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EXERCISE METHOD AND EFFECT EVALUATION OF HIGH INTENSITY INTERVAL EXERCISE INTERVENTIONNAFLD IN EXERCISE AND MEDICAL INTEGRATION

PURPOSE: Major depressive disorder is associated with less productivity, earlier retirement, and more sick-days at the workplace. These associations also exist for patients with metabolic syndrome. For both, exercise is a generally recommended part of multimodal treatments. However, for individuals with metabolic syndrome, in which depression is more prevalent and severe, evidence for the efficacy of exercise interventions is limited. METHODS: Company employees with diagnosed metabolic syndrome (n=314, age: 48 ± 8 yrs) were randomized to a 6-month exercise intervention (150 min per week) or wait-list control. Participants received individual recommendations for exercise activities by personal meetings, telephone or via a smartphone app. Physical activities were supervised and adapted using activity monitor data transferred to a central database. Work ability (work ability index), depression severity (hospital anxiety and depression scale [HADS]), and health-related quality of live (short form 36 [SF-36]) were assessed. RESULTS: We included 314 subjects from which 287 finished the intervention. After baseline stratification for normal (HADS scores 0-7) and increased depression scores (HADS scores 821) individuals with increased severity scores had similar age, body composition, blood lipids, and cardiorespiratory fitness compared to those with normal scores, but lower total work ability (33.1 ± 5.4 vs. 38.2 ± 4.9 points, p<0.05) and component sum scores of health-related quality of life. After 6 months total work ability increased in the exercise group compared to controls with the magnitude of the observed increase being significantly greater for subjects with increased depression severity at baseline (3.7 ± 3.4 points) compared to those with normal severity scores (1.2 ± 2.4 points) (p=0.021). CONCLUSIONS: A 6-month exercise intervention for company employees with metabolic syndrome showed strongest effects on self-perceived work ability in individuals with mild to severe depression severity. This suggests exercise programs offered to workers with metabolic syndrome not only reduces individual disease risk but may also reduce healthcare and employers costs arising from metabolic syndrome and mental disease conditions.