The metabolic syndrome and associated lifestyle factors among the Iranian population


1 Department of Metabolic Syndrome, Isfahan University of Medical Sciences, Isfahan, Iran

2 Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Cardiac Rehabilitation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Research, Isfahan University of Medical Sciences, Isfahan, Iran

5 Intervenetional Cardiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Iran

6 Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

7 Department of Cardiology, Shahrekord University of Medical Sciences, Shahrekord, Iran


Background: This study aims to evaluate the impact of the Isfahan Healthy Heart Program (IHHP) interventions concerning healthy behavior, on the prevalence of the metabolic syndrome (MetS) and its components in the Iranian population.
Materials and Methods: The IHHP targeted the population at large in three districts in central Iran from 2000 to 2007. Numerous interventional activities were performed to improve lifestyle. The main intervention strategies were public education through mass media, intersectional cooperation, health professional education, marketing and organizational development, legislation and policy development, as well as research and evaluation. MetS was defined based on the Adult Treatment Panel (ATP) III definition. The logistic regression method was applied to explore the relationship between lifestyle factors with components of metabolic risk factors.
Results: The mean age of the participants was 44.68 ± 14.43 years in 2001. The mean values of the MetS components differed from 2001 to 2007. The mean of systolic blood pressure (SBP) decreased from 126.7 ± 22.31 to 124.21 ± 20.0 and from 129.47 ± 23.08 to 126.26 ± 21.88 among females in both the intervention and reference areas. Similar changes were observed among males. The mean diastolic blood pressure (DBP) and triglycerides decreased significantly in the intervention area and increased significantly in the reference area in both sexes. High density protein cholesterol (HDL-C) was decreased in both sexes, from 2001 to 2007, in both areas. A strong relationship between tobacco control with high SBP and hypertriglyceridemia was found (P < 0.01).
Conclusion: Lifestyle improvement programs could be useful to improve the MetS status among men and women.


