Lepidium meyenii Supplemented Diet Modulates Neurobehavioral and Biochemical Parameters in Mice Fed High-Fat High-Sugar Diet.

BACKGROUND: Metabolic syndrome has been associated with an increased risk of cardiovascular disease, diabetes mellitus, and neurodegenerative disorders. Known side-effects of currently- available drugs necessitate the search for possibly better treatment options. OBJECTIVE: This study examined the effects of dietary lepidium meyenii (MACA) supplementation on neurobehaviour, metabolic profile, levels of inflammatory markers, and oxidative stress parameters in a mouse model of metabolic syndrome. METHODS: Mice were randomly assigned into 8 groups of ten animals each. Groups consist of standard diet (SD) control, high fat/high sugar (HFHS) control and three groups each of lepidium meyenii incorporated into either SD or HFHS diet at 0.1, 0.2 and 0.4%. Mice were fed for seven weeks, and body weight was measured weekly. Open-field behaviors and radial-arm/Y-maze spatial memory were scored at the end of the study. Twenty-four hours after the last behavioral test, fasting blood glucose levels were estimated. Animals were then euthanized, and blood was drawn for estimation of serum lipid profile. Whole brains were excised, weighed and homogenized to estimate the levels of lipid peroxidation, inflammatory markers, antioxidant status, and acetylcholinesterase activity. RESULTS: MACA-supplemented diet was associated with a decrease in body weight gain, an increase in food intake (at lower concentrations), suppression of grooming behavior, and decrease in acetylcholinesterase activity. MACA-supplement also reversed HFHS-induced memory impairment, anxiety, hyperglycaemia, lipid derangement, oxidative stress, and derangement of inflammatory markers. CONCLUSION: Dietary supplementation with MACA shows beneficial effects in mitigating the effects of metabolic syndrome on the brain in mice.

[Effect of biofeedback therapy on metabolic syndrome under different levels of job stress].

Objective: To investigate the effect of biofeedback therapy on metabolic syndrome (MS) and the effect of different levels of job stress on the outcome. Methods: The physicians in tertiary hospitals who were diagnosed with MS from January to December, 2016 were divided into biofeedback group and health education group according to different intervention methods, and moderate group, medium group, and high group according to different levels of job stress. A 6-month intervention was implemented from May to October, 2017. A two-way factorial design was used to analyze the main effect of biofeedback on physical and biochemical parameters and the interaction of biofeedback and job stress. Results: After 6 months of intervention, the patients in both the biofeedback group and the moderate group had significantly decreased waist circumference, body mass index, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and levels of triglyceride (TG) , total cholesterol, low-density lipoprotein cholesterol (LDL-C) , and fasting plasma glucose (FPG) and a significantly increased level of high-density lipoprotein cholesterol (HDL-C) (all P<0.05) ; the patients in both the health education group and the moderate group had significantly decreased SBP, DBP, and levels of TG, LDL-C, and FPG (P<0.05) . The factorial analysis of variance showed that there was a synergistic interaction between the intervention method and job stress level in SBP, DBP, TG, HDL-C, LDL-C, and FPG among MS patients (P<0.05) . The high group had significantly more improvements in all indices compared with the medium group and the moderate group (P<0.05) . Conclusion: Biofeedback therapy can effectively improve blood pressure, blood lipids, and blood glucose in MS patients, and is more effective for patients with high job stress level.

A Healthy Beverage Consumption Pattern Is Inversely Associated with the Risk of Obesity and Metabolic Abnormalities in Korean Adults.

