title: Diet or exercise: what is more effective in preventing or reducing metabolic alterations?
abstract: OBJECTIVE
  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 (beta=-0.023; 95% CI -0.028 -0.017; P<0.001) and the associations between fiber and glucose (beta=-0.022; -0.031 -0.013; 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.
authors.affiliation: Department of Internal Medicine, University of Turin, Corso Dogliotti 14, 10126 Turin, Italy. sbo@molinette.piemonte.it
authors.forename: Simona
authors.initials: S
authors.lastname: Bo
authors.forename: Giovannino
authors.initials: G
authors.lastname: Ciccone
authors.forename: Sabrina
authors.initials: S
authors.lastname: Guidi
authors.forename: Roberto
authors.initials: R
authors.lastname: Gambino
authors.forename: Marilena
authors.initials: M
authors.lastname: Durazzo
authors.forename: Luigi
authors.initials: L
authors.lastname: Gentile
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cassader
authors.forename: Paolo
authors.initials: P
authors.lastname: Cavallo-Perin
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Pagano
mesh_terms: D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D004032:Diet / Q000379:methods; D004038:Diet, Reducing / Q000379:methods*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000517:prevention & control*; D008875:Middle Aged; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D015431:Weight Loss / Q000502:physiology
chemical_list: D002097:C-Reactive Protein