Introduction In Japan, a new screening and intervention program specifically targeting the metabolic syndrome has been conducted since April 2008. The aim of the study was to evaluate the effects of a 6 month lifestyle modification program on metabolic parameters and dietary patterns in the rural Japanese over 40 years old.

Methods 159 rural inhabitants over 40 years old with metabolic syndrome risk factors, were randomly allocated into intensive intervention (n=79) and standard care control (n=80) groups. The subjects in the intervention group participated in a 6-month lifestyle modification program consisting of health education, exercise, diet, or counselling every month with self-monitoring body weight, blood pressure and fasting blood glucose (FBG) everyday, whereas those in the control group participated in a standard care program consisting of health education without self-monitoring. Food frequency questionnaires and health examination were conducted before and after the program.

Results The participants in the intervention group showed significant reductions in daily intake of carbohydrates (p<0.05) and fruits (p<0.01), body weight (p<0.001), waist circumference (p<0.001), systolic and diastolic blood pressure (both p<0.001), FBG (p<0.05), haemoglobin A1c (p<0.05), triglyceride (p<0.001) and a significant gain in HDL-cholesterol (p<0.001), whereas those in the control group showed significant reductions only in body weight (p<0.001), waist circumference (p<0.001), systolic and diastolic blood pressure (p<0.05 and p<0.001, respectively). The men in the intervention group showed significant reductions in daily intake of alcohol (p<0.05).

Conclusion The intensive intervention program was more effective in reducing multiple metabolic parameters and dietary consumption than the standard care one.