Nutritional interventions in metabolic syndrome: a systematic review

There is no consensus on the most appropriate nutritional strategy for treating metabolic syndrome (MS), such that cardiovascular risk is reduced. This study was designed to assess the strength of evidence of the benefits of various nutritional interventions in MS remission. Performed in Medline, Cochrane Library and PubMed databases, the virtual search consisted of randomized clinical trials published between 1999 and 2009 in any language, studies involving individuals aged 18 or older and diagnosed with MS, regardless of the criterion. The Boolean operator and was used in the combination of the MeSH terms "Metabolic Syndrome", "Metabolic x Syndrome" and "Metabolic Syndrome X", the entry terms "Dysmetabolic Syndrome X", Metabolic Cardiovascular Syndrome," "Metabolic X Syndrome" and "Syndrome X, Metabolic", plus the terms "diet", "intervention and diet", "treatment and diet" and "supplementation". For each study included in the review, we estimated the prevalence of MS and the calculation of effectiveness after the follow-up period. Relative risk measures for each study were described by Forest Plot. We identified 131 articles, which, after eligibility criteria, resulted in 15 studies. These studies were divided into four groups: normocaloric diet associated with exercise; isolated normocaloric diet, low-calorie diet combined with exercises; and isolated low-calorie diet. Tests with low-calorie diet associated with exercising revealed higher efficiency values, helping to emphasize the global aspects of lifestyle change in the treatment of MS, in which healthy and low-calorie diet should be complemented with the practice of physical activity.