title: Effects of clinically significant weight loss with exercise training on insulin resistance and cardiometabolic adaptations.
abstract: OBJECTIVE
  To determine response rates for clinically significant weight loss (CWL) following different aerobic exercise training amounts and whether enhanced cardiometabolic adaptations are observed with CWL compared to modest weight loss (MWL) or neither.
  
  
  METHODS
  Participants (N = 330) performed 6 months of aerobic training at 4 kcal per kilogram per week (KKW), 8 KKW, or 12 KKW (50%, 100%, and 150% of recommended levels respectively). Weight loss was categorized as CWL (≥5%) or MWL (3.0% to 4.9%) or neither.
  
  
  RESULTS
  The CWL response rate was greater in the 8 KKW group (20.2%, CI: 13.0% to 27.5%) compared to 4 KKW (10.3%, CI: 4.6% to 16.0%), but not compared to the 12 KKW group (14.6%, CI: 7.6% to 21.6%). Reductions in HOMA-IR were observed in participants with CWL (-0.60, CI: -0.98 to -0.22) and with MWL (-0.48, CI: -0.87 to -0.10), but not those who achieved neither (-0.06, CI -0.22 to 0.10). No changes between groups were observed for cholesterol, fitness, or blood pressure.
  
  
  CONCLUSIONS
  Low response rates for CWL were observed following training, even at levels above recommended levels. Achieving MWL with exercise may represent a reasonable initial weight loss target since the improvement in insulin resistance with MWL is similar to what is achieved with CWL.
authors.affiliation: Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA.|Center for Health Disparities, East Carolina University, Greenville, North Carolina, USA.
authors.forename: Damon L
authors.initials: DL
authors.lastname: Swift
authors.affiliation: Department of Kinesiology, Louisiana State University, Baton Rouge, Louisiana, USA.
authors.forename: Neil M
authors.initials: NM
authors.lastname: Johannsen
authors.affiliation: Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA.
authors.forename: Conrad P
authors.initials: CP
authors.lastname: Earnest
authors.affiliation: Department of Exercise Science and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
authors.affiliation: Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
mesh_terms: D005081:Exercise Therapy / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008875:Middle Aged; D050177:Overweight / Q000628:therapy*; D015431:Weight Loss / Q000502:physiology*; D061217:Weight Reduction Programs / Q000379:methods / Q000706:statistics & numerical data