Some of these same issues bedeviled the exercise science highlighted in the other new review, which was published in February in Mayo Clinic Proceedings. For this study, the researchers zeroed in on fat and, in particular, visceral fat, a particularly hazardous type of fat that accumulates around our middles and deep beneath the skin, smothering internal organs and heightening the risk of metabolic problems.
Several drugs currently are approved to trim visceral and other types of fat, including metformin and orlistat. Exercise also has been shown to reduce visceral fat. But there has been little science comparing those approaches.
So, the researchers, most of them from the University of Texas Southwestern Medical Center in Dallas, rounded up recent relevant drug experiments and similar randomized trials using exercise to fight visceral fat. All of the experiments had to have lasted for at least six months. Then they aggregated results.
Again, as in the other review, drugs and exercise both succeeded for most participants; using either approach, most people lost some visceral fat. But in this review, exercise was slightly superior in that for every pound someone dropped, more of it was visceral fat when they exercised than when they used drugs.
The upshot of the review is that “lifestyle changes such as exercise should be the first step” when people set out to reduce visceral fat, says Dr. Ian Neeland, an assistant professor of internal medicine at UT Southwestern Medical Center, who oversaw the new review.
He and his colleagues also found that aerobic exercise trimmed visceral fat more effectively than strength training, although most of the exercise trials were small-scale and had no placebo control.
Taken together, the new reviews indicate that exercise can equal or exceed the effects of drugs on high blood pressure and visceral fat. But they also underscore that clinical exercise science could stand to raise its game and develop greater rigor in testing exercise as medicine.
Long-lasting studies that directly compare different drugs and various types of workouts are needed, Dr. Neeland says, although they will be logistically difficult and expensive.
Source : Nytimes
