Aktifitas fisik yang direkomendasikan berupa aktifitas fisik yang regular dan

menggunakan rejimen yang sedang. Latihan standar yang direkomendasikan adalah dengan
durasi 30 menit perhari untuk aktifiktas fisik dengan intensitas sedang. Namun sebuah preferensi
merekomendasikan 60 menit untuk latihan intensitas sedang seperti berjalan cepat, dengan
ditambah kegiatan lainnya dengan durasi singkat 10-15 menit seperti berjalan ke tempat kerja,
berkebun, mengerjakan pekerjaan rumah, jogging, berenang, bersepeda, bermain golf, hingga
kegiatan dengan menggunakan alat sederhana yaitu treadmill, dan latihan ketahanan. Selain itu,
aktifitas sedentary yang paling sering seperti menonton televisi dan bermain games harus
dihindari.
Pedoman AHA menyarankan untuk melakukan penilaian risiko kardiovaskuler pada
pasien sebelum memulai jenis latihan. Pada pasien dengan risiko tinggi (sindrom koroner akut
atau revaskularisasi), latihan fisik harus dilakukan dibawah pengawasan. Dokter harus dapat
menilai aktifitas fisik yang dapat dilakukan pada pasien tersebut. Aktifitas fisik harus
ditingkatkan secara perlahan baik dari segi intensitas mapun durasi.

Lifestyle activity should be increased slowly in intensity and duration (by 5 min/session/week),
starting from a low-intensity exercise (<3 metabolic equivalent) in sedentary subjects, to avoid
excessive fatigue, muscle pain, strains, or injuries [159]. Patients should be encouraged to
register their baseline physical activity or to check their baseline number of steps by a
pedometer.Whenever the brisk walking is chosen as the preferred activity, they should be
instructed to add 500 steps at 3-day intervals to a target value of 10,000–12,000 steps/day [126].
Prescribing multiple short bouts (10min each) rather than one long session may help the patients
to accumulate more minutes of exercise. This 30 minutes of physical activity achieved in three
10- minute sessions is equivalent to the energy expenditure of 1500 kcal a week. The impact of
exercise on insulin sensitivity is evident for 24 to 48 hours and disappears within three to five
days.Thus, an individual would need to follow the AHA and American College of Sports
Medicine recommendation to exercise at least 30min/d most days of the week [160] for a
continued benefit of exercise on insulin action. Physical training has been shown to reduce the
skeletal muscle lipid and insulin resistance, regardless of BMI [161]. A combination of
resistance and aerobic exercise is the best, but any activity is better than none, and patients who
have been sedentary need to start with walking and gradually increase duration and intensity
[162]. According to the Centre for Disease Control and Prevention (CDC) and the American
College of Sports Medicine, physically inactive or sedentary subjects were defined as those who
did not engage in at least 150 minutes of physical activities per week [163]. The odds having the
MetS were almost doubled in adults reporting no moderate or vigorous physical activity
compared with those who engage in at least 150 min/wk [164]. Furthermore, Koplan andDietz
have shown that a regular exercise improves insulin sensitivity, decreases plasma TGs levels,
and reduces cardiovascular morbidity and mortality [165].

Aktivitas 50 kg 75 kg 100 kg

Bersepeda, 6 mil/jam 160 240 312

Bersepeda, 12 mil/jam 270 410 534
Jogging/ lari, 7 mil/jam 610 920 1230
Lompat tali 500 750 1000
Jogging/ lari, 5,5 mil/jam 440 660 962
Jogging/ lari, 10 mil/jam 850 1280 1664
Berenang, 25 yard/menit 185 275 358
Berenang, 50 yard/menit 325 500 650
Tenis, single 265 400 535
Berjalan, 2 mil/jam 160 240 312
Berjalan, 3 mil/jam 210 320 416
Berjalan, 4,5 mil/jam 295 440 572