Visceral adipose tissue (VAT), the fat surrounding internal organs, is associated with an increased risk of diabetes, cancer, and cardiovascular disease. Reducing body weight, particularly VAT, may reduce the risk of these diseases; however, there are no current recommendations on how best to reduce VAT.
Researchers from the US and Canada systematically searched the literature for randomized controlled trials that compared placebo controls to monitored exercise versus FDA-approved drug therapy to reduce VAT. Changes in VAT were measured by magnetic resonance imaging (MRI) or computerized tomography (CT) scans over a 6-month period.
Of 2,515 titles and abstracts reviewed, the authors selected and pooled results for 3,602 patients from 17 randomized controlled trials. About 65% of those enrolled in the exercise trials were women with a mean age of 54 and a mean BMI of 31 (obese). The drug therapy trials were more evenly split amongst men and women (53% women) and enrolled slightly younger and more obese people (mean age of 51; mean BMI of 34).
Compared with controls, both exercise and drug therapy were associated with significant reductions in VAT, with greater reductions seen with exercise. For example, in order to lose 3 cm2 in VAT, you would need to lose 18kg of weight with medication versus only 14kg with exercise.
In an interview, Dr. Ian Neeland, senior author, explains this finding as follows:
The location and type of fat is important. If you just measure weight or BMI, you can underestimate the benefit to your health of losing weight…exercise can actually melt visceral fat.
Rao, S., Pandey, A., Garg, S., Park, B., Mayo, H., Després, J. P., … & Neeland, I. J. (2019, February). Effect of Exercise and Pharmacological Interventions on Visceral Adiposity: A Systematic Review and Meta-analysis of Long-term Randomized Controlled Trials. In Mayo Clinic Proceedings(Vol. 94, No. 2, pp. 211-224). Elsevier.
Photo by Matthew LeJune on Unsplash.
