Daily exercise lowers blood pressure and reduces visceral adipose tissue areas in overweight Japanese men.

OBJECTIVE: To investigate the link between a reduction in blood pressure (BP) and daily exercise. DESIGN: Cross-sectional and longitudinal clinical intervention study with exercise education. SUBJECTS: 43 overweight Japanese men aged 32-59 years (BMI, 29.0+/-2.3 kg/m2) at baseline. Among the participants, a randomly selected 23 overweight men (BMI, 28.5+/-1.7) were further enrolled into the 10 months exercise program. MEASUREMENTS: BP was measured every week and steps per day were also recorded every day throughout the observation period. Fat distribution was evaluated by visceral fat (V) and subcutaneous fat (S) areas measured with computed tomography (CT) scanning at umbilical level, at before, 5 months and after intervention. Anthropometric parameters were also measured at same point. Aerobic exercise level, muscle strength, flexibility and calorie intake and insulin resistance (HOMA index) were investigated at before and after the study. RESULTS: In a cross sectional analysis, systolic BP (SBP) and diastolic BP (DBP) were significantly correlated with body composition. In a second longitudinal analysis, SBP was significantly reduced at 2 months and DBP was also reduced at 3 months, and almost maintained until the end of the observation period. Increasing daily walking was observed in 3 months and maintained until 10 months. Body composition, aerobic exercise level, muscle strength, flexibility and insulin resistance were significantly improved. There was positive correlation between DeltaDBP and Deltavisceral fat area (1-5, 5-10, 1-10 months). By stepwise multiple regression analysis, only Deltavisceral fat area was independently related to DeltaDBP at a significant level (1-10 months: DeltaDBP=-0.608+0.105Deltavisceral fat area, r2=0.227, P=0.0334). CONCLUSION: The present study indicated daily exercise lowers BP and visceral fat area is the critical factor for BP change.

Evaluation of exercise prescription for hypertensive obese men by ventilatory threshold.

BACKGROUND: Prescription of aerobic exercise for obese subjects with mild hypertension in clinical practice remains to be investigated. METHODS: Forty-one Japanese obese males with hypertension were enrolled and compared with 41 age-and sex-matched obese subjects without hypertension and control subjects. In addition, 25 obese subjects with or without hypertension participated in a one-year follow up study. They were instructed to keep their low exercise intensity and record their daily walking. Before and after exercise prescription, body composition, blood pressure and aerobic exercise level were evaluated. Ventilatory threshold (VT) was determined breath by breath during exercise test using a ramp protocol and rates of oxygen consumption (VO2), work rate (WR), heart rate (HR), deltaHR, %HR max, %HR reserve and rate of perceived exertion (RPE) were measured at VT. RESULTS: At VT, obese subjects with hypertension had significantly lower VO2 (13.5 +/- 2.1 mL/kg/min) and WR (75.1 +/- 16.5W) than control subjects (VO2, 18.1 +/- 5.7; WR, 92.0 +/- 32.4). %HR reserve was also significantly lower compared with control subjects, while %HR max, was not different. RPE was also similar among the 3 groups. By prescribed low-grade exercise during one-year follow-up study, not only body composition but also blood pressure at rest was improved in obese subjects with and without hypertension. CONCLUSIONS: Our results indicated reduced exercise capacity in Japanese obese males. Exercise intensity of 60%HR max, 30%HR reserve and RPE 12 is recommended in obese subjects with hypertension as well as obese subjects without hypertension.

Daily walking reduces visceral adipose tissue areas and improves insulin resistance in Japanese obese subjects.

OBJECTIVE: It is known that the accumulation of abdominal fat is one of the risk factors for atherosclerosis. Although exercise is commonly prescribed to reduce body weight, the efficacy of low intensity exercise for the reduction of abdominal visceral adipose tissue remains to be investigated. RESEARCH DESIGN AND METHODS: Thirty one obese Japanese males (body mass index (BMI) > or = 25) ranging in age from 32 to 59, participated in a 1-year follow up study and they were instructed to have a modest increase in daily activity and record their daily walking. Before and after exercise prescription, body composition, blood pressure, physical fitness i.e. aerobic exercise level, muscle strength and flexibility were recorded. Insulin resistance was evaluated using a homeostasis model assessment, the HOMA index. RESULTS: HOMA index, parameters of body composition, blood pressure, triglyceride and HDL cholesterol were significantly improved. The aerobic exercise level, leg strength, weight-bearing index (leg strength/body weight) and the steps taken per day were significantly increased. By stepwise multiple regression analysis, Delta visceral adipose tissue area was the major determinant for Delta HOMA index. (Delta HOMA index=-0.386+0.016 Delta visceral adipose tissue area, r2=0.267, P<0.01). Exercise capacity and calorie intake were not significantly related to Delta visceral adipose tissue area, while Delta steps per day was significantly correlated with Delta visceral adipose tissue area (Delta visceral adipose tissue area=-21.363-0.004 Delta steps per day, r2=0.184, P=0.0326). CONCLUSIONS: Taken together, intra-abdominal visceral adipose tissue is critically involved in insulin resistance and daily walking rather than improvement of exercise capacity correlated with the reduction of visceral adipose tissue in obese Japanese males.