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Aerobic or resistance exercise in metabolic syndrome – the STRRIDE-AT/RT trial

Comment by Paul Leeson, EACPR Exercise, Basic and Translational Research Section


Teams from Duke University Medical Centre and East Carolina University have recently reported the results of a randomised trial of exercise intervention in nearly 200 subjects. What is interesting is that they performed a ‘head-to-head’ comparison of aerobic and resistance training as a means to improve cardiovascular health in those with features of the metabolic syndrome. All the participants were in their forties and fifties, sedentary, overweight and dyslipidemic. They had to maintain the exercise regimes for up to 8 months and a quarter of the recruits did not manage the programme. However, if they did, those who had done aerobic exercise seemed to gain benefit. They lost 1.5kg in weight, improved their peak oxygen consumption and lowered their triglycerides. Resistance training improved strength but did nothing for metabolic profile.

The individuals that did the best, however, were those who were randomised to a combined aerobic and resistance training regime. As well as the changes in weight and triglycerides seen in the aerobic training group they also had reductions in their waist circumference by 2.5cm, their blood pressure by 3mmHg and their overall metabolic syndrome z-score. A major complication in interpretation of this finding is that, because this group was doing both aerobic and resistance training, they undertook significantly more exercise per week. It is therefore difficult to know whether it was the combination or just the amount of exercise that delivered the benefit. The one clear finding is that resistance training alone appeared to offer no benefit for cardiovascular parameters and the study highlights the importance, and value, of promoting aerobic training in those with early features of the metabolic syndrome to improve risk profile.