Exercise in Obesity, Metabolic Syndrome, and Diabetes

https://doi.org/10.1016/j.pcad.2011.03.013Get rights and content

Abstract

The risk of developing both metabolic syndrome and type 2 diabetes mellitus (T2DM) is inversely associated with regular exercise training (ET). Excess weight is also strongly associated with increased risk of both metabolic syndrome and T2DM. There is strong evidence that even a moderate amount of weight loss achieved through changes in diet and ET can greatly reduce the risk of developing T2DM.

For the purpose of general health, exercise programs should have both aerobic and resistance training components. The 2008 federal physical activity (PA) guidelines recommend obtaining at least 150 minutes per week of moderate-intensity PA, 75 minutes per week of vigorous-intensity PA, or a combination of the 2. In addition, all individuals should strive for at least 2 days per week of resistance training activity. For the purpose of weight loss, the combination of ET and reduced energy intake has been found to be more effective than either alone.

Section snippets

MetS, Weight, and ET

The MetS is typically defined as a clustering of abnormal levels of lipids (high-density lipoprotein cholesterol and triglycerides), glucose, blood pressure, and excess abdominal obesity. Given that abdominal obesity is a component of the definition of MetS, it makes sense that excess weight is a strong risk factor for its development. In the cross-sectional studies that examined the prevalence of metabolic equivalents (METs) across levels of physical activity (PA; Fig. 1A), all found an

Diabetes, ET, and weight loss

There are very strong epidemiologic data demonstrating that both regular ET and maintaining a healthy weight greatly reduce the risk of developing T2DM.24, 25, 26 Furthermore, within individuals with T2DM, maintaining higher levels of fitness is associated with reduced risk of developing cardiovascular disease (CVD).27, 28 As demonstrated in Fig. 3, although there is a strong inverse trend for risk of CVD mortality across levels of fitness; in the lower levels of fitness, each 1-MET increment

Exercise prescription for general health and weight loss

As stated in the 2008 Physical Activity Guidelines, regular ET has meaningful health benefits for individuals of any weight.34 These guidelines suggest that individuals should strive to achieve at least 150 minutes per week of moderate-intensity PA combined with at least 2 days per week of RT activity. However, for those that prefer to participate in vigorous-intensity PA, the minimal weekly goal is only 75 minutes or more per week.

There is sufficient evidence to conclude that ET interventions,

Summary

Regular ET has meaningful health benefits for individuals of any weight. For the purpose of general health, ET programs should have both aerobic ET and RT components. The 2008 federal PA guidelines suggest that individuals should strive to achieve at least 150 minutes per week of moderate-intensity PA, or for those that prefer to participate in vigorous-intensity PA, the minimal weekly goal is only 75 minutes or more per week. All individuals should also strive for at least 2 days per week of

Statement of Conflict of Interest

The author declares that there is no conflict of interest.

References (46)

  • K.G. Alberti et al.

    The metabolic syndrome—a new worldwide definition

    Lancet

    (2005)
  • S. Zhu et al.

    Lifestyle behaviors associated with lower risk of having the metabolic syndrome

    Metabolism

    (2004)
  • M. Halldin et al.

    The metabolic syndrome: prevalence and association to leisure-time and work-related physical activity in 60-year old men and women

    Nutr Metab Cardiovasc Dis

    (2007)
  • Centers for Disease Control and Prevention

    National Diabetes Fact Sheet, General Information and National Estimates on Diabetes in the US, 2007

    Centers for Disease Control and Prevention

    (2007)
  • Centers for Disease Control and Prevention

    National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2000

    (2002)
  • Expert Panel on Detection EaToHBCiA

    Executive Summary of Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

    JAMA

    (2001)
  • K.G. Alberti et al.

    Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation

    Diabet Med

    (1998)
  • B. Balkau et al.

    Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR)

    Diabet Med

    (1999)
  • US Department of Health and Human Services

    Physical Activity Guidelines Advisory Committee Report 2008. Washington, D.C.

    (2008)
  • T.A. Lakka et al.

    Sedentary lifestyle, poor cardiorespiratory fitness, and the metabolic syndrome

    Med Sci Sports Exerc

    (2003)
  • E.S. Ford et al.

    Sedentary behavior, physical activity, and the metabolic syndrome among U.S. adults

    Obes Res

    (2005)
  • S. Carroll et al.

    Metabolic clustering, physical activity and fitness in nonsmoking, middle-aged men

    Med Sci Sports Exerc

    (2000)
  • S. Bertrais et al.

    Sedentary behaviors, physical activity, and metabolic syndrome in middle-aged French subjects

    Obes Res

    (2005)
  • M.L. Irwin et al.

    Physical activity and the metabolic syndrome in a tri-ethnic sample of women

    Obes Res

    (2002)
  • U. Ekelund et al.

    Physical activity energy expenditure predicts progression toward the metabolic syndrome independently of aerobic fitness in middle-aged healthy Caucasians: the Medical Research Council Ely Study

    Diabetes Care

    (2005)
  • D.E. Laaksonen et al.

    Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome

    Diabetes Care

    (2002)
  • M.R. Carnethon et al.

    Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors

    JAMA

    (2003)
  • I. Ferreira et al.

    The metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness: the Amsterdam Growth and Health Longitudinal Study

    Arch Intern Med

    (2005)
  • M.J. LaMonte et al.

    Influence of cardiorespiratory fitness on the association between C-reactive protein and metabolic syndrome prevalence in racially diverse women

    J Womens Health (Larchmt )

    (2005)
  • R. Jurca et al.

    Associations of muscle strength and aerobic fitness with metabolic syndrome in men

    Med Sci Sports Exerc

    (2004)
  • R. Jurca et al.

    Association of muscular strength with incidence of metabolic syndrome in men

    Med Sci Sports Exerc

    (2005)
  • K. Wijndaele et al.

    Muscular strength, aerobic fitness, and metabolic syndrome risk in Flemish adults

    Med Sci Sports Exerc

    (2007)
  • L.E. Davidson et al.

    Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial

    Arch Intern Med

    (2009)
  • Cited by (138)

    • Role of exercise in the prevention and treatment of metabolic syndrome

      2023, Metabolic Syndrome: From Mechanisms to Interventions
    • ROLE OF HERBS IN METABOLIC SYNDROME

      2024, AAP Advances in Nutraceuticals: The Flavonoids: Extraction and Applications
    View all citing articles on Scopus

    Statement of Conflict of Interest: see page 417.

    View full text