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Published in: BMC Medicine 1/2011

Open Access 01-12-2011 | Research article

Even low level of physical activity is associated with reduced mortality among people with metabolic syndrome, a population based study (the HUNT 2 study, Norway)

Authors: Dorthe Stensvold, Javaid Nauman, Tom IL Nilsen, Ulrik Wisløff, Stig A Slørdahl, Lars Vatten

Published in: BMC Medicine | Issue 1/2011

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Abstract

Background

Low levels of physical activity may increase the risk of developing metabolic syndrome, a cluster of metabolic factors that are associated with the risk of premature death. It has been suggested that physical activity may reduce the impact of factors associated with metabolic syndrome, but it is not known whether physical activity may reduce mortality in people with metabolic syndrome.

Methods

In a prospective study of 50,339 people, 13,449 had metabolic syndrome at baseline and were followed up for ten years to assess cause-specific mortality. The population was divided into two age groups: those younger than 65 years of age and those older than age 65. Information on their physical activity levels was collected at baseline.

Results

Metabolic syndrome was associated with higher mortality from all causes (hazard ratio (HR) 1.35, 95% confidence interval (95% CI) 1.20 to 1.52) and from cardiovascular causes (HR 1.78, 95% CI 1.39 to 2.29) in people younger than 65 years old than among other populations. In older people, there was no overall association of metabolic syndrome with mortality. People with metabolic syndrome who reported high levels of physical activity at baseline were at a reduced risk of death from all causes compared to those who reported no physical activity, both in the younger age group (HR 0.52, 95% CI 0.37 to 0.73) and in the older age group (HR 0.59, 95% CI 0.47 to 0.74).

