–22.

    Article  PubMed  CAS  Google Scholar 

  50. Huang Z, Willett WC, Manson JE, et al. Body weight, weight change, and risk for hypertension in women. Ann Intern Med 1998;128:81–8.

    PubMed  CAS  Google Scholar 

  51. Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2003;42:878–84.

    Article  PubMed  CAS  Google Scholar 

  52. Manson JE, Colditz GA, Stampfer MJ, et al. A prospective study of maturity-onset diabetes mellitus and risk of coronary heart disease and stroke in women. Arch Intern Med 1991;151:1141–7.

    Article  PubMed  CAS  Google Scholar 

  53. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999;282:2131–5.

    Article  PubMed  CAS  Google Scholar 

  54. Albert MA, Ridker PM. The role of C-reactive protein in cardiovascular disease risk. Curr Cardiol Rep 1999;1:99–104.

    Article  PubMed  CAS  Google Scholar 

  55. Morrow DA, Ridker PM. C-Reactive protein, inflammation, and coronary risk. Med Clin North Am 2000;84:149–61, ix.

    Article  PubMed  CAS  Google Scholar 

  56. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-Reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000;342:836–43.

    Article  PubMed  CAS  Google Scholar 

  57. Bougoulia M, Triantos A, Koliakos G. Effect of weight loss with or without orlistat treatment on adipocytokines, inflammation, and oxidative markers in obese women. Hormones (Athens) 2006;5:259–69.

    Google Scholar 

  58. Blair SN, Kohl HW, III, Paffenbarger RS, Jr., Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA 1989;262:2395–401.

    Article  PubMed  CAS  Google Scholar 

  59. Wei M, Kampert JB, Barlow CE, et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA 1999;282:1547–53.

    Article  PubMed  CAS  Google Scholar 

  60. Wessel TR, Arant CB, Olson MB, et al. Relationship of physical fitness vs body mass index with coronary artery disease and cardiovascular events in women. JAMA 2004;292:1179–87.

    Article  PubMed  CAS  Google Scholar 

  61. Orakzai RH, Orakzai SH, Nasir K, et al. Association of increased cardiorespiratory fitness with low risk for clustering of metabolic syndrome components in asymptomatic men. Arch Med Res 2006;37:522–8.

    Article  PubMed  CAS  Google Scholar 

  62. Simonelli C, Eaton RP. Reduced triglyceride secretion: a metabolic consequence of chronic exercise. Am J Physiol 1978;234:E221–7.

    PubMed  CAS  Google Scholar 

  63. Simonelli C, Eaton RP. Cardiovascular and metabolic effects of exercise: the strong case for conditioning. Postgrad Med 1978;63:71–7.

    PubMed  CAS  Google Scholar 

  64. Tsekouras YE, Yanni AE, Bougatsas D, Kavouras SA, Sidossis LS. A single bout of brisk walking increases basal very low-density lipoprotein triacylglycerol clearance in young men. Metabolism 2007;56:1037–43.

    Article  PubMed  CAS  Google Scholar 

  65. Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpoole PW. Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care 2003;26:557–62.

    Article  PubMed  CAS  Google Scholar 

  66. Goodpaster BH, He J, Watkins S, Kelley DE. Skeletal muscle lipid content and insulin resistance: evidence for a paradox in endurance-trained athletes. J Clin Endocrinol Metab 2001;86:5755–61.

    Article  PubMed  CAS  Google Scholar 

  67. Ring-Dimitriou S, Paulweber B, von Duvillard SP, et al. The effect of physical activity and physical fitness on plasma adiponectin in adults with predisposition to metabolic syndrome. Eur J Appl Physiol 2006;98:472–81.

    Article  PubMed  CAS  Google Scholar 

  68. Nassis GP, Papantakou K, Skenderi K, et al. Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls. Metabolism 2005;54:1472–9.

    Article  PubMed  CAS  Google Scholar 

  69. Ascherio A, Katan MB, Zock PL, Stampfer MJ, Willett WC. Trans fatty acids and coronary heart disease. N Engl J Med 1999;340:1994–8.

    Article  PubMed  CAS  Google Scholar 

  70. Toft I, Bonaa KH, Ingebretsen OC, Nordoy A, Jenssen T, Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995;123:911–8.

    PubMed  CAS  Google Scholar 

  71. Glauber H, Wallace P, Griver K, Brechtel G. Adverse metabolic effect of omega-3 fatty acids in non-insulin-dependent diabetes mellitus. Ann Intern Med 1988;108:663–8.

