ISSN: 2638-6003
Wei Y Huang1 and Hsuan Huang2*
Received: December 17, 2020; Published:January 06, 2021
Corresponding author:Huang Hsuan, Department of Occupational Therapy, National Cheng Kung University, Taiwan
DOI: 10.32474/OSMOAJ.2021.04.000198
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This study examined the influence of aerobic exercise on the cardiorespiratory endurance and skeletal muscle of metabolic syndrome. An experimental research method was adopted, sampling community health service center people participating in health examination, 15 middle-aged men with waist circumference greater than 90cm (age 49.11±3.32) as subjects. Participants received 60-min aerobic exercise sessions two times a week for 10 weeks (20 sessions in total). The research tool uses a body composition analyzer (In Body) to detect skeletal muscle and basal metabolic rate; a three-minute cardiorespiratory endurance test (Harvard Step Test) is used to understand the subject’s cardiorespiratory endurance index after aerobic training. The results of the study found that weight loss, skeletal muscle rate t = -6.58*, and basal metabolic rate t = -5.77* all improved, and the cardiopulmonary endurance index increased from 52.64 to 58.31, from “poor” to “average” “within. The study concluded that aerobic exercise can consume more deep fat, reduce the risk of suffering from metabolic syndrome, help improve cardiorespiratory endurance and skeletal muscles, and achieve the results of rehabilitation and health improvement.
Keywords: Metabolic Syndrome; Cardiorespiratory Endurance; Aerobic Exercise; Skeletal Muscle Rate; Basal Metabolic Rate
Metabolic syndrome (MS) is a group of metabolic diseases
that appear in the same person. Its main metabolic abnormalities
include obesity, dyslipidemia, hyperglycemia, hypertension, insulin
resistance or glucose intolerance and other risk factors [1-4], one
person At the same time, as long as there are more than three risk
factors, it can be presumed to be metabolic syndrome [5], that is, MS
is not a disease but a warning sign of the body [6,7], it is also a “predisease
state” in which the body begins to experience metabolic
abnormalities. MS is an aggregation of risk factors that increase
the incidence of cardiovascular events and diabetes mellitus (DM).
Population aging is accompanied by higher prevalence of MS
[8,9]. The prevalence of MS increases with age, with about 40% of
people older than 60 years meeting the criteria [10]. Now days MS
can no longer be considered a disease of only adult populations.
Alarmingly, MS and DM are increasingly prevalent in the pediatric
population, again in parallel with a rise in obesity [11]. Most middleaged
people have abdominal obesity, and thus constitute a high-risk
group for MS. Statistics have indicated that people with visceral
obesity have a 50% chance of developing MS [12]. Middle-aged
people who belong to the high-risk group of MS can easily lead to
chronic diseases such as diabetes, heart disease, and hypertension
if they do not control their diet and exercise [13-15].
General body composition is composed of body fat mass, body
fat percentage, skeletal muscle rate (SMR) and basal metabolic rate
(BMR) [16]. Among them, the MS is closely related to its own BMR
[17], and because the BMR is positively correlated with SMR growth
and exercise [18]. One of the most critical elements of physical
fitness is cardiorespiratory endurance. Relying on the kinetic
functions of the heart and lungs, cardiorespiratory endurance
refers to the body’s ability to continue supplying energy to the
human circulatory system and muscles over extended periods
[17]. There had been positive reports [19,21] about how advanced
cardiorespiratory endurance not only enables one to engage in
aerobic exercises, such as walking and jogging for a longer time. From the above literature, we could see the feasibility of this study. After
a long period of aerobic exercise, people with metabolic syndrome
and generally healthy people should be able to improve the growth
rate of skeletal muscle and improve cardiorespiratory endurance
[22,25]. This was also the focus of this research. In addition to
dietary control, frequent exercise is the best method for staving off
MS, where daily exercise invigorates the body [26]. Evidence has
indicated that aerobic exercise is an effective method of improving
cardiorespiratory endurance, aerobic exercise can significantly
improve health [27,30]. Relevant studies have indicated that
starting from 30 years old, lack of exercise is the primary driver of
aging-related loss of muscle mass [31,32]. Some other studies have
indicated that exercise can enhance bone density, reduce body fat,
enhance metabolism, and prevent chronic diseases [33,34]. Aerobic
exercise can strengthen the muscles surrounding and supporting
the joints can help maintain a good body shape and enhance the
integrity of the joints, thereby helping to prevent injuries [35,36].
