PLoS One. 2015 Jul 15;10(7):e0132959.

Associations of Low-Intensity Resistance Training with Body Composition and Lipid Profile in Obese Patients with Type 2 Diabetes.

 

Hamasaki H1, Kawashima Y2, Tamada Y3, Furuta M4, Katsuyama H2, Sako A2, Yanai H2.
  • 1Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan; General Internal Medicine, Community Healthcare Studies, Jichi Medical University Graduate School, Tochigi, Japan.
  • 2Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan.
  • 3Department of Rehabilitation, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan.
  • 4Department of Nutrition, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan.

 

Abstract

Resistance training to increase muscle mass and functional capacity is an integral part of diet and exercise programs for the management of obesity and type 2 diabetes. Low-intensity resistance training with slow movement and tonic force generation (LST) may be a practical and safe regimen for elderly obese individuals but the health benefits are uncertain. This study investigated the effects of LST on body composition and metabolic parameters in obese patients with type 2 diabetes. Twenty-six obese patients with type 2 diabetes engaged in LST training during hospitalization and were advised to maintain this regimen for 12 weeks after discharge. We compared lipid profile, arterial stiffness, and body composition before and after LST training. After 12 weeks of LST training, the ratio of lower extremity muscle mass to body weight increased significantly (0.176 ± 0.028 to 0.184 ± 0.023, mean ± SD), while body fat mass and body fat percentage decreased significantly (36.2 ± 10.9 kg to 34.3 ± 9.4 kg and 41.2 ± 8.6% to 40.1 ± 7.7%, respectively). Moreover, high-density lipoprotein cholesterol was significantly increased (42.2 ± 14 mg/dl to 46.3 ± 12.4 mg/dl) and both free fatty acids and lipoprotein(a) were decreased (665.2 ± 212.1 μEq/l to 525.4 ± 231.3 μEq/l and 15.4 ± 18 mg/dl to 13.8 ± 18 mg/dl, respectively). No significant change was observed in arterial stiffness. Although this study was a non-controlled investigation and some confounding factors including dietary intake, medication and compliance with training might affect the study result, a brief (12-week) LST training program may be a safe and effective strategy for the management of obesity and type 2 diabetes.

PMID: 26176700

 

Supplementary

The pandemic of obesity and type 2 diabetes is major health problem. There is strong evidence that moderate-to-vigorous intensity resistance training is beneficial for treating patients with obesity and type 2 diabetes, however such patients usually have low physical fitness and suffer from complications and comorbidities which cause physical disability. Little evidence is available regarding the optimal intensity of resistance training for obese patients with type 2 diabetes. Low-intensity resistance exercise with slow movement and tonic force generation (LST) is effective for gaining muscle size and strength without a considerable physical burden (1). This low-intensity training can be safely performed by obese patients with type 2 diabetes, especially the elderly. We hypothesized that poor lower extremity physical performance was associated with cardiovascular disease risk factors (2), and prescribed LST training for lower extremity (vertical half-squat exercise) for 12 weeks. The results suggest that LST training of the lower extremities was effective to improve body composition and lipid profile in obese patients with type 2 diabetes (Figure 1). Moreover, LST training may be suitable for the management of sarcopenic obesity. Sarcopenia is an age-related condition characterized by loss of skeletal muscle mass and decreased muscle strength (3). The prevalence of obesity increases in elderly people with sarcopenia. Such sarcopenic obesity increases the risks for disability and mortality (4). In the present study, the elder patients (two 67-year-old women, a 68-year-old man and a 75-year-old woman) were able to perform the exercise program completely, without injury. We propose that LST training could be a good strategy for the management of obesity, type 2 diabetes and sarcopenia.

 

HH fig1

Fig 1. After 12-week LST training, the ratio of lower extremity muscle mass to body weight increased, body fat mass decreased, and lipid profile (HDL-C, high-density lipoprotein-cholesterol; FFA, free fatty acid; Lp(a), lipoprotein(a)) was improved.

 

References

  1. Tanimoto M, Ishii N. (2006) Effects of low-intensity resistance exercise with slow movement and tonic force generation on muscular function in young men. J Appl Physiol (1985) 100: 1150-1157.
  2. Hamasaki H, Kawashima Y, Adachi H, Moriyama S, Katsuyama H, Sako A, Yanai H. (2015) Associations between lower extremity muscle mass and metabolic parameters related to obesity in Japanese obese patients with type 2 diabetes. PeerJ 3: e942.
  3. Evans WJ. (1995) What is sarcopenia? J Gerontol A Biol Sci Med Sci 50: 5-8.
  4. Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V. (2008) Sarcopenic obesity: a new category of obesity in the elderly. Nutr Metab Cardiovasc Dis 18: 388-95.

 

 

 

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