Advertisement

Different modalities of exercise to reduce visceral fat mass and cardiovascular risk in metabolic syndrome: the RESOLVE* randomized trial

  • Frédéric Dutheil
    Correspondence
    Corresponding author at: Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Blaise Pascal University, 63000 Clermont-Ferrand, France. Tel.: +33 6 88 22 48 48; fax: +33 4 73 27 46 49.
    Affiliations
    Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France

    School of Exercise Science, Australian Catholic University, Locked Bag 4115, Fitzroy MDC, VIC 3065, Australia

    Sport Medicine and Functional Exploration, University Hospital CHU G. Montpied, Clermont-Ferrand, France

    INRA, UMR 1019, UNH, CRNH Auvergne, University of Auvergne, Clermont-Ferrand, France

    Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France
    Search for articles by this author
  • Gérard Lac
    Affiliations
    Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France
    Search for articles by this author
  • Bruno Lesourd
    Affiliations
    Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France

    Geriatrics, PRES Clermont University of Auvergne, Faculty of Medicine, Clermont-Ferrand, France
    Search for articles by this author
  • Robert Chapier
    Affiliations
    Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France
    Search for articles by this author
  • Guillaume Walther
    Affiliations
    Laboratory of Pharm-Ecology Cardiovascular EA4278, School of Sport Sciences and Exercise, University of Avignon, France
    Search for articles by this author
  • Agnès Vinet
    Affiliations
    Laboratory of Pharm-Ecology Cardiovascular EA4278, School of Sport Sciences and Exercise, University of Avignon, France
    Search for articles by this author
  • Vincent Sapin
    Affiliations
    Biochemistry, University Hospital CHU G. Montpied, Clermont-Ferrand, France
    Search for articles by this author
  • Julien Verney
    Affiliations
    Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France
    Search for articles by this author
  • Lemlih Ouchchane
    Affiliations
    Biostatistics, PRES Clermont University of Auvergne, Faculty of Medicine, Clermont-Ferrand, France
    Search for articles by this author
  • Martine Duclos
    Affiliations
    Sport Medicine and Functional Exploration, University Hospital CHU G. Montpied, Clermont-Ferrand, France

    INRA, UMR 1019, UNH, CRNH Auvergne, University of Auvergne, Clermont-Ferrand, France
    Search for articles by this author
  • Philippe Obert
    Affiliations
    School of Exercise Science, Australian Catholic University, Locked Bag 4115, Fitzroy MDC, VIC 3065, Australia

    Laboratory of Pharm-Ecology Cardiovascular EA4278, School of Sport Sciences and Exercise, University of Avignon, France
    Search for articles by this author
  • Daniel Courteix
    Affiliations
    Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France

    School of Exercise Science, Australian Catholic University, Locked Bag 4115, Fitzroy MDC, VIC 3065, Australia
    Search for articles by this author

      Abstract

      Background

      Opinions differ over the exercise modalities that best limit cardiovascular risk (CVR) resulting from visceral obesity in individuals with metabolic syndrome (MetS). As little is known about the combined effects of resistance and endurance training at high volumes under sound nutritional conditions, we aimed to analyze the impact of various intensities of physical activity on visceral fat and CVR in individuals with MetS.

      Methods

      100 participants, aged 50–70 years, underwent a diet restriction (protein intake 1.2 g/kg/day) with a high exercise volume (15–20 h/week). They were randomized to three training groups: moderate-resistance–moderate-endurance (re), high-resistance–moderate-endurance (Re), or moderate-resistance–high-endurance (rE). A one-year at-home follow-up (M12) commenced with a three-week residential program (Day 0 to Day 21). We measured the change in visceral fat and body composition by DXA, MetS parameters, fitness, the Framingham score and carotid-intima–media-thickness.

      Results

      78 participants completed the program. At D21, visceral fat loss was highest in Re (−18%, p < .0001) and higher in rE than re (−12% vs. −7%, p < .0001). Similarly, from M3, visceral fat decreased more in high-intensity-groups to reach a visceral fat loss of −21.5% (Re) and −21.1% (rE) > −13.0% (re) at M12 (p < .001). CVR, MetS parameters and fitness improved in all groups. Visceral fat loss correlated with changes in MetS parameters.

      Conclusion

      Increased intensity in high volume training is efficient in improving visceral fat loss and carotid-intima–media-thickness, and is realistic in community dwelling, moderately obese individuals. High-intensity-resistance training induced a faster visceral fat loss, and thus the potential of resistance training should not be undervalued (ClinicalTrials.gov number: NCT00917917).

