Obesity Clinical Trial
Official title:
Peripheral Effects of Exercise on Cardiovascular Health (STRRIDE II)
This study will investigate the separate and combined effects of aerobic and resistance training on cardiovascular risk factors in overweight men and women with mild to moderate dyslipidemia.
BACKGROUND:
Substantial evidence supports a favorable relationship 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 exposure required to achieve health benefits is poorly defined and the mechanisms
through which these beneficial adaptations occur are poorly understood. This 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.
DESIGN NARRATIVE:
In Studies of a Targeted Risk Reduction Intervention through Defined Exercise II (STRRIDE
II), participants will be randomly assigned to one of four exercise training regimens after
a 4-month sedentary control period. After an initial ramp period of up to 2 months,
participants will be asked to train for 6 months in a given exercise program. The programs
differ either in the dose of aerobic exercise or in the mode (e.g., aerobic exercise,
resistance exercise, or a combination). Parameters reflecting changes in carbohydrate and
lipid metabolism will be studied at an integrative physiologic level and with measurable
biological endpoints in peripheral skeletal muscle (capillary surface area). It is proposed
that the elucidation of the peripheral mechanisms mediating the favorable responses in
carbohydrate and lipid metabolism to chronic physical activity will lead to better
understanding of the health benefits conferred by physical activity and cardiovascular
fitness. This may also point the way toward better exercise recommendations for clients with
significant cardiovascular risk factors. The purpose of this study is to investigate the
peripheral biological mechanisms through which chronic physical activity will alter
carbohydrate metabolism and lipid metabolism that results in improvement in parameters of
cardiovascular health and fitness. The driving hypothesis is that the health benefits
derived from habitual exercise are primarily mediated through adaptations occurring in
skeletal muscle. The mechanism of change in skeletal muscle differs by the mode of exercise
training. It is hypothesized that the health benefits of aerobic exercise are mediated
primarily by qualitative changes in skeletal muscles (alterations in exposed capillary
surface area in skeletal muscle induced by exercise training) and that the health benefits
of resistance exercise are mediated primarily by quantitative changes in skeletal muscles
(alterations in fiber area in skeletal muscle induced by exercise training). The
investigators will use combination exercise regimens in moderately obese patients with mild
to moderate lipid metabolic abnormalities in order to investigate whether induced
alterations in skeletal muscle fiber area, metabolic capacity, and capillary surface area
account for favorable alterations in insulin sensitivity, glucose metabolism, lipoprotein
levels, and lipid metabolism.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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