    PubMed  CAS  Google Scholar 

  72. Popp-Snijders C, Schouten JA, Heine RJ, van der Meer J, van der Veen EA. Dietary supplementation of omega-3 polyunsaturated fatty acids improves insulin sensitivity in non-insulin-dependent diabetes. Diabetes Res 1987;4:141–7.

    PubMed  CAS  Google Scholar 

  73. Vessby B, Unsitupa M, Hermansen K, et al. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study. Diabetologia 2001;44:312–9.

    Article  PubMed  CAS  Google Scholar 

  74. Salmeron J, Hu FB, Manson JE, et al. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr 2001;73:1019–26.

    PubMed  CAS  Google Scholar 

  75. Montoya MT, Porres A, Serrano S, et al. Fatty acid saturation of the diet and plasma lipid concentrations, lipoprotein particle concentrations, and cholesterol efflux capacity. Am J Clin Nutr 2002;75:484–91.

    PubMed  CAS  Google Scholar 

  76. Willett W, Manson J, Liu S. Glycemic index, glycemic load, and risk of type 2 diabetes. Am J Clin Nutr 2002;76:274S–80S.

    PubMed  CAS  Google Scholar 

  77. Liu S, Manson JE, Buring JE, Stampfer MJ, Willett WC, Ridker PM. Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. Am J Clin Nutr 2002;75:492–8.

    PubMed  CAS  Google Scholar 

  78. Liu S, Manson JE, Stampfer MJ, et al. Dietary glycemic load assessed by food-frequency questionnaire in relation to plasma high-density-lipoprotein cholesterol and fasting plasma triacylglycerols in postmenopausal women. Am J Clin Nutr 2001;73:560–6.

    PubMed  CAS  Google Scholar 

  79. Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002;287:2414–23.

    Article  PubMed  CAS  Google Scholar 

  80. Nordmann AJ, Nordmann A, Briel M, et al. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 2006;166:285–93.

    Article  PubMed  CAS  Google Scholar 

  81. Abbasi F, McLaughlin T, Lamendola C, et al. High carbohydrate diets, triglyceride-rich lipoproteins, and coronary heart disease risk. Am J Cardiol 2000;85:45–8.

    Article  PubMed  CAS  Google Scholar 

  82. Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet 2002;359:2072–7.

    Article  PubMed  CAS  Google Scholar 

  83. Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial. JAMA 2003;290:486–94.

    Article  PubMed  CAS  Google Scholar 

  84. Davies MJ, Baer DJ, Judd JT, Brown ED, Campbell WS, Taylor PR. Effects of moderate alcohol intake on fasting insulin and glucose concentrations and insulin sensitivity in postmenopausal women: a randomized controlled trial. JAMA 2002;287:2559–62.

    Article  PubMed  CAS  Google Scholar 

  85. Gigleux I, Gagnon J, St-Pierre A, et al. Moderate alcohol consumption is more cardioprotective in men with the metabolic syndrome. J Nutr 2006;136:3027–32.

    PubMed  CAS  Google Scholar 

  86. Klatsky AL. Alcohol and cardiovascular disease – more than one paradox to consider. Alcohol and hypertension: does it matter? Yes. J Cardiovasc Risk 2003;10:21–4.

    Article  PubMed  Google Scholar 

  87. Orchard TJ, Temprosa M, Goldberg R, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med 2005;142:611–9.

    PubMed  CAS  Google Scholar 

  88. Lindstrom J, Louheranta A, Mannelin M, et al. The Finnish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care 2003;26:3230–6.

    Article  PubMed  Google Scholar 

  89. Dattilo AM, Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr 1992;56:320–8.

    PubMed  CAS  Google Scholar 

  90. Hubbard RS, Beck EC. Changes in the glucose tolerance of obese subjects after weight reduction. J Clin Invest 1939;18:783–9.

    Article  PubMed  CAS  Google Scholar 

  91. Kukkonen-Harjula KT, Borg PT, Nenonen AM, Fogelholm MG. Effects of a weight maintenance program with or without exercise on the metabolic syndrome: a randomized trial in obese men. Prev Med 2005;41:784–90.

