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Regular use of glucosamine, chondroitin, or fish oil supplements reduces high-sensitivity C-reactive protein (hs-CRP) by 16% to 22%, a marker of inflammation, according to a new study. Inflammation is now recognized as a factor in cancer and cardiovascular disease as well as many rheumatoid diseases. A number of over-the-counter dietary supplements are being marketed for the purpose of reducing inflammation, but data supporting the claims are limited.
To address this situation, Elizabeth D. Kantor, from the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, and colleagues analyzed data on dietary supplements and hs-CRP in 9947 participants in the National Health and Nutrition Examination Survey. In their article, published online November 8 in the American Journal of Epidemiology, the researchers report that regular use of glucosamine, chondroitin, or fish oil significantly reduced serum hs-CRP.
In participants who regularly used a supplement, the researchers found hs-CRP reductions of 17% (95% confidence interval [CI], 7% - 26%) with glucosamine, 22% (95% CI, 8% - 33%) with chondroitin, and 16% (95% CI, 0.3% - 29%) with fish oil compared with participants who did not take the supplements. The analyses were adjusted for age, gender, race, smoking history, and body mass index.
Effects Limited to Women
Kantor, who is a PhD candidate at the research center, told Medscape Medical News, "I was not particularly surprised by any of our findings. Our observation of an association between fish oil use and CRP supports recent randomized control trials which have shown fish oil to reduce CRP. Our observation of an association between use of glucosamine and chondroitin supplements and CRP aligns with laboratory studies which suggest that these supplements have anti-inflammatory properties. Further understanding these associations (and whether associations vary by gender) is an important step in evaluating the chemopreventive potential of these supplements."
The anti-inflammatory effects of glucosamine and chondroitin in the overall study population were driven by effects in women, who had hs-CRP reductions of 27% (ratio, 0.73; 95% CI, 0.61 - 0.88) with regular glucosamine use and 33% (ratio, 0.67; 95% CI, 0.53 - 0.84) with regular chondroitin use. Effects in men were small and nonsignificant.
The supplements methylsulfonylmethane, garlic, ginkgo biloba, saw palmetto, and pycnogenol were not associated with reduced inflammation.
The magnitude of the effect seen with the supplements is "comparable to what we and others have observed for the association between statin use and CRP," the authors write. "Our results suggest a biologic mechanism to substantiate the epidemiologic observation of an association between glucosamine and chondroitin use and reduced risk of chronic diseases."
However, not everyone is convinced by the data. Although Eric L. Matteson, MD, chair of the Department of Rheumatology at the Mayo Clinic in Rochester, Minnesota, does sometimes discuss use of fish oil supplements with his patients with arthritis, he told Medscape Medical News that he has some reservations about the clinical implications of the Kantor study.
"Data Interesting but Not Compelling"
"I find the data interesting but not compelling," Dr. Matteson said. "The hs-CRP is influenced by many factors, and it is not clear that even the very many adjustments for potentially interacting or confounding variables are able to permit a conclusion that it is in fact the putative exposure [to glucosamine, chondroitin, or ginseng] which leads to the lower hs-CRP. A direct interventional study would be needed to do that. People who take supplements may be otherwise more heath conscious than those who don't, which also could be contributing to the results."
Dr. Matteson added, "It is further not clear that the very low levels of inflammation suggested by the hs-CRP are relevant in arthritis. We don't use this test clinically to evaluate arthritis because it is too sensitive and too influenced by a host of other factors. This is why we only use the regular CRP for assessing inflammation in diseases like RA. It should be expected that use of these supplements would slow the development of [osteoarthritis], but there is no solid proof of this, so the relevance of the CRP reductions with respect to [osteoarthritis] is questionable."
Kantor, however, contends that the findings are clinically important. "We became interested in this area of research after observing that use of glucosamine, chondroitin, and fish oil supplements were associated with reduced risk of chronic diseases with which inflammation had been implicated. Our current study provides a plausible biologic mechanism by which these supplements may reduce risk of these diseases. The fact that these supplements have already been associated with the clinically relevant outcome provides potential clinical significance to these findings. However, further research is needed to better understand these associations and the potential clinical significance of these findings."
The study was supported by the US National Cancer Institute. The study authors and Dr. Matteson have disclosed no relevant financial relationships.
Am J Epidemiol. Published online November 8, 2012. Abstract
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The optimal workout is highly efficient, involves circuit and interval training, and focuses on compound exercises.
People have different levels of fitness, goals, physical or medical limitations, amounts of time available for training, and preferences for types of exercise. Workouts should be tailored for your specified goals, needs, and desires. Workouts should be continuously restructured and advanced to take your fitness to a new level.
Circuit and Interval Training
For most people circuit and interval training are the most effective and efficient methods of training.
These types of workouts will permit you to work out constantly through your entire training session at varying levels of intensity
Interval training is a type of physical training that involves a series of low- to high-intensity exercise workouts. The high-intensity periods are typically at or close to anaerobic exercise, while the recovery periods may involve activity of lower intensity aerobic.
Circuit training is a method of physical conditioning in which one moves from one exercise to another, with minimal rest, usually in a series of different stations or pieces of equipment that involve different body parts. An elevated heart rate should be maintained throughout the workout in order to provide for cardiovascular conditioning.
Compound exercises in weight training are those that involve more than one joint and muscle group.
Examples are squats, deadlifts, lunges, presses, and chin-ups. For example, the squat involves the joints of the knee, hip and ankle, and the muscles of the upper and lower legs and buttocks.
To optimize the benefit of the time that you spend in the gym, you should be exercising almost constantly, but at varying levels of intensity and with varying muscle groups.
Your heart should be maintained in a cardiovascular training range throughout the work out while the client continues to do exercises.
These techniques not only burn calories, build muscle, and increase metabolism, but in addition they will improve lactic acid threshold and allow you to work at a high level of intensity for longer periods of time.
This type of workout will also improve your cardiovascular endurance.
They also give the added benefit of an after-burn effect which last for over 48 hour after exercise.
The “afterburn effect,” also called “excess post-exercise oxygen consumption” or EPOC, refers to the correlation between the number of calories burned post-exercise and the activity’s intensity. The afterburn effect only occurs with high intensity anaerobic exercise. The more intense the exercise, the more oxygen the body consumes afterward, meaning a higher sustained metabolic rate and thus more calories burned after the activity.
Anaerobic exercise is exercise intense enough to trigger anaerobic metabolism. It is used by athletes in non-endurance sports to promote strength, speed and power and by body builders to build muscle mass. Muscle energy systems trained using anaerobic exercise develop differently compared to aerobic exercise, leading to greater performance in short duration, high intensity activities, which last from mere seconds up to about 2 minutes.[1][2]Any activity lasting longer than about two minutes has a large aerobic metabolic component. (Wikipedia, the free encyclopedia)
Within 6 weeks you should begin to see results.
