Endurance vs. Endurance-Strength Training for Central Obesity: Which is Best?

In the realm of fitness and health, battling central obesity is a common concern for many individuals. Central obesity, often referred to as abdominal or visceral fat, poses significant health risks, including an increased likelihood of developing cardiovascular diseases, diabetes, and various metabolic disorders. This study, published in the journal Healthcare compared the effects of endurance training and endurance-strength training on obese women for 3 months. Both approaches led to similar improvements in body fat loss, fitness level, and blood pressure. Endurance-strength training additionally increased muscle mass. Women with abdominal obesity can choose either form of training for significant health benefits, depending on individual preference for muscle gain or overall fitness goals.

Key Points

Methodology:

• 44 women with abdominal obesity were randomly assigned to either endurance training (group A) or endurance-strength training (group B).

• Both groups trained for 3 months, 3 times per week, for 60 minutes per session.

• Body composition analysis (DXA) and graded exercise tests (GXT) were conducted before and after the training program.

Results:

• Both groups:

  • Significant decreases in body mass, BMI, total body fat, waist, and hip circumference.

  • Increased peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at the ventilatory threshold.

  • Decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure.

• Endurance-strength training group:

  • A marked increase in total body lean mass and fat-free mass.

Conclusion:

Both endurance and endurance-strength training demonstrated similar positive effects on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity. Although endurance-strength training led to greater increases in lean mass, no significant differences were observed between the groups for the other measured parameters.

Key takeaways:

• This study suggests that both endurance and endurance-strength training are effective options for improving health and fitness in women with abdominal obesity.

• While endurance-strength training offers the added benefit of increased muscle mass, both approaches lead to similar improvements in other key areas.

• The choice between the two types of training may depend on individual preferences and goals. Those seeking greater muscle development may prefer endurance-strength training, while those primarily interested in overall fitness and fat loss may find endurance training equally effective.

Additionally:

• The study duration was 3 months, and the long-term effects might differ.

• The sample size was relatively small, and larger studies are needed to confirm these findings.

Understanding Central Obesity

Before we delve into the specifics of exercise, it's crucial to comprehend the nature of central obesity. This type of fat accumulates around the abdominal area and internal organs, which distinguishes it from subcutaneous fat. Central obesity is linked to a higher risk of health complications, making it a top priority for those seeking to improve their overall well-being.

In the pursuit of overall health and fitness, one of the key dilemmas that individuals often face is how to strike a balance between reducing body weight, improving body composition, and maintaining or enhancing bone health. This conundrum is particularly relevant for centrally obese women. A pilot study has shed light on this issue by comparing the effects of two distinct exercise regimens: endurance training and endurance-strength training.

The Study

The study enrolled a group of centrally obese women and randomly assigned them to either the endurance training group or the endurance-strength training group. Over three months, the participants underwent their respective exercise programs, and their progress was meticulously monitored.

Methods

Three weekly sessions, each lasting 60 minutes, were conducted for 12 weeks over non-consecutive days (Monday, Wednesday, and Friday). Both programs emphasized equivalent training volumes but differed in their focus.

Warm-up: Both groups started with five minutes of light exercise at 50–60% of their maximum heart rate (HRmax).

Endurance Group: The main phase (45 minutes) centred on individualised cycling on an ergometer within 50–80% of HRmax.

Endurance-Strength Group: The main phase (45 minutes) combined a 25-minute endurance component (similar to the endurance group) with a 20-minute strength component.

Strength Component (Endurance-Strength Group):

• Monday: Upper body exercises with a barbell (1.6 kg) and two weights (1.25 kg each)

• Wednesday: Spine stabilization, deep muscle-forming, and balance exercises using a gym ball

• Friday: Lower body exercises with a barbell

The number of repetitions and sets (3–6) depended on individual muscle strength. The target was 16 repetitions for barbell curls and 30 for squats. Resistance was set at 50–60% of each participant's one-repetition maximum (RM). See Table S2 for a detailed exercise plan.

Cool-down: Both groups finished with five minutes of unloaded cycling and five minutes of light stretching and breathing exercises.

• The training intensity was personalized and remained constant throughout the intervention.

• Qualified instructors and medical personnel supervised sessions at a professional sports club.

• Dietary habits and daily activity levels were not altered during the study.

Key Findings:

• Both endurance and endurance-strength training significantly reduced fat mass in centrally obese women after 3 months.

• Endurance-strength training was more effective than endurance training in increasing lean mass, particularly in the legs and gynoid area.

• Both training programs negatively affected bone health, with endurance training significantly decreasing total body bone mineral density (BMD) and content (BMC) and endurance-strength training only reducing BMD.

• Endurance training increased osteocalcin (bone formation marker) levels, while endurance-strength training increased tartrate-resistant acid phosphatase 5b (bone resorption marker) levels.

• The study suggests that exercise choice for central obesity depends on individual goals: endurance for cardiovascular health, endurance strength for balanced body composition improvement, and alternative training protocols for protecting bone health.

Details:

• The study compared two 3-month training programs in centrally obese women (n = 44): endurance (mostly cycling) and endurance-strength (cycling + strength training).

• Fat mass decreased significantly in both groups, but not lean mass in the endurance group.

