Metabolic Syndrome
What is the reasonable weight loss goal in the first year?
2-10%
The primary goal of treatment is to reduce the risk of _______ and ________
CVD; type II diabetes
Ectopic obesity, such as IMAT, appears to independently contribute to impaired glucose metabolism and ______ insulin sensitivity
decreased
Metabolic disease is considered a ______
disease
Ectopic obesity
fat accruing in different locations
Most people with MS will be stratified as _________ or ______ which might prompt for additional screening and specific decisions about the prescribed intensity of testing and exercise
moderate; high risk
Signs and symptoms tend to overlap, but the S&S of ______ and diabetes are often prevelant
obesity
Exercise testing is not used for diagnostic purposes, but rather _____ purposes
prescriptive
Since the syndrome represents a confluence of many factors, there is no _______ etiological explanation for its development
singular
This can be accomplished via:
1. PA and EX 2. Surgery 3. Drugs
Modes of exercise prescription for MS patients
1. Aerobic 2. Resistance 3. Flexibility
These abnormal findings include:
1. Elevated waist circumference 2. Reduced HDL's 3. Elevated fasting glucose 4. Elevated blood pressure
Omega 3-fatty acids
Class an Primary Effects: Fish Oil Exercise Effects: None
Telmisartan, irbesartan, valsaratan
Class and Primary Effects: ANG II receptor blocker/ Blood pressure Exercise Effects: Decreased exercise blood pressure
Genfibrozil, fenofibrate
Class and Primary Effects: Fibrates/ Lipid Lowering Exercise Effects: Increase arrythmias and angina in patients with prior MI
Niacin
Class and Primary Effects: Nicotinic Acid/ Increase in HDL Exercise Effects: Possibly decrease in BP
Metformin
Class and Primary Effects: Oral antihyperglycemic Exercise Effects: None
Rimonabant
Class and Primary Effects: Selective CBI/ weight reduction
Lovastatin, Simvastatin, Pravastatin, Rosuvastain
Class and Primary Effects: Statins/ Lipid Lowering Exercise Effects: No effect
Resistance Training
Mode: 8-10 exercises for major muscle groups Freq: 2 days/week Intensity: 12-15 RM Duration: One Set
Flexibility
Mode: Static Stretching Freq: Postexercise Intensity: N/A Duration: 10-30s per exercise of each major muscle group
Aerobic exercise
Mode: Walking, cycling, swimming Freq: 5-7 days/weel Intensity: 50-75% VO2 max Duration: 45-60 minutes
___________________ (TNF-alpha, II-6) formation and secretion is increased by ectopic obesity, which leads to increased triglycerides, cholesterol, ROS, CRP and decreased HDL's
Pro-inflammatory cytokines
______________ (PAI-1, fibrinogen) are also linked to MS, but cause-effect vs. association has yet to be well established
Pro-thrombic
_____________ obesity appears to be a significant contributor to MS
abdominal
All five risk components of metabolic syndrome are modifiable, but ________ is the main driver, so treatment should focus on reducing this first
abdominal obesity
Decreases in ______ density, size, and function may also contribute to the severity of metabolic syndrone
mitochondrial
The new harmonized definition of metabolic syndrome recommends that diagnosis includes ___________ or more abnormal findings
three
Low intensity ______ and _____ protocols are often well tolerated by patients with obesity and MS
treadmill; bike