Reversal for metabolic syndrome criteria following the CHANGE program: What are the driving forces? Results from an intervention community-based study

Objective: To examine the impact of the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program on the reversal of one or more metabolic syndrome (MetS) criteria among community members with MetS and define the significant predictors of upholding individual MetS criterion from 2020 to 2023. Methods: The program enrolled 278 community members with/or at risk of MetS. Participants followed regular physical activity and a Mediterranean diet for 12 months with the assistance of a registered dietitian and a kinesiologist. A licensed practical nurse and/or registered nurse measured participants' weight, height, waist circumference, and blood pressure and withdrew blood samples for laboratory investigations. Physical activity, physical fitness, Mediterranean diet score (MDS), anthropometric measurements, and laboratory investigations were assessed at the baseline and every three months. Descriptive statistics were calculated, and binary logistic regression analysis was performed to define the significant predictors of upholding each criterion of the MetS. Results: Participants' mean age was 60.5 +/- 11.7 years, and 74.8% were females. Participants with MetS decreased by 5.04% by the end of the program. The percentage of participants with each MetS criterion showed a significant decrease at the end of the study, except for low HDL, which remained with no change. Moreover, the mean of physical activity, physical fitness tests, and MDS scores showed a significant increase after the 12 months of study. Compared to baseline, daily sedentary and screen times showed a significant decrease at the end of the program (8.6 vs. 7.2 and 3.2 vs. 2.6 hours, respectively). Logistic regression analysis revealed that age, female gender, low educational attainment, physical activity, physical fitness, and screen time were significant predictors for upholding one or more MetS criteria. Conclusion: MetS criteria can be reversed following the CHANGE program. Sociodemographic and lifestyle features are significant predictors for upholding MetS criteria. The program is cost-effective considering its low cost and could lead to significant savings on healthcare costs. Further studies among different communities are recommended to confirm the generalizability of the results.