Exercise and the metabolic syndrome with weight regain

Abstract

Weight loss improves metabolic syndrome (MetS) factors, but risk may return with weight regain. This study was designed to determine if exercise training can maintain improvements in MetS risk factors during weight regain. In a randomized control trial,102 overweight or obese (body mass index 25.0-39.9 kg/m(2)) men and women (age 21-52 yr), with characteristics of the MetS, lost 10% of body weight with supervised walking/jogging at 60% of maximal oxygen consumption (Vo(2 max)) (-400 kcal/session), 5 days/wk, and caloric restriction (-600 kcal/day) over a 4- to 6-mo period. After weight loss, 77 remaining subjects underwent programmed weight regain (+50% of lost weight) for 4-6 mo with random assignment to two groups: no exercise (NoEX) or continued supervised exercise (EX). Blood pressure, regional fat, glucose homeostasis, lipids, and inflammatory markers were assessed at baseline, post-weight loss, and post-weight regain. Groups were compared by two-way repeated-measures ANOVA on the 67 subjects. After weight loss (9.7 +/- 0.2% of body weight), significant (P < 0.05) improvements were observed in almost all parameters assessed. Following weight regain (54.4 +/- 1.6% of lost weight), the NoEX group exhibited deterioration in most metabolic markers, while the EX group maintained improvements in Vo(2 max), blood pressures, glucose homeostasis, high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), oxidized LDL, and other markers of inflammation, but did not maintain improvements in triglyceride and cholesterol concentrations or abdominal fat. Results of this design of controlled human weight regain suggest that aerobic exercise can counter the detrimental effects of partial weight regain on many markers of disease risk.

Physical Activity in the Prevention of Chronic Kidney Disease

“…However, the importance of adipose tissue distribution in predicting CVD risk remains to be determined [47]. Nevertheless, there is evidence that the loss of visceral adiposity with exercise-assisted weight loss is associated with a reduction in circulating inflammatory molecules [48] and oxidative stress [36], which may be important to maintaining normal renal function [49]. …”

Exercise Training and Energy Expenditure following Weight Loss

“…A number of studies have shown that physical activity is important for maintaining metabolic health independent of weight loss (20; 32) and may be protective during weight regain (3; 11; 36). Despite these well publicized benefits, over 60% of individuals in the U.S. do not meet physical activity recommendations.…”

Weight Regain Following Intentional Weight Loss in Older Adults

“…Subsequently, there is an interest in whether these benefits are maintained if weight regain occurs after intentional weight loss. Young to middle-aged subjects underwent a 4-to 6-month weight loss plus exercise program, which resulted in almost an average 10 % weight loss, and then were randomly assigned to continued supervised exercise or no exercise [40]. After almost an average 55 % weight regain, those who exercised were able to maintain improvements in VO 2 max, diastolic blood pressure (DBP), fasting insulin, HOMA-IR, and low-density cholesterol, whereas those who did not exercise had an increase in systolic blood pressure (SBP), fasting insulin, and HOMA-IR.…”

“…Unexpectedly, HDL-cholesterol continued to increase in both groups. Changes in dietary intake were cited as plausible contributors to the changes in metabolic syndrome risk factors with the weight regain [40]. In another study with a moderate amount (>4 %) of weight regain but not total return of body weight to baseline, the reduction in total and LDLcholesterol during weight loss was no longer present at 6-month follow-up [41].…”