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A pilot study of exercise training to reduce trunk fat in adults with HIV-associated fat redistribution

Roubenoff, Ronenn; Weiss, Lauren; McDermott, Ann; Heflin, Tanya; Cloutier, Gregory J.; Wood, Michael; Gorbach, Sherwood

Concise Communication

Objective: Body fat redistribution (‚lipodystrophy‚), with gain in abdominal and trunk fat, and decline in facial and limb fat, is a newly recognized problem in patients with HIV infection that has been linked to use of HIV-1 protease inhibitors. Increased abdominal fat may predispose these patients to hypertension, diabetes, and coronary artery disease. At this time no effective treatment is available. We examined whether exercise training could reduce trunk fat in men with fat redistribution.

Design: Open-label pilot study.

Methods: Ten men with increasing abdominal girth participated in a 16 week pilot study of progressive resistance training with an aerobic component. They trained in a community health club three times per week. Total body lean and fat mass, and trunk fat mass, were assessed by dual-energy x-ray absorptiometry (DXA).

Results: After 16 weeks of exercise, strength increased for three of the four exercises tested (leg press + 13% [p<0.02], leg extension + 19% [p<0.03], seated row + 7% [p<0.13], chest press + 18% [p<0.005]). There was a significant decline in total body fat by 1.5kg (=2.1 percentage points, p<0.01); most of the decline in body fat occurred in trunk fat, which decreased by 1.1kg (p<0.03). Weight, lean mass (+ 1.1±2.6kg, p=0.23), and bone mineral density measured by DXA did not change. No adverse effects were seen from the training.

Conclusions: Exercise training may reduce trunk fat mass in HIV-positive men with fat redistribution.Controls trials of this approach are warranted.

From the aDepartment of Community Health, bTupper Research Institute, Department of Medicine, Tufts University School of Medicine, and cJean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA; and dMetropolitan Health Club, Boston, MA 02116, USA.

Sponsorship: This work was supported by NIH grant DK45734, and through the General Clinical Research Center funded by the Division of Research Resources, NIH grant M01-RR00054.

Testing equipment was a kind gift of Keiser Sports Health Equipment Co., Fresno, CA, USA. The contents of this publication do not necessarily reflect the views or policies of the US Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government.

Correspondence to: Ronenn Roubenoff MD, MHS, Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA HNRCA, Tufts University, 711 Washington Street, Boston, MA 02111, USA. Tel: +1 (617) 556-3172; fax: +1 (617) 556-3083; e-mail roubenoff@hnrc.tufts.edu

Received: 19 January 1999; revised: 22 April 1999; accepted: 30 April 1999.

Copyright © 1999 Wolters Kluwer Health, Inc.