Metabolic syndrome has been rapidly increasing throughout the world, with lifestyle being identified as the most significant risk contributing to this condition [1, 2]. Metabolic syndrome refers to the co-occurrence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia and hypertension . This increase is associated with the global epidemic of obesity and diabetes .
Owing to rapid transitions toward high energy intake and sedentary lifestyle in the past few decades, the metabolic syndrome has become a major health challenge globally. The grand problem is that at intervention completion, high-risk participants often face the challenges of compliance and sustainability. Although people are constantly exposed to an abundance of information regarding the benefits of healthy lifestyles, Americans continue to struggle with obesity, physical inactivity, and inadequate nutrition .
Additional studies revealed that certain economically disadvantaged ethnic minorities and elderly populations were at significantly higher risk for cardiovascular disease (CVD) due to unhealthy lifestyles. In addition, minority communities were reported to have greater than equal or double the risk for CVD. Compared to other populations, minorities were also at greater risk for other conditions such as hypertension, diabetes, and dyslipidemia with increased potential for obesity, poor nutrition and sedentary lifestyles [5–7].
There are specific determinants used to diagnose the metabolic syndrome. In this study, we used the National Cholesterol Education Program's Adult Treatment Panel III (NCEP: ATP III)’s definition to identify the clinical indicators: high-density lipoprotein cholesterol (HDL-C), central obesity, hypertension, high fasting glucose and high triglyceride (TG) values [8, 9]. Study subjects were diagnosed as having the metabolic syndrome if he or she had three or more of the following criteria: 1) waist circumference ≥ 90 cm for men and ≥ 80 cm for women; 2) TG ≥ 150 mg/dL; 3) HDL-C < 40 mg/dL for men and < 50 mg/dL for women; 4) blood pressure ≥ 130/85 mmHg; and 5) fasting glucose ≥ 100 mg/dL . Clinicians prefer simple guidelines with which to assess patients and improve management, and the generally accepted definition for metabolic syndrome prescribed by the NCEP: ATP-III definition is simple to use and is the preferred standard .
People at high risk for metabolic syndrome should manage dietary factors in conjunction with exercise. The basic principle for nutritional management is that the intake of saturated fat, trans-fats and cholesterol is low, the consumption of simple sugars is reduced, and the consumption of fruits, vegetables and whole grains is increased, resulting in positive outcomes which have been demonstrated through various studies [10, 11].
In the current literature, research findings indicated that in the United States, there have been persistent racial and ethnic disparities in CVD morbidity and mortality. National efforts have given attention to reducing these disparities; but the cause of long-term health disparities remains unknown . A number of community-based interventions have consistently emerged in research literature with moderate success. Considering a different approach, this intervention incorporated cultural and religious sensitivity in order to design a faith-based component as one of the constructs for lifestyle health success. Numerous commercially designed lifestyle programs have been conducted in minority and ethnic-church congregations but these programs typically do not use faith as a motivating factor for lifestyle health behavioral change. Therefore, this study was designed incorporating faith engagement as a key fundamental motivation of lifestyle change.
Health behavior research in the African-American/Afro-Caribbean community suggests a strong correlation between health and religious beliefs. A qualitative study conducted with members of an African-American church community in South Carolina, identified faith as an enabler to increase physical activity . Within the African-American/Afro-Caribbean community faith is an essential part of the culture, therefore programs that address this component have a greater potential for a positive impact on behavioral change . Extensive research within this cultural context indicates that faith-based initiatives have typically utilized trained lay personnel or health professionals to promote health risk prevention in the church/community-based setting.
The objective of this study was to examine the validity of the Fit 4 You Retreat Lifestyle Intervention program. This intervention integrates the unique elements of the African-American/Afro-Caribbean culture like faith and gospel music with health principles such as plant-based nutrition, physical activity, and health education to enhance compliance and reduce risk factors associated with metabolic syndrome.