Low Levels of Leisure-Time Physical Activity and Cardiorespiratory Fitness Predict Development of the Metabolic Syndrome
- David E. Laaksonen, MD, MPH14,
- Hanna-Maaria Lakka, MD, PHD23,
- Jukka T. Salonen, MD, PHD236,
- Leo K. Niskanen, MD, PHD4,
- Rainer Rauramaa, MD, PHD57 and
- Timo A. Lakka, MD, PHD27
- 1Department of Physiology, University of Kuopio, Kuopio, Finland
- 2Research Institute of Public Health, University of Kuopio, Kuopio, Finland
- 3Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland
- 4Department of Medicine, University of Kuopio, Kuopio, Finland
- 5Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- 6Inner Savo Health Center, Kuopio, Finland
- 7Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
OBJECTIVE—Little is known about the association of leisure-time physical activity (LTPA) and cardiorespiratory fitness with development of the metabolic syndrome, which predisposes diseases such as diabetes and atherosclerosis. We studied the associations of LTPA and cardiorespiratory fitness with development of the metabolic syndrome (World Health Organization [WHO] and the National Cholesterol Education Program [NCEP] definitions).
RESEARCH DESIGN AND METHODS—LTPA over the previous 12 months, Vo2max (ml · kg−1 · min−1), and cardiovascular and metabolic risk factors were assessed in a population-based cohort of 612 middle-aged men without the metabolic syndrome.
RESULTS—At the 4-year follow-up, 107 men had metabolic syndrome (WHO definition). Men engaging in >3 h/week of moderate or vigorous LTPA were half as likely as sedentary men to have the metabolic syndrome after adjustment for major confounders (age, BMI, smoking, alcohol, and socioeconomic status) or potentially mediating factors (insulin, glucose, lipids, and blood pressure), especially in high-risk men. Vigorous LTPA had an even stronger inverse association, particularly in unfit men. Men in the upper third of Vo2max were 75% less likely than unfit men to develop the metabolic syndrome, even after adjustment for major confounders. Adjustment for possible mediating factors attenuated the association. Associations of LTPA and Vo2max with development of the metabolic syndrome, as defined by the NCEP, were qualitatively similar.
CONCLUSIONS—In particular, high-risk men engaging in currently recommended levels of physical activity were less likely to develop the metabolic syndrome than sedentary men. Cardiorespiratory fitness was also strongly protective, although possibly not independent of mediating factors.
- ACSM, American College of Sports Medicine
- CDC, Centers for Disease Control and Prevention
- IFG, impaired fasting glycemia
- IGT, impaired glucose tolerance
- KIHD, Kuopio Ischemic Heart Disease Risk Factor Study
- LTPA, leisure-time physical activity
- MET, metabolic equivalent
- NCEP, National Cholesterol Education Program
- OR, odds ratio
- WHO, World Health Organization
Address correspondence and reprint requests to Professor Jukka T. Salonen, MD, PhD, MScPH, Research Institute of Public Health, University of Kuopio, 70211 Kuopio, Finland. E-mail:.
Received for publication 1 February 2002 and accepted in revised form 22 May 2002.
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