Multifaceted Exercise Training Affects Abdominal Adiposity and Plasma Adiponectin Levels in the Japanese Elderly

Abstract

It is well established that abdominal adiposity is a strong predictor of morbidity. The combination of sarcopenia and obesity is strongly associated with disability in the elderly. Adiponectin, an adipose tissue derived-protein, is inversely correlated with body mass index (BMI), body fat mass, and fat distribution. However, the effect of exercise training on abdominal fat and circulating adinopectin in the elderly has not been fully investigated. PURPOSE: To evaluate the influence of a twice-weekly group exercise program on abdominal fat and circulating adiponectin levels in the elderly. METHODS: Thirty-three community-dwelling older persons (16 males, 17 females; ages: 72.4 +/− 6.9 yrs; BMI: 24.9 +/− 3.4), participated in a 12-week supervised, multifaceted group exercise (MGE) training program followed by a 12-week unsupervised program. The 12-week MGE program included stretching, strengthening, and balance-training exercises. Following the MGE program, participants continued to exercise in a maintenance phase for an additional 12 weeks which consisted of machine training in an unsupervised setting. Participants were evaluated for measures of gait speed, grip and leg strength, dynamic balance, agility, and flexibility. Abdominal adipose tissue areas were measured by computed tomography. Blood samples were taken for plasma adiponectin levels. Daily activity was measured using a hip-mounted accelerometer. The measurements were taken before training (T1), after 12-weeks of the MGE program (T2), and at the end of the 12-week of maintenance phase (T3). RESULTS: Twelve weeks of MGE produced significant increases in the physical function measures. Although leg strength and gait speed decreased from T2 to T3, the results remained significantly elevated from T1 values. From T1 to T2, a 51% increase in daily steps occurred, and this increase was maintained at T3. A significant reduction of intra-abdominal fat area was seen by T3 (T1: 117.2 +/− 53.5, T3:109.1 +/−47.7cm2; P< .05), whereas subcutenous fat area showed no significant change. Plasma adiponectin levels were progressively elevated from T1 to T3 (T1: 10.7+/− 5.9, T2: 11.5+/−6.5, T3: 12.2+/−7.1 μg/mL; P <.05) CONCUSION: In the frail older adults, 12 weeks of MGE training was effective for increasing the physical fitness and plasma adiponectin levels. The beneficial effects for abdominal fat and plasma adiponectin levels were sustained following the participation in the unsupervised setting and the physical activity at home. The combination of socialization at an exercise facility and functional independence at home appear to be an important part of the geriatric exercise program.