Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Obesity (Silver Spring). 2009 Dec;17 Suppl 3(0 3):S27-33. doi: 10.1038/oby.2009.385.
The obese are at increased risk for cardiovascular disease and type 2 diabetes. However, some who are obese have no metabolic abnormalities. So, it is not adipose tissue per se, but perhaps where it is located that is important for determining metabolic consequences. Regular exercise is known to reduce risk for metabolic disease through numerous mechanisms. The purpose of this report is to highlight some of the efficacy-based data on the effects of exercise (and also a sedentary lifestyle) on abdominal obesity, visceral fat, and metabolic risk. We also discuss how impaired fatty acid oxidation (FAO) in skeletal muscle may be related to both insulin resistance and a contributor to weight gain. In summary, it is evident that exercise in sufficient amounts can lead to substantial decreases in body weight, total body fat, and visceral fat. Additionally, evidence now supports the conclusion that there is a dose-response relationship between exercise amount and these changes, i.e., more exercise leads to additional benefits. Additionally, there are a number of important cardiometabolic risk factors that were most favorably effected by moderate-intensity compared to vigorous-intensity exercise. Unfortunately, it is also apparent that in sedentary middle-aged men and women, short periods of physical inactivity lead to significant weight gain, substantial increases in visceral fat, and further metabolic deterioration. Finally, favorable modulation of mitochondrial oxidative capacity in skeletal muscle by exercise training may reduce a block for complete oxidation of fatty acids in muscle and thereby relieve a block to effective insulin signaling.
肥胖者患心血管疾病和 2 型糖尿病的风险增加。然而，有些肥胖者没有代谢异常。因此，重要的不是脂肪组织本身，而是它所在的位置，这对确定代谢后果很重要。众所周知，有规律的运动通过多种机制降低代谢疾病的风险。本报告的目的是强调一些关于运动（以及久坐的生活方式）对腹部肥胖、内脏脂肪和代谢风险的影响的基于疗效的数据。我们还讨论了骨骼肌中脂肪酸氧化（FAO）受损如何与胰岛素抵抗和体重增加有关。总之，很明显，适量的运动可以导致体重、全身脂肪和内脏脂肪的大量减少。此外，现在有证据支持运动量与这些变化之间存在剂量反应关系，即运动越多，益处就越多。此外，还有许多重要的心血管代谢风险因素，其中中等强度运动比剧烈强度运动更有利于降低这些风险因素。不幸的是，很明显，在久坐的中年男性和女性中，短暂的身体不活动会导致体重显著增加，内脏脂肪大量增加，以及进一步的代谢恶化。最后，运动训练对骨骼肌线粒体氧化能力的有利调节可能会减少脂肪酸在肌肉中完全氧化的障碍，从而缓解有效的胰岛素信号传递的障碍。