As the use of beverages in diets is increasing, several studies have examined the effect of beverage consumption in human health. Thus, we aimed at identifying specific beverage patterns and determining their associations with obesity and metabolic syndrome (MetS) risk factors in Korean adults. Based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2012 data, 19,800 Korean adults (≥20 years) with a single 24-h dietary recall and health examination data were investigated. All beverage items consumed by participants were categorized into 15 beverage groups based on the KNHANES coding system. Three major beverage consumption patterns were identified according to factor analysis: (1) the "healthy beverage" (high intake of dairy products, 100% fruit/vegetable juices and low intake of alcoholic beverages); (2) the "sugar-sweetened beverage" (high intake of soda, sweetened coffee/tea, and fruit drink); and (3) the "unsweetened beverage" (high intake of unsweetened coffee) patterns. Multivariable logistic regression analyses were conducted to determine the odds of obesity (body mass index ≥25 kg/m2) and MetS (defined by National Cholesterol Education Program III [NCEP III]) for each beverage pattern after controlling for covariates. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations of the "healthy beverage" pattern with risks of obesity, abdominal obesity, and elevated triglycerides, fasting blood glucose (FBG), and blood pressure (BP) were 0.88 (0.79-0.98), 0.83 (0.74-0.92), 0.88 (0.78-0.99), 0.85 (0.79-0.98), and 0.81 (0.72-0.92), respectively. AORs (95% CIs) of associations of the "sugar-sweetened beverage" pattern with risks of abdominal obesity, elevated FBG and BP were 1.15 (1.03-1.30), 1.14 (1.01-1.29), and 1.18 (1.04-1.33), respectively. However, no associations were found between the "unsweetened beverage" pattern and any parameters examined. Intake of healthy beverages should be encouraged to reduce risks of obesity and metabolic abnormalities; however, individuals who consume sugar-sweetened beverages should be advised on the adverse effects of those beverages on the risk of obesity and MetS.

Mindfulness Is Associated with the Metabolic Syndrome among Individuals with a Depressive Symptomatology.

The Metabolic Syndrome (MetS) is a major public health burden. Dispositional mindfulness has recently been associated with eating disorders, being overweight, and could therefore be associated with the MetS. We aimed to examine in a cross-sectional design the relationship between mindfulness, the MetS, and its risk factors in a large sample of the adult general population and the influence of depressive symptomatology on this association. Adults participating in the NutriNet-Santé study who had completed the Five Facets Mindfulness Questionnaire and attended a clinical and biological examination were available for inclusion. Multivariable logistic regression models adjusted for socio-demographic and lifestyle factors were performed. A total of 17,490 individuals were included. Among individuals with a depressive symptomatology, those with higher mindfulness were less likely to have a MetS (OR: 0.73, 95% CI: 0.57-0.93), a high waist circumference, a low HDL-cholesterol level and an elevated fasting blood glucose level (all p <0.05). In those without depressive symptomatology, individuals with higher mindfulness were less likely to have a high waist circumference (p <0.01). In conclusion, higher mindfulness was associated with lower odds of developing a MetS only among individuals with a depressive symptomatology.

Metabolic syndrome - A truly psychosomatic disorder? A global hypothesis.

Exact cause of the metabolic syndrome [MS], a global epidemic, is still unclear. Man has same fundamental needs to live as animals but modern man's life-style compels him to acquire certainty of resources for all his needs in a complex social network. Today money has become the sole life essential need. Contrarily none of the animals needs to earn money. Brain is also an organ of the human body with a unique thought process to define logical actions to achieve a person's goals. This way life is a flow of desires followed by logical actions. The person struggles to attain desired goals via the allostatic load but a perceived insurmountable threat can make his flow of life stalled to freeze him. Published data from varied branches of medical science indicates role of hormones in overall homeostasis. Particularly multifaceted role of serotonin is well documented. Adrenalin being the primary mediator of Cori cycle is also well known. From the integration of observations from published data with reference to common human's modern lifestyle, it is hypothesized that a perceived trapped situation in life creates acute chaos of thoughts in brain, which results in acute excess of stress hormones and concurrent depletion of resting hormones, which in turn triggers MS. In global terms, MS indicates an acute imbalance of a few hormones and implies psychosomatic roots of the disorder. This may pave a better way in deciding a personalized holistic protocol with combination of counter regulatory psychoactive medications.

Associations among integrated psychoneuroimmunological factors and metabolic syndrome.

