Aerobic exercise but not resistance exercise reduces intrahepatic lipid content and visceral fat and improves insulin sensitivity in obese adolescent girls: a randomized controlled trial.

It is unclear whether regular exercise alone (no caloric restriction) is a useful strategy to reduce adiposity and obesity-related metabolic risk factors in obese girls. We examined the effects of aerobic (AE) vs. resistance exercise (RE) alone on visceral adipose tissue (VAT), intrahepatic lipid, and insulin sensitivity in obese girls. Forty-four obese adolescent girls (BMI ≥95th percentile, 12-18 yr) with abdominal obesity (waist circumference 106.5 ± 11.1 cm) were randomized to 3 mo of 180 min/wk AE (n = 16) or RE (n = 16) or a nonexercising control group (n = 12). Total fat and VAT were assessed by MRI and intrahepatic lipid by proton magnetic resonance spectroscopy. Intermuscular AT (IMAT) was measured by CT. Insulin sensitivity was evaluated by a 3-h hyperinsulinemic (80 mU·m(2)·min(-1)) euglycemic clamp. Compared with controls (0.13 ± 1.10 kg), body weight did not change (P > 0.1) in the AE (-1.31 ± 1.43 kg) and RE (-0.31 ± 1.38 kg) groups. Despite the absence of weight loss, total body fat (%) and IMAT decreased (P < 0.05) in both exercise groups compared with control. Compared with control, significant (P < 0.05) reductions in VAT (Δ-15.68 ± 7.64 cm(2)) and intrahepatic lipid (Δ-1.70 ± 0.74%) and improvement in insulin sensitivity (Δ0.92 ± 0.27 mg·kg(-1)·min(-1) per µU/ml) were observed in the AE group but not the RE group. Improvements in insulin sensitivity in the AE group were associated with the reductions in total AT mass (r = -0.65, P = 0.02). In obese adolescent girls, AE but not RE is effective in reducing liver fat and visceral adiposity and improving insulin sensitivity independent of weight loss or calorie restriction.

Energy expenditure, cardiorespiratory, and perceptual responses to shallow-water aquatic exercise in young adult women.

INTRODUCTION: Aquatic exercise (AE) is a popular form of physical activity, yet few studies have assessed the individual's energy expenditure (EE) associated with a continuous bout of AE. Studies using indirect calorimetry to measure EE have reported limitations associated with test methodology and the ability to control individual's exercise intensity or tempo. PURPOSE: To evaluate EE and cardiorespiratory (CR) responses during a 40-minute shallow-water AE session in young adult women. METHODS: Twenty-one healthy women (aged 21.7 ± 3.4 years) completed an orientation practice session and a 40-minute shallow-water AE session using a traditional exercise class format and the SWEAT video-based instructional cuing program. The high-intensity interval format included the following segments: 1) warm-up (3 minutes); 2) CR segment ( 22 minutes); 3) muscular endurance segment (ME; 10 minutes); and 4) cool-down (5 minutes). Subject oxygen consumption (VO2; mL/kg/min), heart rate (HR) and OMNI overall ratings of perceived exertion (RPE-O) were assessed each minute. Average kcal/min1, metabolic equivalents (METs; 1 MET = 3.5 mL/kg/min), and total kcals per segment and for the overall session were calculated. RESULTS: The total subject EE throughout the 40-minute trial (including warm-up and cool-down segments) was 264 kcals, with an overall average of 6.3 kcals/min (5.6 METs).The average kcals/min expended throughout CR segments 2 through 6 was 8.05 (7.1 METs), with the Hoverjog segment producing the greatest average kcals/min at 8.3 (7.3 METs). The CR portion (22 min) contributed 65% of the total EE (171 kcals) of the 40-minute AE trial. For the overall AE trial, the highest and average subject VO2 achieved were 33.3 and 19.7 mL/kg/min, respectively. The average highest subject heart rate achieved was 177 beats per minute (bpm), equivalent to 90% of the participant's age-predicted HRmax. CONCLUSION: Energy expenditure during a 40-minute AE session met national recommendations for a daily moderate-to-vigorous bout of physical activity offering a viable alternative to land-based exercise. Because AE serves as a partial-weight bearing modality, future studies are needed to clarify the EE of shallow-water AE in apparently healthy and clinical populations.

Role of physical activity in the treatment of nonalcoholic fatty liver disease in children and adolescents.

Currently, nonalcoholic fatty liver disease (NAFLD) is the most frequent liver abnormality observed in obese children and adolescents. A strong body of evidence suggests that increased liver fat is significantly associated with visceral adiposity, metabolic syndrome, and insulin resistance in obese children and adolescents. Diet and exercise are generally recommended to treat obese youth with NAFLD as they do not carry side effects and confer multiple cardiometabolic benefits. Studies in adult populations report a beneficial effect of regular physical activity on reducing liver fat. In children and adolescents, available data show that weight loss induced by increasing physical activity and calorie restriction is beneficial to reduce liver fat and associated health risk factors such as insulin resistance and dyslipidemia. Currently, evidence regarding the independent effects of regular exercise alone (e.g., without calorie restriction) on NAFLD are unclear. Additionally, there is no data regarding the optimal exercise regimen (e.g., type, dose, intensity) that should be prescribed for reducing NAFLD in children and adolescents. The purpose of this review is to examine the role of physical activity on NAFLD in children and adolescents.