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Erik Hemmingsson, Ulf Ekelund, and Joanna Udden

Background:

The impact of walking and bicycling on insulin resistance (IR) in women with abdominal obesity is unclear.

Methods:

Pooled analysis of data from a randomized trial on physically active commuting (bicycling + walking vs walking only) in women with abdominal obesity [n = 98; age:47.3 ± 7.6 yrs; waist circumference (WC):103.1 ± 7.8 cm]. Bicycling and walking data were collected during 7 consecutive days by trip meters (Trelock FC-410) and pedometers (Yamax digiwalker SW-200) at baseline, 2, 4, and 6 months. Owing to a skew distribution we analyzed bicycling as a binary dummy variable with a 10 km/week cut-off. Fasting serum insulin and homeostatic model assessment – insulin resistance (HOMA-IR) were assessed at baseline and 6 months, as were body mass index (BMI), WC, and dual x-ray absorptiometry (DXA)-assessed % whole-body fat.

Results:

Increased bicycling by 10 km/wk was associated with reductions in fasting serum insulin at follow-up independent of age, treatment allocation, baseline phenotype, Δ walking, and Δ % body fat (β = −10.9, P = .042), but not HOMA-IR (β = −2.0, P = .13). Increased walking was not associated with fasting serum insulin (P = .33) or HOMA-IR (P = .44) at follow-up, after adjustment for the same covariates and Δ bicycling.

Conclusion:

Increased bicycling but not walking was associated with reduced insulin levels at follow-up. Bicycling may be more effective than walking for reducing insulin levels in abdominally obese women.

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Alex Pinheiro Gordia, Teresa Maria Bianchini de Quadros, Jorge Mota, and Luciana Rodrigues Silva

Purpose:

Weight status-referenced pedometer step-count guidelines for young people have been developed for populations from high-income countries and may not be applicable to middle- and low-income countries. The objectives of this study were 1) to develop cut-off points for pedometer-determined step count in young Brazilians using waist circumference (WC) as a reference criterion, and 2) to analyze the capacity of previous recommendations to discriminate abdominal obesity in the sample studied.

Methods:

A cross-sectional study was conducted on 1,044 schoolchildren (456 boys) aged 6–17 years from Northeastern Brazil. WC was measured and daily step counts were determined with a pedometer.

Results:

The area under the curve (AUC) of step count was significant for boys (AUC = 0.55; 95%CI: 0.50–0.59) and girls (AUC = 0.57; 95%CI: 0.53–0.61). Our cut-off points (14,414 and 11,355 steps for boys and girls, respectively) were more balanced in terms of sensitivity and specificity compared with previous recommendations. The use of previous guidelines to classify step count in the sample provided very low sensitivity or specificity and wide variation in the prevalence of insufficient physical activity (39.3–77.0%).

Conclusions:

A universal step-count recommendation for young people may not be adequate and specific guidelines seem to be necessary for different countries or regions.

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Brittany T. MacEwen, Travis J. Saunders, Dany J. MacDonald, and Jamie F. Burr

Background:

Sit-stand desks reduce workplace sitting time among healthy office workers; however, their metabolic and behavioral impact in higher risk populations remains unknown.

Methods:

25 office workers with abdominal obesity were randomized to an intervention (sit-stand workstation) or control group (seated desk) for 12 weeks. Physical activity, sedentary behavior, and cardiometabolic risk factors were assessed before and after the intervention period in both groups.

Results:

In comparison with the control group, which did not change, the intervention group experienced significant reductions in workday (344 ± 107 to 186 ± 101 min/day) and total (645 ± 140 to 528 ± 91 min/day) sitting time, as well as increases in workday standing time (154 ± 108 to 301 ± 101 min/day, P < .05). There were no changes in sitting or standing time outside of work hours, steps taken each day, or any marker of cardiometabolic risk in either group (all P > .05).

Conclusion:

Sit-stand desks were effective in reducing workplace sedentary behavior in an at-risk population, with no change in sedentary behavior or physical activity outside of work hours. However, these changes were not sufficient to improve markers of cardiometabolic risk in this population.