1. The first benefit that most people report is an increase in energy and stamina.
2. Weight loss and increase lean mass: your body should appear more "toned" (leaner and more defined.)
Instead of seeing an undefined arm you will begin to see a separation of muscles: the deltoids, the biceps and triceps. As your percentage of body fat decreases and your core muscles develop, you will begin to notice your abs and obliques where previously all you could see was belly fat. Your glutes, thighs, and calves will also begin to take shape.
3. Increase strength, muscle endurance, gain muscle mass, improve stamina & cardiovascular conditioning.
4. Improvement in athletic performance and overall functioning: speed, power, and agility. As your strength increases and weight decreases, your speed and quickness and agility will drastically increase.
Training programs should not be merely designed to burn calories like walking on a treadmill.
Programs should be designed to transform your body to make you lean while increasing your metabolism.
You need to increase your lean muscle mass, convert fat to muscle, and thereby increasing your basal metabolic rate, which is the rate your body burns calories at rest, or also called your metabolism.
Working out should increase your muscular strength and endurance and cardiovascular capacity making it much easier and enjoyable to exercise and burn calories.
As long as you can maintain the lean muscle mass that you gain, your metabolism will continue at a higher rate and you will not gain weight when you go on vacation or stray from your diet.
You can burn calories by taking a walk in the park. You can go on a crash diet. However, these methods of weight loss will have no major positive effect on your metabolism, and at the end of the day, when you go on vacation, or go back to your normal eating habits, the few pounds that you lost will come back plus some. These methods of weight loss do not increase your lean muscle mass and therefore do not increase your basal metabolic rate. This is why yo-yo dieting and sporadic aerobic exercise does not work.
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Most people who are interested in personal training have at least one of the following common fitness goals:
1. Weight loss or a decrease in body fat percentage. (improvement in body composition)
2. Increase in muscular definition or muscle tone or in muscle mass.
3. Improvement in performance including increased strength, speed, endurance, quickness, or athletic performance.
4. Improvement in health including decrease in cardiac risk factors such as cholesterol, high blood pressure, diabetes, and obesity. Also improvement in bone health; decrease in risk for osteopenia and osteoporosis.
5. Increase in energy.
6. Improvement in function after injuries. (post-rehabilitation)
7. Improvement in daily function and maintenance of independent living.
This is particularly important for elderly. Includes improvement in stability, strength, agility and flexibility.
Before Getting Started
You should discuss your current level of fitness, health, experience, goals and personal preferences with your personal trainer.
Then you should have a preliminary fitness assessment including blood pressure, weight, body fat analysis, and medical history.
Based on the your preliminary fitness assessment, health, experience, goals and personal preferences your trainer will design an individualized training program that will effectively, efficiently and safely allow you to reach your goals.
During your training sessions your trainer will not only coach and motivate you, but he will continuously assess your performance on an ongoing basis and modifies the training program accordingly.
The Metamorphosis
In six weeks you should see remarkable changes in your body, your physical capacity, and energy.
In another two to six months most of you should reach your goals.
This will take longer if you are severely overweight and your goal is to lose 50 lbs or more or if your goal is to make enormous gains in muscle mass.
The reason for these seemingly quick results is that the human body is highly adaptable. If you do not exercise, your body adapts to your sedentary lifestyle, your metabolism decreases, and the body stores calories as adipose.
If you use your muscles against resistance, your muscles, bones, and tendons adapt by becoming stronger, your muscles become more defined, and your adipose will turn to lean body mass or disappear.
If you exert your cardiovascular system, your cardiovascular capacity will increase, your peripheral vascular resistance and blood pressure will decrease, and your heart will become stronger and more efficient.
As you expend more energy exercising, your energy, stamina, and metabolism will increase to accommodate.
You would benefit from a personal trainer if you are in one of the following groups:
•A sedentary young, middle aged or elderly individual who wants to improve his or her energy, appearance, physical capacity, or health.
•A person including a competitive athlete who wants to increase his or her speed, strength, or athletic performance.
•An elderly adult who wants to improve his or her stability, strength, health and functional capacity.
•A person of any age who wants to build a lean, muscular, and fabulous body.
•A person who is training on his own and not seeing results.
•A person with special needs such as post- rehab, problems with stability or posture, recurrent injuries, back pain, a specific weakness, high level of stress, medical problems like high cholesterol, high blood pressure, diabetes, or morbid obesity, anxiety or depression, or post-bariatric surgery.
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Most people who are interested in personal training have at least one of the following common fitness goals:
1. Weight loss or a decrease in body fat percentage. (improvement in body composition)
2. Increase in muscular definition or muscle tone or in muscle mass.
3. Improvement in performance including increased strength, speed, endurance, quickness, or athletic performance.
4. Improvement in health including decrease in cardiac risk factors such as cholesterol, high blood pressure, diabetes, and obesity. Also improvement in bone health; decrease in risk for osteopenia and osteoporosis.
5. Increase in energy.
6. Improvement in function after injuries. (post-rehabilitation)
7. Improvement in daily function and maintenance of independent living.
This is particularly important for elderly. Includes improvement in stability, strength, agility and flexibility.
Before Getting Started
You should discuss your current level of fitness, health, experience, goals and personal preferences with your personal trainer.
Then you should have a preliminary fitness assessment including blood pressure, weight, body fat analysis, and medical history.
Based on the your preliminary fitness assessment, health, experience, goals and personal preferences your trainer will design an individualized training program that will effectively, efficiently and safely allow you to reach your goals.
During your training sessions your trainer will not only coach and motivate you, but he will continuously assess your performance on an ongoing basis and modifies the training program accordingly.
The Metamorphosis
In six weeks you should see remarkable changes in your body, your physical capacity, and energy.
In another two to six months most of you should reach your goals.
This will take longer if you are severely overweight and your goal is to lose 50 lbs or more or if your goal is to make enormous gains in muscle mass.
The reason for these seemingly quick results is that the human body is highly adaptable. If you do not exercise, your body adapts to your sedentary lifestyle, your metabolism decreases, and the body stores calories as adipose.
If you use your muscles against resistance, your muscles, bones, and tendons adapt by becoming stronger, your muscles become more defined, and your adipose will turn to lean body mass or disappear.
If you exert your cardiovascular system, your cardiovascular capacity will increase, your peripheral vascular resistance and blood pressure will decrease, and your heart will become stronger and more efficient.
