Assessing the utility of cardiorespiratory fitness, visceral fat, and liver fat in predicting changes in insulin sensitivity beyond simple changes in body weight after exercise training in adolescents

To examine the utility of changes in cardiorespiratory fitness (CRF) and body composition in response to exercise training in adolescents with obesity beyond simple measures of body weight change. This is a secondary analysis of our previously published randomized trials of aerobic, resistance, and combined training. We included 104 adolescents (body mass index (BMI) ≥85th percentile) who had complete baseline and post-intervention data for CRF, regional body fat, insulin sensitivity, and oral glucose tolerance. Associations between changes in body composition and CRF with cardiometabolic variables were examined adjusted for age, sex, Tanner stage, race, exercise group, and weight loss. At baseline, CRF, visceral fat and liver fat were correlated with insulin sensitivity with and without adjustment for BMI percentile. Training-associated changes in CRF, visceral fat, and liver fat were also correlated with insulin sensitivity changes, but not independent of body weight change. After accounting for body weight change, none of the body composition or CRF were associated with changes in insulin sensitivity, glucose tolerance, systolic blood pressure, or high-density lipoprotein cholesterol. Although CRF and body composition were strong independent correlates of insulin sensitivity at baseline, changes in CRF and visceral fat were not associated with changes in insulin sensitivity after accounting for body weight change. Clinicaltrials.gov registration nos.: NCT00739180, NCT01323088, NCT01938950. Novelty With exercise training, changes in body weight, CRF, visceral fat, and liver fat were correlated with changes in insulin sensitivity. Changes in body composition or CRF generally did not remain significant correlates of changes in insulin sensitivity after adjusting for body weight changes.

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Longitudinal changes in body composition in older men and women: role of body weight change and physical activity

American Journal of Clinical Nutrition ◽

10.1093/ajcn/76.2.473 ◽

2002 ◽

Vol 76 (2) ◽

pp. 473-481 ◽

Cited By ~ 417

Author(s):

Virginia A Hughes ◽

Walter R Frontera ◽

Ronenn Roubenoff ◽

William J Evans ◽

Maria A Fiatarone Singh

Keyword(s):

Physical Activity ◽

Body Composition ◽

Body Weight ◽

Weight Change ◽

Older Men ◽

Body Weight Change ◽

Men And Women ◽

Longitudinal Changes ◽

Older Men And Women

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Effect of exercise training on insulin sensitivity and glucose metabolism in lean, obese, and diabetic men

Journal of Applied Physiology ◽

10.1152/jappl.1991.71.6.2402 ◽

1991 ◽

Vol 71 (6) ◽

pp. 2402-2411 ◽

Cited By ~ 119

Author(s):

K. R. Segal ◽

A. Edano ◽

A. Abalos ◽

J. Albu ◽

L. Blando ◽

...

Keyword(s):

Body Composition ◽

Body Weight ◽

Insulin Sensitivity ◽

Glucose Metabolism ◽

Exercise Training ◽

Cardiorespiratory Fitness ◽

Insulin Action ◽

Training Session ◽

Hepatic Glucose ◽

Glucose Output

To clarify the impact of vigorous physical training on in vivo insulin action and glucose metabolism independent of the intervening effects of concomitant changes in body weight and composition and residual effects of an acute exercise session, 10 lean, 10 obese, and 6 diet-controlled type II diabetic men trained for 12 wk on a cycle ergometer 4 h/wk at approximately 70% of maximal O2 uptake (VO2max) while body composition and weight were maintained by refeeding the energy expended in each training session. Before and 4–5 days after the last training session, euglycemic hyperinsulinemic (40 mU.m2.min-1) clamps were performed at a plasma glucose of 90 mg/dl, combined with indirect calorimetry. Total insulin-stimulated glucose disposal (M) was corrected for residual hepatic glucose output. Body weight, fat, and fat-free mass (FFM) did not change with training, but cardiorespiratory fitness increased by 27% in all groups. Before and after training, M was lower for the obese (5.33 +/- 0.39 mg.kg FFM-1.min-1 pretraining; 5.33 +/- 0.46 posttraining) than for the lean men (9.07 +/- 0.49 and 8.91 +/- 0.60 mg.kg FFM-1.min-1 for pretraining and posttraining, respectively) and lower for the diabetic (3.86 +/- 0.44 and 3.49 +/- 0.21) than for the obese men (P less than 0.001). Insulin sensitivity was not significantly altered by training in any group, but basal hepatic glucose production was reduced by 22% in the diabetic men. Thus, when intervening effects of the last exercise bout or body composition changes were controlled, exercise training per se leading to increased cardiorespiratory fitness had no independent impact on insulin action and did not improve the insulin resistance in obese or diabetic men.

