Ann Pediatr Endocrinol Metab.  2013 Mar;18(1):26-31. 10.6065/apem.2013.18.1.26.

Combined aerobic and resistance exercise is effective for achieving weight loss and reducing cardiovascular risk factors without deteriorating bone health in obese young adults

Affiliations
  • 1Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
  • 2Department of Medicine, Graduate School, Chosun University, Gwangju, Korea.
  • 3Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea. sskey@chosun.ac.kr

Abstract

PURPOSE
Weight loss reduces cardiovascular risk factors in the obese. However, weight reduction through diet negatively affects long-term bone health. The aim of study was to determine the ability of combined aerobic and resistance exercise (CE) to reduce weight and cardiovascular risk without diminishing bone health.
METHODS
Twenty-five young adults participated in an 8-week weight loss CE program. Subjects were allocated to an obese group or a control group by body mass index (BMI). Body weight, BMI, body composition, and bone mineral density (BMD) of the lumbar spine and total hip were measured before and after the CE trial. Serum levels of metabolic markers, including adipokines and bone markers, were also evaluated.
RESULTS
Weight loss was evident in the obese group after the 8 weeks CE trial. Fat mass was significantly reduced in both groups. Fasting insulin, homeostatic model assessment-insulin resistance (HOMA-IR), leptin and aminotransferases level were significantly reduced from baseline only in the obese group. High density lipoprotein cholesterol increased in both groups. Hip BMD increased in the obese group. In all study subjects, BMI changes were correlated with HOMA-IR, leptin, and HDL changes. BMI decreases were correlated with lumbar spine BMD increases, lumbar spine BMD increases were positively correlated with osteocalcin changes, and lumbar spine bone mineral content increases were correlated negatively with C-terminal telopeptide of type 1 collagen changes.
CONCLUSION
These findings suggest that CE provides effective weight loss and improves cardiovascular risk factors without diminishing BMD. Furthermore, they indicate that lumbar spine BMD might be maintained by increasing bone formation and decreasing bone resorption.

Keyword

Exercise; Bone; Adipokines; Cardiovascular risk; Obesity

MeSH Terms

Adipokines
Body Composition
Body Mass Index
Body Weight
Bone Density
Bone Resorption
Cholesterol
Cholesterol, HDL
Collagen Type I
Diet
Fasting
Hip
Humans
Insulin
Leptin
Lipoproteins
Obesity
Osteocalcin
Osteogenesis
Risk Factors
Spine
Transaminases
Weight Loss
Young Adult
Adipokines
Cholesterol
Cholesterol, HDL
Collagen Type I
Insulin
Leptin
Lipoproteins
Osteocalcin
Transaminases

