Study of How Exercise or Weight Loss Effects Metabolic Syndrome

Research procedures: The interventions in this study will be caloric dietary restrictions intended to result in a 10% reduction of body weight within 6 months, or a supervised aerobic exercise program designed to improve cardiovascular fitness. The diet with weight loss group will meet with a registered dietician on a weekly basis for the first 2 months and then bi-weekly for the duration of the study for education and review of the subject's caloric intake. Similarly, the exercise group subjects will participate in weekly supervised aerobic exercise sessions. At these visits, a food logbook and an exercise logbook will be turned into the study staff to review. Prior to inclusion in the study, the patient's medical record will be reviewed for evidence of metabolic syndrome, specifically, recent lipid analysis, blood sugar, weight, height, waist circumference, and blood pressure. A self-report history and physical examination form, Perceived Behavior Control Scale, Self-Efficacy Scale, Beck Depression Inventory will also be included as part of the enrollment process and ongoing participation. Pre-intervention/initial screening includes fasting triglycerides, HDL, glucose, hs-CRP, Uric Acid, insulin, and plasma creatinine, 24-hour urine collection, blood pressure, waist and hip circumference, height, weight, VO2 max estimated from sub maximal standardized treadmill exercise test, Beck Depression Inventory, Perceived Behavioral Control Scale, Self-Efficacy Scale and Pre-intervention 3-day food record and physical activity questionnaire to assess baseline diet and activity levels. During study monitoring: daily exercise log (exercise group), assessed weekly, (determine the intensity, duration, and frequency of aerobic exercise), daily food log (diet with weight loss group), assessed for caloric intake, quarterly 3-day food records, assessed for caloric intake, and composition of fats, carbohydrates and proteins, quarterly blood pressure, weight, height, waist and hip circumference, quarterly fasting serum triglyceride, HDL, fasting serum glucose, and uric acid, and quarterly physical activity questionnaire, Beck Depression Inventory, Perceived Behavioral Control Scale, and Self-Efficacy Scale. Post-study assessment: fasting serum triglycerides, HDL, serum glucose, uric acid, hs-CRP, insulin, and plasma creatinine, 24-hour urine collection, body weight, height, and waist and hip circumference, VO2 max estimated from sub maximal standardized treadmill exercise test, and 3-day food record, physical activity questionnaire, Beck Depression Inventory, Perceived Behavioral Control Scale, and Self-Efficacy Scale. The control group will complete the pre and post measurements and the 3-day food record and physical activity questionnaire as required by the diet and exercise groups.