Randomized Controlled Trial of Training Intensity in Adiposity

Abstract

The purpose of the study was to examine the effects of training intensity on abdominal fatness reduction and improvements of metabolic risk factors in Korean women (N=45, aged 45.4±7.3 yrs). Subjects were randomly assigned to control (CON, N=15) or low-intensity exercise (LIEX, N=15) or high-intensity exercise (HIEX, N=15). The LIEX and HIEX groups participated in a 12-wk exercise intervention at intensities of 40–50% and 70–75% of VO₂max, respectively. Outcome assessments performed at baseline and at the end of 12-wk period included abdominal adipose tissues, VO₂max, blood lipids, fasting glucose and insulin, and LPL- and HSL-mRNAs in abdominal subcutaneous adipose tissue (SAT). Unlike the CON group, women in the exercise groups had significant improvements in VO₂max (+11%, P<0.001), SAT (−12%, P=0.026), TG (−23%, P=0.002), HDLC (+7.2%, P=0.013), insulin (−23%, P=0.037), and HOMA-IR (−25%, P=0.015) relative to baseline values. Changes in baseline CRF were in a dose-dependent manner based in intensity (−1.2±1.7, 2.1±2.8, and 4.7±3.2 ml/kg/min for CON, LIEX, and HIEX, respectively, P<0.001). We found no evidence that LIEX- and HIEX differ in their effects on abdominal adiposity, risk factors, and LPL- and HSL-mRNA expressions in SAT. In conclusion, the current findings suggest that low- and high-intensity exercise are equally effective in reducing abdominal adiposity and in improving risk factors.

Key words

exercise training - cardio/respiratory fitness - abdominal fat tissue - risk factors

