Korean Diabetes J.  2010 Feb;34(1):23-31. 10.4093/kdj.2010.34.1.23.

Effects of Aerobic Exercise on Abdominal Fat, Thigh Muscle Mass and Muscle Strength in Type 2 Diabetic Subject

• Kwon HR
• Min KW
• Ahn HJ
• Seok HG
• Koo BK
• Kim HC
• Han KA

• KMID: 2298042
• DOI: http://doi.org/10.4093/kdj.2010.34.1.23

Abstract

BACKGROUND
Aerobic exercise can effectively reduce visceral fat. However, few studies have examined the effect of daily physical activity on obesity and cardiopulmonary function in the subjects with diabetes. We examined the effect of moderate intensity of walking in obese diabetes patients by monitoring of daily activity and measuring the change in abdominal fat area, muscle are and maximal muscle strength. METHODS: We randomly assigned 27 obese women with type 2 diabetes to an aerobic exercise group (AG, n = 13) and control group (CG, n = 14). The AG performed moderate intensity walking for 60 minutes per exercise, 5 times per week, and for 12 weeks. The activity energy expenditure was monitored by a multi-record accelerometer. The CG maintained routine daily activities. At the time of the initiation of the study and after 12 weeks of exercise, the aerobic exercise capacity was assessed using oxygen consumption rate at anaerobic threshold (VO2-AT). The abdominal fat area and the quadriceps muscle area were measured by computed tomography, and the maximum muscle strength of the upper and lower limbs was measured by a chest press and a leg press, respectively. RESULTS: The mean age of the study subjects was 56.6 +/- 8.0 years, the mean duration of diabetes was 6.3 +/- 6.0 years, and the body weight index (BMI) was 27.3 +/- 2.7 kg/m2. The BMI of the AG was significantly decreased (P = 0.003). In the AG, the visceral fat area and subcutaneous fat area were also significantly decreased (P = 0.018 and P < 0.001, respectively) but not in CG. VO2-AT of the AG was significantly improved, while that of the CG did not change (P = 0.009 and P = 0.115, respectively). The quadriceps muscle mass and the maximal muscle strength of the AG did not change, however, the CG showed a significant decrease. Duration of moderate intensity exercise was correlated with the decrease in total abdominal fat area (r = -0.484; P = 0.011) and that of high intensity exercise was correlated with improvement of cardiopulmonary function (r = 0.414; P = 0.032). CONCLUSION: Daily moderate intensity aerobic exercise is effective at reducing abdominal fat mass, while high intensity exercise improves cardiopulmonary function.

Keyword

Abdominal fat; Exercise; Muscle strength; Diabetes mellitus, type 2

MeSH Terms

Abdominal Fat
Anaerobic Threshold
Body Weight
Diabetes Mellitus, Type 2
Energy Metabolism
Exercise
Female
Humans
Intra-Abdominal Fat
Leg
Lower Extremity
Motor Activity
Muscle Strength
Muscles
Obesity
Oxygen Consumption
Quadriceps Muscle
Subcutaneous Fat
Thigh
Thorax
Walking

Figure

• 

  Fig. 1 Percent changes of regional fat and thigh muscle. *P values < 0.05 compared to baseline and intervention within group.

Reference

1. World Health organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity. 1997. Geneva: World Health organization.

2. Hunter GR, Kekes-Szabo T, Snyder SW, Nicholson C, Nyikos I, Berland L. Fat distribution, physical activity, and cardiovascular risk factors. Med Sci Sports Exerc. 1997. 29:362–369.

3. Williams MJ, Hunter GR, Kekes-Szabo T, Snyder S, Treuth MS. Regional fat distribution in women and risk of cardiovascular disease. Am J Clin Nutr. 1997. 65:855–860.

4. Kotani K, Tokunaga K, Fujioka S, Kobatake T, Keno Y, Yoshida S, Shimomura I, Tarui S, Matsuzawa Y. Sexual dimorphism of age-related changes in whole-body fat distribution in the obese. Int J Obes Relat Metab Disord. 1994. 18:207–212.

5. Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S. Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism. 1987. 36:54–59.

6. Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG. American Diabetes Association. North American Association for the Study of Obesity. American Society for Clinical Nutrition. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. Diabetes Care. 2004. 27:2067–2073.

7. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C, White RD. Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006. 29:1433–1438.

