Development of the supporting system for the patients with multiple risk factors by exercise therapy

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1) Postprandial glucose and lipid metabolism and exercise therapyHigh sensitive C-reactive protein may be a predictive marker in high risk obese women, because it is independently associated with both fasting and postprandial free fatty acid and postprandial insulin level. Mild intensity exercise therapy improves postprandial blood profiles even after normal fat meal in obese subjects.2) Determination of the optimal exercise intensityThe work rate at the Lactate threshold (LT) showed significant correlation with the number of risk fatocrs. LT is a safe intensity where ST segment depression has not occurred. Insulin resistance may involve the pathological ST depression during exercise.The estimated target heart rate during exercise has been determined from age, however we suggest that their risk factors should be taken into consideration. Futhermore, careful modification in the prescribed exercise regimen is needed according to improvement in the fitness and in risk factors.The breaking point in double product (DPBP) could be successfully detected in men and women with or without metabolic syndrome. The %BW at the DPBP was suggested to be a useful and reliable index for both an appropriate exercise prescription on a cycle ergometer as well as tracking the temporal trends in physical and metabolic fitness.The exercise prescription in the patients with both osteoarthritis of the knee and multiple risk factors should be lower than that for the patients without osteoarthritis.3) Mechanism and process of impairment and improvement in multiple risk factors by physical fitness.The change in the monocyte and neutrophil counts are associated with the inprovement in both fasting and postprandial triglyceride and aerobic capacity. In the process of the change in the risk factors in obese subjects, the improvement in the fitness and metabolic conditions precede to the changes in body weight.