Managing Cardiometabolic Risk

Exercise-induced weight loss and intra-abdominal fat reduction

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Cross-sectional data shows that individuals who are more physically active have lower amounts of intra-abdominal fat (12-14). Even for a given degree of obesity, individuals who are more active tend to have the lowest levels of intra-abdominal fat compared to their sedentary counterparts (15, 16). In addition, numerous intervention studies have demonstrated that exercise training can reduce intra-abdominal fat through weight loss (17-24).

It was originally suggested that exercise alone produced only a marginal (1 to 2 kg) decrease in body weight (25). These earlier conclusions were based on evidence from intervention studies wherein the prescribed negative energy balance was too low to induce substantive weight loss (26). The literature suggests, however, that exercise can produce a wide array of intra-abdominal fat changes, from a minor reduction of approximately 5% (21) up to a 50% reduction (20). These changes also correspond to a wide array of reductions in body weight. In general, the highest levels of exercise cause the highest energy deficit, which leads to greater weight loss and a greater reduction in intra-abdominal fat. For example, approximately 60 minutes of daily exercise over 3 months caused a 1.0 and 0.7 kg (-28 and -26%) reduction in intra-abdominal fat along with a 7.7 and 6.6 kg weight loss in obese men and women, respectively (17, 18).

Reference

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12. Kanaley JA, Sames C, Swisher L, et al. Abdominal fat distribution in pre- and postmenopausal women: The impact of physical activity, age, and menopausal status. Metabolism 2001; 50: 976-82.

13. Major GC, Piche ME, Bergeron J, et al. Energy expenditure from physical activity and the metabolic risk profile at menopause. Med Sci Sports Exerc 2005; 37: 204-12.

14. Hunter GR, Kekes-Szabo T, Treuth MS, et al. Intra-abdominal adipose tissue, physical activity and cardiovascular risk in pre- and post-menopausal women. Int J Obes Relat Metab Disord 1996; 20: 860-5.

15. Wong SL, Katzmarzyk P, Nichaman MZ, et al. Cardiorespiratory fitness is associated with lower abdominal fat independent of body mass index. Med Sci Sports Exerc 2004; 36: 286-91.

16. Janssen I, Katzmarzyk PT, Ross R, et al. Fitness alters the associations of BMI and waist circumference with total and abdominal fat. Obes Res 2004; 12: 525-37.

17. Ross R, Dagnone D, Jones PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000; 133: 92-103.

18. Ross R, Janssen I, Dawson J, et al. Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obes Res 2004; 12: 789-98.

19. Boudou P, De Kerviler E, Vexiau P, et al. Effects of a single bout of exercise and exercise training on steroid levels in middle-aged type 2 diabetic men: relationship to abdominal adipose tissue distribution and metabolic status. Diabetes Metab 2000; 26: 450-7.

20. Park SK, Park JH, Kwon YC, et al. The effect of combined aerobic and resistance exercise training on abdominal fat in obese middle-aged women. J Physiol Anthropol Appl Human Sci 2003; 22: 129-35.

21. Irwin ML, Yasui Y, Ulrich CM, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA 2003; 289: 323-30.

22. Slentz CA, Duscha BD, Johnson JL, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study. Arch Intern Med 2004; 164: 31-9.

23. Stewart KJ, Bacher AC, Turner K, et al. Exercise and risk factors associated with metabolic syndrome in older adults. Am J Prev Med 2005; 28: 9-18.

24. Donnelly JE, Hill JO, Jacobsen DJ, et al. Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the Midwest Exercise Trial. Arch Intern Med 2003; 163: 1343-50.

25. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. Obes Res 1998; 6 Suppl 2: 51S-209S.

26. Ross R, Freeman JA and Janssen I. Exercise alone is an effective strategy for reducing obesity and related comorbidities. Exerc Sport Sci Rev 2000; 28: 165-70.

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