As you expend more energy exercising, your energy, stamina, and metabolism will increase to accommodate.
You would benefit from a personal trainer if you are in one of the following groups:
•A sedentary young, middle aged or elderly individual who wants to improve his or her energy, appearance, physical capacity, or health.
•A person including a competitive athlete who wants to increase his or her speed, strength, or athletic performance.
•An elderly adult who wants to improve his or her stability, strength, health and functional capacity.
•A person of any age who wants to build a lean, muscular, and fabulous body.
•A person who is training on his own and not seeing results.
•A person with special needs such as post- rehab, problems with stability or posture, recurrent injuries, back pain, a specific weakness, high level of stress, medical problems like high cholesterol, high blood pressure, diabetes, or morbid obesity, anxiety or depression, or post-bariatric surgery.
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Exercise Gains Momentum as Psychiatric Treatment
Nancy A. Melville
Nov 16, 2012 Authors & Disclosures
SAN DIEGO, California – The benefits of exercise in nearly every aspect of physical health are well known, but evidence in recent years suggests a unique effect on some psychiatric disorders, prompting mental health clinicians to rethink treatment strategies and to consider the possibility of exercise not just in therapy but as therapy.
"Above and beyond the standard benefits of exercise in healthy living and general well-being, there is strong evidence demonstrating the ability of exercise to in fact treat mental illness and have significant benefits on a neurotrophic, neurobiologic basis," Douglas Noordsy, MD, told delegates attending Psych Congress 2012: US Psychiatric and Mental Health Congress.
Some of the strongest evidence is seen in depression, where psychiatric benefits from exercise have been shown in some cases to match those achieved with pharmacologic interventions and to persist to prevent remission in the long term.
Dr. Noordsy referenced a study from researchers at Duke University in which 156 patients with major depressive disorder (MDD) were randomly assigned either to aerobic exercise, sertraline therapy (50 mg to 200 mg), or both for 4 months.
The difference in remission rates in the exercise and selective serotonin reuptake inhibitor (SSRI) groups after 4 months were not significant – 60% and 69%, respectively, but at a 10-month follow-up, the exercise group showed a significantly lower relapse rate ( P = .01) (Psychosom Med 2000;62:633-638).
"The patients who were independently exercising on their own after the treatment period had half the odds for meeting the depression criteria 6 months later compared to patients who didn't exercise after the 4-month study," said Dr. Noordsy, an associate professor and director of psychosis services at the Geisel School of Medicine at Dartmouth College, in Hanover, New Hampshire.
A similar study from the same group of researchers 10 years later in a larger sample involving 202 patients assigned to supervised exercise, sertraline therapy (50 mg to 200 mg) or placebo showed remission rates of 46% at 4 months and 66% at the 16-month follow-up across both treatment groups, with no significant greater improvement with SSRIs compared with exercise in predicting MDD remission at 1 year ( Psychosom Med 2011 Feb-Mar;73:127-33; epub 2010 Dec 10).
Other studies have shown equally impressive results in exercise for a variety of populations, including pregnant women with depression, who have a high interest in avoiding medications, people with HIV, and even patients with heart failure, who showed not only a significant reduction in depression related to exercise but also reduced mortality ( Am J Cardiol2011;107:64-68).
Anxiety
The evidence in relation to anxiety, although not as strong, still suggests a benefit, and the rigors of a cardiovascular workout seem particularly suited to addressing the physiologic effects associated with anxiety, Dr. Noordsy said.
"We know that with anxiety, the heart rate goes up, you start breathing fast, and it kind of snowballs with more anxiety, and that can trigger a panic attack," he explained.
"So one of the important positive effects of physical exercise is it allows people to become conditioned to having their heart rate and respiratory rate increase when they're not associated with anxiety, thereby addressing the triggers."
Evidence is somewhat lacking in the area of bipolar disorder, but patients often have symptoms similar enough to depression to suggest a benefit, Dr. Noordsy said.
"The evidence on depression in bipolar disorder is strong enough that I certainly feel comfortable in talking about exercise as part of [bipolar patients'] management."
In terms of more serious psychotic disorders such as schizophrenia, evidence is limited on benefits of exercise for the core symptoms of psychosis or cognition. However, several studies have shown improvement in comorbidities and metabolic issues related to antipsychotics that such patients commonly face.
One study of a jogging intervention among 80 inpatients with chronic schizophrenia, in which 40 patients jogged for 40 minutes 3 times a week, depression, anxiety, phobia, and obsessive-compulsive behaviors declined significantly compared with 40 inpatient control participants who were inactive and showed no improvement.
Dementia Prevention
The evidence on the benefits of exercise in cognitive function disorders, such as dementia and Alzheimer's disease, is much more extensive, with as many as 8 strong studies on dementia alone in the last 3 years showing improvements with activities such as walking and strength training on memory and executive function.
Dr. Noordsy noted one particularly remarkable study in which researchers compared patients with and without the ApoE gene, which is linked strongly to late-onset Alzheimer's disease.
In the study, patients who were ApoE-negative showed similarly low mean cortical binding potential, related to plaque buildup in the brain, regardless of whether they exercised or not.
But although ApoE-positive individuals (n = 39) had values that were substantially higher, the ApoE-positive patients who exercised (n = 13) had values similar to those who did not carry the gene ( Arch Neurol 2012;69:636-643).
"You could look at these results and rightfully say physical exercise neutralizes your risk for developing Alzheimer's disease if you're ApoE positive," Dr. Noordsy said.
How to Get Patients Moving
Perhaps the biggest caveat with all mental health conditions is how to motivate patients who are struggling with psychiatric disorders to exercise.
Dr. Noordsy offered some key suggestions:
· Start with an assessment: "I start with an assessment of lifetime history of activity and current activity in my baseline assessment template," Dr. Noordsy said. "I educate the patient on the potential effects of exercise on their disorder and how it fits on the menu of other treatment options."
· Make clear recommendations: "There is a lot of evidence in areas such as smoking cessation and in the addiction literature showing that a substantial subset of people will respond to very clear recommendations," he said.
· Offer motivational tools: A behavioral planner, for instance, that allows for goal setting, or connecting a patient with an exercise group can be helpful.
· Consider the patient's current activity capacity in recommending a regimen: "The general amount of exercise believed to result in a benefit is about 30 to 60 minutes per day, between 3 and 7 days per week." Some studies have shown strength training to be as beneficial as aerobic activity. For the latter, Dr. Noordsy suggested that one easy method often used in determining maximum heart rate, in general, for people without heart disease or other conditions is to simply subtract their age from 220.