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Exercise and body composition revisited: the effect of body weight change

Applied Radiation and Isotopes ◽

10.1016/s0969-8043(97)00075-4 ◽

1998 ◽

Vol 49 (5-6) ◽

pp. 575 ◽

Cited By ~ 2

Author(s):

Gilbert B. Forbes

Keyword(s):

Body Composition ◽

Body Weight ◽

Weight Change ◽

Body Weight Change

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Contribution of Gestational Weight Gain on Maternal Glucose Metabolism in Women with GDM and Normal Glucose Tolerance

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa195 ◽

2020 ◽

Author(s):

Fernanda L Alvarado ◽

Perrie O’Tierney-Ginn ◽

Patrick Catalano

Keyword(s):

Body Composition ◽

Body Weight ◽

Weight Gain ◽

Insulin Sensitivity ◽

Glucose Metabolism ◽

Glucose Tolerance ◽

Normal Glucose Tolerance ◽

Gestational Weight ◽

Normal Glucose ◽

The Relationship

Abstract Context Efforts to decrease the risk of developing metabolic complications of pregnancy such as gestational diabetes (GDM) through lifestyle intervention (decreasing excessive gestational weight gain (GWG)) during pregnancy have met with limited success. Objective The purpose of this study was to determine the relationship between the longitudinal changes in weight/body composition and insulin sensitivity and response in women with normal glucose tolerance (NGT) and those who developed GDM. Design We conducted a secondary analysis of a prospective cohort developed before conception and again at 34-36 weeks gestation. Twenty-nine NGT and seventeen GDM women were evaluated for longitudinal changes in insulin sensitivity/response using the hyperinsulinemic-euglycemic clamp and an IV-glucose tolerance test. Body composition was estimated using hydrodensitometry. Both absolute (Δ) and relative change (%Δ) between these two time points were calculated. We performed simple and multiple linear regression analysis to assess the relationship between GWG and measures of glucose metabolism, i.e. insulin sensitivity and response. Results Based on the primary study design there was no significant difference in clinical characteristics between women with NGT and those developing GDM. Prior to pregnancy, women who developed GDM had lower insulin sensitivity levels (p=0.01) compared to NGT women. Absolute change and %Δ in insulin sensitivity/insulin response and body weight/body composition was not significantly different between NGT and GDM women. Changes in body weight contributed to only 9% of the Δ insulin sensitivity both in women developing GDM and NGT women. Conclusions These data suggest that other factors – such as maternal pre-pregnancy insulin sensitivity and placental derived factors affecting insulin sensitivity rather than maternal GWG account for the changes in glucose metabolism during human pregnancy.

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Effects of a Low-Fat Vegan Diet on Gut Microbiota in Overweight Individuals and Relationships with Body Weight, Body Composition, and Insulin Sensitivity. A Randomized Clinical Trial

Nutrients ◽

10.3390/nu12102917 ◽

2020 ◽

Vol 12 (10) ◽

pp. 2917

Author(s):

Hana Kahleova ◽

Emilie Rembert ◽

Jihad Alwarith ◽

Willy N. Yonas ◽

Andrea Tura ◽

...

