Effects Of An Eight-year Exercise Intervention On Metabolic Syndrome And Medication Use. A Randomized Clinical Trial

The premise that lifestyle modification through exercise training could improve metabolic syndrome (MetS) components and reduce medicine use is encouraging from the individual and public health perspective. PURPOSE: To assess if long-term exercise training, could restrain the worsening of MetS and the increased medicine use that normally occurs with aging in these patients. METHODS: Sixty-eight individuals with MetS were tested on three occasions during eight years. Participants were stratified in blocks by age, number of MetS factors, and body mass index (BMI) and randomized to the exercise training (TRAIN; n=34) or standard care (STD CARE; n=34) groups. All participants were under the supervision of their primary care physician and continued their routine medication. Additionally, the TRAIN group underwent supervised high-intensity interval cycling (HIIT) three times per week for 16 weeks (end of November to early April) during 8 consecutive years. RESULTS: MetS Z-score was similarly reduced over time in both groups (p=0.561 for group*time interaction). Conversely, after 8 years, the medicine use score, a score accounting for increases in dose and number of medicines, increased by 136% in the STD CARE group (p<0.001) while did not significantly change (19%, p=1.00) in the TRAIN group (p=0.015 for group*time interaction). VO2MAX increased from baseline to eight-year in TRAIN (10%; 2.53; 95% CI 0.11 to 4.96 mL·kg-1·min-1; P=0.04) and tended to decrease in STD CARE (-7%; -1.53; 95% CI -3.85 to 0.79 mL·Kg·min-1; P=0.32). A significant group*time interaction was found for cardiorespiratory fitness (CRF, assessed by VO2max; p=0.013). CONCLUSION: Our data suggest that yearly exercise training prevents the doubling of medication use that otherwise occurs during 8 years as MetS progresses. Although both, exercise training and medication, are equally effective in improving MetS (i.e., Z-score), the medicine therapy entails increased expenses and unwanted side effects. ClinicalTrials.gov identifier: NCT05120778 PID2020-116159RB- IOO