Invited Commentary

Commentary on "Association of Body Mass Index and Waist Circumference with Subclinical Atherosclerosis in Retired NFL Players"

Authors: Raul D. Santos, MD, PhD

Abstract

Exercise is pivotal for the prevention of cardiovascular disease (CVD). Unfortunately, there is no legacy effect; one can exercise frequently when young and because of the usual circumstances of modern life, become sedentary in adulthood. When one stops exercising, over time the benefits to cardiovascular fitness, blood pressure, lipids, insulin sensitivity, coagulation, and inflammation tend to vanish. As such, people should attempt to remain active for the rest of their lives so that they may ‘‘live long and prosper.’’ Indeed, lack of exercise has been associated with many diseases that can predispose people to CVD such as obesity, atherogenic dyslipidemia, hypertension, insulin resistance, and type 2 diabetes mellitus. The concept of the metabolic syndrome was created as a clinical entity signalling an elevated risk of type 2 diabetes mellitus and CVD that is associated with, and almost certainly caused by, increased body adiposity.1 One of the pivotal components of metabolic syndrome is an elevated waist circumference (WC), a marker of increased abdominal adiposity. Abdominal or visceral adipocytes are endocrine cells that secrete adipocytokines predisposing to insulin resistance, dyslipidemia, and inflammation differently from peripheral adipocytes that are more like a fat depot.

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