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Abstract
This study examined how achievement of session goals contributes to outcomes of subjects after participation in a 12-week lifestyle intervention program in men with metabolic syndrome (MetS). Thirty office workers with MetS, aged 47.2 ± 6.6 years, participated in this study, from March to July, 2011. The intervention program included face-to-face counseling five times during the 12-week period. Counselors and subjects designed session goals for each round. The average of the goal achievement rate was calculated based on compliance for each round. The subjects were divided into three groups according to their tertiles of achievement rate: Low-compliance group (LC, ＜ 59%), medium-compliance group (MC, 59-70%), and high-compliance group (HC, ＞ 70%). Anthropometry, biochemical index, and nutrient intake were examined at baseline and at the end of the 12-week intervention program. After the intervention, diastolic blood pressure (DBP) showed a significant decrease in the LC group, and waist circumference (WC) showed a significant decrease in the MC group. Systolic blood pressure (SBP), DBP, and low-density lipoprotein cholesterol (LDL) showed a significant decrease in the HI group. Changes in SBP and DBP were significantly lower in the HC group than in the MC group (p ＜ 0.05, p ＜ 0.01). Changes in LDL were significantly lower in the HC group than in the MC group (p ＜ 0.05). Results for intake of total energy, protein, fat, and sodium, as well as rates of carbohydrate and fat intake, showed a significant decrease in all participants (p ＜ 0.05). The change in fiber was significantly higher in the HC group than in the MC group (p ＜ 0.05). The change of fruit serving size showed a significant increase in the HC group (p ＜ 0.01). The number of risk factors for MetS showed a significant decrease in the LC and HC groups (p ＜ 0.05), however, no significant mean differences were observed among the three groups. In conclusion, participation in this intervention program resulted in positive effects on risk factors for MetS, nutrient intake, and dietary habits, especially in the High-compliance group.
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Fig. 2.
Comparisons of changed fruit and vegetable serving size among the compliance groups. 1) Mean ± S.D. 2) Analysis by NPAR Wilcoxon test at ∗: p ＜0.05, ∗∗: p ＜0.01.
Fig. 3.
Comparisons of changed MetS risk factors among the compliance groups. 1) Mean ± S.D. 2) Analysis by NPAR Wilcoxon test at ∗: p ＜ 0.05, ∗∗: p ＜ 0.01.
Table 1.
General characteristics of the subjects according to compliance of session goal
| Variables | Low-compliance (n = 10) | Medium-compliance (n = 10) | High-compliance (n = 10) | Total (n = 30) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Before | After | p-value | Before | After | p-value | Before | After | p-value | Before | After | p-value | |
