Vitamin D Can Significantly Lower Your Risk of Metabolic Syndrome

The Role of Vitamin D in Disease Prevention

A growing body of evidence shows that vitamin D plays a crucial role in disease prevention and maintaining optimal health. There are about 30,000 genes in your body, and vitamin D affects nearly 3,000 of them, as well as vitamin D receptors located throughout your body.

According to one large-scale study, optimal Vitamin D levels can slash your risk of cancer by as much as 60 percent. Keeping your levels optimized can help prevent at least 16 different types of cancer, including pancreatic, lung, ovarian, prostate and skin cancers.

How Vitamin D Performance Testing Can Help Optimize Your Health

Is it any wonder then that no matter what disease or condition is investigated, vitamin D appears to play a crucial role? This is why I am so excited about the D*Action Project by GrassrootsHealth. Dr. Robert Heaney is the research director of GrassrootsHealth and is part of the design of the D*action Project as well as analysis of the research findings.

GrassrootsHealth shows how you can take action today on known science with a consensus of experts without waiting for institutional lethargy. It has shown how by combining the science of measurement (of vitamin D levels) with the personal choice of taking action and, the value of education about individual measures that one can truly be in charge of their own health.

In order to spread this health movement to more communities, the project needs your involvement. To participate, simply purchase the D*Action Measurement Kit and follow the registration instructions included. (Please note that 100 percent of the proceeds from the kits go to fund the research project. I do not charge a single dime as a distributor of the test kits.)

As a participant, you agree to test your vitamin D levels twice a year during a five-year study, and share your health status to demonstrate the public health impact of this nutrient. There is a $65 fee every six months for your sponsorship of this research project, which includes a test kit to be used at home, and electronic reports on your ongoing progress. You will get a follow up email every six months reminding you “it’s time for your next test and health survey.”

Vitamin D Linked to Metabolic Syndrome in Postmenopausal Women

Postmenopausal women with vitamin D deficiency have greater risk for metabolic syndrome than those with sufficient levels, data from a cross-sectional cohort study suggest. Levels of 25-hydroxyvitamin-D [25(OH)D] below 20 ng/mL were also linked to a greater likelihood of high triglycerides and low high-density lipoprotein (HDL) cholesterol.

“These results suggest that the maintenance of adequate serum levels of 25(OH)D in postmenopausal women may reduce the risk of developing [metabolic syndrome], a condition that is known to be related to cardiovascular events and mortality in this group,” write Eneida Boteon Schmitt, MD, from São Paulo State University’s Botucatu Medical School in Brazil, and colleagues.

They note, however, that the observational, cross-sectional design of the study prevents causal inferences and that unmeasured confounders may play a role in the findings. Also, as 90% of the study participants were white, the findings may not be generalizable to other races/ethnicities.

The study, published in the January 2018 issue of Maturitas, included 463 women, 45 to 75 years old, who had not menstruated for at least a year, were not taking vitamin D supplements, and had a diagnosis of cardiovascular disease. The researchers measured their total cholesterol, HDL levels, low-density lipoprotein (LDL) levels, triglycerides, glucose, insulin, and 25(OH)D levels.

Vitamin D deficiency was defined as serum 25(OH)D levels below 20 ng/mL, whereas levels between 20 and 29 ng/mL were insufficient. Levels of at least 30 ng/mL were considered sufficient. Diagnosis of metabolic syndrome required presence of at least three of five criteria: a waist circumference greater than 88 cm, triglycerides at least 150 mg/dL, HDL levels below 50 mg/dL, blood pressure at least 130/85 mm Hg, and glucose at least 100 mg/dL.

Just under a third (32.0%) of the women had sufficient vitamin D levels, and a similar proportion (32.6%) had insufficient levels. The remaining 35.4% were deficient. Physical activity levels, use of hormone therapy, smoking, and prevalence of diabetes or arterial hypertension were similar among all three groups of women. Age, body mass index, HDL and LDL, glucose, waist circumference, blood pressure, age at menopause, and time since menopause were also comparatively similar among the groups.

More than half (57.8%) of the women without sufficient vitamin D (below 30 ng/mL) had metabolic syndrome compared with 39.8% of women with sufficient vitamin D levels (P = .003).

