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A dose–response relation between aerobic exercise and visceral fat reduction: systematic review of clinical trials

International Journal of Obesity volume 31, pages 1786–1797 (2007)Cite this article

A Corrigendum to this article was published on 18 February 2008

Abstract

Objective:

It has been suggested that exercise has preferential effects on visceral fat reduction. However, the dose–response effect remains unclear because of limited evidence from individual studies. The purpose of this study was to systematically review the current literature to establish whether reduction of visceral fat by aerobic exercise has a dose–response relationship.

Methods:

A database search was performed (PubMed, 1966–2006) with appropriate keywords to identify studies exploring the effects of aerobic exercise as a weight loss intervention on visceral fat reduction. Visceral fat reduction was expressed as the percentage of visceral fat change per week (%ΔVF/w). The energy expenditure by aerobic exercise was expressed as ∑(metabolic equivalents × h per week (METs·h/w)).

Results:

Nine randomized control trials and seven non-randomized control trials were selected. In most of the studies, the subjects performed aerobic exercise generating 10 METs·h/w or more. Among all the selected groups (582 subjects), visceral fat decreased significantly (P<0.05) in 17 groups during the intervention, but not in the other 4 groups. There was no significant relationship between METs·h/w from aerobic exercise and %ΔVF/w in all the selected groups. However, when subjects with metabolic-related disorders were not included (425 subjects), METs·h/w from aerobic exercise had a significant relationship with %ΔVF/w (r=−0.75). Moreover, visceral fat reduction was significantly related to weight reduction during aerobic exercise intervention, although a significant visceral fat reduction may occur without significant weight loss.

Conclusion:

These results suggest that at least 10 METs·h/w in aerobic exercise, such as brisk walking, light jogging or stationary ergometer usage, is required for visceral fat reduction, and that there is a dose–response relationship between aerobic exercise and visceral fat reduction in obese subjects without metabolic-related disorders.

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References

  1. World Health Organization. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser 2003; 916: 1–149.

    Google Scholar 

  2. Bastard JP, Maachi M, Lagathu C, Kim MJ, Caron M, Vidal H et al. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw 2006; 17: 4–12.

    CAS  PubMed  Google Scholar 

  3. Matsuzawa Y, Funahashi T, Kihara S, Shimomura I . Adiponectin and metabolic syndrome. Arterioscler Thromb Vasc Biol 2004; 24: 29–33.

    Article  CAS  Google Scholar 

  4. Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD et al. Intra-abdominal fat is a major determinant of the national cholesterol education program adult treatment panel III criteria for the metabolic syndrome. Diabetes 2004; 53: 2087–2094.

    Article  CAS  Google Scholar 

  5. Ford ES, Giles WH, Dietz WH . Prevalence of the metabolic syndrome among US adults: findings from the third national health and nutrition examination survey. JAMA 2002; 287: 356–359.

    Article  Google Scholar 

  6. Curioni CC, Lourenco PM . Long-term weight loss after diet and exercise: a systematic review. Int J Obes 2005; 29: 1168–1174.

    Article  CAS  Google Scholar 

  7. Douketis JD, Macie C, Thabane L, Williamson DF . Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes 2005; 29: 1153–1167.

    Article  CAS  Google Scholar 

  8. Saris WH . Exercise with or without dietary restriction and obesity treatment. Int J Obes Relat Metab Disord 1995; 19: S113–S116.

    PubMed  Google Scholar 

  9. Mourier A, Gautier JF, De Kerviler E, Bigard AX, Villette JM, Garnier JP et al. Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM. Effects of branched-chain amino acid supplements. Diabetes Care 1997; 20: 385–391.

    Article  CAS  Google Scholar 

  10. Kay SJ, Fiatarone Singh MA . The influence of physical activity on abdominal fat: a systematic review of the literature. Obes Rev 2006; 7: 183–200.

    Article  CAS  Google Scholar 

  11. McAuley KA, Smith KJ, Taylor RW, McLay RT, Williams SM, Mann JI . Long-term effects of popular dietary approaches on weight loss and features of insulin resistance. Int J Obes 2006; 30: 342–349.

    Article  CAS  Google Scholar 

  12. Ross R, Janssen I . Is abdominal fat preferentially reduced in response to exercise-induced weight loss? Med Sci Sports Exerc 1999; 31: S568–S572.

    Article  CAS  Google Scholar 

  13. Ross R, Janssen I . Physical activity, total and regional obesity: dose–response considerations. Med Sci Sports Exerc 2001; 33: S521–S527; discussion S528–S529.

    Article  CAS  Google Scholar 

  14. Smith SR, Zachwieja JJ . Visceral adipose tissue: a critical review of intervention strategies. Int J Obes Relat Metab Disord 1999; 23: 329–335.

