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58

Indian
Umamaheswari,
J Physiol Pharmacol
Dhanalakshmi,
2017;Karthik,
61(1) : John
58–64
and Sultana Indian J Physiol Pharmacol 2017; 61(1)

Original Article

Effect of Exercise Intensity on Body Composition in Overweight and


Obese Individuals

K. Umamaheswari*, Y. Dhanalakshmi, S. Karthik, Nitin Ashok John


and Rehena Sultana
Department of Physiology,
Government Indira Gandhi Medical College,
Kathirkamam, Puducherry

Abstract
Introduction: Exercise is an important component of weight loss program. The amount and intensity of
exercise required to produce a change in body composition and anthropometric measures are yet to be
determined. Traditional steady state exercises performed at moderate intensity have been examined for
weight and fat loss. Recently, High intensity exercise done for less duration is emerging and gaining
importance. We aimed at investigating the intensity of exercise required to produce a significant change in
anthropometric and body composition measurements.
Materials and methods: Volunteers, sedentary overweight and obese in the age group of 19-35 years, were
randomized into group I (n-35) those performing moderate intensity exercise at 50-74% heart rate maximum
reserve for 40 min and group II (n=37) high intensity exercise at 75%-84% of heart rate maximum reserve
for 20 min on a bicycle ergometer for a duration of 15 weeks. Anthropometric measures and body composition
were determined using skin fold caliper.
Results: There was a significant change in the weight, waist hip ratio, skin fold thickness, circumference
measures, fat mass, fat percentage, and lean body mass among moderate (p<0.000) and high intensity
group (p<0.000). A significant change in fat mass (p<0.002) lean body mass (p<0.001) and fat % (p<0.000)
in the high intensity group compared to moderate intensity group was observed.
Conclusion: It is concluded that 15 weeks of exercise at high intensity is more effective in changing the
body composition considering the strategy of time commitment in overweight and obese individuals.

Introduction world and an associated modifiable risk factor for


various metabolic disorders. The reason for the
increasing trend of obesity in adults is a sedentary
Obesity is a major health problem of the developing
life style. It is important to prevent obesity, and
exercise is established as an important component
*Corresponding author : of behavioral weight loss program (1). The National
Dr. K. Umamaheswari, Associate Professor, Department program for prevention and control of diabetes and
of Physiology, ESIC Medical College & PGIMSR, KK Nagar, cardiovascular disease suggests moderate to vigorous
Chennai – 600 078, Mobile: 9790218060
Email : umamaheswarik89@yahoo.in
activity for 5-7 days/week (2). Recognizing exercise
protocols that are effective in reducing body fat and
(Received on April 12, 2016)
feasible to be followed by overweight, sedentary
Indian J Physiol Pharmacol 2017; 61(1) Exercise Intensity and Body Composition 59

individuals are important. Also an effective exercise (BMI≥25) in the age group of 19-35 were included.
training depends on exercise intensity and the Exclusion criteria comprised individuals with history
duration. Different types of exercise are studied for of previous surgery, cardiopulmonary and musculo-
the purpose of weight loss. Traditional steady state skeletal disorders, diabetics, hypertensives, and
low and moderate intensity exercises done over a asthmatics. Complete clinical examination, ECG and
period of 45-60 min almost every day in a week have echocardiogram were taken and fitness obtained from
resulted in noteworthy change in body weight thereby physician before volunteers were involved for the
reducing cardiovascular and metabolic disease risk. exercise program. 91 volunteers enrolled for the
Recently, high intensity intermittent exercise (HIT) study. 72 of them completed the 15 weeks exercise
that involve repeated brief sprinting at an all- out protocol. 12 opted out due to various reasons not
intensity followed immediately by low intensity related to the study. There was no injury stated due
exercise or rest done for 3-4 days in a week of less to the exercise.
duration is gaining importance for the purpose of
weight loss and change in body composition. It is Anthropometric measurements:
also considered as an economical exercise protocol
for reducing fat in overweight individuals (3, 4). A digital weighing scale that could measure to the
Studies have examined moderate and high intensity nearest 0.1 kg was used to record weight, and height
exercise for a change in body composition and have was measured to the nearest centimeter using a
reported conflicting results (5, 6). Limited work have stadiometer, in the Frankfurt plane position. Waist
investigated the low volume HIT on people with risk circumference was measured in centimeters (cms)
for cardio metabolic disorders and their impending midway between the uppermost point on the iliac
benefits are still uncertain. The optimal amount of crest and the lowermost margin of the ribs with the
exercise necessary to produce a change in body measuring tape parallel to the ground and patient in
composition is yet to be ascertained and moreover, inspiration. Hip circumference was measured in cms
an exercise program to be operational, must be at the maximum circumference of the buttocks at
economical and easy to implement without the the level of the greater trochanter (7). Waist hip ratio
necessity of complicated exercise equipment. was calculated to be waist circumference in cms
Therefore, we investigated, a protocol of moderate divided by hip circumference in cms. Mean of three
and high intensity exercise on a simple stationary readings of each measurement was taken for the
bicycle ergometer that was required to produce calculation of WHR. Mid arm, mid-thigh and mid-calf
significant change in body composition in overweight circumference (8) were also measured.
and obese individuals.
Measurement of body composition:

