Health benefits of a 4-month group-based diet and lifestyle modification program for individuals with metabolic syndrome

Background: Individualised highly prescriptive lifestyle programs for obesity management tend to be limited by resource constraints and difficulty with uptake. Aim: To evaluate the health benefits of a minimally prescriptive group-based lifestyle intervention in participants with the metabolic syndrome (MetS). Methods: 153 obese adults with MetS were randomised to intervention (INT) or control (CON) for 16 weeks. INT was provided with education, practical strategies and group-based support to achieve diet and physical activity (PA) modifications based on Australian national guidelines. Anthropometric, cardio-metabolic, physical fitness and diet assessments were undertaken at baseline and 16 weeks. Results: Compared with CON, INT demonstrated greater improvements in weight, BMI, body fat mass and percent, abdominal fat mass (AbdoFat) and waist circumference; systolic, diastolic and mean arterial blood pressure; total cholesterol and low-density lipoprotein cholesterol; physical work capacity (PWC) and handgrip strength (p < 0.01, group × time for all). Energy intake and % energy from saturated fat (%Sfat) decreased in both groups (p < 0.05 for time). Dietary glycemic index (GI) decreased more in INT (p < 0.01, group × time). Reductions in weight, waist and AbdoFat were associated with reductions in %Sfat (r = 0.379, 0.306, 0.319, respectively; p < 0.01) and GI (r = 0.308, 0.411, 0.296, respectively; p < 0.01). Reductions in AbdoFat were inversely related to increased PWC (r = -0.385; p < 0.001). Withdrawals were similar in INT (6%) and CON (14%) (p = 0.48). Conclusions: A group-based minimally prescriptive lifestyle modification program with a high retention rate achieved significant improvements in body composition, physical and cardio-metabolic fitness. Group-based programs may provide an achievable and effective, but less resource intensive, method for obesity and MetS management than individualised approaches.