8. An KH. Effect of low intensity aerobic exercise in type 2 diabetic patients. J Korea Sport Res. 2005. 16:421–429.

9. An KH, Min KW, Han KA. The effects of aerobic training versus resistance training in non-obese type 2 diabetics. J Korean Diabetes Assoc. 2005. 29:486–494.

10. Gan SK, Kriketos AD, Ellis BA, Thompson CH, Kraegen EW, Chisholm DJ. Changes in aerobic capacity and visceral fat but not myocyte lipid levels predict increased insulin action after exercise in overweight and obese men. Diabetes Care. 2003. 26:1706–1713.

11. Mourier A, Gautier JF, De Kerviler E, Bigard AX, Villette JM, Garnier JP, Duvallet A, Guezennec CY, Cathelineau G. Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM. Effects of branched-chain amino acid supplements. Diabetes Care. 1997. 20:385–391.

12. Kumahara H, Schutz Y, Ayabe M, Yoshioka M, Yoshitake Y, Shindo M, Ishii K, Tanaka H. The use of uniaxial accelerometry for the assessment of physical-activity-related energy expenditure: a validation study against whole-body indirect calorimetry. Br J Nutr. 2004. 91:235–243.

13. Baechle TR, Earle RW. Essentials of strength training and conditioning. 2000. 2nd ed. Champaign: Human Kinetics.

14. Min KW, An KH, Sohn TS, Park YM, Hong YS, Kim YS, Park YB, Park KS, Lee GW, Kim IJ, Han KA, Yu JM, Son HS, Baik SH, Lee WC, Cho CG, Lee HW, Park SW. The study of physical activity in the Korean with type 2 diabetes. J Korean Diabetes Assoc. 2005. 29:517–525.

15. Yim MJ. The study of daily physical activity in old women using pedometer with accelerometer. J Korean Soc Study Obes. 2004. 13:195–203.

16. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995. 273:402–407.

17. Paffenbarger RS Jr, Blair SN, Lee IM, Hyde RT. Measurement of physical activity to assess health effects in free-living populations. Med Sci Sports Exerc. 1993. 25:60–70.

18. Fujimoto WY, Bergstrom RW, Boyko EJ, Leonetti DL, Newell-Morris LL, Wahl PW. Susceptibility to development of central adiposity among populations. Obes Res. 1995. 3:Suppl 2. 179S–186S.

19. Björntorp P. Hazards in subgroups of human obesity. Eur J Clin Invest. 1984. 14:239–241.

20. Achten J, Jeukendrup AE. The effect of pre-exercise carbohydrate feedings on the intensity that elicits maximal fat oxidation. J Sports Sci. 2003. 21:1017–1024.

21. Astorino TA. Is the ventilatory threshold coincident with maximal fat oxidation during submaximal exercise in women? J Sports Med Phys Fitness. 2000. 40:209–216.

22. Lee SH, Lee YS. Comparison of maximal and minimal Fat oxidation exercise intensity and physiological and metabolic variables by treadmill graded maximal exercise test protocols. Korean J Sport Sci. 2005. 16:42–55.

23. Lee S, Kuk JL, Katzmarzyk PT, Blair SN, Church TS, Ross R. Cardiorespiratory fitness attenuates metabolic risk independent of abdominal subcutaneous and visceral fat in men. Diabetes Care. 2005. 28:895–901.

24. Jung YJ, Shin JH, Yum KS, Song CH, Choi WS, Kim KS, Park JH. The association between obesity indices and physical fitness. J Korean Acad Fam Med. 2003. 24:271–278.

25. Kemi OJ, Haram PM, Loennechen JP, Osnes JB, Skomedal T, Wisløff U, Ellingsen Ø. Moderate vs. high exercise intensity: differential effects on aerobic fitness, cardiomyocyte contractility, and endothelial function. Cardiovasc Res. 2005. 67:161–172.

26. Weiss EP, Racette SB, Villareal DT, Fontana L, Steger-May K, Schechtman KB, Klein S, Ehsani AA, Holloszy JO. Washington University School of Medicine CALERIE Group. Lower extremity muscle size and strength and aerobic capacity decrease with caloric restriction but not with exercise-induced weight loss. J Appl Physiol. 2007. 102:634–640.

27. Jeong SK, Seo MW, Kim YH, Kweon SS, Nam HS. Does waist indicate dyslipidemia better than BMI in Korean adult population? J Korean Med Sci. 2005. 20:7–12.