Obésité abdominale et lipoprotéines: effets de l'exercice

It is now well established that the regional distribution of body fat is a significant risk factor for non-insulin-dependent diabetes mellitus and cardiovascular disease. Several alterations in glucose-insulin homeostasis and in plasma lipid transport may, at least partly, explain the increased risk of diseases related to abdominal obesity. Furthermore, it is now clear that obese patients with high levels of deep abdominal fat represent the subgroup of obese individuals carrying the greatest risk of cardiovascular disease. In abdominal obese subjects, aerobic exercise training of low intensity and high duration will have a significant effet on energy balance that will lead to changes in body composition. In this regard, our results indicate that total and abdominal fat losses are significant correlates of the changes in carbohydrate and lipid metabolism that are observed in response to aerobic exercise training. The improvement in insulin sensitivity appears to play a central role in improving plasma lipid transport in exercise trained individuals. In summary, although we have not been able to normalize the level of total body fat in our obese subjects, our results indicate that aerobic exercise of long duration and of low intensity, performed on a daily basis, is associated with substantial improvements in plasma lipoprotein levels that suggest a reduced risk of cardiovascular disease. From a practical standpoint, it is suggested that walking at a brisk pace (≈50% of maximal aerobic power), probably represents the best exercise prescription for the treatment of the metabolic complications of abdominal obesity.