Samaras K, Kelly PJ, Chiano MN, et al.: Genetic and environmental influences on total body and central abdominal fat: the effect of physical activity in female twins. Ann Intern Med 1999, 130:873-882.Abstract: Obesity is known to reflect both genetic and environmental pathogenetic factors. This study was designed to examine the relation among physical activity and total body and central abdominal fat, and the influence of physical activity in persons who are genetically susceptible to generalized or central adiposity. To accomplish their goal, they enrolled 970 healthy female twins who ranged in age from 39 to 70 years and in body mass index from 16.4 to 44.0 kg/m 2 . There were 241 monozygotic pairs and 228 dizygotic pairs. Seven percent of the twins were obese, 30% were overweight, and 7% were underweight.Total body and central abdominal fat were measured by dual energy radiograph absorptiometry. Physical activity was assessed by quantitative and semiquantitative questionnaire.As anticipated, total body and abdominal central adiposity were lower with higher levels of activity, and physical activity was the strongest independent predictor of total body fat. Among the analyses done in the monozygotic twin study, there were 40 pairs of monozygotic pairs who were concordant for energy intake. Among those who are concordant for moderate intensity activity, the mean difference in body mass was 2.68 ± 0.39 kg, whereas in those who were discordant for two hours of moderate intensity activity, the mean within pair difference was 5.42 ± 1.5 kg. The within pair difference is two hours with moderate intensity of sporting activity accounted for a within pair difference of 1.4 kg of body fat.The take home message from the authors is that this study "... implies that persons with a strong family history of obesity may not be disadvantaged in their response to increased physical activity, despite strong genetic factors regulating fat mass".
Editor's Comments:Why should an article that does not mention blood pressure, much less hypertension frequency, be reviewed in a journal devoted to hypertension research? The answer must be obvious to all: The average body mass index in most US studies in hypertension is in the 28 to 29 kg/m 2 range, and more than half of our patients with hypertension are overweight or obese. This fact complicates all of our thinking about hypertension from genetic studies on pathogenesis to therapeutics.Even fewer people would deny the utility of exercise, with a fall in body weight comes a fall in blood pressure, an improvement in metabolic profile, and a reduction in insulin resistance. This study indicates that these positive effects can be extended to those who are genetically programmed to obesity.On the other hand, this study uncovers some sobering facts. The differences in body mass index and body mass fat in the twins who managed an additional two hours of heavy activity a week versus the twin who did not was very modest, little more than a kilo of body fat, when they were concordant for caloric i...