Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome
Abstract
:1. Overview
2. Physical Activity and the Metabolic Syndrome
2.1. Observational Studies Associating Physical Activity Patterns with Metabolic Risk
2.2. Exercise Intervention Studies and the Metabolic Syndrome
2.3. Meta-Analyses of Exercise and Cardiometabolic Risk
2.4. Synopsis—Physical Activity and the Metabolic Syndrome
3. Cardiorespiratory Fitness and the Metabolic Syndrome
Synopsis—Cardiorespiratory Fitness and the Metabolic Syndrome
4. Mechanisms Underlying the Metabolic Syndrome and Implications for Physical Activity and Fitness
4.1. Pathophysiology of Metabolic Syndrome
4.2. Insulin Resistance
4.3. Adipose Fuel Metabolism
4.4. Inflammation
4.5. Genetics/Epigenetics
4.6. Circadian Disruption and Metabolic Syndrome
5. Summary
Funding
Conflicts of Interest
References
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Observational Studies | |||
Author, Year; (Reference) | N (Men/Women), Mean Age | Assessment | Key Results |
Thune, 1998; [25] | 5220/5869 34.4 and 33.7 years, respectively | PA self-report | Higher PA associated with better lipid profile, overall metabolic risk profile over 7 years |
Laaksonen, 2002; [26] | 612 men 51.4 years | Assessment of LTPA over previous 12 months among high risk men; followed for 4 years | >3 h/week moderate to vigorous LTPA half as likely as sedentary men to have MetSyn Men in top 33% VO2max 75% less likely than unfit men to develop MetSyn over 4 years |
Sisson, 2010; [27] | 697/749 47.5 years | Accelerometry | MetS prevalence decreased as steps/day increased; odds of having MetSyn were 10% lower for each additional 1000 steps/day |
Healy, 2008; [28] | 67/102 53.4 years | Accelerometer evaluation of time spent in sedentary, light, moderate-to-vigorous, and mean activity intensity in participants with diabetes and obesity | Moderate-to-vigorous activity associated with lower triglycerides. Sedentary time, light-intensity time, and exercise intensity associated with waist circumference and clustered metabolic risk |
Ekelund, 2007; [29] | 103/155 40.8 years | Accelerometry, exercise test, biometric measures on adults with a family history of type 2 diabetes | Total body movement inversely associated with triglycerides, insulin, HDL and clustered metabolic risk; moderate-and vigorous-intensity PA inversely associated with clustered metabolic risk |
Exercise Intervention Studies | |||
Author, Year | N | Intervention | Key Results |
Look AHEAD, 2013; [30] | 3063/2082 58.8 years | Subjects with type 2 diabetes randomly assigned to intensive lifestyle intervention or diabetes support and education | Intervention group had greater reductions in weight loss, glycated hemoglobin and greater initial improvements in exercise capacity and all cardiovascular risk factors (except LDL) |
Stewart, 2004; [31] | 53/62 63.6 years | 6 months of exercise training in subjects with or at high risk for MetSyn | Exercise group improved peak VO2, muscle strength, and lean body mass; reductions in total and abdominal fat related to improved CVD risk |
Katzmarzyk, 2003; [32] | 288/333 31.6 | 20 weeks of supervised aerobic exercise training | Of 105 patients with MetSyn, 30.5% were no longer classified as having metabolic syndrome after exercise training |
Balducci, 2008; [33] | 329/234 | Twice weekly aerobic & resistance training for 1 year | Exercise group improved fitness, HbA1c, and CVD risk profile |
Diabetes Prevention Program Research Group, 2002; [34] | 3234 50.6 | Lifestyle intervention (150 min/week PA and nutritional counseling) vs. Metformin vs. placebo | Lifestyle intervention group achieved a 38% reversal of MetSyn and a 41% reduction of new onset MetSyn. |
Author, Year; (Reference) | N (Men/Women) | Key Results |
---|---|---|
Carnethon, 2003; [49] | 4487 (2029/2458) | Only men and women in the highest 40% of maximal treadmill performance were protected against developing MetSyn. |
Franks, 2004; [50] | 847 men | A strong inverse association between physical activity and MetSyn. The magnitude of the association between physical activity and the MetSyn was >3-fold greater than for VO2max. |
LaMonte, 2005; [46] | 10,498 (9007/1491) | An independent and progressive decline in the risk of developing MetSyn with higher CRF for men and women. Also, 20% to 26% lower risks occurred among participants with moderate CRF and 53% to 63% lower risks observed in highest CRF categories vs. the lowest CRF category. |
Hassinen, 2008; [44] | 1347 (671/676) | Men and women in the lowest third of VO2max had 10.2 times (men) and 10.8 times (women) higher risk of having MetSyn than those in the highest VO2max category. |
Hassinen, 2010; [48] | 1226 (589/637) | Risk of developing MetSyn within 2 years of follow-up was 44% lower for each 1-SD increase in VO2 max. Each 1-SD higher VO2 max from baseline resulted in 1.8 times higher likelihood to resolve MetSyn during 2 years of follow-up. |
Earnest, 2013; [51] | 38,659 (30,927/7732) | CRF demonstrated a strong inverse relationship with MetSyn in both genders. The association was strongest in those with lower waist circumference and fasting glucose, in both genders. |
Adams-Campbell, 2016; [47] | 170 women | CRF was inversely related to the prevalence of the metabolic syndrome in overweight/obese African-American postmenopausal women. |
Ingle, 2017; [52] | 9666 men | The likelihood of developing MetSyn was approximately 50% lower in fit men compared to unfit, independent of BMI particularly in men <50 years. |
Kelly, 2018; [45] | 3636 (2007/1629) | Significant, inverse and graded association between VO2max and MetSyn. Highest fit had >20 times lower risk of having MetSyn compared to least-fit individuals. The difference in VO2max between those with MetSyn and those without was ≈ 2.5 METs. |
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Myers, J.; Kokkinos, P.; Nyelin, E. Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome. Nutrients 2019, 11, 1652. https://doi.org/10.3390/nu11071652
Myers J, Kokkinos P, Nyelin E. Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome. Nutrients. 2019; 11(7):1652. https://doi.org/10.3390/nu11071652
Chicago/Turabian StyleMyers, Jonathan, Peter Kokkinos, and Eric Nyelin. 2019. "Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome" Nutrients 11, no. 7: 1652. https://doi.org/10.3390/nu11071652