High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction.

BACKGROUND: To examine the effect of high-intensity interval training (HIIT) on metabolic syndrome (MetS) and body composition in cardiac rehabilitation (CR) patients with myocardial infarction (MI). METHODS: We retrospectively screened 174 consecutive patients with MetS enrolled in CR following MI between 2015 and 2018. We included 56 patients who completed 36 CR sessions and pre-post dual-energy X-ray absorptiometry. Of these patients, 42 engaged in HIIT and 14 in moderate-intensity continuous training (MICT). HIIT included 4-8 intervals of high-intensity (30-60 s at RPE 15-17 [Borg 6-20]) and low-intensity (1-5 min at RPE < 14), and MICT included 20-45 min of exercise at RPE 12-14. MetS and body composition variables were compared between MICT and HIIT groups. RESULTS: Compared to MICT, HIIT demonstrated greater reductions in MetS (relative risk = 0.5, 95% CI 0.33-0.75, P < .001), MetS z-score (- 3.6 ± 2.9 vs. - 0.8 ± 3.8, P < .001) and improved MetS components: waist circumference (- 3 ± 5 vs. 1 ± 5 cm, P = .01), fasting blood glucose (- 25.8 ± 34.8 vs. - 3.9 ± 25.8 mg/dl, P < .001), triglycerides (- 67.8 ± 86.7 vs. - 10.4 ± 105.3 mg/dl, P < .001), and diastolic blood pressure (- 7 ± 11 vs. 0 ± 13 mmHg, P = .001). HIIT group demonstrated greater reductions in body fat mass (- 2.1 ± 2.1 vs. 0 ± 2.2 kg, P = .002), with increased body lean mass (0.9 ± 1.9 vs. - 0.9 ± 3.2 kg, P = .01) than the MICT. After matching for exercise energy expenditure, HIIT-induced improvements persisted for MetS z-score (P < .001), MetS components (P < .05), body fat mass (P = .002), body fat (P = .01), and lean mass (P = .03). CONCLUSIONS: Our data suggest that, compared to MICT, supervised HIIT results in greater improvements in MetS and body composition in MI patients with MetS undergoing CR.

[Evaluation of the effectiveness of rehabilitation of elderly patients with metabolic syndrome, taking into account the provisions of International classification of functioning, disability and health.]

The article contains data on rehabilitation measures in elderly patients with metabolic syndrome. Individual-oriented treatment and rehabilitation programs implemented in primary health care allow to reliably reduce the severity and risk of progression of restrictions of life, increase the independence of patients The elderly, having metabolic syndrome, complicated the development of type 2 diabetes mellitus. It is proposed to assess the effectiveness of rehabilitation, taking into account the provisions of the International Classification of functioning, restrictions on life and health and by drawing up an individual geriatric profile.

Obesity and metabolic syndrome in COPD: Is exercise the answer?

Approximately half of all patients with chronic obstructive pulmonary disease (COPD) attending pulmonary rehabilitation (PR) programmes are overweight or obese which negatively impacts upon dyspnoea and exercise tolerance particularly when walking. Within the obese population (without COPD), the observed heterogeneity in prognosis is in part explained by the variability in the risk of developing cardiovascular disease or diabetes (cardiometabolic risk) leading to the description of metabolic syndrome. In obesity alone, high-intensity aerobic training can support healthy weight loss and improve the constituent components of metabolic syndrome. Those with COPD, obesity and/or metabolic syndrome undergoing PR appear to do as well in traditional outcomes as their normal-weight metabolically healthy peers in terms of improvement of symptoms, health-related quality of life and exercise performance, and should therefore not be excluded. To broaden the benefit of PR, for this complex population, we should learn from the extensive literature examining the effects of exercise in obesity and metabolic syndrome discussed in this review and optimize the exercise strategy to improve these co-morbid conditions. Standard PR outcomes could be expanded to include cardiometabolic risk reduction to lower future morbidity and mortality; to this end exercise may well be the answer.

Nordic walking in the second half of life.

