New Insights about How to Make an Intervention in Children and Adolescents with Metabolic Syndrome: Diet, Exercise vs. Changes in Body Composition. A Systematic Review of RCT.

Enrique Albert Pérez, Victoria Mateu Olivares, Rosa María Martínez-Espinosa, Mariola D Molina Vila, Manuel Reig García-Galbis

Journal: Nutrients 2018;10(7):878

PMID: 29986479

Plain Language Summary

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Metabolic Syndrome is the term used to group a cluster of health concerns including overweight, obesity, hypertension, elevated cholesterol, blood glucose intolerance and insulin resistance which together can contribute to the development of Type II Diabetes and Cardiovascular Disease. Diagnosis is usually given if a patient has three or more of these conditions however the diagnosis in children and adolescents is often inconsistent, and so guidelines for therapeutic strategies for metabolic syndrome also vary greatly. This review looked at 9 studies of children aged up to 19 years old, all diagnosed with metabolic syndrome, and given dietary, physical, psychological, and pharmacological interventions, to try and understand what the best clinical approach might be. It was found that a balanced diet combined with aerobic and resistance exercise helped to significantly reduce body mass, more so than the trials which included treatment with Metformin. A balance diet included calorie restriction and carbohydrate reduction, carefully planned around the daily exercise program of 2-3 resistance sessions each week and frequent cardio sessions of differing intensity and duration. They concluded that a minimum of 6 months was needed to reach optimal weight loss and body fat loss. Overall, the findings of this study support diet and physical exercise as beneficial clinical interventions, whilst the use of medication is still unclear.

Abstract

OBJECTIVE

To record which interventions produce the greatest variations in body composition in patients ≤19 years old with metabolic syndrome (MS).

METHOD

search dates between 2005 and 2017 in peer reviewed journals, following the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). The selection criteria were: diagnostic for MS or at least a criterion for diagnosis; randomized clinical trials, ≤19 years of age; intervention programs that use diet and/or exercise as a tool (interventions showing an interest in body composition).

RESULTS

1781 clinical trials were identified under these criteria but only 0.51% were included. The most frequent characteristics of the selected clinical trials were that they used multidisciplinary interventions and were carried out in America. The most utilized parameters were BMI (body mass index) in kg/m² and BW (body weight) in kg.

CONCLUSIONS

Most of the clinical trials included had been diagnosed through at least 2 diagnostic criteria for MS. Multidisciplinary interventions obtained greater changes in body composition in patients with MS. This change was especially prevalent in the combinations of dietary interventions and physical exercise. It is proposed to follow the guidelines proposed for patients who are overweight, obese, or have diabetes type 2, and extrapolate these strategies as recommendations for future clinical trials designed for patients with MS.

Address: Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain. [email protected].; Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain. [email protected].; Division of Biochemistry and Molecular Biology, Department of Agrochemistry and Biochemistry, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain. [email protected].; Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain. [email protected].; Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain. [email protected].; Department of Mathematics, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain. [email protected].; Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain. [email protected].; Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama, Avda Copayapu 2862, III Region, Copiapo 1530000, Chile. [email protected].
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