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Randomized Controlled Trial
. 2022 Jan 7;77(1):131-139.
doi: 10.1093/gerona/glab111.

Effect of Aerobic or Resistance Exercise, or Both, on Intermuscular and Visceral Fat and Physical and Metabolic Function in Older Adults With Obesity While Dieting

Debra L Waters  1   2 , Lina Aguirre  1   3 , Burke Gurney  4 , David R Sinacore  5   6 , Kenneth Fowler  3 , Giulia Gregori  7   8 , Reina Armamento-Villareal  7   8 , Clifford Qualls  9 , Dennis T Villareal  7   8
Affiliations
Randomized Controlled Trial

Effect of Aerobic or Resistance Exercise, or Both, on Intermuscular and Visceral Fat and Physical and Metabolic Function in Older Adults With Obesity While Dieting

Debra L Waters et al. J Gerontol A Biol Sci Med Sci. .

Abstract

Background: Obesity exacerbates age-related effects on body composition and physical and metabolic function. Which exercise mode is most effective in mitigating these deleterious changes in dieting older adults with obesity is unknown.

Methods: In a randomized controlled trial, we performed a head-to-head comparison of aerobic (AEX), resistance (REX), or combination (COMB) exercise during matched ~10% weight loss in 160 obese older adults. Prespecified analyses compared 6-month changes in intermuscular adipose tissue (IMAT) and visceral adipose tissue (VAT) assessed using MRI, insulin sensitivity index (ISI) by oral glucose tolerance test, physical function using Modified Physical Performance Test (PPT), VO2peak, gait speed, and knee strength by dynamometry.

Results: IMAT and VAT decreased more in COMB than AEX and REX groups (IMAT; -41% vs -28% and -23% and VAT: -36% vs -19% and -21%; p = .003 to .01); IMAT and VAT decreased in all groups more than control (between-group p < .001). ISI increased more in COMB than AEX and REX groups (86% vs 50% and 39%; p = .005 to .03). PPT improved more in COMB than AEX and REX groups, while VO2peak improved more in COMB and AEX than REX group (all p < .05). Knee strength improved more in COMB and REX than AEX group (all p < .05). Changes in IMAT and VAT correlated with PPT (r = -0.28 and -0.39), VO2peak (r = -0.49 and -0.52), gait speed (r = -0.25 and -0.36), and ISI (r = -0.49 and -0.52; all p < .05).

Conclusions: Weight loss plus combination aerobic and resistance exercise was most effective in improving ectopic fat deposition and physical and metabolic function in older adults with obesity.

Keywords: Clinical trials; Exercise; Functional performance; Obesity.

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Figures

Figure 1.
Figure 1.
Mean percentage changes in body weight and composition (A), abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes (B), thigh SAT, thigh intermuscular adipose tissue (IMAT), and thigh muscle volumes (C), and insulin sensitivity index (D) in the control (red bars), aerobic (orange bars), resistance (olive green bars), and combination (darker green bars) groups. Percentage changes are presented as least-squares adjusted means; T bars indicate standard errors. The asterisk indicates p < .05 for the comparison with the control group, the dagger p < .05 for the comparison with the aerobic group, and the double dagger p < .05 for the comparison with the resistance group. Error bars represent the least-squares adjusted SE from repeated-measures analysis of variance.
See this image and copyright information in PMC

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