Daily exercise lowers blood pressure and reduces visceral adipose tissue areas in overweight Japanese men

Visceral fat mass dynamics in a 2-year randomized STrength versus ENdurance training trial in people with obesity

AIM

To compare the effectiveness of strength versus endurance training on reducing visceral fat in individuals with obesity.

MATERIALS AND METHODS

For the STrength versus ENdurance (STEN) 24-month randomized clinical trial, we assigned 239 participants with abdominal obesity to either strength or endurance training (two to three times a week, 60 min/training session) in addition to standard nutritional counselling to promote a healthy diet. Changes in abdominal visceral adipose tissue (VAT) area quantified by magnetic resonance imaging after 12 months were defined as a primary endpoint.

RESULTS

Participants (aged 44 years, 74% women, body mass index: 37 kg/m2, mean VAT volume: 4050 cm3) had an approximately 50% retention rate and a 30% good training programme adherence at 12 months. There was no difference between strength and endurance training in VAT volume dynamics after 12 and 24 months (p = .13). Only in the good adherence group did we find a trend for reduced VAT volume in both training regimens. Independently of the exercise programme, there was a continuous trend for moderate loss of abdominal subcutaneous AT volume, body fat mass, body mass index and improved parameters of insulin sensitivity. Although parameters of physical fitness improved upon both exercise interventions, the dynamics of resting energy expenditure, glucose and lipid metabolism parameters were not different between the intervention groups and did not significantly improve during the 2-year trial (p > .05).

CONCLUSIONS

Despite heterogeneous individual training responses, strength and endurance training neither affected VAT volume nor key secondary endpoints differently.

The Effect of Combined Drug Management and an Exercise Program on Symptoms and the Happiness Level in Elderly Women

The aim of this study was to determine the effect of combined drug management and an exercise program on symptoms and the happiness levels of elderly women people living at home. This interventional study included a total of 35 women, aged 65 to 74 years, who were registered at the Family Healthcare Centre. A 14-week program was combined with exercise and drug management. Pre-test and post-test evaluations results were recorded. The Edmonton Symptom Assessment Scale (ESAS), Oxford Happiness Questionnaire-Short Form (OHQ-SF) and a sociodemographic form and Follow-Up form were used for data collection. The mean ESAS points of the symptoms of pain, tiredness, sadness, and insomnia showed a significant decrease after intervention and the sense of well-being improved ( p < .001). A statistically significant increase was determined in the happiness levels of the participants after intervention. The combined program of drug management and exercise was found to be effective in raising happiness levels and reducing symptoms in elderly women.

Experimental Weight Gain Increases Ambulatory Blood Pressure in Healthy Subjects: Implications of Visceral Fat Accumulation

OBJECTIVE

To examine whether experimentally induced weight gain raises ambulatory blood pressure (BP) in healthy subjects and identify any relationship between changes in BP and changes in regional fat distribution.

PATIENTS AND METHODS

Twenty-six normal weight subjects were randomized to 8 weeks of weight gain through overfeeding (n=16; age, 30.4±6.6 years) or to weight maintenance (controls; n=10; age, 27.1±7.7 years) between July 2004 and August 2010. Measures of body composition via dual energy X-ray absorptiometry and computed tomography, circulating biomarkers, and 24-hour ambulatory BP were obtained at baseline and after the 8-week experimental phase.

RESULTS

Overfeeding resulted in 3.7 kg (95% CI, 2.9-4.5) increase in body weight in weight gainers, with increments in total (46.2 cm²; 95% CI, 27.6-64.9), visceral (13.8 cm²; 95% CI, 5.8-21.9), and subcutaneous fat (32.4 cm²; 95% CI, 13.5-51.3). No changes occurred in the maintenance group. Increases in 24-hour systolic BP (4 mm Hg; 95% CI, 1.6-6.3), mean BP (1.7 mm Hg; 95% CI, 0.3-3.3), and pulse pressure (2.8 mm Hg; 95% CI, 1.1-4.4) were evident after weight gain in the experimental group, whereas BP remained unchanged in controls. Changes in mean BP correlated only with changes in visceral fat (ρ=0.45; P=.02), but not with changes in other body composition measures.

