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Role of diet and exercise in the management of hyperinsulinemia and associated atherosclerotic risk factors

Authors
Journal
The American Journal of Cardiology
0002-9149
Publisher
Elsevier
Publication Date
Volume
69
Issue
5
Identifiers
DOI: 10.1016/0002-9149(92)90981-4
Keywords
  • Preventive Cardiology
Disciplines
  • Medicine

Abstract

Abstract Hyperinsulinemia, hypertension, hypertriglyceridemia and obesity are independent risk factors for coronary artery disease and are often found in the same person. This study investigated the effects of an intensive, 3-week, dietary and exercise program on these risk factors. The group was divided into diabetic patients (non-insulin-dependent diabetes mellitus [NIDDM], n = 13), insulin-resistant persons (n = 29) and those with normal insulin, ≤ 10 μU/ml (n = 30). The normal groups had very small but statistically significant decreases in all of the risk factors. The patients with NIDDM had the greatest decreases. Insulin was reduced from 40 ± 15 to 27 ± 11 μU/ml, blood pressure from 142 ± 9 83 ± 3 to 132 ± 6 71 ± 3 mm Hg, triglycerides from 353 ± 76 to 196 ± 31 mg/dl and body mass index from 31.1 ± 4.0 to 29.7 ± 3.7 kg/m 2. Although there was a significant weight loss for the group with NIDDM, resulting in the decrease in body mass index, 8 of 9 patients who were initially overweight were still overweight at the end of the program, and 5 of the 8 were still obese (body mass index >30 kg/m 2), indicating that normalization of body weight is not a requisite for a reduction or normalization of other risk factors. Insulin was reduced from 18.2 ± 1.8 to 11.6 ± 1.2 μU/ml in the insulin-resistant group, with 17 of the 29 subjects achieving normal fasting insulin (< 10 μU/ml). Blood pressure was reduced from 129 ± 4 84 ± 3 to 124 ± 5 78 ± 2 mm Hg, while triglycerides were reduced from 204 ± 17 to 162 ± 15 mg/dl. Body mass index was reduced from 32.6 ± 5.3 to 31.2 ± 5.1 kg/m 2, with only 4 of 24 who were overweight reaching a normal weight.

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