비만한 중년 남성에서 열량제한과 운동을 통한 체중 감소의 효과

Abstract

Background: With abdominal obesity being recognized as an important risk factor of metabolic disease and atherosclerosis, it is important to determine the optimal weight loss program for decreasing this risk. The goal of this study was to determine beneficial health effects of modest weight loss with low calorie diet and exercise in middle-aged overweight Korean men. Method: Sixteen overweight men aged 40-49 years participated in a 3-month weight- management program. The diet and exercise program reduced daily energy intake by 300-400 kcal from daily energy need and expended about 100 kcal in walking and other light exercise. Compliance with the diet and exercise protocol was monitored through 7-day records of diet and physical activity maintained by subjects monthly. Adipose tissue and muscle areas were calculated from computerized tomography scans at 3 body levels, Ll, IA and mid portion of thigh before and after weight loss. Anthropometries, serum levels of lipids and hormones and response areas of glucose, C-peptide, insulin and free fatty acid during oral glucose tolerance test (OGTT) were determined. Result: After 3 months of diet and exercise, body weight fell an average of 4.9 kg (6.3%) and waist circumference reduced an average of Scm. Modest weight loss appeared to decrease blood pressure in overweight males. Although weight loss did not show any significant differences in thigh muscle and femoral subcutaneous fat areas, there was about 20% reduction in visceral, subcutaneous and total fat areas of Ll and L4 levels after weight loss. Mean values of serum total cholesterol, even though within normal range before weight loss, decreased significantly after weight loss. Serum triglyceride concentration fell from 192 to 143 mg/dL in association the loss of weight. Modest weight loss showed a 30% decrease in fasting insulin and response areas of insulin during OGTT. There was a 16% but not significant decrease in the response area of free fatty acid during OGTT after weight reduction. Conclusion: The result suggests that modest weight reduction with diet and exercise can show a rapid decrease in abdominal fat without muscle loss, compared with in femoral fat. Modest weight loss about 6% of initial weight can be viable apprach to help decrease serum lipids and hyperinsulinemia and improve insulin responsiveness to glucose challenge.