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Core 2. Epidemiology and Prevention of CV Disease: Physiology, Pharmacology and Lifestyle
Session Title: Lifestyle and Therapeutic Interventions for Cardiovascular Risk

Abstract 13579: Evidence that Changes in Both Global Diet Quality and in Physical Activity Level Synergistically Reduce Visceral Adiposity in Men With the Metabolic Syndrome

Originally publishedCirculation. 2011;124:A13579

    SYNERGIE was a healthy eating/physical activity-exercise program designed for the clinical management of men with features of the metabolic syndrome (MS). In the present study, we aimed to identify which components of the program (physical activity (PA), caloric/macronutrient intake or diet quality (DQ) using the DASH score (Dietary Approach to Stop Hypertension)) were related to the loss of visceral adiposity (VA). The SYNERGIE program targeted a daily energy deficit of approximately 500 kcal, coupled with a PA program (160 min/wk), based on a personalized follow-up by trained dieticians and kinesiologists. From the 144 subjects initially recruited, 93 viscerally obese men (age: 49±1 y, waist circumference: 108±9 cm, triglycerides: 2.46±0.09 mmol/L) who completed a 3-day dietary journal at baseline and after one year of lifestyle intervention and a daily PA journal for one year were analysed. Body composition and fat distribution were assessed using dual-energy X-ray absorptiometry and computed tomography. After one year of intervention, the improvements in body composition and fat distribution (-7.1% of body weight, -8% of waist circumference, -6.1% of fat mass, -26% of VA, p<0.0001) were significantly correlated to the volume of reported PA and to the improvement in cardiorespiratory fitness (p<0.01). Whereas no correlation was found with the changes in total caloric intake (-559±68 kcal) or in the diet macronutrient composition, improvements in body composition/fat distribution were related to the significant increase in DASH score (r=-0.32, p=0.003 and r=-0.33, p=001 for changes in VA and body weight respectively). When divided according to the median for PA and DASH score, only patients with both high PA (average 217 min/wk) and high DASH score (average 66.5), significantly improved their body composition/fat distribution when compared to the low PA (average 95 min/wk)-low DASH score (average 43.7) group (p<0.05). The present results highlight the contribution of DQ beyond macronutrient/caloric content and suggest that synergistic changes in both DQ and PA levels reduce VA. Such findings emphasize the need to focus globally on both diet quality and physical activity in the management of viscerally obese men with the features of MS.

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