Physical activity, strength training and nutritional support in patients with metabolic syndrome from a Northeaster Portuguese primary health care: a pilot community intervention program
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abstract
Metabolic syndrome (MetS) is a common metabolic disorder characterized by a
cluster of factors such as central obesity, dysglycemia, dyslipidaemia and
hypertension (1). The combination of these factors increases the risk of metabolic
and cardiovascular diseases. The prevalence of MetS has been increasing in the
Portuguese population (2). Primary prevention using physical activity (PA),
exercise and healthy lifestyles seems to be adequate
The prevalence of Metabolic Syndrome (MetS) has been increasing exponentially in the Portuguese population. Primary prevention using physical activity (PA), exercise and healthy lifestyles seems to
be limited. Thus, current study aims to present the design and preliminary findings of a pilot community intervention for patients with MetS. Methods: A randomized controlled trial was conducted between April and July 2022 with patients with MetS, from a Northeaster Portuguese primary health care. Eight participants completed the three-month intervention program, 6 women (51.0±6.4 years) and 2 men (46.5±4.9 years). The program included: (1) evaluation and prescription of PA (steps/day and floors/day); (2) nutritional and dietary support; (3) strength training sessions; (3) blood testing; (4) anthropometric and body composition assessment. A pre- and post-intervention follow up was conducted. Garmin®F 745 were used for PA prescription and assessment. PA targets per day were: number of steps ≥10 000; uphill walking ≥10 floors; and minutes of intensity ≥150 per week. Nutritional and dietary evaluation was recorded by completing the food frequency questionnaire with subsequent recommendation of changes to healthy diet. The designed strength training program was: (i) frequency of 2x/week; (ii) 8 to 10 exercises, in order to work the main muscle groups; (iii) 2 sets of 10 to 12 repetitions; (iv) 60 to 70% of one maximum repetition. Blood samples evaluated glycated hemoglobin (HbA1c), fating glucose (FG), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, total cholesterol (TC), systolic (SBP) and diastolic blood pressure (DBP). Body weight (kg), lean body mass (kg) and fat mass percentage (%) was evaluated by bio-impedance
scale (Tanita MC 780-P MA®). MetS parameters was defined by joint interim statement (JIS) criteria (Alberti et al, 2009). Results: Regarding PA parameters at the end of the three-month program, the average number of daily steps was 11 818, the number of daily floors was 15.35 and moderate to vigorous PA was 253 minutes/week. An improvement in pre- and post-intervention blood concentrations and pressure was observed, namely in HbA1c (-7.4%±15.2), FG (-4.9%±14.4), HDL (-4.8%±9.7), TC (-1.9%±19.9), SBP (-15.6%±10.7) and DBP (-12.7%±9.3). All participants registered a weight loss (-3.4%±2.0), with an increase in lean mass (-4.5%±2.0) and a decrease in fat mass (-8.7%±6.3). Except for one participant, all improved in heart rate recovery after exercise (19.3%±28.2), suggesting an improvement in cardiovascular capacity. Conclusions: The effect of the implemented pilot community intervention program was greater in the participants who followed the program more rigorously. Additionally, the strength training may have been important in increasing lean body mass. The inclusion of PA, strength training and nutritional support in primary health care, through a supervised program, seems to be a key strategy to reduce the risk associated with MetS and delay the complications associated with cardiometabolic diseases.
This study is a result of the project
“GreenHealth - Digital strategies in
biological assets to improve wellbeing
and promote green health”
(Norte-01-0145-FEDER-000042),
supported by North Portugal Regional
Operational Programme (NORTE
2020), under the PORTUGAL 2020
Partnership Agreement, through the
European Regional Development Fund
(ERDF)”.