Participation in moderate-to-vigorous leisure time physical activity is related to decreased visceral adipose tissue in adults with spinal cord injury

Abstract

Increased visceral adiposity places individuals with chronic spinal cord injury (SCI) at increased risk of cardiometabolic disease. The purpose of this study was to identify if people with chronic SCI who participate in any moderate- to vigorous-intensity leisure time physical activity (LTPA) have lower visceral adipose tissue (VAT) area compared with those who report none. Participants included 136 adult men (n = 100) and women (n = 36) with chronic (mean (±SD) 15.6 ± 11.3 years post-injury) tetraplegia (n = 66) or paraplegia (n = 70) recruited from a tertiary rehabilitation hospital. VAT area was assessed via whole-body dual-energy X-ray absorptiometry using a Hologic densitometer and the manufacturer's body composition software. Moderate-to-vigorous LTPA was assessed using the Leisure Time Physical Activity Questionnaire for People with SCI (LTPAQ-SCI) or the Physical Activity Recall Assessment for People with SCI (PARA-SCI). Summary scores were dichotomized into any or no participation in moderate-to-vigorous LTPA to best represent the intensity described in current population-specific physical-activity guidelines. Data were analyzed using univariate and multiple regression analyses to identify the determinants of VAT. Overall, the model explained 67% of the variance in VAT area and included time post-injury, age-at-injury, android/gynoid ratio, waist circumference, and moderate-to-vigorous LTPA. Participation in any moderate-to-vigorous LTPA was significantly (95% confidence interval: -34.71 to -2.61, p = 0.02) associated with VAT after controlling for injury-related and body-composition correlates. Moderate-to-vigorous LTPA appears to be related to lower VAT area, suggesting potential for LTPA to reduce cardiometabolic disease risk among individuals with chronic SCI.

Associations between leisure time physical activity and cardiovascular risk factors among older adults with long-term spinal cord injury

“…Our results are again supported by previous findings [12]. In addition, a recent study by Pelletier et al [27] (n = 136, mean age 49 years, mean time since injury 16 years, 74% men) showed a significant relationship between less visceral adipose tissue and moderate-to-heavy LTPA. Together, these findings infer that participation in LTPA has a promising effect on body composition, although causal inferences cannot be made due to the cross-sectional study designs.…”

Effects of High-Intensity Interval Training Versus Moderate-Intensity Training on Cardiometabolic Health Markers in Individuals With Spinal Cord Injury: A Pilot Study

“…Regular moderate-to-vigorous physical activity is associated with less visceral adipose tissue in persons with SCI. 44 Additionally, endurance training has been shown to improve body composition in this population. 45,46 While many studies performed in nondisabled individuals have shown improved body composition following HIIT in both men and women, [47][48][49] we are aware of only one study that assessed body composition following HIIT in the SCI population.…”

Effects of dose de‐escalation following testosterone treatment and evoked resistance exercise on body composition, metabolic profile, and neuromuscular parameters in persons with spinal cord injury

“…Several studies suggested that VAT is associated with a spectrum of inflammatory biomarkers and likely impacts hepatic metabolism and causes mitochondrial dysfunction (Farkas et al, 2017; O'Brien, Wade, et al, 2017; Sumrell et al, 2018). The increase in the level of physical activity and NMES‐RT successfully reduce VAT in persons with SCI (Gorgey, Khalil, et al, 2019; Pelletier et al, 2018). During the initial 16‐week training period in these participants, both TT+RT and TT only modestly decreased VAT CSA.…”

“…Alternating leg exercise with an arm cycling exercise or circuit RT programs may encourage long‐term compliance and allow participants to increase their daily level of physical activity. Leisure time physical activity has been shown to attenuate the development of chronic comorbidities and the gain in VAT in persons with SCI (Buchholz et al, 2009; Pelletier et al, 2018).…”