The role of physical activity and fitness in the prevention and treatment of metabolic syndrome
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Corresponding author Peter T. Katzmarzyk, PhD School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada. E-mail: [email protected] Current Cardiovascular Risk Reports 2007, 1:228–236 Current Medicine Group LLC ISSN 1932-9520 Copyright © 2007 by Current Medicine Group LLC
The metabolic syndrome is a significant public health problem that is increasing in prevalence throughout the developed and the developing world. Lifestyle changes are recommended as the primary tool in the prevention and treatment of risk factor clustering. Physical activity should be considered a cornerstone of prevention and treatment efforts related to metabolic syndrome. Considerable evidence supports that physically inactive men and women are at increased risk for prevalent and incident metabolic syndrome. Mounting evidence, although limited, supports that physical activity is a useful option in treating metabolic syndrome and its associated health risks. Further research is required to develop effective physical activity programs for the treatment of individuals that exhibit risk factor clustering.
Introduction The metabolic syndrome (MetS) is a clustering of risk factors, including abdominal obesity, dyslipidemia, hypertension, and insulin resistance, that predisposes toward the development of cardiovascular disease, type 2 diabetes, and premature mortality. The prevalence of MetS is high and is increasing in North America [1,2]. MetS has been estimated to affect approximately one in four men and women in the United States [2] and to be prevalent among youth [3]. The concept of risk factor clustering with respect to metabolic disorders appears to have originated in 1923, when Kylin [4] described a syndrome of hypertension, hyperglycemia, and elevated serum uric acid among German patients. In 1988, Reaven [5] introduced the contemporary concept of MetS when he used the term “Syndrome X”
to describe a syndrome of resistance to insulin-stimulated glucose uptake, glucose intolerance, hyperinsulinemia, hypertension, decreased high-density lipoprotein (HDL) cholesterol, and increased very-low–density lipoprotein triglycerides [5]. Over the past two decades, the conceptualization of MetS has undergone several transformations, and several operational definitions or clinical criteria for the syndrome have been proposed [6–8,9•,10•]. Three clinical criteria for MetS currently in use include those of the World Health Organization (WHO) [6], US National Cholesterol Education Panel (NCEP)/American Heart Association (AHA)/US National Heart, Lung and Blood Institute (NHLBI) [9•], and the International Diabetes Federation (IDF) [10•]. The WHO criteria require having impaired fasting glucose, impaired glucose tolerance, type 2 diabetes or insulin resistance, and two or more of the following: obesity (waist-to-hip ratio > 0.90 in men and > 0.85 in women or BMI > 30 kg/m2), microalbuminuria (urinary albumin excretion rate s 20 Ng/min or albumin: creatinine ratio s 20 mg/g), dyslipidemia (triglycerides s 1.7 mmol/L or
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