May 20, 2014
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Exercise halted CVD progression in middle-aged overweight, obese women

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Women who are overweight or obese and already at risk for diabetes or cardiovascular disease could delay or prevent the progression of cardiometabolic syndrome by keeping physically active, according to findings published in The Journal of Clinical Endocrinology & Metabolism.

“The most important and positive finding of this study are the beneficial effects of physical activity in protecting against CVD risk, even in the presence of known risk factors,” Unab I. Khan, MD, MS, of Albert Einstein College of Medicine and Montefiore Medical Center in Bronx, N.Y., told Endocrine Today. “Hence, we as physicians should promote physical activity for all our patients.”

Unab I. Khan, MD, MS

Unab I. Khan

Khan and colleagues evaluated 866 metabolically healthy women who participated in the Study of Women Across the Nation (SWAN) — a 7-year multicenter, multiethnic, longitudinal study of women going through menopause. The researchers used discrete-time proportional hazard modeling to determine the incident progression from metabolically benign overweight/obese (MBO, fewer than two metabolic syndrome abnormalities) to at-risk overweight/obese (ARO, two or more metabolic syndrome abnormalities), as well as factors related to progression. Data included blood pressure, cholesterol and blood glucose levels, as well as physical activity surveys.

From baseline, 373 women (43%) progressed to the ARO phenotype. They showed higher baseline BMI and a higher prevalence of cardiometabolic abnormalities compared with those who remained MBO, including higher glucose, triglycerides, BP, LDL and HDL cholesterol. Increase in BMI was associated with a modest increase in the risk of progression, as seen by multivariable analyses.

All cardiometabolic abnormalities correlated with increased risk of progression; however, the baseline impaired fasting glucose showed the strongest association with risk (HR=3.24; 95% CI, 2.1-4.92). Physical activity protected against progression risk (HR=0.86; 95% CI, 0.8-0.92).

“Because it is such a struggle for many people to lose weight, keeping people in a state of metabolically healthy obesity offers one potential avenue for reducing the rate of [CVD].” Khan said in a press release. “This demonstrates the important role exercise plays in protecting women from the adverse health effects of obesity.” – by Allegra Tiver

Disclosure: The SWAN study received support from the NIH, National Institute on Aging, National Institute of Nursing Research and Office of Research on Women’s Health.