Methods Skin fold measurements were taken from various sites


including biceps, triceps, scapular, abdominal,
This study was conducted in the Department of suprailiac, thigh and medial calf sites according
Physiology at Indira Gandhi Medical College, to standard procedures using skin fold caliper.
Puducherry. Institute ethical committee approval was All skinfolds were measured to the nearest 1 mm.
obtained. Written material explaining the purpose of Mean of 3 readings was recorded at all the sites.
the study was circulated in the college and hospital, All measurements were taken by the same
volunteers who wished to participate in the study investigator before and after completion of exercise
reported to Physiology department. Informed written protocol. Durnin’s age specific equations (1974)
consent was taken from volunteers. They were was adopted to calculate body density that was
assigned to moderate or high intensity exercise group further used in Siri’s equation (1961) to determine
randomly based on lot method. All procedures the total body fat. Fat percentage, fat mass, lean
followed were according to revised Helsinki Declaration body mass (9) were derived using standardized
of 2000. Sedentary overweight and obese individuals equations.
60 Umamaheswari, Dhanalakshmi, Karthik, John and Sultana Indian J Physiol Pharmacol 2017; 61(1)

Exercise protocol:
Results
Subjects were instructed to abstain from caffeine
Of the 91 volunteers 72 completed the exercise
and alcohol at least two days prior to the exercise
protocol. They were grouped into Group I (n=37) who
session and have food two hours prior to the exercise performed moderate intensity exercise and Group II
session. During the visit to the laboratory, subjects (n=35) who performed high intensity exercise
were well acquainted with the exercise protocol for respectively. The baseline characteristics of the study
two weeks and encouraged to get their doubts population, mean age 24.3±6.2, 23.2±5.6 and BMI
clarified. Exercise was performed on the bicycle 29.24±2.59, 29.69±3.2 of the participants in both the
ergometer at the fixed weight to reach the calculated groups respectively were similar. Comparison of the
target heart rate using karvonen formula (10). anthropometric measurements and body composition
before and after exercise in group I is shown in Table
Exercise protocol for moderate intensity exercise I. All the measurements showed a significant change
group included performance of Steady state cycling after performance of moderate intensity exercise for
at the heart rate of 50%-74%. of heart rate maximum a period of 15 weeks. The comparison of the
reserve for a duration of 40 min, 5 days/week (n=37) measures before and after completion of exercise
and High intensity exercise group (n=35) performed protocol in group II showed a significant change as
8 sec sprint cycling on bicycle ergometer at the presented in Table II. Fig. 1 depicts the change in
heart rate of 75%-84% of heart rate maximum reserve the body composition measures between group I and
followed by 12 sec of low intensity cycling for a II in which, there was a significant improvement in
duration of 20 min, 3 times/week with 5 min of warm the lean body mass (p<0.000) and a decrease in fat
up and 5 min of cool down in both the groups. mass (p=0.002), fat percentage (p<0.000) in both

TABLE I : Comparison of body composition before and after moderate intensity exercise.