Conclusion

Among people with metabolic syndrome, physical activity was associated with reduced mortality from all causes and from cardiovascular causes. Compared to inactivity, even low levels of physical activity were associated with reduced mortality.
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Literature
1.
go back to reference Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002, 288: 2709-2716. 10.1001/jama.288.21.2709.CrossRefPubMed Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002, 288: 2709-2716. 10.1001/jama.288.21.2709.CrossRefPubMed
2.
go back to reference Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002, 287: 356-359. 10.1001/jama.287.3.356.CrossRefPubMed Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002, 287: 356-359. 10.1001/jama.287.3.356.CrossRefPubMed
3.
go back to reference Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA: Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health. 2007, 7: 220-10.1186/1471-2458-7-220.CrossRefPubMedPubMedCentral Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA: Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health. 2007, 7: 220-10.1186/1471-2458-7-220.CrossRefPubMedPubMedCentral
4.
go back to reference Lennie TA: The metabolic syndrome. Circulation. 2006, 114: e528-e529. 10.1161/CIRCULATIONAHA.106.633156.CrossRefPubMed Lennie TA: The metabolic syndrome. Circulation. 2006, 114: e528-e529. 10.1161/CIRCULATIONAHA.106.633156.CrossRefPubMed
5.
go back to reference Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM: Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007, 49: 403-414. 10.1016/j.jacc.2006.09.032.CrossRefPubMed Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM: Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007, 49: 403-414. 10.1016/j.jacc.2006.09.032.CrossRefPubMed
6.
go back to reference Grundy SM, Hansen B, Smith SC, Cleeman JI, Kahn RA, American Heart Association, National Heart, Lung, and Blood Institute, American Diabetes Association: Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation. 2004, 109: 551-556. 10.1161/01.CIR.0000112379.88385.67.CrossRefPubMed Grundy SM, Hansen B, Smith SC, Cleeman JI, Kahn RA, American Heart Association, National Heart, Lung, and Blood Institute, American Diabetes Association: Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation. 2004, 109: 551-556. 10.1161/01.CIR.0000112379.88385.67.CrossRefPubMed
7.
go back to reference Laaksonen DE, Lakka HM, Salonen JT, Niskanen LK, Rauramaa R, Lakka TA: Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome. Diabetes Care. 2002, 25: 1612-1618. 10.2337/diacare.25.9.1612.CrossRefPubMed Laaksonen DE, Lakka HM, Salonen JT, Niskanen LK, Rauramaa R, Lakka TA: Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome. Diabetes Care. 2002, 25: 1612-1618. 10.2337/diacare.25.9.1612.CrossRefPubMed
8.
go back to reference Lakka TA, Laaksonen DE: Physical activity in prevention and treatment of the metabolic syndrome. Appl Physiol Nutr Metab. 2007, 32: 76-88. 10.1139/h06-113.CrossRefPubMed Lakka TA, Laaksonen DE: Physical activity in prevention and treatment of the metabolic syndrome. Appl Physiol Nutr Metab. 2007, 32: 76-88. 10.1139/h06-113.CrossRefPubMed
9.
go back to reference Sisson SB, Camhi SM, Church TS, Martin CK, Tudor-Locke C, Bouchard C, Earnest CP, Smith SR, Newton RL, Rankinen T, Katzmarzyk PT: Leisure time sedentary behavior, occupational/domestic physical activity, and metabolic syndrome in U.S. men and women. Metab Syndr Relat Disord. 2009, 7: 529-536. 10.1089/met.2009.0023.CrossRefPubMed Sisson SB, Camhi SM, Church TS, Martin CK, Tudor-Locke C, Bouchard C, Earnest CP, Smith SR, Newton RL, Rankinen T, Katzmarzyk PT: Leisure time sedentary behavior, occupational/domestic physical activity, and metabolic syndrome in U.S. men and women. Metab Syndr Relat Disord. 2009, 7: 529-536. 10.1089/met.2009.0023.CrossRefPubMed
10.
go back to reference Korniloff K, Häkkinen A, Kautiainen H, Koponen H, Peltonen M, Mäntyselkä P, Oksa H, Kampman O, Vanhala M: Leisure-time physical activity and metabolic syndrome plus depressive symptoms in the FIN-D2D survey. Prev Med. 2010, 51: 466-470. 10.1016/j.ypmed.2010.09.007.CrossRefPubMed Korniloff K, Häkkinen A, Kautiainen H, Koponen H, Peltonen M, Mäntyselkä P, Oksa H, Kampman O, Vanhala M: Leisure-time physical activity and metabolic syndrome plus depressive symptoms in the FIN-D2D survey. Prev Med. 2010, 51: 466-470. 10.1016/j.ypmed.2010.09.007.CrossRefPubMed
11.
