Metabolic Syndrome, Weight and Cardiovascular Co-Morbidities

: A Randomised Study Comparing the Effect of Three Dietary Approaches on Cardiovascular Risk in Subjects with the Metabolic Syndrome

Abstract

The metabolic syndrome is a cluster of disorders (obesity, dyslipidaemia, hyperinsulinaemia and hypertension) which individually or collectively lead to an increase in the risk of cardiovascular disease. Over the years it has been associated with endothelial dysfunction, raised markers of chronic inflammation, insulin resistance and clotting dysregulation.

Studies have shown that the prevalence of the metabolic syndrome in adults over the age of 20 years to be 24%, with approximately 12 million adults within the United Kingdom fulfilling the criteria for diagnosis. Numbers of individuals with the metabolic syndrome continue to rise following population trends of increasing sedentary lifestyle, high calorie intake, smoking, and stress. Associated is an increase in obesity, type 2 diabetes, cardiac disease, stroke and death. The increase is such that we can no longer be complacent about how we address the metabolic syndrome or its associated components.

The management of the metabolic syndrome is varied and includes alterations in diet, physical exercise, and oral medication. It is well documented that a 10% reduction in weight leads to reductions in lipid abnormalities, diabetes and diabetes related deaths, other total morbidity and deaths. Many dietary regimens have been postulated to benefit not only weight gain but improve cardiovascular risk. To address this we investigated the effect three different diets (low fat; low carbohydrate, high fat; and low glycaemic load) had on the metabolic syndrome to assess whether it is the changes in dietary caloric or macronutrient intake, or overall weight loss that had the greater influences on those aspects of metabolic syndrome which could potentially reduce cardiovascular risk.

Our primary outcome was to identify which diet had the greatest effect on weight. The secondary outcome was to identify the changes seen in the parameters which make up the components of the metabolic syndrome. Tertiary outcomes included changes in cardiovascular risk, inflammatory markers and cytokines.

Date of Award	5 Jan 2014
Original language	English
Awarding Institution	University of Bath
Supervisor	J P D Reckless (Supervisor), Conrad Earnest (Supervisor) & Gordon Taylor (Supervisor)