BACKGROUND: Metabolic syndrome (MetS) has been reported to cause considerable psychoneuroimmunology (PNI) disturbances such as, psychological distress, autonomic nervous imbalance, and impaired immune function. Associations among these psychoneuroimmunology (PNI) factors and their integrated effects with MetS and risk components of MetS necessitate further exploration. OBJECTIVE: This study investigated associations among psychoneuroimmunological factors, their integrated effects with MetS and risk components of MetS. METHODS: This was a cross-sectional study. Participants were recruited from two health management centers at a medical center in Northern Taiwan. Demographics and data on psychological distress (e.g., perceived stress and depression) were collected using self-reported questionnaires. Heart rate variability (HRV) and C-reactive protein values (CRP) were measured to evaluate participants' autonomic nervous function and immune reaction. The risk components of MetS (e.g., elevated blood pressure, impaired fasting glucose, dyslipidemia, and abdominal obesity) were identified according to the Taiwan-specific definition of MetS and were determined based on participants' health examination profiles. RESULTS: A total of 345 participants with complete data were included for data analysis. Compared with healthy controls, participants with MetS exhibited higher depression scores (11.2±8.5 vs. 8.7±7.0), higher CRP values (2.1±2.5 vs. 0.7±1.0), and lower HRV (total power: 758.7±774.9 vs. 1064.4±1075.0). However, perceived stress in participants with MetS did not significantly differ from that of their healthy counterparts (p>0.05). Univariate analyses indicated that associations among psychoneuroimmunological factors and MetS risk components were statistically heterogeneous: a) perceived stress and depression were significantly associated only with high blood glucose (p<0.05); b) CRP was significantly associated with all MetS risk components (p<0.05); and c) HRV was significantly associated with high triglycerides and high fasting blood glucose (p<0.05). Multivariate analysis indicated that the integrated effects of depression, CRP, and HRV were significantly associated with MetS (p<0.01) after controlling for age and education level. CONCLUSIONS: Higher depression scores, higher CRP values, and lower HRV are independently and additively associated with MetS and risk components of MetS. Accordingly, a multidisciplinary approach to alleviating psychological distress, immune dysfunction, and autonomic nervous imbalance is recommended for promoting well-being in people with subclinical metabolic abnormalities or MetS to minimize downstream health consequences.

Heart Rate Variability, Flow, Mood and Mental Stress During Yoga Practices in Yoga Practitioners, Non-yoga Practitioners and People with Metabolic Syndrome.

Heart Rate Variability (HRV) and respiratory sinus arrhythmia are directly associated with autonomic flexibility, self-regulation and well-being, and inversely associated with physiological stress, psychological stress and pathology. Yoga enhances autonomic activity, mitigates stress and benefits stress-related clinical conditions, yet the relationship between autonomic activity and psychophysiological responses during yoga practices and stressful stimuli has not been widely explored. This experimental study explored the relationship between HRV, mood states and flow experiences in regular yoga practitioners (YP), non-yoga practitioners (NY) and people with metabolic syndrome (MetS), during Mental Arithmetic Stress Test (MAST) and various yoga practices. The study found that the MAST placed a cardio-autonomic burden in all participants with the YP group showing the greatest reactivity and the most rapid recovery, while the MetS group had significantly blunted recovery. The YP group also reported a heightened experience of flow and positive mood states compared to NY and MetS groups as well as having a higher vagal tone during all resting conditions. These results suggest yoga practitioners have a greater homeostatic capacity and autonomic, metabolic and physiological resilience. Further studies are now needed to determine if regular yoga practice may improve autonomic flexibility in non-yoga practitioners and metabolic syndrome patients. Clinical Trial No 'ACTRN 2614001075673'.

Effects of a 12-Week Hatha Yoga Intervention on Metabolic Risk and Quality of Life in Hong Kong Chinese Adults with and without Metabolic Syndrome.

OBJECTIVE: To determine the efficacy of a 12-week Hatha yoga intervention to improve metabolic risk profiles and health-related quality of life (HRQoL) in Chinese adults with and without metabolic syndrome (MetS). METHODS: We conducted a controlled trial within an university-affiliated hospital. 173 Chinese men and women aged 18 or above were assigned to either the yoga intervention group (n = 87) or the control group (n = 86). Primary outcomes included 12-week change in metabolic risk factors and MetS z score. Secondary outcome was HRQoL (Medical Outcomes Short Form Survey at 12 weeks). RESULTS: The mean age of participants was 52.0 (SD 7.4, range 31-71) years. Analysis involving the entire study population revealed that the yoga group achieved greater decline in waist circumference (p<0.001), fasting glucose (p<0.01), triglycerides (p<0.05), and MetS z score (p<0.01). Yoga training also improved general health perceptions (p<0.01), physical component score (p<0.01), and social functioning (p<0.01) domains score of HRQoL. However, no significant differences between groups were observed in the mean change of systolic/diastolic blood pressures or high-density lipid protein cholesterol (all p>0.05). There were no significant differences in the intervention effects on waist circumference and MetS z score between the MetS subgroups (both p>0.05). CONCLUSION: A 12-week Hatha yoga intervention improves metabolic risk profiles and HRQoL in Chinese adults with and without MetS. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12613000816752.

