The role of exercise therapy and physical fitness in prevention and treatment of metabolic syndrome

Regimen measures including increase of physical activity and weight reduction are of crucial importance in the metabolic syndrome treatment since they influence directly its causes. As documented by numerous retrospective epidemiologic studies, physical inactivity and low physical fitness (except abdominal obesity and other factors) leads to the development of metabolic syndrome as a complex of the cardiovascular diseases risk factors. Moreover, physical inactivity seems to be more serious risk than abdominal obesity. The submitted work presents an overview of epidemiologic studies results related to the evaluation of physical activity level and cardiorespiratory fitness in prevention of individual metabolic syndrome components and the relation of these indicators to the degree of the compounding of these abnormalities. Positive influence of aerobic physical activity in the metabolic syndrome treatment lies in the decrease of insulin resistance through the activation of glucose transporters (GLUT - 4) in skeletal muscles and probably also through the change in muscular morphology (change in muscle fibres IIb to IIa); the involvement of the highest possible number of muscle groups and regular repetition of physical activity is an important condition of its positive influence. Increased insulin sensitivity leads to further adaptation changes in metabolism (blood lipids, visceral fat, glucose tolerance), in cardiovascular area (blood pressure, heart rate) and to the possibility to influence positively the sympathovagal dysbalance accompanying the metabolic syndrome. Regarding the exercise therapy administration to the metabolic syndrome patients, there can be used the rules outgoing of the recommendations of American Diabetes Association, taking account also of the series of limitations arising from the associated obesity, hypertension, type 2 diabetes, specific diabetic complications etc. Exercise therapy should be dosed similarly to any other kind of therapy and different effects can be expected from different doses. In clinical practice it is important to decide what type of exercise therapy, what intensity, duration and frequency we chose for the patient in order to offer him a therapy which will be safe, available, acceptable also from the psychological aspect and at the same time lead to the a positive effect.

Keywords: metabolic syndrome; insulin resistance; exercise therapy; physical inactivity; cardiorespiratory fitness