NEW PARMA – nov/dec 2010

Physical exercise is a natural drug which can lead to the improvement of the cardio-vascular apparatus…and helps preventing impotence..

In the late few years, metabolic syndrome has been one of the most debated topics at conferences on Sports Medicine. As we saw in the specific article on this very magazine, this syndrome basically consists in a deficit of insulin functioning, followed by overweight above all at central level, hypertension and borderline dyslipidemia, reduced tolerance to carbohydrates and predisposition to diabetes. It seems it must be treated above all changing one’s life style, that is, following a correct diet and doing proper physical exercise. What sounds like an original idea in fact should not be considered such because even Paracelsus, the father of modern medicine, in the year 400 BC believed that “if we should ever find the correct amount of food and of physical exercise, not too little, nor too much, this would be the best solution to assure oneself perfect health”. Perhaps health institutions, oppressed by their enormous budget deficit, have realized it would cost them far less to promote correct life styles and to pay a dietician, a psychologist and a gym for each patient who risks developing cardio-vascular disease (infarction, ictus) and diabetes – which would involve enormous costs for the patient’s constant intake of medicines, physical therapies and hospitalization. At this point the expert in Sports Medicine, who should have the basic competence of the specialist in internal diseases (an athlete can develop any pathology like any other human being), with the collaboration of a dietician or an expert in dietetics, should be the perfect professional figure to prescribe the right physical exercise. At this point it becomes a real matter of prescribing physical exercise, it is not enough to simply recommend to “take a little exercise or a daily walk”. It has been  proven that in order to have a real effect on parameters such as artery pressure, glycaemia, loss of weight, physical exercise must be prescribed in specific doses and modes in exactly the same way as a drug, that is, according to a certain quantity, intensity and rate. It has been scientifically demonstrated that physical exercise is a natural drug which can improve the activity of the cardio-vascular apparatus as it improves the contractible ability of the heart, it decreases peripheral resistance improving general blood flux, helping to prevent impotence (it must be remembered that erectile dysfunction is a forewarning of metabolic syndrome and cardio-vascular risk), it helps burning sugar and keeping glycaemia under control. Some researches have shown that regular physical exercise can reduce the risk of developing breast and colon cancer (it rises HDL cholesterol level, generally known as “good cholesterol” which can prevent arteriosclerosis). As for type of training to follow, it is a widespread opinion that aerobic exercise gives better results both concerning the cardio-vascular system and weight loss, but also training applying weights favourably influences the metabolic syndrome since muscular mass is responsible for 70-80% of the removal of insulin stimulated glucose. Aerobic activity as well as training with weights have a positive influence on many metabolic syndrome risk factors. Training with weights reduces body fat and increases HDL, it reduces haematic  pressure and helps glycemic control. A recent study has shown that stronger men have a 34% lower risk of developing the metabolic syndrome compared with weaker ones. In presence of metabolic syndrome associated with abdomen obesity and no specific cardio-vascular pathologies or diabetes mellitus, aerobic activity should be prescribed 5-7 days a week at an intensity between 40-70% of maximum heart rate for about 40-60 minutes and training with weights 2-3 times a week using 80-90% of maximal weight (a weight which can be lifted only once) repeating correctly between 2-5 times each exercise concerning each single muscular group. Training to gain strength is fundamental to maintain or develop lean mass and to reduce risks. People who are very overweight are often recommended to use light weights and to repeat exercises a number of times, but this is a mistake. Losing weight is possible by following a diet and doing aerobic activity. Heavy weights are useful to improve lean mass thus increasing metabolism.