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

Pablo Pérez-Martínez, Dimitri P Mikhailidis, Vasilios G Athyros, Mónica Bullo, Patrick Couture, María I Covas, Lawrence de Koning, Javier Delgado-Lista, Andrés Díaz-López, Christian A Drevon, Ramón Estruch, Katherine Esposito, Montserrat Fitó, Marta Garaulet, Dario Giugliano, Antonio García-Ríos, Niki Katsiki, Genovefa Kolovou, Benoît Lamarche, Maria Ida Maiorino, Guillermo Mena-Sánchez, Araceli Muñoz-Garach, Dragana Nikolic, José M Ordovás, Francisco Pérez-Jiménez, Manfredi Rizzo, Jordi Salas-Salvadó, Helmut Schröder, Francisco J Tinahones, Rafael de la Torre, Ben van Ommen, Suzan Wopereis, Emilio Ros, José López-Miranda, Pablo Pérez-Martínez, Dimitri P Mikhailidis, Vasilios G Athyros, Mónica Bullo, Patrick Couture, María I Covas, Lawrence de Koning, Javier Delgado-Lista, Andrés Díaz-López, Christian A Drevon, Ramón Estruch, Katherine Esposito, Montserrat Fitó, Marta Garaulet, Dario Giugliano, Antonio García-Ríos, Niki Katsiki, Genovefa Kolovou, Benoît Lamarche, Maria Ida Maiorino, Guillermo Mena-Sánchez, Araceli Muñoz-Garach, Dragana Nikolic, José M Ordovás, Francisco Pérez-Jiménez, Manfredi Rizzo, Jordi Salas-Salvadó, Helmut Schröder, Francisco J Tinahones, Rafael de la Torre, Ben van Ommen, Suzan Wopereis, Emilio Ros, José López-Miranda

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.

© The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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