Lifestyle Interventions Associated With Changes in Waist Circumference, Weight, BMI in MetS

Lifestyle interventions can lead to reductions in waist circumference, weight, and body mass index (BMI) in patients with metabolic syndrome (MetS), according to study results presented at the National Lipid Association (NLA) Scientific Sessions 2023, held in Atlanta, Georgia, between June 1 and 4, 2023.

The study was aimed at improving identification, adherence, and education in primary care among adult patients with MetS.

The researcher conducted a lifestyle intervention quality improvement program in Southeast Texas at a primary care nurse practitioner clinic in 2021 that included adult patients enrolled in the Model for Improvement Framework — Plan Do Study Act.

The program included a chart review and written and verbal education, along with the method and content of education, accurate diagnosis of MetS, and frequency of waist circumference documentation. The researcher assessed anthropometric patient measurements and survey of physical activity and dietary habits, and conducted a survey of provider and staff measurement processes, self-perceived efficacy, and satisfaction, as well as health literacy.

The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATPIII) definition was used for MetS (defined as ≥3 blood glucose >100; blood pressure >130/85; high-density lipoprotein cholesterol <40 [men] or <50 [women]; waist circumference >40 inches [men] or >35 inches [women]; and triglycerides >150).

Results showed, at baseline screening, 7 of 25 participants had the presence of 3 or more of the diagnostic criteria. After the completion of the project, 23 of the 25 participants had 3 or more of the diagnostic criteria.

Changes before vs after the project were noted (mean weight, 233.13±58.75 vs 228.28±59.32 pounds; waist circumference, 47.1±6.51 vs 45.5±6.42 inches; BMI, 37.69±8.13 vs 36.83±8.24; health literacy, 73±21.79 vs 98±6.16, respectively; P =.000 for all). Reductions in weight, waist circumference, and BMI were found to be statistically significant. The mean health literacy increased 25% and diagnostic accuracy 64%.

“Early diagnosis and implementation of lifestyle intervention programs are effective at reducing markers of MetS,” the researcher concluded, with “patient reporting of progress [improving] adherence.”

Some of the key takeaways from the study were that providers must assess MetS and metabolic dysfunction, and waist circumference, of their patients, and must enable patients to self-report progress, if they are enrolled in a lifestyle program. In addition, clinicians should recognize the importance of early diagnosis and implementation of lifestyle changes, and that verbal, along with written, education may improve health literacy.