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Structured hypocaloric diet is more effective than behavioral therapy in reducing metabolic syndrome in Mexican postmenopausal women: a randomized controlled trial

Perichart-Perera, Otilia PhD, RDN1; Balas-Nakash, Margie MSc1; Muñoz-Manrique, Cinthya MSc1; Legorreta-Legorreta, Jennifer BS1; Rodríguez-Cano, Ameyalli MCN1; Mier-Cabrera, Jennifer PhD1; Aguilera-Pérez, Jesús Rafael MD2

doi: 10.1097/GME.0000000000000160
Original Articles

Objective This study aims to compare the effects of a lifestyle intervention using a behavioral therapy (BT) approach with the effects of a cardioprotective structured hypocaloric diet on metabolic syndrome in Mexican postmenopausal women.

Methods This study is a randomized clinical trial (2006-2009) of Mexican postmenopausal women with metabolic syndrome (Adult Treatment Panel III criteria) who were recruited from the Postmenopause Clinic of the National Institute of Perinatology in Mexico City. Women were assigned to one of two groups—group 1 (structured hypocaloric diet; n = 63): energy restriction (−300 to −500 kcal/d) emphasizing cardioprotective dietary changes; and group 2 (BT; n = 55): goal setting, problem-solving, and stimulus control to achieve cardioprotective dietary and lifestyle recommendations. Metabolic syndrome prevalence, as well as weight, waist circumference, fat mass, and fasting biochemical markers (glucose and lipid profile), were measured at baseline and at 2, 4, and 6 months after the intervention. Metabolic syndrome risk (relative risk and absolute risk reduction), mean differences between groups, and logistic regression were evaluated using Statistical Package for the Social Sciences software, version 17.0.

Results A total of 118 women were studied (mean [SD] age, 53.81 [6.43] y). No baseline differences were observed between groups. At the end of the study, a higher reduction in metabolic syndrome prevalence was observed in group 1 (−38.1%) compared with group 2 (−12.7%; relative risk, 0.237; 95% CI, 0.092-0.608; P = 0.003). The effect was maintained even when adjusted by age, hormone therapy and antihypertensive drug use.

Conclusions A cardioprotective structured hypocaloric diet is more effective than the BT approach in reducing metabolic syndrome after 6 months of intervention. Both strategies have positive effects on different individual cardiovascular risk factors.

From the 1Nutrition and Bioprogramming Department, Torre de Investigación, Mexico City, Mexico; and 2Postmenopause Clinic, Instituto Nacional de Perinatología, Lomas de Virreyes, Mexico City, Mexico.

Received July 16, 2013; revised and accepted October 18, 2013.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Otilia Perichart-Perera, PhD, RDN, Nutrition and Bioprogramming Department, 2° piso, Torre de Investigación, Instituto Nacional de Perinatología, Montes Urales 800, Lomas de Virreyes, Mexico City CP 11000, Mexico. E-mail:

© 2014 by The North American Menopause Society.