go back to reference Tjonna AE, Lee SJ, Rognmo O, Stolen TO, Bye A, Haram PM, Loennechen JP, Al-Share QY, Skogvoll E, Slordahl SA, Kemi OJ, Najjar SM, Wisloff U: Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation. 2008, 118: 346-354. 10.1161/CIRCULATIONAHA.108.772822.CrossRefPubMedPubMedCentral Tjonna AE, Lee SJ, Rognmo O, Stolen TO, Bye A, Haram PM, Loennechen JP, Al-Share QY, Skogvoll E, Slordahl SA, Kemi OJ, Najjar SM, Wisloff U: Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation. 2008, 118: 346-354. 10.1161/CIRCULATIONAHA.108.772822.CrossRefPubMedPubMedCentral
12.
go back to reference Stensvold D, Tjonna AE, Skaug EA, Aspenes S, Stolen T, Wisloff U, Slordahl SA: Strength training versus aerobic interval training to modify risk factors of metabolic syndrome. J Appl Physiol. 2010, 108: 804-810. 10.1152/japplphysiol.00996.2009.CrossRefPubMed Stensvold D, Tjonna AE, Skaug EA, Aspenes S, Stolen T, Wisloff U, Slordahl SA: Strength training versus aerobic interval training to modify risk factors of metabolic syndrome. J Appl Physiol. 2010, 108: 804-810. 10.1152/japplphysiol.00996.2009.CrossRefPubMed
13.
go back to reference Johnson JL, Slentz CA, Houmard JA, Samsa GP, Duscha BD, Aiken LB, McCartney JS, Tanner CJ, Kraus WE: Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise). Am J Cardiol. 2007, 100: 1759-1766. 10.1016/j.amjcard.2007.07.027.CrossRefPubMedPubMedCentral Johnson JL, Slentz CA, Houmard JA, Samsa GP, Duscha BD, Aiken LB, McCartney JS, Tanner CJ, Kraus WE: Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise). Am J Cardiol. 2007, 100: 1759-1766. 10.1016/j.amjcard.2007.07.027.CrossRefPubMedPubMedCentral
14.
go back to reference Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007, 116: 1081-1093.CrossRefPubMed Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007, 116: 1081-1093.CrossRefPubMed
15.
go back to reference O'Donovan G, Blazevich AJ, Boreham C, Cooper AR, Crank H, Ekelund U, Fox KR, Gately P, Giles-Corti B, Gill JM, Hamer M, McDermott I, Murphy M, Mutrie N, Reilly JJ, Saxton JM, Stamatakis E: The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences. J Sports Sci. 2010, 28: 573-591. 10.1080/02640411003671212.CrossRefPubMed O'Donovan G, Blazevich AJ, Boreham C, Cooper AR, Crank H, Ekelund U, Fox KR, Gately P, Giles-Corti B, Gill JM, Hamer M, McDermott I, Murphy M, Mutrie N, Reilly JJ, Saxton JM, Stamatakis E: The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences. J Sports Sci. 2010, 28: 573-591. 10.1080/02640411003671212.CrossRefPubMed
16.
go back to reference Holmen J, Midthjell K, Krüger Ø, Langhammer A, Holmen T, Bratberg G, Vatten L, Lund-Larsen P: The Nord-Trøndelag Health Study 1995-97 (HUNT 2): objectives, contents, methods and participation. Norsk Epidemiologi. 2003, 13: 19-32. Holmen J, Midthjell K, Krüger Ø, Langhammer A, Holmen T, Bratberg G, Vatten L, Lund-Larsen P: The Nord-Trøndelag Health Study 1995-97 (HUNT 2): objectives, contents, methods and participation. Norsk Epidemiologi. 2003, 13: 19-32.
17.
go back to reference Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009, 120: 1640-1645. 10.1161/CIRCULATIONAHA.109.192644.CrossRefPubMed Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009, 120: 1640-1645. 10.1161/CIRCULATIONAHA.109.192644.CrossRefPubMed
18.
go back to reference Paffenbarger RS, Lee IM: Physical activity and fitness for health and longevity. Res Q Exerc Sport. 1996, 67: S11-S28.CrossRefPubMed Paffenbarger RS, Lee IM: Physical activity and fitness for health and longevity. Res Q Exerc Sport. 1996, 67: S11-S28.CrossRefPubMed
19.
go back to reference Andersen LB, Schnohr P, Schroll M, Hein HO: All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med. 2000, 160: 1621-1628. 10.1001/archinte.160.11.1621.CrossRefPubMed Andersen LB, Schnohr P, Schroll M, Hein HO: All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med. 2000, 160: 1621-1628. 10.1001/archinte.160.11.1621.CrossRefPubMed
20.
go back to reference Lee IM, Skerrett PJ: Physical activity and all-cause mortality: what is the dose-response relation?. Med Sci Sports Exerc. 2001, 33: S459-S471. 10.1097/00005768-200106001-00016. discussion S493-S494CrossRefPubMed Lee IM, Skerrett PJ: Physical activity and all-cause mortality: what is the dose-response relation?. Med Sci Sports Exerc. 2001, 33: S459-S471. 10.1097/00005768-200106001-00016. discussion S493-S494CrossRefPubMed
21.
go back to reference Wisloff U, Nilsen TI, Droyvold WB, Morkved S, Slordahl SA, Vatten LJ: A single weekly bout of exercise may reduce cardiovascular mortality: how little pain for cardiac gain? 'The HUNT study, Norway'. Eur J Cardiovasc Prev Rehabil. 2006, 13: 798-804. 10.1097/01.hjr.0000216548.84560.ac.CrossRefPubMed Wisloff U, Nilsen TI, Droyvold WB, Morkved S, Slordahl SA, Vatten LJ: A single weekly bout of exercise may reduce cardiovascular mortality: how little pain for cardiac gain? 'The HUNT study, Norway'. Eur J Cardiovasc Prev Rehabil. 2006, 13: 798-804. 10.1097/01.hjr.0000216548.84560.ac.CrossRefPubMed
