Metabolic Syndrome

Question 1

What is MetS and what are its effects?

Answer 1

Group of interconnected physiological, biochemical, clinical and metabolic factors that cause a state of low grade inflammation, directly increasing the RF of CVD and all-cause mortality.

Question 2

How does abdominal obesity contribute to MetS?

Answer 2

Obesity = blood supply to adipocytes = constant hypoxia = necrosis and macrophage infiltration to the adipose tissue causing localised inflammation

Question 3

How does Insulin resistance contribute to MetS?

Answer 3

Causes a ↓ endothelial NO production = endothelial dysfunction, & a ↓ in GLUT4 translocation = ↓ skeletal muscle & fat glucose uptake

Question 4

How does Dyslipidemia contribute to MetS

Answer 4

↑ FFA to liver = ↑ TRG containing VLDL and ↑ TRG synthesis. Results in ↑ oxidative stress and endothelial dysfunction

Question 5

How is MetS diagnosed?

Answer 5

presence of >3 of these components:
•	Abdominal obesity (>35inchs – women, >40inches – men)
•	TRG > 150mg.dL
•	HDL-C 10/85mmHg
•	FBG >100mg.dL

Question 6

What medications are clients with MetS typically on?

Answer 6

• B-blockers – cardioprotective in patients with CVD
• ACE inhibitors (antihypertensives)
• Statins (Cholesterol)

Question 7

Is Metformin used in this population?

Answer 7

No!

As it has not been shown to decrease the risk of CVD in MetS

Question 8

What are the aerobic recommendations for this population?

Answer 8

F: Most days of the week
I: Continuous or intermittent low (40-60%V02R or HRR) to moderate (590-75%V02R or HRR) exercise
T: 30min/day or 150-250mins of moderate intensity PA/wk
T: Continuous or intermittent low to moderate exercises involving large muscle groups
V: 1200-2000kcal/wk
P: Increase the volume of exercise to stimulate weight loss. Progressively increase ex duration, and intensity as aerobic capacity increases

Question 9

What are the strength recommendations for this population?

Answer 9

F: Each muscle group should be trained 2-3x/wk
I: 60-70% 1RM for untrained individuals, 40-50% for sedentary individuals beginning an RT program
T: -4 sets. A single set of RT can be effective at increasing strength in older adults. 10-15 repetitions is effective at ↑ strength in middle-aged to older individuals
T: Involve each major muscle group, Multijoint exercises affected more than one muscle group. Can use machine-based exercises, free-weight exercises, resistance-band exercises or body weight exercise
P: Begin at 50% 1RM, progress to 75-80% 1RM. A gradual progression of greater resistance, and/or repetitions per set, and/or increasing frequency is recommended

Question 10

What are the Special considerations in clients with MetS

Answer 10

Individuals are likely to have low exercise capacity due to obesity, thus start with a low initial WL (2-3 METs) and progress in small increments (0.5-1MET) Effect of CVD risk factors