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Managing pediatric metabolic syndrome: a systematic review of current approaches.

  • 2025-05-28
  • BMC pediatrics 25(1)
    • Kasra Talebi Anaraki
    • Motahar Heidari-Beni
    • Mehrnoosh Arefian
    • Roya Kelishadi

Study Design

Type
Systematic Review
Population
children with metabolic syndrome
Methods
a systematic search was conducted in Medline, Scopus, Embase, Web of Science, and Google Scholar up to April 15, 2025. All interventional studies that had assessed the effects of lifestyle modifications, pharmacological interventions in the management of pediatrics MetS were included

Background

There are various pharmacological and non-pharmacological approaches in the management and treatment of metabolic syndrome (MetS). We aimed to systematically review the effect of different approaches in the management of pediatric MetS.

Methods

A systematic search was conducted in Medline, Scopus, Embase, Web of Science, and Google Scholar up to April 15, 2025. All interventional that had assessed the effects of lifestyle modifications in terms of changes in dietary habits, increased physical activity, and pharmacological interventions in the management of pediatrics MetS were included.

Results

Among 1701 records found in the databases, 31 articles were included. Lifestyle modification, physical exercise, and dietary habits alteration were the commonest effective approaches in modulating MetS. The Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets improved the metabolic profile of MetS and reduced its prevalence. Metformin was the most frequently prescribed medication that was prescribed for pediatric MetS. However, its efficacy alone in comparison to lifestyle modifications remains to be determined. The effect of omega-3 supplements on the metabolic profile of MetS cases was inconsistent, but vitamin D supplementation was shown to have some favorable effects. Natural products such as fermented camel milk, grape juice, and pomegranate juice did not show any significant improvement in pediatric MetS.

Conclusion

Multidisciplinary lifestyle modification is considered the first recommendation for the prevention and management of MetS in childhood. Metformin can be an effective adjuvant therapy to lifestyle modifications in some cases of MetS, especially in children with other comorbidities.

Trial code

CRD42024502835.

Research Insights

  • Pomegranate→Improved Metabolic Health

    Natural products such as fermented camel milk, grape juice, and pomegranate juice did not show any significant improvement in pediatric MetS

    Effect
    Neutral
    Effect size
    Small
  • Vitamin D→Improved Metabolic Health

    Natural products such as fermented camel milk, grape juice, and pomegranate juice did not show any significant improvement in pediatric MetS

    Effect
    Neutral
    Effect size
    Small
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