Lifestyle intervention in the management of metabolic syndrome: could we improve adherence issues?

Current guidelines for the treatment of the metabolic syndrome (MetSyn) propose lifestyle changes (diet and physical activity) as a first-line intervention. However, few studies have been conducted thus far in this field. Weight loss has been recognized as an important issue in the management of MetSyn, in addition to exercise training. Moreover, improvement in MetSyn parameters was sustained only when changes in lifestyle were maintained, rendering maintenance as an important treatment issue. Multiple follow-up booster sessions proved more effective in maintaining lifestyle changes than one counseling session at the end of follow-up. Several behavioral techniques have also been used to improve patients' adherence. Although most of these were found effective in achieving short-term adherence to the dietary regimen (and exercise treatment), the evidence is limited regarding specific strategies that are most helpful, in the context of a structured, tailored MetSyn intervention, for the long-term maintenance of lifestyle changes.