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Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: a randomized, controlled trial

¹ From the Section on Gerontology and Geriatric Medicine, J Paul Sticht Center on Aging, Department of Internal Medicine (BJN, XW, MFL, and JD), General Clinical Research Center (LE), and Department of Health and Exercise Science (MJB), Wake Forest University Health Sciences, Winston-Salem, NC; the Department of Exercise and Nutrition Sciences, State University of New York, Buffalo, NY (TY); and the Department of Radiology, Wake Forest University Health Sciences, Winston-Salem, NC (LL and JJC).

² The funding sources had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.

³ Supported by the NIH (grant R01-AG/DK20583), Wake Forest University Claude D Pepper Older Americans Independence Center (P30-AG21332), and Wake Forest University General Clinical Research Center (M01-RR07122).

⁴ Reprints not available. Address correspondence to BJ Nicklas, J Paul Sticht Center on Aging, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail: bnicklas{at}wfubmc.edu.

Background: Exercise intensity may affect the selective loss of abdominal adipose tissue.

Objective: This study showed whether aerobic exercise intensity affects the loss of abdominal fat and improvement in cardiovascular disease risk factors under conditions of equal energy deficit in women with abdominal obesity.

Design: This was a randomized trial in 112 overweight and obese [body mass index (in kg/m²): 25–40; waist circumference >88 cm], postmenopausal women assigned to one of three 20-wk interventions of equal energy deficit: calorie restriction (CR only), CR plus moderate-intensity aerobic exercise (CR + moderate-intensity), or CR plus vigorous-intensity exercise (CR + vigorous-intensity). The diet was a controlled program of underfeeding during which meals were provided at individual calorie levels (400 kcal/d). Exercise (3 d/wk) involved treadmill walking at an intensity of 45–50% (moderate-intensity) or 70–75% (vigorous-intensity) of heart rate reserve. The primary outcome was abdominal visceral fat volume.

Results: Average weight loss for the 95 women who completed the study was 12.1 kg (±4.5 kg) and was not significantly different across groups. Maximal oxygen uptake (O₂max) increased more in the CR + vigorous-intensity group than in either of the other groups (P < 0.05). The CR-only group lost relatively more lean mass than did either exercise group (P < 0.05). All groups showed similar decreases in abdominal visceral fat (25%; P < 0.001 for all). However, changes in visceral fat were inversely related to increases in O₂max (P < 0.01). Changes in lipids, fasting glucose or insulin, and 2-h glucose and insulin areas during the oral-glucose-tolerance test were similar across treatment groups.

Conclusion: With a similar amount of total weight loss, lean mass is preserved, but there is not a preferential loss of abdominal fat when either moderate- or vigorous-intensity aerobic exercise is performed during caloric restriction. This trial was registered at clinicaltrials.gov as NCT00664729.