To date, numerous investigations have identified the role of exercise and physical activity in prevention and treatment of Type 2 diabetes and cardiovascular disease (CVD). This review paper analyzed epidemiological findings which investigated the effects of obesity, physical activity participation and the level of fitness levels on prevalence and risk factors of Type 2 diabetes and CVD. These studies showed that not only prevention of obesity, but also participation of physical activity and maintenance of good level of fitness are important to prevent and treat Type 2 diabetes and CVD. In addition, prevention of obesity and improvement of high fitness levels at early ages (childhood and adolescence) are important to prevent the prevalence and incidence of Type 2 diabetes and CVD.
Cardiovascular Diseases ; Incidence ; Insulin Resistance ; Korea ; Motor Activity ; Obesity ; Prevalence ; Risk Factors

BACKGROUND: Obesity-induced insulin resistance is an important risk factor for type 2 diabetes and cardiovascular disease. However, as potential mechanisms of increased insulin, how oxidative stress (OS) advanced glycation end-products (AGEs) can be changed through exercise is not fully understood. METHODS: A total of 36 C57BL/6 mice were fed either a high-fat diet (HFD; n=19) or chow diet (Chow; n=17) for 7 weeks. The two groups were then divided into voluntary running wheel exercise or no-exercise subgroups each, and the four groups were provided with another 8 weeks of intervention: 1) HFD+exercise (HE; n=11), 2) HFD+no exercise (HN; n=8), 3) Chow+exercise (CE; n=8), and 4) Chow+no exercise (CN; n=9). Body weight, fasting insulin level, and AGEs were measured before and after intervention. ANOVA and Pearson's multiple correlation coefficients were used for statistical analysis using SPSS statistics software version 20.0. RESULTS: The HE group showed significantly greater weight reduction (P<0.01), while CE and CN did not show significantly different weight reductions between each other. Also, the fasting insulin level was significantly lower in the HE group than in the HN group. The 7-week HFD intervention significantly increased OS and AGEs. However, 8 weeks of exercise did not significantly change OS and AGEs among the groups. CONCLUSION: The findings of the current study suggest that OS and AGEs may not be related to the pathway of exercise-induced improvement in insulin levels in obese mice.
Animals ; Body Weight ; Cardiovascular Diseases ; Diet ; Diet, High-Fat ; Fasting ; Glycosylation End Products, Advanced ; Insulin Resistance ; Insulin ; Mice ; Mice, Obese ; Oxidative Stress ; Risk Factors ; Running ; Weight Loss

BACKGROUND: The purpose of the current study was to investigate the association between the level of obesity and physical fitness (PF) during adolescence and the risk factors of metabolic disorders during adulthood. METHODS: In the current analysis, 3,993 Korean adults (mean age, 38.70 +/- 1.69 years) were recruited. The level of body index (BI) and PF were examined during adolescence through high school record, and their health examination data, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), total cholesterol (TC), and current body mass index (BMI) were obtained from National Health Insurance Corporation Data. Gender-specific analyses were administered to compare health exam data across the level of BI, the level of PF, and a mixed level of BI and PF. RESULTS: Most obese males during high school had statistically higher SBP, DBP, FG, and BMI in adulthood, and most obese females had higher BMI, as compared to most lean males or females. Least fit males during high school had statistically higher BMI in adulthood, and least fit females had statistically higher SBP, DBP, FG, TC, and BMI, as compared to most fit males or females. There was a significant relationship between the mixed level of BI and PF and SBP, DBP, TC and current BMI in both genders. CONCLUSION: Maintaining a healthy level of body weight and PF during adolescence is recommended to prevent the development of metabolic diseases in adulthood.
Adolescent ; Adult ; Blood Pressure ; Body Mass Index ; Body Weight ; Cholesterol ; Fasting ; Female ; Glucose ; Humans ; Male ; Metabolic Diseases ; National Health Programs ; Obesity ; Physical Fitness ; Risk Factors

