Community-based lifestyle intervention improves metabolic syndrome and related markers among Kenyan adults

Okube, Okubatsion Tekeste; Kimani, Samuel; Mirie, Waithira

doi:10.1007/s40200-022-01023-1

Cited by 9 publications

(42 citation statements)

References 54 publications

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“…The changes in lifestyle characteristics have been reported elsewhere [31]. Relative to the baseline values and the control group, the intervention group experienced signi cant average reductions in body weight (-4.6 vs -0.4 kgs, p = 0.027), body mass index (-1.6 vs -0.14, p = 0.012), waist circumference (-2.29 vs -0.12 cm, p = 0.019), waist hip ratio (-0.02 vs -0.0, P = 0.003), waist height ratio (-0.01 vs 0.0, p = 0.015), systolic BP (-4.06 vs + 0.24 mmHg, p = 0.025), diastolic BP (-2.4 vs -0.23 mmHg, p = 0.033), fasting blood glucose (− 0.5 vs + 0.08 mmol/L; p < 0.001), Triglycerides (-0.33 vs -0.01 mmol/L, p = 0.006), and an increase in high-density lipoprotein cholesterol (+ 0.25 vs + 0.02 mmol/L; p < 0.001) at the end-line.…”

Section: Resultsmentioning

confidence: 98%

“…Details on the participants' baseline characteristics, study site, design, and procedures are reported in our published work [31]. Brie y, this was a randomized control trial design carried out in adults with MetS.…”

Section: Methodsmentioning

confidence: 99%

“…Eligible individuals were assigned to either lifestyle intervention group (n = 176) or usual care group (n = 176) using a block strati ed randomization technique. Details of the randomization have been reported in an earlier article [31]. Those in the intervention arm received world Health Organization (2011-a) recommended lifestyle modi cation intervention comprised of physical activity, dietary counselling and behavioral intervention.…”

Section: Methodsmentioning

confidence: 99%

“…Details of the assessment of behavioural characteristics including dietary intake patterns, physical activity, alcohol intake and cigarette smoking as well as validity and reliability of the study tools have been reported in our previous published work [31].…”

Section: Assessment Of Behavioural Characteristicsmentioning

confidence: 99%

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Effectiveness of a community-based intervention in improving cardio-metabolic risk factors in adults with Metabolic Syndrome: A Randomized Controlled Trial.

Okube

Kimani

Mirie

2023

Preprint

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Background Cardiovascular diseases (CVDs) are disproportionately burdened the low- and middle-income countries (LMICs), where awareness and detection rates remain low. Community-based approaches addressing health behaviors including diet, regular physical activity and not smoking cigarettes have all been proved to substantially reduce the risk of CVDs in the high-income countries. However, their effects in improving cardio-metabolic risk factors in adults with Metabolic Syndrome in the LMICs remains unknown. Objective This study aimed to evaluate the effectiveness of community-based lifestyle intervention in improving cardio-metabolic risk factors among adults with MetS. Methods This was a randomized controlled trial study conducted for a period of 15-months among adults with MetS. Eligible individuals (n = 352) were randomly allocated to either the control or the intervention group on 1:1 ratio. The treatment arm received World Health Organization recommended lifestyle intervention that encouraged physical activity and healthy diet through face-to-face contacts. The control group received usual medical care involved drug treatment and general medical advice. Anthropometric, clinical and biochemical measurements as well as lifestyle characteristics were assessed before and 12-months after the intervention. The measurements were compared between and within the groups during analyses using chi-square test, independent t-test and paired t-test. Results The changes in lifestyle characteristics have been reported elsewhere [31]. Relative to the baseline values and the control group, the intervention group experienced significant average reductions in body weight (-4.6 vs -0.4 kgs, p = 0.027), body mass index (-1.6 vs -0.14, p = 0.012), waist circumference (-2.29 vs -0.12 cm, p = 0.019), waist hip ratio (-0.02 vs -0.0, P = 0.003), waist height ratio (-0.01 vs 0.0, p = 0.015), systolic BP (-4.06 vs + 0.24 mmHg, p = 0.025), diastolic BP (-2.4 vs – 0.23 mmHg, p = 0.033), fasting blood glucose (− 0.5 vs + 0.08 mmol/L; p < 0.001), Triglycerides (-0.33 vs -0.01 mmol/L, p = 0.006), and an increase in high-density lipoprotein cholesterol (+ 0.25 vs + 0.02 mmol/L; p < 0.001) at the end-line. Conclusion Community-based lifestyle intervention comprised diet and physical activity significantly improved cardio-metabolic risk factors in adults with MetS. Population-based screening and adoption of a healthy lifestyle should be considered for the prevention, reduction, and treatment of cardio-metabolic risk factors in the LMICs. The strategy could be implemented through nurses and community health workers.

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Section: Resultsmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Assessment Of Behavioural Characteristicsmentioning

confidence: 99%

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Effectiveness of a community-based intervention in improving cardio-metabolic risk factors in adults with Metabolic Syndrome: A Randomized Controlled Trial.

