Evaluating and prescribing physical activity and exercise in health centers for individuals with metabolic syndrome: moving from pilot study to broad implementation
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abstract
Physical activity (PA) and exercise are vital for health promotion (Ács et al., 2020; Blue, 2017). Regular exercise, combined with dietary advice, significantly improved to normal values the metabolic syndrome (MetS) factors (Magalhães et al., 2023; Teixeira et al., 2022). Thus, the health centres should provide PA assessment and prescription, ensuring trained personnel, dedicated space, and regular follow-up for patients (Bragada et al., 2023). Indeed, the exponential increase of MetS conditions such as obesity, dysglycemia, dyslipidemia and hypertension, will impose an medical expenses on healthcare systems with indirect costs in labour productivity and missed work days (Hone et al., 2019; WHO, 2021). This global problem can only be solved with health education and exercise-based primary prevention (Hone et al., 2019). In our pilot study conducted over a 3-month period in collaboration with family physicians, focusing on individuals with MetS, we found that regular PA and exercise, combined with dietary counselling, had a significant impact on improving MetS risk factors, particularly fasting blood glucose, diastolic blood pressure, and systolic blood pressure. Anthropometric variables showed improvements in weight, lean body mass, and body fat mass. In regard to glycated hemoglobin (HbA1c), there was a clinically significant reduction in the majority of participants. Additionally, exercise led to an improvement in heart rate recovery after exercise, reflecting an increase in cardiovascular capacity (Bragada et al., 2023). In this context, it would be highly beneficial if health centres had the necessary resources and qualified personnel to assess and prescribe physical exercise for specific population groups who, based on medical advice, should increase their engagement in exercise and physical activities (Magalhães et al., 2023; Teixeira et al., 2022). The intervention strategies of health centres can take into account the following aspects: (1) set up multidisciplinary task force with a qualified physical exercise professional or exercise physiologist, a nutritionist and a nurse; (2) providing a suitable and dedicated space for conducting physical activity and dietary counselling consultations; (3) acquiring essential basic equipment for assessments; (4) having the family physician refer the patient to the PA consultation during their visit; (5) conducting regular assessments of physical activity levels and clinical analyses; (6) implementing longitudinal follow-up.