Reference

1. Yanovski SZ, Yanovski JA. Obesity. N Engl J Med. 2002; 2. 21. 346:591–602. PMID: 11856799.
Article
2. Tsigos C, Hainer V, Basdevant A, Finer N, Fried M, Mathus-Vliegen E, et al. Management of obesity in adults: European clinical practice guidelines. Obes Facts. 2008; 1:106–116. PMID: 20054170.
Article
3. Haslam DW, James WP. Obesity. Lancet. 2005; 366:1197–1209. PMID: 16198769.
Article
4. Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, et al. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003; 138:24–32. PMID: 12513041.
Article
5. Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E, et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007; 176:S1–S13. PMID: 17420481.
Article
6. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. 2005; 82(1 Suppl):222S–225S. PMID: 16002825.
Article
7. Fernandez ML. The metabolic syndrome. Nutr Rev. 2007; 65(6 Pt 2):S30–S34. PMID: 17605311.
Article
8. Hui SL, Perkins AJ, Zhou L, Longcope C, Econs MJ, Peacock M, et al. Bone loss at the femoral neck in premenopausal white women: effects of weight change and sex-hormone levels. J Clin Endocrinol Metab. 2002; 87:1539–1543. PMID: 11932278.
Article
9. Bacon L, Stern JS, Keim NL, Van Loan MD. Low bone mass in premenopausal chronic dieting obese women. Eur J Clin Nutr. 2004; 58:966–971. PMID: 15164118.
Article
10. Heinonen A, Kannus P, Sievanen H, Oja P, Pasanen M, Rinne M, et al. Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures. Lancet. 1996; 348:1343–1347. PMID: 8918277.
Article
11. Villareal DT, Shah K, Banks MR, Sinacore DR, Klein S. Effect of weight loss and exercise therapy on bone metabolism and mass in obese older adults: a one-year randomized controlled trial. J Clin Endocrinol Metab. 2008; 93:2181–2187. PMID: 18364384.
Article
12. Rector RS, Loethen J, Ruebel M, Thomas TR, Hinton PS. Serum markers of bone turnover are increased by modest weight loss with or without weight-bearing exercise in overweight premenopausal women. Appl Physiol Nutr Metab. 2009; 34:933–941. PMID: 19935856.
Article
13. World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment. Geneva: World Health Organization;2000.
14. Maiorana A, O'Driscoll G, Goodman C, Taylor R, Green D. Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes. Diabetes Res Clin Pract. 2002; 56:115–123. PMID: 11891019.
Article
15. Cederberg H, Mikkola I, Jokelainen J, Laakso M, Härkonen P, Ikaheimo T, et al. Exercise during military training improves cardiovascular risk factors in young men. Atherosclerosis. 2011; 216:489–495. PMID: 21402378.
Article
16. Garrow JS, Summerbell CD. Meta-analysis: effect of exercise, with or without dieting, on the body composition of overweight subjects. Eur J Clin Nutr. 1995; 49:1–10. PMID: 7713045.
17. Kondo T, Kobayashi I, Murakami M. Effect of exercise on circulating adipokine levels in obese young women. Endocr J. 2006; 53:189–195. PMID: 16618976.
Article
18. Nassis GP, Papantakou K, Skenderi K, Triandafillopoulou M, Kavouras SA, Yannakoulia M, et al. Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls. Metabolism. 2005; 54:1472–1479. PMID: 16253636.
Article
19. Marcell TJ, McAuley KA, Traustadottir T, Reaven PD. Exercise training is not associated with improved levels of C-reactive protein or adiponectin. Metabolism. 2005; 54:533–541. PMID: 15798963.
Article
20. Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011; 364:1218–1229. PMID: 21449785.
Article
21. Martyn-St James M, Carroll S, et al. Effects of different impact exercise modalities on bone mineral density in premenopausal women: a meta-analysis. J Bone Miner Metab. 2010; 28:251–267. PMID: 20013013.
Article
22. Martyn-St James M, Carroll S. High-intensity resistance training and postmenopausal bone loss: a meta-analysis. Osteoporos Int. 2006; 17:1225–1240. PMID: 16823548.
Article
23. Jensen LB, Kollerup G, Quaade F, Sørensen OH. Bone minerals changes in obese women during a moderate weight loss with and without calcium supplementation. J Bone Miner Res. 2001; 16:141–147. PMID: 11149478.
Article
24. Lanyon LE. Functional strain as a determinant for bone remodeling. Calcif Tissue Int. 1984; 36(Suppl 1):S56–S61. PMID: 6430523.
Article
25. Villareal DT, Fontana L, Weiss EP, Racette SB, Steger-May K, Schechtman KB, et al. Bone mineral density response to caloric restriction-induced weight loss or exercise-induced weight loss: a randomized controlled trial. Arch Intern Med. 2006; 166:2502–2510. PMID: 17159017.
Article
26. Lester ME, Urso ML, Evans RK, Pierce JR, Spiering BA, Maresh CM, et al. Influence of exercise mode and osteogenic index on bone biomarker responses during short-term physical training. Bone. 2009; 45:768–776. PMID: 19520194.
Article
27. Ashizawa N, Ouchi G, Fujimura R, Yoshida Y, Tokuyama K, Suzuki M. Effects of a single bout of resistance exercise on calcium and bone metabolism in untrained young males. Calcif Tissue Int. 1998; 62:104–108. PMID: 9437042.
Article
28. Fujimura R, Ashizawa N, Watanabe M, Mukai N, Amagai H, Fukubayashi T, et al. Effect of resistance exercise training on bone formation and resorption in young male subjects assessed by biomarkers of bone metabolism. J Bone Miner Res. 1997; 12:656–662. PMID: 9101378.
Article
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