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Nuno M. Pimenta, Helena Santa-Clara, Xavier Melo, Helena Cortez-Pinto, José Silva-Nunes, and Luís B. Sardinha

Central accumulation and distribution of body fat (BF) is an important cardiometabolic risk factor. Waist-to-hip ratio (WHR), commonly elevated in nonalcoholic fatty liver disease (NAFLD) patients, has been endorsed as a risk related marker of central BF content and distribution, but no standardized waist circumference measurement protocol (WCmp) has been proposed. We aimed to investigate whether using different WCmp affects the strength of association between WHR and BF content and distribution in NAFLD patients. BF was assessed with dual energy X-ray absorptiometry (DXA) in 28 NAFLD patients (19 males, 51 ± 13 years, and 9 females, 47 ± 13 years). Waist circumference (WC) was measured using four different WCmp (WC1: minimal waist; WC2: iliac crest; WC3: mid-distance between iliac crest and lowest rib; WC4: at the umbilicus) and WHR was calculated accordingly (WHR1, WHR2, WHR3 and WHR4, respectively). High WHR was found in up to 84.6% of subjects, depending on the WHR considered. With the exception of WHR1, all WHR correlated well with abdominal BF (r = .47 for WHR1; r = .59 for WHR2 and WHR3; r = .58 for WHR4) and BF distribution (r = .45 for WHR1; r = .56 for WHR2 and WHR3; r = .51 for WHR4), controlling for age, sex and body mass index (BMI). WHR2 and WHR3 diagnosed exactly the same prevalence of high WHR (76.9%). The present study confirms the strong relation between WHR and central BF, regardless of WCmp used, in NAFLD patients. WHR2 and WHR3 seemed preferable for use in clinical practice, interchangeably, for the diagnosis of high WHR in NAFLD patients.

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Maxwell Ruby, Chris P. Repka, and Paul J. Arciero

Background:

Yoga/Stretching (YS) and functional resistance (FR) training are popular exercise routines. A protein-pacing (PP) diet is a common dietary regimen. Thus, we assessed the effectiveness of a PP diet alone and in combination with either YS or FR to improve body composition and cardiometabolic health.

Methods:

Twenty-seven overweight women (age = 43.2 ± 4.6 years) were randomized into 3 groups: yoga (YS, n = 8) or resistance (FR, n = 10) training (3 days/week) in conjunction with PP diet (50% carbohydrate, 25% protein, and 25% fat) or PP diet-only (PP, n = 9) throughout 12-week study. PP maintained preexisting levels of physical activity. Body weight (BW), total (BF) and abdominal (ABF) body fat, waist circumference (WC), plasma biomarkers, and aerobic fitness (VO2) were measured at baseline and 12 weeks.

Results:

WC and total cholesterol improved in all groups, whereas glycemia tended to improve (P = .06) in S. BF, ABF, and VO2 increased significantly in YS and FR (P < .05). Feelings of vigor increased in YS and tension decreased in FR (P < .05).

Conclusions:

YS training tended to decrease blood glucose compared with FR and PP and is equally effective at enhancing body composition, and aerobic fitness in overweight women providing a strong rationale for further research on YS training.

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Anna Gabriela Silva Vilela Ribeiro, Rozangela Verlengia, Maria Rita Marques de Oliveira, Matheus Valério Almeida Oliveira, Idico Luiz Pellegrinotti, and Alex Harley Crisp

%), abdominal obesity (66%), and excess body fat (70%) and had 5.78 times the odds of having a higher score of physical (Table  3 ). Thus, this more favorable outcome of the accumulation MVPA in bouts of ≥10 min could be related to the fact that the sustained activities are performed in greater intensity than

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Elin Ekblom-Bak, Örjan Ekblom, Gunnar Andersson, Peter Wallin, and Björn Ekblom

significantly lower OR (range: 0.66–0.84) for perceiving very poor/poor overall health, being generally and abdominal obese and having a high diastolic BP after adjusting for age and performed year of the health assessment (Table  3 ). In addition, they had increased OR for being current regular exercisers (OR