References

• 1 American College of Sports Medicine .ASCM's Guidelines for Exercise Testing and Prescription. 7th ed. Philadelphia, PA: Lippinocott Williams & Wilkins; 2006: 237-240
• 2 American College of Sports Medicine Position. . American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness and flexibility in healthy adults.  Med Sci Sports Exerc. 1998;  30 975-991
• 3 Bjorntorp P. Portal adipose tissue as a generator of risk factors for cardiovascular disease and diabetes.  Arteriosclerosis. 1990;  10 493-496
• 4 Centers for Disease Control and Prevention .Physical activity and health: Report of the Surgeon General (S/N 017-023-00196-5). Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 1996
• 5 Church TS, Earnest CP, Skinner JS, Blair SN. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial.  JAMA. 2007;  297 2081-2891
• 6 Despres JP. The insulin resistance-dyslipidemic syndrome of visceral obesity: Effect on patient’s risk.  Obes Res. 1998;  6 8S-17S
• 7 Despres JP, PouliotM, Moorjani S, Nadeau A, Tremblay A, Lupien P, Theriault G, Bouchard C. Loss of abdominal fat and metabolic response to exercise training in obese women.  Am J Physiol. 1991;  261 E159-E167
• 8 Frayn KN, Coppack SW, Fielding BA, Humphreys SM. Coordinated regulation of hormone sensitive lipase and lipoprotein lipase in human adipose tissue in vivo: implications for the control of fat storage and fat mobilization.  Adv Enzyme Regul. 1995;  35 163-178
• 9 Hansen D, Dendale P, Jonkers RAT, Beelen M, Manders RJF, Corluy L, Mullens A, Berger J, Meeusen R, van Loon LJC. Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA1c in obese type 2 diabetes patients.  Diabetologia. 2009;  52 1789-1797
• 10 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
• 11 Houmard J, Tanner C, Slentz C, Duscha B, McCarthy J, Krauss W. Effect of the volume and intensity of exercise training on insulin sensitivity.  J Appl Physiol. 2004;  96 101-106
• 12 Irving BA, Davis CK, Brock DW, Weltman JY, Swift D, Barrett EJ, Gaesser GA, Weltman A. Effect of exercise training intensity on abdominal visceral fat and body composition.  Med Sci Sports Exerc. 2008;  40 1863-1872
• 13 Jakicic JM, Clark K, Coleman E, Donnelly JE, Foreyt J, Melanson E, Volek J, Volpe SL. American College of Sports Medicine. American College of Sports Medicine position stand: appropriate intervention strategies for weight loss and prevention of weight regain for adults.  Med Sci Sports Exerc. 2001;  33 2145-2156
• 14 Jocken JWE, Langin D, Smit E, Saris WHM, Valle C, Hul GB, Holm C, Arner P, Blaak EE. Adipose triglyceride lipase and hormone-sensitive lipase protein expression is decreased in the obese insulin-resistant state.  Clin Endocrinol Metab. 2007;  92 2292-2299
• 15 Kissebah A, Krakower G. Regional adiposity and morbidity.  Physiol Rev. 1994;  74 761-811
• 16 Klein S, Burke LE, Bray GA, Blair S, Allison DB, Pi-Sunyer X, Hong Y, Eckel RH. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation.  Circulation. 2004;  110 2952-2967
• 17 Kolehmainen M, Vidal H, Ohisalo JJ, Pirien E, Pirinen E, Alhava E, Uusitupa MIJ. Hormone sensitive lipase expression and adipose tissue metabolism show gender differences in obese subjects after weight loss.  Int J Obes. 2002;  26 6-16
• 18 Lafontan M, Langin D. Lipolysis and lipid mobilization in human adipose tissue.  Prog Lipid Res. 2009;  48 275-297
• 19 Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ. Appropriate waist circumference cutoff points for central obesity in Korean adults.  Diabetes Res Clin Pract. 2007;  75 72-80
• 20 Leon AS, Casal D, Jacobs Jr D. Effects of 2 000 kcal per week of walking and stair climbing on physical fitness and risk factors for coronary heart disease.  J Cardpulm Rehabil. 1996;  16 183-192
• 21 Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner R. Homeostasis model assessment: Insulin resistance and B-cell function from fasting plasma glucose and insulin concentrations in man.  Diabetologia. 1985;  28 412-419
• 22 National Cholesterol Education Program (NCEP) . Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report.  Circulation. 2002;  106 3143-3142
• 23 National Institutes of Health Consensus Panel . Physical activity and cardiovascular health.  NIH Consensus Statement. 1995;  13 1-33
• 24 Nicklas B, Rogus E, Goldberg A. Exercise blunts declines in lipolysis and fat oxidation after dietary-induced weight loss in obese older women.  Am J Physiol. 1997;  273 E149-E155
• 25 Nicklas BJ, Wang X, You T, Lyles MF, Demons J, Easter L, Berry MJ, Lenchik L, Carr JJ. Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: a randomized, controlled trial.  Am J Clin Nutr. 2009;  89 1043-1052
• 26 Ohkawara K, Tanaka S, Miyachi M, Ishikawa-Takata K, Tabata I. A dose-response relation between aerobic exercise and visceral fat reduction: systematic review of clinical trials.  Int J Obes (Lond). 2007;  31 1786-1797
• 27 Pomerleau M, Imbeault P, Parker T, Doucet E. Effects of exercise intensity on food intake and appetite in women.  Am J Clin Nutr. 2004;  80 1230-1236
• 28 Preiss-Landl K, Zimmermann R, Hämmerle G, Zechner R. Lipoprotein lipase: the regulation of tissue specific expression and its role in lipid and energy metabolism.  Curr Opin Lipidol. 2002;  13 471-481
• 29 Reynisdottir S, Langin D, Carlström K, Holm C, Rössner S, Arner P. Effects of weight reduction on the regulation of lipolysis in adipocytes of women with upper-body obesity.  Clin Sci. 1995;  89 421-429
• 30 Ross R, Rissanen J, Pedwell H, Clifford J, Shragge P. Influence of diet and exercise on skeletal muscle and visceral adipose tissue in men.  J Appl Physiol. 1996;  81 2445-2455
• 31 Schulz KF, Altman DG, Moher D. for the CONSORT Group . CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials.  BMJ. 2010;  340 c332
• 32 Slentz CA, Aiken LB, Houmard JA, Bales CW, Johnson JL, Tanner CJ, Duscha BD, Kraus WE. Inactivity, exercise, and visceral fat. STRRIDE: a randomized, controlled study of exercise intensity and amount.  J Appl Physiol. 2005;  99 1613-1618
• 33 Svendsen O, Hassager C, Christiansen C. Effect of an energy-restrictive diet, with or without exercise, on lean tissue mass, resting metabolic rate, cardiovascular risk factors, and bone in overweight postmenopausal women.  Am J Med. 1993;  95 131-140
• 34 Tchernof A, Calles-Escandon J, Sites C, Poehlman E. Menopause, central body fatness, and insulin resistance: effects of hormone-replacement therapy.  Coronary Artery Dis. 1998;  9 503-511
• 35 Tremblay A, Simoneau J, Bouchard C. Impact of exercise intensity on body fatness and skeletal muscle metabolism.  Metab Clin Exp. 1994;  43 814-818
• 36 Viguerie N, Vidal H, Arner P, Holst C, Verdich C, Avizou S, Astrup A, Saris WHM, Macdonald IA, Klimcakova E, Clement K, Martinez A, Hoffstedt J, Sorensen TIA, Langin D. For the Nutrient-Gene Interaction in Human Obesity – Implications for Dietary Guideline (NUGENOB) Project. Adipose tissue gene expression in obese subjects during low-fat and high-fat hypocaloric diets.  Diabetologia. 2005;  48 123-131
• 37 Yoshioka M, Doucet E, St-Pierre S, Alméras N, Richard D, Labrie A, Després JP, Bouchard C, Tremblay A. Impact of high-intensity exercise on energy expenditure, lipid oxidation and body fatness.  Int J Obes. 2001;  25 332-339
• 38 Zimmermann R, Strauss JG, Haemmerle G, Schoiswohl G, Birner-Gruenberger R, Riederer M, Lass A, Neuberger G, Eisenhaber F, Hermetter A, Zechner R. Fat mobilization in adipose tissue is promoted by adipose triglyceride lipase.  Science. 2004;  306 1383-1386

Correspondence