This document provides exercise prescriptions for individuals with metabolic diseases and cardiovascular risk factors. It discusses metabolic syndrome, which is defined as having three or more risk factors related to obesity, insulin resistance, hypertension, and dyslipidemia. These increase the risk of type 2 diabetes and cardiovascular disease. The document then outlines exercise prescription guidelines for conditions like hypertension, dyslipidemia, overweight/obesity, and types 1 and 2 diabetes. The prescriptions generally recommend aerobic exercise 3-7 days per week at a moderate intensity for 30+ minutes, as well as 2-3 days per week of resistance and flexibility training.

1. CENTER FOR PHYSIOTHERAPY AND
REHABILITATION SCIENCE
JAMIA MILLIA ISLAMIA
SUBMITTED TO: DR. JAMAL ALI MOIZ
SUBMITTED BY: FARZANA KHATOON
MPT 3RD SEM

2. EXERCISE PRESCRIPTION FOR
INDIVIDUALS WITH METABOLIC
DISEASE AND CARDIOVASCULAR
DISEASE RISK FACTORS

3. INTRODUCTION
• Lifestyle therapy (modifications of diet and
physical activity) is prescribed in the
prevention and treatment of many
cardiometabolic diseases, including high blood
pressure (BP) (hypertension), abnormal blood
lipids (dyslipidemia), or the cluster of
cardiovascular and metabolic risk factors
known as the metabolic syndrome.

4. METABOLIC SYNDROME –
• Metabolic syndrome is defined as the
clustering of individual cardiovascular and
metabolic risk factors that are related to
obesity, insulin resistance, hypertension, and
dyslipidemia.
• This clustering of abnormal risk increases an
individual’s disease predisposition for both
Type 2 diabetes and CVD.

5. By definition, an individual is classified as having
metabolic syndrome if he or she is diagnosed with
any three of five risk factors:-
• Fasting plasma glucose ≥100 mg ∙ dL −1
• High -density lipoprotein cholesterol (HDL-C)
less than 40 mg ∙ dL −1 in men or less than 50 mg
∙ dL −1 in women.
• Triglycerides (TG) ≥150 mg ∙ dL −1
• Waist circumference >102 cm in men or >88 cm
in women
• Systolic blood pressure (SBP) ≥130 mm Hg or
diastolic blood pressure (DBP) ≥85 mm Hg

6. • Metabolic syndrome is considered largely a
disease of unhealthy lifestyle practices with
many of the underlying risk factors for
development of the syndrome such as - poor
diet and exercise, such as low levels of
physical activity and fitness, high intake of soft
drinks, diet soda, carbohydrates, meat, and
fried foods, and unhealthy behaviors such as
skipping breakfast and heavy alcohol
consumption.

7. • Accoding to American Heart Association
(AHA)/National Heart, Lung, and Blood
Institute emphasize that the primary aim of
treatment for metabolic syndrome is to treat
the modification of underlying risk factors
(obesity, physical inactivity, and atherogenic
diet) through lifestyle changes.
• Guidelines include reducing body weight by
7%–10% over the first year of therapy with the
goal to achieve a body mass index (BMI) ˂25
kg ∙ m−2

8. HYPERTENSION
• BP is defined as the force exerted by the blood
against artery walls during the heart’s
contraction and relaxation, with high BP or
hypertension representing a pathological
condition which contributes to CVD risk.

9. Classification of BP categories according to the frequently used Seventh Report of the Joint
National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
(JNC 7) (7) as well as the updated guidelines by the Eighth Report of the Joint National Committee
on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 8)
JNC 7 Guidelines (SBP and DBP) JNC 8 Guidelines (SBP and DBP)
Blood pressure classification system Blood pressure goals
Normal - ˂120 mmHg and ˂80 mmHg ˂60 yr or with diabetes or CKD
˂140 and 90 mm Hg
Pre hypertension 120–139 or 80–89 mm
Hg
≥60 yr
˂150 and 90 mm Hg
Stage 1 hypertension 140–159 or 90–99
mm Hg
Stage 2 hypertension ≥160 or ≥100 mm Hg

10. DYSLIPIDEMIA
• Dyslipidemia is defined as abnormal levels of
blood lipids. There are three atherogenic
lipoproteins: very low density lipoprotein
(VLDL), intermediatedensity lipoprotein
(IDL), and LDL-C.
• LDL-C is the major atherogenic protein and
lipid risk marker
• 10% increase in LDL-C leads to an
approximate 20% increase in coronary heart
disease (CHD) risk

11. EXERCISE PRESCRIPTION FOR HYPERTENSION
Frequency 5–7 d ∙ wk
Intensity Moderate
Time ≥30 min ∙ d −1
Type Aerobic
Resistance Muscle strengthening 2–3 d ∙ wk −1
Flexibility 2–3 d ∙ wk −1 ; static stretch 10–30 s; 2–4 repetitions of each
exercise

12. EXERCISE PRESCRIPTION FOR DYSLIPIDEMIA
Frequency ≥5 d ∙ wk −1 to maximize caloric
expenditure
Intensity Moderate
Time 30–60 min ∙ d −1
Type Aerobic ecercise
Resistance Muscle strengthening 2–3 d ∙ wk −1
Moderate-to vigorous intensity; 2–4
sets of 8–12 repetitions
Flexibility 2–3 d ∙ wk −1 ; static stretch 10–30 s;
2–4 repetitions of each exercise

13. EXERCISE PRESCRIPTION FOR OVERWEIGHT AND
OBESITY
Frequency ≥5 d ∙ wk −1
Intensity Moderate to vigorous exercise
Time 30 min ∙ d −1
Type Aerobic exercise
Resistance Muscle strengthening 2–3 d ∙ wk −1 moderate-to vigorous
intensity; 2–4 sets of 8–12 repetitions
Flexibility 2–3 d ∙ wk −1 ; static stretch 10–30 s; 2–4 repetitions of each
exercise

14. EXERCISE PRESCRIPTION FOR TYPE 1 DM
Frequency 3 days vigorous or 5 days moderate exercise
Intensity Moderate (40%–59% VO2R or 11– 12 RPE) to vigorous
(60%–89% VO2R or 14– 17 RPE)
Time At least 150 min ∙ wk −1 of moderate intensity, 60 min ∙ wk
−1 at vigorous intensity, or a combination
Type Walk, jog, cycle, row, swim, aquatic activities, seated
exercises
Resistance ex 2–3 d ∙ wk −1 at 60%–80% 1-RM
Flexibility ex Static, dynamic, and/or PNF stretching Stretch to the point of
feeling tightness or slight discomfort Hold static stretch for
10–30 s; 2–4 repetitions of each exercise

15. EXERCISE PRESCRIPTION FOR TYPE 2 DM
Frequency 7 d ∙ wk −1
Intensity Moderate (40%–59% VO2R or 11– 12 RPE) to vigorous (60%–
89% VO2R or 14– 17 RPE)
Time At least 150 min ∙ wk −1 of moderate to-vigorous ex
Type Walk, jog, cycle, row, swim, aquatic activities, seated exercises
Resistance
ex
2–3 d ∙ wk −1 at 60%–80% 1-RM
Flexibility
ex
Static, dynamic, and/or PNF stretching Stretch to the point of
feeling tightness or slight discomfort. Hold static stretch for 10–
30 s; 2–4 repetitions of each exercise

17. THANK YOU