BACKGROUND AND OBJECTIVES: Supervised lifestyle interventions, including dietary and exercise programs, may be infeasible to implement in real-world settings. Therefore, this study aimed to evaluate the effectiveness of a home-based lifestyle modification intervention on blood pressure (BP) management. METHODS: Eighty-five patients aged over 20 years and diagnosed with prehypertension or mild hypertension were randomly assigned to an advice-only comparison group (C group, n=28), a Dietary Approaches to Stop Hypertension (DASH) diet education group (D group, n=30), or a DASH and home-based exercise group (D+Ex group, n=27). The intervention lasted for 8 weeks. The primary outcome was the difference in office systolic blood pressure (SBP) before and after the study period (Trial registry at ClinicalTrials.gov, NCT01637909). RESULTS: Seventy-two participants (87.8%) completed the trial. The degree of change in office SBP did not significantly differ among the intervention groups; however, the D+Ex group demonstrated a tendency toward decreased SBP. Upon analysis of 24-hour ambulatory BP measurements, daytime ambulatory SBP was significantly lower in the D+Ex group (134 mmHg; 95% confidence interval [CI], 131 to 137; p=0.011) than in the C group (139.5 mmHg; 95% CI, 130.9 to 137), and daytime ambulatory SBP was significantly decreased in the D+Ex group (−5.2 mmHg; 95% CI, −8.3 to −2.1; p=0.011) compared to the C group (0.4 mmHg, 95% CI, −2.5 to 3.3). CONCLUSIONS In conclusion, lifestyle modification emphasizing both diet and exercise was effective for lowering BP and should be favored over diet-only modifications.

OBJECTIVES: The purpose of this study was (1) to examine whether the addition of resting heart rate (RHR) to the existing undiagnosed diabetes mellitus (UnDM) prediction model would improve predictability, and (2) to develop and validate UnDM prediction models by using only easily assessable variables such as gender, RHR, age, and waist circumference (WC). METHODS: Korea National Health and Nutrition Examination Survey (KNHANES) 2010, 2012, 2014, 2016 data were used to develop the model (model building set, n=19,675), while the data from 2011, 2013, 2015, 2017 were used to validate the model (validation set, n=19,917). UnDM was defined as a fasting glucose level ≥126 mg/dL or glycated hemoglobin ≥6.5%; however, doctors have not diagnosed it. Statistical package for the social sciences logistic regression analysis was used to determine the predictors of UnDM. RESULTS: RHR, age, and WC were associated with UnDM. When RHR was added to the existing model, sensitivity was reduced (86 vs. 73%), specificity was increased (49 vs. 65%), and a higher Youden index (35 vs. 38) was expressed. When only gender, RHR, age, and WC were used in the model, a sensitivity, specificity, and Youden index of 70%, 67%, and 37, respectively, were observed. CONCLUSIONS Adding RHR to the existing UnDM prediction model improved specificity and the Youden index. Furthermore, when the prediction model only used gender, RHR, age, and WC, the outcomes were not inferior to those of the existing prediction model.

Parallel with the current pediatric obesity epidemic, the escalating rates of youthonset type 2 diabetes mellitus (T2DM) have become a major public health burden. Although lifestyle modification can be the first-line prevention for T2DM in youths, there is a lack of evidence to establish optimal specific exercise strategies for obese youths at high risk for T2DM. The purpose of this narrative review is to summarize the potential impact of exercise on 2 key pathophysiological risk factors for T2DM, insulin sensitivity and β-cell function, among obese youths. The studies cited are grouped by use of metabolic tests, i.e., direct and indirect measures of insulin sensitivity and β-cell function. In general, there are an increasing number of studies that demonstrate positive effects of aerobic exercise, resistance exercise, and the 2 combined on insulin sensitivity. However, a lack of evidence exists for the effect of any exercise modality on β-cell functional improvement. We also suggest a future direction for research into exercise medical prevention of youth-onset T2DM. These suggestions focus on the effects of exercise modalities on emerging biomarkers of T2DM risk.