| Age | 46.0 ± 5.91) | 46.7 ± 7.2 | 48.8 ± 6.9 | 47.2 ± 6.6 | 0.630 | |||||||
| Education level | ||||||||||||
| ≤ High school | 01 (10.0)2) | 00 (0.0) | 03 (30.0) | 04 (13.3) | 0.182 | |||||||
| ≤ University | 05 (50.0) | 08 (80.0) | 06 (60.0) | 19 (63.3) | ||||||||
| ≤ Graduate school | 04 (40.0) | 02 (20.0) | 01 (10.0) | 07 (23.3) | ||||||||
| Marital status | ||||||||||||
| Single | 00 (0.0) | 00 (0.0) | 00 (0.0) | 00 (0.0) | ||||||||
| Married | 10 (100.0) | 10 (100.0) | 10 (100.0) | 30 (100.0) | ||||||||
| Smoking | ||||||||||||
| ea/day | 11.0 ± 8.50 | 13.3 ± 5.80 | 0.3173) | 20.6 ± 4.70 | 17.7 ± 4.10 | 0.102 | 14.4 ± 10.8 | 12.8 ± 12.3 | 0.180 | 16.9 ± 8.80 | 15.2 ± 7.50 | 0.2024) |
| Never smoked | 3 (30.0) | 3 (30.0) | 2 (20.0) | 2 (20.0) | 2 (20.0) | 02 (20.0) | 07 (23.3) | 07 (23.3) | ||||
| Former smokers | 4 (40.0) | 4 (40.0) | 1.0005) | 1 (10.0) | 1 (10.0) | 1.000 | 4 (40.0) | 05 (50.0) | 0.881 | 09 (30.0) | 10 (33.3) | 0.910 |
| Current smokers | 3 (30.0) | 3 (30.0) | 7 (70.0) | 7 (70.0) | 4 (40.0) | 03 (30.0) | 14 (46.7) | 13 (43.3) | ||||
| Alcohol drinking | ||||||||||||
| g/day | 28.5 ± 19.1 | 25.9 ± 18.2 | 0.749 | 56.3 ± 39.1 | 50.5 ± 29.7 | 0.695 | 35.3 ± 27.9 | 40.0 ± 44.3 | 0.670 | 40.0 ± 31.2 | 38.8 ± 33.0 | 0.351 |
| ≤ 2/week | 6 (60.0) | 7 (70.0) | 1.000 | 5 (50.0) | 8 (80.0) | 0.350 | 8 (80.0) | 10 (100.0) | 0.474 | 19 (63.3) | 25 (83.3) | 0.080 |
| ≥ 3/week | 4 (40.0) | 3 (30.0) | 5 (50.0) | 2 (20.0) | 2 (20.0) | 00 (0.0) | 11 (36.7) | 05 (16.7) | ||||
| Exercise | ||||||||||||
| ≤ 2/week | 8 (80.2) | 5 (50.0) | 0.350 | 8 (80.2) | 5 (50.0) | 0.350 | 2 (20.0) | 05 (50.0) | 0.350 | 18 (60.0) | 15 (50.0) | 0.302 |
| ≥ 3/week | 2 (20.0) | 5 (50.0) | 2 (20.0) | 5 (50.0) | 8 (80.0) | 05 (50.0) | 12 (40.0) | 15 (50.0) | ||||
| Checking nutrition labels | ||||||||||||
| No | 8 (80.0) | 3 (30.0) | 0.070 | 7 (70.0) | 4 (40.0) | 0.370 | 8 (80.0) | 03 (30.0) | 0.070 | 23 (76.7) | 10 (33.3) | 0.001 |
| Yes | 2 (20.0) | 7 (70.0) | 3 (30.0) | 6 (60.0) | 2 (20.0) | 07 (70.0) | 07 (23.3) | 20 (66.7 | ||||
Table 2.
Comparisons of changed scores in measured body composition and biochemical index among the compliance groups
| Low-compliance (n = 10) | Medium-compliance (n = 10) | High-compliance (n = 10) | p-value4) | Total (n = 30) | p-value5) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Before | After | Δscore2) | Before | After | Δscore | Before | After | Δscore | Before | After | |||
| WT, kg | 79.9 ± 12.41) | 80.7 ± 13.1 | -0.8a6) | 82.0 ± 9.8 | 81.0 ± 9.7 | -1.0b | 80.6 ± 11.0 | 79.1 ± 8.3 | 0-1.5a | 0.041 | 80.8 ± 10.8 | 80.3 ± 10.2 | 0.308 |
| BMI, kg/m2 | 26.5 ± 3.9 | 26.8 ± 4.2 | -0.3a | 26.8 ± 2.5 | 26.5 ± 2.4 | -0.3b | 27.0 ± 4.2 | 26.5 ± 3.9 | 0-0.5ab | 0.035 | 26.8 ± 3.5 | 26.6 ± 3.5 | 0.290 |
| PBF, % | 21.4 ± 10.0 | 22.8 ± 4.5 | -1.5 | 25.0 ± 2.4 | 24.7 ± 1.6 | -0.3 | 23.1 ± 5.7 | 22.4 ± 4.6 | 0-0.7 | 0.827 | 23.2 ± 6.7 | 23.3 ± 3.8 | 0.866 |
