title: Influence of change in aerobic fitness and weight on prevalence of metabolic syndrome.
abstract: BACKGROUND
  The metabolic syndrome is the clustering of several cardiometabolic risk factors that can lead to the development of coronary heart disease and type 2 diabetes. We evaluated whether a change in aerobic fitness resulting from a lifestyle intervention could significantly change the odds of metabolic syndrome prevalence.
  
  
  METHODS
  Participants (n = 810) were recruited into PREMIER, a multicenter, randomized, controlled clinical trial with outcome assessments at 6 and 18 months. The primary eligibility criterion was a diagnosis of prehypertension or stage 1 hypertension. PREMIER randomized participants to 2 lifestyle interventions, both of which included increased physical activity, or an advice-only control group. Participants completed a submaximal treadmill exercise test; we used reduction in heart rate as the measure of improved aerobic fitness. We used logistic regression to determine intervention effects on metabolic syndrome prevalence. Our models controlled for dietary pattern change.
  
  
  RESULTS
  The lifestyle interventions had no significant effect on metabolic syndrome prevalence at 6 months or 18 months. When combining intervention and control groups, at 6 and 18 months, a 1-beat-per-minute reduction in heart rate was associated with a 4% reduction in prevalence of metabolic syndrome (P < .001). When we tested for weight change as a mediator, the association was no longer significant.
  
  
  CONCLUSIONS
  Increased aerobic fitness may reduce prevalence of metabolic syndrome. This association appears to be mediated through concomitant weight change.
authors.affiliation: University of Maryland School of Public Health, College Park, Maryland, USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Crist
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Champagne
authors.forename: Leonor
authors.initials: L
authors.lastname: Corsino
authors.forename: Lillian F
authors.initials: LF
authors.lastname: Lien
authors.forename: Guangyu
authors.initials: G
authors.lastname: Zhang
authors.forename: Deborah Rohm
authors.initials: DR
authors.lastname: Young
mesh_terms: D001835:Body Weight; D003376:Counseling; D004032:Diet; D015444:Exercise; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D015438:Health Behavior; D006339:Heart Rate; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000628:therapy*; D008875:Middle Aged; D010809:Physical Fitness; D015995:Prevalence; D016896:Treatment Outcome; D015431:Weight Loss