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Weight Loss Improves Glucose Tolerance in Nonobese, Healthy Adults

Posted: Wednesday, November 22, 2006

Weight loss from exercise or calorie restriction improved glucose tolerance in nonobese, healthy men and women, according to the results of a randomized controlled trial.

"Weight loss, through calorie restriction or increases in energy expenditure via exercise, improves glucose tolerance and insulin action," write Edward P. Weiss, MD, and colleagues from the Washington University School of Medicine Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) Group. "However, exercise-induced energy expenditure may further improve glucoregulation through mechanisms independent of weight loss.... The purpose of the present study was to test the hypothesis that exercise training–induced weight loss results in greater improvements in glucose tolerance and insulin action than does similar weight loss induced by calorie restriction."

Sedentary men and women aged 50 to 60 years with a body mass index (BMI) of 23.5 to 29.9 kg/m2 were randomized to 12 months of exercise training (n = 18), calorie restriction (n = 18), or to a healthy lifestyle control group (n = 10). An oral-glucose tolerance test determined the insulin sensitivity index and areas under the curve for glucose and insulin. Adiponectin and tumor necrosis factor alpha (TNF-a) concentrations were measured in fasting serum, and dual-energy x-ray absorptiometry was used to measure fat mass.

The exercise training and calorie restriction groups had similar yearlong energy deficits, as reflected in body weight and fat mass changes. The insulin sensitivity index increased, and the glucose and insulin areas under the curve decreased in the exercise training and calorie restriction groups and were unchanged in the healthy lifestyle group and not significantly different between the exercise training and calorie restriction groups. There were marginally significant increases in adiponectin and decreases in the ratio of TNF-a to adiponectin in the exercise training and calorie restriction groups, but not in the healthy lifestyle group.

"Weight loss induced by exercise training or calorie restriction improves glucose tolerance and insulin action in nonobese, healthy, middle-aged men and women," the authors write. "However, it does not appear that exercise training–induced weight loss results in greater improvements than those that result from calorie restriction alone."

The National Institutes of Health supported this study through some of its investigators. The authors have disclosed no relevant financial relationships.

Source: Diabetes In Control: Am J Clin Nutr. 2006;84:1033-1042