Are there specific treatments for the metabolic syndrome?
Giugliano, D. (Dario), Ceriello, Antonio and Esposito, Katherine. (2008) Are there specific treatments for the metabolic syndrome? American Journal of Clinical Nutrition, Vol.87 (No.1). pp. 8-11. ISSN 0002-9165Full text not available from this repository.
The concept of the metabolic syndrome, although controversial, continues to gain acceptance. Whereas each risk factor of the metabolic syndrome (visceral obesity, atherogenetic dyslipidemia, elevated blood pressure, and dysglycemia) can be dealt with individually, the recommended initial therapeutic approach is to focus on reversing its root causes of atherogenetic diet, sedentary lifestyle, and overweight or obesity. No single diet is currently recommended for patients with the metabolic syndrome, although epidemiologic evidence suggests a lower prevalence of the metabolic syndrome associated with dietary patterns rich in fruit, vegetables, whole grains, dairy products, and unsaturated fats. We conducted a literature search to identify clinical trials specifically dealing with the resolution of the metabolic syndrome by lifestyle, drugs, or obesity surgery. Criteria used for study selection were English language, randomized trials with a placebo or control group (except for surgery), a follow-up lasting >= 6 mo, and a time frame of 5 y. We identified 3 studies based on lifestyle interventions, 5 studies based on drug therapy, and 3 studies based on laparoscopic weight-reduction surgery The striking resolution of the metabolic syndrome with weight-reduction surgery (93%) as compared with lifestyle (25%) and drugs (19%) strongly suggests that obesity is the driving force for the occurrence of this condition. Although there is no "all-inclusive" diet yet, it seems plausible that a Mediterranean-style diet has most of the desired attributes, including a lower content of refined carbohydrates, a high content of fiber, a moderate content of fat (mostly unsaturated), and a moderate-to-high content of vegetable proteins.
|Item Type:||Journal Article|
|Subjects:||R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
|Divisions:||Faculty of Medicine > Warwick Medical School|
|Library of Congress Subject Headings (LCSH):||Metabolic syndrome -- Treatment, Obesity, Clinical trials|
|Journal or Publication Title:||American Journal of Clinical Nutrition|
|Publisher:||American Society for Nutrition|
|Number of Pages:||4|
|Page Range:||pp. 8-11|
|Access rights to Published version:||Restricted or Subscription Access|
|Funder:||II Università di Napoli|
|References:||1. Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical reappraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 2004;48:1684 –9. 2. Grundy SM. Drug therapy of the metabolic syndrome: minimizing the emerging crisis in polypharmacy. Nat Rev Drug Discov 2006;5:295– 309. 3. NCEP. 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). JAMA 2001;285:2486 –97. 4. Weinberg SL. The diet-heart hypothesis: a critique. J Am Coll Cardiol 2004;43:731–3. 5. Howard BV, Manson JE, Stefanick ML, et al. Low-fat dietary pattern and weight change over 7 years. The Women’s Health Initiative Dietary Modification Trial. JAMA 2006;295:39–49. 6. Esposito K, Ciotola M, Giugliano D. Low-carbohydrate diet and coronary heart disease in women. N Engl J Med 2007;356:750 –2. 7. Ebbeling CB, Leidig MM, Feldman HA, Lovesky MM, Ludwig DS. Effects of a low-glycemic load vs low-fat diet in obese young adults. JAMA 2007;297:2092–102. 8. Howard BV. Dietary fat and cardiovascular disease: putting the Women’s Health Initiative in perspective. Nutr Metab Cardiovasc Dis 2007; 17:171– 4. 9. Grundy SM, Cleeman JI, Daniels RD, et al. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112:2735–52. 10. Lichtenstein AH, Appel LJ, Brands M, et al. Diet and lifestyle recommendations revision 2006. A scientific statement from the American Heart Association Nutrition Committee. Circulation 2006;114:82–96. 