CONCLUSION

Modest weight gain causes elevation in 24-hour BP in healthy subjects. The association between increased BP and abdominal visceral fat accumulation suggests that visceral deposition of adipose tissue may contribute specifically to the enhanced risk of hypertension associated with weight gain.

Circulating leptin levels are associated with physical activity or physical fitness in Japanese

OBJECTIVE

The aim of this study was to evaluate the link between circulating leptin levels and physical activity and/or physical fitness in apparently healthy Japanese.

METHODS

A total of 85 men and 111 women who were not taking any medication were enrolled in this cross-sectional study. Circulating leptin levels, physical activity measured by tri-axial accelerometers and peak oxygen uptake were evaluated. We also assessed anthropometric data, blood pressure, blood examinations and energy intake.

RESULTS

Circulating leptin levels were 3.2 ± 2.3 ng/mL in men and 5.9 ± 3.8 ng/mL in women. Circulating leptin levels were significantly and positively correlated with body weight, body mass index, abdominal circumference, insulin and the homeostasis model assessment index, and significantly and negatively correlated with peak oxygen uptake in both sexes. Stepwise multiple regression showed that peak oxygen uptake in men and physical activity evaluated by Σ[metabolic equivalents h per week(METs h/w)]. in women were determinant factors for circulating leptin levels after adjusting for confounding factors.

Circulating adiponectin levels are associated with peak oxygen uptake in Japanese

OBJECTIVE

The aim of this study was to investigate the link between circulating adiponectin levels and peak oxygen uptake and/or physical activity in Japanese.

METHODS

A total of 528 subjects (188 men and 340 women) were enrolled in this cross-sectional study. Circulating adiponectin levels, physical activity measured by tri-axial accelerometers, peak oxygen uptake and metabolic risk parameters were evaluated. We also assessed anthropometric factors, blood pressure, blood examinations and energy intake.

RESULTS

Circulating adiponectin levels were 6.7 ± 3.0 μg/mL in men and 11.0 ± 4.9 μg/mL in women. Circulating adiponectin levels were positively correlated with physical fitness after adjusting for age, physical activity evaluated by Σ [metabolic equivalents × h per week (METs h/w)], cigarette smoking habit and energy intake in both sexes. However, these associations were attenuated further after adjusting for body mass index including other confounding factors, especially in men. However, circulating adiponectin levels were not associated with physical activity in either sex.

CONCLUSION

Circulating adiponectin levels were associated with peak oxygen uptake rather than physical activity.

Lifestyle modification and endothelial function in obese subjects

The metabolic syndrome is a cluster of metabolic and vascular abnormalities that include central obesity, insulin resistance, hyperinsulinemia, glucose intolerance, hypertension, dyslipidemia, hypercoagulability and an increased risk of coronary and cerebral vascular disease. These metabolic and vascular abnormalities are the main cause of cardiovascular mortality in western societies. Endothelial dysfunction, an early step in the development of atherosclerosis, has been reported in obese nondiabetic individuals and in patients with Type 2 diabetes. It has also been observed in individuals at high risk for Type 2 diabetes, including those with impaired glucose tolerance and the normoglycemic first-degree relatives of Type 2 diabetic patients. Recent evidence points to adipocytes as a complex and active endocrine tissue whose secretory products, including free fatty acids and several cytokines (i.e., leptin, adiponectin, tissue necrosis factor-alpha, interleukin-6, and resistin) play a major role in the regulation of human metabolic and vascular biology. These adipocytokines have been claimed to be the missing link between insulin resistance and cardiovascular disease. Interventions designed to improve endothelial and/or adipose-tissue functions may reduce cardiovascular events in obese individuals with either the metabolic syndrome or Type 2 diabetes. Lifestyle modification in the form of caloric restriction and increased physical activity are the most common modalities used for treating those individuals at risk and is unanimously agreed to be the initial step in managing Type 2 diabetes. Several recent studies have demonstrated favorable impacts of lifestyle modifications in improving endothelial function and insulin sensitivity, in addition to altering serum levels of adipocytokines and possibly reducing cardiovascular events. This review discusses current knowledge of the role of lifestyle modifications in ameliorating cardiovascular risk in obese subjects with either the metabolic syndrome or Type 2 diabetes.

Serum vaspin levels are associated with physical activity or physical fitness in Japanese: a pilot study

AIM

To investigate the link between serum vaspin levels and physical activity and/or physical fitness in Japanese.