Aerobic exercise will strengthen the skeletal muscles and help the
bones to stay strong. Just like your brain, skeletal muscles need to
be exercised to maintain muscle strength [37]. Some MS become
obese, muscle strength deteriorates, physical vitality decreases,
and even chronic diseases are caused by lack of exercise [38].
MS is a symptom produced by modern society and civilization,
and because aerobic exercise has a positive effect on the physical
composition of individuals, this study uses middle-aged people with
MS as the research object, and uses aerobic exercise to understand
the cardiorespiratory endurance and skeletal muscles of MS.
An experimental research method was adopted, in cooperation with the community health service center, and implemented in the school gym. The subjects were people who participated in the health checkup at the community health service center. Middleaged men with a waist circumference greater than 90cm were the sample objects, a total of 15 people were sampled (age = 47.89 ± 6.24 years). Participants received 60-min aerobic exercise training sessions two times a week for 10 weeks (20 sessions in total). All training and testing are performed by the research team. This study did not involve personal privacy and strictly adhered to research ethics. As for the subjects’ psychological symptoms, disease history, family factors and other potential variables, they were listed as control variables. Aerobic training courses are shown in Table 1[39].
A body composition analyzer (InBody 230) was used to measure SMR, and BMR. The mechanism underlying the InBody analyzer is the method of bioelectrical impedance analysis, which utilizes the impedance of current flow; specifically, the lower the conductivity of the muscles, blood, body fat, and skin, the higher the impedance is [40]. Take a 3-minute test of cardiorespiratory endurance (Harvard step test) to learn about the subjects’ cardiorespiratory endurance index after aerobic training. Use a 35cm high step, 96 beats per minute metronome, a total of three minutes of operation, after completing the test, measure 1 minute to 1.5 minutes, 2 minutes to 2.5 minutes, 3 minutes to 3.5 minutes, three 30-second wrist pulse rates. The cardiorespiratory endurance index score is then determined by the following equations. Cardiorespiratory Endurance Index = (100 x test duration in seconds) divided by (2 x sum of heart beats in the recovery periods). And consider the male cardiorespiratory endurance index norm [41], as shown in Table 2.
Pre-test and post-test data were obtained and analyzed in SPSS (version 23.0). Descriptive statistics (specifically, the mean and standard deviation) were used to summarize the participants’ characteristics, and t tests were used to analyze after aerobic training changes in cardiorespiratory endurance (CRE), SMR and BMR.
The results of this study are divided into two parts: First, Descriptive statistics of SMR, BMR, CRE before and after aerobic exercise; Second, Difference analysis of SMR, BMR, CRE before and after aerobic exercise for subjects.
In this study, 15 men (age 49.11±3.32) were the subjects. These subjects were middle-aged men with waist circumference greater than 90 cm. According to the data in Table 3, the weight of the subjects was overweight or obese, and the cardiorespiratory endurance did not reach the standard average value. The data in Table 4 shows that the average weight of the subjects decreased significantly after aerobic exercise training, while the skeletal muscle, basal metabolism, and cardiopulmonary endurance were significantly improved.
Pre-test results: The average weight of the subjects was 84.47 kg, the SMR was 29.30%, which was slightly too low, the BMR was 1585 kcal/day, and the cardiorespiratory endurance index was 52.64, which was a poor state.
