Metabolic Adaptations to Weight Loss With and Without Exercise
Overview
- Phase
- Not Applicable
- Intervention
- MICT Exercise
- Conditions
- Obesity
- Sponsor
- University of Michigan
- Enrollment
- 68
- Locations
- 1
- Primary Endpoint
- Adipose tissue fibrosis
- Status
- Recruiting
- Last Updated
- 18 days ago
Overview
Brief Summary
Study Purpose:
The combination of caloric restriction and exercise is the most common first-line treatment for obesity-related disorders, yet we know very little about how these two very different treatments work together. A deeper understanding about mechanisms underlying the health benefits of adding exercise to a weight loss program will not only aid efforts to optimize more effective lifestyle interventions, but it can also uncover novel targets for the treatment/prevention of obesity-related diseases.
Although a reduction in body fat is the fundamental adaptation to weight loss, we know almost nothing about the effects that adding exercise has on structural and functional changes within fat tissue that may further enhance metabolic health. This is very important because many obesity-related metabolic health complications are tightly linked with abnormalities in abdominal fat tissue. We argue exercise-induced modifications in abdominal fat tissue will reveal persistent health benefits even if some weight is regained
Study Summary:
10% Weight Loss Phase - Subject participation in the study will involve a series of metabolic tests before, at midpoint, and after undergoing a 10% weight loss program (with or without exercise training depending on group randomization). During this, subjects will be randomized into one of two different experimental groups:
- Moderate Intensity Continuous Training (MICT) exercise group
- No exercise (control) group
Follow-up Phase: After completing the metabolic testing post-weight loss, all study-related diet and exercise supervision will end and subjects will be free to make their own choices regarding diet and exercise/physical activity behavior. Subjects will then be asked to complete follow-up testing at 2-, 4- and 6- months post-weight loss.
Total involvement in the study for each subject will likely be about 10-13 months (4-7 months during weight loss phase, 6 months during follow-up phase).
Investigators
Jeffrey F Horowitz
Professor of Movement Science and Director of the Substrate Metabolism Laboratory (SML) at the University of Michigan School of Kinesiology
University of Michigan
Eligibility Criteria
Inclusion Criteria
- •Age: 18-40
- •Body Mass Index: 30-40 kg/m2
- •Weight stable (±3kg for greater than or equal to about 2 months)
- •No regularly planned exercise/physical activity
- •Women must have regularly occurring menses and must be premenopausal
Exclusion Criteria
- •EKG abnormalities
- •Evidence/history of cardiovascular disease, diabetes or other metabolic disease
- •Medications known to affect lipid or glucose metabolism
- •Pregnant or lactating
- •Tobacco or e-cigarette use
- •Prior experience of hypersensitivity to insulin, human albumin, and potassium chloride injection.
- •Allergies/hypersensitivity to local anesthetics of the amide type (e.g., lidocaine)
- •History of hyperkalemia or potential for developing hyperkalemia (including but not limited to taking drugs that may induce hyperkalemia such as cardiac glycosides or potassium sparing diuretics)
- •Anti-coagulant medication (e.g., Coumadin, Rivaroxaban) and Lidocaine allergy/sensitivity are exclusion criteria for the biopsy procedure.
Arms & Interventions
Moderate Intensity Continuous Training (MICT) exercise group
45 minutes of continuous steady-state exercise at 70% maximal heart rate throughout the 10% weight loss phase of the study
Intervention: MICT Exercise
No exercise (Control)
to remain sedentary (no planned physical exercise) throughout the duration of the 10% weight loss phase of the study
Intervention: No Exercise (Control)
Outcomes
Primary Outcomes
Adipose tissue fibrosis
Time Frame: 30 minutes
measured histologically using Sirus Red Staining, quantified using ImageJ software
Insulin sensitivity
Time Frame: 2 hours
a hyperinsulinemic-euglycemic clamp will be used to quantify peripheral insulin sensitivity
Fatty acid turnover
Time Frame: 2 hours
stable isotope tracer infusion methods will be used to assess fatty acid turnover
Adipose tissue capillarization
Time Frame: 30 minutes
measured immunohistochemically using an antibody for CD31, quantified using ImageJ software
Secondary Outcomes
- Body weight change(6 months)
- Body fat mass(30 minutes)
- Oral Glucose Tolerance Test (OGTT)(2 hours)