Sarrafzadegan N, Sayed-Tabatabaei FA, Bashardoost N, Maleki A, Totonchi M, Habibi HR, et al. The prevalence of coronary artery disease in an urban population in Isfahan, Iran. Acta Cardiol 1999;54:257-63.  Back to cited text no. 1
Gharipour M, Sarrafzadegan N, Sadeghi M, Andalib E, Talaie M, Shafie D, et al. Predictors of metabolic syndrome in the Iranian population: waist circumference, body mass index, or waist to hip ratio? Cholesterol 2013;2013:198384.  Back to cited text no. 2
Tavassoli AA, Gharipour M, Khosravi A, Kelishadi R, Siadat ZD, Bahonar A, et al. Gender differences in obesogenic behaviour, socioeconomic and metabolic factors in a population-based sample of Iranians: The IHHP Study. J Health Popul Nutr 2010;28:602-9.  Back to cited text no. 3
Gharipour M, Sarrafzadegan N, Sadeghi M, Andalib E, Talaie M, et al. Predictors of metabolic syndrome in the Iranian population: waist circumference, body mass index, or waist to hip ratio? Cholesterol. 2013;2013:198384  Back to cited text no. 4
Giri M. Medical management of obesity. Acta Clin Belg 2006;61:286-94.  Back to cited text no. 5
Panagiotakos DB, Pitsavos C, Chrysohoou C, Skoumas J, Tousoulis D, Toutouza M, et al. Impact of lifestyle habits on the prevalence of the metabolic syndrome among Greek adults from the ATTICA study. Am Heart J 2004;147:106-12.  Back to cited text no. 6
Gharipour M, Kelishadi, R, Khosravi A, Shirani S, Masjedi M, Sarrafzadegan N. The impact of a community trial on the pharmacological treatment in the individuals with the metabolic syndrome: Findings from the Isfahan Healthy Heart Program, 2001-2007. Arch Med Sci 2012;8:1009-17.  Back to cited text no. 7
Iseki K. Metabolic syndrome and chronic kidney disease: A Japanese perspective on a worldwide problem. J Nephrol 2008;21:305-12.  Back to cited text no. 8
Baghaei A, Sarrafzadegan N, Rabiei K. How effective are strategies for non-communicable disease prevention and control on high risk population in a developing country Isfahan Healthy Program. Arch Med Sci 2010;6:24-31.  Back to cited text no. 9
Ebrahim S, Beswick A, Burke M, Davey SG. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database Syst Rev 2006;4:CD001561.  Back to cited text no. 10
Sarrafzadegan N, Sadri GH, Malek Afzali H, Baghaei M, Mohammadi Fard N, Shahrokhi S, et al. Isfahan Healthy Heart Programme: A comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience. Acta Cardiol 2003;58:309-20.  Back to cited text no. 11
Sarrafzadegan N, Baghaei AM, Sadri GH, Kelishadi R, Malekafzali H, Boshtam M. Isfahan Healthy Heart Program: Evaluation of comprehensive, community-based interventions for non-communicable disease. Prev Control J 2006;2:73-84.  Back to cited text no. 12
Sarrafzadegan N, Kelishadi R, Esmaillzadeh A, Mohammadifard N, Rabiei K, Roohafza H, et al. Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran. Bull World Health Organ 2009;87:39-50.  Back to cited text no. 13
Mohammadifard N, Kelishadi R, Safavi M, Sarrafzadegan N, Sajadi F, Sadri GH., Effect of a community-based intervention on nutritional behavior in a developing country setting: The Isfahan Healthy Program. Public Health Nutr 2009;17:1-9.  Back to cited text no. 14
Sarrafzadegan N, Azadbakht L, Mohammadifard N, Esmaillzadeh A, Safavi M, Sajadi F, et al. Do lifestyle interventions affect dietary diversity score in the general population? Public Health Nutr 2009;12:1924-30.  Back to cited text no. 15
Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001;285;2486-97.  Back to cited text no. 16
Liu K, Daviglus ML, Loria CM, Colangelo LA, Spring B, Moller AC, et al. Healthy lifestyle through young adulthood and the presence of low cardiovascular disease risk profile in middle age: The Coronary Artery Risk Development in (Young) Adults (CARDIA) study. Circulation 2012;125:996-1004.  Back to cited text no. 17
Cornier MA, Dabelea D, Hernandez TL, Lindstrom RC, Steig AJ, Stob NR, et al. The metabolic syndrome. Endocr Rev 2008;29:777-822.  Back to cited text no. 18
Miyatake N, Fujii M, Miyachi M, Tabata I, Takeshi S, Hirao T, et al. Changes in metabolic syndrome and its components with lifestyle modification in Japanese men. Intern Med 2010;49:261-5.  Back to cited text no. 19
Wagh A, Stone NJ. Treatment of metabolic syndrome. Expert Rev Cardiovasc Ther 2004;2:213-28.  Back to cited text no. 20
TPelikánova T. Treatment of diabetes in metabolic syndrome. Vnitr Lek 2009;55:637-45.  Back to cited text no. 21
Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev 2011;2:CD007506.  Back to cited text no. 22
Ilanne-Parikka P, Laaksonen DE, Eriksson JG, Lakka TA, Lindstr J, Peltonen M, et al. Finnish Diabetes Prevention Study Group. Leisure-time physical activity and the metabolic syndrome in the Finnish diabetes prevention study. Diabetes Care 2010;33:1610-7.  Back to cited text no. 23
Kirkendoll K, Clark PC, Grossniklaus D, Igho-Pemu P, Mullis R, Dunbar SB. Metabolic syndrome in African Americans: Views on making lifestyle changes. J Transcult Nurs 2010;21:104-13.  Back to cited text no. 24
Gulseth HL, Gjelstad IM, Tierney AC, Shaw DI, Helal O, Hees AM, et al. Dietary fat modifications and blood pressure in subjects with the metabolic syndrome in the LIPGENE dietary intervention study. Br J Nutr 2010;104:160-3.  Back to cited text no. 25