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Meta-Analysis
. 2021 Dec;22(4):877-890.
doi: 10.1007/s11154-021-09644-2. Epub 2021 Mar 17.

Education-based, lifestyle intervention programs with unsupervised exercise improve outcomes in adults with metabolic syndrome. A systematic review and meta-analysis

Casey L Peiris  1 , Maria van Namen  2 , Gráinne O'Donoghue  3
Affiliations
Meta-Analysis

Education-based, lifestyle intervention programs with unsupervised exercise improve outcomes in adults with metabolic syndrome. A systematic review and meta-analysis

Casey L Peiris et al. Rev Endocr Metab Disord. 2021 Dec.

Abstract

To determine whether lifestyle intervention programs comprising dietary intervention and prescribed, unsupervised exercise improve outcomes for people with metabolic syndrome. A systematic review and meta-analysis of randomised controlled trials. Online databases CINAHL, MEDLINE, PubMed and Embase were searched from the earliest date available to October 2020. Post-intervention data were pooled to calculate mean differences (MD) or standardised mean differences (SMD) and 95% confidence intervals (CI) using inverse variance methods and random effects models. Trial methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale and overall quality of each meta-analysis was assessed using the Grading of Recommendation Assessment, Development and Evaluation approach. Eleven studies from 9 randomised controlled trials with 1,835 participants were included. There was high quality evidence that lifestyle intervention programs with unsupervised exercise reduced waist circumference (MD -2.82 cm, 95%CI -5.64 to 0.00, I2 91%) and blood pressure (systolic: MD -3.89 mmHg, 95%CI -5.19 to -2.58, I2 4%; diastolic: MD -3.16 mmHg, 95%CI -4.83 to -1.49, I2 50%) and increased physical activity levels (SMD 0.47, 95%CI 0.24 to 0.70, I2 45%) when compared to usual care. There was low quality evidence that they improved quality of life (SMD 0.59, 95%CI 0.05 to 1.13, I2 84%). Unsupervised programs had no significant effect on fasting blood glucose (unless > 3 months duration), metabolic syndrome prevalence or cholesterol. Lifestyle intervention programs with prescribed, unsupervised exercise are a practical alternative to supervised programs for people with metabolic syndrome when time, access or resources are limited or when social distancing is required.

Keywords: Diet; Exercise; Lifestyle intervention; Metabolic syndrome.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow of trials through the review
Fig. 2
Fig. 2
Mean difference (95% confidence interval) for the effect of unsupervised lifestyle intervention programs on waist circumference
Fig. 3
Fig. 3
a Mean difference (95% confidence interval) for the effect of unsupervised lifestyle intervention programs on systolic blood pressure. b Mean difference (95% confidence interval) for the effect of unsupervised lifestyle intervention programs on diastolic blood pressure
Fig. 4
Fig. 4
Standardised mean difference (95% confidence interval) for the effect of unsupervised lifestyle intervention programs on fasting blood glucose levels
Fig. 5
Fig. 5
Risk ratio (95% confidence interval) for the effect of unsupervised lifestyle intervention programs on prevalence of metabolic syndrome
See this image and copyright information in PMC

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