Longitudinal relationship of diet and oxidative stress with depressive symptoms in patients with metabolic syndrome after following a weight loss treatment: the RESMENA project.

BACKGROUND & AIM: Metabolic syndrome and depression seem to share some common underlying mechanisms, although less is known about the impact of metabolic syndrome dietary treatments on depression. This study examined the association between a hypocaloric treatment designed to reduce metabolic syndrome features in self-perceived depression and the potential involvement of dietary components and oxidative stress changes. METHODS: Analyses were based on volunteers (n = 55) with metabolic syndrome (age 50 ± 1 y.o.; 38M/17F), where depressive symptoms were assessed using the Beck Depression Inventory. Participants followed two hypocaloric diets (control diet and RESMENA diet) with the same energy restriction (-30% TCV) for six months. Depressive symptoms, dietary records, anthropometrical measurements, biochemical parameters and oxidative stress levels were analysed. RESULTS: Both diets improved self-perceived depression similarly (p = 0.528). Participants with lower depressive symptoms at baseline reported a significantly higher intake of omega-3 polyunsaturated fatty acids (p trend = 0.002). Interestingly, after adjusting for potential confounders, the increase in folate consumption (p = 0.011) and the decrease in plasma malondialdehyde levels (p = 0.012) throughout the intervention, were associated with the improvement in depressive symptoms. CONCLUSIONS: A higher intake of folate and a decline in malondialdehyde plasma levels during a weight loss intervention, were related to improvements in manifestations of depression (www.clinicaltrials.gov; NCT01087086).

Posttraumatic stress disorder and cardiometabolic disease.

The need for addressing posttraumatic stress disorder (PTSD) among combat veterans returning from Afghanistan and Iraq is a growing public health concern. Current PTSD management addresses psychiatric parameters of this condition. However, PTSD is not simply a psychiatric disorder. Traumatic stress increases the risk for inflammation-related somatic diseases and early mortality. The metabolic syndrome reflects the increased health risk associated with combat stress and PTSD. Obesity, dyslipidemia, hypertension, diabetes mellitus, and cardiovascular disease are prevalent among PTSD patients. However, there has been little appreciation for the need to address these somatic PTSD comorbidities. Medical professionals treating this vulnerable population should screen patients for cardiometabolic risk factors and avail themselves of existing preventive diet, exercise, and pharmacologic modalities that will reduce such risk factors and improve overall long-term health outcomes and quality of life. There is the promise that cardiometabolic preventive therapy complementing psychiatric intervention may, in turn, help improve the posttraumatic stress system dysregulation and favorably impact psychiatric and neurologic function. © 2013 S. Karger AG, Basel.

Beneficial effects of herbs, spices and medicinal plants on the metabolic syndrome, brain and cognitive function.

Herbs and spices have been used since ancient times to not only improve the flavor of edible food but also to prevent and treat chronic health maladies. While the scientific evidence for the use of such common herbs and medicinal plants then had been scarce or lacking, the beneficial effects observed from such use were generally encouraging. It is, therefore, not surprising that the tradition of using such herbs, perhaps even after the advent of modern medicine, has continued. More recently, due to an increased interest in understanding the nutritional effects of herbs/spices more comprehensively, several studies have examined the cellular and molecular modes of action of the active chemical components in herbs and their biological properties. Beneficial actions of herbs/spices include anti-inflammatory, antioxidant, anti-hypertensive, gluco-regulatory, and anti-thrombotic effects. One major component of herbs and spices is the polyphenols. Some of the aforementioned properties are attributed to the polyphenols and they are associated with attenuating the metabolic syndrome. Detrimental changes associated with the metabolic syndrome over time affect brain and cognitive function. Metabolic syndrome and type-2 diabetes are also risk factors for Alzheimer's disease and stroke. In addition, the neuroprotective effects of herbs and spices have been demonstrated and, whether directly or indirectly, such beneficial effects may also contribute to an improvement in cognitive function. This review evaluates the current evidence available for herbs/spices in potentially improving the metabolic syndrome, as well as their neuroprotective effects on the brain, and cognitive function in animal and human studies.