Vitamin D below 30 ng/mL was associated with higher total cholesterol, triglycerides, and insulin levels. It was also associated with a higher score on the homeostasis model assessment of insulin resistance, in which insulin resistance is defined as a score above 2.7.

After adjustment for age, time since menopause, body mass index, smoking, and physical activity level, women deficient in 25(OH)D had nearly double the odds of metabolic syndrome as those with sufficient levels (odds ratio [OR], 1.90). Women with deficient vitamin D also had 55% greater odds of high triglycerides and 60% greater odds of low HDL. Decreasing concentrations of vitamin D correlated with an increase in the number of metabolic syndrome criteria met.

“There are several possible physiopathological mechanisms that could explain the effect of [vitamin D] on the components of [metabolic syndrome],” the authors write. “The most plausible explanation is that [vitamin D] influences insulin secretion and sensitivity, which play a major role in [metabolic syndrome].”

The researchers also noted shared risk factors among people with diabetes and those with low vitamin D levels, such as older age, being an ethnic/racial minority, having obesity, and being physically inactive.

“Although [vitamin D] deficiency is prevalent…across the adult age range, the reduction in outdoor activities and the possible decrease in the capacity of aged skin to synthesize 25(OH)D may contribute to high prevalence of [vitamin D] deficiency in postmenopausal women,” the authors add.

Although the authors speculate that a causal relationship is plausible between low vitamin D and poorer cholesterol levels, they also point out alternative explanations and note the need for studies to clarify the relationship.

“People engaging in high levels of outdoor physical exercise, which would raise 25(OH)D levels due to greater sun exposure, may be more likely also to have healthy eating habits, which could favorably affect their lipid profile,” they write.

More Coffee May Up Metabolic Syndrome Risk in Type 1 Diabetes

In a snapshot cross-sectional analysis of study participants with type 1 diabetes in Finland, drinking three or more cups of filtered coffee a day was associated with increased odds of having metabolic syndrome, in contrast to previous findings in the general population.

The article, by B Stutz of the University of Helsinki, Finland, and colleagues, based on data from the Finnish Diabetic Nephropathy (FinnDiane) study, was published online February 1 in Nutrition, Metabolism & Cardiovascular Diseases.

“In contrast to the previous observations in other populations, coffee consumption was associated with higher odds of [metabolic syndrome] in the current study” in people with type 1 diabetes, the researchers report.

Among these individuals with type 1 diabetes, those who drank moderate or high amounts of coffee had a significantly increased risk of metabolic syndrome compared with those who did not drink coffee, after adjusting for multiple variables.

Those who drank any amount of coffee were more likely to have hypertension.

The reasons for these findings remain to be determined and more study is also needed to see how coffee consumption might affect health outcomes in people with type 1 diabetes, the researchers conclude.

Association Mainly Driven by Hypertension

In the general population, regular coffee drinkers have been reported to have a lower risk of developing metabolic syndrome, and thus a lower risk of cardiovascular disease and early mortality.

However, it has not been clear whether patients with type 1 diabetes who are regular coffee drinkers would also have a lower risk of metabolic syndrome.

To investigate this, researchers examined 1040 participants from the FinnDiane study who had type 1 diabetes — defined as diabetes onset before age 35 years and permanent insulin therapy within a year of diagnosis — and complete data from a diet questionnaire along with information on metabolic syndrome criteria.

Metabolic syndrome was defined as having three of the following five criteria: waist circumference ≥ 94 cm in men and ≥ 80 cm in women; triglycerides ≥ 1.7 mmol/L or on lipid-lowering medication; high-density lipoprotein cholesterol (HDL-C) < 1.0 mmol/L in men and < 1.3 mmol/L in women, or on medication to increase HDL-C; blood pressure ≥ 130/85 mmHg or use of antihypertensive medication; and fasting blood glucose ≥ 110 mg/dL.

Participants were classed as having the following coffee consumption levels:

  • None: < 1 cup/day, 134 participants (13%)
  • Low: 1–2 cups/day, 230 participants (22%)
  • Moderate: 3–4 cups/day, 371 participants (36%)
  • High: ≥ 5 cups/day, 305 participants (29%)

Of the 906 coffee drinkers, 825 (91%) drank filtered coffee, so researchers pooled data for the different types of coffee.