11. Halton TL, Willett WC, Liu S, et al. Low carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med 2006;355:1991– 2002. 12. Williams DE, Prevost AT, Whichelow MJ, Cox BD, Day NE, Vareham NJ. A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome. Br J Nutr 2000;83:257–66. 13. Pereira MA, Jacobs DR Jr, Van Horn L, Slattery ML, Kartashov AI, Ludwig DS. Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study. JAMA 2002;287:2081–9. 14. Ford ES, Mokdad AH, Giles WH, et al. The metabolic syndrome and antioxidant concentrations: findings from the third National Health and Nutrition Examination Survey. Diabetes 2003;52:2346 –52. 15. Zhu S, St-Onge MP, Heshka S, Heymsfield SB. Lifestyle behaviors associated with lower risk of having the metabolic syndrome. Metabolism 2004;53:1503–11. 16. McKeown NM, Meigs JB, Liu S, Saltzmann E, Wilson PW, Jacques PF. Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care 2004;27:538–46. 17. Panagiotakos DB, Pitsavos CH, Chrysohoou C, et al. The impact of lifestyle habits on the prevalence of the metabolic syndrome among Greek adults from the ATTICA study. Am Heart J 2004;147:106 –12. 18. Baxter AJ, Coyne T, McClintock C. Dietary pattern and metabolic syndrome— a review of epidemiological evidence. Asia Pac J Clin Nutr 2006;15:134–42. 19. Sonnenberg L, Pencina M, Kimokoti R, et al. Dietary patterns and the metabolic syndrome in obese and nonobese Framingham women. Obes Res 2005;13:153– 62. 20. Millen BE, Pencina MJ, Kimokoti RW, et al. Nutritional risk and the metabolic syndrome in women: opportunities for preventive intervention from the Framingham Nutrition Study. Am J Clin Nutr 2006;84: 434–51. 21. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC.Dietary patterns, insulin resistance, and prevalence of the metabolic syndrome in women. Am J Clin Nutr 2007;85:910–8. 22. 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. 23. Orchard TJ, Tempros 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. 24. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F. Beneficial effects of a dietary approaches to stop hypertension eating plan on features of the metabolic syndrome. Diabetes Care 2005;28:2823–31. 25. Van Gaal LF, Rissanen AM, Scheen AJ, Ziegler O, Rossner S, for the RIO-Europe Study Group. Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study. Lancet 2005;365:1389 –97. 26. Després J-P, Golay A, Sjöström L, for the Rimonabant in Obesity-Lipids Study Group. Effects of rimonabant on metabolic risk factors in overweight patients with dyslipidemia. N Engl J Med 2005;353:2121–34. 27. Pi-Sunyer FX, Aronne LJ, Heshmati HM, Devin J, Rosenstock J, for the RIO-North America Study Group. Effect of rimonabant, a cannabinoid-1 receptor blocker, on weight and cardiometabolic risk factors in overweight or obese patients: RIO-North America: a randomized controlled trial. JAMA 2006;295:761–75. 28. Esposito K, Ciotola M, Carleo D, et al. Effect of rosiglitazone on endothelial function and inflammatory markers in patients with the metabolic syndrome. Diabetes Care 2006;29:1071– 6. 29. Lee WJ, Huang MT,WangW,LinCM,Chen TC, Lai IR. Effects of obesity surgery on the metabolic syndrome. Arch Surg 2004;139:1088–92. 30. Mattar SG, Velcu LM, Rabinovitz M, et al. Surgically-induced weight loss significantly improves non-alcoholic fatty liver disease and the metabolic syndrome. Ann Surg 2005;242:610 –7. 31. Madan AK, OrthW,Ternovits CA, Tichansky DS. Metabolic syndrome: yet another co-morbidity gastric bypass helps cure. Surg Obes Relat Dis 2006;2:48 –51. 32. Esposito K, Ceriello A, Giugliano D. The effects of diet on inflammation. Emphasis on the metabolic syndrome. J Am Coll Cardiol 2006;48: 677–85. 33. Esposito K, Ciotola M, Giugliano D. Mediterranean diet, endothelial function and vascular inflammatory markers. Public Health Nutr 2006; 9(8A):1073– 6.|
Actions (login required)