BACKGROUND AND OBJECTIVES: Supervised lifestyle interventions, including dietary and exercise programs, may be infeasible to implement in real-world settings. Therefore, this study aimed to evaluate the effectiveness of a home-based lifestyle modification intervention on blood pressure (BP) management. METHODS: Eighty-five patients aged over 20 years and diagnosed with prehypertension or mild hypertension were randomly assigned to an advice-only comparison group (C group, n=28), a Dietary Approaches to Stop Hypertension (DASH) diet education group (D group, n=30), or a DASH and home-based exercise group (D+Ex group, n=27). The intervention lasted for 8 weeks. The primary outcome was the difference in office systolic blood pressure (SBP) before and after the study period (Trial registry at ClinicalTrials.gov, NCT01637909). RESULTS: Seventy-two participants (87.8%) completed the trial. The degree of change in office SBP did not significantly differ among the intervention groups; however, the D+Ex group demonstrated a tendency toward decreased SBP. Upon analysis of 24-hour ambulatory BP measurements, daytime ambulatory SBP was significantly lower in the D+Ex group (134 mmHg; 95% confidence interval [CI], 131 to 137; p=0.011) than in the C group (139.5 mmHg; 95% CI, 130.9 to 137), and daytime ambulatory SBP was significantly decreased in the D+Ex group (−5.2 mmHg; 95% CI, −8.3 to −2.1; p=0.011) compared to the C group (0.4 mmHg, 95% CI, −2.5 to 3.3). CONCLUSIONS: In conclusion, lifestyle modification emphasizing both diet and exercise was effective for lowering BP and should be favored over diet-only modifications.
Blood Pressure ; Diet ; Education ; Humans ; Hypertension ; Life Style ; Prehypertension

BACKGROUND: The purpose of this study was to examine the association between resting heart rate (RHR), the risk factors and prevalences of metabolic syndrome (MetS) and type 2 diabetes (T2D) in Korean adults. METHODS: A cross sectional analysis was performed on data from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES V) using frequency analysis, analysis of covariance (ANCOVA), and logistic regression. Participants were stratified according to RHR into 5 groups; <60 bpm, 60-69 bpm, 70-79 bpm, 80-89 bpm, and > or =90 bpm. RESULTS: The results show that risk factors of MetS and T2D increased as RHR increased. Compared to those with a RHR of <60 bpm, the prevalence of MetS increased in those with RHR of 60-69 bpm, 70-79 bpm, 80-89 bpm and > or =90 bpm by 1.46 (95% confidence interval [CI] 1.03-2.08), 2.05 (95% CI, 1.42-2.96), 2.34 (95% CI, 1.57-3.48), and 2.34 (95% CI, 1.23-4.47), respectively. Similarly, compared to those with a RHR of <60 bpm, the prevalence of T2D increased in those with RHR of 60-69 bpm, 70-79 bpm, 80-89 bpm, and > or =90 bpm by 1.01 (95% CI, 0.72-1.41), 1.44 (95% CI, 1.02-2.05), 1.83 (95% CI, 1.25-2.68), and 2.40 (95% CI, 1.30-4.44), respectively. CONCLUSION: In conclusion, RHR was significantly associated with risk factors and prevalences of MetS and T2D. This study suggests that RHR is associated with MetS and T2D and can be used to predict such diseases.
Adult ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Heart Rate ; Heart ; Humans ; Korea ; Logistic Models ; Nutrition Surveys ; Prevalence ; Risk Factors

PURPOSE: The purpose of this study was to investigate the exercise participation experiences of colorectal cancer survivors. METHODS: A phenomenological method was used in this study. Ten adult colorectal cancer survivors were recruited and data were collected through in-depth interviews. RESULTS: The factors involved in the experiences of colorectal cancer survivors' exercise participation were categorized into 3 parts: (1) mental depression and isolation due to physical change, (2) barriers of exercise, (3) exercise participation for recovery. Though participants were aware of their changed body after cancer treatment and faced difficulties participating in exercise, they want to overcome these challenges through exercise participation. CONCLUSION: The results of this study show the exercise participation experiences of colorectal cancer survivors. Based on these findings, exercise maintenance can be promoted more effectively, and a higher exercise adherence of colorectal cancer survivors can be achieved.

Exercise has long been recognized as an important component of treatment for various diseases. However, the benefits and risks of exercise interventions must be carefully evaluated to ensure the former outweighs the latter. As cancer patients undergo diverse treatment modalities with distinct objectives, a systematic approach partitioning the cancer journey into distinct phases is necessary to inform tailored exercise prescriptions. This narrative review summarizes exercise benefits and mechanisms for cancer patients and survivors across four distinct survivorship periods—before surgery, after surgery and before adjuvant treatment, during nonsurgical treatment (adjuvant and neoadjuvant), and during extended survival. In summary, exercise reduces the risks of complications and declines in physical functioning while improving fatigue, quality of life, and the ability to manage treatment effects. Although additional research is warranted, existing evidence is sufficient to integrate exercise into clinical oncology practice and cancer survivorship programs.