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to International Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Mottillo S.
        • Filion K.B.
        • Genest J.
        • et al.
        The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis.
        J Am Coll Cardiol. 2010; 56: 1113-1132
        • Alberti K.G.
        • Zimmet P.
        • Shaw J.
        The metabolic syndrome—a new worldwide definition.
        Lancet. 2005; 366: 1059-1062
        • Matsuzawa Y.
        • Funahashi T.
        • Nakamura T.
        The concept of metabolic syndrome: contribution of visceral fat accumulation and its molecular mechanism.
        J Atheroscler Thromb. 2011; 18: 629-639
        • Balducci S.
        • Zanuso S.
        • Nicolucci A.
        • et al.
        Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES).
        Arch Intern Med. 2010; 170: 1794-1803
        • Balducci S.
        • Zanuso S.
        • Nicolucci A.
        • et al.
        Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss.
        Nutr Metab Cardiovasc Dis. 2010; 20: 608-617
        • Bateman L.A.
        • Slentz C.A.
        • Willis L.H.
        • et al.
        Comparison of aerobic versus resistance exercise training effects on metabolic syndrome (from the Studies of a Targeted Risk Reduction Intervention Through Defined Exercise—STRRIDE-AT/RT).
        Am J Cardiol. 2011; 108: 838-844
        • Camhi S.M.
        • Stefanick M.L.
        • Ridker P.M.
        • Young D.R.
        Changes in C-reactive protein from low-fat diet and/or physical activity in men and women with and without metabolic syndrome.
        Metabolism. 2010; 59: 54-61
        • Castaneda C.
        • Layne J.E.
        • Munoz-Orians L.
        • et al.
        A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes.
        Diabetes Care. 2002; 25: 2335-2341
        • Cauza E.
        • Hanusch-Enserer U.
        • Strasser B.
        • et al.
        The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus.
        Arch Phys Med Rehabil. 2005; 86: 1527-1533
        • Cuff D.J.
        • Meneilly G.S.
        • Martin A.
        • et al.
        Effective exercise modality to reduce insulin resistance in women with type 2 diabetes.
        Diabetes Care. 2003; 26: 2977-2982
        • Eriksson J.
        • Tuominen J.
        • Valle T.
        • et al.
        Aerobic endurance exercise or circuit-type resistance training for individuals with impaired glucose tolerance?.
        Horm Metab Res. 1998; 30: 37-41
        • Irving B.A.
        • Davis C.K.
        • Brock D.W.
        • et al.
        Effect of exercise training intensity on abdominal visceral fat and body composition.
        Med Sci Sports Exerc. 2008; 40: 1863-1872
        • Kalter-Leibovici O.
        • Younis-Zeidan N.
        • Atamna A.
        • et al.
        Lifestyle intervention in obese Arab women: a randomized controlled trial.
        Arch Intern Med. 2010; 170: 970-976
        • Kim C.J.
        • Kim D.J.
        • Park H.R.
        Effects of a cardiovascular risk reduction intervention with psychobehavioral strategies for Korean adults with type 2 diabetes and metabolic syndrome.
        J Cardiovasc Nurs. 2011; 26: 117-128
        • Maruyama C.
        • Kimura M.
        • Okumura H.
        • et al.
        Effect of a worksite-based intervention program on metabolic parameters in middle-aged male white-collar workers: a randomized controlled trial.
        Prev Med. 2010; 51: 11-17
        • Seligman B.G.
        • Polanczyk C.A.
        • Santos A.S.
        • et al.
        Intensive practical lifestyle intervention improves endothelial function in metabolic syndrome independent of weight loss: a randomized controlled trial.
        Metabolism. 2011; 60: 1736-1740
        • Ismail I.
        • Keating S.E.
        • Baker M.K.
        • Johnson N.A.
        A systematic review and meta-analysis of the effect of aerobic vs. resistance exercise training on visceral fat.
        Obes Rev. 2012; 13: 68-91
        • Dutheil F.
        • Lesourd B.
        • Courteix D.
        • et al.
        Blood lipids and adipokines concentrations during a 6-month nutritional and physical activity intervention for metabolic syndrome treatment.
        Lipids Health Dis. 2010; 9: 148
        • Dutheil F.
        • Lac G.
        • Courteix D.
        • et al.
        Treatment of metabolic syndrome by combination of physical activity and diet needs an optimal protein intake: a randomized controlled trial.
        Nutr J. 2012; 11: 72
        • Kamel E.G.
        • McNeill G.
        • Van Wijk M.C.
