Managing Cardiometabolic Risk

Exercise without weight loss and intra-abdominal fat reduction

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Although the above suggests that regular exercise can reduce intra-abdominal adiposity independent of weight loss, it is important to note that exercisers who lose weight generally lose more intra-abdominal fat than exercisers who maintain body weight (17, 18) (Figure 2). From a clinical perspective, exercise-induced weight loss therefore causes the greatest reduction in intra-abdominal fat and the greatest improvements in metabolic status. However, given the challenges associated with losing large amounts of weight, it is equally important to reduce intra-abdominal adiposity and related health risk with minimal weight loss.

Gender and intra-abdominal fat reduction with weight loss

A number of studies that have failed to find significant reductions in intra-abdominal fat in women have raised the possibility that women may be resistant to exercise and/or diet-induced reductions in intra-abdominal fat (24, 37, 49-51). For example, 16 months of supervised aerobic exercise at the same exercise intensity and of the same duration reduced 5% of the intra-abdominal fat in young men but failed to produce a significant reduction in young women (24). Further evidence from a trial using either diet or diet with exercise suggests a similar pattern (37). In that study, even though both sexes lost approximately 8.5 kg of body weight in response to the diet-only intervention, the men reduced their intra-abdominal fat by 1.4 kg compared to only 0.4 kg for the women.

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.

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.

37. Redman LM, Heilbronn LK, Martin CK, et al. Effect of calorie restriction with or without exercise on body composition and fat distribution. J Clin Endocrinol Metab 2007; 92: 865-72.

49. Donnelly JE, Jacobsen DJ, Heelan KS, et al. The effects of 18 months of intermittent vs. continuous exercise on aerobic capacity, body weight and composition, and metabolic fitness in previously sedentary, moderately obese females. Int J Obes Relat Metab Disord 2000; 24: 566-72.

50. Snyder KA, Donnelly JE, Jabobsen DJ, et al. The effects of long-term, moderate intensity, intermittent exercise on aerobic capacity, body composition, blood lipids, insulin and glucose in overweight females. Int J Obes Relat Metab Disord 1997; 21: 1180-9.

51. Wilmore JH, Després JP, Stanforth PR, et al. Alterations in body weight and composition consequent to 20 wk of endurance training: the HERITAGE Family Study. Am J Clin Nutr 1999; 70: 346-52.

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