Diet or exercise: what is more effective in preventing or reducing metabolic alterations?

Abstract

Objective/design: The influence of diet and exercise on metabolic syndrome is controversial since fit individuals might also eat healthier foods. We evaluated the association of diet/exercise variation with reductions in metabolic variables and C-reactive protein (CRP) values in the experimental and control arms of a 1-year randomized lifestyle intervention trial performed in patients with multiple metabolic abnormalities. Methods: A prospective study of 169 cases and 166 controls after a lifestyle intervention was performed. Results: In the intervention group, 15/169 (8.9%), 63/169 (37.3%), and 70/169 (41.4%) reached only dietary, only exercise, and dietary/exercise targets respectively. Reductions in weight, body mass index (BMI), and waist were significant only in patients who increased exercise. Most controls did not reach any target (131/166, 78.9%), while only few patients reached only dietary (13/166, 7.8%), only exercise (5/166, 3.0%), and dietary/exercise targets (17/166, 10.2%). Weight, BMI, and waist reduction was more pronounced in those reaching the exercise target. In the whole cohort, increased exercise was inversely associated with weight, BMI, waist, and CRP, increased saturated fat was directly associated with weight, BMI, waist, and diastolic pressure variations, while increased fiber intake was inversely associated with glucose values in a multiple regression model. After adjusting for waist changes, the associations between exercise and CRP (ßZK0.023; 95% CI K0.028 K0.017; P!0.001) and the associations between fiber and glucose (ßZK0.022; K0.031 K0.013; P!0.001) remained significant. Conclusions: Independent of weight reduction, exercise level and fiber intake are inversely associated with CRP and fasting glucose values respectively. Change in lifestyle may lower inflammation and prevent metabolic deterioration.European Journal of Endocrinology 159 685-691

Evidence-Based Guideline of the German Nutrition Society: Fat Intake and Prevention of Selected Nutrition-Related Diseases

“…In the intervention study of Bo et al [33] (LOE Ic), a positive association between SFA intake and weight gain was observed. In the cohort study of Butte et al [31] (LOE IIb), however, it was not.…”

The dynamic behaviour of metabolic syndrome and its components in an eight-year population-based cohort from the Mediterranean

“…Accordingly, high blood pressure and impaired glucose metabolism make the early detection of subjects with a very high risk of developing MS possible, allowing them to be prioritised for making the necessary lifestyle changes for both these components and for the later appearance of obesity and dyslipidaemia. Physical exercise [34,35] and changes in diet [36] have been shown to not only reduce the components of MS, but also to prevent its occurrence. This same reasoning may also explain why subjects' triglycerides may experience a substantial change, even though their HDL levels remain stable during the study follow-up period because these participants may have already adjusted their habits towards healthier lifestyles by increasing physical activity and/or changing their diet.…”

Erythrocyte saturated fatty acids and systemic inflammation in adults

“…For example, although most feeding trials suggest postprandial elevation in CRP following an SFA-rich meal, postprandial changes in other inflammatory markers such as IL-6 and tumor necrosis factor-alpha (TNFα) are largely inconsistent [29–32]. In cohort studies using dietary assessment, even the association between SFA intake and CRP has yet to be established, with results ranging from null [33], borderline positive [34], to significant in males only [35]. At least one study has applied both semi-quantitative FFQs and plasma lipid FA measurements [36].…”