Effects of Diet and Physical Activity in an Integrated CVD and T2DM Prevention at High Risk Abdominal Obese Individuals

Abstract

Obesity is the complex of a multifactorial phenotype determined of interaction between behavioral factors, mainly energy intake and expenditure that affects body fat mass, genetic variations (hereditary predisposition), different biological factors (sex, vulnerable ages related to increased weight, hormone activity), community situation and environmental factors. In general, abdominal obesity, CVD and T2DM can be considered as diseases related to unhealthy diet and physical inactivity. Also, it’s known that physical activity level (PALs) is an independent predictor of T2DM. The question of an integrated CVD and T2DM prevention at high risk obese individuals is important scientific problem. Targeted “lifestyle” intervention programme is beneficial especially in abdominal obese individuals. Overall results including our data are additional argument that any other preventive-therapeutic programme is not possible to be applied as alteration for physical activity (PA) [2]. With aim to promote preventive-therapeutic programmes intended for abdominal obese individuals with increased cardiometabolic risk for development of CVD and T2DM, we develop a model of efficient intervention with a proposal - a measure for macronutrient content of diet and increasing cardiorespiratory fitness - VO 2 max (ml -1 kg -1 min -1 ). Within the randomised controlled trial at a group of abdominal obese individuals with presence risk factors (RF) for arteriosclerosis, CVD and T2DM chosen according to a previously given criteria, we suggest the following two types of programmes to be applied: I. a combined preventive-therapeutic programme composed of moderate hypo-energetic diets with a low atherogenic potential, low glycaemic index (GI) and individually dosed, programmed PA; II. low fat, low GI, moderate hypo energetic diets. The programme’s objectives are as follows: 1. To examine the influence of the suggested preventivetherapeutic programmes on the basis of a follow up of the intensity of the dynamics and the course of changes of certain anthropometrical variables and indexes for evaluation of the obesity degree and the abdominal distribution of the fat, the functional variables for estimation of the cardiorespiratory fitness and the laboratory variables – indicators for glycoregulation and the metabolism of the lipids;