OBJECTIVES: The objective of this article is to review the literature regarding the effectiveness and safety of Nordic walking (NW) in therapeutic rehabilitation in patients of an advanced age. METHODS: Randomized studies comparing NW with different patterns of long-lasting physical rehabilitation in older adults (average age 65 years) were selected for the review. Studies were identified through a Medline database search covering the last 21 years. RESULTS: Seventy-four studies on this subject were identified, 37 of them fulfilled the required criteria and 27 of these were analyzed in this review. DISCUSSION: Nordic walking provides a safe and effective way to enhance physical activity in the elderly. It could also serve as a method of rehabilitation that improves fitness, the performance and the exercise capacity of aged persons with diseases associated with an advanced age: cardiovascular diseases due to atherosclerosis; metabolic syndrome without diabetes; early stage Parkinson's disease; chronic obstructive pulmonary disease and lowering depression in women with Sjögren's Syndrome.

Effectiveness of community-based exercise intervention programme in obese adults with metabolic syndrome.

AIMS AND OBJECTIVES: The objective of this study was to change the anthropometric, clinical, biochemical indicators and the rate of metabolic syndrome among obese adults in community. BACKGROUND: Obesity is an indicator of metabolic syndrome and cardiometabolic diseases. Obesity increases national health care expenditure in Taiwan. The high prevalence of obesity is not only a public health issue but also an economic problem. Changes in lifestyle can help to prevent metabolic syndrome for individuals with obesity. DESIGN: A randomised controlled trial was applied. METHODS: In this randomised controlled trial by location, 136 metabolically abnormal obese individuals were included. The related indicators with metabolic syndrome were measured at baseline and after six months. The experimental group participated in a six-month community-based programme including provided exercise environments, exercise skills and volunteers' reminding. The control group was only provided environment and skills. RESULTS: One hundred and thirty-one participants completed this trail. In comparison with the baseline, the intervention group showed a significant increase in high-density lipoprotein cholesterol (2·34 mg/dl), and decrease in body weight (1·09 kg), waist circumference (3·63 cm), systolic blood pressure (10·52 mmHg), diastolic blood pressure (5·21 mmHg), fasting blood glucose (5·84 mg/dl) and body mass index (0·74 kg/m(2) ). In the control group, significant decrease in body mass index and waist circumference were discovered. Compared to the changes between the two groups, the results showed there were significant differences in waist circumference, systolic blood pressure, diastolic blood pressure and high-density lipoprotein cholesterol. CONCLUSIONS: The community-based intervention could help to improve high-density lipoprotein cholesterol, reduce body weight, body mass index, waist circumference, blood pressure and fasting blood glucose in metabolically abnormal obese. RELEVANCE TO CLINICAL PRACTICE: This community-based programme helped metabolically abnormal obese individuals become metabolically healthy. In the future, community nurses will work with village heads and volunteers. They can encourage residents in the communities to have healthy lifestyle. As a result, the goal of this programme will be successfully achieved with less time and effort.

Impact of lifestyle modification on left ventricular function and cardiopulmonary exercise capacity in patients with heart failure with normal ejection fraction and cardiometabolic syndrome: a prospective interventional study.

BACKGROUND: Heart failure with normal left ventricular ejection fraction (HFNEF) accounts for about one third of all heart failure patients with considerable mortality. The metabolic syndrome (MS) is a risk factor for diastolic dysfunction and HFNEF. We hypothesized that modifying metabolic burden by exercise training and weight loss might improve left ventricular diastolic function, heart failure symptoms and rehospitalization rate. METHODS AND RESULTS: Forty patients with HFNEF, MS and prediabetes were enrolled in this prospective study. Echocardiography and cardiopulmonary exercise testing (CPET) were done at baseline and after 3 months lifestyle modification (LSM). NT-pro BNP and adiponectin were determined at baseline as both peptidehormones play a crucial role in MS and heart failure. After discharge a 3-month LSM program with the aim of weight reduction by diet and exercise was started. After the intervention period a weight reduction of ≥ 2% was defined as successful LSM (group A = 23 patients), while a weight reduction < 2% was classified as unsuccessful LSM (group B = 17 patients). At baseline NT-pro BNP (424 ± 381 versus 121 ± 99 pg/ml, P < 0.01) and adiponectin (10.1 ± 6.2 versus 4.6-2.0 µg/ml, P < 0.01) were higher in group A than in group B. After 3 months of LSM, CPET showed a significant improve- ment of VO2 peak (P < 0.01), EqCO2 (P < 0.001), O2-pulse (P = 0.02) and VE / VCO2 slope (P = 0.01) in group A. After one year of follow-up a modest but significant reduction of left atrial size and mitral flow to mitral annulus velocity ratio E/E' was seen in group A. LSM resulted in significant improvement of NYHA status (P = 0.03) and higher freedom of rehospitalization (P = 0.04) in group A. CONCLUSION: Successful lifestyle modification in obese, prediabetic patients with HFNEF improves diastolic left ventricular function and cardiopulmonary exercise capacity. As these measures result in improved NYHA status and less hospitalization, LSM might be a promising approach to prevent chronic diastolic heart failure.