Keyword(s):

Body Composition ◽

Body Weight ◽

Insulin Sensitivity ◽

Gut Microbiota ◽

Fat Mass ◽

Treatment Effect ◽

Visceral Fat ◽

Vegan Diet ◽

Low Fat ◽

Vegan Group

Diet modulates gut microbiota and plays an important role in human health. The aim of this study was to test the effect of a low-fat vegan diet on gut microbiota and its association with weight, body composition, and insulin resistance in overweight men and women. We enrolled 168 participants and randomly assigned them to a vegan (n = 84) or a control group (n = 84) for 16 weeks. Of these, 115 returned all gut microbiome samples. Gut microbiota composition was assessed using uBiome Explorer™ kits. Body composition was measured using dual energy X-ray absorptiometry. Insulin sensitivity was quantified with the predicted clamp-derived insulin sensitivity index from a standard meal test. Repeated measure ANOVA was used for statistical analysis. Body weight decreased in the vegan group (treatment effect −5.9 kg [95% CI, −7.0 to −4.9 kg]; p < 0.001), mainly due to a reduction in fat mass (−3.9 kg [95% CI, −4.6 to −3.1 kg]; p < 0.001) and in visceral fat (−240 cm3 [95% CI, −345 to −135 kg]; p < 0.001). PREDIcted M, insulin sensitivity index (PREDIM) increased in the vegan group (treatment effect +0.83 [95% CI, +0.48 to +1.2]; p < 0.001). The relative abundance of Faecalibacterium prausnitzii increased in the vegan group (+5.1% [95% CI, +2.4 to +7.9%]; p < 0.001) and correlated negatively with changes in weight (r = −0.24; p = 0.01), fat mass (r = −0.22; p = 0.02), and visceral fat (r = −0.20; p = 0.03). The relative abundance of Bacteroides fragilis decreased in both groups, but less in the vegan group, making the treatment effect positive (+18.9% [95% CI, +14.2 to +23.7%]; p < 0.001), which correlated negatively with changes in weight (r = −0.44; p < 0.001), fat mass (r = −0.43; p < 0.001), and visceral fat (r = −0.28; p = 0.003) and positively with PREDIM (r = 0.36; p < 0.001), so a smaller reduction in Bacteroides fragilis was associated with a greater loss of body weight, fat mass, visceral fat, and a greater increase in insulin sensitivity. A low-fat vegan diet induced significant changes in gut microbiota, which were related to changes in weight, body composition, and insulin sensitivity in overweight adults, suggesting a potential use in clinical practice.

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The Association between Adult Weight Gain and Insulin Resistance at Middle Age: Mediation by Visceral Fat and Liver Fat

Journal of Clinical Medicine ◽

10.3390/jcm8101559 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1559 ◽

Cited By ~ 1

Author(s):

Inge Verkouter ◽

Raymond Noordam ◽

Saskia le Cessie ◽

Rob M. van Dam ◽

Hildo J. Lamb ◽

...

Keyword(s):

Insulin Resistance ◽

Body Weight ◽

Weight Gain ◽

Weight Change ◽

Visceral Fat ◽

Middle Age ◽

Liver Fat ◽

Adult Weight ◽

Total Body Fat ◽

Total Body

We aimed to investigate the role of the amount of visceral fat and liver fat in the association between adult weight change and insulin resistance at middle age. In the Netherlands Epidemiology of Obesity study, adult weight change was calculated with recalled body weight at age 20 years and measured body weight at middle age. Measures of insulin resistance were calculated using both fasting and postprandial glucose and insulin concentrations. Visceral fat was assessed by magnetic resonance (MR) imaging and liver fat by proton-MR spectroscopy (N = 1758). We examined the association between adult weight change and insulin resistance with linear regression, adjusted for confounding factors. To investigate mediation, we additionally adjusted for total body fat, visceral fat, and liver fat. In participants who gained ≥50% of body weight during adulthood, homeostatic model assessment for insulin resistance (HOMA-IR) was 3.22 (95% CI 2.76; 3.77) times higher than in weight maintainers. In a joint model, total body fat mediated this association for 8.1% (95% CI −9.2; 25.4), visceral fat for 32.0% (18.6; 45.4%) and liver fat for 22.5% (15.0; 30.1). The association between adult weight gain and insulin resistance at middle age is largely mediated by both visceral fat and liver fat.

