Obesity Clinical Trial
To investigate the separate effects of the amount of exercise and exercise intensity on cardiovascular risk factors in overweight men and women with mild to moderate dyslipidemia.
BACKGROUND:
Substantial evidence supports a favorable relationships between cardiovascular fitness,
physical activity and cardiovascular health. In particular, it is well established that
increased levels of physical activity result in favorable improvements in lipid and
carbohydrate metabolism. There is also evidence that increased physical activity and
cardiovascular fitness have beneficial effects on cardiovascular health independent of the
effects on specific cardiovascular risk factors. One hypothesis proposes that the beneficial
effects of regular exercise in humans is mediated through peripheral mechanisms, in
particular through the chronic adaptations in skeletal muscle to habitual exercise. The
exercise exposures required to achieve health benefits in humans are poorly defined and the
mechanisms through which these beneficial adaptations occur are poorly understood. The study
will investigate the peripheral biological mechanisms through which chronic physical
activity alters carbohydrate metabolism and lipid metabolism, resulting in improvements in
these parameters of cardiovascular health and fitness in humans.
DESIGN NARRATIVE:
In this clinical trial, Studies of a Targeted Risk Reduction Intervention through Defined
Exercise (STRRIDE I), subjects were randomly assigned to one of three graded exercise
training regimens or a sedentary control group and asked to train, after an initial ramp
period of up to two months, for six months at a given exercise intensity and dose.
Parameters reflecting changes in carbohydrate and lipid metabolism were studied at an
integrative physiologic level and with measurable biological endpoints in peripheral
skeletal muscle (e.g., capillary surface area). It was proposed that the elucidation of the
peripheral mechanisms mediating the favorable responses in carbohydrate and lipid metabolism
to chronic physical activity would lead to better understanding of the health benefits
conferred by physical activity and cardiovascular fitness in humans and point the way toward
better exercise recommendations for clients with significant cardiovascular risk factors.
The purpose of this study was to investigate the peripheral biological mechanisms through
which chronic physical activity altered carbohydrate metabolism and lipid metabolism,
resulting in improvements in these parameters of cardiovascular health and fitness in
humans. The driving hypothesis was that health benefits derived from habitual exercise were
primarily mediated through adaptations occurring in skeletal muscle, probably related to
alterations in exposed capillary surface area in skeletal muscle induced by exercise
training. The investigators used graded exercise regimens in moderately obese human subjects
with mild to moderate lipid metabolic abnormalities to investigate whether induced
alterations in skeletal muscle fiber type, metabolic capacity and capillary surface area
accounted for favorable alterations in insulin sensitivity and glucose metabolism,
lipoprotein levels and lipid metabolism.
;
Allocation: Randomized, Primary Purpose: Prevention
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