[Evaluation of a program for management of metabolic syndrome in adults with overweight and obesity]. / Evaluación de un programa ministerial para manejo del síndrome metabólico en adultos con sobrepeso y obesidad.

BACKGROUND: The Chilean Ministry of Health developed a healthy lifestyles intervention directed to adults with overweight and cardiovascular risk factors, called "Program on Healthy Eating and Physical Activity" (PASAF). AIM: To evaluate the impact of PASAF on nutritional status and metabolic parameters. PATIENTS AND METHODS: We analyzed databases from three primary care centers belonging to a municipality of Metropolitan Santiago. We selected adults enrolled in the PASAF during three years (2007-2009). The program lasted four months and included an assessment of anthropometric and metabolic parameters at baseline and at the end, eight workshops with a nutritionist, seven with a psychologist and 32 sessions of physical activity. RESULT: We evaluated 526 subjects aged ≥18 years (93% females), of whom 85.6% attended the last appointment for assessment. Analyzing available data, attendance to workshops was <50% of the scheduled sessions. Weight, body mass index and waist circumference decreased significantly (median: -1.4 kg, -0.6 kg/m² and -3 cm, respectively). The median weight loss was 1.8% of initial weight and 17.1% of participants experienced a decrease ≥5% of their initial weight. There were significant improvements in lipid levels and blood pressure among participants with lower initial excess weight. A reduction in fasting blood glucose was observed only among subjects who lost ≥5% of their initial weight. CONCLUSIONS: The PASAF modestly reduced nutritional parameters. Correction of metabolic parameters was especially effective in less obese subjects. The attendance to workshops was low.

Walking promotes metabolic and baroreflex sensitivity improvement in fructose-fed male rats.

The aim of this study was to investigate metabolic and cardiovascular responses to walking in fructose-fed rats. Male Wistar rats were divided into control (C), sedentary fructose (SF) and walking fructose (WF). Fructose-fed rats received D-fructose (100 g/l). WF rats walked on a treadmill at constant load (0.3 km/h) during 1 h/day, 5 days/week for 8 weeks. Measurements of triglyceride concentrations, adipose tissue and glycemia were carried out together with insulin tolerance test to evaluate metabolic profile. Arterial pressure (AP) signals were directly recorded. Baroreflex sensitivity (BR) was evaluated by the reflex tachycardia (TR) and bradycardia (BR) to AP changes. The results showed that walking decreased the adipose tissue (SF: 6.5 ± 0.4; WF: 2.8 ± 0.1; C: 3.0 ± 0.3 g), blood triglyceride levels (SF: 291 ± 6.5; WF: 150 ± 8.1; C: 103 ± 4.5 mg/dl) and increased insulin sensitivity (SF: 2.5 ± 0.2; WF: 3.3 ± 0.32; C: 4.8 ± 0.4 %/min). Baroreflex sensitivity was improved in the WF group expressed by BR (SF: 0.75 ± 0.10; WF: 1.18 ± 0.10; C: 1.5 ± 0.14 ms/mmHg) and TR (SF: 0.80 ± 0.12; WF: 1.21 ± 0.10; C: 1.35 ± 0.11 ms/mmHg), as well as when verified by the alpha index. Although the WF group showed decreased AP when compared with the SF group, the values still enhanced in relation to C rats (SF: 137 ± 2; WF: 129 ± 1; C: 115 ± 6 mmHg). Our findings allow a better understanding of the effects of walking, a low-intensity exercise training, on the hemodynamic and metabolic aspects of male rats with metabolic syndrome and indicate that walking seems to be particularly effective in treating metabolic disturbances in this model.

