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1 Cardiology, Duke University Medical Center, Durham, NC, USA
2 Duke Center for Living, Duke University Medical Center, Durham, NC, USA
3 Department of Exercise & Sports Science & Human Performance Laboratory, East Carolina University, Greenville, NC, USA
4 Cardiology, Duke University Medical Center, Durham, NC, USA; Geriatric Research, Education & Clinical Center, Durham Veterans Administration Medical Center, Durham, NC, USA
5 Cardiology, Duke University Medical Center, Durham, NC, USA; Duke Center for Living, Duke University Medical Center, Durham, NC, USA
* To whom correspondence should be addressed. E-mail: william.kraus{at}duke.edu.
Background - 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. Methods and Results - 175 sedentary, overweight men and women with mild-to-moderate dyslipidemia were randomly assigned to participate for six months in a control group or for approximately eight months in one of three exercise groups: 1) Low-amount-moderate-intensity, equivalent to walking 12 miles/week (19.2 km) at 40-55 percent of peak oxygen consumption; 2) Low-amount-vigorous-intensity, equivalent to jogging 12 miles/week at 65-80 percent of peak oxygen consumption; or 3) High-amount-vigorous intensity, equivalent to jogging 20 miles/week (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. CONCLUSIONS: Significant gains in visceral fat over only six months emphasize the high cost of continued inactivity. A modest exercise program, consistent with recommendations from the from the Centers for Disease Control/American College of Sports Medicine, 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.
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