OBJECTIVES: This study aims to examine the effectiveness of a 6-month lifestyle modification program on the improvement in metabolic syndrome (MetS) status and in stages of change for lifestyle behaviors associated with MetS among Korean older adults. METHODS: A lifestyle modification program was developed based on the transtheoretical model. The program consisted of health counseling, education classes, a self-management handbook, newsletters and a health diary. Older adults aged >= 60 (n = 480) with MetS were randomly assigned to the intervention group (IG) or the comparison group (CG). The IG received a comprehensive 6-month lifestyle modification intervention, while the CG received minimal information on MetS and lifestyle modification. Health examination and selfadministered survey were conducted before and after the intervention to determine the effectiveness of the program. RESULTS: After the intervention, the prevalence of MetS decreased to 38.1% in the IG and 52.4% in the CG (p = 0.046). The IG improved abdominal obesity (p = 0.016), blood pressure (p = 0.030), and triglyceride (p = 0.005) more than the CG did. The IG demonstrated significant improvements in the behavioral stages for portion control (p = 0.021), balanced diet (p < 0.001) and adequate intake of fruits and vegetables (p = 0.012). The IG reduced the prevalence of abdominal obesity (OR 2.34) and improved MetS status (OR 1.79) better than the CG. The IG were more likely to advance from preaction stages at baseline to action stage at post-intervention for portion control (OR 3.29) and adequate intake of fruits and vegetables (OR 2.06). CONCLUSION: Lifestyle modification can improve the MetS status and behavioral stages in older adults.

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