Adherence

Personalized diet counseling interventions that emphasize specific food substitutions (e.g., poultry over red meat, increased plant protein, increased fish, increased olive oil, increased fruits and vegetables, eating breakfast, increased milk/alternatives, healthier fats, healthier snacks, and increased nuts) are associated with significantly improved diet quality (HEI-C) in patients with metabolic syndrome.

For patients with metabolic syndrome, diet counseling is most effective when it focuses on specific food swaps (like eating more fish, poultry, plants, and nuts) and habits (like eating breakfast) rather than general 'balanced meal' advice. Additionally, counselors should prioritize self-monitoring and reviewing past successes over frequent goal setting, as these techniques are linked to better diet quality improvements.