Managing Cardiometabolic Risk

Exercise and Abdominal Obesity

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It has been suggested that abdominal obesity, especially intra-abdominal obesity, may be a central component of cardiometabolic risk that is linked to many other individual risk factors (20). According to recent reviews (21, 22), regular exercise appears to readily reduce abdominal and intra-abdominal obesity. This evidence is presented below.

The literature suggests that regular exercise causes a wide range of intra-abdominal fat changes, from a minor reduction of approximately 5% (23) up to a 50% reduction (24). These changes in intra-abdominal fat also produce a wide range of reductions in body weight. Generally, the highest levels of exercise induce the highest energy deficit, which causes greater weight loss and a greater reduction in intra-abdominal fat. For example, approximately 60 minutes of daily exercise over three months is associated with a 1.0 and 0.7 kg (-28 and -26%) reduction in intra-abdominal fat and a 7.7 and 6.6 kg weight loss in obese men and women, respectively (25, 26). Approximately 20 to 25 minutes of daily exercise was reported to reduce intra-abdominal fat by only 6 to 10%, which corresponded with a modest weight loss (1.4 to 1.8 kg) in overweight women (23) and obese women with diabetes (27). Illustrating a dose-response relationship between exercise dose, weight loss, and intra-abdominal fat loss, Irwin et al. (23) found that women who were highly active (>28 min/day) lost 6.9% of their intra-abdominal fat, compared to a 5.9% loss among intermediate active women (19 to 28 min/day), a 3.4% loss in low active women (≤18 min/day), and a 0.1% gain in controls over a year-long intervention.

Reference

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20. Després JP. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk. Eur Heart J 2006; 8: B4-B12.

21. Janiszewski PM and Ross R. Physical activity in the treatment of obesity: beyond body weight reduction. Appl Physiol Nutr Metab 2007; 32: 512-22.

22. Ross R and Janssen I. Physical activity, total and regional obesity: dose-response considerations. Med Sci Sports Exerc 2001; 33: S521-7; discussion S8-9.

23. 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. 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.

25. 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.

26. 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.

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.

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