A Nutritional Approach to the Metabolic Syndrome

Poor diet and sedentary lifestyle contribute to the development of metabolic syndrome (MetS); addressing both is crucial for its management. A diet featuring the Mediterranean dietary pattern or low glycemic load has been shown to prevent and ameliorate MetS. Plant compounds, including soy protein and phytosterols, have been associated with reduced cardiovascular disease (CVD) risk. Recently, phytochemicals from hops and acacia were identified as lipogenic, antiinflammatory compounds that reduced serum insulin and glucose levels in animals. A 12-week, randomized lifestyle intervention study in overweight and obese women with LDL ≥3.37 mmol/L (130 mg/dL) compared a Mediterranean-style, low-glycemic-load diet and soy/phytosterol-based medical food to an AHA low-fat diet. The modified Mediterranean diet with medical food was superior in reducing markers of MetS and CVD risk. A subsequent,randomized 12-week study in men and women with MetS and LDL ≥3.37 mmol/L (130 mg/dL) showed that supplementation with soy/phytosterol-based medical food plus phytochemicalsenhanced the benefits of a Mediterranean-style low-glycemic-load diet and aerobic exercise. At the completion of the study, 43% of participants receiving medical food and phytochemicalsexhibited net resolution of MetS compared with only 22% of those on diet and exercise alone. A subanalysis of participants at high risk (MetS + LDL ≥4.14 mmol/L [160 mg/dL]) indicated minimal benefit from lifestyle change alone but marked benefits with the addition of medical food and phytochemicals. Case studies illustrate long-term benefits of this supplemented lifestyle change program. In conclusion, institution of a phytochemical-enhanced lifestyle intervention promises to be a clinically useful approach in MetS management.