· Help the patient find an activity that works best for them, rather than recommending anything specific, Dr. Noordsy suggested. "Have the patient choose the activity that is right for them."
· Help guide the patient to educational resources, such as information sources or books. "The book I've used the most with patients is John Ratey's Spark: The Revolutionary New Science of Exercise and the Brain," Dr. Noordsy recommended. "The book is very scientific and accessible to a lay audience," he said.
Importantly, discussing the role of exercise in the context of human evolution might be a more effective approach with patients than the standard recommendation to get some exercise.
"Instead of 'this is something you ought to be doing,' we might instead say, 'this is something humans are designed to do, and when we don't do it, our bodies and brains fall apart'."
Another important component in helping patients benefit from exercise is simply to improve awareness among clinicians, Dr. Noordsy added.
"We see evidence on the benefits of exercise for psychiatric conditions coming together, and there is a need to increase awareness of this among clinicians as well as reinforce the research community to be taking a more careful look at physical exercise," he said.
"This may not have as much of an industrial backing as some of the other interventions we use, but I think it's quite exciting."
Psych Congress 2012: US Psychiatric and Mental Health Congress. Presented November 9, 2012.
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Quickest Way to Lose Weight for Those Stressful Corporate and Business Professionals
by Lisa Huttons
As a very busy business professional, everyone is generally in a hurry; progressing from scheduled appointment to scheduled appointment and also hurrying deadline following deadline. For many individuals, getting some exercise is the very least of our fears. The truth is, most of us are simply way too completely maxed following a incredibly long work day to allow them to trudge our way to a fitness center to get a reasonable work out. For individuals that do make it to a health club, very like they will not be totally maximizing their own exercise time by simply engaging in the routines that make any difference.
So in the following paragraphs, I am going to demonstrate the quickest way to lose weight in order to get the most optimum results within the least amount of time.
Exercises tend to be typically grouped into 2 types: isolation and compound.
Isolation exercises:
Much like the term implies, isolation exercises are individual joint workouts that isolate an individual body part. Types of isolation exercises can be triceps extension, bicep curls, leg extension and also lateral shoulder raises.
Compound exercises:
These are generally multi-joint exercises that works a number of muscle groups simultaneously. Examples of compound exercises would be bent over rows, bench press, pushups, squats, dips, pull ups not to mention dead lifts.
Should your purpose is to burn fat as well as burn unhealthy calories, then the quickest way to lose weight and also entirely improve your exercise routine period would be to only concentrate on just compound exercises. The nature of compound exercises call for much more effort from your very own body and as a result, it comes with a much better calorie expenditure per work out ratio.
For instance, why don't we do a comparison of 2 leg exercises:
1. Leg extensions: isolation exercise
2. Barbell squats: compound exercise
When executing leg extensions, really the only muscle groups focused tend to be generally your own upper thighs (quadriceps) along with a little of your calf muscles.
Barbell squats conversely, stimulates not merely your upper thighs, but additionally your hamstrings, calf muscles, small of the back, abdominal muscles as well as backside! (Which means this one single physical exercise properly focuses on almost all trouble spots that a lot of women have concerns with)
Let's assume that most of us devote exactly the same period of time doing both exercises, the barbell squats undoubtedly burns up much more calories plus it also concentrates on numerous muscle groups at the same time workout some other body parts.
Therefore the next time for anybody who is in a hurry and they are interested in the quickest way to lose weight, choose solely compound exercises and that you will rapidly notice as well as feel the big difference.
Weight Training: Do's and Don'ts of Proper Technique
Effective weight training depends on proper technique. Follow these do's and don'ts to maximize your weight training program.
By Mayo Clinic staff
You don't have to be a bodybuilder or professional athlete to reap the benefits of weight training. When done correctly, weight training can help you lose fat, increase your strength and muscle tone, and improve your bone density. If done incorrectly, however, weight training won't give you these benefits — and may even lead to injury.
Check your technique
You might learn weight training techniques by watching friends or others in the gym — but sometimes what you see isn't safe. Incorrect weight training technique can lead to sprains, strains, fractures and other painful injuries that may hamper your weight training efforts. If you're just getting started, work with a knowledgeable weight training specialist — a physical therapist, athletic trainer or other fitness specialist who's familiar with proper weight training technique. If you've been using weights for a while, consider scheduling time with a trainer to demonstrate your technique and identify any changes you may need to make.
Quickest Way to Lose Weight for Those Stressful Corporate and Business Professionals
by Lisa Huttons
As a very busy business professional, everyone is generally in a hurry; progressing from scheduled appointment to scheduled appointment and also hurrying deadline following deadline. For many individuals, getting some exercise is the very least of our fears. The truth is, most of us are simply way too completely maxed following a incredibly long work day to allow them to trudge our way to a fitness center to get a reasonable work out. For individuals that do make it to a health club, very like they will not be totally maximizing their own exercise time by simply engaging in the routines that make any difference.
So in the following paragraphs, I am going to demonstrate the quickest way to lose weight in order to get the most optimum results within the least amount of time.
Exercises tend to be typically grouped into 2 types: isolation and compound.
Isolation exercises:
Much like the term implies, isolation exercises are individual joint workouts that isolate an individual body part. Types of isolation exercises can be triceps extension, bicep curls, leg extension and also lateral shoulder raises.
Compound exercises:
These are generally multi-joint exercises that works a number of muscle groups simultaneously. Examples of compound exercises would be bent over rows, bench press, pushups, squats, dips, pull ups not to mention dead lifts.
Should your purpose is to burn fat as well as burn unhealthy calories, then the quickest way to lose weight and also entirely improve your exercise routine period would be to only concentrate on just compound exercises. The nature of compound exercises call for much more effort from your very own body and as a result, it comes with a much better calorie expenditure per work out ratio.
For instance, why don't we do a comparison of 2 leg exercises:
1. Leg extensions: isolation exercise
2. Barbell squats: compound exercise
When executing leg extensions, really the only muscle groups focused tend to be generally your own upper thighs (quadriceps) along with a little of your calf muscles.
Barbell squats conversely, stimulates not merely your upper thighs, but additionally your hamstrings, calf muscles, small of the back, abdominal muscles as well as backside! (Which means this one single physical exercise properly focuses on almost all trouble spots that a lot of women have concerns with)
Let's assume that most of us devote exactly the same period of time doing both exercises, the barbell squats undoubtedly burns up much more calories plus it also concentrates on numerous muscle groups at the same time workout some other body parts.
Therefore the next time for anybody who is in a hurry and they are interested in the quickest way to lose weight, choose solely compound exercises and that you will rapidly notice as well as feel the big difference.
