#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The role of exercise therapy and physical fitness in prevention and treatment of metabolic syndrome


Authors: H. Svačinová
Authors‘ workplace: Klinika funkční diagnostiky a rehabilitace Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta prof. MUDr. Jarmila Siegelová, DrSc.
Published in: Vnitř Lék 2005; 51(1): 87-92
Category: Reviews

Overview

Regimen measures including increase of physical activity and weight reduction are of crucial importance in the metabolic syndrome treatment since they influence directly its causes. As documented by numerous retrospective epidemiologic studies, physical inactivity and low physical fitness (except abdominal obesity and other factors) leads to the development of metabolic syndrome as a complex of the cardiovascular diseases risk factors. Moreover, physical inactivity seems to be more serious risk than abdominal obesity. The submitted work presents an overview of epidemiologic studies results related to the evaluation of physical activity level and cardiorespiratory fitness in prevention of individual metabolic syndrome components and the relation of these indicators to the degree of the compounding of these abnormalities. Positive influence of aerobic physical activity in the metabolic syndrome treatment lies in the decrease of insulin resistance through the activation of glucose transporters (GLUT – 4) in skeletal muscles and probably also through the change in muscular morphology (change in muscle fibres IIb to IIa); the involvement of the highest possible number of muscle groups and regular repetition of physical activity is an important condition of its positive influence. Increased insulin sensitivity leads to further adaptation changes in metabolism (blood lipids, visceral fat, glucose tolerance), in cardiovascular area (blood pressure, heart rate) and to the possibility to influence positively the sympathovagal dysbalance accompanying the metabolic syndrome. Regarding the exercise therapy administration to the metabolic syndrome patients, there can be used the rules outgoing of the recommendations of American Diabetes Association, taking account also of the series of limitations arising from the associated obesity, hypertension, type 2 diabetes, specific diabetic complications etc. Exercise therapy should be dosed similarly to any other kind of therapy and different effects can be expected from different doses. In clinical practice it is important to decide what type of exercise therapy, what intensity, duration and frequency we chose for the patient in order to offer him a therapy which will be safe, available, acceptable also from the psychological aspect and at the same time lead to the a positive effect.

Key words:
metabolic syndrome – insulin resistance – exercise therapy – physical inactivity – cardiorespiratory fitness


Sources

1. ACSM (American College of Sports Medicine). Exercise and Type 2 Diabetes. Position Stand. Med Sci Sports Exerc 2000; 7: 1345–1360.

2. American Diabetes Association. Physical activity. Exercise and Diabetes mellitus. Diabetes care 2003; 26 (Suppl 1): S73–S76.

3. Banks EAJr, Brozinick JT, Yaspelkis BB 3rd et al. Muscle glucose transport, GLUT-4 content, and degree of exercise training in obese Zucker rats. Am J Physiol 1992; 263: E1010–E1015.

4. Blair SN, Cheng Y, Holder SJ. Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exerc 2001; 33 (Suppl 6): S379–S399.

5. Blair SN, Kampert JB, Kohl HW III et al. Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-Cause Mortality in Men and Women. JAMA 1996; 276 (3): 205–210.

6. Dela F, Ploug T, Handberg A et al. Physical training increases GLUT–4 protein and mRNA in patients with NIDDM. Diabetes 1994; 43: 862–865.

7. Dengel DR, Pratley RE, Hagberg JM et al. Distinct effects of aerobic exercise training and weight loss on glucose homeostasis in obese sedentary men. J Appl Physiol 1996; 81: 318–325.

8. Eriksson J, Taimela S, Koivisto VA. Exercise and the metabolic syndrome. Diabetologia 1997; 40: 125–135.

9. Fletcher GF, Balady G, Blair SN et al. American Heart Association. Statement on Exercise: Benefits and Recommendations for Physical Activity Programs for All Americans. Circulation 1966; 94: 857–862.

10. Fluckey JD, Hickey MS, Brambrink JK et al. Effects of resistance exercise on glucose tolerance in normal and glucose-intolerance subjects. J Appl Physiol 1994; 77: 1087–1092.

11. Haapanen N, Miilunpalo S, Vuori OP et al. Association of leisure time physical activity with the a risk of coronary heart disease, hypertension and diabetes in middle-aged men and women. Int J Epidemiol 1998; 27: 335–336.

12. Hejnová J, Majerčík M, Richterová B et al. Vliv silově dynamického tréninku na inzulinovou rezistenci u jedinců s obezitou a diabetem II. typu. DMEV 2003; Suppl 3: 38.

13. Helmrich SP, Ragland DR, Leung RW et al. Physical activity and reduced occurrence of non-insulin dependent diabetes mellitus. N Engl J Med 1991; 325 (3): 147–155.

14. Henriksen EJ. Invited review: effects of acute exercise and exercise training on insulin resistance. J Appl Physiol 2002; 93: 788–796.

15. Holloszy JO, Schultz J, Kusnierkiewicz J et al. Effects of exercise on glucose tolerance and insulin resistance. Acta Med Scand 1986; Suppl 711: 55–65.

16. Houmard JA, Shinebarger MH, Dolan PL et al. Exercise training increases GLUT-4 protein concentration in previously sedentary middle-aged men. Am J Physiol 1993; 264: E896–E901.

