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25 March 2002
Weight Loss And Walking In Obese Women Produces Extra Health Benefits 
In older obese women, midthigh fat deposits are associated with risk factors for cardiovascular disease (CVD), type 2 diabetes and lipid disorders. Ryan et al., in a study published in The American Journal of Clinical Nutrition, demonstrated that a regime of low-intensity walking combined with weight loss could specifically reduce midthigh fat while improving glucose metabolism as well as lipid metabolic risk factors for CVD. Women with the most midthigh fat at baseline lost the most fat and gained the most muscle in this region and realized the greatest improvements in glucose metabolism. The 24 subjects were all overweight nonsmokers averaging 58 years old, were not receiving hormone replacement therapy, and had no overt evidence of any disease. During the 6 month weight loss intervention, the women attended weekly classes led by a registered dietitian who provided them with instruction in the principles of a reducing diet conforming to American Heart Association guidelines. Additionally they were encouraged to perform low-intensity walking 3 days per week, with one of the weekly walking sessions performed on a treadmill at an exercise facility associated with the research site. At baseline, a CT scan of the midthigh region was done to quantify muscle area and fat tissue, and assessments were made of glucose metabolism and blood lipids including total cholesterol, triglycerides, HDL and LDL cholesterol. At the conclusion of treatment, the women's body weight and body mass index had decreased by an average of 8%; waist and hip circumferences had decreased by 4%; and the walking intervention produced an overall 8% increase in aerobic capacity. There was a significant 4% decrease in the circumference of the midthigh which, when assessed using a CT scan, showed a 16% decrease in fat and a 7% increase in muscle. The increase in midthigh muscle area as a result of walking was similar to that previously reported in men, consistent with the prevention of sarcopenia (loss of skeletal muscle mass) in these postmenopausal obese women. Sarcopenia is a major age-related cause of loss of mobility and subsequent injury from falls in elderly persons. At baseline 42% of the women had impaired glucose tolerance; however, this metabolic abnormality was reduced to 17% at the conclusion of the program, consistent with positive body composition changes. Although overall cholesterol levels did not change significantly, plasma triglycerides were reduced by an average of 19%. The combination of moderate weight loss and increased physical fitness in the midthigh area was associated with an array of extended health benefits for the women in this study.
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