Methods

Twenty-five subjects, five males and 20 females, 20-65 years of age, were recruited forthestudy. To select people at risk for Metabolic Syndrome,

Men were required to have a waist measurement >40 inches

Women had to have a waist measurement >34.5 inches.

Moreover, all had to have two or more ofthefollowing additional symptoms of Metabolic Syndrome:

• elevated blood pressure (>130/85 mm Hg),
• elevated triglycerides (>150 mg/dl),
• elevated fasting glucose (>110 mg/dL),
• low HDL cholesterol (<50 mg/dL for females, <40 mg/dL for males).

The lifestyle change program employed in this study was developed by Dr. Ray Strand, a family practice physician in Rapid City, SD. This 12-week, internet-based program was specifically designed to help people reverse insulin resistance through dietary modification and increased exercise.

Specifically, during Weeks 1-4 oftheprogram, subjects were instructed to consume

• one low-glycaemic meal replacement shake for breakfast,
• a second shake for lunch,
• one low-glycaemic nutrition bar as a daily snack,
• and a normal, but low-glycaemic dinner prepared according to instructions

provided by Dr. Strand. During Weeks 5-12 oftheprogram, subjects consumed one low-glycaemic meal replacement shake per day, one snack bar, and two normal, but low-glycaemic meals. In addition, throughoutthe12 weeks, subjects took a multivitamin-mineral supplement daily. All meal replacement shakes, snack bars, and nutritional supplements were provided by USANA Health Sciences, Inc., Salt Lake City, UT (7). Subjects were further coached to increasetheir physical activity and to ultimately exercise at least 45 min per day, five days per week, duringthelast eight weeks oftheprogram.

To determinetheimpact ofthelifestyle program onthesubjects’ health, measurements ofthefollowing parameters were made during Baseline (Week 0), Interim (Week 6), and Final (Week 12) Visits tothestudy clinic: weight (lbs), height (in), waist circumference (in), blood pressure (mm Hg), blood cholesterol (total, LDL, HDL; mg/dL), serum triglycerides (mg/dL), plasma glucose (mg/dL), and insulin sensitivity (8).

Results

Twenty-one ofthe25 study participants showed good (>80%) compliance withthedietary and exercise recommendations oftheprogram.

Four showed relatively poor compliance.

Neverthe-less, we included data from all subjects inthestatistical analyses of results. The attached figures show

the changes in average weight, total cholesterol, serum triglycerides, systolic blood pressure, insulin sensitivity, and urinary 8-isoprostanes (a marker of oxidative stress) forthe25 participants. In addition,thefollowing results were observed.

• The average BMI of participants declined from 34 ± 5 (Baseline) to 32 ± 5 (final).
• Waist circumference declined from 41.5 ± 4.2 (Baseline) to 38.9 ± 4.4 in (Final).
• Diastolic blood pressure declined from 85 ± 7 mm Hg (Baseline) to 80 ± 7 mm Hg (Final).
• LDL cholesterol dropped from 134 ± 23 mg/dL (Baseline) to 111 ± 24 mg/dL (Final),
• while HDL cholesterol remained unchanged at 43 ± 10 mg/dL throughoutthestudy.

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