Effect of six weeks of endurance exercise and following detraining on serum brain derived neurotrophic factor and memory performance in middle aged males with metabolic syndrome.

AIM: Brain derived neurotrophic factor (BDNF) and physical inactivity contribute to the development of metabolic syndrome (MetS). Aerobic training has been reported to improve MetS, however less attention has been directed toward the role of training and detraining on cognitive function in MetS. METHODS: Twenty one healthy middle-aged males and 21 with MetS were distributed into four groups: MetS exercise (ME), MetS control (MC), Healthy exercise (HE) and healthy control (HC). Both ME and HE, followed a 6-week aerobic training program (3 sessions/week). Digit Span memory test and blood sampling were conducted pre training, post training and also following a six weeks detraining. Data were analyzed using spearman, pearson and repeated measure ANOVA tests. RESULTS: Baseline serum BDNF level was positively correlated with waist circumference (r=0.383, P=0.012) and showed significant elevation in MetS compared with healthy subjects (1101.66±61.34 vs. 903.72±46.57 pg/mL, P=0.014). After aerobic exercise BDNF level significantly increased in HE, but decreased in ME group (P=0.001). Both short and mid term memory significantly increased (P<0.05) only in HE group. CONCLUSION: Exercise induced cognitive improvement might be mediated via BDNF-linked mechanisms in healthy people. However, the health status of individuals should be considered.

[Discover the sport en institution]. / Découvrir le sport en institution.

In order to promote physical activity to users of psychiatric services, the Maison Blanche public health facility organised a sports discovery day with a specialised partner, the French Federation of Adapted Sport (FFSA). Feedback on the day revealed a high level of satisfaction. Such initiatives favour physical activity among users and thereby help to fight the negative somatic effects of mental illness and antipsychotic drugs.

[The application of the non-invasive lung ventilation technique (CPAP therapy) for the early comprehensive rehabilitation of the patients with metabolic syndrome and "night-piker" arterial hypertension].

The treatment of patients presenting with metabolic syndrome and "night-piker" arterial hypertension is a most difficult task facing modern therapy. It was shown that metabolic disorders and night-time elevation of arterial pressure in such patients are attributable to obstructive sleep apnea syndrome (OSAS). The present study included 32 patients suffering moderately severe or severe OSAS in conjunction with metabolic syndrome, and "night-piker" arterial hypertension. We tried to elucidate the role of CPAP therapy in the treatment and early rehabilitation of such patients. The study group included 17 patients and the control group was comprised of 15 subjects. The quality of sleep significantly improved in all the patients (100%) during 4 weeks of CPAP therapy; simultaneously, normalization of hemodynamics (the absence of the morning rise in AP) was documented. The morning rise in AP (up to 140/80 mmHg at awakening) persisted in 9 (60%) control patients. The mean cholesterol level decreased by 28.65% and 25.89% in the study and control groups respectively (p>0.1). (all patients in both groups were treated with statins). The level of C-reactive protein decreased more significantly in the study group compared with the control one (38.22% and 15.32% respectively; p<0.05). It is concluded that CPAP therapy produces beneficial effect in the patients with OSAS suffering hypertension during the night or early in the morning. CPAP therapy during 1 month did not have an appreciable effect on metabolic parameters. At the same time, long-term CPAP therapy promoted the reduction in the level of C-reactive protein known to be a predictor of cardiac complications.

The effects of dietary weight loss with or without exercise training on liver enzymes in obese metabolic syndrome subjects.

