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Maximum Wellness, Episode 10: Aerobic and Resistance Exercise Selectively Reduce High Risk Cardiac Fat

Cardiovascular disease (CVD) — in many instances associated with lifestyle-modifiable risk factors — is the leading cause of death worldwide. One such risk factor is the accrual of excess visceral (fat stored within the abdominal cavity) fat — accelerating a risk to type 2 diabetes, when waist measurements in men and women exceed 40 and 35 inches, respectively — going in the fourth decade of life.

Excessive cardiac adipose (fat) tissue — which consists of two separate fat reservoirs (epicardial and pericardial) — is also considered to be a CVD risk. Epicardial fat is visceral fat located between the heart and the pericardium, which is a two-layer, sac-like tissue that surrounds the heart — holding it in place. Pericardial fat is fatty tissue that surrounds the heart.

Researchers from the University of Copenhagen and Southern Denmark comment in Effect of Aerobic and Resistance Exercise on Cardiac Tissue — appearing in June 2019 online in JAMA (Journal of the American Medical Association) Cardiology — that research supports the fact that exercise targets visceral adipose tissue and lowers CVD risk.

As a result, they “hypothesized that both endurance and resistance training would reduce epicardial and pericardial fat compared with an inactive control group.” Using data from a large randomized exercise intervention clinical trial — Exercise-induced Changes in Visceral Adipose Tissue Mass Are Regulated by IL-6 Signaling: a randomized Controlled Trial — performed between August 2016 to April 2018, fifty individuals with abdominal obesity participated.

The participants were randomized to participate in either three weekly forty-five minute sessions of supervised high-intensity interval endurance training, resistance training, or no exercise (the control group).

The endurance exercise was composed of high-intensity intervals performed on an ergometer bicycle, while those in the resistance exercise group performed 3 to 5 sets of each exercise at sixty percent of their one repetition maximum — which increased to eighty percent over the twelve weeks.

The researchers used magnetic resonance imaging (MRI) to access changes in epicardial and pericardial adipose tissue mass.

The clinicians concluded that, “in individuals with abdominal obesity, both endurance and resistance training reduced epicardial adipose tissue mass, while only resistance training reduced pericardial adipose tissue mass. These data highlight the potential preventive importance of different exercise modalities, as means to reduce cardiac fat in individuals with abdominal obesity.”

The researchers, however, commented that it would have been nice to combine the two exercise modalities, “which would have been interesting to reveal their potential additive effects.”

Having 40 years of experience with hospital-affiliated weight management and wellness programs, which combined both interval training with circuit (ten exercises) resistance training, we saw firsthand — using DXA scans for body composition determination at baseline, six, and twelve-week intervals, just how effective the compound approach was in reducing both total and visceral fat in our male and female participants.

Remember, you should always consult your physician before beginning any exercise, diet, or nutritional supplementation program.