Exercise for Weight Loss: Calories Burned in 1 Hour
By Mayo Clinic staff
Being active is an important part of any weight-loss or weight-maintenance program. When you're active, your body uses more energy (calories). And when you burn more calories than you consume, you lose weight.Because 3,500 calories equals about 1 pound (0.45 kilogram) of fat, you need to burn 3,500 calories more than you take in to lose 1 pound. So if you cut 500 calories from your diet each day, you'd lose about 1 pound a week (500 calories x 7 days = 3,500 calories). Because of changes that occur in the body over time, however, calories may need to be decreased further to continue weight loss.While diet has a stronger effect on weight loss than physical activity does, physical activity, including exercise, has a stronger effect in preventing weight gain and maintaining weight loss.For most healthy adults, the Department of Health and Human Services recommends these exercise guidelines:
• Aerobic activity. Get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity. However, to effectively lose or maintain weight, some people may need up to 300 minutes a week of moderate physical activity. You also can do a combination of moderate and vigorous activity. The guidelines suggest that you spread out this exercise during the course of a week, and sessions of activity should be at least 10 minutes in duration.
• Strength training. Do strength training exercises at least twice a week. No specific amount of time for each strength training session is included in the guidelines.Moderate aerobic exercise includes such activities as brisk walking, swimming and mowing the lawn. Vigorous aerobic exercise includes such activities as running and aerobic dancing. Strength training can include use of weight machines, or activities such as rock climbing or heavy gardening.Specific calorie expenditures vary widely depending on the exercise, intensity level and your individual situation.
EXERCISES TO REDUCE CELLULITE IN BUNS & THIGHS
While cellulite is not a medical concern, Mayo Clinic reports that the presence of dimply skin in the butt, thighs or legs makes women feel self-conscious. Cellulite is caused by fat cells that push up through the surface of the skin. According to Mayo Clinic, it affects eight out of 10 women. While complete removal of cellulite in the buns and thighs may be impossible, regular cardio combined with strength training exercises that target the glutes and thighs reduce cellulite's appearance.
STRENGTH TRAINING & CARDIO EXERCISES
Wayne Westcott, fitness research director at the South Shore YMCA in Quincy, Massachusetts, conducted an eight-week study evaluating the role cardio and strength training play in cellulite reduction. Study participants did three weekly 20-minute sessions of cardio and three weekly 20-minute full-body strength training sessions. Participants lost 1 lb per week and those who dieted doubled their weight loss. According to the American Council on Exercise (ACE), this weekly formula for exercise improves body composition and reduces cellulite.
Lunges and squats are examples of lower body strength training exercises, and upper body exercises include bicep curls, push-ups and rows. According to ACE, it is impossible to target a specific area for weight loss--toning the entire body contributes to cellulite reduction and burns fat in the thighs and buns. Appropriate modes of cardio exercise include swimming, hiking, running, cycling, dancing and speed walking.
LUNGES
Lunges tones the glutes, inner thighs and leg muscles while firming surrounding skin. Mayo Clinic reports that cellulite becomes more visible when skin loses elasticity. To perform a lunge, stand up straight and bend your knees slightly. Next, adjust your feet so that they are shoulder-width apart and relax your shoulders. Step your right foot forward three feet, aligning your right knee directly over your right ankle while lifting onto the toes of your left foot. Lower your left knee towards the ground, stopping before it hits the floor. Finally, push up through the heel of your right foot and return to standing. After completing 15 lunges with your right leg, switch leg positioning and do the same with your left leg.
DUMBBELL SQUATS
ACE recommends the dumbbell squat exercise as an effective way to reduce cellulite in the lower body. Squatting challenges the inner thighs and glutes while slimming the legs. To do a dumbbell squat, hold a light weight in each hand and rest your arms by your side. Next, adjust your feet so that they are hip-width apart, align your knees with your ankles and bend your knees slightly. Tightening your abdominal muscles helps you maintain proper form during this exercise. Stick your glutes out behind you and lower your hips toward the ground. Finally, stop when the backs of your legs are parallel to the ground, push up through your heels and return to standing. As you build strength, increase the weight you hold for additional gains.
Resistance training preserves muscle during weight loss and will enable the body to lose only fat when in a negative calorie balance.
Effects of Resistance vs. Aerobic Training Combined With an 800 Calorie Liquid Diet on Lean Body Mass and Resting Metabolic Rate -1999
1. Randy W. Bryner, EdD,
2. Irma H. Ullrich, MD FACN,
3. Janine Sauers, MS,
4. David Donley, MS,
5. Guyton Hornsby, PhD,
6. Maria Kolar, MD and
7. Rachel Yeater, PhD
+Author Affiliations
- Department of Human Performance and Applied Exercise Science (R.W.B., J.S., D.D., G.H., R.Y.), West Virginia University, Morgantown, West Virginia
- Department of Medicine, School of Medicine (I.H.U., M.K.), West Virginia University, Morgantown, West Virginia
1. Address reprint requests to: Randy W. Bryner, EdD, Department of Human Performance and Applied Exercise Science, PO Box 9227, 8317 HSC, Morgantown, WV 26506
Abstract
Objective: Utilization of very-low-calorie diets (VLCD) for weight loss results in loss of lean body weight (LBW) and a decrease in resting metabolic rate (RMR). The addition of aerobic exercise does not prevent this. The purpose of this study was to examine the effect of intensive, high volume resistance training combined with a VLCD on these parameters.
Methods: Twenty subjects (17 women, three men), mean age 38 years, were randomly assigned to either standard treatment control plus diet (C+D), n=10, or resistance exercise plus diet (R+D), n=10. Both groups consumed 800 kcal/day liquid formula diets for 12 weeks. The C+D group exercised 1 hour four times/week by walking, biking or stair climbing. The R+D group performed resistance training 3 days/week at 10 stations increasing from two sets of 8 to 15 repetitions to four sets of 8 to 15 repetitions by 12 weeks. Groups were similar at baseline with respect to weight, body composition, aerobic capacity, and resting metabolic rate.
Results: Maximum oxygen consumption (Max VO2) increased significantly (p<0.05) but equally in both groups. Body weight decreased significantly more (p<0.01) in C+D than R+D. The C+D group lost a significant (p<0.05) amount of LBW (51 to 47 kg). No decrease in LBW was observed in R+D. In addition, R+D had an increase (p<0.05) in RMR O2 ml/kg/min (2.6 to 3.1). The 24 hour RMR decreased (p<0.05) in the C+D group.
Conclusion: The addition of an intensive, high volume resistance training program resulted in preservation of LBW and RMR during weight loss with a VLCD.