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Danielle R. Bouchard, K. Ashlee McGuire, Lance Davidson, and Robert Ross

One hundred forty-six abdominally obese adults age 60–80 yr were studied to investigate the interaction between cardiorespiratory fitness (CRF) and obesity on functional limitation. Obesity was determined by fat mass (FM), CRF was determined by a maximal treadmill test, and functional limitation was based on 4 different tasks that are predictive of subsequent disability. Both FM (r = –.34, p ≤ .01) and CRF (r = .54, p ≤ .01) were independently associated with functional limitation in bivariate analysis. After further control for sex, age, and the interaction term (CRF × FM), FM was no longer independently associated with functional limitation (p = .10). Analyses were also based on sex-specific tertiles of FM and CRF. The referent group demonstrated significantly lower functional limitation than the low-CRF/low-FM and the low-CRF/high-FM groups (both p ≤ .05). These results highlight the value of recommending exercise for abdominally obese adults.

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Katrina D. DuBose, Cheryl L. Addy, Barbara E. Ainsworth, Gregory A. Hand, and J. Larry Durstine

Background:

This study was performed to determine the relationship between leisure-time physical activity (LTPA) and the metabolic syndrome (MS) in 16,681 adults (43 ± 0.44 y) enrolled in NHANES III.

Methods:

LTPA was classified as regularly active ( 5 d/wk moderate and/or 3 d/wk vigorous), irregularly active (some LTPA), or inactive (no LTPA). The MS was positive with three or more conditions: 1) abdominal obesity, 2) low HDL-C, 3) hypertriglyceridemia, 4) elevated blood pressure, or 5) elevated glucose. Logistic regression examined the relationship between LTPA and the MS, adjusting for age, race, smoking status, and educational attainment stratified by gender.

Results:

In men only, irregular activity and inactivity was related to an increase in the MS (irregular: OR = 1.52 95% CI 1.11, 1.23; inactive: OR = 1.60, 95% CI 1.18, 1.98; test for trend P = 0.004). Inactivity increased the odds for abdominal obesity (P < 0.05).

Conclusions:

LTPA levels might influence the development of MS and abdominal obesity.

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Joan Khoo, Subbiah Dhamodaran, Dan-Dan Chen, Siew-Yoon Yap, Richard Yuan-Tud Chen, and Roger Ho-Heng Tian

The adipokines chemerin and adiponectin are reciprocally related in the pathogenesis of insulin resistance and inflammation in obesity. Weight loss increases adiponectin and reduces chemerin, insulin resistance, and inflammation, but the effects of caloric restriction and physical activity are difficult to separate in combined lifestyle modification. We compared effects of diet- or exercise-induced weight loss on chemerin, adiponectin, insulin resistance, and inflammation in obese men. Eighty abdominally obese Asian men (body mass index [BMI] ≥ 30 kg/m2, waist circumference [WC] ≥ 90 cm, mean age 42.6 years) were randomized to reduce daily intake by ~500 kilocalories (n = 40) or perform moderate-intensity aerobic and resistance exercise (200–300 min/week) (n = 40) to increase energy expenditure by a similar amount for 24 weeks. The diet and exercise groups had similar decreases in energy deficit (−456 ± 338 vs. −455 ± 315 kcal/day), weight (−3.6 ± 3.4 vs. −3.3 ± 4.6 kg), and WC (−3.4 ± 4.4 vs. −3.6 ± 3.2 cm). The exercise group demonstrated greater reductions in fat mass (−3.9 ± 3.5 vs. −2.7 ± 5.3 kg), serum chemerin (−9.7 ± 11.1 vs. −4.3 ± 12.4 ng/ml), the inflammatory marker high-sensitivity C-reactive protein (−2.11 ± 3.13 vs. −1.49 ± 3.08 mg/L), and insulin resistance as measured by homeostatic model assessment (−2.45 ± 1.88 vs. −1.38 ± 3.77). Serum adiponectin increased only in the exercise group. Exercise-induced fat mass loss was more effective than dieting for improving adipokine profile, insulin resistance, and systemic inflammation in obese men, underscoring metabolic benefits of increased physical activity.