High-Intensity Exercise Intervals Best Bet for Metabolic Syndrome 

Results of a trial showing that people with metabolic syndrome might benefit from an exercise regimen that includes aerobic interval training have now been published. According to the investigators, high-intensity exercise actually reversed most of the risk factors associated with metabolic syndrome; after just 16 weeks of the exercise program.

Almost half the patients enrolled in this arm of the trial no longer had metabolic syndrome, without making any changes to their diets. Less impressive gains were seen with consistent, moderate exercise.

The findings were first during a poster session at the 2006 International Symposium on Atherosclerosis. Now, commenting on the published results, investigators say their findings hint that the standard recommendation for 30 minutes per day of moderate exercise — something espoused by the American Heart Association (AHA) and other organizations — might not be optimal in this specific high-risk group.

Senior author of the study, Dr Ulrik Wisløff (Norwegian University of Science and Technology), emphasized that this was a three-times-per-week exercise regimen, totaling just 120 minutes.

"This is the first time a study has compared the real cardiovascular effects of exercise intensity in individuals with metabolic syndrome," he said. "Individuals who took part in the study exercised with different intensities but used the same amount of energy in each training session."

32 people with metabolic syndrome were randomized to continuous moderate exercise, aerobic interval training, or no specific exercise recommendations. A total of 28 patients completed the full 16-week trial and follow-up tests. Subjects in the moderate-exercise group exercised for slightly longer than those in the interval group, so that the amount of energy expenditure was the same between groups.

After 16 weeks of exercising three times per week, according to the randomization protocol, subjects in both exercise groups lost roughly the same amount of weight and reduced waist circumference, compared with the control group. But subjects in the interval group also experienced greater improvements in endothelial function, blood-pressure lowering, insulin sensitivity, fasting glucose, high-density lipoprotein (HDL) cholesterol, and mitochondrial biogenesis (a measure of cell’s ability to produce fuel for work).

At the end of the 16 weeks, 46% of subjects in the interval group no longer met the criteria for metabolic syndrome, compared with 37% in the moderate-exercise group. All subjects in the control group met the criteria for metabolic syndrome at follow-up.

The authors of the study hypothesized that the benefits of high-intensity intervals over consistent moderate exercise relate to the higher heart rates required for interval training. Patients in the interval group increased their ability to absorb oxygen by 35%, whereas those in the moderate-exercise group increased their ability to absorb oxygen by only 16%. The study suggests there should not be a one-size-fits-all approach to exercise recommendations.

"Prescription of exercise training/physical activity should be different for individuals with metabolic syndrome and in inactive individuals," Wisløff said.  "Look at the effects of today’s recommendations: they do not work, or we do not get people to exercise as much as recommended. Instead, more and more people get fat and get metabolic syndrome."

He believes that most people with metabolic syndrome have not exercised regularly for at least five to 10 years, so committing to current exercise recommendations is a challenge.

"A lot of people find it hard to train most days of the week, and today’s recommendations may therefore be a hindrance instead of a motivator for these persons," Wisløff said. "Our take-home message is that these people should try to perform the interval regimen described in the paper two times per week over 10 to 14 weeks. We normally see that these people get fit fast, and the only side effects of this ‘medicine’ observed so far is that they start to be more physically active on the other days of the week. We have clearly demonstrated that it is not possible to substitute exercise intensity with exercise duration: shorter and harder training sessions may be good medicine for improved fitness and reversal — and prevention — of established cardiovascular risk factors."

Dr Barry Franklin, author of the association’s physical-activity guidelines, points out that this is not the first study to show that if total energy expenditure of exercise is held constant, more vigorous-intensity exercise seems to convey greater cardioprotective benefits than exercise of a moderate intensity.

Circulation. July 7, 2008:Tjønna AE, Lee SJ, Rognmo Ø, et al. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome. 

===============================

Learn about the ONlY Instant Disposable In Office A1c Test:  Studies have shown that by providing the A1c test in the office while the patient is present, can lower A1c by a full point.  Learn about the only 99% accurate disposable A1c test that is CLIA waived and cost less than 10 dollars and reimbursed at least 21 dollars.    
https://www.a1ctest.com

===============================

Help us keep this newsletter free-update your profile.
https://www.diabetesincontrol.com/surveys/index.php