Efficacy of a multidimensional self-management intervention on low-education women with metabolic syndrome: a cluster randomized controlled trial.

Low-education women, a substantially older population, are subject to increased risks of metabolic syndrome and consequent cardiometabolic diseases; early detection and effective management were urgently needed. Ninety-nine women with metabolic syndrome, age 61 and education ≤ 6 years, from four community units were randomly assigned to either a self-management intervention (n = 51) or a control arm (n = 48). The intervention consisted of five dimensions, physical activity and diet modifications (daily exercise classes and two nutrition courses), goal setting, coaching and peer support, problem-solving, and self-monitoring. The control arm received an education leaflet. Assessments were performed at baseline, six months, and 18 months. Compared with the control, the intervention participants improved the overall rate of meeting the recommended servings for six health foods, including vegetables, dairy products, and nuts (except whole grains, fruits, and protein); the rate of meeting regular leisure-time physical activity; and criteria biomarkers-waist circumference, fasting blood glucose, high-density lipoprotein cholesterol (except blood pressure and triglycerides); as well as body weight and body mass index; consequently decreased the number of risk factors and rate of metabolic syndrome. In conclusion, the multidimensional self-management intervention improved physical activity, healthy eating, and metabolic syndrome risks among low-education women with metabolic syndrome.

A parsimonious and comprehensive screening tool for adult health behaviors.

BACKGROUND: A practical screening tool for early detection of unhealthy behaviors among adults to provide tailored care can have an important role in public health nursing. PURPOSE: To develop a screening tool with valid psychometric properties for adult health behaviors (AHBs). METHODS: A cross-sectional study was conducted between March 2018 and September 2019 in central-southern Taiwan. The AHBs development included qualitative and quantitative measurement of items based on literature reviews and expert opinion and exploration and confirmatory factor analysis. RESULTS: A total of 765 community adult participants: 377 women and 388 men, with a mean age of 39.3 (SD = 10.6), ranging from 20 to 64 years completed the AHBs screening tool. Analysis of the 23-items AHBs scale identified six dimensions - stress management, physical activity, health responsibility, life appreciation, healthy eating, and oral hygiene accounting for 67.3% of the variance. Total scale scores were significantly associated with a criterion variable of life satisfaction. CONCLUSION: The AHBs scale is a suitable screening tool that can be used to identify adults' unhealthy behaviors early, which is useful for public health nurses to conduct a regular assessment and initiate individualized health programs.

Utility of quantitative ultrasound in community screening for hepatic steatosis.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. Quantitative ultrasound facilitates clinical grading of hepatic steatosis (the early stage of NAFLD). However, the utility of quantitative ultrasound as a first-line method for community screening of hepatic steatosis remains unclear. Therefore, this study aimed to investigate the utility of quantitative ultrasound to screen for hepatic steatosis and for metabolic evaluation at the community level. In total, 278 participants enrolled from a community satisfied the study criteria. Each subject underwent anthropometric and biochemical examinations, and abdominal ultrasound imaging was performed to measure the controlled attenuation (CAP), integrated backscatter (IB), and information Shannon entropy (ISE). The assessment outcomes were compared with the fatty liver index (FLI), hepatic steatosis index (HSI), metabolic syndrome (MetS), and insulin resistance to evaluate the screening performance through the area under the receiver operating characteristic curve (AUROC) and Delong's test. Ultrasound ISE, CAP, and IB were effective in screening hepatic steatosis, MetS, and insulin resistance. In screening for hepatic steatosis, the AUROCs of ISE, CAP, and IB were 0.85, 0.83, and 0.80 (the cutoff FLI = 60), respectively, and 0.84, 0.75, 0.77 (the cutoff HSI = 36), respectively, and those for the evaluation of MetS and insulin resistance were 0.79, 0.75, 0.79, respectively, and 0.83, 0.76, 0.78, respectively. Delong's test revealed that ISE outperformed CAP and IB for the detection of hepatic steatosis and insulin resistance (P < .05). Based on the present results, ultrasound ISE is a potential imaging biomarker during first-line community screening of hepatic steatosis and insulin resistance.

Gender differences in lifestyle and risk factors of metabolic syndrome: Do women have better health habits than men?