17. Howorka K, Pumprla J, Haber P et al. Effects of physical training on heart rate variability in diabetic patients with various degrees of cardiovascular autonomic neuropathy. Cardiovasc Res 1997; 34: 206–214.

18. Hughes VA, Fiatrone MA, Fielding RA et al. Exercise increases muscle GLUT-4 levels and insulin action in subjects with impaired glucose tolerance. Am J Physiol 1993; 264: E855–E862.

19. Ivy JL. Role of Exercise Training in the Prevention and Treatment of Insulin Resistance and Non–Insulin–Dependent Diabetes Mellitus. Sports Med 1997; 24 (5): 321–336.

20. Kelley DE, Goodpasture BH. Effects of exercise on glucose homeostasis in Type 2 diabetes mellitus. Med Sci Sports Exerc 2001; 33 (Suppl 6): S495–S501.

21. Laaksonen DE, Lakka HM, Salonen JT et al. Low Levels of Leisure-Time Physical Activity and Cardiorespiratory Fitness predict development of the Metabolic Syndrome. Diabetes Care 2002; 25 (9): 1612–1618.

22. Lakka TA, Laaksonen DE, Lakk HM et al. Sedentary Life Style, Poor Cardiorespiratory Fitness, and the Metabolic Syndrome. Med Sci Sports Exerc 2003; 8: 1279–1286.

23. LaRovere MT, Bersano C, Gnemmi M et al. Exercise inducted Increase in Baroreflex Sensitivity predicts Improved Prognosis after myocardial Infarction. Circulation 2002; 106: 945–949.

24. Laukkanen JA, Lakka TA, Raurama P et al. Cardiovascular fitness as a predictor of mortality in men. Arch Intern Med 2001; 26, 161: 825–831.

25. Lee DD, Blair SN, Jackson AS. Cardiorespiratory fitness, body composition, and all cause and cardiovascular disease mortality in men. Am J Clin Nutr 1999; 69: 373–380.

26. Lee IM, Rexrode KM, Cook NR et al. Physical activity and coronary heart disease in women: is „no pain, no gain“ passe? JAMA 2001; 285: 1447–1454.

27. Levine BD, Friedman DB, Blomquist CG et al. Exercise. In: Willerson JT, Cohn JN. Cardiovascular Medicine. London: Churchill Livingstone 2000; 2216–2223.

28. Máček M, Máčková J. Může pravidelná pohybová aktivita prodloužit život? Med Sport Boh Slov 1999; 8: 65–71.

29. Manson JE, Rimm EB, Stampfer MJ et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 1991; 338: 774–779.

30. Maiorana A, O’Driscoll G, Goodman C et al. Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes. Diabetes Res Clin Pract 2002; 2: 115–123.

31. Miller WJ, Shermann WM, Ivy JL. Effect of strength training on glucose tolerance and post-glucose insulin response. Med Sci Sports Exerc 1984; 16: 539–543.

32. Perry IJ, Wanamethee SG, Walker MK et al. Prospective study of Risk Factor for Development of Non-insulin Dependent Diabetes in middle Aged British Men. BMJ 1995; 310: 560–564.

33. Phillips SM, Han XX, Green HJ et al. Increments in skeletal muscle GLUT–1 and GLUT-4 after endurance training in humans. Am J Physiol 1996; 270: E452–E462.

34. Ploug T, Stallknecht BM, Pedersen O et al. Effects of endurance training on glucose transport capacity and glucose transporter expression in rat skeletal muscle. Am J Physiol 1990; 259: 778–786.

35. Sesso HD, Paffenbarger RS jr, Lee IM. Physical Activity and Coronary Heart Disease in Men. The Harvard Alumni Health Study. Circulation 2000; 102: 975–980.

36. Schneider SH, Khachadurian AK, Amorosa LF et al. Ten year experience with an exercise-based outpatient life-style modification program in the treatment of diabetes mellitus. In: White DR, Sherman C. Exercise in Diabetes Management. The Physician and Sportmedicine 1999; 27: 63–78.

37. Svačina Š, Owen K. Syndrom inzulinové rezistence. Praha: Triton 2003.

38. Svačinová H, Homolka P, Olšovský J et al. Training program and cardiorespiratory parameters in obese patients with type 2 diabetes mellitus. Brno: Scripta medica LF MU 2002; 3: 157–162.

39. Svačinová H, Olšovský J, Žáčková V et al. Vliv tréninku chůzí na aerobní kapacitu a krevní lipidy u diabetiků 2. typu. Vnitř Lék 2003; 3: 205–209.

40. Svačinová H, Siegelová J, Olšovský J et al. Baroreflex sensitivity in patients with type 2 diabetes mellitus: effect of exercise. Brno: Scripta medica LF MU 2002; 4: 209–213.

41. Wannamethee SG, Shaper AG, Walker M. Changes in physical activity, mortality and incidence of coronary heart disease in older men. Lancet 1998; 30: 351: 1603–1608.

42. Whaley MH, Kampert JB, Kohl HV 3rd et al. Physical fitness and clustering of risk factors associated with the metabolic syndrome. Med Sci Sports Exerc 1999; 31 (2): 287–293.

43. Zpráva hlavního lékaře USA o tělesné aktivitě a zdraví. JAMA-CS 1996; 11: 833.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 1

2005 Issue 1

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#