RT Journal Article
SR Electronic
T1 Family physician-led, team-based, lifestyle intervention in patients with metabolic syndrome: results of a multicentre feasibility project
JF CMAJ Open
FD Canadian Medical Association
SP E229
OP E236
DO 10.9778/cmajo.20160101
VO 5
IS 1
A1 Jeejeebhoy, Khursheed
A1 Dhaliwal, Rupinder
A1 Heyland, Daren K.
A1 Leung, Roger
A1 Day, Andrew G.
A1 Brauer, Paula
A1 Royall, Dawna
A1 Tremblay, Angelo
A1 Mutch, David M.
A1 Pliamm, Lew
A1 Rhéaume, Caroline
A1 Klein, Doug
YR 2017
UL http://www.cmajopen.ca/content/5/1/E229.abstract
AB Background: Metabolic syndrome (MetS) is a medical condition with major complications and health care costs. Previous research has shown that diet and exercise can improve and reverse this condition. The goal of this study was to test the feasibility and effectiveness of implementing the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program into diverse family medicine practices to improve MetS.Methods: In this longitudinal before-after study, 305 adult patients with MetS were recruited from 3 diverse family medicine team-based organizations to the CHANGE personalized diet and exercise program. Participants were followed for 12 months. Primary outcomes included feasibility and reversal of MetS. Secondary outcomes included improvement in MetS components, changes in diet quality, aerobic fitness and cardiovascular risk.Results: Participants attended 76% and 90% of the kinesiologist and dietitian visits, respectively. At 12 months, 19% of patients (95% confidence interval [CI] 14%-24%) showed reversal of MetS, VO2max increased by 16% (95% CI 13%-18%), and Healthy Eating Index and Mediterranean Diet Scores improved by 9.6 (95% CI 7.6-11.6) points on a 100-point scale and by 1.4 (95% CI 1.1-1.6) points on a 14-point scale, respectively. In addition, the Prospective Cardiovascular Munster (PROCAM) 10-year risk of acute coronary event decreased by 1.4%, from a baseline of 8.6%.Interpretation: A team-based program led by the family physician that educates patients about the risks of MetS, and with a dietitian and kinesiologist, empowers them to undertake an individualized supervised program of diet modification and exercise, is feasible, improves aerobic capacity and diet quality, reverses MetS and improves MetS components at 12 months.