· diet
INTRODUCTION
Obesity is a major health problem in the United States affecting more than 34 million Americans [1]. Weight loss through dieting alone has been shown to result in a dramatic and sustained reduction in resting metabolism [2,3]. Very-low-calorie diets (VLCD) are often recommended in cases of extreme clinical obesity [4]. Their use has primarily been limited to persons who have failed to lose weight in more conventional diet programs and whose body mass index (BMI) is greater than 30 [5]. The problem often associated with the VLCD is the significant loss of lean tissue and a subsequent decrease in resting metabolism, especially in the early phase of the diet [6]. Endurance exercise in combination with severe energy restriction has been shown to result in less decrease in fat free mass (FFM) as compared with dieting alone [7,8]. However, a number of other studies have reported that endurance training in conjunction with very-low-calorie diets have either produced no effect [9–12] on the retention of FFM, or even caused an augmented loss compared with the very-low-calorie diets alone [13,14].
It has been suggested that resistance-training may be more effective than aerobic exercise in preserving or increasing FFM and resting metabolic rate (RMR) [15], especially in conjunction with a VLCD [16]. This combination, however, has not been extensively studied. A limited number of studies have combined resistance training with a VLCD and reported no added benefit for the retention of FFM compared to the VLCD alone [12,17]. However, resistance training during severe energy restriction and large-scale weight loss has been shown to produce significant hypertrophy in the skeletal muscle in which training occurred [18]. It does not attenuate the loss, however, of FFM in non-exercised tissue. It is possible that previous studies using resistance exercise protocols have utilized an insufficient volume of exercise. A review of several weight loss studies involving exercise concluded that those which produced the greatest weight loss involved either intensive training programs or were of relatively long duration [19]. The purpose of this study was to compare the effects of an intensive high volume resistance training program with a standard treatment control aerobic training program in subjects consuming a VLCD for 12 weeks. Changes in body weight, FFM and RMR were compared between groups.
METHODS
Participants
Twenty subjects (17 women, three men) with a mean age of 36.7±11.5 years, weight of 95.1±13.0 kg, and a BMI of 35.2±2.9 kg/m2 were recruited through newspaper advertisements to participate in a 12-week diet and exercise study. The criteria for participation in the study were no involvement in a regular exercise or weight loss program for at least 6 months prior to the first visit and no known cardiovascular, endocrinologic or orthopedic disorders. After informed consent was obtained, all potential subjects underwent a complete medical examination to determine their ability to participate. Eligible subjects were randomly assigned to one of two groups: standard treatment control plus VLCD (C+D, females=8, males=2), or resistance exercise plus VLCD (R+D, females=9, males=1). Each subject was given a maximum stress test, body composition analysis, and RMR determination prior to the start of the study. Subject characteristics can be found in Table 1.
Table 1.
Subject Characteristics at Baseline (Mean±SD)
C+D (N=10) | R+D (N=10) | |
|---|---|---|
Age (years) | 39.0 ±11.6 | 35.8 ±13.2 |
Body weight (kg) | 93.8 ±15.1 | 97.7 ±15.2 |
BMI | 35.2 ±3.9 | 35.5 ±2.0 |
Fat (%) | 44.5 ±7.0 | 46.2 ±6.8 |
LBW (kg) | 51.4 ±10.6 | 51.6 ±7.9 |
Peak VO2 (ml/kg/minute) | 21.2 ±2.6 | 21.1 ±4.2 |
RMR (kcal/day) | 1569.2 ±202.39 | 1737.1 ±393.4 |
RMR (ml/kg/minute) | 2.2 ±0.5 | 2.6 ±0.5 |
Resting Metabolic Rate
The RMR of subjects was determined at baseline and week 12. Following an overnight fast of at least 12 hours, subjects reported to the Human Performance Laboratory for the determination of RMR. Subjects were fitted with a Hans Rudolf face mask which was connected to an Aerosport metabolic system for the determination of breath by breath oxygen analysis. Subjects rested quietly in a supine position for 30 minutes in a thermo-neutral environment. The mean oxygen consumption (VO2) was calculated over the final 5 minutes and was used to determine the RMR. A menstrual history was taken for each of the female subjects at the start of the study. The goal of the study was to keep the phase of the menstrual cycle constant for the baseline and week 12 RMR test. However, since the study was exactly 12 weeks in duration, three of the females (one in C+D; two in R+D) who had a regular cycle during the study were post tested in the alternate cycle phase due to variations in cycle length.
Peak Oxygen Consumption and Hydrostatic Weighing
Peak oxygen consumption (PVO2) was determine at baseline and at 12 weeks by a symptom limited treadmill graded exercise test (GXT) using a modified Balke treadmill protocol [20]. Participants received a verbal overview of the GXT procedure and were fitted with a noseclip and a Hans Rudolph non-rebreathing mouthpiece for collection of expired air during the GXT. Breath by breath oxygen analysis was done with an Aerosport metabolic system. The protocol was initiated at a comfortable but brisk walking speed at 0% elevation. Treadmill speed remained constant throughout while the elevation was raised 1% each minute until volitional fatigue. Criteria for considering the GXT a maximal effort included at least two of the following: a plateau in maximal oxygen consumption, a respiratory ratio greater than 1.0, or voluntary discontinuation by the participant despite urging from the staff. Hydrostatic weighing was used to determine percent fat and fat free mass at baseline and at 12 weeks by a previously validated method [21].
Diet
All participants were given the same diet for the entire 12-week study period. The VLCD consisted of a liquid formula (40% protein, 49% carbohydrate, 11% fat) ingested five times a day yielding a total of 800 kcals daily. Two multivitamin tablets were also consumed daily. Diet and vitamins were provided by Health Management Resources Inc., Boston, MA. Participants were asked to refrain from other food or non diet beverages. All subjects met with an investigator weekly and were questioned about their medical condition and their compliance to the dietary protocol. Only 1 week worth of supplement was given at a time requiring subjects to be present at the weekly weigh-in and meeting sessions. Adherence to the diet was questioned if weight loss was less then 2 lbs per week. Each subject was asked to give a verbal declaration of adherence to the diet at each weekly meeting. Self-reported compliance was excellent.
Exercise Training Protocols
Resistance Training plus Diet.
The Resistance Training (R+D) group performed resistance exercises 3 days/week at 10 stations which included four lower body and six upper body exercises for 12 weeks. The initial 2 week were used to familiarize subjects to the resistance training apparatus and to determine the maximum weight that could be lifted either once (1RM) or eight times (8RM). The 1RM was determined as follows: Subjects performed one set of six to eight repetitions with a weight that could be lifted 12 to 15 times. A second set of two to three repetitions with a slightly heavier weight was performed. The weight was then increased to a cautious estimate of the 1RM at which time subjects attempted a single lift. If successful, the weight was gradually increased until the subject could not complete the one repetition lift. The 1RM test was conducted during week 2 and again at the end of week 12.
