In the Diabe tes Prevention Program Trial, lifestyle modification led to 38% resolution of MetS after 3 years. In contrast, only minimal resolution of MetS was seen in PD173955? the Diabetes Pre vention Program Trial after one year with either met formin or lifestyle management. Our study suggests that by complementing a therapeutic lifestyle program with a soy and phytosterol based powdered beverage and tablets containing hops RIAA and acacia PAC, subjects can improve to a similar magnitude attained at 2 and 3 years in just 12 weeks. Most therapeutic treatments for hypercholesterolemia focus on achieving Inhibitors,Modulators,Libraries LDL goals recommended by NCEP. However, the NHANES 2003 2004 showed that despite better control of LDL, other lipid risk factors remained suboptimal in many US adults, particularly among those with CVD, diabetes, or MetS.

Non HDL cholesterol, a stronger predictor of CVD and mortality risk than LDL, has now been added by the NCEP Adult Treat ment Panel III as a secondary target of therapy. In addition, because apo B indicates the total number of atherogenic lipoprotein particles and apo A I, a major lipoprotein in HDL, has a critical role in reverse choles terol transport, the apo B apo Inhibitors,Modulators,Libraries A I has been proposed as a risk factor for CVD. Increasing evidence from multiple studies has repeatedly shown that the apo B apo A I predicts cardiovascular risk the lower the ratio, the lower Inhibitors,Modulators,Libraries is the risk and is a better marker than LDL and lipid ratios. In the Inter Heart study, the apo B apo A I was the strongest determi nant of MI risk, even higher than smoking. the OR of top vs.

lowest decile was 4. 73. The authors state the apo B apo A I might be the best marker of the balance of atherogenic Inhibitors,Modulators,Libraries and antiatherogenic particles. Subjects in both PED and MED arms showed significant reduction in non HDL cholesterol and apo B apo A I at 8 weeks com pared to baseline, but only the PED arm showed contin ued reduction in the ratio at 12 weeks. These data suggest further cardiovascular benefit from the added phytochem icals. Conclusion The worldwide prevalence and multi factorial nature of MetS do not reasonably support a pharmacologic approach for treatment or prevention. Fortunately, life style modification including dietary alteration has dem onstrated success in correcting metabolic abnormalities associated with the development of type 2 diabetes and CVD.

The present study provides evidence that supple mentation of a modified Mediterranean style, low glyc emic load diet with a combination Inhibitors,Modulators,Libraries of phytochemicals addressing multiple inflammatory and insulin signaling nearly pathways simultaneously may be a novel, effective means to managing MetS. This comprehensive, supplemented lifestyle program represents a potentially powerful approach to the management of at risk individuals with MetS and hypercholesterolemia.