| LBM, kg | 57.8 ± 5.4 | 57.3 ± 6.9 | -0.5 | 56.7 ± 6.7 | 56.7 ± 6.5 | -0.0 | 57.2 ± 7.3 | 57.0 ± 7.0 | 0-0.2 | 0.911 | 57.2 ± 6.3 | 57.0 ± 6.5 | 0.707 |
| WC, cm | 91.0 ± 9.3 | 90.7 ± 9.2 | -0.3 | 94.1 ± 8.1 | 92.3 ± 6.8∗ | -1.8 | 92.2 ± 8.6 | 90.3 ± 6.9 | 0-1.9 | 0.306 | 92.4 ± 8.5 | 91.1 ± 7.5∗3) | 0.056 |
| SBP, mmHg | 132.2 ± 13.8 | 128.6 ± 12.3 | -3.6ab | 131.9 ± 8.1 | 137.1 ± 12.5 | -5.2a | 131.6 ± 8.6 | 119.9 ± 9.6∗ | -11.7b | 0.020 | 131.9 ± 10.1 | 128.5 ± 13.2 | 0.164 |
| DBP, mmHg | 84.1 ± 7.4 | 76.9 ± 11.1∗ | -7.3a | 78.4 ± 5.7 | 80.9 ± 10.5 | -2.5b | 80.7 ± 10.6 | 71.7 ± 9.7∗ | 0-9.0ac | 0.004 | 81.1 ± 8.2 | 76.5 ± 10.8∗ | 0.007 |
| FBS, mg/dL | 105.3 ± 16.3 | 104.0 ± 24.1 | -1.3 | 115.8 ± 24.5 | 121.5 ± 43.9 | -5.7 | 115.0 ± 34.6 | 97.6 ± 22.6 | -17.4 | 0.179 | 112.0 ± 25.8 | 107.7 ± 32.3 | 0.348 |
| TG, mg/dL | 209.5 ± 90.4 | 213.8 ± 107.3 | -4.3 | 267.5 ± 152.2 | 222.4 ± 101.3 | -45.1 | 146.2 ± 77.0 | 154.3 ± 81.4 | -30.2 | 0.073 | 207.7 ± 118.8 | 204.2 ± 100.2 | 0.824 |
| TC, mg/dL | 196.1 ± 30.7 | 201.7 ± 25.5 | -5.6 | 191.8 ± 36.2 | 200.4 ± 34.6 | -8.6 | 207.2 ± 31.9 | 185.4 ± 42.1 | -21.8 | 0.087 | 198.4 ± 32.5 | 195.8 ± 34.3 | 0.624 |
| HDL, mg/dL | 35.6 ± 7.8 | 39.4 ± 8.7 | -3.8 | 34.9 ± 7.2 | 37.4 ± 6.7 | -2.5 | 44.1 ± 11.1 | 40.0 ± 6.8 | 0-4.1 | 0.067 | 38.2 ± 9.5 | 38.9 ± 7.3 | 0.588 |
| LDL, mg/dL | 130.8 ± 27.8 | 133.9 ± 27.7 | -3.1ab | 117.2 ± 31.9 | 122.6 ± 42.5 | -5.4a | 145.0 ± 28.2 | 122.5 ± 37.6∗ | -22.5b | 0.041 | 131.0 ± 30.6 | 126.3 ± 35.6 | 0.288 |
6) The different letters are significant difference among groups based on Mann-Whitney test. WT: weight, BMI: body mass index, PBF: percent body fat, LBM: lean body mass, WC: waist circumference, SBP: systolic blood pressure, DBP: diastolic blood pressure, FBS: fasting blood sugar, TG: triglyceride, TC: total cholesterol, HDL: high-density lipoprotein, LDL: low-density lipoprotein
Table 3.
Comparisons of changed dietary intakes of nutrients among the compliance groups
| Low-compliance (n = 10) | Medium-compliance (n = 10) | High-compliance (n = 10) | p-value4) | Total (n = 30) | p-value5) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Before | After | Δscore2) | BEFORE | AFTER | Δscore | Before | After | Δscore | Before | After | |||
| Energy, kcal | 2,305.7±674.11) | 1,968.7±211.4 | -337.0 | 2,280.6±545.8 | 1,708.7±403.2∗3) | -572.0 | 2,062.6±558.4 | 1,660.6±262.3∗ | -402.0 | 0.422 | 2,216.3±585.3 | 1,779.3±323.5 | 0.001 |
| % carbohy- drate | 53.6±6.9 | 59.9±9.6 | -2.4 | 57.9±6.9 | 55.6±11.1 | -8.6 | 59.3±7.6 | 61.3±7.6 | -6.4 | 0.772 | 64.7±7.5 | 58.9±9.5 | 0.372 |
| % protein | 18.5±3.6 | 15.7±1.7∗ | -5.9 | 15.6±6.1 | 19.2±4.8 | -0.5 | 16.6±2.5 | 17.4±2.3 | -1.6 | 0.057 | 20.1±4.1 | 17.5±3.5 | 0.595 |
| % fat | 27.9±7.1 | 24.4±8.8 | -7.9 | 26.6±5.1 | 25.2±9.5 | -4.4 | 24.1±7.6 | 21.2±6.1 | -6.3 | 0.910 | 29.8±7.6 | 23.6±8.1 | 0.184 |
