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HIGHLIGHTED TOPICS
Role of Exercise in Reducing the Risk of Diabetes and Obesity

Inactivity, exercise, and visceral fat. STRRIDE: a randomized, controlled study of exercise intensity and amount

¹Divisions of Cardiology and ²Geriatrics, ³Duke Center for Living, Duke University Medical Center, Durham; ⁴Geriatric Research, Education, and Clinical Center, Durham Veterans Administration Medical Center, and ⁵Department of Exercise and Sports Science and Human Performance Laboratory, East Carolina University, Greenville, North Carolina

Submitted 1 February 2005 ; accepted in final form 22 June 2005

Despite the importance of randomized, dose-response studies for proper evaluation of effective clinical interventions, there have been no dose-response studies on the effects of exercise amount on abdominal obesity, a major risk factor for metabolic syndrome, diabetes, and cardiovascular disease. One hundred seventy-five sedentary, overweight men and women with mild to moderate dyslipidemia were randomly assigned to participate for 6 mo in a control group or for 8 mo in one of three exercise groups: 1) low amount, moderate intensity, equivalent to walking 12 miles/wk (19.2 km) at 40–55% of peak oxygen consumption; 2) low amount, vigorous intensity, equivalent to jogging 12 miles/wk at 65–80% of peak oxygen consumption; or 3) high amount, vigorous intensity, equivalent to jogging 20 miles/wk (32.0 km). Computed tomography scans were analyzed for abdominal fat. Controls gained visceral fat (8.6 ± 17.2%; P = 0.001). The equivalent of 11 miles of exercise per week, at either intensity, prevented significant accumulation of visceral fat. The highest amount of exercise resulted in decreased visceral (–6.9 ± 20.8%; P = 0.038) and subcutaneous (–7.0 ± 10.8%; P < 0.001) abdominal fat. Significant gains in visceral fat over only 6 mo emphasize the high cost of continued inactivity. A modest exercise program, consistent with recommendations from the Centers for Disease Control/American College of Sports Medicine (CDC/ACSM), prevented significant increases in visceral fat. Importantly, a modest increase over the CDC/ACSM exercise recommendations resulted in significant decreases in visceral, subcutaneous, and total abdominal fat without changes in caloric intake.

Studies of Targeted Risk Reduction Interventions through Defined Exercise; exercise training; visceral fat; exercise amount

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