Measurements Before exercise After exercise P value


Mean±SD Mean±SD

Weight* (kg) 76.14±10.1 72.4±10.3 0.000


Waist hip ratio* 0.81±0.1 0.80±0.9 0.024
Mid arm circumference* (cm) 32.4±2.4 30.5±2.2 0.000
Mid-thigh circumference* (cm) 56.9±4.3 52.86±4.5 0.000
Mid-calf circumference* (cm) 38.68±3.7 35.61±3.4 0.000
Sum of skin fold measurements (mm)* 87.61±16.6 78.46±14.5 0.000
Fat percentage* 34.2±2.6 32.6±2.7 0.000
Fat mass* (kg) 25.9±3.3 23.3±3.2 0.000
Fat free mass/lean body mass* (kg) 50.2±7.2 49.1±8 0.000

*p<0.05 significance

TABLE II : Comparison of body composition before and after high intensity exercise.

Measurements Before exercise After exercise P value


Mean±SD Mean±SD

Weight* (kg) 79.1±9.8 76.3±9.7 0.000


Waist hip ratio* 0.84±0.7 0.80±0.5 0.000
Mid arm circumference* (cm) 32.6±2.5 30.2±2.6 0.000
Mid-thigh circumference* (cm) 57.7±4.04 53.3±4.3 0.000
Mid-calf circumference* (cm) 38.6±3.2 35.4±3.3 0.000
Sum of skin fold measurements* (mm) 86.93±12.08 77.93±11.2 0.000
Fat percentage* 34.15±1.9 31.05±1.6 0.000
Fat mass* (kg) 27.07±4.06 23.7±3.29 0.000
Fat free mass/lean body mass* (kg) 52.05±6.2 52.6±6.9 0.004

*p<0.05 significance
Indian J Physiol Pharmacol 2017; 61(1) Exercise Intensity and Body Composition 61

Fig. 1 : Comparison of change in body composition between high and moderate intensity exercise groups.
*p<0.05 significance

Fig. 2 : Comparison of change in circumference between high and moderate intensity exercise groups.
*p<0.05 significance

the groups. However, on comparison between group –9.0±2.5 in group I and II respectively. But comparing
I and Group II the change was statistically significant the change in skin fold measurements between the
in group II. Comparing the change in circumference groups did not show statistical significance.
measurements between both the groups significant
change in the mid arm circumference (p=0.025) (Fig. Discussion
2) in the high intensity group was observed.
Comparison of Waist hip ratio with a mean value of Body composition refers to the constituents of body-
0.80±0.9, 0.80±0.5 in Group I and Group II lean mass, fat mass and water, and is not only
respectively did not show a statistical significance important for athletes, since an athlete’s performance
(p=0.14). Similarly, there was a significant decrease is partially influenced by the proportion of his fat-
in sum of skin fold measurements of –9.14±4.1, free mass (FFM) and fat mass (FM), but also for
62 Umamaheswari, Dhanalakshmi, Karthik, John and Sultana Indian J Physiol Pharmacol 2017; 61(1)

