Physical fitness has an important role
for our healthy living. The impact of this fitness is reflected both in
improvement in quality
and in improved longevity of life
according to various studies.
Dr. Hee-Jin Hwang and Dr. Sang-Hwan Kim from the Department of
Family Medicine, International St. Mary's Hospital, conducted a cross-sectional
study to determine the relation between the prevalence of metabolic syndrome
and physical fitness in
‘Physical fitness in the Elderly people should be promoted as it leads to a happier, healthier and longer life with less chances of developing metabolic syndrome and its accompanying complications.’
Their sample consisted of 227 subjects - 121 males and
106 females aged >60 years, who came to Yonsei Woori Geriatric Hospital
during the period of November 2008 - February 2009 and who signed up for the
research with an informed consent. The subjects were assessed using various
measurement was based on a lifestyle questionnaire, which included questions
regarding age and gender, current smoking habits, alcohol consumption and
self-reported amounts of physical activity. People with chronic liver or kidney
disease were excluded from the study.
Body or anthropometric
measurements were done using JENIX automatic measuring equipment to check for height and weight, and body mass
index (BMI) was calculated. Waist
(WC) was also measured.
, both systolic and diastolic was measured using a
sphygmomanometer. Blood tests included fasting glucose, total cholesterol,
triglyceride levels, High density
(HDL-C), low density
(LDL-C) and C - reactive protein (CRP) levels. Also glycated
hemoglobin level (HbA1c) was
tested which is elevated in diabetics.
was measured taking 3
parameters into account - muscular
strength was checked by assessing the grasping power using a digital
dynamometer; Muscular endurance was tested by employing the sit-up test which
checked the tone of the abdominal muscles in sitting up from a supine position
per 30 seconds; and cardio-pulmonary fitness
was assessed using Tecumseh step test in which heart rate was recorded before,
during and 1 minute after working on a high stepper at the rate of 24
A measure of physical activity was sought through an
International Physical Activity Questionnaire (IPAQ) which took into account
activities ranging from sedentary to vigorous exercise, work schedule, mode of
transport, domestic chores and spending of leisure time.
The research showed that there was no difference in
statistics between people having metabolic syndrome and
no metabolic syndrome in relation to age,
gender, smoking and drinking habits, diastolic BP, total cholesterol, LDL-C
levels, CRP, and physical activity. But there were significant differences seen
in case of BMI, WC, prevalence of diabetes and hypertension, fasting glucose
levels, HbA1c, triglycerides and HDL-C.
refers to a group of inter-related risk factors which are of metabolic origin
and which promote the development of cardiovascular problems. It is mostly
associated with type 2
Three or more of the below criteria must be present to have metabolic syndrome:
obesity - WC >102 cm in males and >88 cm in females (For Asians it
has been corrected to >90 cm in males and >80 cm in females).
- High fasting
glucose - >100 mg/dl fasting or on diabetic medications.
- High blood pressure - >130 mm Hg systolic and
>85 mm Hg diastolic BP.
- High triglyceride levels - >150 mg/dl.
- Low HDL-C
levels - <40 mg/dl for males and <50 mg/dl for females.
The study showed that 'increased BMI
were related to increased grasping power. This could be explained by the fact
that more skeletal muscle mass has more grasping power. Also higher triglyceride levels
showed lower performance on the
sit up test which can be related to central adiposity and insulin resistance.
High diastolic BP and high fasting glucose
also showed an increased heart rate
at rest. This proves the association between the additional aspects of physical
fitness like muscle strength and endurance; and risk of developing metabolic syndrome.
There were a few limitations to the study as well. It
is a cross-sectional study hence cause-effect relationship could not be established.
Self-reported physical activity is usually greater than an objective
measurement hence it could have altered the possibility of a relationship
between metabolic syndrome and physical
activity. There was a selection bias wherein only older people coming to one
hospital were chosen thus excluding younger population with metabolic syndrome
and the older people who did not go to that particular hospital. Lastly muscle
strength is validated in adolescents but not in the elderly, hence it is not an
effective measurement for the older age group.
In conclusion, the research aims at promoting
practices that not only improve cardio-pulmonary fitness but also enhance
muscle endurance in the elderly.