Post-test results: The average weight of the subjects was 78.67 kg, the SMR was 34.98% above the normal range (32~34% of the normal range), and the BMR was 1623 kcal/day, which was in the normal range (the male is 1400~1700) Card) [42], cardiorespiratory endurance index (cardiorespiratory endurance index) of 58.31 belongs to average state. According to the above data, aerobic exercise can increase the body’s BMR [43,44], and improve the effect of cardiopulmonary endurance [45,46], and the BMR is positively correlated with skeletal muscle [47]. Increasing skeletal muscle can increase the BMR, which not only helps burn calories and avoid weight gain, so the metabolic rate is low, and the risk of weight gain is low higher.
Table 5 shows the difference analysis of SMR, BMR, CRE before and after aerobic exercise, all of which have significant differences. In terms of weight: t = 7.89* reached a significant level of .05, which means that after the aerobic exercise course, the average weight dropped from 84.47 kg to 78.67 kg. In terms of skeletal muscle rate: t = -6.58* reached a significant level of .05, and the average skeletal muscle rate increased from 29.30% to 34.98%. In terms of basal metabolic rate: t = -5.77* reached a significant level of .05. The average basal metabolic rate increased from 1585 kcal/day to 1623 kcal/day, with an average daily increase of 38 calories. Cardiorespiratory endurance index (CRE index): t = -18.96* reached a significant level of .05. After the subjects undergo aerobic exercise, the cardiorespiratory endurance index increased from 52.64 to 58.31, that is, from “poor” to “average” range (see Table 2). Based on the above results, the subjects significantly increased their cardiorespiratory endurance index and skeletal muscle rate after ten weeks of aerobic exercise training.
This study focused on improvements to cardiorespiratory endurance, skeletal muscle and basal metabolism from middleaged people with metabolic syndrome of aerobic exercise.
In general, the public is often interested in studies reporting that certain types of physical activity can lead to weight loss [48]. The present study’s findings revealed the following. In general, aerobic exercise does not immediately affect all middle-aged people with metabolic syndrome. In particular, aerobic exercise effect on skeletal muscle and basal metabolism are relatively weak, thus, a longer aerobic exercise period may be required for improvements in BMR to be notable. This is consistent with findings in the literature. For example, a study noted that although basal metabolic rate gradually decreases with age, an individual can enhance their metabolic function as long as they maintain favorable exercise habits [49]. According to research reports, metabolic syndrome has become a precursor to chronic diseases in middle-aged people (at least 3 of the following: abdominal adiposity, low HDL cholesterol, high triglycerides, hypertension, and impaired fasting glucose) [50]. With the successful conquest of communicable infectious diseases in most of the world, this new non-communicable disease (NCD) has become the major health hazard of modern world [51]. Many studies have confirmed that exercise can prevent the occurrence of metabolic syndrome early, because exercise is a cost-effective intervention to both prevent and reduce the impact of the metabolic syndrome [52,55].
“Exercise is Medicine, Exercise is the best medicine”, aerobic exercise is an important item for regular exercise. Cardiopulmonary function is the most important fitness in physical fitness, and it is also closely related to cardiovascular disease risk factors. Therefore, in regular exercise, aerobic exercise can be listed as an important item, and it must also improve and maintain good cardiopulmonary function, which can not only promote health and prevent diseases disease and can improve the quality of life. Although aerobic exercise and CRE are often used interchangeably, it is important to recognize that they are different; aerobic exercise is a behavior and CRE is an attribute. CRE is improved by aerobic exercise, but it is influenced by other factors, including genetics. Some studies have reported that a 20‐week supervised aerobic exercise training reduced metabolic syndrome prevalence by 31% [56]. Nevertheless, this experiment most middle-aged people with metabolic syndrome will improve CRE by following the aerobic exercise. A few prospective studies have revealed that aerobic exercise and cardiorespiratory endurance are predictors of metabolic syndrome incidence [57,58]. One clinical intervention studies have shown that regular aerobic exercise clearly improved risk factors for metabolic syndrome in obese people [59,60]. Studies have also shown that confirmed the improvement of metabolic syndrome with increased cardiorespiratory endurance [61,62]. Cardiopulmonary endurance is an objective indicator of aerobic exercise patterns, which is negatively correlated with the incidence of metabolic syndrome [63,64]. Laaksonen, et al [63]. reported that half and two-thirds of adult men had a 47% and 75% reduction in the probability of developing metabolic syndrome in the results of the maximum oxygen uptake experiment.
