Kolnes Kristoffer Jensen, Petersen Maria Houborg, Lien-Iversen Teodor, Højlund Kurt, Jensen Jørgen
Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark.
Front Physiol. 2021 Sep 24;12:737709. doi: 10.3389/fphys.2021.737709. eCollection 2021.
In obesity, excessive abdominal fat, especially the accumulation of visceral adipose tissue (VAT), increases the risk of metabolic disorders, such as type 2 diabetes mellitus (T2DM), cardiovascular disease, and non-alcoholic fatty liver disease. Excessive abdominal fat is associated with adipose tissue dysfunction, leading to systemic low-grade inflammation, fat overflow, ectopic lipid deposition, and reduced insulin sensitivity. Physical activity is recommended for primary prevention and treatment of obesity, T2DM, and related disorders. Achieving a stable reduction in body weight with exercise training alone has not shown promising effects on a population level. Because fat has a high energy content, a large amount of exercise training is required to achieve weight loss. However, even when there is no weight loss, exercise training is an effective method of improving body composition (increased muscle mass and reduced fat) as well as increasing insulin sensitivity and cardiorespiratory fitness. Compared with traditional low-to-moderate-intensity continuous endurance training, high-intensity interval training (HIIT) and sprint interval training (SIT) are more time-efficient as exercise regimens and produce comparable results in reducing total fat mass, as well as improving cardiorespiratory fitness and insulin sensitivity. During high-intensity exercise, carbohydrates are the main source of energy, whereas, with low-intensity exercise, fat becomes the predominant energy source. These observations imply that HIIT and SIT can reduce fat mass during bouts of exercise despite being associated with lower levels of fat oxidation. In this review, we explore the effects of different types of exercise training on energy expenditure and substrate oxidation during physical activity, and discuss the potential effects of exercise training on adipose tissue function and body fat distribution.
在肥胖症中，腹部脂肪过多，尤其是内脏脂肪组织（VAT）的堆积，会增加代谢紊乱的风险，如2型糖尿病（T2DM）、心血管疾病和非酒精性脂肪肝病。腹部脂肪过多与脂肪组织功能障碍有关，会导致全身性低度炎症、脂肪溢出、异位脂质沉积和胰岛素敏感性降低。建议进行体育活动以预防和治疗肥胖症、T2DM及相关疾病。仅通过运动训练实现体重的稳定减轻在人群层面上尚未显示出有前景的效果。由于脂肪含有高热量，需要大量的运动训练才能实现体重减轻。然而，即使没有体重减轻，运动训练也是改善身体成分（增加肌肉量和减少脂肪）以及提高胰岛素敏感性和心肺适能的有效方法。与传统的低至中等强度持续耐力训练相比，高强度间歇训练（HIIT）和冲刺间歇训练（SIT）作为运动方案更省时，并且在减少总脂肪量、提高心肺适能和胰岛素敏感性方面产生类似的效果。在高强度运动期间，碳水化合物是主要能量来源，而在低强度运动时，脂肪成为主要能量来源。这些观察结果表明，尽管HIIT和SIT与较低水平的脂肪氧化相关，但它们仍可在运动期间减少脂肪量。在本综述中，我们探讨了不同类型的运动训练对身体活动期间能量消耗和底物氧化的影响，并讨论了运动训练对脂肪组织功能和身体脂肪分布的潜在影响。