On average, individuals who did not drink coffee were 40 years old and had diabetes for 21 years, whereas coffee drinkers were older (mean age 46 to 49 years) and had diabetes longer (mean duration 27 to 30 years).

There were more current smokers in the group that had a high consumption of coffee (22%) than in the groups that drank less (up to 12%) or no coffee (3%).

There were also more men in the group who drank 5 or more cups of coffee a day (60%) than in the groups that drank less or no coffee (32% to 45%).

Coffee drinkers were more likely to be taking antihypertensive or lipid-lowering medications than nondrinkers.

The prevalence of metabolic syndrome increased stepwise from 51% to 64% to 65% to 70% among people whose coffee consumption was none, low, moderate, or high, respectively.

Compared with noncoffee drinkers, those who drank 3 or 4 cups a day had a 1.8-fold increased risk of having metabolic syndrome, and those who drank 5 or more cups a day had a 2.1-fold increased risk (P < .05 for both), after adjusting for age, sex, total calories, alcohol, physical activity, and smoking.

Similarly, compared with noncoffee drinkers, those who drank 1 or more cups of coffee a day had a 2.2- to 2.8-fold increased risk of hypertension, after adjusting for multiple variables (P < .05).

“The association between coffee consumption and [metabolic syndrome] seems to be mainly driven by the blood pressure component,” Stutz and colleagues observe.

Children with Psoriasis Carry High Comorbidity Risks

Children with psoriasis are significantly more likely to develop obesity, hyperlipidemia, hypertension, diabetes, metabolic syndrome, polycystic ovarian syndrome, liver disease, and elevated liver enzymes than are children without the disease, according to a retrospective review of insurance claims data.

These risks are independent of obesity status: in non-obese children with psoriasis, the risk of comorbidities was 40% to 75% higher than in children without psoriasis, reported Megha M. Tollefson, MD, of the Mayo Clinic in Rochester, MN, and colleagues. But even in children without psoriasis, obesity was a much stronger contributor to comorbidities.

“In recent years, it has become increasingly clear that psoriasis is more than a ‘skin-deep’ condition and that it may frequently be associated with other systemic comorbidities, even in children,” the researchers wrote online in JAMA Dermatology. “While the association in adult patients is well established, the patterns and predictors of the risk of comorbidities in children with psoriasis are still not clear.

“There is mounting evidence that children with psoriasis are more likely to be obese than children without psoriasis, but this finding begs the question of whether the systemic comorbidities that are seen in children with psoriasis are attributable to obesity, or whether psoriasis is actually an independent risk factor for these comorbidities.”

In this study of claims from Optum Laboratories Data Warehouse, a Massachusetts-based Mayo Clinic partner, the researchers studied de-identified records of 29,957 children with psoriasis (affected children) and 29,957 children without psoriasis, matched for age, sex, and race, from 2004 through 2013.

The children, all under age 19, were divided into four groups:

  • Non-obese without psoriasis (reference cohort)
  • Non-obese with psoriasis
  • Obese without psoriasis
  • Obese with psoriasis

The average age of the children was 12.0, and 53.5% of the total were girls. At baseline, more affected children were obese than non-obese (2.9% versus 1.5%; P<0.001).

The average follow-up period for both groups was about 3 years. During this time, pediatric psoriasis patients were significantly more likely to develop comorbidities than those without psoriasis, with non-alcoholic liver disease, diabetes, and hypertension showing the highest risks.

Among non-obese children, the risk of comorbidities was significantly higher in those with psoriasis; these included elevated lipid levels (HR 1.42), hypertension (HR 1.64), diabetes (HR 1.58), metabolic syndrome (HR 1.62), polycystic ovarian syndrome (HR 1.49), non-alcoholic liver disease (HR 1.76), and elevated liver enzyme levels (HR 1.46).

Even in children without psoriasis, obesity was a much stronger contributor to comorbidities, carrying an 18-fold higher risk of non-alcoholic liver disease, a 16-fold higher risk of metabolic syndrome, a seven-fold higher risk of hypertension, a six-fold higher risk of hyperlipidemia, an almost three-fold higher risk of diabetes, and a 2.3-fold higher risk of elevated liver enzyme levels than the reference group; there was also a six-fold higher risk of polycystic ovarian syndrome in girls.

