Leisure-time physical activity and the metabolic syndrome in the Finnish diabetes prevention study

Pirjo Ilanne-Parikka, David E Laaksonen, Johan G Eriksson, Timo A Lakka, Jaanaöm Lindstr, Markku Peltonen, Sirkka Aunola, Sirkka Keinánen-Kiukaanniemi, Matti Uusitupa, Jaakko Tuomilehto, Finnish Diabetes Prevention Study Group, Pirjo Ilanne-Parikka, David E Laaksonen, Johan G Eriksson, Timo A Lakka, Jaanaöm Lindstr, Markku Peltonen, Sirkka Aunola, Sirkka Keinánen-Kiukaanniemi, Matti Uusitupa, Jaakko Tuomilehto, Finnish Diabetes Prevention Study Group

Abstract

Objective: To assess the effects of leisure-time physical activity (LTPA) and resistance training on metabolic syndrome (MetS) and its components in a post hoc analysis of the Finnish Diabetes Prevention Study, a randomized controlled lifestyle counseling trial.

Research design and methods: A cohort of 486 middle-aged overweight men and women with impaired glucose tolerance were followed for an average of 4.1 years. The intervention and control groups were combined in the analyses. LTPA was assessed by questionnaires, dietary intake by food records, and features of the MetS by anthropometric and biochemical measures annually. Resistance training sessions were documented for 137 participants.

Results: Increased moderate-to-vigorous LTPA, even after adjustments for changes in dietary intakes of total and saturated fat, fiber, and energy, and change in BMI was associated with a greater likelihood for resolution (29.7 vs. 19.1%; P = 0.004 in the upper versus lower third of change) and a lesser likelihood for development (23.5 vs. 44.7%; P = 0.041) of the MetS. Of the components of the MetS, the increase in moderate-to-vigorous LTPA was associated most strongly with improvement of glycemia. Among the 137 participants who participated in resistance training, MetS components were favorable in individuals who were in the upper third of participation rate (median 51 times/year) compared with individuals in the lowest third (median 8.5 times/year).

Conclusions: Increased moderate-to-vigorous LTPA was associated with a decreased likelihood of developing the MetS and an increased likelihood of its resolution in individuals at high risk for type 2 diabetes.

Trial registration: ClinicalTrials.gov NCT00518167.

Figures

Figure 1
Figure 1
Incidences (%) for the development (for individuals without MetS at baseline, n = 125) (□) and the resolution (for individuals with MetS at baseline, n = 361) (■) of the MetS according to LTPA change tertiles for total LTPA (A), moderate-to-vigorous LTPA (B), and low-intensity LTPA (C). Model 1: adjustments for age, sex, intervention group, and DPS study years. The change in low-intensity LTPA was also adjusted for change in moderate-to-vigorous LTPA and vice versa. Model 2: model 1 and adjustments for change in dietary intakes of total fat, saturated fat, fiber, and energy. Model 3: model 2 and change in BMI.

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