Healthy lifestyle may sustain MetS remission post-treatment

Promoting healthy habits through a behaviour-based lifestyle program helps keep metabolic syndrome (MetS) in remission after treatment, according to the Enhancing Lifestyles in Metabolic Syndrome (ELM) study.

ELM included adults with MetS who were motivated to pursue lifestyle changes. They were randomly allocated to the intervention group or the comparator group. All participants received education and were instructed to wear an activity monitor.

Participants in the intervention group attended 19 in-person meeting sessions over 6 months. These meetings were aimed at establishing the following habits as part of their daily routine: vegetables at meals, brisk walks, sensory awareness, and emotion regulation. Repetition of these habits was encouraged by attention to participants’ experience of immediate benefits and peer support.

On the other hand, participants in the comparator group received evidence-based educational materials in the mail monthly during the 24 months.

The primary outcome was MetS remission at 24 months, determined through blinded laboratory evaluation and clinical examination. Secondary outcomes included cardiometabolic and lifestyle risk factors at 6 and 24 months.

The analysis included 618 participants (mean age 55.5 years, 74.7 percent female), of whom 306 (49.5 percent) were in the intervention group and 312 (50.5 percent) in the comparator group. A total of 517 participants (83.7 percent) completed the 24-month follow-up, and 513 of them had obesity.

At 6 months, MetS remission occurred in 24.8 percent of participants in intervention group and 17.9 percent in the comparator group (adjusted odds ratio [aOR], 1.64, 95 percent confidence interval [CI], 1.07–2.53; p=0.03). Remission occurred alongside improvements in waist circumference, triglycerides, fasting glucose, body mass index, weight, haemoglobin A1c, MetS severity, perceived stress, vegetable intake, moderate-intensity physical activity, daily steps, sensory awareness, and the habits of daily brisk walks and vegetables at meals.

At 24 months, the percentage of participants in MetS remission was 27.8 percent in the intervention group vs 21.2 percent in the comparator group (aOR, 1.46, 95 percent CI, 1.01–2.14; p<0.05). Sustained improvements in fasting glucose, vegetable intake, daily steps, sensory awareness, and the habit of daily brisk walks were observed.