The training protocol was as follows: During the initial training session, subjects exercised by lifting a weight that was considered light for one set of approximately 15 repetitions per station. For the second workout, subjects performed two sets using the same weight as the first workout for each station. A gradual increase in weight was used until subjects were lifting a weight that could be lifted at least eight times but no more than 12 times as determined by the 8RM for two sets by the end of week 2 of training. Three sets were done at week 6 and four sets at week 9 all utilizing the same intensity and number of repetitions as described previously. Rest periods of approximately 1 minute were given between each exercise throughout the training session in a circuit-type workout. Careful monitoring of subjects was done to insure that once an individual was able to lift a weight 12 times on the final set, additional weight was added on the next training session. In addition, heart rate was monitored during the 1-minute resting periods periodically throughout the exercise session by radial artery palpation. This procedure was used throughout the 12-week training period to maintain a consistent level of training intensity. Training sessions were scheduled three times per week with a mandatory 1-day rest between visits to eliminate soreness and insure full recovery due to the aggressive nature of the protocol. Very few subjects complained of fatigue or soreness throughout the entire 12-week period.
Standard Treatment Control plus Diet.
The Standard Treatment Control (C+D) group exercised 4 days/week by walking, biking, or stair climbing. Exercise duration began at 20 minutes/day and increased 10 minutes/day/week until subjects were exercising 50 to 60 minutes each session. A self-paced protocol was used to simulate the HMR program in which exercise intensity is not prescribed but exercise is encouraged. In addition, heart rate was monitored approximately every 10 minutes during exercise by radial artery palpation. All participants were individually monitored at each exercise session to assure compliance with both the resistance and aerobic training protocols.
Data Analysis
A series of independent repeated measures analysis of variance (ANOVA) calculations were used to assess the degree to which exercise training (resistance vs. standard treatment control) produced changes in cardiovascular fitness, metabolic, and weight variables over two time points (pre-post training). Because of the low number of male subjects, data were analyzed both with males included and excluded. Results were similar, therefore the following results reflect the entire subject pool. A probability level of 0.05 was selected as the criterion for statistical significance.
RESULTS
No differences were observed between groups at the start of the study for body weight, percent fat, LBW, Max VO2, or RMR (Table 1). Compliance to exercise sessions was excellent in both groups during the 12-week study, averaging 92.5%±17.9% and 91.4%±21.8% for the C+D and R+D groups, respectively with no difference between groups. The C+D exercised at a greater (p<0.01) heart rate intensity compare to R+D during the daily training sessions (78.4%±5.9% vs. 69.0%±7.7%; mean±SD percent of max HR)
Maximum VO2 and treadmill time to fatigue was measured during the pretest and immediately after the 12-week study period (Table 2). There was a significant increase (p<0.05) in peak VO2 for both of the C+D and R+D groups (C+D: 21.2±2.6 to 27.6±3.4 ml/kg/minute; R+D: 21.1±4.2 to 27.4±5.5 ml/kg/minute, mean±SD) which was of similar magnitude. There was a significant group by test interaction (p<0.05) for the treadmill time to fatigue. (C+D: 12.0±3.7 to 17.5±2.8 minutes; R+D: 10.9±2.7 to 13.8±6.1 minutes, mean±SD). The C+D group had a significantly greater improvement than did R+D.
Table 2.
Changes in Body Composition Data, RMR and Peak VO2 (Mean±SD)
C+D (N=10) | R+D (N=10) | |||
|---|---|---|---|---|
Pre | Post | Pre | Post | |
Body weight (kg) | 93.8 ±15.1 | 75.7 ±10.6* | 97.7 ±15.2 | |
BMI | 35.2 ±3.9 | 28.6 ±2.8* | 35.5 ±2.0 | 29.7 ±1.7* |
Fat (%) | 44.5 ±7.0 | 37.1 ±6.0* | 46.2 ±6.8 | 37.6 ±4.9* |
LBW (kg) | 51.4 ±10.6 | 47.3 ±7.0* | 51.6 ±7.9 | 50.8 ±9.0 |
Fat (kg) | 40.8 ±9.1 | 28.0 ±6.47 | 44.9 ±19.9 | 30.4 ±5.3 |
Peak VO2 (ml/kg/minute) | 21.2 ±2.6 | 27.6 ±3.4* | 21.1 ±4.2 | 27.4 ±5.5* |
Treadmill time (minutes) to fatigue | 12.0 ±3.7 | 17.5 ±2.8* | 10.9 ±2.7 | |
RMR (kcal/day) | 1569.2 ±202.4 | 1358.5 ±297.1* | 1737.1 ±393.4 | 1800.4 ±362.0† |
Body weight, body fat, LBM, BMI, and percentage of fat measured during the pretest and post test can be found in Table 2. Although both groups lost a significant amount of weight (p<0.05) there was a significant group by test interaction (p<0.01) for body weight. As can be seen in Table 2, C+D experienced a significantly greater decrease in body weight than did R+D, (19.4 vs. 14.7%). Each group experienced a similar reduction (p<0.05) in body fat (C+D: 40.8±9.1 to 28.0±6.5 kg, R+D: 44.9±10.9 to 30.4±5.3, kg), fat percentage (C+D: 44.5±7.0 to 37.1±6.0, R+D: 46.2±6.8 to 37.6±4.8), and BMI (C+D: 35.2±3.9 to 28.6±2.8, R+D: 35.5±2.0 to 29.7±1.7). There was also a significant (p<0.05) group by test interaction for LBW. Lean body weight decreased (p<0.05) in the C+D group (51.3±10.7 to 47.3±7.0 kg, mean±SD). No reduction in LBW was observed in the R+D group (51.6±7.8 to 50.7±9.0 kg, mean±SD).
There was a significant group by test interaction for the RMR expressed either as ml/kg/minute total weight (Fig. 1) or ml/kg LBW/minute (Fig. 2). As can be seen in Fig. 1, RMR increased (p<0.05) in the R+D group and was greater after 12 weeks compared with C+D. The RMR was also significantly greater (p<0.05) in the R+D versus the C+D group after 12-weeks expressed as ml/kg LBW/minute (Fig. 2) or 24-hour RMR (Table 2). The 24-hour RMR (Table 2)decreased significantly (p<0.05) in the C+D group (1569.2±202.4 to 1358.5±297.1 kcal/day, mean±SD).
