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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
Nicklas BJ, Wang X, You T, Lyles MF, Demons J, Easter L, Berry MJ, Lenchik L, Carr JJ
The American Journal of Clinical Nutrition 2009 Apr;89(4):1043-1052
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 to 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 (approximately 400 kcal/d). Exercise (3 d/wk) involved treadmill walking at an intensity of 45 to 50% (moderate-intensity) or 70 to 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 (approximately 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.
Copyright by the American Society for Clinical Nutrition.

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