Physical activity, exercise, and the metabolic syndrome

Abstract

Abstract The metabolic syndrome refers to a clustering of cardiometabolic risk factors to one individual. The metabolic syndrome in children and adolescents is still a debated concept and there are over 40 different definitions of paediatric metabolic syndrome. Using a continuous cardiometabolic risk score may be the most appropriate method to describe the clustering of cardiometabolic risk factors in children and adolescents. Observational studies suggest inverse dose–response associations between physical activity and clustered cardiometabolic risk score and individual cardiometabolic risk factors, such as adiposity, insulin resistance, blood pressure, and dyslipidaemia. Intervention studies have produced inconsistent results with some studies inducing beneficial effects on cardiometabolic risk factors while others show no effects. High-volume exercise interventions emphasising higher exercise intensity could decrease adiposity and help to prevent overweight and obesity. Such exercise interventions may also improve general cardiometabolic risk profile. Resistance training may produce beneficial effects on body composition, but the effects on other cardiometabolic risk factors are inconsistent. The optimal dose of physical activity and exercise for preventing and treating metabolic syndrome in children and adolescents is yet to be described. The evidence also suggests that higher levels of physical fitness are linked to lower risk of metabolic syndrome and clustering of cardiometabolic risk factors as well as lower levels of individual cardiometabolic risk factors. Nevertheless, it is important to understand that several measures of physical fitness are confounded by adiposity when assessing the associations of physical fitness with cardiometabolic health.