A systematic review and meta‐analysis of the effect of aerobic vs. resistance exercise training on visceral fat

Abstract

It is increasingly recognized that the location of excess adiposity, particularly increased deposition of visceral adipose tissue (VAT), is important when determining the adverse health effects of overweight and obesity. Exercise therapy is an integral component of obesity management, but the most potent exercise prescription for VAT benefit is unclear. We aimed to evaluate the independent and synergistic effects of aerobic exercise (AEx) and progressive resistance training (PRT) and to directly compare the efficacy of AEx and PRT for beneficial VAT modulation. A systematic review and meta-analysis was performed to assess the efficacy of exercise interventions on VAT content/volume in overweight and obese adults. Relevant databases were searched to November 2010. Included studies were randomized controlled designs in which AEx or PRT in isolation or combination were employed for 4 weeks or more in adult humans, where computed tomography (CT) or magnetic resonance imaging (MRI) was used for quantification of VAT pre- and post-intervention. Of the 12196 studies from the initial search, 35 were included. After removal of outliers, there was a significant pooled effect size (ES) for the comparison between AEx therapy and control (-0.33, 95% CI: -0.52 to -0.14; P < 0.01) but not for the comparison between PRT therapy and control (0.09, 95% CI: -0.17 to -0.36; P = 0.49). Of the available nine studies which directly compared AEx with PRT, the pooled ES did not reach statistical significance (ES = 0.23, 95% CI: -0.02 to 0.50; P = 0.07 favouring AEx). The pooled ES did not reach statistical significance for interventions that combined AEx and PRT therapy vs. control (-0.28, 95% CI: -0.69 to 0.14; P = 0.19), for which only seven studies were available. These data suggest that aerobic exercise is central for exercise programmes aimed at reducing VAT, and that aerobic exercise below current recommendations for overweight/obesity management may be sufficient for beneficial VAT modification. Further investigation is needed regarding the efficacy and feasibility of multi-modal training as a means of reducing VAT.

Fitness and Lean Mass Increases during Combined Training Independent of Loading Order

“…Over recent years, a growing body of scientific knowledge strongly suggests that regular performance of aerobic and resistance training is a major factor in the prevention and treatment of cardiovascular disease including risk factors such as obesity, diabetes and blood lipid levels (23).…”

“…The benefits of combined endurance (E) and strength (S) training for the maintenance and development of physical fitness and body composition have been extensively investigated and their importance especially for sedentary and moderately active populations is well known (15,19,21,23,34). Over recent years, a growing body of scientific knowledge strongly suggests that regular performance of aerobic and resistance training is a major factor in the prevention and treatment of cardiovascular disease including risk factors such as obesity, diabetes and blood lipid levels (23).…”

“…), intensity and volume of training performed, as well as on dietary prescriptions (i.e. diet restriction vs. freely chosen diet) and the population studied (1,23,38).…”

Measurement of body composition as a surrogate evaluation of energy balance in obese patients

“…Therefore increased levels of daily physical activity should be simultaneously promoted. Although resistance training retains or improves the relative percentage of lean mass to total body, current evidence failed to detect a loss of fat mass of a similar magnitude to aerobic training which promotes fat mass loss together with beneficial changes in muscle tissue [97][98][99] . Studies evaluating efficacy of dietary restriction together with exercise program showed more favorable results (as weight loss rate and body composition improvement) compared to diet or exercise prescription alone [69] .…”

Efficacy of moderate-intensity walking provided feedback by ECE PEDO on abdominal fat in overweight and obese women: A randomized, exercise study

“…Current physical activity and exercise recommendations offer that the inclusion of aerobic exercise is essential for exercise programs for overweight/obesity management. [4] The American College of Sports Medicine (ACSM) suggests 150 to 250 min/week of aerobic physical activity with moderate-intensity for individuals with overweight and obese. [5] Although physical activity is commonly recommended to reduce overall obesity, the effect of exercise-induced weight loss on abdominal adiposity has been still investigated.…”