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Dose Effect of Cardiorespiratory Exercise on Metabolic Syndrome in Postmenopausal Women

      As an ancillary report to a large National Institutes of Health (NIH)–funded trial, we examined the effects of 6 months of exercise training at 50%, 100%, and 150% of the NIH Consensus Recommendations for physical activity (i.e., 4, 8, and 12 kcal/kg of energy expenditure/wk [KKW]) versus a nonexercise control group on the metabolic syndrome (MS) in sedentary, overweight, moderately hypertensive, postmenopausal women. We examined the clinically defined National Cholesterol Education Program MS, individual components scores, and summed z-scores, expressed as a continuous variable (zMS), using chi-square and general linear models to assess the clinical and progressive nature of MS, respectively. Our results showed significant improvements in zMS for all exercise groups and MS for the 8- and 12 KKW groups only (all, p for trend = 0.02). Post hoc analyses showed that 12 KKW for zMS and 8 and 12 KKW for MS was significant versus the control group (all, p <0.05). When examining the composite scores, we observed significant trends for improvement in waist circumference (p for trend = 0.001), fasting glucose (p for trend = 0.01), and systolic blood pressure (p for trend = 0.02), which appeared to be dose dependent, given the additive nature for incorporating the within-group improvements in waist circumference (4, 8, and 12 KKW), fasting glucose (8 and 12 KKW), and systolic blood pressure (12 KKW). Our results suggest that low-to-moderate intensity cardiorespiratory exercise appears to improve components of the MS in postmenopausal women at levels at or greater than NIH recommendations and that zMS improves at half the NIH recommendations. Greater levels of energy expenditure appear to enhance this effect by incorporating a greater number of requisite MS composite scores.
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      References

        • Grundy S.M.
        • Hansen B.
        • Smith Jr., S.C.
        • Cleeman J.I.
        • Kahn R.A.
        Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management.
        Circulation. 2004; 109: 551-556
        • Earnest C.P.
        • Artero E.G.
        • Sui X.
        • Lee D.C.
        • Church T.S.
        • Blair S.N.
        Cross-sectional association between cardiorespiratory fitness, cardiometabolic risk factors and metabolic syndrome in the Aerobics Center Longitudinal Study.
        Mayo Clin Proc. 2013; 88: 259-270
        • Church T.S.
        • Earnest C.P.
        • Skinner J.S.
        • Blair S.N.
        Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial.
        JAMA. 2007; 297: 2081-2091
        • Morss G.M.
        • Jordan A.N.
        • Skinner J.S.
        • Dunn A.L.
        • Church T.S.
        • Earnest C.P.
        • Kampert J.B.
        • Jurca R.
        • Blair S.N.
        Dose Response to Exercise in Women aged 45-75 yr (DREW): design and rationale.
        Med Sci Sports Exerc. 2004; 36: 336-344
      1. Physical activity and cardiovascular health: NIH consensus development panel on physical activity and cardiovascular health.
        JAMA. 1996; 276: 241-246
        • Alberti K.G.
        • Eckel R.H.
        • Grundy S.M.
        • Zimmet P.Z.
        • Cleeman J.I.
        • Donato K.A.
        • Fruchart J.C.
        • James W.P.
        • Loria C.M.
        • Smith Jr., S.C.
        Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.
        Circulation. 2009; 120: 1640-1645
        • Brage S.
        • Wedderkopp N.
        • Ekelund U.
        • Franks P.W.
        • Wareham N.J.
        • Andersen L.B.
        • Froberg K.
        Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS).
        Diabetes Care. 2004; 27: 2141-2148
        • Ekelund U.
        • Brage S.
        • Franks P.W.
        • Hennings S.
        • Emms S.
        • Wareham N.J.
        Physical activity energy expenditure predicts progression toward the metabolic syndrome independently of aerobic fitness in middle-aged healthy Caucasians: the Medical Research Council Ely Study.
        Diabetes Care. 2005; 28: 1195-1200
        • Johnson J.L.
        • Slentz C.A.
        • Houmard J.A.
        • Samsa G.P.
        • Duscha B.D.
        • Aiken L.B.
        • McCartney J.S.
        • Tanner C.J.
        • Kraus W.E.
        Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise).
        Am J Cardiol. 2007; 100: 1759-1766
      2. International Position Paper on Women's Health and Menopause: A Comprehensive Approach. NIH Publication No. 02–3284. National Heart, Lung, and Blood Institute, Bethesda2000 (Available at:) (Accessed on May 17, 2007)
        • Mesch V.R.
        • Boero L.E.
        • Siseles N.O.
        • Royer M.
        • Prada M.
        • Sayegh F.
        • Schreier L.
        • Benencia H.J.
        • Berg G.A.
        Metabolic syndrome throughout the menopausal transition: influence of age and menopausal status.
        Climacteric. 2006; 9: 40-48
        • Carr M.C.
        The emergence of the metabolic syndrome with menopause.
        J Clin Endocrinol Metab. 2003; 88: 2404-2411
      3. Earnest CP, Artero EG, Sui X, Lee DC, Church TS, Blair SN. Maximal estimated cardiorespiratory fitness, cardiometabolic risk factors, and metabolic syndrome in the Aerobics Center Longitudinal Study. Mayo Clin Proc Epub 2013 Feb 2.

