 |
|
Diet and Exercise in the Treatment of Obesity
Effects of 3 Interventions on Insulin Resistance
Ruth S. Weinstock, MD, PhD;
Huiliang Dai, MD;
Thomas A. Wadden, PhD
Arch Intern Med. 1998;158:2477-2483.
Background In short-term studies, diet and exercise both improve insulin sensitivity.
Objective To determine the effects of a 48-week supervised diet and exercise program on weight and insulin sensitivity after initial weight loss and weight maintenance, and then subsequent weight regain over 96 weeks.
Methods Forty-five obese women were randomly assigned to 1 of 3 treatment groups: (l) diet alone, (2) diet and aerobic training, and (3) diet and strength training. All subjects received the same 48-week group behavior modification program and diet (approximately 3879 kJ/d [approximatley 925 kcal/d] for the first 16 weeks; approximately 6276 kJ/d [approximately 1500 kcal/d] thereafter). Exercising subjects were provided 3 supervised exercise sessions per week for the first 28 weeks and 2 sessions weekly until week 48. During weeks 48 to 96, subjects were unsupervised. Oral glucose tolerance tests were performed at baseline and weeks 16, 24, 44, and 96.
Results Subjects across the 3 conditions achieved a mean weight loss of 13.8 kg by week 16, which was associated with decreased insulin levels (61.8% of baseline) There were no significant differences among groups in changes in body mass index, which is a measure of weight in kilograms divided by the square of the height in meters, weight, glucose tolerance, or insulin levels at weeks 16, 24, and 44. No additional beneficial effect of aerobic or strength exercise on insulin resistance, as reflected by serum insulin levels before and after a glucose load, was demonstrated. The 22 subjects who were studied at week 96 maintained a loss of approximately 10% of initial weight. Insulin levels, however, had returned to pretreatment levels.
Conclusions This study confirms the beneficial effect of weight reduction on hyperinsulinemia in obese individuals. Participation in supervised exercise did not result in additional improvement in weight loss or insulin sensitivity. We also observed a marked increase in insulin levels with only partial weight regain. Determining the amount of sustained weight loss necessary for continued improvement in insulin sensitivity will require further study.
From the Department of Medicine, SUNY Health Science Center and Veterans Affairs Medical Center, Syracuse, NY (Drs Weinstock and Dai), and the Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pa (Dr Wadden).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Physical activity, diet and behaviour modification in the treatment of overweight and obese adults: a systematic review
Soderlund et al.
The Journal of the Royal Society for the Promotion of Health 2009;129:132-142.
ABSTRACT
Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: a randomized, controlled trial
Nicklas et al.
Am. J. Clin. Nutr. 2009;89:1043-1052.
ABSTRACT
| FULL TEXT
Effects of Exercise and Caloric Restriction on Insulin Resistance and Cardiometabolic Risk Factors in Older Obese Adults--A Randomized Clinical Trial
Yassine et al.
J Gerontol A Biol Sci Med Sci 2009;0:gln032v1-gln032.
ABSTRACT
| FULL TEXT
Single risk factor interventions to promote physical activity among patients with chronic diseases: Systematic review
Hudon et al.
cfp 2008;54:1130-1137.
ABSTRACT
| FULL TEXT
Improvements in glucose tolerance and insulin action induced by increasing energy expenditure or decreasing energy intake: a randomized controlled trial.
Weiss et al.
Am. J. Clin. Nutr. 2006;84:1033-1042.
ABSTRACT
| FULL TEXT
Beneficial Effects of a Dietary Approaches to Stop Hypertension Eating Plan on Features of the Metabolic Syndrome
Azadbakht et al.
Diabetes Care 2005;28:2823-2831.
ABSTRACT
| FULL TEXT
Effects of Dietary Weight Loss on Sympathetic Activity and Cardiac Risk Factors Associated with the Metabolic Syndrome
Straznicky et al.
J. Clin. Endocrinol. Metab. 2005;90:5998-6005.
ABSTRACT
| FULL TEXT
Independent and additive effects of energy restriction and exercise on glucose and insulin concentrations in sedentary overweight men
Cox et al.
Am. J. Clin. Nutr. 2004;80:308-316.
ABSTRACT
| FULL TEXT
Weight loss improves neurovascular and muscle metaboreflex control in obesity
Trombetta et al.
Am. J. Physiol. Heart Circ. Physiol. 2003;285:H974-H982.
ABSTRACT
| FULL TEXT
Exercise Comes of Age: Rationale and Recommendations for a Geriatric Exercise Prescription
Singh
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2002;57:M262-282.
FULL TEXT
Effects of an Energy-Restrictive Diet With or Without Exercise on Abdominal Fat, Intermuscular Fat, and Metabolic Risk Factors in Obese Women
Janssen et al.
Diabetes Care 2002;25:431-438.
ABSTRACT
| FULL TEXT
Optimal Exercise Intensity for Individuals With Impaired Glucose Tolerance
Wright and Swan
Diabetes Spectr. 2001;14:93-97.
ABSTRACT
| FULL TEXT
Effects of Walking Training on Weight Maintenance After a Very-Low-Energy Diet in Premenopausal Obese Women: A Randomized Controlled Trial
Fogelholm et al.
Arch Intern Med 2000;160:2177-2184.
ABSTRACT
| FULL TEXT
Exercise and Weight Loss Reduce Blood Pressure in Men and Women With Mild Hypertension: Effects on Cardiovascular, Metabolic, and Hemodynamic Functioning
Blumenthal et al.
Arch Intern Med 2000;160:1947-1958.
ABSTRACT
| FULL TEXT
Overweight, Obesity, and Health Risk
National Task Force on the Prevention and Treatmen
Arch Intern Med 2000;160:898-904.
ABSTRACT
| FULL TEXT
Primary Prevention of Coronary Heart Disease : Integrating Risk Assessment With Intervention
Grundy
Circulation 1999;100:988-998.
FULL TEXT
|
