Brief interventions in counselling for nutrition and the prevalence of metabolic syndrome in primary care adult patients

Abstract

This research i) examined the influence of a brief nutrition-based intervention among primary care patients in changing nutrition and clinical values related to metabolic syndrome (study 1), and ii) assessed nutrition and the prevalence of metabolic syndrome and its clinical determinants among primary care patients in different sociodemographic groups (study 2). In study 1, a systematic literature review was conducted on eight databases during Sept.-Oct. 2016 with a final update in Nov. 2017. In study 2, data (n=557 for RO II-III, n=251 for RO IV-V) collected in primary care practices in Central Finland in 2006-2008 for the EVI study were analysed using Chi-Square test, GLM and Logistic Regression. Study 1: The systematic search produced 983 articles, five of which met the inclusion criteria. The studies found only a weak effect of a brief intervention in modifying nutrition behaviour. The brief interventions had no influence on clinical outcomes. Study 2: Sociodemographic status influenced both the prevalence of metabolic syndrome and incidence of the single clinical determinants of metabolic syndrome. Both were most commonly found in men, the lower educated, retirees, and students and the unemployed. In total, 40 % of men and 27 % of women had metabolic syndrome. The association between obesity and metabolic syndrome was strong: only 4 % of the patients without metabolic syndrome were obese. No influence on the prevalence of metabolic syndrome was found for nutrition or nutrition-related health behaviours. To conclude, high quality trials are needed to appraise the effectiveness of brief interventions in modifying nutrition. The prevalence of metabolic syndrome differed between the sociodemographic groups; hence health promotion and disease prevention should be targeted accordingly. Owing to data limitations, no influence on the prevalence of metabolic syndrome was observed for nutrition or other health-related behaviours; however a clear association was found between the prevalence of metabolic syndrome and obesity. Thus, metabolic syndrome should be addressed in primary care patients when obesity, alone or with abnormal blood pressure, another easy-to-address indicator, is present.