Excessive visceral adipose tissue appears to trigger a cascade of metabolic disturbances that seem to coexist with ectopic fat storage in muscle, liver, heart and the ß-cell. Therefore, the reduction of visceral adipose tissue potentially plays a pivotal role in the treatment of the metabolic syndrome. The purpose of this systematic review and meta-analysis is to describe the overall effect of exercise on visceral adipose tissue and to provide an overview of the effect of different exercise regimes, without caloric restriction, on visceral adipose tissue in obese persons. A systematic literature search was performed according to the PRISMA statement for reporting systematic reviews and meta-analyses. The initial search resulted in 87 articles after removing duplicates. After screening on title, abstract and full-text 15 articles (totalling 852 subjects) fulfilled the a priori inclusion criteria. The quality of each eligible study was assessed in duplicate with “The Critical Review Form for Quantitative Studies”. Using random-effects weights, the standardized mean difference (Hedge's g) of the change in visceral adipose tissue was −0.497 with a 95% confidence interval of −0.655 to −0.340. The Z-value was −6.183 and the p-value (two tailed) was <0.001. A subgroup analysis was performed based on gender, type of training and intensity. Aerobic training of moderate or high intensity has the highest potential to reduce visceral adipose tissue in overweight males and females. These results suggest that an aerobic exercise program, without hypocaloric diet, can show beneficial effects to reduce visceral adipose tissue with more than 30 cm2 (on CT analysis) in women and more than 40 cm2 in men, even after 12 weeks.

Aim: To determine the effect of whole body vibration (WBV), combined with caloric restriction, on weight, body composition and metabolic risk factors in overweight and obese adults. Methods: A randomized, controlled study with a 6-month intervention period and a 6-month ‘no intervention’ follow-up. 61 of the 79 participants completed the study. Data were collected at baseline and at 3, 6 and 12 months in the control group (CONTROL), the diet only group (DIET), the diet plus fitness group (FITNESS) and the diet plus WBV group (VIBRATION). Results: Weight decreased significantly in all three intervention groups. Only FITNESS and VIBRATION managed to maintain a weight loss of 5% or more in the long term. Visceral adipose tissue (VAT) changed most in VIBRATION: –47.8 ± 41.2 and –47.7 ± 45.7 cm2 after 6 and 12 months respectively compared to CONTROL (–3.6 ± 20.5 or +26.3 ± 30.6 cm²), DIET (–24.3 ± 29.8 or –7.5 ± 28.3 cm²) and FITNESS (–17.6 ± 36.6 or –1.6 ± 33.3 cm²) (p < 0.001). Conclusions: Combining aerobic exercise or WBV training with caloric restriction can help to achieve a sustained long-term weight loss of 5–10%. These preliminary data show that WBV training may have the potential to reduce VAT more than aerobic exercise in obese adults, possibly making it a meaningful addition to future weight loss programs.

The daily load of carrying schoolbags is influenced by the mode of carriage. Electromyographic (EMG) activity from rectus abdominis and erector spinae was recorded bilaterally in five static conditions: no bag; shoulder bag; backpack; front pack; double pack. Nineteen students carried a load of 15% of their body weight. A double pack, with the load equally distributed in a front and a backpack, showed no significant differences in EMG activity compared with unloaded standing. The activity levels of erector spinae significantly decreased while carrying a backpack and increased with a shoulder bag and a front pack. Rectus abdominis revealed significantly higher EMG levels in the backpack trial. Asymmetrical activity between the right and the left part of the back muscles was clearly observed while carrying a shoulder bag with the weight at the right side of the body. The abdominal muscles revealed a slightly significant asymmetry for the shoulder bag and, surprisingly, also for the backpack. These findings suggest that the physical stresses associated with carrying book bags can be minimized by the design of a double pack. Asymmetry in muscle activity may indicate a failure of trunk stabilization and contribute to the development back pain.

BACKGROUND AND OBJECTIVES: Endothelial dysfunction is the first, although reversible, sign of atherosclerosis and is present in obese adolescents. The primary end point of this study was to investigate the influence of a multicomponent treatment on microvascular function. Additional objectives and end points were a reduced BMI SD score, improvements in body composition, exercise capacity, and cardiovascular risk factors, an increase in endothelial progenitor cells (EPCs), and a decrease in endothelial microparticles (EMPs).