When the researchers analyzed the interaction between obesity and psoriasis, they found none, suggesting that while both obesity and psoriasis contribute to the development of pediatric comorbidities, the effect is additive, not exponential.

Asked for her perspective, Amy Paller, MD, chair of the Department of Dermatology at Northwestern Medicine Feinberg School of Medicine in Chicago, who was not involved with the study, noted that several studies have clearly demonstrated the association of obesity and pediatric psoriasis, and a large recent study also linked a high waist circumference to height ratio to more severe pediatric psoriasis. “The association of a variety of other ‘metabolic syndrome’ comorbidities has been controversial, however, and whether it is the obesity or psoriasis itself that increases the risk remains unknown.

“While there are issues with the use of a claims database, especially given the frequent misdiagnosis of psoriasis by non-dermatologists, several metabolic-related disorders were shown to be significantly increased in risk,” she said, adding that the fact that the associations were seen even among non-obese psoriasis patients suggests that early systemic intervention might lower risks.

The study has several limitations, Tollefson and colleagues noted. For example, it relies on data from administrative claims, and the diagnoses were not confirmed by medical record review. Also of possible concern are undercoding and misclassification of comorbidities. Extremely obese children would be more likely to have a corresponding obesity code than those with a body mass index of 25 to 40, the researchers added. “The lower prevalence of obesity in our cohort than in some others suggests that obesity may have been undercoded as a whole, with the resulting contribution from psoriasis being slightly overestimated.”

In addition, systemic medications used to treat psoriasis potentially might have influenced the risk of some comorbidities.

Study Shows Keto Diet May Reverse Metabolic Syndrome

ketogenic diet

study tried to find out if a ketogenic diet could reverse the pathological processes that lead to metabolic syndrome.

Researchers looked to see if fasting triglycerides, BMI (body mass index), BFM (body fat mass), and weight could be lowered and to see if A1c levels could be lowered or normalized. They looked for increases in RMR (resting metabolic rate) and ketones.

They studied a group of 30 individuals who had been diagnosed by their primary care provider as having metabolic syndrome and randomly prescribed them one of three protocols. One group sustained a ketogenic diet with no exercise. The second group ate a standard American diet with no exercise and the third group was asked to eat a standard American diet but include 3-5 days of 30 minutes of exercise.

What is a Ketogenic Diet?

In the study paper, they explained that “Ketogenic diets are characterized by a reduction in carbohydrates (usually less than 50g/day) with a relative increase in the physiological proportion of dietary fat with adequate protein to feed individual lean body mass.”

They add that ketosis is an energy state the body uses when glucose availability is low whereby ketones are made by the liver. The researchers state that recently, evidence has shown that a ketogenic diet can help conditions like “diabetes, polycystic ovarian syndrome (PCOS), neurological degeneration, cancer, as well as marked improvement of respiratory and cardiovascular disease risk factors”.

Why Are These Results Notable?

The results showed that over the course of 10 weeks those who ate a ketogenic diet had reductions in weight, body fat percentage, BMI, and A1C levels.

The researchers wrote in their study paper that “All variables for the ketogenic group out-performed those of the exercise and non-exercise groups, with five of the seven demonstrating statistical significance.”

The two groups eating a standard American diet did not see any significant changes in any of the five main biomarkers for metabolic syndrome.

These findings are of interest because modern countries like the U.S. are enduring a growing epidemic of metabolic syndrome. Metabolic syndrome increases the likelihood of obesity, pre-diabetes, type 2 diabetes, and “numerous degenerative diseases”, write the researchers.

According to the study authors, based on their results–their statistical data, “the null hypothesis that a ketogenic diet has no effect on the five principle biomarkers of metabolic syndrome can be rejected.” These researchers say that “nutritional ketosis is a noteworthy modality of preventative and restorative care”.

They hope more studies can be done for the sake of developing a standard of care surrounding a ketogenic diet that results in a safe and effective practice.

Increasing serum albumin protective against metabolic syndrome

Among healthy adults, increasing serum albumin levels are associated with a decreased risk for metabolic syndrome, independent of higher baseline albumin levels, recent findings suggest.

