Metabolic syndrome primary prevention


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]

Overview
Primary prevention strategies intend to avoid the development of disease. Different strategies like dietary modification, increasing physical activity and weight reduction are found useful in the primary prevention (development) of metabolic syndrome.

Primary Prevention
Metabolic syndrome is formed by a constellation of risk factors like obesity and insulin resistance that increases the risk of a patient for complications like stroke, diabetes and coronary heart diseases. Various strategies have been proposed to prevent the development of metabolic syndrome (primary prevantion). These include:


 * Diet and Nutrition: Low sodium High potassium Increased dietary intake of fruits, vegetables, and low-fat dairy products DASH-style diet
 * Increased physical activity (such as walking 30 minutes every day), and a healthy, reduced calorie diet.


 * Weight reduction - Weight reduction helps by increasing insulin sensitivity and HDL-C levels. It also helps in decreasing plasma glucose, plasma LDL-C, plasma triglycerides, blood pressure and inflammatory reactions. Improvement in fibrinolys and endothelial function is also seen.

Supportive trial data

 * There are many studies that support the value of a healthy lifestyle as above.  However, one study stated that these measures are effective in only a minority of people. The International Obesity Taskforce states that interventions on a sociopolitical level are required to reduce development of the metabolic syndrome in populations.


 * A 2007 study of 2,375 male subjects over 20 years suggested that daily intake of a pint of milk or equivalent dairy products more than halved the risk of metabolic syndrome. Other studies both support and dispute the authors' findings.


 * Transcendental Meditation for 16 weeks in patients with coronary heart disease improved blood pressure and insulin resistance components of the metabolic syndrome compared with a control group receiving health education. This suggests that the beneficial effects may be due to the decrease of stress in these patients due to the meditation. Nevertheless, the results of this randomized control trial should be interpreted with cautions as the patient population was small (n=103) and follow up was 16 weeks only.