    Article  CAS  Google Scholar 

  15. Donnelly JE, Hill JO, Jacobsen DJ, Potteiger J, Sullivan DK, Johnson SL et al. Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the Midwest Exercise Trial. Arch Intern Med 2003; 163: 1343–1350.

    Article  Google Scholar 

  16. Giannopoulou I, Ploutz-Snyder LL, Carhart R, Weinstock RS, Fernhall B, Goulopoulou S et al. Exercise is required for visceral fat loss in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab 2005; 90: 1511–1518.

    Article  CAS  Google Scholar 

  17. Green JS, Stanforth PR, Rankinen T, Leon AS, Rao Dc D, Skinner JS et al. The effects of exercise training on abdominal visceral fat, body composition, and indicators of the metabolic syndrome in postmenopausal women with and without estrogen replacement therapy: the HERITAGE family study. Metabolism 2004; 53: 1192–1196.

    Article  CAS  Google Scholar 

  18. Halverstadt A, Phares DA, Ferrell RE, Wilund KR, Goldberg AP, Hagberg JM . High-density lipoprotein-cholesterol, its subfractions, and responses to exercise training are dependent on endothelial lipase genotype. Metabolism 2003; 52: 1505–1511.

    Article  CAS  Google Scholar 

  19. Irwin ML, Yasui Y, Ulrich CM, Bowen D, Rudolph RE, Schwartz RS et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA 2003; 289: 323–330.

    Article  Google Scholar 

  20. Miyatake N, Nishikawa H, Morishita A, Kunitomi M, Wada J, Suzuki H et al. Daily walking reduces visceral adipose tissue areas and improves insulin resistance in Japanese obese subjects. Diabetes Res Clin Pract 2002; 58: 101–107.

    Article  CAS  Google Scholar 

  21. Park SK, Park JH, Kwon YC, Kim HS, Yoon MS, Park HT . The effect of combined aerobic and resistance exercise training on abdominal fat in obese middle-aged women. J Physiol Anthropol Appl Human Sci 2003; 22: 129–135.

    Article  Google Scholar 

  22. Ross R, Janssen I, Dawson J, Kungl AM, Kuk JL, Wong SL et al. Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obes Res 2004; 12: 789–798.

    Article  Google Scholar 

  23. Short KR, Vittone JL, Bigelow ML, Proctor DN, Rizza RA, Coenen-Schimke JM et al. Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity. Diabetes 2003; 52: 1888–1896.

    Article  CAS  Google Scholar 

  24. Slentz CA, Duscha BD, Johnson JL, Ketchum K, Aiken LB, Samsa GP et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE—a randomized controlled study. Arch Intern Med 2004; 164: 31–39.

    Article  Google Scholar 

  25. Wilund KR, Ferrell RE, Phares DA, Goldberg AP, Hagberg JM . Changes in high-density lipoprotein-cholesterol subfractions with exercise training may be dependent on cholesteryl ester transfer protein (CETP) genotype. Metabolism 2002; 51: 774–778.

    Article  CAS  Google Scholar 

  26. Japan Society for the Study of Obesity. New criteria for ‘obesity disease’ in Japan. Circ J 2002; 66: 987–992.

    Article  Google Scholar 

  27. Schwartz RS, Shuman WP, Larson V, Cain KC, Fellingham GW, Beard JC et al. The effect of intensive endurance exercise training on body fat distribution in young and older men. Metabolism 1991; 40: 545–551.

    Article  CAS  Google Scholar 

  28. World Health Organization. Physical status: The use and interpreation of anthropometry. Technical Report Series: Geneva, 1995, pp 312–334.

  29. Ross R, Dagnone D, Jones PJ, Smith H, Paddags A, Hudson R et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000; 133: 92–103.

    Article  CAS  Google Scholar 

  30. Kvist H, Chowdhury B, Grangard U, Tylen U, Sjostrom L . Total and visceral adipose-tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations. Am J Clin Nutr 1988; 48: 1351–1361.

    Article  CAS  Google Scholar 

  31. Shen W, Punyanitya M, Wang Z, Gallagher D, St-Onge MP, Albu J et al. Visceral adipose tissue: relations between single-slice areas and total volume. Am J Clin Nutr 2004; 80: 271–278.

    Article  CAS  Google Scholar 

  32. Lee S, Janssen I, Ross R . Interindividual variation in abdominal subcutaneous and visceral adipose tissue: influence of measurement site. J Appl Physiol 2004; 97: 948–954.

    Article  Google Scholar 

  33. Boudou P, de Kerviler E, Erlich D, Vexiau P, Gautier JF . Exercise training-induced triglyceride lowering negatively correlates with DHEA levels in men with type 2 diabetes. Int J Obes Relat Metab Disord 2001; 25: 1108–1112.