[The combined rehabilitative treatment of the children with obesity and metabolic syndrome].

The present study included a total of 66 children at the age from 11 to 16 years with obesity and metabolic syndrome. The latter condition in the childhood and adolescence is characterized by the pronounced disturbances of basal metabolism, vasoactive systems, psychoemotional status, and regulatory hormonal functions that determine the choice of rehabilitative modalities. The combined treatment of such disturbances is considered to be an efficacious method for the rehabilitation of these patients. It is recommended that cortexin be prescribed to the children presenting with obesity and metabolic syndrome because this medication promotes correction of the hormonal and metabolic status and improves the brain cognitive function.

Intervenção nutricional e o impacto na adesão ao tratamento em pacientes com síndrome Metabólica / Nutritional intervention and the impact on adherence to treatment in patients with metabolic syndrome

FUNDAMENTO: A síndrome metabólica representa um conjunto de fatores de risco, associados a doenças cardiovasculares e a diabete melito tipo 2. O tratamento inclui mudanças no estilo de vida, dieta, atividade física e medicamentos. A adesão do paciente é crucial ao tratamento da doença. Objetivo: Avaliar dois modelos de intervenção dietoterápica e a relação com a adesão ao tratamento e o impacto na melhora clínica de pacientes com síndrome metabólica. MÉTODOS: Ensaio clínico randomizado, com duração de quatro meses. Os pacientes foram randomizados em grupos intervenção e controle. Todos seguiram dieta específica por quatro meses. O grupo Intervenção recebeu pacote de intervenção, com dieta individualizada, manual de orientação, aconselhamento via telefone e material educativo. Foram realizadas anamnese nutricional, avaliação antropométrica, avaliação dietética, orientação dietética individualizada e exames bioquímicos. RESULTADOS: Os pacientes que chegaram mais motivados foram aqueles que tiverem maior redução nos valores do índice de massa corporal (p < 0,001), que reduziu de 31,7 kg/m² (DP ± 3,9) para 30,9 kg/m² (DP ± 3,8), na circunferência abdominal a redução foi de 108,1 cm (DP ± 9,8) para 105,9 cm (DP ± 9,5). As associações estatisticamente significativas se deram nas correlações entre índice de massa corporal, glicemia e triglicerídeos, redução do consumo de leite integral (p = 0,002), aumento no consumo de cereais integrais (p = 0,008) e de leite desnatado (p = 0,010), e entre o aumento no consumo de vegetais e a redução dos triglicerídeos. CONCLUSÃO: Ambos os grupos mostraram melhora significativa nos parâmetros clínicos, que foi significativamente associada a motivação prévia. Os pacientes que chegaram mais motivados foram aqueles que responderam melhor ao tratamento.

BACKGROUND: Metabolic syndrome is associated with increased risk of cardiovascular events disease and type 2 diabetes. Treatment includes modifications on life style, diet and physical activity. Treatment adherence plays a crucial role in the successful treatment of this disease. OBJECTIVE: To evaluate two models of dietary intervention, and the relationship with adherence to treatment and impact on clinical improvement of patients with metabolic syndrome. METHODS: Randomized clinical trial, lasting four months. Participants were randomized assigned to the intervention or control group. Both groups were instructed to follow a diet for 4 months. Subjects in the intervention group additionally received an intervention package, with metabolic syndrome manual book, telephone counseling and nutrition education leaflets. In both groups nutritional anamnesis, anthropometric assessment, dietary assessment, individualized dietary and biochemical tests were done. RESULTS: Patients who arrived more motivated were those who has the greatest reduction in the values of body mass index, which decreased from 31.7 kg/m² (SD ± 3.9) to 30.9 kg/m² (SD ± 3.8), reduction in waist circumference was 108.1 cm (SD ± 9.8) to 105.9 cm (SD ± 9.5). The statistically significant associations were in the correlation between body mass index, blood glucose and triglycerides, reducing the consumption of whole milk, increased consumption of whole grains and skimmed milk and between the increase in vegetable intake and reducing triglycerides. CONCLUSION: Both groups showed significant improvement in all clinical parameters that was significantly associated with the previous motivation. Patients who arrived more motivated were those who responded better to treatment.