22.
go back to reference Lee DC, Sui X, Ortega FB, Kim YS, Church TS, Winett RA, Ekelund U, Katzmarzyk PT, Blair SN: Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Br J Sports Med. 2011, 45: 504-510. 10.1136/bjsm.2009.066209.CrossRefPubMed Lee DC, Sui X, Ortega FB, Kim YS, Church TS, Winett RA, Ekelund U, Katzmarzyk PT, Blair SN: Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Br J Sports Med. 2011, 45: 504-510. 10.1136/bjsm.2009.066209.CrossRefPubMed
23.
go back to reference Lollgen H, Bockenhoff A, Knapp G: Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med. 2009, 30: 213-224. 10.1055/s-0028-1128150.CrossRefPubMed Lollgen H, Bockenhoff A, Knapp G: Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med. 2009, 30: 213-224. 10.1055/s-0028-1128150.CrossRefPubMed
24.
go back to reference Hildrum B, Mykletun A, Dahl AA, Midthjell K: Metabolic syndrome and risk of mortality in middle-aged versus elderly individuals: the Nord-Trondelag Health Study (HUNT). Diabetologia. 2009, 52: 583-590. 10.1007/s00125-009-1271-5.CrossRefPubMed Hildrum B, Mykletun A, Dahl AA, Midthjell K: Metabolic syndrome and risk of mortality in middle-aged versus elderly individuals: the Nord-Trondelag Health Study (HUNT). Diabetologia. 2009, 52: 583-590. 10.1007/s00125-009-1271-5.CrossRefPubMed
25.
go back to reference Tjonna AE, Stolen TO, Bye A, Volden M, Slordahl SA, Odegard R, Skogvoll E, Wisloff U: Aerobic interval training reduces cardiovascular risk factors more than a multitreatment approach in overweight adolescents. Clin Sci (Lond). 2009, 116: 317-326. 10.1042/CS20080249.CrossRef Tjonna AE, Stolen TO, Bye A, Volden M, Slordahl SA, Odegard R, Skogvoll E, Wisloff U: Aerobic interval training reduces cardiovascular risk factors more than a multitreatment approach in overweight adolescents. Clin Sci (Lond). 2009, 116: 317-326. 10.1042/CS20080249.CrossRef
26.
go back to reference Haram PM, Kemi OJ, Lee SJ, Bendheim MO, Al-Share QY, Waldum HL, Gilligan LJ, Koch LG, Britton SL, Najjar SM, Wisloff U: Aerobic interval training vs. continuous moderate exercise in the metabolic syndrome of rats artificially selected for low aerobic capacity. Cardiovasc Res. 2009, 81: 723-732.CrossRefPubMed Haram PM, Kemi OJ, Lee SJ, Bendheim MO, Al-Share QY, Waldum HL, Gilligan LJ, Koch LG, Britton SL, Najjar SM, Wisloff U: Aerobic interval training vs. continuous moderate exercise in the metabolic syndrome of rats artificially selected for low aerobic capacity. Cardiovasc Res. 2009, 81: 723-732.CrossRefPubMed
27.
go back to reference Wisloff U, Ellingsen O, Kemi OJ: High-intensity interval training to maximize cardiac benefits of exercise training?. Exerc Sport Sci Rev. 2009, 37: 139-146. 10.1097/JES.0b013e3181aa65fc.CrossRefPubMed Wisloff U, Ellingsen O, Kemi OJ: High-intensity interval training to maximize cardiac benefits of exercise training?. Exerc Sport Sci Rev. 2009, 37: 139-146. 10.1097/JES.0b013e3181aa65fc.CrossRefPubMed
28.
go back to reference Walsh MC, Hunter GR, Sirikul B, Gower BA: Comparison of self-reported with objectively assessed energy expenditure in black and white women before and after weight loss. Am J Clin Nutr. 2004, 79: 1013-1019.PubMed Walsh MC, Hunter GR, Sirikul B, Gower BA: Comparison of self-reported with objectively assessed energy expenditure in black and white women before and after weight loss. Am J Clin Nutr. 2004, 79: 1013-1019.PubMed
29.
go back to reference Kurtze N, Rangul V, Hustvedt BE, Flanders WD: Reliability and validity of self-reported physical activity in the Nord-Trøndelag Health Study (HUNT 2). Eur J Epidemiol. 2007, 22: 379-387. 10.1007/s10654-007-9110-9.CrossRefPubMed Kurtze N, Rangul V, Hustvedt BE, Flanders WD: Reliability and validity of self-reported physical activity in the Nord-Trøndelag Health Study (HUNT 2). Eur J Epidemiol. 2007, 22: 379-387. 10.1007/s10654-007-9110-9.CrossRefPubMed
Metadata
Title
Even low level of physical activity is associated with reduced mortality among people with metabolic syndrome, a population based study (the HUNT 2 study, Norway)
Authors
Dorthe Stensvold
Javaid Nauman
Tom IL Nilsen
Ulrik Wisløff
Stig A Slørdahl
Lars Vatten
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2011
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-9-109

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