title: Impact of weight loss with or without exercise on abdominal fat and insulin resistance in obese individuals: a randomised clinical trial.
abstract: Evidence supports an important contribution of abdominal obesity and inflammation to the development of insulin resistance (IR) and CVD. Weight loss in obese individuals can reduce inflammation and, consequently, IR, but the role of training remains unclear. The aim of this study was to evaluate the effects of body weight reduction with and without exercise over abdominal fat tissue (primary outcome) and IR. In this randomised clinical trial, forty-eight obese individuals (age 31·8 (SD 6·0) years, BMI 34·8 (SD 2·7) kg/m2) were randomised to either a diet-only group (DI) or a diet and exercise group (DI þ EXE). Treatment was maintained until 5% of the initial body weight was lost. At baseline and upon completion, the following parameters were analysed: biochemical parameters such as glycaemia and insulin for the determination of homeostasis model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP) and abdominal computed tomography for the determination of visceral and subcutaneous adipose tissue. A total of thirteen individuals dropped out before completing the weight-loss intervention and did not repeat the tests. In both the DI (n 18) and DI þ EXE (n 17) groups, we observed significant and similar decreases of visceral adipose tissue (difference between means: 7·9 (95% CI 29·5, 25·2) cm2, P¼0·36), hs-CRP (difference between means: 20·06 (95% CI 20·19, 0·03) mg/l, P¼0·39) and HOMA (difference between means: 20·04 (95% CI 20·17, 0·08), P¼0·53). In the present study, 5% weight loss reduced abdominal fat and IR in obese individuals and exercise did not add to the effect of weight loss on the outcome variables.
authors.affiliation: Endocrine Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. apfayh@yahoo.com.br
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Trussardi Fayh
authors.forename: André Luiz
authors.initials: AL
authors.lastname: Lopes
authors.forename: Pablo Rober
authors.initials: PR
authors.lastname: Fernandes
authors.forename: Alvaro
authors.initials: A
authors.lastname: Reischak-Oliveira
authors.forename: Rogério
authors.initials: R
authors.lastname: Friedman
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism*; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D004038:Diet, Reducing; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000178:diet therapy / Q000378:metabolism* / Q000628:therapy; D056128:Obesity, Abdominal / Q000178:diet therapy / Q000378:metabolism / Q000628:therapy; D015431:Weight Loss / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D002097:C-Reactive Protein