| Carbohy- drate, g | 292.0±108.0 | 291.7±67.3 | -0.3 | 274.9±61.6 | 227.1±68.3 | -47.7 | 285.3±52.8 | 251.7±44.7 | -33.5 | 0.268 | 284.0±75.6 | 256.9±64.9 | 0.118 |
| Protein, g | 99.6±31.2 | 76.1±11.3∗ | -23.4 | 84.9±23.6 | 76.8±21.8 | -8.0 | 81.9±24.6 | 71.8±16.2 | -10.0 | 0.687 | 88.8±26.9 | 74.9±16.5 | 0.036 |
| Fat, g | 68.7±29.5 | 52.5±19.0 | -16.2 | 58.1±24.8 | 47.6±24.4 | -10.5 | 56.5±34.2 | 39.5±14.9 | -17.0 | 0.836 | 61.1±29.2 | 46.6±19.9 | 0.029 |
| Fiber, g | 25.6±9.6 | 23.5±5.6 | -2.1ab6) | 25.4±6.9 | 18.6±6.1 | -6.8a | 21.3±6.0 | 27.7±12.8 | -6.4b | 0.025 | 24.1±7.6 | 23.3±9.3 | 0.709 |
| Ca, mg | 653.0±250.9 | 602.3±107.2 | -50.7 | 627.3±237.8 | 543.8±111.6 | -83.5 | 548.9±162.8 | 465.2±239.4 | -83.7 | 0.965 | 609.8±217.6 | 537.1±168.8 | 0.129 |
| P, mg | 1,268.7±373.3 | 1,118.8±108.2 | -149.9 | 1,240.8±334.6 | 1,049.3±222.0 | -191.5 | 1,114.9±293.9 | 970.4±219.5 | -144.5 | 0.946 | 1,208.1±330.8 | 1,046.2±194.1 | 0.029 |
| Fe, mg | 16.7±2.8 | 15.0±3.4 | -1.7 | 16.2±3.5 | 13.7±3.1 | -2.5 | 15.9±3.6 | 13.2±3.4 | -2.7 | 0.889 | 16.3±3.2 | 14.0±3.3 | 0.013 |
| Na, mg | 3,218.3±783.2 | 2,587.1±542.0∗ | -631.2 | 3,615.1±1,459.8 | 3,213.7±1,686.4 | -401.5 | 3,067.6±710.9 | 2,286.0±992.8 | -781.6 | 0.836 | 3,300.3±1,031.4 | 2,695.6±1,197.6 | 0.001 |
| K, mg | 3,429.9±1,037.8 | 3,067.3±709.1 | -362.6 | 3,427.1±701.3 | 2,949.3±841.0 | -477.8 | 3,023.6±562.6 | 2,661.1±674.6 | -362.5 | 0.924 | 3,293.5±789.2 | 2,892.6±739.5 | 0.034 |
| Vit A, μgRE | 1,308.7±792.8 | 838.9±551.7 | -469.8 | 1,096.2±439.3 | 927.4±427.8 | -168.7 | 1,015.9±621.7 | 954.3±460.0 | -61.6 | 0.498 | 1,140.3±625.1 | 906.9±468.4 | 0.108 |
| Vit B1, mg | 1.5±0.5 | 1.3±0.4 | -0.2 | 1.3±0.4 | 1.9±2.0 | -0.6 | 1.3±0.6 | 1.2±0.6 | -0.1 | 0.676 | 1.4±0.5 | 1.5±1.2 | 0.652 |
| Vit B2, mg | 1.4±0.3 | 1.1±0.4 | -0.3 | 1.3±0.6 | 1.4±0.5 | -0.1 | 1.2±0.5 | 1.1±0.4 | -0.1 | 0.354 | 1.3±0.5 | 1.2±0.5 | 0.460 |
| Vit B6, mg | 2.9±1.0 | 2.8±0.6 | -0.1 | 2.6±0.8 | 2.4±0.7 | -0.3 | 2.5±0.7 | 2.1±0.6 | -0.4 | 0.889 | 2.7±0.8 | 2.4±0.7 | 0.162 |
| Niacin, mg | 27.6±15.7 | 19.1±4.1 | -8.6 | 19.3±3.2 | 18.5±6.1 | -0.8 | 18.8±5.4 | 15.8±5.6 | -3.1 | 0.325 | 21.9±10.3 | 17.8±5.4 | 0.047 |
| Vit C, mg | 115.3±64.7 | 104.2±39.5 | -11.0 | 145.1±42.0 | 80.0±40.1∗∗ | -65.0 | 97.5±49.3 | 92.1±55.7 | -5.4 | 0.118 | 119.3±54.8 | 92.1±45.3 | 0.036 |
| Vit E, mg | 15.4±4.6 | 16.6±6.4 | -1.2 | 18.4±7.0 | 14.5±4.5 | -3.9 | 15.8±6.3 | 14.2±7.9 | -1.6 | 0.432 | 16.5±6.0 | 15.1±6.3 | 0.352 |
| Folate, μg | 360.2±101.9 | 292.1±66.4 | -68.1 | 354.6±111.2 | 251.0±111.5 | -103.6 | 281.9±100.4 | 257.1±74.3 | -24.8 | 0.215 | 332.3±107.3 | 266.8±85.3 | 0.017 |
| Cholesterol, mg | 328.3±187.4 | 297.4±182.2 | -30.8 | 414.7±221.6 | 399.0±265.5 | -15.6 | 331.8±218.9 | 288.7±196.7 | -43.1 | 0.939 | 358.3±206.6 | 328.4±216.3 | 0.535 |
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