Can Adoption of Regular Exercise in Later Life Prevent Metabolic Syndrome?

Abstract

0088 Clustering of early metabolic markers of cardiovascular disease risk may be modifiable through lifestyle interventions including regular exercise. It is not known whether regular physical exercise adopted later in life can alter the development of these markers and associated morbidity. Purpose: To determine the effect of regular exercise training initiated in later life, and development of metabolic risk factors. Methods: Two inception cohorts of previously sedentary healthy adults aged 55–85 years at baseline (1986–89); one initiating regular supervised physical exercise training (ACTIVE) and the other an age-matched sedentary control (CONTROL) were assessed for anthropometric, biochemical and clinical markers of the metabolic syndrome. Those free of metabolic syndrome were followed for 10 years. Four hundred and fiftysix subjects completed baseline assessment and 36 were excluded with presence of metabolic risk factors. ACTIVE (n = 193) initiated regular exercise training according to published guidelines. Training prescription was updated yearly. SEDENTARY (n = 178) was a randomly selected, geographically similar group of communitydwelling residents obtained using census data who received maximal exercise treadmill testing at baseline and after 10 years but who did not receive formal regular exercise programming during that interval. Markers of metabolic syndrome included elevated systolic blood pressure; LDL-C; serum triglycerides; fasting blood glucose; BMI and waist circumference as per published guidelines. Clinical outcomes included exercise METS, presence of ST-segment depression or angina during exercise, reported cardiac events and co-morbidities using the Charlson co-morbidity index score. Results: At baseline, no differences between groups were observed. At follow up, more metabolic abnormalities were observed in the SEDENTARY compared to ACTIVE for 1 or 2 (64 vs 36%, p<0.001) and 3 or more (35 vs 22%, p<0.003) respectively. SEDENTARY compared to ACTIVE group had more cardiac events (41 vs 33%, p<0.005), comorbid conditions (Charlson score 0.9 vs 0.4, p<0.01), achieved a lower workload (5.0 [9.1% decrease] vs 5.9 [3.5% increase] METS, p<0.01) and had a greater likelihood of a positive exercise test composite (32 vs 10%, p<0.001). Conclusions: Higher fitness achieved over 10 years of regular exercise training in older adults was associated with reduced development of metabolic risk factors. Even when fitness improved among sedentary controls, there was not a similar improvement in risk factors compared to engaging in a regular exercise program.