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Extended Ketogenic Diet and Physical Training Intervention in Military Personnel

Military Medicine ◽

10.1093/milmed/usz046 ◽

2019 ◽

Vol 184 (9-10) ◽

pp. e538-e547 ◽

Cited By ~ 10

Author(s):

Richard A LaFountain ◽

Vincent J Miller ◽

Emily C Barnhart ◽

Parker N Hyde ◽

Christopher D Crabtree ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Insulin Sensitivity ◽

Exercise Training ◽

Physical Performance ◽

Body Mass ◽

Military Personnel ◽

Visceral Fat ◽

Whole Body ◽

Ketogenic Diets

AbstractIntroductionKetogenic diets (KDs) that elevate ketones into a range referred to as nutritional ketosis represent a possible nutrition approach to address the emerging physical readiness and obesity challenge in the military. An emerging body of evidence demonstrates broad-spectrum health benefits attributed to being in nutritional ketosis, but no studies have specifically explored the use of a KD in a military population using daily ketone monitoring to personalize the diet prescription.Materials and MethodsTo evaluate the feasibility, metabolic, and performance responses of an extended duration KD, healthy adults (n = 29) from various military branches participated in a supervised 12-wk exercise training program. Fifteen participants self-selected to an ad libitum KD guided by daily measures of capillary blood ketones and 14 continued their normal mixed diet (MD). A battery of tests were performed before and after the intervention to assess changes in body mass, body composition, visceral fat, liver fat, insulin sensitivity, resting energy metabolism, and physical performance.ResultsAll KD subjects were in nutritional ketosis during the intervention as assessed by daily capillary beta-hydroxybutyrate (βHB) (mean βHB 1.2 mM reported 97% of all days) and showed higher rates of fat oxidation indicative of keto-adaptation. Despite no instruction regarding caloric intake, the KD group lost 7.7 kg body mass (range −3.5 to −13.6 kg), 5.1% whole-body percent fat (range −0.5 to −9.6%), 43.7% visceral fat (range 3.0 to −66.3%) (all p < 0.001), and had a 48% improvement in insulin sensitivity; there were no changes in the MD group. Adaptations in aerobic capacity, maximal strength, power, and military-specific obstacle course were similar between groups (p > 0.05).ConclusionsUS military personnel demonstrated high adherence to a KD and showed remarkable weight loss and improvements in body composition, including loss of visceral fat, without compromising physical performance adaptations to exercise training. Implementation of a KD represents a credible strategy to enhance overall health and readiness of military service members who could benefit from weight loss and improved body composition.

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The composition and energy content of empty body-weight change in mature cattle

Animal Science ◽

10.1017/s0003356100032086 ◽

1984 ◽

Vol 39 (3) ◽

pp. 365-369 ◽

Cited By ~ 17

Author(s):

I. A. Wright ◽

A. J. F. Russel

Keyword(s):

Body Composition ◽

Body Weight ◽

Weight Change ◽

Protein Concentration ◽

Energy Content ◽

Body Weight Change ◽

Lactating Cows ◽

Body Weights ◽

Body Energy ◽

Standard Energy

ABSTRACTBody-composition data from 73 non-pregnant, non-lactating cows of five genotypes were used to calculate the composition of empty body-weight change in mature cattle. The composition of empty body-weight change was shown to be dependent on empty body weight, containing more fat and less water, protein and ash at higher empty body weights. There were no differences between the genotypes. Between 300 and 600 kg empty body weight the protein concentration in empty body-weight change ranged from 125 to 40 g/kg, whilst application of standard energy values for fat and protein gave equivalent figures for body energy of 22·5 to 32·7 MJ/kg.

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