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 Each type of exercise and a combination of the two produced 9
percent reductions in body weight over six months. But the
combination provided the best mix of protection against muscle and
bone loss with improved aerobic capacity.
Aerobic exercise and weight training, also known as resistance
training, "have additive effects in improving your physical
function," chief author Dr. Dennis Villareal of the Baylor College
of Medicine and the DeBakey VA Medical Center in Houston told
Reuters Health by phone. "Overall the patient feels it, and we were
able to document that objectively."
The findings in the New England Journal of Medicine have broad
significance because one third of older adults in the United States
are obese, with all the health risks that come with being very
overweight. Yet there is concern that weight loss might make them
even more frail because bone and muscle might be lost as well.
The results suggest that fear is unfounded.
One hundred sixty volunteers from New Mexico with a body-mass index
of 30 or higher, putting them in the obese category, and no history
of regular exercise were enrolled in the study. Of this group, 141
participants, mostly white well-educated women, completed it. To
assess physical performance, the Villareal team used a 37-point
scale, where higher numbers indicated better physical performance.
The volunteers who participated in 60-minute aerobic or weight
training sessions three times a week for six months showed increases
in performance of 14 percent, improving by 3.9 points on that
37-point scale.
The volunteers who got both aerobic and strength training in longer
sessions that lasted 75 to 90 minutes showed an improvement of 5.5
points, or 21 percent.
"In essence, the combined group exercised more than the aerobic
group alone and the resistance group alone," said Dr. Felipe Lobelo
of the Emory University - Rollins School of Public Health in
Atlanta, who was not involved in the study. "So in terms of the
volume of energy expenditure, that group did more. So to me it's not
surprising to me that they got more benefits."
But Villareal said there was concern that the two types of exercise,
if combined in a single session, might interfere with each other so
the exercise time in the combined group was longer.
"Otherwise they will be doing less resistance and less aerobic as
compared to the resistance group and the aerobic group," he said.
"That's not a fair comparison."
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"I think the 'interference' between endurance training and strength
training found in some laboratory-based training studies has been
overblown," said Dr. Benjamin Levine, director of the Institute for
Exercise and Environmental Medicine in Dallas, which is partly run
by the University of Texas Southwestern Medical Center.
"Virtually every competitive athlete knows that the best outcome
comes from a combination of strength, endurance and technical
training," Levine, who was not involved in the study, wrote in an
email. "I am not sure why the investigators tried to combine them on
the same day, but this study shows that - depending on patient
preference and logistics - combining them is not detrimental."
Not surprisingly, some of the exercisers had some adverse events
such as shoulder, knee, hip or back pain. One person in the aerobic
group fell, receiving hand and forehead scrapes.
Levine said the study, known as LITOE, "highlights a common
misperception about obese individuals - although these patients were
considered 'frail,' their overall cardiorespiratory capacity was
actually remarkably normal, which is common in obese individuals who
have to carry around a lot of weight in their daily lives."
He added, "I look forward to seeing the follow up on these patients
to learn how they do over the long term, since six months is a short
time and fitness/strength/vitality is a lifelong process.”
"How easy it is going to be to replicate this in real life is still
unknown," Lobelo said. "The next studies will have to tease out
whether you can get people to do this in a real-life scenario."
SOURCE: http://bit.ly/2qepy1a New England Journal of Medicine,
online May 17, 2017.
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