Metabolic Syndrome And Exercise

The relatively recent recognition of the metabolic syndrome as a clinically definable entity implies that few studies are available that address the specific effects of exercise training on the prevalence of metabolic syndrome. To our knowledge, there is only one exercise-training study that has published data analyzed (post hoc) based on the new ATP III definition of metabolic syndrome. This study is the Heritage Family Study11. The Heritage Family Study was a multicenter study, including a large number of individuals across a large age range (18-65 yr) in African American and Caucasian men and women. Complete data were available on 621 subjects who completed the exercise training. Of these, 105 had metabolic syndrome as defined by ATP III. The race and gender distribution coupled with the wide age range of study participants in this trial makes the findings likely generalizable to a large portion of the U.S. adult population. Furthermore, the research design emphasized close attention to the details of measurement and quality control within and between sites, strengthening the validity of the conclusions.31 Of pertinence, the exercise exposure was very carefully monitored and standardized with the data presented representing those individuals who completed 95 percent or more of the prescribed exercise sessions.

In the Heritage Family Study, of the 105 subjects who had the ATP III definition of metabolic syndrome (waist circumference, fasting, triglycerides, HDL-C and glucose, and blood pressure), nearly one third (30.5 percent, 32 of the 105) were no longer defined as having metabolic syndrome after the exercise-training program of 20 weeks. This was a highly physiologically, clinically, and statistically significant effect. It is particularly impressive, given that the exercise stimulus was of a fairly modest weekly amount (likely very similar total amount of exercise as approximately 30 min of moderate-intensity exercise six days per week) and was of a relatively modest training duration. In Figure 4.1, the prevalence of individual risk factors and the prevalence of metabolic syndrome is shown with both before and after prevalence rates. Of the five risk factors, all except the prevalence of low HDL-C were significantly decreased with exercise training. In individuals with a clustering of metabolic syndrome risk factors (i.e., three or more risk factors), the prevalence of metabolic syndrome was even more substantially reduced with the exercise-training intervention than any of the individual risk factors. In Table 4.4, the prevalence percentages for each of the five risk factors are shown individually for each subject subgroup (black men, white men, black women, and white women). The consistency of the exercise effects on metabolic syndrome across race and gender subgroups and over a large range of ages emphasize, as did the previous cross-sectional studies, the strong generalizability of these effects.

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