METHODS

A total of 156 subjects (81 men and 75 women) was enrolled in this cross-sectional study. Serum vaspin levels, physical activity by uniaxial accelerometers, peak oxygen uptake, and metabolic risk parameters were evaluated. We also assessed anthropometric and body composition parameters.

RESULTS

Serum vaspin levels were over the level of 10 ng/mL in 15 subjects (9.6 %: Vaspin High group). In Vaspin Low group (<5 ng/mL: 74 men and 67 women), serum vaspin levels were 0.12 ± 0.18 ng/mL in men and 0.39 ± 0.70 ng/mL in women. Peak oxygen uptake was significantly and positively correlated with serum vaspin levels even after adjusting for age, physical activity evaluated by Σ[metabolic equivalents × h per week (METs[Symbol: see text]h/w)], BMI, and other confounding factors in men. In turn, physical activity was significantly and positively correlated with serum vaspin levels even after adjusting for confounding factors in women.

CONCLUSION

Serum vaspin levels were closely associated with physical fitness in men and physical activity in women independent of body composition in this Japanese cohort.

Serum interleukin-18 levels are associated with physical activity in Japanese men

Objective

To investigate the link between serum interleukin-18 (IL-18) levels and physical activity in Japanese men.

Methods

A total of 81 men (45.7±17.6 years old) was enrolled in this cross-sectional investigation study. We assessed anthropometric and body composition parameters. Serum IL-18 levels, physical activity by uniaxial accelerometers, peak oxygen uptake and metabolic risk parameters were also evaluated.

Results

Serum IL-18 levels were 179.4±84.7 pg/mL. Physical activity evaluated by Σ[metabolic equivalents × h per week (METs⋅h/w)]was significantly and negatively correlated with serum IL-18 levels (r = −0.252, p = 0.0235). These associations remained even after adjusting for age, peak oxygen uptake and other confounding factors.

Conclusion

Serum IL-18 levels were closely associated with physical activity independent of peak oxygen uptake in Japanese men.

The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis

Excessive visceral adipose tissue appears to trigger a cascade of metabolic disturbances that seem to coexist with ectopic fat storage in muscle, liver, heart and the ß-cell. Therefore, the reduction of visceral adipose tissue potentially plays a pivotal role in the treatment of the metabolic syndrome. The purpose of this systematic review and meta-analysis is to describe the overall effect of exercise on visceral adipose tissue and to provide an overview of the effect of different exercise regimes, without caloric restriction, on visceral adipose tissue in obese persons. A systematic literature search was performed according to the PRISMA statement for reporting systematic reviews and meta-analyses. The initial search resulted in 87 articles after removing duplicates. After screening on title, abstract and full-text 15 articles (totalling 852 subjects) fulfilled the a priori inclusion criteria. The quality of each eligible study was assessed in duplicate with “The Critical Review Form for Quantitative Studies”. Using random-effects weights, the standardized mean difference (Hedge's g) of the change in visceral adipose tissue was −0.497 with a 95% confidence interval of −0.655 to −0.340. The Z-value was −6.183 and the p-value (two tailed) was <0.001. A subgroup analysis was performed based on gender, type of training and intensity. Aerobic training of moderate or high intensity has the highest potential to reduce visceral adipose tissue in overweight males and females. These results suggest that an aerobic exercise program, without hypocaloric diet, can show beneficial effects to reduce visceral adipose tissue with more than 30 cm² (on CT analysis) in women and more than 40 cm² in men, even after 12 weeks.

Body adipose distribution among patients with type 2 diabetes mellitus

SUMMARY

Both diabetes mellitus (DM) and obesity are prevalent in adults. The relationship between DM and body adipose tissue (AT) distribution is complex and although it has been investigated extensively, the subject remains controversial. Although a causal association between DM and obesity and AT distribution cannot be established on the basis of existing data, it is possible to conclude from many studies that gene, serum sex steroids level, daily physical activity and food supply can be the risk of obesity and AT redistribution factor among type 2 DM patients (T2DM). Obesity and AT redistribution of T2DM patients can increase the risk of insulin resistant (IR), cardiovascular disease and many other disorders. Even though obesity and AT redistribution screening or prophylactic treatment in all patients with T2DM is not being recommended at present, such patient populations should be given general guidelines regarding exercise, food intake control, and even medicinal treatment. The extent of diagnostic and therapeutic interventions should be based on the individual's risk profile.:

Evaluation of ventilatory threshold and its relation to exercise habits among Japanese

OBJECTIVE

The aim of this study was to evaluate aerobic exercise levels, expressed in terms of ventilatory threshold (VT), in a Japanese population and explore the relationship between VT and exercise habits in this population.