AIM: Insulin resistance and visceral adiposity are predisposing factors for fatty liver disease. The main objectives of this study were (i) to compare the effects of caloric restriction (CR) alone or together with moderate-intensity aerobic exercise training (CR+EX) on liver enzymes, a surrogate marker of liver injury, in obese metabolic syndrome (MetS) subjects and (ii) to identify anthropometric, metabolic, cardiovascular and dietary predictors of changes in liver enzymes. METHODS: Sedentary men and women (n = 63), aged 55 ± 6 (s.d.) years with body mass index 32.7 ± 4.1 kg/m(2) and confirmed MetS, were randomized to 12-week CR, CR+EX or no treatment (Control). RESULTS: Weight loss averaged 7.6% in the CR and 9.1% in the CR+EX group (time effect, p < 0.001; group effect, p = 0.11); insulin sensitivity improved by 49 and 45%, respectively (both p < 0.001). Fitness (maximal oxygen consumption) increased by 19% in the CR+EX group only (p < 0.001). Alanine aminotransferase (ALT) levels decreased by 20% in the CR and 24% in the CR+EX group (time effect, both p < 0.001; group effect, p = 0.68); corresponding values for γ-glutamyltransferase (GGT) were -28 and -33%, respectively (time effect, both p < 0.001; group effect, p = 0.28). Reduction in abdominal fat mass (measured by DXA from L1 to L4) independently predicted ΔALT (r = 0.42, p = 0.005) and ΔGGT (r = 0.55, p < 0.001), whereas change in dietary saturated fat intake was independently associated with ΔALT (r = 0.35, p = 0.03). CONCLUSIONS: Reductions in central adiposity and saturated fat intake are key drivers of improvement in liver enzymes during lifestyle interventions. Exercise training did not confer significant incremental benefits in this study.

[The efficacy of the combined rehabilitative treatment of the patients presenting with obesity, metabolic syndrome, and diseases of the hepatobiliary system].

A total of 80 patients presenting with exogenous constitutional obesity, metabolic syndrome, and diseases of the hepatobiliary system (including chronic non-calculous cholecystitis and fatty hepatosis) were enrolled to participate in the present study. The basal treatment consisted of the adequate reducing diet, remedial gymnastics, massage, reflexo-acupuncture, the application of galvanic muds, and controlled intake of chofitol. It was supplemented with magnetic laser irradiation of selected abdominal regions, and electrical stimulation of femoral, dorsal, and abdominal muscles. It was shown that the combination of the above procedures and physical factors significantly improves the overall outcome of the treatment. The patients suffering intestinal dysbacteriosis were prescribed the intake of probiotic Nor Narine together with Jermuk mineral water; they were found to benefit from such treatment due to normalization of intestinal biocenosis and improvement of their general condition. The clinical and paraclinical data obtained in this study give evidence of the therapeutic efficacy of certain physical factors and especially their combination used for the medical rehabilitation of the patients presenting with constitutional obesity, metabolic syndrome, and digestive disorders. Moreover, the well-apparent positive results were documented from the combined treatment with magnetic laser radiation and therapeutic muds.

[The combined rehabilitative treatment of the children with obesity and metabolic syndrome].

The present study included a total of 66 children at the age from 11 to 16 years with obesity and metabolic syndrome. The latter condition in the childhood and adolescence is characterized by the pronounced disturbances of basal metabolism, vasoactive systems, psychoemotional status, and regulatory hormonal functions that determine the choice of rehabilitative modalities. The combined treatment of such disturbances is considered to be an efficacious method for the rehabilitation of these patients. It is recommended that cortexin be prescribed to the children presenting with obesity and metabolic syndrome because this medication promotes correction of the hormonal and metabolic status and improves the brain cognitive function.

Physical activity as the main therapeutic tool for metabolic syndrome in childhood.

