PDM: Metabolic Syndrome (2013)

PDM: Metabolic Syndrome (2013)

• Assessment
  In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, two-hour post-prandial blood glucose, A1C)?

  • Conclusion

    While limited research reports that low intensity physical activity, independent of weight loss and dietary change, has no significant impact on fasting glucose levels in adults with metabolic syndrome, limited research on moderate intensity physical activity reports mixed results on fasting glucose levels.

    In addition, while one feeding study reports that physical activity significantly decreases post-prandial glucose levels, both intervention and feeding studies report no significant impact of intensity on post-prandial glucose levels.

    Additional longer-term intervention studies are needed to ascertain an effect of physical activity on glycemic-related outcomes in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for impaired glucose tolerance and impaired fasting glucose. 

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, 2-hour post prandial blood glucose, A1C)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Cohen BE, Chang AA, Grady D, Kanaya AM. Restorative yoga in adults with metabolic syndrome: A randomized, controlled pilot trial. Metab Syndr Relat Disord. 2008; 6(3): 223-229.
      • Mestek ML, Plaisance EP, Ratcliff LA, Taylor JK, Wee SO, Grandjean PW. Aerobic exercise and postprandial lipemia in men with the metabolic syndrome. Med Sci Sports Exerc. 2008; 40(12): 2,105-2,111.
      • Pescatello LS, Blanchard BE, Van Heest JL, Maresh CM, Gordish-Dressman H, Thompson PD. The metabolic syndrome and the immediate antihypertensive effects of aerobic exercise: a randomized control design. BMC Cardiovasc Disord. 2008; 8: 12.
      • Zhang JQ, Ji LL, Fretwell VS, Nunez G. Effect of exercise on postprandial lipemia in men with hypertriglyceridemia. Eur J Appl Physiol. 2006; 98(6): 575-582.
  • Search Plan and Results: PDM: Physical Activity and Metabolic Syndrome 2012
     
  In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on lipid outcomes (TG, HDL)?

  • Conclusion

    While limited research reports that low intensity or short duration physical activity, independent of weight loss and dietary change, has no significant impact on triglyceride levels in adults with metabolic syndrome, limited research reports that moderate intensity physical activity, at a level of 135 minutes per week, significantly reduces plasma triglycerides by 33mg per dL (0.37mmol per L).

    The majority of research reported no significant impact of physical activity on HDL-cholesterol levels, regardless of duration or intensity.

    Additional longer-term intervention studies are needed to ascertain an effect of physical activity on lipid outcomes in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for lipid levels.

     

     

     

     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on lipid outcomes (TG, HDL)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Camhi SM, Stefanick ML, Katzmarzyk PT, Young DR. Metabolic syndrome and changes in body fat from a low-fat diet and/or exercise randomized controlled trial. Obesity (Silver Spring). 2010; 18(3): 548-554.
      • Casella-Filho A, Chagas AC, Maranhao RC, Trombetta IC, Cesena FH, Silva VM, Tanus-Santos JE, Negrao CE, da Luz PL. Effect of exercise training on plasma levels and functional properties of high-density lipoprotein cholesterol in the metabolic syndrome. Am J Cardiol. 2011; 107(8): 1,168-1,172.
      • Cohen BE, Chang AA, Grady D, Kanaya AM. Restorative yoga in adults with metabolic syndrome: A randomized, controlled pilot trial. Metab Syndr Relat Disord. 2008; 6(3): 223-229.
      • Mestek ML, Plaisance EP, Ratcliff LA, Taylor JK, Wee SO, Grandjean PW. Aerobic exercise and postprandial lipemia in men with the metabolic syndrome. Med Sci Sports Exerc. 2008; 40(12): 2,105-2,111.
      • Zhang JQ, Ji LL, Fretwell VS, Nunez G. Effect of exercise on postprandial lipemia in men with hypertriglyceridemia. Eur J Appl Physiol. 2006; 98(6): 575-582.
  • Search Plan and Results: PDM: Physical Activity and Metabolic Syndrome 2012
     
  In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on anthropometric outcomes (WC, WHR)?

  • Conclusion

    While limited research reports that low-intensity physical activity, independent of weight loss and dietary change, has no significant impact on waist circumference in adults with metabolic syndrome, limited research on moderate-intensity physical activity, at a level of 135 to 180 minutes per week, significantly reduces waist circumference by three cm.

    Additional longer-term intervention studies are needed to ascertain an effect of physical activity on anthropometric outcomes in adults with metabolic syndrome, with or without meeting the metabolic syndrome criteria for anthropometric measures.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on anthropometric outcomes (WC, WHR)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Camhi SM, Stefanick ML, Katzmarzyk PT, Young DR. Metabolic syndrome and changes in body fat from a low-fat diet and/or exercise randomized controlled trial. Obesity (Silver Spring). 2010; 18(3): 548-554.
      • Casella-Filho A, Chagas AC, Maranhao RC, Trombetta IC, Cesena FH, Silva VM, Tanus-Santos JE, Negrao CE, da Luz PL. Effect of exercise training on plasma levels and functional properties of high-density lipoprotein cholesterol in the metabolic syndrome. Am J Cardiol. 2011; 107(8): 1,168-1,172.
      • Cohen BE, Chang AA, Grady D, Kanaya AM. Restorative yoga in adults with metabolic syndrome: A randomized, controlled pilot trial. Metab Syndr Relat Disord. 2008; 6(3): 223-229.
  • Search Plan and Results: PDM: Physical Activity and Metabolic Syndrome 2012
     
  In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on blood pressure?

  • Conclusion

    While limited research reports that low-intensity or short-duration physical activity, independent of weight loss and dietary change, has no significant impact on blood pressure in adults with metabolic syndrome, limited research on moderate-intensity physical activity, at a level of 135 minutes per week, demonstrates it significantly reduces systolic blood pressure by 6mmHg and diastolic blood pressure by 3mmHg.

    Additional longer-term intervention studies are needed to ascertain an effect of physical activity on blood pressure in adults with metabolic syndrome, with or without meeting the metabolic syndrome criteria for blood pressure.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on blood pressure?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Casella-Filho A, Chagas AC, Maranhao RC, Trombetta IC, Cesena FH, Silva VM, Tanus-Santos JE, Negrao CE, da Luz PL. Effect of exercise training on plasma levels and functional properties of high-density lipoprotein cholesterol in the metabolic syndrome. Am J Cardiol. 2011; 107(8): 1,168-1,172.
      • Cohen BE, Chang AA, Grady D, Kanaya AM. Restorative yoga in adults with metabolic syndrome: A randomized, controlled pilot trial. Metab Syndr Relat Disord. 2008; 6(3): 223-229.
      • Pescatello LS, Blanchard BE, Van Heest JL, Maresh CM, Gordish-Dressman H, Thompson PD. The metabolic syndrome and the immediate antihypertensive effects of aerobic exercise: a randomized control design. BMC Cardiovasc Disord. 2008; 8: 12.
  • Search Plan and Results: PDM: Physical Activity and Metabolic Syndrome 2012
     
• Intervention
  In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on renal outcomes?

  • Conclusion

    There were no studies identified to evaluate the impact of physical activity, independent of weight loss and dietary change, on renal outcomes in adults with metabolic syndrome.

    Intervention studies are needed to ascertain the effect of physical activity on renal outcomes in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for renal measures.

     

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: PDM: Physical Activity and Metabolic Syndrome 2012