Reductions in visceral fat during weight loss and walking are associated with improvements in Vo2max

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 ((V) over dot O-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 ((V) over dot O-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 (V) over dot O-2 max reduced VAT by an average of 20%, whereas those who did not increase (V) over dot O-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 (V) over dot O-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 (V) over dot O-2 max with weight loss and walking are associated with greater reductions in visceral adiposity in obese postmenopausal women.