Abstract
Metabolic syndrome and its various features (obesity, hypertension, dyslipidemia, diabetes, and nonalcoholic fatty liver disease) are increasing worldwide and constitute a severe risk for the sustainability of the present universal Italian health care system. Lifestyle interventions should be the first therapeutic strategy to prevent/treat metabolic diseases, far before pharmacologic treatment. The role of diet and weight loss has been fully ascertained, whereas the role of physical activity is frequently overlooked both by physicians and by patients. Physical activity has favorable effects on all components of the metabolic syndrome and on the resulting cardiovascular risk, the cornerstone in the development of cardiometabolic diseases. The quantity and the frequency of physical activity necessary to produce beneficial effects has not been defined as yet, but brisk walking is considered particularly appropriate, as it can be practiced by a large number of individuals, without any additional cost, and has a low rate of injury. The effects of exercise and leisure time physical activity extend from prevention to treatment of the various components of the metabolic syndrome, as well as to mood and quality of life. Any effort should be done to favor adherence to protocols of physical activity in the community.
Highlights
The epidemic of metabolic disorders, driven by obesity, 37 constitutes a challenge for health systems worldwide. 38Several factors are contributing to the increasing preva- 39 lence of the various features of the metabolic syndrome 40(hypertension, dyslipidemia, and type 2 diabetes)
Several factors are contributing to the increasing preva- lence of the various features of the metabolic syndrome
The primary endpoint of the study was a composite outcome consisting of incident cardiovascular events, to be tested after a programmed follow-up of 13.5 years
Summary
The epidemic of metabolic disorders, driven by obesity, 37 constitutes a challenge for health systems worldwide. 38Several factors are contributing to the increasing preva- 39 lence of the various features of the metabolic syndrome 40(hypertension, dyslipidemia, and type 2 diabetes). For the hundreds of millions worldwide who have the ‘‘metabolic syndrome’’, lifestyle modification is the most appealing approach because of its non-toxicity and high efficacy, compared with medications, and physi- 49 cal activity (PA) is a fundamental component It is outside the scope of the present review to discuss the reason(s) and the real existence of the syndrome, i.e., whether a residual risk exists above that conferred by individual features or old and new cardiovascular risk factors [1]. Lifestyle modifications are mandatory for the individual components, and more so when they sum up, in the case of overt disease, and when the indi- vidual components are in the range of ‘‘pre-disease’’ (i.e., prediabetes, prehypertension, mild dyslipidemia not requiring drug treatment or low-grade visceral fat accu- mulation) [2] This is the reason for the progressive reduction of the diagnostic cut-offs that occurred along the years (Table 1)
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