“The results of the current study support the idea that serum albumin change might be one of the major antioxidative biomarkers for the prediction of incident metabolic syndrome,” Sang-Man Jin, MD, clinical assistant professor at Samsung Medical Center and Sungkyunkwan University School of Medicine in Seoul, South Korea, and colleagues wrote. “Although the mechanism cannot be determined directly based upon the current data, we speculate that the chronic inflammation and oxidative stress involved in the initiation of metabolic syndrome could explain the association between change in serum albumin concentration and the risk of incident metabolic syndrome.”

In a retrospective, longitudinal study of electronic medical records, Jin and colleagues analyzed data from 12,567 adults without metabolic syndrome, diabetes or cardiovascular disease at baseline enrolled in a health screening program at Samsung Medical Center. Patients had at least four follow-up visits between 2006 and 2012. The risk for developing metabolic syndrome was analyzed according to baseline serum albumin level and change in serum albumin concentration during follow-up.

During a mean 5.02 years’ follow-up (63,060 person-years) 2,582 adults (20.55%; 1,746 men) developed metabolic syndrome between 2006 and 2012. Researchers found that, as percent change in serum albumin level increased, the rate of incident metabolic syndrome decreased, as did the proportion of men, BMI, waist circumference, systolic and diastolic blood pressure, fasting insulin and cholesterol levels. In the fully adjusted model, when compared with patients in the first quartile of change in serum albumin level (negative percent change), the HR for metabolic syndrome among patients in the fourth quartile ( 8.51% increase) was 0.262 (95% CI, 0.224-0.305); HR for those in the third quartile (< 8.51% increase) was 0.353 (95% CI, 0.307-0.405); HR for those in the second quartile (0-4.55% increase) was 0.478 (95% CI, 0.421-0.544). Researchers also observed an inverse correlation between percent change in serum albumin and serum level of high-sensitivity C-reactive protein (P < .001). – by Regina Schaffer

BP elevations during pregnancy may raise risk for metabolic syndrome

Pregnant women who have persistent BP rises in the upper ranges of normal may face increased risk for developing metabolic syndrome and higher CV risk after giving birth, according to findings published in Hypertension.

“Our findings underscore an important issue that has long been ignored in clinical practice — the fact that criteria for hypertension in pregnancy are derived from the general population,” Jian-Min Niu, MD, department of obstetrics, Guangdong Women and Children Hospital, China, said in a press release. “We anticipate that if reaffirmed in further research, our study could spark a change in what we currently deem healthy [BP] in pregnant women.”

Researchers sought to study the associations between pregnancy BP strata and the development of metabolic syndrome.

They analyzed data from a cohort of 507 women from Guangzhou, China. Among the requirements were that the women had normal BP levels (< 140 mm Hg systolic/90 mm Hg diastolic); had normal glucose and lipid profiles; had no history of vaginal bleeding, alcohol or substance abuse; and were nonsmokers.

The original 507 participants each underwent seven or more BP evaluations during pregnancy. The cohort eventually shrank to 309 women due to data-permission issues and a 60.9% postpartum follow-up rate over 1.6 years. In addition, glucose and lipid levels were evaluated from study entry through follow-up.

Researchers stratified the cohort according to three diastolic BP trajectory categories: a low J-shaped group (34.2%; 62.5 ± 5.8 mm Hg to 65 ± 6.8 mm Hg); a moderate U-shaped group (52.6%; 71 ± 5.9 mm Hg to 69.8 ± 6.2 mm Hg); and an elevated J-shaped group within the range of hypertension (13.2%; 76.2 ± 6.7 mm Hg to 81.8 ± 4.8 mm Hg).

The researchers found that the hypertension-range group had a 6.5 greater odds of developing postpartum metabolic syndrome than the low J-shaped group (adjusted OR = 6.55; 95% CI, 1.79-23.92).

Niu and colleagues also developed a model for prediction of postpartum metabolic syndrome that included diastolic BP (membership in the elevated J-shaped group), fasting glucose > 4.99 mmol/L and triglycerides > 3.14 mmol/L at term, which showed good calibration and discrimination (C statistic, 0.764; 95% CI, 0.674-0.855; P < .001).