AIMS AND OBJECTIVES: To examine the gender-specific lifestyles of adults with metabolic syndrome in the Taiwanese community. BACKGROUND: Many studies show different prevalence of metabolic syndrome in males and females; however, few studies have investigated gender-specific lifestyle risk factors, which are important for effectively reducing prevalence. DESIGN: A cross-sectional study design was used. METHODS: Between 2012 and 2015, a total of 1,066 individuals were recruited in northern Taiwan. Data were collected by questionnaires and analysed by descriptive statistics, chi-square tests and logistic regression. This study followed the STROBE guidelines. RESULTS: The prevalence of metabolic syndrome was 40.8% in men and 36.0% in women. Women had healthier dietary habits, a higher rate of moderate-vigorous physical activity, and a lower rate of smoking and obesity than men. Men, who were overweight or obese, lacked vigorous physical activity, often consumed excess amounts of salt and fat, and seldom consumed appropriate amounts of protein tended to have metabolic syndrome. Women with an unhealthy metabolism tended to be overweight or obese and seldom consumed dairy products. CONCLUSIONS: Men, who had normal body weight, performed vigorous physical activity, seldom consumed excess amounts of salt and fat, and often consumed appropriate amounts of protein tended not to have metabolic syndrome. Women with a healthy metabolism were of normal body weight and often consumed dairy products. There exist gender differences in health habits with metabolic syndrome. RELEVANCE TO CLINICAL PRACTICE: Although the associated risk factors differed between men and women, controlling body weight and maintaining a healthy lifestyle may reduce the risk of metabolic syndrome.

Long-Term Lifestyle Intervention in Elderly With Metabolic Syndrome.

The purpose of this study was to examine the effects of a long-term community-based lifestyle intervention on the biochemical indicators and prevalence of metabolic syndrome among elderly adults. This was a randomized controlled trial in northern Taiwan from August 2013 to February 2015. Sixty-nine elderly adults participated in this study. There were three measurements. The experimental group participated in exercise and diet interventions. The control group participated in the exercise intervention. Repeated measurement and ANCOVA were performed to evaluate the effectiveness. After 18 months, body weight (1.06 kg), body mass index (1.21 kg/m2), waist circumference (3.32 cm), blood pressure, and prevalence (30.4%) of metabolic syndrome were significantly reduced in all subjects. There were significant differences in waist circumference and high-density lipoprotein cholesterol between the two groups. This intervention can lower the indicators and prevalence of metabolic syndrome. Exercise and diet interventions could promote further metabolic changes.

CE: Original Research: Examining the Links Between Lifestyle Factors and Metabolic Syndrome.

: Background: As it is in many other developed countries, obesity is a growing health concern in Taiwan, affecting nearly 20% of the adult population. Obesity can increase the risk of developing metabolic syndrome, diabetes, and cardiovascular disease. Recent data indicate that the prevalence of metabolic syndrome in Taiwan is 25.5%. Yet some overweight and obese individuals have normal metabolic profiles. It's not clear why some overweight or obese people remain metabolically healthy while others do not. PURPOSE: The purpose of this study was to examine lifestyle risk factors for metabolic syndrome in people who are overweight or obese. We were particularly interested in distinguishing those lifestyle factors associated with metabolic health in this population. METHODS: Data collected from community-based physical examinations in northern Taiwan were used for this cross-sectional study. A survey was conducted from 2013 to 2014. We collected data on demographic variables, clinically pertinent measures (weight; height; waist circumference; blood pressure; and levels of fasting blood glucose, triglycerides, and high-density lipoprotein cholesterol), and lifestyle factors (smoking, drinking, exercise, and dietary habits). To analyze the data, we used percentage, mean, standard deviation, χ test, independent t test, the Fisher exact test, phi correlation, and logistic regression. RESULTS: The overall prevalence of metabolic syndrome among all 734 participants was 36.4%. For the normal weight, overweight, and obese groups, the prevalence of metabolic syndrome was 12.4%, 36.4%, and 61.6%, respectively. The results of logistic regression showed, however, that obese individuals who exercised regularly and ate sufficient amounts of fruit were less likely to have metabolic syndrome, and that overweight individuals who were nonsmokers and ate sufficient amounts of vegetables were also less likely to have metabolic syndrome. CONCLUSIONS: Lifestyle factors may significantly affect the development of metabolic syndrome in people who are overweight or obese. Our findings indicate that practicing healthy lifestyle behaviors may be the best way to prevent metabolic syndrome. Public health interventions promoting smoking cessation, regular exercise, and good dietary habits can be created and conducted at relatively low cost. At the community level, all nurses can prioritize such interventions for their overweight and obese patients.