View larger version:
Fig. 1
Resting metabolic rate (RMR, mean±SD) expressed as ml/kg/minute for the resistance plus diet (R+D) and standard treatment control aerobic plus diet (C+D) groups. RMR increased significantly (p<0.05) pre to post in R+D. It was also significantly greater (p<0.05) in the R+D than in the C+D group after 12 weeks. No change was observed in the C+D group pre to post.
View larger version:
Fig. 2
Resting metabolic rate (RMR, mean±SD) expressed as ml/kg LBW/minute for the resistance plus diet (R+D) and standard treatment control aerobic plus diet (C+D) groups. RMR was significantly greater (p<0.05) in the R+D than in the C+D group after 12 weeks. No change was observed in the C+D group pre to post.
The 1RM test results for leg press (LPRM), leg extension (LERM), bench press (BPRM), and shoulder press (SPRM) determined for R+D can be found in Table 3. There was a significant (p<.01) increase in strength in all four measures pre to post. The increases in strength ranged from 23.0±3.7% for SPRM to 48.0±30.1% for LERM. The average intensity during the final week of training for the R+D group for these four measures was 75.9±8.3% of the maximum 1RMs.
Table 3.
Changes in Strength after 12 Weeks of Resistance Training in the R+D Group (Mean±SD)
R+D (N=10) | |||
|---|---|---|---|
Pre | Post | % Change | |
SPRM (lbs) | 62.7 ±16.3 | 76.5 ±22.0* | 23.0 ±3.7 |
BPRM (lbs) | 67.9 ±16.5 | 95.0 ±25.5* | 42.4 ±23.4 |
LPRM (lbs) | 333.0 ±70.4 | 468.5 ±72.7* | 38.7 ±22.4 |
LERM (lbs) | 94.2 ±35.0 | 135.7 ±32.6* | 48.0 ±30.1 |
· R+D, resistance treatment plus VLCD.
SPRM=shoulder press one repetition maximum; BPRM=bench press one repetition maximum; LPRM=leg press one repetition maximum; LERM=leg extension one repetition maximum.
· ↵* p<0.05, significantly different from pretest values.
DISCUSSION
The results from the present study indicate that the addition of a high intensity high volume resistance training program to a VLCD can attenuate the loss of LBM and increase RMR while still producing a significant weight loss. Combining aerobic exercise and a VLCD resulted in a significant decrease in body weight, LBM, and RMR. Resistance exercise was also associated with an increase in peak VO2 similar to changes seen in the standard treatment control aerobic group.
Other studies have reported that weight loss through the combination of diet and aerobic exercise results in significant loss of both body fat and LBM [9–12] similar to the present findings. The percentages of fat and lean body mass lost on VLCDs has been reported to be approximately 75% and 25%, respectively [22]. These percentages can fluctuate and may be affected by the amount of protein intake [23] and the amount of physical activity performed during the VLCD period. The diet used in the present study was composed of 40% protein or approximately 80 g/day. Froidevaux and others [23] reported that a low-energy diet supplemented with protein (77±4 g protein/day) resulted in a body fat mass decrease of 11±4 kg corresponding to 83±19% of weight loss. This would indicate that a diet supplemented with protein may contribute to the maintenance of LBM during periods of severe energy restriction. However, although diet composition can potentially affect the type of tissue lost during conditions of negative energy balance, such effects are usually very small given the short duration of most obesity treatment programs and therefore of minimal significance during the weight loss period [24]. Some evidence indicates that aerobic training concurrent with VLCD can cause greater loss in FFM than occurs with a VLCD alone [13,14]. Resistance training may be more advantageous to use during periods of severe energy restriction as it has been shown to have a low metabolic cost and to create a smaller energy deficit then aerobic training. This ultimately could help preserve FFM.
The relative percent change in weight after 12 weeks of VLCD was significantly greater in the standard treatment control aerobic training versus resistance training group. The scheduled exercise sessions per week for the C+D and R+D groups were four and three sessions, respectively. Subject compliance to exercise was excellent for both groups and did not differ. The resistance training group only exercised three times weekly because the aggressive program necessitated a day of rest between workouts. The C+D group exercised 4 days per week because this has been the experimental design used in past studies with VLCD [12,17] and because the purpose of this group was to serve as a standard treatment control. In addition, subjects in C+D exercised at a greater intensity per session (higher percent of maximum HR) as compared with the resistance trained subjects. Therefore, it is likely that these subjects expended more energy throughout the 12-week training program compared with R+D contributing to the greater weight loss. It is also possible that subjects in C+D were under a greater influence of catabolic hormones such as epinephrine during and immediately following each workout. Previous studies have reported that exercise can stimulate the sympathetic nervous system and that the release of catecholamines, especially epinephrine, during exercise is an intensity dependent process [25,26]. There is a possibility that subjects in R+D would have lost more weight had they exercised four times per week as opposed to three. However, what is known is that resistance training three times per week while consuming a VLCD was associated with a significant large loss of clinically relevant body weight and that this loss was almost entirely fat weight.
Few studies have been conducted that combine resistance training with weight loss and even fewer have examined this type of exercise in combination with a VLCD. Ballor and others [27] reported that resistance training can increase fat free mass in subjects consuming a diet of approximately 1200 kcal/day. However, most studies that have combined a VLCD (800 kcals or less) have reported that resistance training does not attenuate the loss of LBM or decrease in RMR. Resistance training combined with severe energy restriction (approximately 520 kcal/day) showed no greater retention of FFM than when severe energy restriction was used by itself [12]. In a similar study, Donnelly et al [17] reported that resistance training alone or in combination with aerobic training showed no greater effects in increasing weight loss or decreasing the loss of FFM or RMR compared to VLCD alone. The same study also reported no differences between aerobic and resistance training for any of the aforementioned parameters. Comparisons with these and the present study are difficult due to the different experimental designs used in each study, especially the resistance training protocols. The present study incorporated a progressive intensive resistance training protocol of high volume designed to not only prevent the decline in FFM with weight loss but enhance it if possible. Maintaining FFM and RMR may be very important during periods of weight loss.
Previous research has shown that significant muscle hypertrophy is possible in an individual undergoing severe energy restriction. Both slow twitch and fast twitch cross-sectional fiber area increased significantly in muscles that were resistive trained for 90 days in individuals who were consuming a VLCD [18]. Similar to the present study, dietary intake was approximately 800 kcals/day. However, hypertrophy was only seen in exercised muscles and the resistance training was unable to prevent the loss of overall FFM any better then diet alone. Muscular activity during severe energy restriction may decrease protein catabolism by decreasing the sensitivity of working muscles to catabolic hormones [28]. However, it is possible that some baseline level of dietary intake (