They wrote, “Pregnancy is a known, long-term CV risk for women. The presence of hypertensive disorders in pregnancy is generally recognized as a maladaptation to pregnancy-induced hemodynamic and metabolic alterations.”

In the release, Niu said, “Early identification of metabolic risk factors and implementations of lifestyle modifications may help delay the onset of CVD that would present itself 20 to 30 years after [childbirth].” – by James Clark

Sexual dysfunction linked to metabolic syndrome in postmenopausal women

Decreased sexual activity, desire and satisfaction are associated with metabolic syndrome in older women, according to study findings published in The American Journal of Medicine.

“In these healthy community-dwelling older women, the prevalence of low sexual desire was significantly higher in women who met the diagnostic criteria for metabolic syndrome,” Susan Trompeter, MD, clinical professor in the department of medicine at the University of California, San Diego School of Medicine and the VA San Diego Healthcare System, said in a press release. “In addition, we observed a higher prevalence of dysfunction by [Female Sexual Function Index] criteria in desire, arousal, orgasm and satisfaction, comparing sexually active women with metabolic syndrome to those without.”

Susan Trompeter

Susan Trompeter

Trompeter, Elizabeth Barrett-Connor, MD, of the division of epidemiology, department of family medicine and public health, University of California, San Diego, and colleagues evaluated data from the Rancho Bernardo study on 376 postmenopausal women (mean baseline age, 73 years) who completed a clinic visit between 1999 and 2002 and returned the Female Sexual Function Index (FSFI) mailed in 2002.

The questionnaire evaluated female sexual function through 19-items. Metabolic syndrome was defined as meeting at least three of the five following criteria: impaired glucose tolerance; waist circumference greater than 88 cm; triglycerides 150 mg/dL or greater; HDL cholesterol less than 50 mg/dL; and systolic blood pressure of at least 130 mm Hg or diastolic BP of at least 85 mm Hg, or a diagnosis of hypertension or current antihypertensive medication use.

Elizabeth Barrett-Connor

Elizabeth Barrett-Connor

Overall, 42% of participants met the criteria for metabolic syndrome: 23% met three of five criteria, 14% met four criteria and 5% met five criteria.

About 39% of participants reported sexual activity within the past 4 weeks, and sexual activity was linked to older age and living with a spouse or partner. Twenty-three percent of participants reported sexual desire, and 78% reported sexual satisfaction. A decrease in sexual activity and sexual desire was linked to older age and number of years since menopause.

More participants who were sexually inactive (48.3%) met the criteria for metabolic syndrome compared with 31.1% of sexually active participants (P = .001). Compared with about one-quarter of participants reporting sexual desire, nearly half (45.6%) of participants reporting no sexual desire met the criteria for metabolic syndrome (P = .008).

Compared with participants without metabolic syndrome, participants with metabolic syndrome had lower sexual desire (P = .0401) and lower arousal (P = .0086) scores, individually and combined (P = .0047). Reported orgasm frequency was lower (P = .0427), and the prevalence of orgasm dysfunction (P = .0134) was higher among participants with metabolic syndrome.

“Overlapping pathways affecting sexual function in women are complex and still poorly understood; however, both physiological and psychological variables contribute to sexual activity and function,” Trompeter said in the release. “Prevention of chronic disease and optimization of health may preserve sexual activity and satisfaction.” – by Amber Cox

NIH grants $1.8 million for gut microbiome research in obesity, metabolic syndrome

The National Institute of Diabetes and Digestive Kidney Diseases of the NIH has awarded a 4-year $1.8 million grant to a Georgia State researcher studying the role of the gut microbiome in the development of obesity and metabolic syndrome, according to a press release from the university.

“The overall goal of the project is to understand how alterations in bacteria in the intestine can promote low-grade inflammation and metabolic diseases, including obesity,” grant recipient Andrew Gewirtz, PhD, a professor in the Institute for Biomedical Sciences at Georgia State University, said in the press release. “Additionally, we’re going to be looking at how changes in diet can protect against obesity, especially how dietary fiber can alter gut bacteria in a beneficial way.”