individuals of all ages, gender and ethnic groups Controversial results have been reported by Desprest
(11). Evaluation of weight alone does not reveal al (17) who examined women who exercised for 90
a change in fat or fat free mass. Estimation of min at 55% of maximal aerobic power (VO 2max) four
body composition using hydrostatic weighing is to five times a week for a period of 14 months. The
an intricate procedure. Determination of body training program induced a significant mean reduction
composition using anthropometric measures would in body fat mass of 4.6 kg (p<0.01), with no change
be a convenient and economical method. Moreover, in fat-free mass. The change has been observed in
most validation studies that measures body the moderate intensity group but no comparison was
composition based on anthropometric measures made with the high intensity exercise group in this
correlates well with the predicted hydrostatic weighing study. Leijssen et al. (5) reported no change in body
measures (12). fat percentage between performing exercise at
VO 2max 40% (low intensity) and 70% VO 2max (high
Majann et al (13) and John et al (14) reported that intensity) after 12 weeks of exercise in obese men.
moderate to high doses of exercise in combination
with a decrease in energy intake resulted in 8% to The exercise protocol followed in our study was
10% reductions in body weight following a 12-month similar to Trapp et al (18) who conducted an exercise
intervention. Participants randomized to vigorous program that included high intensity exercise (n=15)
exercise intensity did not have greater weight loss for a duration of 20 min and moderate intensity
than those randomized to a similar dose of exercise exercise (n=15) of 40 min duration and observed a
performed at a moderate intensity. Our findings are 2.5 kg loss of subcutaneous fat in the high intensity
consistent with these observations. The reduction of group with no change in the moderate intensity group.
weight in moderate and high intensity group was Fat loss of 50% was attained with less exercise
6.15%, 5.2% respectively. The smaller loss of weight time commitment. Our results are also in favor of
in high intensity group can be explained by a high intensity exercise for fat loss. Considering the
comparable increase in the fat free mass in this strategy of time commitment it gives an additional
group. If the gain in fat free mass is attributed to benefit in producing changes in body composition.
muscle hypertrophy rather than glycerol stores then
resting metabolic rate increases which is favourable The waist hip ratio also significantly reduced in the
for long term weight control. high intensity group. Van et al (19) also reported
that the high intensity group ameliorated waist
It is evident from our results, that the fat mass and circumference and the waist-to-hip ratio after
fat percentage showed a significant decrease in the intervention. The reasoning probably could be
high compared to the moderate intensity group. These individuals with obesity oxidize more fat during
findings are similar to those observed by Knoepfli et intense physical activity favoring a reduction in WHR
al (15) who reported a reduction in absolute body (20).
mass, relative total fat mass and an improvement in
the waist hip ratio, lean body mass during training Comparing the change in the circumference between
in football and runners of 25-45 years males for a both the groups, a significant decrease in the mid
period of 12 weeks in the football group relating it to arm circumference was noted in the high intensity
the high intensity exercise. Also Bryner et al (16) group. There was a decrease in the mid- thigh and
compared two types of exercise intensity, running mid- calf circumference in both the groups but on
for 40-45 min with a heart rate of 132 beats/min comparison between the groups it did not show a
moderate intensity, 163 beats/min high intensity in statistical significance. These findings can again be
women in the age group of 18-34 years and observed explained by an increase in the lean body mass in
that there was significant drop in percent body fat both types of exercise.
while in the moderate intensity group the reduction
of was not significant. The authors concluded in favor The underlying mechanism behind reduction in body
of high intensity exercise for fat loss. adiposity with high intensity exercise is not clear.
Indian J Physiol Pharmacol 2017; 61(1) Exercise Intensity and Body Composition 63

Possible mechanisms include factors affecting energy approximately seven one hour sessions per week
intake (21) and post-exercise energy expenditure (22). which could be wearisome and make them lose
Phelan (23) et al observed that, carbohydrate interest in performing regular exercise.
oxidation was significantly greater for the high
intensity protocol (75% VO 2 max) than for the low Exercise protocols must be motivating, stress free
intensity (50% VO2max) activity and total fat oxidation and realistic to achieve set goals of physical fitness.
(exercise plus a 3-h recovery) was greater during A strict regimen of exercise along with long duration
the low intensity exercise treatment. However, the of performance will be dreary.
calculated fat oxidation was 23.8% higher 3 h after
the performance of high compared to low intensity The present study aimed at comparing moderate and
exercise and thus postulated that high intensity high intensity exercise protocol required to produce
exercise allows large amounts of glucose to be a change in the body anthropometric measures and
utilized and after the exercise training greater body composition in overweight and obese individuals.
contribution of fat oxidation meet the energy We conclude from our results that both high and
requirement. Repeated bouts of high-intensity, moderate intensity exercise produce a significant
intermittent exercise leads to increased lactate and change in the body composition and circumference
catecholamine levels. The accompanying increase measurements. High intensity exercise is more
in glycerol levels suggests that fat stores may supply effective and offers an additional advantage of less
a significant amount of energy during this form of duration for an improvement in the level of physical
exercise. It is feasible that it creates a “substrate fitness and a decrease in body weight compared to
shuttle” whereby there are repeated shifts from moderate intensity exercise protocol of extended
anaerobic to aerobic energy sources (24). duration. Most studies have analysed different
intensities of exercise in normal individuals, whereas
In terms of energy expenditure, Ohkawara et al (25) we have tried evaluating an exercise protocol which
calculated that about 520-550 kcal is expended when would be feasible to be followed by overweight and
performing a moderate intensity exercise session obese individuals to produce a change in body
lasting an hour on a stationary bicycle ergometer composition. We believe our results will have strong
and, to attain an optimal exercise caloric expenditure implications and contribute to weight reduction
of 3,780 kcal per week an individual has to perform programs.

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