    Article  CAS  Google Scholar 

  34. Despres JP, Pouliot MC, Moorjani S, Nadeau A, Tremblay A, Lupien PJ et al. Loss of abdominal fat and metabolic response to exercise training in obese women. Am J Physiol 1991; 261: E159–E167.

    CAS  PubMed  Google Scholar 

  35. American College of Sports Medicine. ACSM's guideline for exercise testing and prescription. 7 edn. Lippincott Williams & Wilkins: Philadelphia, 2006.

  36. Tanaka S . Ambulation speed and duration during free-living conditions. Physical activity and obesity satellite conference: Brisbane, Australia, 2006, p 123.

    Google Scholar 

  37. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000; 32: S498–S504.

    Article  CAS  Google Scholar 

  38. Ballor DL, Poehlman ET . Exercise-training enhances fat-free mass preservation during diet-induced weight loss: a meta-analytical finding. Int J Obes Relat Metab Disord 1994; 18: 35–40.

    CAS  PubMed  Google Scholar 

  39. Kelley DE, Simoneau JA . Impaired free fatty acid utilization by skeletal muscle in non-insulin-dependent diabetes mellitus. J Clin Invest 1994; 94: 2349–2356.

    Article  CAS  Google Scholar 

  40. Blaak EE, van Aggel-Leijssen DP, Wagenmakers AJ, Saris WH, van Baak MA . Impaired oxidation of plasma-derived fatty acids in type 2 diabetic subjects during moderate-intensity exercise. Diabetes 2000; 49: 2102–2107.

    Article  CAS  Google Scholar 

  41. Kang J, Kelley DE, Robertson RJ, Goss FL, Suminski RR, Utter AC et al. Substrate utilization and glucose turnover during exercise of varying intensities in individuals with NIDDM. Med Sci Sports Exerc 1999; 31: 82–89.

    Article  CAS  Google Scholar 

  42. Raguso CA, Coggan AR, Gastaldelli A, Sidossis LS, Bastyr III EJ, Wolfe RR . Lipid and carbohydrate metabolism in IDDM during moderate and intense exercise. Diabetes 1995; 44: 1066–1074.

    Article  CAS  Google Scholar 

  43. Jakicic JM, Clark K, Coleman E, Donnelly JE, Foreyt J, Melanson E et al. American college of sports medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2001; 33: 2145–2156.

    Article  CAS  Google Scholar 

  44. Elfhag K, Rossner S . Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 2005; 6: 67–85.

    Article  CAS  Google Scholar 

  45. van Baak MA, van Mil E, Astrup AV, Finer N, Van Gaal LF, Hilsted J et al. Leisure-time activity is an important determinant of long-term weight maintenance after weight loss in the Sibutramine trial on obesity reduction and maintenance (STORM trial). Am J Clin Nutr 2003; 78: 209–214.

    Article  CAS  Google Scholar 

  46. De Lorenzo A, Deurenberg P, Pietrantuono M, Di Daniele N, Cervelli V, Andreoli A . How fat is obese? Acta Diabetol 2003; 40: S254–S257.

    Article  Google Scholar 

  47. Kotani K, Tokunaga K, Fujioka S, Kobatake T, Keno Y, Yoshida S et al. Sexual dimorphism of age-related changes in whole-body fat distribution in the obese. Int J Obes Relat Metab Disord 1994; 18: 202–207.

    Google Scholar 

  48. Chowdhury B, Sjostrom L, Alpsten M, Kostanty J, Kvist H, Lofgren R . A multicompartment body composition technique based on computerized tomography. Int J Obes Relat Metab Disord 1994; 18: 219–234.

    CAS  PubMed  Google Scholar 

  49. Kvist H, Sjostrom L, Tylen U . Adipose tissue volume determinations in women by computed tomography: technical considerations. Int J Obes 1986; 10: 53–67.

    CAS  PubMed  Google Scholar 

  50. Numao S, Hayashi Y, Katayama Y, Matsuo T, Tomita T, Ohkawara K et al. Effects of obesity phenotype on fat metabolism in obese men during endurance exercise. Int J Obes 2006; 30: 1189–1196.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Health Promotion and Exercise Program, National Institute of Health and Nutrition, Shinjuku-ku, Tokyo, Japan

    K Ohkawara, S Tanaka, M Miyachi, K Ishikawa-Takata & I Tabata

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  1. K Ohkawara
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Correspondence to K Ohkawara.

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Ohkawara, K., Tanaka, S., Miyachi, M. et al. A dose–response relation between aerobic exercise and visceral fat reduction: systematic review of clinical trials. Int J Obes 31, 1786–1797 (2007). https://doi.org/10.1038/sj.ijo.0803683

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Keywords

  • central obesity
  • metabolic-related disorder
  • clinical trial
  • METs·h/w
  • aerobic exercise

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