DGDispatch

AAFP: Low-Fat, High-Fiber, Exercising Helpful for Metabolic Syndrome

By Ric Susman

ORLANDO, FL -- October 22, 2004 -- Changing one's lifestyle with diet and
exercise appears to have a positive impact on components of the metabolic
syndrome, which are closely related to diabetes and heart disease, researchers
reported here October 16th at the 17th World Conference of Family Doctors.

"Changes in lifestyle can have a rapid effect in changing the physiological
profile of patients," said Caroline Van Sant-Crowle, MD, a resident at the
Morton Plant Mease Health Care, Clearwater, Florida, in her poster presentation
during the meeting, which was held in conjunction with the American Academy of
Family Physicians Scientific Assembly.

The major characteristics of metabolic syndrome include insulin resistance,
abdominal obesity, elevated blood pressure, and lipid abnormalities such as
elevated levels of triglycerides and low levels of high-density lipoprotein
(HDL) cholesterol. Any three of those conditions is considered an operational
definition of metabolic syndrome.

To assess the impact of a very-low fat, high-fiber diet and of an exercise
program on patients with the metabolic syndrome, Dr. Van Sant-Crowle and her
team recruited 38 patients among individuals attending the Pritikin Longevity
Center in Aventura, Florida.

Patients were attending the Pritikin Center for a variety of conditions, such
as heart disease, diabetes, obesity, and hypertension. Upon arrival, guests
received a complete physical evaluation by physicians, dietitians, exercise
physiologists, and lifestyle counselors. Then, they received individual
instruction on the diet and exercise program.

The diet contained 12% to 15% fat calories and more than 30 grams of fiber
daily. As the food served to the patients was not restricted to a specific
calorie intake, according to Dr. Van Sant-Crowle, "Patients were encouraged to
eat all they wanted, we were not going to police them." Along with a mostly
salad based diet, their sodium intake was reduced to less than 1600 mg/day.

"The patients had to want to stay with the diet," Dr. Van Sant-Crowle said. "I
personally saw people ordering pizzas to their room and going to a local Burger
King," she said.

As part of the exercise program, patients performed 45 to 60 minutes of aerobic
activity daily. Strength training exercises were included in the workout about
3 times a week.

After 2 weeks on the program, Dr. Van Sant-Crowle was able to find significant
changes in the several areas:
- Mean cholesterol level dropped by 32.5 mg/dL, a decrease from baseline that
was significant at the P < .0001 level.

- Low-density lipoprotein cholesterol decreased by 16.3 mg/dL, reaching
significance at the P = .0027 level.
- Systolic blood pressure decreased by 18 mg Hg (P < .0001), and diastolic
blood pressure by 6.84 mm Hg (P = .0003).
- The ratio between total cholesterol and HDL cholesterol decreased by .44,
which was significant at the P = .028 level.
- The triglyceride/HDL ratio decreased by 1.33, achieving significance at the P
= .0003.
- There was a 3.65 mg/dL decrease in HDL-cholesterol, but that was not
different from baseline was not significant.

Of the five criteria used to describe the metabolic syndrome, 58% of the
patients in the study no longer met three or more of those criteria by the time
the patients completed the study.

[Presentation title: "Efficacy of Low-Fat, High-Fiber, Exercise Program for
Metabolic Syndrome." Poster 3051]

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