• Total body BMD and BMC significantly decreased in the endurance group, while only BMD decreased in the endurance-strength group.

• Changes in densitometric parameters did not differ significantly between groups, but bone turnover marker changes did.

• Endurance training increased osteocalcin, suggesting increased bone formation.

• Endurance-strength training increased tartrate-resistant acid phosphatase 5b, suggesting increased bone resorption.

• Bone loss might be due to rapid fat loss, a lack of weight-bearing exercises, and a short intervention duration.

• The study acknowledges limitations: small sample size, unknown menopausal status, wide age range, short intervention, and limitations in strength training assessment.

• Future research recommends longer interventions, alternative training protocols with weight-bearing exercises, and assessing additional bone metabolism parameters.

Implications:

• This study provides valuable insights into the effects of different training programs on central obesity and bone health.

• Individuals with central obesity should consider their specific health goals when choosing an exercise program.

• Endurance training is effective for fat loss and cardiovascular health but may not be optimal for building lean mass or protecting bone health.

• Endurance-strength training seems promising for improving body composition, but further research is needed to confirm its long-term effects on bone health.

• Alternative training protocols with weight-bearing exercises and longer durations might be necessary to protect bone health while addressing obesity.

Additional Points:

• The study emphasizes the importance of individualizing exercise programs based on specific needs and goals.

• Combining different training modalities like endurance and strength may offer a balanced approach to improving overall health and body composition in individuals with central obesity.

• Further research is needed to develop and evaluate effective exercise programs for preventing bone loss while addressing obesity and improving cardiovascular health in different populations.

Impact on Body Composition

Both endurance training and endurance-strength training demonstrated significant reductions in fat mass, a positive outcome for those looking to shed unwanted weight. However, there were notable differences between the two approaches.

• Endurance Training: This regimen resulted in a decrease in total body bone mineral density (BMD) and bone mineral content (BMC). This decrease is a potential concern for individuals who aim to maintain or improve their bone health while losing weight.

• Endurance-Strength Training: In contrast, this program only reduced BMD and did not affect BMC significantly. Notably, this approach had a more favourable impact on lean mass in specific areas, including the gynoid region and the legs.

The data suggested that endurance-strength training may be more effective in increasing lean mass, making it an appealing option for those seeking both weight loss and muscle gain.

Mechanical Stimulation and Exercise Types

Mechanical stimuli from exercise significantly impact bone metabolism and can potentially inhibit age-related bone loss. Weight-bearing exercises, such as walking and climbing stairs, have a positive effect on osteogenesis. Certain sports, including jumping, dancing, volleyball, basketball, and running, are more favourable for bone health than swimming or cycling.Cycling, for instance, exerts minimal load on the upper limbs, which may explain the lack of effect on fat and lean mass in the arms observed in the endurance group. In contrast, the lower limbs perform intense work during cycling, possibly preventing the loss of BMD and BMC at the femoral neck. The type and volume of exercises play a significant role in their impact on bone mass.

Duration and Frequency of Exercise

The duration, frequency, and length of the training program are crucial factors influencing its effectiveness. The study implemented moderate-intensity training programs performed three times a week for 60 minutes, aligning with the Physical Activity Guidelines for Americans recommendations. However, the intervention lasted for only 12 weeks, which might be too short to assess the full effects on bone health, as bone remodelling can take several months. Prolonging the intervention may ensure the completion of the entire bone remodeling cycle, but it could also lead to a drop in motivation and an increased dropout rate.

To Summarize

1. Central Obesity Health Risks: Central obesity, also known as visceral fat, poses significant health risks such as cardiovascular diseases, diabetes, and metabolic disorders.

2. Endurance Training Benefits: Endurance training boosts metabolism, enhances cardiovascular health, and reduces stress, making it effective against central obesity.

3. Endurance-Strength Training: Combining endurance with strength exercises helps build lean muscle, boosts metabolism, and improves functional fitness.

4. Study Overview: A pilot study on centrally obese women compared endurance and endurance-strength training over three months to assess their effects on body composition and bone health.

5. Findings Overview: Both training methods reduced fat mass. Endurance-strength training increased lean mass more effectively but negatively affected bone health.

6. Impact on Bone Health: Endurance training decreased total body bone mineral density and content, while endurance-strength training only affected bone mineral density.

7. Exercise Types and Bone Health: Weight-bearing exercises like running and jumping positively impact bone health compared to cycling or swimming.

8. Duration and Effectiveness: The study used moderate-intensity training three times a week for 60 minutes, but longer interventions may be necessary to assess full bone health effects.

Conclusion

In summary, this pilot study demonstrated that both endurance and endurance-strength training can effectively reduce fat mass but may negatively impact bone health, with endurance-strength training having a more favorable effect on increasing lean mass. These results emphasize the importance of considering the specific goals and health needs of individuals when designing an exercise program.

Reference Articles

Jamka M, Piotrowska-Brudnicka SE, Karolkiewicz J, Skrypnik D, Bogdański P, Cielecka-Piontek J, Sultanova G, Walkowiak J, Mądry E. The Effect of Endurance and Endurance-Strength Training on Bone Health and Body Composition in Centrally Obese Women—A Randomised Pilot Trial. Healthcare. 2022; 10(5):821. https://doi.org/10.3390/healthcare10050821

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