Reductions in visceral fat during weight loss and walking are associated with improvements in VO(2 max)

The accumulation of visceral fat is independently associated with an increased risk for cardiovascular disease. The aim of this study was to determine whether the loss of visceral adipose tissue area (VAT; computed tomography) is related to improvements in maximal O(2) uptake (VO(2 max)) during a weight loss (250-350 kcal/day deficit) and walking (3 days/wk, 30-40 min) intervention. Forty obese [body fat 47 +/- 1 (SE) %], sedentary (VO(2 max) 19 +/- 1 ml. kg(-1). min(-1)) postmenopausal women (age 62 +/- 1 yr) participated in the study. The intervention resulted in significant declines in body weight (-8%), total fat mass (dual-energy X-ray absorptiometry; -17%), VAT (-17%), and subcutaneous adipose tissue area (-17%) with no change in lean body mass (all P < 0.001). Women with an average 10% increase in VO(2 max) reduced VAT by an average of 20%, whereas those who did not increase VO(2 max) decreased VAT by only 10%, despite comparable reductions in body fat, fat mass, and subcutaneous adipose tissue area. The decrease in VAT was independently related to the change in VO(2 max) (r(2) = 0.22; P < 0. 01) and fat mass (r(2) = 0.08; P = 0.05). These data indicate that greater improvements in VO(2 max) with weight loss and walking are associated with greater reductions in visceral adiposity in obese postmenopausal women.