Managing Cardiometabolic Risk

Exercise-induced weight loss and intra-abdominal fat reduction

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Conversely, approximately 20 to 25 minutes of daily exercise reduced intra-abdominal fat by only 6 to 10%, for a modest weight loss of 1.4 to 1.8 kg in overweight women (21) and obese women with diabetes (27). Illustrating a dose-response relationship between exercise dose, weight loss, and intra-abdominal fat loss, Irwin et al. (21) found that women who were highly active (>28 min/day) lost 6.9% of intra-abdominal fat, compared to a 5.9% loss among intermediate active (19 to 28 min/day), a 3.4% loss in low active (≤18 min/day), and a 0.1% gain in controls over a year-long intervention.

For a given amount of exercise-induced weight loss, the relative amount of intra-abdominal fat lost is generally greater than the amount of abdominal subcutaneous fat lost (17, 18, 24, 27, 28). This suggests that intra-abdominal fat may be more sensitive to exercise-induced weight loss than other fat depots. In general, exercise training reduces intra-abdominal fat by approximately 0.5 kg for every 4 kg of body weight lost in both men and women (17, 18). Also, it appears that as little as 20 minutes of daily exercise with an energy expenditure of less than 1,500 kcal/week can spur modest reductions in intra-abdominal fat (5 to 10%). Increasing daily exercise to 60 minutes with an energy expenditure of 3,500 to 4,500 kcal/week causes much greater reductions in intra-abdominal fat (~30%). While intra-abdominal fat cannot be readily measured, waist circumference is recommended as a reliable measure of intra-abdominal fat (29).

Reference

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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.

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.

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.

27. Giannopoulou I, Ploutz-Snyder LL, Carhart R, et al. Exercise is required for visceral fat loss in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab 2005; 90: 1511-8.

28. Cuff DJ, Meneilly GS, Martin A, et al. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care 2003; 26: 2977-82.

29. Pouliot M-C, Després JP, Lemieux S, et al. Waist circumference and abdominal sagitttal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994; 73: 460-8.

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