    Article  PubMed  Google Scholar 

  92. Appel LJ, Sacks FM, Carey VJ, et al. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA 2005;294:2455–64.

    Article  PubMed  CAS  Google Scholar 

  93. Kris-Etherton PM, Pearson TA, Wan Y, et al. High-monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations. Am J Clin Nutr 1999;70:1009–15.

    PubMed  CAS  Google Scholar 

  94. Wannamethee SG, Shaper AG, Whincup PH. Modifiable lifestyle factors and the metabolic syndrome in older men: Effects of lifestyle changes. J Am Geriatr Soc 2006;54:1909–14.

    Article  PubMed  Google Scholar 

  95. Muzio F, Mondazzi L, Harris WS, Sommariva D, Branchi A. Effects of moderate variations in the macronutrient content of the diet on cardiovascular disease risk factors in obese patients with the metabolic syndrome. Am J Clin Nutr 2007;86:946–51.

    PubMed  CAS  Google Scholar 

  96. Lien LF, Brown AJ, Ard JD, et al. Effects of PREMIER lifestyle modifications on participants with and without the metabolic syndrome. Hypertension 2007;50:609–16.

    Article  PubMed  CAS  Google Scholar 

  97. Corcoran MP, Lamon-Fava S, Fielding RA. Skeletal muscle lipid deposition and insulin resistance: effect of dietary fatty acids and exercise. Am J Clin Nutr 2007;85:662–77.

    PubMed  CAS  Google Scholar 

  98. Katzmarzyk PT, Leon AS, Wilmore JH, et al. Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study. Med Sci Sports Exerc 2003;35:1703–9.

    Article  PubMed  CAS  Google Scholar 

  99. Dumortier M, Brandou F, Perez-Martin A, Fedou C, Mercier J, Brun JF. Low intensity endurance exercise targeted for lipid oxidation improves body composition and insulin sensitivity in patients with the metabolic syndrome. Diabetes Metab 2003;29:509–18.

    Article  PubMed  CAS  Google Scholar 

  100. Votruba SB, Horvitz MA, Schoeller DA. The role of exercise in the treatment of obesity. Nutrition 2000;16:179–88.

    Article  PubMed  CAS  Google Scholar 

  101. Fenkci S, Sarsan A, Rota S, Ardic F. Effects of resistance or aerobic exercises on metabolic parameters in obese women who are not on a diet. Adv Ther 2006;23:404–13.

    Article  PubMed  CAS  Google Scholar 

  102. Johnson JL, Slentz CA, Houmard JA, et al. Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise). Am J Cardiol 2007;100:1759–66.

    Article  PubMed  Google Scholar 

  103. Anderssen SA, Carroll S, Urdal P, Holme I. Combined diet and exercise intervention reverses the metabolic syndrome in middle-aged males: results from the Oslo Diet and Exercise Study. Scand J Med Sci Sports 2007;17:687–95.

    Article  PubMed  CAS  Google Scholar 

  104. Jakicic JM, Otto AD. Physical activity considerations for the treatment and prevention of obesity. Am J Clin Nutr 2005;82:226S–9S.

    PubMed  CAS  Google Scholar 

  105. Johannsen DL, Redman LM, Ravussin E. The role of physical activity in maintaining a reduced weight. Curr Atheroscler Rep 2007;9:463–71.

    Article  PubMed  Google Scholar 

  106. Schoeller DA, Shay K, Kushner RF. How much physical activity is needed to minimize weight gain in previously obese women? Am J Clin Nutr 1997;66:551–6.

    PubMed  CAS  Google Scholar 

  107. McManus K, Antinoro L, Sacks F. A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord 2001;25:1503–11.

    Article  PubMed  CAS  Google Scholar 

  108. Yannakoulia M. Eating behavior among type 2 diabetic patients: a poorly recognized aspect in a poorly controlled disease. Rev Diabet Stud 2006;3:11–6.

    Article  PubMed  Google Scholar 

  109. Oh EG, Hyun SS, Kim SH, et al. A randomized controlled trial of therapeutic lifestyle modification in rural women with metabolic syndrome: a pilot study. Metabolism 2008;57:255–61.

    Article  PubMed  CAS  Google Scholar 

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Yannakoulia, M., Fappa, E., Hwang, J., Mantzoros, C.S. (2009). Diet and Exercise in the Prevention and Management of the Metabolic Syndrome. In: Mantzoros, C. (eds) Nutrition and Metabolism. Nutrition and Health. Humana Press. https://doi.org/10.1007/978-1-60327-453-1_8

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