Managing Metabolic Syndrome Through Exercise

The Metabolic Syndrome (MetS) is the group of five cardiovascular (CV) risk factors that include the following: impaired fasting glucose (IFG) or Type 2 diabetes (T2D), abdominal overweight/obesity, hypertriglyceridemia (high triglycerides), low high-density lipoprotein cholesterol (HDL-C), and elevated blood pressure or hypertension (HTN). A person who has three or more of these CV risk factors would be diagnosed with MetS.

The are many underlying causes of MetS. Some research suggests that abdominal obesity and insulin resistance are the two driving forces behind the development of MetS. Physical inactivity and low levels of cardiorespiratory fitness (CRF) are also key contributors with MetS, and some believe these two may be components of MetS.

The health benefits of physical activity (PA) are well known. Research has examined the effects PA and CRF on MetS. Increased levels of PA and CRF have been shown to possibly reduce the risk of MetS. Increased levels of muscular strength from resistance training (RT) also can provide protection or management of MetS. One study indicated that engaging in enough PA and or exercise to expend 400 calories per day (brisk walking for one hour for example) can help prevent MetS.

Cross-sectional data provide an emerging picture of associations of both physical activity habits and cardiorespiratory fitness with the metabolic syndrome. With proper dietary intervention and regular exercise, blood sugar levels can fall so dramatically, studies have found, that many persons with type 2 diabetes no longer require diabetes medication.

The PA recommendations by the American College of Sports Medicine (ACSM) for adults 18 to 65 years of age provide a base for exercise prescription in adults. The current recommended level of PA for the management or prevention of MetS is 30 to 60 minutes of moderate-intensity exercise 3-7 days a week, supplemented by 2-3 days per week of RT. Examples of moderate intensity PA include walking two miles in 30 minutes. Biking four miles in 15 minutes. Going up and down stairs for 15 minutes. Resistance training should include 8-10 exercises to work all major muscle groups. Anywhere from 1-3 sets per exercise for 8-12 repetitions. Although there are no specific RT recommendations for MetS at the present time, it should be noted that RT can have specific benefits on the prevention or management of MetS, independent of aerobic exercise.

With nearly two thirds of the U.S. adult population being classified as overweight or obese and one third having IFG or T2D, it is not surprising that MetS prevalence is increasing. We know that both increased levels of PA and CRF reduce the risk of developing MetS. Exercise training should be considered an important part of therapeutic lifestyle change and may improve insulin resistance and other metabolic and cardiac risk factors.