METHODS

This was a cross-sectional study in which data collected from 547 men and 524 women aged 20-69 years and not on medications, were used to assess exercise habits and parameters at VT, namely, oxygen uptake, work rate, and heart rate.

RESULTS

Age-related changes in parameters at VT were noted. Of the participants, 205 men (37.5%) and 142 women (27.1%) had exercise habits. Oxygen uptake and work rate at VT in subjects with exercise habits were significantly higher than those without exercise habits after age had been adjusted for in both sexes. Anthropometric parameters were significantly correlated with oxygen uptake at VT, and the highest correlation coefficient rate was found between oxygen uptake at VT and body fat percentage (men r = -0.589, women r = -0.631).

CONCLUSION

The mean values determined here may provide a useful database for evaluating VT in Japanese adult subjects.

Central obesity and cigarette smoking are key determinants of cardiovascular disease deaths in Australia: a public health perspective

BACKGROUND

Our objective is to develop a parsimonious model to predict coronary heart disease (CHD) and cardiovascular disease (CVD) deaths using individual components of the Framingham risk score plus measures of central obesity.

METHODS

15 year mortality follow-up of 8662 representative Australian adults in the National Heart Foundation Risk Factor Prevalence Survey of 1989, excluding those with a baseline history of heart disease, stroke or diabetes. Measures included blood pressure, fasting lipids, smoking history, body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR). Multivariable logistic regression was used to assess the effects of the Framingham risk variables and central obesity variables on cardiovascular disease mortality.

RESULTS

Smoking status, high density lipoprotein cholesterol (HDL-C) and the total cholesterol (TC) to HDL-C ratio were significant univariate predictors of CHD deaths. These together with systolic blood pressure were significant predictors of CVD deaths. The obesity measures of WC and WHR were significant univariate predictors but BMI was not. In multivariable analyses, only smoking status and waist to hip ratio were identified as key independent risk factors for CHD and CVD deaths, although TC to HDL-C ratio contributed minimally to CHD deaths. Receiver operator characteristic (ROC) curves for the Framingham risk score in comparison to the WHR plus smoking model were virtually identical, with no added effect of the lipid ratio.

CONCLUSION

The preferred model for predicting CHD and CVD deaths uses central obesity plus smoking with no added influence of measured lipids or blood pressure. A public health focus on identifying and modifying central obesity is at least as important as the measurement and treatment of lipids and hypertension.

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial

Background

Recent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies.

Objective

Using a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations.

Method

Sixty-three women and 16 men (49.2 years ± 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data.

Results

Significant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p = .008), occupational (p = .045) and total walking (p = .03), and significantly fewer minutes in time spent in weekend (p = .003) and total sitting (p = .022).

Conclusion

A pedometer-based walking program, incorporating a physical activity consultation, is effective in promoting walking and improving positive affect over 12 weeks in community based individuals. The discussion examines possible explanations for the lack of significant changes in health outcomes. Continued follow-up of this study will examine adherence to the intervention and possible resulting effects on health outcomes.

Comparison of ventilatory threshold and exercise habits between Japanese men with and without metabolic syndrome

OBJECTIVE

We compared the levels of ventilatory threshold (VT) and exercise habits in subjects with metabolic syndrome with those in age, sex-matched subjects without metabolic syndrome.

METHODS

We used data of 155 Japanese men (47.1+/-9.2 years) with metabolic syndrome; the diagnosis was given by the definition and the diagnostic standard for metabolic syndrome in Japan. The influence of metabolic syndrome on oxygen uptake, work rate and heart rate at VT, and exercise habits were evaluated.