Okube

Kimani

Mirie

2023

Preprint

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“…The four cluster-RCTs accounted for clustering effects in their analysis so there was no unit of analysis errors 43 46 49 52. Six studies were appraised as unclear risk due to insufficient information about protection against contamination 44 47 48 50 51 53. One study was rated as unclear risk due to lack of sufficient information about allocation concealment.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of integrated chronic care models for cardiometabolic multimorbidity in sub-Saharan Africa: a systematic review and meta-analysis

et al. 2023

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ObjectivesThis review aimed at identifying the elements of integrated care models for cardiometabolic multimorbidity in sub-Saharan Africa (SSA) and their effects on clinical or mental health outcomes including systolic blood pressure (SBP), blood sugar, depression scores and other patient-reported outcomes such as quality of life and medication adherence.DesignSystematic review and meta-analysis using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach.Data sourcesWe systematically searched PubMed, Embase, Scopus, Web of Science, Global Health CINAHL, African Journals Online, Informit, PsycINFO, ClinicalTrials.gov, Pan African Clinical Trials Registry and grey literature from OpenSIGLE for studies published between 1999 and 2022.Eligibility criteria for selecting studiesWe included randomised controlled trial studies featuring integrated care models with two or more elements of Wagner’s chronic care model.Data extraction and synthesisTwo independent reviewers used standardised methods to search and screen included studies. Publication bias was assessed using the Doi plot and Luis Furuya Kanamori Index. Meta-analysis was conducted using random effects models.ResultsIn all, we included 10 randomised controlled trials from 11 publications with 4864 participants from six SSA countries (South Africa, Kenya, Nigeria, Eswatini, Ghana and Uganda). The overall quality of evidence based on GRADE criteria was moderate. A random-effects meta-analysis of six studies involving 1754 participants shows that integrated compared with standard care conferred a moderately lower mean SBP (mean difference=−4.85 mm Hg, 95% CI −7.37 to −2.34) for people with cardiometabolic multimorbidity; Hedges’ g effect size (g=−0.25, (−0.39 to −0.11). However, integrated care compared with usual care showed mixed results for glycated haemoglobin, depression, medication adherence and quality of life.ConclusionIntegrated care improved SBP among patients living with cardiometabolic multimorbidity in SSA. More studies on integrated care are required to improve the evidence pool on chronic care models for multimorbidity in SSA. These include implementation studies and cost-effectiveness studies.PROSPERO registration numberCRD42020187756.

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Dietary outcomes of community-based CVD preventive interventions: a systematic review and meta-analysis

Hassen

Sisay

Geertruyden

et al. 2023

Public Health Nutr.

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Objective: We aimed to synthesize available evidence on the effects of community-based interventions in improving various dietary outcome measures. Design: Systematic review and meta-analysis Setting: We searched databases including Medline, EMBASE, PSYCINFO, CINAHL, and the Cochrane registry for studies reported between January 2000 and June 2022. The methodological quality of the included studies was evaluated using the Cochrane risk of bias tools for each study type. For some of the outcomes, we pooled the effect size using a random-effects meta-analysis. Participants: A total of 51 studies, 33 randomized and 18 non-randomized, involving 100 746 participants were included. Results: Overall, 37 studies found a statistically significant difference in at least one dietary outcome measure favoring the intervention group, whereas 14 studies found no statistically significant difference. Our meta-analyses indicated that, compared to controls, interventions were effective in decreasing daily energy intake (MJ/day) (MD: -0.25; 95% CI: -0.37, -0.14), fat % of energy (MD: -1.01; 95% CI: -1.76, -0.25), and saturated fat % of energy (MD: -1.54; 95% CI: -2.01, -1.07). Furthermore, the interventions were effective in improving fiber intake (g/day) (MD: 1.08; 95% CI: 0.39, 1.77). Effective interventions use various strategies including tailored individual lifestyle coaching, health education, health promotion activities, community engagement activities and/or structural changes. Conclusion: This review shows the potential of improving dietary patterns through community-based CVD preventive interventions. Thus, development and implementation of context-specific preventive interventions could help to minimize dietary risk factors, which in turn decrease morbidity and mortality due to CVDs and other non-communicable diseases.

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Community-based lifestyle intervention improves metabolic syndrome and related markers among Kenyan adults

Cited by 9 publications

References 54 publications

Effectiveness of a community-based intervention in improving cardio-metabolic risk factors in adults with Metabolic Syndrome: A Randomized Controlled Trial.

Effectiveness of a community-based intervention in improving cardio-metabolic risk factors in adults with Metabolic Syndrome: A Randomized Controlled Trial.

Effectiveness of integrated chronic care models for cardiometabolic multimorbidity in sub-Saharan Africa: a systematic review and meta-analysis

Dietary outcomes of community-based CVD preventive interventions: a systematic review and meta-analysis

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