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Home-based lifestyle intervention for rural adults improves metabolic syndrome parameters and cardiovascular risk factors: a randomised controlled trial [with consumer summary]
Blackford K, Jancey J, Lee AH, James AP, Waddell T, Howat P
Preventive Medicine 2016 Aug;89:15-22
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The presence of metabolic syndrome (MetS) increases the risk of developing type 2 diabetes and cardiovascular disease. Targeted interventions to reduce MetS for high risk populations are crucial for the prevention of these chronic diseases. This study evaluated the effectiveness of a 6-month home-based physical activity and diet intervention for rural adults with, or at risk of MetS. The randomised controlled trial was conducted in Albany and surrounding towns, Western Australia, 2014 to 2015. Participants were screened for MetS using the International Diabetes Federation criteria, and eligible participants were randomly assigned to the intervention (n = 201) or control (n = 200) group. The intervention group received printed and online programme materials and motivational support, and the control group was waitlisted to receive the programme after post-test data collection. Anthropometry, lipid profiles, glycaemic status, and blood pressure were measured at baseline and 6-months post-test. In total, 312 (77.8%) participants completed post-test data collection and were included in the anthropometric analysis, and 274 (68.3%) participants were included in the blood sample analysis. After controlling for confounders, the intervention group significantly improved their triglyceride (-0.10mM, p = 0.002), total cholesterol (-0.09mM, p = 0.02), and non-HDL cholesterol (-0.08mM, p = 0.02) concentrations compared to the control group. Waist circumference (-2.11cm, p = 0.03), waist-to-hip ratio (-0.01, p = 0.04), weight (-0.70kg, p = 0.01), and body mass index (-0.20kg/m2, p < 0.001) were also improved. These findings suggest that comprehensive home-based prevention programmes that include a combination of dietary and physical activity interventions are a promising means to prevent the onset of chronic disease in rural adults. TRIAL REGISTRATION: anzctr.org.au identifier ACTRN12614000512628.
Copyright by Academic Press.

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