        • Ford E.S.
        • Li C.
        Physical activity or fitness and the metabolic syndrome.
        Exp Rev Cardiovasc Ther. 2006; 4: 897-915
        • Katzmarzyk P.T.
        • Leon A.S.
        • Wilmore J.H.
        • Skinner J.S.
        • Rao D.C.
        • Rankinen T.
        • Bouchard C.
        Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study.
        Med Sci Sports Exerc. 2003; 35: 1703-1709
        • Stewart K.J.
        • Bacher A.C.
        • Turner K.
        • Lim J.G.
        • Hees P.S.
        • Shapiro E.P.
        • Tayback M.
        • Ouyang P.
        Exercise and risk factors associated with metabolic syndrome in older adults.
        Am J Prev Med. 2005; 28: 9-18
        • Watkins L.L.
        • Sherwood A.
        • Feinglos M.
        • Hinderliter A.
        • Babyak M.
        • Gullette E.
        • Waugh R.
        • Blumenthal J.A.
        Effects of exercise and weight loss on cardiac risk factors associated with syndrome X.
        Arch Int Med. 2003; 163: 1889-1895
        • Green J.S.
        • Stanforth P.R.
        • Rankinen T.
        • Leon A.S.
        • Rao Dc D.
        • Skinner J.S.
        • Bouchard C.
        • Wilmore J.H.
        The effects of exercise training on abdominal visceral fat, body composition, and indicators of the metabolic syndrome in postmenopausal women with and without estrogen replacement therapy: the HERITAGE family study.
        Metabolism. 2004; 53: 1192-1196
      4. Earnest CP, Lupo M, Thibodeaux J, Hollier C, Butitta B, Lejeune E, Johannsen NM, Gibala M, Church TS. Interval training in men at risk for insulin resistance. Int J Sports Med Epub 2012 Nov 23.

        • Tjonna A.E.
        • Lee S.J.
        • Rognmo O.
        • Stolen T.O.
        • Bye A.
        • Haram P.M.
        • Loennechen J.P.
        • Al-Share Q.Y.
        • Skogvoll E.
        • Slordahl S.A.
        • Kemi O.J.
        • Najjar S.M.
        • Wisloff U.
        Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study.
        Circulation. 2008; 118: 346-354
        • Grundy S.M.
        • Cleeman J.I.
        • Daniels S.R.
        • Donato K.A.
        • Eckel R.H.
        • Franklin B.A.
        • Gordon D.J.
        • Krauss R.M.
        • Savage P.J.
        • Smith Jr., S.C.
        • Spertus J.A.
        • Costa F.
        Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement.
        Circulation. 2005; 112: 2735-2752
        • Reaven G.M.
        Banting lecture 1988: role of insulin resistance in human disease.
        Diabetes. 1988; 37: 1595-1607
        • Reaven G.M.
        The insulin resistance syndrome: definition and dietary approaches to treatment.
        Annu Rev Nutr. 2005; 25: 391-406