        Usefulness of anthropometry and DXA in predicting intra-abdominal fat in obese men and women.
        Obes Res. 2000; 8: 36-42
      1. Obesity: preventing and managing the global epidemic. Report of a WHO consultation.
        World Health Organ Tech Rep Ser. 2000; 894: 1-253
        • Willardson J.M.
        • Kattenbraker M.S.
        • Khairallah M.
        • Fontana F.E.
        Research note: effect of load reductions over consecutive sets on repetition performance.
        J Strength Cond Res. 2010; 24: 879-884
      2. ATS statement: guidelines for the six-minute walk test.
        Am J Respir Crit Care Med. 2002; 166: 111-117
        • Sunagawa H.
        • Honda S.
        • Yoshii K.
        • et al.
        Direct estimation of cardiac reserve through analysis of relation between oxygen consumption and heart rate during exercise testing.
        Jpn Circ J. 1985; 49: 1302-1306
        • Black A.E.
        • Coward W.A.
        • Cole T.J.
        • Prentice A.M.
        Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements.
        Eur J Clin Nutr. 1996; 50: 72-92
        • Vinet A.
        • Karpoff L.
        • Walther G.
        • et al.
        Vascular reactivity at rest and during exercise in middle-aged obese men: effects of short-term, low-intensity, exercise training.
        Int J Obes (Lond). 2011; 35: 820-828
        • Touboul P.J.
        • Hennerici M.G.
        • Meairs S.
        • et al.
        Mannheim carotid intima–media thickness consensus (2004–2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006.
        Cerebrovasc Dis. 2007; 23: 75-80
        • Wilson P.W.
        • D'Agostino R.B.
        • Levy D.
        • et al.
        Prediction of coronary heart disease using risk factor categories.
        Circulation. 1998; 97: 1837-1847
        • Goodpaster B.H.
        • Delany J.P.
        • Otto A.D.
        • et al.
        Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial.
        JAMA. 2010; 304: 1795-1802
        • Nordin B.E.
        The effect of calcium supplementation on bone loss in 32 controlled trials in postmenopausal women.
        Osteoporos Int. 2009; 20: 2135-2143
        • Stensvold D.
        • Tjonna A.E.
        • Skaug E.A.
        • et al.
        Strength training versus aerobic interval training to modify risk factors of metabolic syndrome.
        J Appl Physiol. 2010; 108: 804-810
        • Donges C.E.
        • Duffield R.
        • Drinkwater E.J.
        Effects of resistance or aerobic exercise training on interleukin-6, C-reactive protein, and body composition.
        Med Sci Sports Exerc. 2010; 42: 304-313
        • Enright P.L.
        • McBurnie M.A.
        • Bittner V.
        • et al.
        The 6-min walk test: a quick measure of functional status in elderly adults.
        Chest. 2003; 123: 387-398
        • Williams M.A.
        • Haskell W.L.
        • Ades P.A.
        • et al.
        Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism.
        Circulation. 2007; 116: 572-584
        • Lakka T.A.
        • Laaksonen D.E.
        Physical activity in prevention and treatment of the metabolic syndrome.
        Appl Physiol Nutr Metab. 2007; 32: 76-88
        • Slentz C.A.
        • Houmard J.A.
        • Kraus W.E.
        Modest exercise prevents the progressive disease associated with physical inactivity.
        Exerc Sport Sci Rev. 2007; 35: 18-23
        • Kraus W.E.
        • Houmard J.A.
        • Duscha B.D.
        • et al.
        Effects of the amount and intensity of exercise on plasma lipoproteins.
        N Engl J Med. 2002; 347: 1483-1492
        • Kelley G.A.
        • Kelley K.S.
        Progressive resistance exercise and resting blood pressure: a meta-analysis of randomized controlled trials.
        Hypertension. 2000; 35: 838-843
        • Anderson K.M.
        • Wilson P.W.
        • Odell P.M.
        • Kannel W.B.
        An updated coronary risk profile. A statement for health professionals.
        Circulation. 1991; 83: 356-362
        • Sjostrom M.
        • Karlsson A.B.
        • Kaati G.
        • et al.
        A four week residential program for primary health care patients to control obesity and related heart risk factors: effective application of principles of learning and lifestyle change.
        Eur J Clin Nutr. 1999; 53: S72-S77
        • Tabet J.Y.
        • Meurin P.
        • Driss A.B.
        • et al.
        Benefits of exercise training in chronic heart failure.
        Arch Cardiovasc Dis. 2009; 102: 721-730
        • Chudyk A.
        • Petrella R.J.
        Effects of exercise on cardiovascular risk factors in type 2 diabetes: a meta-analysis.
        Diabetes Care. 2011; 34: 1228-1237