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Nutr Rev. 2017 May 1;75(5):307-326. doi: 10.1093/nutrit/nux014.

Lifestyle recommendations for the prevention and management of metabolic syndrome: an international panel recommendation.

Author information

1
P. Pérez-Martínez, J. Delgado-Lista, A. García-Ríos, F. Pérez-Jiménez, and J. López-Miranda are with the Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. P. Pérez-Martínez, M. Bullo, M.I. Covas, J. Delgado-Lista, A. Díaz-López, R. Estruch, M. Fitó, A. García-Ríos, G. Mena-Sánchez, A. Muñoz-Garach, F. Pérez-Jiménez, J. Salas-Salvadó, F.J. Tinahones, R. de la Torre, E. Ros, and J. López-Miranda are with the CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London, London, United Kingdom. V.G. Athyros and N. Katsiki are with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece. M. Bullo, A. Díaz-López, G. Mena-Sánchez, and J. Salas-Salvadó are with the Human Nutrition Unit, Biochemistry Biotechnology Department, Faculty of Medicine and Health Sciences, Hospital Universitari de Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, Reus, Spain. P. Couture and B. Lamarche are with the Institute on Nutrition and Functional Foods, Laval University, Quebec, Canada. M.I. Covas, M. Fitó, and H. Schröder are with the Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Research Institute, Barcelona, Spain. M.I. Covas is with the NUPROAS (Nutritional Project Assessment) Handesbolag, Nacka?, Sweden. L. de Koning is with the the Department of Pathology and Department of Laboratory Medicine, Pediatrics, and Community Health Sciences, University of Calgary, Alberta, Canada. C.A. Drevon is with the Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway. R. Estruch is with the Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomédiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain. K. Esposito, D. Giugliano, and M. Ida Maiorino are with the Division of Endocrinology and Metabolic Diseases, Second University of Naples Diabetes Unit, Second University of Naples, Naples, Italy. M. Garaulet is with the Chronobiology Laboratory, Department of Physiology, University of Murcia and Research Biomedical Institute of Murcia, Murcia, Spain. G. Kolovou is with the 1st Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece. A. Muñoz-Garach and F.J. Tinahones are with the Servicio de Endocrinologia y Nutricion, Hospital Clinico Virgen de la Victoria, Malaga, Spain. D. Nikolic and M. Rizzo are with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J.M. Ordovás is with the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University School of Medicine, Boston, Massachusetts, United States. J.M. Ordovás is with the Department of Epidemiology, National Center of Cardiovascular Investigations, Madrid, Spain; and the Madrid Institute of Advanced Studies-Food, Madrid, Spain. H. Schröder is with the CIBER de Epidemiologia y Salud Pública, Madrid, Spain. R. de la Torre is with the Human Pharmacology and Clinical Neurosciences Research Group, Hospital del Mar Research Institute, Barcelona, Spain. B. van Ommen and S. Wopereis are with the Toegepast Natuurwetenschappelijk Onderzoek, Zeist, The Netherlands. E. Ros is with the Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomédiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain.

Abstract

The importance of metabolic syndrome (MetS) lies in its associated risk of cardiovascular disease and type 2 diabetes, as well as other harmful conditions such as nonalcoholic fatty liver disease. In this report, the available scientific evidence on the associations between lifestyle changes and MetS and its components is reviewed to derive recommendations for MetS prevention and management. Weight loss through an energy-restricted diet together with increased energy expenditure through physical activity contribute to the prevention and treatment of MetS. A Mediterranean-type diet, with or without energy restriction, is an effective treatment component. This dietary pattern should be built upon an increased intake of unsaturated fat, primarily from olive oil, and emphasize the consumption of legumes, cereals (whole grains), fruits, vegetables, nuts, fish, and low-fat dairy products, as well as moderate consumption of alcohol. Other dietary patterns (Dietary Approaches to Stop Hypertension, new Nordic, and vegetarian diets) have also been proposed as alternatives for preventing MetS. Quitting smoking and reducing intake of sugar-sweetened beverages and meat and meat products are mandatory. Nevertheless, there are inconsistencies and gaps in the evidence, and additional research is needed to define the most appropriate therapies for MetS. In conclusion, a healthy lifestyle is critical to prevent or delay the onset of MetS in susceptible individuals and to prevent cardiovascular disease and type 2 diabetes in those with existing MetS. The recommendations provided in this article should help patients and clinicians understand and implement the most effective approaches for lifestyle change to prevent MetS and improve cardiometabolic health.

KEYWORDS:

dietary pattern; lifestyle; metabolic syndrome; panel recommendation

PMID:
28521334
PMCID:
PMC5914407
DOI:
10.1093/nutrit/nux014
[Indexed for MEDLINE]
Free PMC Article

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