Metabolic Syndrome How Exercise Can Be Medicine

One third of the US adult population is affected by metabolic syndrome (MetS), a cluster of events – prediabetes, prehypertension, increased waist measurement, and dyslipidemia – that can lead to type 2 diabetes and cardiovascular disease. 

Thirty-five percent of those adults with metabolic syndrome take, at minimum, two or more daily medications to assist in controlling those conditions associated with MetS – with the potential for adverse drug interaction side effects.

Exercise, as part of a healthy lifestyle modification program, can help to reduce the burden of polypharmacy – many medications taken simultaneously – on MetS individuals. 

University researchers in Spain, reporting in the July 2021 issue of Medicine & Science in Sports & Exercise, sought to determine the effects of a 5-year exercise intervention on MetS, health-related variables, and medication use. 

Using a randomized, controlled trial, 64 middle-age men and women with MetS, who were physically inactive (less than150 minutes per week of moderate-intensity physical activity) were allocated to three alternate day exercise sessions per week or a standard care group – with a block on age, number of MetS factors, and body mass index (BMI). 

The researchers analyzed data at the start of program, and after a 5-year follow-up – using data from a previously published 2-year follow-up. The intervention period lasted 4 month each year of the 5-year period.

The exercise session included a 10-min warm-up at 70% of peak heart rate (HRmax) followed by four 4-min intervals at 90% of HRmax interspersed with 3-min active recovery at 70% of HRmax and a 5-min cooldown period. Heart rate (HR) was continuously displayed on a large screen – with participants self-adjusting the workload to reach their individual HR target value. 

At baseline and at the conclusion of the 5-year intervention period, the study participant’s height, weight, waist circumference, and body composition were assessed. Lab values for serum glucose, insulin, lipid levels (triglyceride, total, HDL, and LDL cholesterol) were obtained – along with a 3-day nutritional diary, which was analyzed for calorie intake and macronutrient composition.

Additionally, the participants, who were under the care of their primary physician for MetS medication and lifestyle guidelines, underwent a maximal, graded cardiopulmonary exercise test to assess heart rate max (HRmax) and maximum oxygen uptake (VO2 Max).

The Spanish researchers concluded that, “exercise training can attenuate (reduce) the increase in medication that would be otherwise required to manage MetS over a 5-yr period. These findings have potential for translation into a real-life scenario, because benefits were observed with only 4 months of supervised training per year and with no concomitant body weight loss or dietary intervention.”

The take-away message is exercise is medicine, when performed under appropriate guidelines, as outlined by your healthcare professional. 

Interested in Reading More? Check out Waist-to-Height Ratio’s (WHtR) Connection to Disease