The Effect of Lifestyle Intervention on Health-Related Quality of Life in Adults with Metabolic Syndrome: A Meta-Analysis

Abstract

The aim of this meta-analysis was to assess the effects of a lifestyle intervention through health education on nutrition, physical activity, and healthy habits on physical and mental health-related quality of life (HRQoL), in adults with metabolic syndrome (MetS). The databases used were PubMed, WOS, and Scopus. The inclusion criteria were: observational, longitudinal and randomized clinical trial (RCT) study designs, adults (both sexes), with at least two criteria of MetS, lifestyle intervention and comparison with a control group, and a measurement of HRQoL with a validated questionnaire. We analyzed the Hedges' g and SF-36 score. I² statistics were calculated and possible publication and small study biases were assessed using Egger's test and funnel plots. Seven RCTs were selected for meta-analysis, based on 637 study participants. Significant improvements were found in the physical dimensions of the HRQoL scores for subjects in the active intervention compared to the group that received general lifestyle information (Hedges' g 0.61, 95% confidence interval (CI) = 0.31-0.91). Mental health-related quality of life was also significantly improved in the intervention group compared with the control group (Hedges' g 0.84, 95% CI = 0.64-1.03). In conclusion, our results suggest that, according to the RCTs selected for this meta-analysis, a lifestyle intervention significantly improves HRQoL in all its domains.

Keywords: diet therapy; exercise; health education; healthy lifestyle; metabolic syndrome; quality of life.

Figure 1

Search Strategy.

Figure 2

Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Flowchart. WOS: Web of Science. SF-36: The Short Form-36 Health Survey.

Figure 3

Funnel plot of the (a) physical health scores and (b) mental health scores.

Figure 4

Forest plot of the physical health scores. Blue navy square centered at the point estimate of the effect size, with a horizontal line extending on either side of the square, representing the 95% confidence interval of the point stimate. Red diamond represents a confidence interval for each dimensions and green diamond represents a confidence a confidence interval for the overall effect size. REML: Restricted maximum-likelihood.

Figure 5

Forest plots of the mental health scores. Blue navy square centered at the point estimate of the effect size, with a horizontal line extending on either side of the square, representing the 95% confidence interval of the point stimate. Red diamond represents a confidence interval for each dimensions and green diamond represents a confidence a confidence interval for the overall effect size. REML: Restricted maximum-likelihood.