The skeletal muscle mass comprises approximately 40%
of total body mass and is the primary source of insulin-mediated
glucose uptake and fatty acid oxidation. The aerobic exercise evokes
adaptation in skeletal muscle in a multitude of nerve stimulation,
the functional response to which is determined by training volume,
mode of training, intensity and frequency. With persistent aerobic
exercise exposure, there is mitochondrial biogenesis, fast-toslow
fiber-type transformation, changes in substrate metabolism,
and angiogenesis. Aerobic exercise brings additional benefits
to energy expenditure from its ability to develop and maintain
the functions of muscle mass and BMR [65,67]. Because their
physiological structures differ, men have greater muscle mass and
less body fat [Tomlinson, et al. 2016]. Studies have observed that
aerobic exercise training reduced body fat but slightly increased
body weight [47,69], because body fat is reduced faster than the
proliferation of skeletal muscle, only decreases body weight slightly.
Many studies have also confirmed that aerobic exercise training can
also increase the proportion of lean muscle mass, strengthen the
skeletal muscles, and enhance metabolic capacity [68,70]. Studies
have indicated that SMR is positively correlated with BMR and
lean muscle mass, which, in turn, are positively associated with
calories burnt in a day [71]. In the absence of exercise in adults,
muscle mass begins to decline after the age of 30, and bone mass
is also lost [72]. Studies have shown that low muscle mass is a risk
factor for low bone density, so even low-intensity aerobic exercise
will have a positive effect on preventing skeletal muscle loss [73].
On the other hand, although bone and muscle mass will change
with weight, some patients with abnormal metabolic function,
the increase in weight is not accompanied by the increase in bone
and muscle mass, which means that osteopenia type obesity will
occur osteosarcopenic obesity [74], and complicating metabolic
syndrome [75,76]. Additionally, some studies have confirmed that
aerobic training can increase the consumption of deep abdominal
fat, which reduces the risks of diabetes and metabolic syndrome
[54,68]. The total weight of men measured in this study belongs to
the obese group, and the abdomen is larger than 90cm. In order to
avoid excessive abdominal fat accumulation, exercise training can
be used to increase muscle mass and increase the basal metabolic
rate, this finding is consistent with others in the literature [29,79].
The damage caused by metabolic syndrome to the human body
should not be underestimated, it worsens one’s health condition
in the short term and can even produce chronic diseases. This
study confirmed that aerobic exercise training is an effective way
to improve the cardiorespiratory endurance and skeletal muscles
of middle-aged people with metabolic syndrome. Many people
incorrectly believe that they cannot control their own bodily
functions, but many studies have confirmed that aerobic exercise
can improve cardiorespiratory endurance and skeletal muscle,
which means that bodily functions can be controlled. While it is
clear that exercise is important, the mechanistic pathways behind
exercise-induced benefits on metabolic syndrome are still being
identified. Further, aerobic exercise will improve cardiorespiratory
endurance and skeletal muscle function of metabolic syndrome
which can act in conjunction with exercise programs, and for
metabolic syndrome individuals whom are unable or unwilling to
exercise to amplify the beneficial effects of exercise. These data
together emphasize the importance of aerobic exercise to prevents
the development of metabolic syndrome and promotes recovery
and improved health in patients with cardiorespiratory endurance
and skeletal muscle.
We thank to the participants and professionals involved in this study. The study was designed by H.W-Y., and H.H.; data were collected and analyzed by H.W-Y.; data interpretation and manuscript preparation were undertaken by H.W-Y., and H.H.; literature analysis by H.W-Y.; collection of funds by H.H. All authors have read and agreed to the published version of the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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