Exercise Training Effects on Waist Circumference

In randomized, controlled trials that provided a significant increase in exercise volume, either through a large, weekly amount of exercise for a short time period (4900 Kcal/wk for 12 weeks; Ross et al.44), or a smaller, weekly amount over a long time period (980 Kcal/wk for 48 weeks; Binder et al.73), or both (2000 Kcal/wk for 36 weeks; Slentz et al.74), statistically and physiologically significant decreases in waist circumference have been observed. In the randomized, controlled exercise-training study by Kraus' group,74 two amounts of exercise (low dose, ~ 1200 Kcal/wk, and high dose, ~ 2000 Kcal/wk) combined with a control (no extra Kcal/wk through exercise) revealed a clear, strong volume of exercise effect on reductions in abdominal obesity as measured by waist circumference (Figure 4.3). In this study,

Low-amount Low-amount High-amount moderate-intensity vigorous-intensity vigorous-intensity

Control

Low-amount Low-amount High-amount moderate-intensity vigorous-intensity vigorous-intensity

FIGURE 4.3 Effects of exercise amount and intensity on mean percent changes in waist circumference. * Indicates P < 0.05 compared with controls. Error bars show SE.

even the low-dose exercise groups had significant reductions in waist circumference compared to the inactive control group. Clearly, when a significant exercise-training stimulus is provided, waist circumference and abdominal obesity are reduced.

Lakka et al. suggested that a sedentary lifestyle and especially poor cardiorespiratory fitness are not only associated with metabolic syndrome but could be considered central, defining features of metabolic syndrome.25 Further, they suggested that measurement of peak VO2 in sedentary men with risk factors could provide a means of identifying individuals who would most benefit from interventions, especially lifestyle interventions, in individuals at risk of developing diabetes mellitus.

Numerous studies have revealed a clear, independent relationship between exercise capacity (cardiorespiratory fitness) and cardiovascular events and all causes of deaths in men.161775-82 And in a recent study by Gulati et al.,83 the authors reported a strong, independent relationship between exercise capacity as a predictor of death in asymptomatic women, which they observed was stronger than what had been previously established among men. Even after adjusting for traditional cardiovascular risk factors via the Framingham Risk Score (a point system assessing risk, which includes total cholesterol, HDL-C, age, systolic blood pressure, diastolic blood pressure, smoking, and the presence or absence of diabetes), they found that the adjusted hazards ratios (with 95 percent CI) of death associated with MET levels of < 5, 5 to 8, and > 8 were 3.1 (2.0 to 4.7), 1.9 (1.3 to 2.9), and 1.00, respectively. Data from the Cooper Clinic had revealed similar, albeit not as strong, relationships between cardiorespiratory fitness and cardiovascular disease mortality16 in women.

Further, Weinsier et al.,84 using U.S. data, and Prentice and Jeb,85 using U.K. data, extensively reviewed the data concerning the question of whether the obesity-and-diabetes epidemic is primarily due to overeating or lack of physical activity (the "gluttony versus sloth" debate). Both have cautiously concluded that, even given the

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