Introduction
Obesity, in particular excess visceral adipose tissue (VAT), is associated with metabolic syndrome resulting in increased morbidity and mortality. By contrast, accumulation of body fat in the subcutaneous gluteal-femoral adipose tissue (GFAT) is generally less associated with health problems or may even mediate some protection against cardiovascular diseases. These findings suggest that fat distribution and particularly the ratio between VAT and GFAT may be of importance for obesity-related health complications. Weight loss with preferential effect on the visceral adipose tissue (VAT) depot could have important clinical benefits. In this study, we investigated the independent and combined effect of regular exercise and diet-induced weight loss on body fat distribution.
Methods
Randomized control design of i) exercise-only (EXO; 12 weeks of exercise without diet-restriction), ii) hypocaloric diet (DIO; 8 weeks of very low energy diet (VLED 600 kcal/day (Nupo)) followed by 4-weeks weight maintenance diet) and iii) hypocaloric-diet and exercise (DEX; 8 weeks VLED 800 kcal/day (Nupo + supplement of 150-200 kcal) + a 4-week weight maintenance diet combined with exercise throughout the 12 weeks). Seventy-nine obese males and females were included. Body fat distribution was quantified by magnetic resonance imaging (MRI)-technology.
Results
In the EXO group, the weight loss (3.5 kg) and the relative reduction in VAT (18%) was significantly lower compared with the weight losses in the DIO and DEX groups (12.3 kg; P≤0.01) and to the reduction in VAT (30-37%; P≤0.001). In all the three groups, the relative reduction of VAT was higher as compared with the reduction in fat mass (FM; combining all fat depots determined by MRI; P≤0.01 for all comparisons). The changes in VAT were associated with changes in FM and related to the initial VAT/FM ratio (r2=0.72; P≤0.01).
Conclusion
Exercise has no additional effects on the reduction of the VAT depot, compared with the major effects of hypocaloric diet alone. In addition, the effects of exercise per se on VAT are relatively limited. The effects on the VAT depot are closely associated with changes in total FM.
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