Physical activity (PA) and diet directly influence obesity and metabolic syndrome (MS) as important determinants of body composition. Understanding how PA relates to MS in youth is of great importance, and could offer a common strategy for clinical and public health approaches to control this condition. The underlying disorder of MS is a condition of insulin resistance, and a strong relationship between PA level and insulin sensitivity is clearly ascertained. The type, duration, frequency and intensity of PA affect fuel metabolism, in particular carbohydrate and lipid oxidation. The possible modulation of metabolism because of increased fat oxidation by PA is the basis for both prevention and restoration of insulin resistance and MS in obese children. In daily clinical practice, diet followed by pharmacologic treatment are usually the approaches taken, whereas PA is often considered just a suggestion. Although diet and PA have different effects on body composition, with both contributing to fat loss, only PA increases muscle mass and thus has a direct effect on metabolic function, expressed by changes in cardiovascular risk factors. Therefore, it is important to remember their complementary but different targets in daily clinical practice, such as body weight control for diet and metabolic health for PA. In this review, we have summarized the literature on the relationship between PA and MS in pediatrics. Then, we have analyzed the possibility of using PA for MS treatment, as an alternative to drugs, by discussing the results of intervention studies, reasons for low compliance to PA, related benefits, adherence difficulties and costs. Finally, we have tried to suggest recommendations for a multiple-step PA strategy in children and adolescents at risk for MS, by considering PA as the 'key' player in treatment.

Exercise training improves in vivo endothelial repair capacity of early endothelial progenitor cells in subjects with metabolic syndrome.

BACKGROUND: Endothelial dysfunction and injury are considered to contribute considerably to the development and progression of atherosclerosis. It has been suggested that intense exercise training can increase the number and angiogenic properties of early endothelial progenitor cells (EPCs). However, whether exercise training stimulates the capacity of early EPCs to promote repair of endothelial damage and potential underlying mechanisms remain to be determined. The present study was designed to evaluate the effects of moderate exercise training on in vivo endothelial repair capacity of early EPCs, and their nitric oxide and superoxide production as characterized by electron spin resonance spectroscopy analysis in subjects with metabolic syndrome. METHODS AND RESULTS: Twenty-four subjects with metabolic syndrome were randomized to an 8 weeks exercise training or a control group. Superoxide production and nitric oxide (NO) availability of early EPCs were characterized by using electron spin resonance (ESR) spectroscopy analysis. In vivo endothelial repair capacity of EPCs was examined by transplantation into nude mice with defined carotid endothelial injury. Endothelium-dependent, flow-mediated vasodilation was analysed using high-resolution ultrasound. Importantly, exercise training resulted in a substantially improved in vivo endothelial repair capacity of early EPCs (24.0 vs 12.7%; p < 0.05) and improved endothelium-dependent vasodilation. Nitric oxide production of EPCs was substantially increased after exercise training, but not in the control group. Moreover, exercise training reduced superoxide production of EPCs, which was not observed in the control group. CONCLUSIONS: The present study suggests for the first time that moderate exercise training increases nitric oxide production of early endothelial progenitor cells and reduces their superoxide production. Importantly, this is associated with a marked beneficial effect on the in vivo endothelial repair capacity of early EPCs in subjects with metabolic syndrome.

[Combined exercise training in men with metabolic syndrome after acute coronary event]. / Kombinovaný trénink u muzu s metabolickým syndromem po akutní koronární príhode.

INTRODUCTION: Favourable effect of exercise training on cardiovascular prognosis in patients with metabolic syndrome have been documented in lot of studies. Less information exist about results of cardiovascular rehabilitation in patients with different forms of coronary heart disease and associated diseases and abnormalities within metabolic syndrome. METHODS: The present article evaluates a benefit of combined, aerobic-resistance training in two groups of patients after percutaneous coronary intervention for acute coronary syndrome: with [group MS(+), n = 42] and without [group MS(-), n = 53] metabolic syndrome. The changes in aerobic capacity (VO2 peak, VO2 peak . kg(-1)), physical performance (W peak, W peak . kg(-1)), blood pressure, BMI and waist circumference after 12 weeks of cardiovascular rehabilitation are evaluated. RESULTS: Significant improvement in aerobic capacity and physical performance were found out both in group MS(+) and MS(-) (p < 0.01, resp. p < 0.001). Decrease of systolic blood pressure was significant in MS(+), whereas in MS(-) together with decrease of diastolic BP in both groups were not significant. The increase in aerobic capacity and physical performance in patients of MS(+) is comparable with those in MS(-); the decrease in systolic BP was more intensive in MS(+) compared to MS(-). The changes in waist circumference and BMI were not significant in both groups. CONCLUSION: The results show, that in patients with high number of risk factors associated with metabolic syndrome was demonstrated at least comparable benefit from cardiovascular rehabilitation compared with those without metabolic syndrome.

