Fitness Versus Fatness: the Debate Continues

Abstract

To the Editor: We read with interest the articles about the effect of exercise training on C-reactive protein (CRP) levels1,2 and the accompanying editorial.3 Okita et al1 showed that a 2-month period of exercise training in women with a wide range (20.4 to 39.0) of body mass index (BMI) reduced CRP concentrations independently of the magnitude of weight loss. Obisesan et al2 reported that gene variants of CRP are not related to reduction of CRP levels induced by exercise training (24 weeks) in 63 sedentary men and women (prevalence of obesity not specified). Surprisingly enough, weight reduction was greater in the first study (3 kg on average) than in the second study (range of weight loss 1.1 to 1.8 kg). In none of the two studies was there any statement about the cut of daily calories at the end of the observation. This seems particularly strange as losing weight with exercise alone is more difficult because of the accompanying increase in free fat mass (muscle) which may counterbalance the decrease of fat mass. Another analysis missing was enucleating the obese group to see for a particular response of CRP levels. So, the reader continues to suspect that part of the effect of exercise training on CRP levels is related to the concomitant weight loss. Okita et al1 stated, and we agree, that there might be an optimal pace of exercise and weight loss to optimize the inflammatory status which needs to be examined in long-term intervention studies. In any case, two such studies escaped his attention. We have demonstrated in two intervention studies of 2-year follow-up in obese women4 and men5 that a multidisciplinary program of changes in lifestyle designed to obtain a substantial reduction in body weight through caloric restriction and increased …