Effects of Weight Loss with and without Exercise on Regional Body Fat Distribution in Postmenopausal Women

Abstract

Background/Aims: The purpose was to determine whether lifestyle interventions have different effects on regional fat in women with normal glucose tolerance vs. impaired glucose tolerance (NGT vs. IGT). Methods: Changes in glucose metabolism (2-h oral glucose-tolerance tests), android to gynoid fat mass ratio (dual energy X-ray absorptiometry [DXA]), visceral to subcutaneous abdominal fat area ratio (CT), and abdominal to gluteal subcutaneous fat cell weight (FCW; adipose tissue biopsies) were determined in 60 overweight postmenopausal women (45-80 years) following 6 months of weight loss alone (WL; n = 28) or with aerobic exercise (AEX + WL; n = 32). Results: The interventions led to ∼8% decrease in weight, but only the AEX + WL group improved fitness (↑11% in VO₂max) and reduced the android-to-gynoid fat mass ratio (↓5%; p < 0.05). Both NGT and IGT groups reduced visceral and subcutaneous abdominal fat areas and abdominal and gluteal FCWs, which related to improvements in homeostatic model assessment (r = 0.34-0.42) and 2-h glucose (r = 0.34-0.35), respectively (p < 0.05). The decline in FCW was 2× greater in women with IGT following WL (p < 0.05). The ratios of abdominal-to-gluteal FCW did not change following either intervention. Conclusions: The mechanisms by which WL with and without exercise impact regional fat loss should be explored as reductions in abdominal fat area and subcutaneous FCW appear to influence glucose metabolism. This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply. Published by S. Karger AG, Basel

Effects of a Hypocaloric, Nutritionally Complete, Higher Protein Meal Plan on Regional Body Fat and Cardiometabolic Biomarkers in Older Adults with Obesity

“…We report that adherence to a hypocaloric, nutritionally complete, meal plan targeting ≥1.0 g/kg/day of protein was effective in reducing greater android to gynoid fat mass, but not visceral to subcutaneous abdominal fat mass, and improving biomarkers of cardiometabolic health, as compared to weight stability. However, in agreement with other findings [2], we also report that greater loss of overall fat mass, independent of the specific fat depot, is associated with the greatest reductions in cardiometabolic risk. Though these data highlight the significance of overall fat loss on cardiometabolic health, they should not detract from the need to decrease central adiposity.…”

“…Aging is associated with weight gain and a shift of fat storage from gluteal/femoral (gynoid) to central abdominal (android) body regions, particularly in the visceral (intra-abdominal) depot [1], which in turn increases the risk for cardiometabolic diseases [2]. Among older adults with obesity, intentional, moderate weight loss (WL; 5–10% of baseline body weight), results in clinically significant improvement in cardiometabolic risk factors, including glucose and lipid profiles [3, 4].…”

“…Among older adults with obesity, intentional, moderate weight loss (WL; 5–10% of baseline body weight), results in clinically significant improvement in cardiometabolic risk factors, including glucose and lipid profiles [3, 4]. However, the change in the distribution of fat from android to gynoid regions with moderate WL is not well characterized, with previous evidence supporting both a decrease [5] and no change [2] in the ratio. Further, though studies consistently suggest that declines in visceral and subcutaneous abdominal fat masses are related to improvements in glucose metabolism in older adults [6, 7], others suggest that it is the overall decline in fat mass that is important, regardless of the specific depot of fat loss [2].…”

“…However, the change in the distribution of fat from android to gynoid regions with moderate WL is not well characterized, with previous evidence supporting both a decrease [5] and no change [2] in the ratio. Further, though studies consistently suggest that declines in visceral and subcutaneous abdominal fat masses are related to improvements in glucose metabolism in older adults [6, 7], others suggest that it is the overall decline in fat mass that is important, regardless of the specific depot of fat loss [2]. These data highlight the need to better understand the role of WL-associated changes in body fat distribution and their influence on cardiometabolic health as these outcomes may have important clinical implications for WL recommendations in older adults.…”

Adipogenesis: A Necessary but Harmful Strategy

“…The analysis of insulin signaling pathways in human viscera and SAT shows that VAT expresses higher levels of proteins specific to the insulin signaling pathway and a higher sensitivity [28]. In summary, VAT is more sensitive to weight loss, more metabolically active, more lipolytic and produces more adipokines than SAT [29,30].…”