Chapter 30 - Role of exercise in the prevention and treatment of metabolic syndrome

Abstract

Metabolic syndrome (MetS) has been on the rise worldwide, contributing to an increase in cardiovascular morbidity and mortality. The components of the MetS such as diabetes, hypertension, dyslipidemia, and obesity are rightly known as “lifestyle” diseases. It is well known that in addition to excess calorie consumption and certain types of diet, a sedentary lifestyle is a significant risk factor for the development of obesity and cardiovascular disease. Physical activity including exercise as well as leisure time physical activity have an important role in both prevention and management of MetS. Regular physical activity benefits individual components of MetS such as waist circumference, adiposity, hyperglycemia, and hypertension. Also, daily exercise has been known to improve cardiorespiratory fitness and reduce cardiovascular risk. Unlike the loss of lean body mass with calorie restriction alone, weight loss as a result of regular exercise combined with a low calorie diet tends to preserve lean body mass while reducing adiposity. Increasing evidence has come to light about the importance of exercise intensity rather than its duration for its beneficial effect on cardiovascular health. This has led to the evolution of various forms of exercise and exercise routines such as the high intensity interval training which may provide greater cardiovascular benefit with shorter duration of exercise. However, such high intensity exercise is contraindicated in certain disease states. International recommendations for exercise for the prevention and treatment of MetS stress the importance of individualizing exercise programs based on the cardiovascular fitness and other existing health conditions of the person. Although low-to-moderate intensity exercise does not require pre-exercise evaluation, high intensity exercise, especially in previously sedentary individuals, warrants medical clearance. In general, beginning with simple low-intensity exercises with a gradual increase in intensity would be prudent to avoid injuries and complications.