Exercise Reduces Medication for Metabolic Syndrome Management: A 5-Year Follow-up Study.

PURPOSE: This study aimed to determine the effects of a 5-yr exercise intervention on metabolic syndrome (MetS) and health-related variables and medication use for MetS management. METHODS: Participants were randomly assigned to an exercise intervention (n = 25, 54 ± 2 yr, 20% women) or control group (n = 26, 54 ± 2 yr, 38% women). The intervention lasted 4 months per year and consisted of high-intensity interval training on a cycloergometer thrice a week. Outcomes were MetS z-score and medication use score, MetS-related variables (including blood pressure, blood glucose homeostasis, and lipid profile), and cardiorespiratory fitness (CRF, as determined by maximal oxygen uptake). RESULTS: MetS z-score was similarly reduced over time in both groups (P = 0.244 for group-time interaction). A quasi-significant and significant group-time interaction was found for MetS number of factors (P = 0.004) and CRF (P < 0.001), respectively. Thus, MetS factors tended to decrease over time only in the exercise group with no change in the control group, whereas CRF increased from baseline to 5-yr assessment in the exercise group (by 1.1 MET, P < 0.001) but decreased in the control group (-0.5 MET, P = 0.025). Medicine use score increased twofold from baseline to 5-yr follow-up in the control group (P < 0.001) but did not significantly change (10%, P = 0.52) in the exercise group (P < 0.001 for group-time interaction). The proportion of medicated patients who had to increase antihypertensive (P < 0.001), glucose-lowering (P = 0.036), or total medication (P < 0.0001) over the 5-yr period was lower in the exercise than that in the control group. CONCLUSIONS: Exercise training can attenuate the increase in medication that would be otherwise required to manage MetS over a 5-yr period.

Conjoint Associations of Adherence to Physical Activity and Dietary Guidelines With Cardiometabolic Health: The Framingham Heart Study.

Background The conjoint associations of adherence to the recent physical activity and dietary guidelines with the metabolic syndrome (MetS) are incompletely understood. Methods and Results We evaluated 2379 FHS (Framingham Heart Study) Third Generation participants (mean age, 47 years; 54.4% women) attending examination cycle 2. We examined the cross-sectional relations of adherence to the 2018 Physical Activity Guidelines for Americans (binary; moderate-to-vigorous physical activity ≥150 versus <150 min/wk) and 2015 Dietary Guidelines for Americans (binary; 2015 Dietary Guidelines for Americans Adherence Index ≥median versus

Austrian Moderate Altitude Studies (AMAS): benefits of exposure to moderate altitudes (1,500-2,500 m).

OBJECTIVES: A considerable part of the millions of Alpine tourists suffer from pre-existing diseases (e.g., metabolic syndrome) and high daily stress levels. The main goal of the Austrian Moderate Altitude Study (AMAS) was to investigate (a) the consequences of an active vacation at moderate altitude on the key parameters of the metabolic syndrome (AMAS I) and (b) the effects of a short active vacation on adult progenitor cells, bio-psychological parameters, and heart rate variability (HRV). METHODS: During the AMAS I pilot study (n = 22; 1,700 m a.s.l.) and AMAS I main study (n = 71; 1,700 m a.s.l. and 200 m a.s.l.), the volunteers simulated 3-week coached hiking vacations. For AMAS II, healthy volunteers (n = 13) participated in a 1-week active holiday at 1,700 m. RESULTS: There were significant improvements of obesity, hypertension, dyslipidemia, and insulin resistance of AMAS I patients after the vacation. In AMAS II participants, we found an increase in circulating endothelial progenitor cells as well as improvements in bio-psychological and HRV parameters. CONCLUSIONS: Active vacations at moderate altitude are associated with a variety of positive health effects in persons with metabolic syndrome and in healthy subjects.