Nutritional intervention and the impact on adherence to treatment in patients with metabolic syndrome.

BACKGROUND: Metabolic syndrome is associated with increased risk of cardiovascular events disease and type 2 diabetes. Treatment includes modifications on life style, diet and physical activity. Treatment adherence plays a crucial role in the successful treatment of this disease. OBJECTIVE: To evaluate two models of dietary intervention, and the relationship with adherence to treatment and impact on clinical improvement of patients with metabolic syndrome. METHODS: Randomized clinical trial, lasting four months. Participants were randomized assigned to the intervention or control group. Both groups were instructed to follow a diet for 4 months. Subjects in the intervention group additionally received an intervention package, with metabolic syndrome manual book, telephone counseling and nutrition education leaflets. In both groups nutritional anamnesis, anthropometric assessment, dietary assessment, individualized dietary and biochemical tests were done. RESULTS: Patients who arrived more motivated were those who has the greatest reduction in the values of body mass index, which decreased from 31.7 kg/m² (SD ± 3.9) to 30.9 kg/m² (SD ± 3.8), reduction in waist circumference was 108.1 cm (SD ± 9.8) to 105.9 cm (SD ± 9.5). The statistically significant associations were in the correlation between body mass index, blood glucose and triglycerides, reducing the consumption of whole milk, increased consumption of whole grains and skimmed milk and between the increase in vegetable intake and reducing triglycerides. CONCLUSION: Both groups showed significant improvement in all clinical parameters that was significantly associated with the previous motivation. Patients who arrived more motivated were those who responded better to treatment.

[Role of the brain in the regulation of metabolism and energy expenditure: the central role of insulin, and insulin resistance of the brain]. / Az agy szerepe az anyagcsere és energiaforgalom szabályozásában: az inzulin központi idegrendszeri hatásai, az agy inzulinrezisztenciája.

Regulatory role of the brain in energy expenditure, appetite, glucose metabolism, and central effects of insulin has been prominently studied. Certain neurons in the hypothalamus increase or decrease appetite via orexigenes and anorexigenes, regulating energy balance and food intake. Hypothalamus is the site of afferent and efferent stimuli between special nuclei and beta- and alpha cells, and it regulates induction/inhibition of glucose output from the liver. Incretines, produced in intestine and in certain brain cells (brain-gut hormones), link to special receptors in the hypothalamus. Central role of insulin has been proved both in animals and in humans. Insulin gets across the blood-brain barrier, links to special hypothalamic receptors, regulating peripheral glucose metabolism. Central glucose sensing, via "glucose-excited" and "glucose-inhibited" cells have outstanding role. Former are active in hyperglycaemia, latter in hypoglycaemia, via influencing beta- and alpha cells, independently of traditional metabolic pathways. Evidence of brain insulin resistance needs centrally acting drugs, paradigm changes in therapy and prevention of metabolic syndrome, diabetes, cardiovascular and oncological diseases.

[Metabolic syndrome, diabetes mellitus and vulnerability: a syndemic approach of chronic diseases]. / Syndrome métabolique, diabète sucré et vulnérabilité: une approche "syndémique" de la maladie chronique.

The pandemic metabolic syndrome is generally attributed to our lifestyle. The current therapeutic strategies are centered on the behavioral changes and pharmacotherapy. A deeply analysis reveals the importance of the socio-cultural determinants with a "dose-responses effect according to the socio-economic level. The "syndemic" theory, which puts at the same level the socio-cultural environment, the behaviors and biomedecine, suggests a more holistic approach. This theory suggests introducing other partners of care, such cultural-mediators and welfare workers trained in the care, to have finally an approach centered on the roots of the causes. The healthcare networks centered on the management of the costs of health should not forget the socio-cultural dimension, unless wanting to select the good cases.

