OBJECTIVE: To determine the effects of exercise amount (kilocalories per session) and intensity (percent of maximal oxygen consumption (%VO2peak)) on adipose tissue (AT) and skeletal muscle (SM) in adults with abdominal obesity. METHODS: Participants (n = 103; 52.7 +/- 7.6 years) were randomized to the following groups: control; low-amount, low-intensity exercise (180 kcal/session (women) and 300 kcal/session (men) at 50% VO2peak); high-amount, low-intensity exercise (HALI; 360 kcal/session (women) and 600 kcal/session (men) at 50% VO2peak); or high-amount, high-intensity exercise (HAHI; 360 kcal/session (women) and 600 kcal/session (men) at 75% VO2peak) for 24 weeks. Activities of daily living were measured by accelerometry. Magnetic resonance imaging was used to measure tissue mass. RESULTS: Reduction in all AT depots was greater in the exercise groups compared with control (p < 0.002); however, there were no differences between exercise groups (p > 0.05). Visceral and abdominal subcutaneous AT reduction was uniform across the abdomen. Total SM mass did not change with exercise compared with control (p = 0.32). However, while lower-body SM mass was maintained (p = 0.32), upper-body SM mass in the high-amount, high-intensity and the high-amount, low-intensity groups was reduced compared with controls (p < 0.008). CONCLUSIONS: In adults with abdominal obesity, substantial reductions in total, abdominal subcutaneous, and visceral AT with a preservation of total SM mass were observed independent of exercise amount or intensity. TRIAL REGISTRATION: ClinicalTrials.gov NCT00955071.

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