PA is any bodily movement that substantially increases energy expenditure. This includes: • Leisure-time physical activities • Occupational activities • Commuting activities • At least 150 minutes a week of moderate intensity or 75 minutes a week of vigorous intensity PA or an equivalent combination In addition, individuals are encouraged to engage in resistance and flexibility exercises whenever possible or necessary. At each visit, the importance of regular PA should be emphasized. The MOH Malaysia advocates walking 10,000 steps a day. This is a practical and easily achievable goal for most individuals.
Wherever possible, individuals should be referred to physiotherapists/ exercise physiologists for exercise prescribtion for primary prevention of CVD. Increases in physical activity are associated with a reduction in the risk of stroke. The goal is to engage in at least 30 minutes of moderate intensity activity on a daily basis Increased physical activity can improve glycaemic control, assist with weight maintenance , reduce the risk of CVD , reduce the need for oral anti-diabetes drug (OADs) and insulin Aerobic and resistance exercise are beneficial for patients with diabetes Combining physical activity with dietary intervention can results in greater A1c reduction . Overweight and obese individuals should gradually increase physical activity to 60–90 minutes per day for long term weight loss, any increase in daily energy expenditure is beneficial Duration of exercise should be at least 150 mins/ week of moderate intensity or at least 90 mins/week of vigorous aerobic and at least 2 sessions/week of resistant exercise. Anti-diabetic agents may need adjustment if exercise is planned. Exercise is thought to be an important intervention, [122 ] and the current recommendation is for patients to perform regular moderate-intensity physical activity for at least 30 minutes continuously at least 5 days per week (ideally, 7 days per week). Maintaining long-term adherence, however, remains a challenge. [123 ] Achieving moderate intensity activity for 120 to 150 minutes a week may reduce the risk of developing metabolic syndrome. [124 ] Among patients who already have metabolic syndrome, physical activity correlates with a much lower (about 50%) risk of developing coronary heart disease. [125 ] In a prospective study, cardiorespiratory fitness was linked to the risk of developing metabolic syndrome in a dose-dependent manner, with male patients in the highest category of fitness having the lowest risk of developing new-onset metabolic syndrome. [126 ] Evidence suggests that excessive sitting and other behaviors that are low in activity and energy expenditure may trigger unique cellular responses that contribute to the development of metabolic syndrome.
- Winter '19
- Professor Robert