[Rehabilitative treatment of metabolic syndrome in a sanatorium].

This study included 386 patients with metabolic syndrome admitted for the treatment to a health spa facility. Diagnosis was established using the specially developed program of combined clinical examination, functional tests, and laboratory analyses. A specific feature of the present spa and resort treatment was the extensive application of carefully selected non-medicinal therapeutic modalities in combination with pharmaceutical preparations. The study has demonstrated that the use of the active treatment program produced beneficial effect in the majority of the patients.

The effects of biofeedback in diabetes and essential hypertension.

The metabolic syndrome is likely to develop in patients in whom genetic predisposition, chronic stress, negative emotion, and unhealthy lifestyle habits converge. In light of the psychophysiologic aspect of most of these factors, biofeedback, relaxation, and other psychophysiologic interventions have been studied and used in patients with elements of the metabolic syndrome, particularly diabetes and hypertension. This article reviews the rationale and evidence for biofeedback for the treatment of diabetes and hypertension, which has been shown to effectively lower blood glucose and blood pressure in numerous studies. Patients with prehypertension may be a particularly appropriate target population for biofeedback for blood pressure reduction. Further research is needed to guide identification of the best candidates for psychophysiologic intervention for these conditions, although patient readiness for change is a clear prerequisite.

A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health-related quality of life, and psychological health in adults with elevated blood glucose.

OBJECTIVES: To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose. DESIGN, SETTING, AND PARTICIPANTS: A single group pre-post feasibility trial with 11 participants (3 male and 8 female; aged 42-65 years) with elevated blood glucose. INTERVENTION: Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home. MAIN OUTCOME MEASURES: Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)); health-related quality of life; stress and depressive symptoms. RESULTS: There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference -1.05, p<0.001), waist circumference (-2.80 cm, p<0.05), and systolic (-11.64 mm Hg, p<0.01) and diastolic blood pressure (-9.73 mm Hg, p<0.001), as well as in HbA1c (-0.32%, p<0.01), insulin resistance (-0.53, p<0.05), stress (-2.27, p<0.05), depressive symptoms (-3.60, p<0.05), and the SF-36 mental health summary score (5.13, p<0.05) and subscales for general health (19.00, p<0.01), mental health (10.55, p<0.01) and vitality (23.18, p<0.05). CONCLUSIONS: The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.

Restorative yoga in adults with metabolic syndrome: a randomized, controlled pilot trial.

BACKGROUND: Metabolic syndrome increases the risk of diabetes and cardiovascular disease. Yoga improves some metabolic parameters, but it has not been studied in persons with metabolic syndrome. We conducted a randomized controlled pilot trial to determine whether a restorative yoga intervention was feasible and acceptable in underactive, overweight adults with metabolic syndrome. METHODS: Twenty six underactive, overweight adult men and women with metabolic syndrome were randomized to attend 15 yoga sessions of 90 minutes each over 10 weeks or to a wait-list control group. Feasibility was measured by recruitment rates, subject retention, and adherence. Acceptability was assessed by interview and questionnaires. Changes in metabolic outcomes and questionnaire measures from baseline to week 10 were calculated. RESULTS: A total of 280 people were screened by phone, and 93 with high likelihood of metabolic syndrome were invited to a screening visit. Of the 68 who attended screening visits, 26 (38%) were randomized, and 24 (92%) completed the trial. Attendance at yoga classes and adherence to home practice exceeded our goals. In the yoga group, all participants gave the study the highest possible satisfaction rating, and the majority (87%) felt that the yoga poses were easy to perform. There was trend to reduced blood pressure (p = 0.07), a significant increase in energy level (p < 0.009), and trends to improvement in well-being (p < 0.12) and stress (p < 0.22) in the yoga versus control group. CONCLUSIONS: Restorative yoga was a feasible and acceptable intervention in overweight adults with metabolic syndrome. The efficacy of yoga for improving metabolic parameters in this population should be explored in a larger randomized controlled trial.