Impact of Mild or Moderate Physical Activity and Progression of Subclinical Atherosclerosis
Condition: Atherosclerosis
MeSH terms: Atherosclerosis
Study type: Interventional

Summary: 
      Subclinical atherosclerosis is identified in roughly 2/3rd of otherwise healthy young adults.
      How much physical activity is required to prevent progression of subclinical atherosclerosis?
      In the 85% of healthy younger Canadian men and women who do NOT perform the recommended 150
      min/week of moderate- to vigorous-intensity physical activity (MVPA) as recommended, is it
      reasonable to aim for a lower regimen of light physical activity (LPA) despite the absence of
      supporting literature, or to the contrary should the investigators insist on achieving MVPA?
      In this perspective, MoMA provides a unique opportunity to determine whether LPA vs. MVPA is
      necessary to limit subclinical atherosclerosis progression in inactive otherwise healthy
      adults. Resolving such unknowns should inform strategies to prevent decades of silent disease
      progression leading to future morbidity and mortality.
    

Detailed description: 
      Cardiovascular disease (CVD) remains rampant in developed regions, topping the list of causes
      of mortality leading to 29% of all deaths. In addition to mortality, the economic impact of
      morbidity and hospitalization related to CVD costs Canadians over $22.2 billion every year.
      By far the leading cause of CVD is atherosclerosis defined as a thickening of the arterial
      wall with fatty deposits. Therefore, atherosclerosis is the underlying mechanism behind the
      #1 cause of mortality and morbidity in developed regions. Autopsy studies performed in
      healthy casualties of the Korean, Vietnam, Iraq and Afghanistan Wars revealed that
      atherosclerosis is present in up to 78% of young men before their 30th birthday, even in the
      absence of traditional risk factors (high blood pressure, dyslipidemia, obesity). Prevention
      of atherosclerosis and its silent progression towards clinical events decades later should
      therefore become a priority in all young adults. A potentially powerful avenue of
      cardiovascular prevention lies in the reduction of subclinical atherosclerosis progression in
      younger adults through physical activity. Unfortunately, only 15% of Canadians meet the
      current recommendations for 150min/week of moderate- to vigorous-intensity physical activity
      (MVPA). In response to the observation that Canadians simply don't find time for/or do not
      appear to value current recommendations, it was suggested that even light-intensity physical
      activity (LPA) might improve biomarker levels compared to a sedentary lifestyle. It appears
      that in the face of failed attempts to convince Canadians to perform 150min/week of MVPA,
      expectations towards LPA have been lowered despite the absence of convincing data.

      MoMA is a randomized controlled trial to study the effects of two doses of physical activity
      on subclinical atherosclerosis burden progression; 270 inactive men and women aged 18-40
      years without CVD or risk factors will be enrolled. At baseline, risk factors, physical
      activity level and nutritional habits will be measured through validated questionnaires;
      blood work and anthropometric parameters measurements will be performed (markers of
      cardiometabolic risk); fitness level will be assessed through treadmill test and
      accelerometer; magnetic resonance imaging of carotid atherosclerosis, liver and adipose
      tissue will be performed.
    

Intervention name(s): Moderate to vigorous physical activity; Light physical activity
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 55-90% maximum heart rate for 150min/week (current recommendations); 40-55% maximum heart rate for 150min/week
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention