Exercise and the metabolic syndrome with weight regain

Abstract

Weight loss improves metabolic syndrome (MetS) factors, but risk may return with weight regain. This study was designed to determine if exercise training can maintain improvements in MetS risk factors during weight regain. In a randomized control trial,102 overweight or obese (body mass index 25.0-39.9 kg/m(2)) men and women (age 21-52 yr), with characteristics of the MetS, lost 10% of body weight with supervised walking/jogging at 60% of maximal oxygen consumption (Vo(2 max)) (-400 kcal/session), 5 days/wk, and caloric restriction (-600 kcal/day) over a 4- to 6-mo period. After weight loss, 77 remaining subjects underwent programmed weight regain (+50% of lost weight) for 4-6 mo with random assignment to two groups: no exercise (NoEX) or continued supervised exercise (EX). Blood pressure, regional fat, glucose homeostasis, lipids, and inflammatory markers were assessed at baseline, post-weight loss, and post-weight regain. Groups were compared by two-way repeated-measures ANOVA on the 67 subjects. After weight loss (9.7 +/- 0.2% of body weight), significant (P < 0.05) improvements were observed in almost all parameters assessed. Following weight regain (54.4 +/- 1.6% of lost weight), the NoEX group exhibited deterioration in most metabolic markers, while the EX group maintained improvements in Vo(2 max), blood pressures, glucose homeostasis, high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), oxidized LDL, and other markers of inflammation, but did not maintain improvements in triglyceride and cholesterol concentrations or abdominal fat. Results of this design of controlled human weight regain suggest that aerobic exercise can counter the detrimental effects of partial weight regain on many markers of disease risk.

Fig. 1.

Design of the study. NoEX, no exercise training; EX, exercise training; PWL, post-weight loss; PWR, post-weight regain.

Fig. 2.

Body weight, body mass index (BMI), maximal oxygen consumption (V̇o_2max), and blood pressure (BP). Data points are means ± SE. *Significantly different, PWL vs. baseline. ^aSignificantly different, PWR vs. baseline within group. ^bSignificantly different, PWL vs. PWR within group. ^cSignificantly different, EX vs. NoEX.

Fig. 3.

Glucose homeostasis. Data points are means ± SE. HOMA, homeostasis model assessment; QUICKI, quantitative insulin sensitivity check. *Significantly different, PWL vs. baseline. ^aSignificantly different, PWR vs. baseline within group. ^bSignificantly different, PWL vs. PWR within group. ^cSignificantly different, EX vs. NoEX.

Fig. 4.

Lipids and lipoproteins. Data points are means ± SE. HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol. *Significantly different, PWL vs. baseline. ^aSignificantly different, PWR vs. baseline within group. ^bSignificantly different, PWL vs. PWR within group.

Fig. 5.

Abdominal fat. Data points are means ± SE. TAT_abd, total abdominal adipose tissue; TSAT, total subcutaneous adipose tissue; VAT, visceral adipose tissue. *Significantly different, PWL vs. baseline. ^aSignificantly different, PWR vs. baseline within group. ^bSignificantly different, PWL vs. PWR within group.

Fig. 6.

Inflammation markers. Data points are means ± SE. OxLDL, oxidized low-density lipoprotein; CRP, C-reactive protein; TNFRII, tumor necrosis factor receptor II. *Significantly different, PWL vs. baseline. ^aSignificantly different, PWR vs. baseline within group. ^bSignificantly different, PWL vs. PWR within group.