Andrew Gewirtz, PhD

Andrew Gewirtz

The project has three main goals. First, Gewirtz will determine the strength of the associations between low-grade inflammation-driving alterations in gut microbiota and metabolic syndrome (high blood pressure, high blood sugar, insulin resistance, hyperlipidemia and hepatic steatosis). This study will be done in humans, in collaboration with Shanti Srinivasan, MD, of Emory University, to confirm previous findings from mice studies.

Second, he will seek to understand how gut microbiota alterations promote inflammation in mice, and how the liver can be protected against low-grade inflammation and non-alcoholic fatty liver disease.

Finally, he will explore how dietary fiber can impact the gut microbiome and protect against obesity, also in mice. This study will compare insoluble and soluble or fermentable fiber.

“Our preliminary results indicate that these have very different types of effects. Hopefully in the end we’ll have a better understanding of what type should be consumed, for fibers that are naturally in foods or as supplements,” Gewirtz said.

Lifestyle intervention improves health-related quality of life in prediabetes, metabolic syndrome

Adults with prediabetes or metabolic syndrome assigned to an intensive 12-month lifestyle intervention program saw improvements in health-related quality of life, as well as improved clinical and behavioral outcomes vs. controls assigned to a waiting list, according to recent findings.

“These community-based lifestyle intervention programs have additional valuable benefits, beyond the improvement of risk factors for type 2 diabetes and heart disease,” Yvonne L. Eaglehouse, PhD, a postdoctoral researcher in the department of epidemiology at the University of Pittsburgh Graduate School of Public Health, said in a press release. “Our study demonstrates that these programs, delivered in diverse community settings, such as senior centers and work sites, simultaneously and significantly improved the quality of life of the participants.”

In a randomized trial, Eaglehouse and colleagues analyzed data from 223 adults with a BMI of at least 24 kg/m² and prediabetes, metabolic syndrome or both (mean age, 58 years; mean baseline weight, 208.8 lb; 62.3% women; 93.7% white; 65.9% full- or part-time workers). Adults were assigned to participation in the Group Lifestyle Balance program, a 12-month, 22-session adaptation of the Diabetes Prevention Program (DPP), either immediately (n = 138) or after a 6-month delay (n = 71; wait-controls) in a 2:1 ratio by intervention site. The program goals include increasing physical activity by at least 150 minutes weekly (median self-reported physical activity, 7.88 hours weekly) and achieving 7% weight loss. Participants were given the option of attending the first 12 weekly sessions in person or participating through individually viewed DVDs with follow-up contact from a lifestyle coach; the remaining 10 biweekly and monthly sessions were conducted in a group setting. Those assigned to the waiting list received general health information by mail and were assigned to the program after the 6-month waiting period.

Participants provided blood samples and completed a self-administered EuroQol health questionnaire at baseline and 6 and 12 months, as well as a second survey developed by the researchers assessing participants’ health state. Participants ranked current health on a visual analogue scale from 0 (“worst imaginable health state”) to 100 (“best imaginable health state”); average score for the group was 71.5 at baseline (U.S. average estimate, 79.2).

In unadjusted models, visual analogue scale scores improved for the cohort at both 6 months (mean increase, 7.38) and 12 months (mean increase, 6.73) after intervention (P < .0001 for both).

After adjusting for age, baseline score and achievement of intervention goals, the mean change in visual analogue score was an increase of 11.83 at 6 months and 11.23 at 12 months (P < .0001 for both).

Unadjusted mean changes in EQ-5D index values were minimal, with no model-estimated mean change at 6 months and a 0.01-point change at 12 months, according to researchers. After adjustment, mean change was an increase of 0.04 at 6 months and 0.05 at 12 months (P < .01 for both).

During intervention, participants also experienced improvements in waist circumference, HbA1c, total and HDL cholesterol, triglycerides and blood pressure, the researchers noted.

“These results indicate that there are additional benefits to community lifestyle-intervention programs beyond the improvement of risk factors for type 2 diabetes and cardiovascular disease, and demonstrate a considerable potential to improve public health when such programs are delivered in community settings,” the researchers wrote.

“This important benefit was most evident in those who started the intervention program having a relatively lower quality of life,” Andrea Kriska, PhD, professor in the department of epidemiology at the University of Pittsburgh Graduate School of Public Health, said in the release. “In other words, those who needed to improve the most.” – by Regina Schaffer