RESULTS

Oxygen uptake and work rate at VT in subjects with metabolic syndrome were significantly lower than those in subjects without metabolic syndrome even after adjusting for body mass index (BMI). The number of subjects with exercise habits was significantly lower in metabolic syndrome. The subjects with exercise habits were significantly older than that in subjects without exercise habits. Furthermore, oxygen uptake and work rate at VT were significantly higher in subjects with exercise habits than those in subjects without exercise habits.

CONCLUSION

Lower level of VT was characteristic in subjects with metabolic syndrome. Promotion of exercise habits is necessary for preventing and improving metabolic syndrome in Japanese men.

Adipose tissue distribution and risk of metabolic disease: does thiazolidinedione-induced adipose tissue redistribution provide a clue to the answer?

The relative effect of visceral and subcutaneous obesity on the risk of chronic metabolic disease has been a matter of long-term dispute. While ample data support either of the fat depots being causative or associative, valid argument for one depot often automatically belittles the other. Paradigms such as the visceral/portal hypothesis and the acquired lipodystrophy/ectopic fat storage and endocrine hypothesis have been proposed. Nevertheless, neither hypothesis alone explains the entire pathophysiological setting. Treatment of diabetes with thiazolidinediones selectively increases fat partitioning to the subcutaneous adipose depot but does not change visceral fat accumulation. This is in contrast to the preferential visceral fat mobilisation by diet and exercise. Surgical removal of visceral or subcutaneous adipose tissue yields relatively long-lasting metabolic improvement only when combined with procedures that ameliorate adipose tissue cell composition. These studies illustrate that human adipose tissue in different anatomic locations does not work in isolation, and that there is a best-fit relationship in terms of volume and function among different fat depots that needs to be met to maintain the systemic energy balance and to prevent the complications related to obesity.

Effects of daily exercise on blood pressure, plasma glucose, and obesity measures in 55–64-year-old obese Asian Indian men: The Calcutta longitudinal study

The present longitudinal study was undertaken to study the effect of brisk walking on blood pressure, plasma glucose, and obesity measures in 55-64-year-old obese Asian Indian men. A total of 45 obese (body mass index > or =25 kg/m(2)) men took part in the study. They were monitored for 20 weeks. Obesity measures, blood pressure, fasting plasma glucose (FPG), and 30 min of brisk walking were recorded for each participant. Brisk walking was defined as 2 km of walking by 30 min with moderate sweating. A general linear model (GLM) repeated-measures analysis procedure with Scheffé's post hoc test revealed that group I (up to 5 weeks of exercise) had significantly greater means compared to groups II (6-10 weeks), III (11-15 weeks), and IV (16-20 weeks) for body mass index (P < 0.01), waist-hip ratio (P < 0.001), percent body fat (P < 0.05), systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001), and FPG (P < 0.001), whereas group I had a significantly lower mean than groups II, III, and IV for frequency of brisk walking (P < 0.01). It was also observed that change in Delta blood pressure and Delta FPG had a significant positive association with Delta obesity measures, independent of age effect. Therefore, brisk walking is recommended to lower blood pressure, blood glucose, and obesity (particularly central obesity) in middle-aged obese individuals.

Re-evaluation of exercise intensity for overweight Japanese men by ventilatory threshold

AIM

To re-evaluate exercise intensity for overweight Japanese men by ventilatory threshold (VT).

METHODS

Cross sectional clinical intervention study.

SUBJECTS AND MATERIALS

One hundred and ten overweight Japanese men aged 32-59 years were recruited. The average body mass index was 28.5+/-2.5 kg/m(2). Aerobic exercise level was evaluated by measuring VT. Fifty per cent heart rate (HR) reserve by Karvonen's formula was calculated and compared with HR at VT. Fat distribution was evaluated by visceral fat and subcutaneous fat areas measured with computed tomography scanning at umbilical levels. Anthropometric parameters such as height, body weight and body fat percentage were also measured.

RESULTS

There was significant correlation between HR at VT and 50% HR reserve by Karvonen's formula (r=0.642, p<0.01). However, HR at VT was significantly lower than 50% HR reserve by Karvonen's formula (HR at VT 103.6+/-10.6 beat/min vs. 50% HR reserve 125.0+/-7.1 beat/min, p<0.01) and HR at VT was corresponded to 28.5+/-8.3% HR reserve by Karovonen's formula.

CONCLUSION

The present study indicated that exercise intensity of 30% HR reserve should be recommended for overweight Japanese men.