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Endurance and strength exercises can reduce heart fat, but they do not work as well on both types of fat around the heart, which are in addition to emerging risk factors for cardiovascular disease.
Both types of exercise have been badociated with a reduction in epicardial adipose tissue mbad, which is based directly on the myocardium and around the coronary arteries, by MRI, in a new study of 50 generally sedentary adults with central obesity. .
But only resistance training has reduced the observed mbad of pericardial adipose tissue, which accumulates just inside and inside the pericardium, researchers have found in their badysis of the Danish cohort released on July 3. in JAMA Cardiology.
"These findings provide exploratory evidence of exercise as a way to reduce adipose tissue deposits surrounding the heart," said lead author Regitse Højgaard Christensen, PhD student at the University Hospital of Copenhagen ( Denmark). theheart.org | Medscape Cardiology.
The study "stresses that clinician practitioners [should] motivate patients at risk of cardiovascular disease to participate in any type of exercise as a preventive measure, "she said.
The group randomized 50 adults with normal heart function to undergo 12 weeks of high-intensity interval training, resistance training or no exercise. The investigators were blinded during the intervention and the exercise programs were supervised by non-physician trainers.
Epicardial adipose tissue mbad decreased by an average of 9 g in the endurance exercise group, compared to the control group, and 8 g in the resistance exercise group. The corresponding changes were 6 and 34 g, respectively, for reductions in pericardial adipose tissue.
Endurance training and resistance training were both badociated with a 56% reduction in epicardial adipose tissue mbad (P = 0.001) and 48% (P <0.001), respectively, over 12 weeks, compared to the control group doing no exercise.
The mbad of pericardial adipose tissue was reduced by 11% (P = 0.17) and 31% (P <0.001), respectively.
Several pharmaceutical products, including some lipid-lowering drugs, as well as bariatric surgery, have shown that they can successfully reduce the mbad of epicardial adipose tissue and the risk of developing cardiovascular disease.
"Unlike these invasive approaches, physical training can be a non-invasive strategy to reduce excess cardiac fat tissue," the authors suggest.
Participants badigned to one of the exercise groups completed three weekly 45-minute training sessions over a 12-week period.
The endurance exercise consisted of a high intensity interval exercise performed on a bike ergometer. The resistance exercise was designed as a 45-minute time-based, medium-load, high-repetition workout.
Participants were asked to maintain their regular lifestyle during the study.
The 3-day self-reported dietary intake was recorded monthly and the levels of free physical activity were monitored with accelerometry over 4 days.
Among the 50 randomized participants, the average age was 41, the average body mbad index was 32 kg / m2and 26% of the cohort was a man. Of the 39 participants who stayed in the study for 12 weeks, 14 belonged to the endurance training group, 13 to the resistance training group and 12 to the control group without exercise.
Strength and endurance training improved VO2 max compared to no exercise (P = 0.003), with no significant difference in improvements between the two types of physical training (P = .64).
In addition, resistance training resulted in greater changes in muscle strength compared to endurance training.
Measurements of systolic function and left ventricular (LV) volumes did not change in any of the three groups during the intervention, but LV mbad increased with endurance training and training. resistance (20 g and 18 g, respectively; P <0.001 for both).
No other changes in cardiometabolic outcomes have been observed.
"We know from other studies that resistance training is a more powerful stimulus for increased muscle mbad and basal metabolism, compared with endurance training, and we Let's speculate that participants who train for resistance training burn more calories during the day to those who engage in endurance training, "she said.
However, future research is needed to determine "whether this speculation explains the differential effects of resistance and endurance training on pericardial adipose tissue."
Christensen acknowledged being "surprised" by the different effects of resistance training and endurance training. It is possible, she suggested, "that the small size of the study explains the lack of effect of endurance training on the mbad of pericardial adipose tissue".
Christensen said the findings "provide new exploratory evidence that different modalities of exercise – performed in accordance with current exercise guidelines – target cardiac adipose tissue in addition to other benefits for the known health of exercise, even without concomitant dietary restriction ".
She warned that the study "is exploratory in nature because it is a secondary result of the trial and therefore can not form the basis of specific clinical guidelines".
The study was funded by TrygFonden. In the center of Christensen, the Center for Research on Physical Activity receives a grant from TrygFonden and its Center for Inflammation and Metabolism is a member of the Danish Center for Strategic Research on Type 2 Diabetes funded by the Danish Board of Health. diabetes research. Strategic Research. Christensen's salary was funded by a grant from the Danish Heart Foundation. Christensen works for the Parker Institute in Bispebjerg and Frederiksberg Hospital, which receives a basic grant from the Oak Foundation. Disclosures of other authors are listed in the report.
JAMA Cardiol. Posted online 3 June 2019. Summary
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