Low intensity endurance exercise targeted for lipid oxidation improves body composition and insulin sensitivity in patients with the metabolic syndrome

Background: To investigate the effects of individualized training on the metabolic syndrome. Methods: Twenty-eight patients, suffering from the metabolic syndrome. were studied before and after 2 months of training and compared to eleven patients who did not follow any training. All the patients were overweight. Training was individualized at the point where fat oxidation was maximal (LIPOXmax) as determined by calorimetry. Results: The patients exhibited a significant reduction in body weight (- 2.6 +/- 0.7 kg; P = 0.002), fat mass (- 1.55 +/- 0.5 kg; P = 0.009), waist 3.53 +/- 1.3cm; P < 0.05) and hip (- 2.21 +/- 0.9cm; P < 0.05) circumferences, and improved the ability to oxidize lipids at exercise (crossover point: + 31.7 +/- 5.8 W; P < 0.0001; LIPOXmax: + 23.5 +/- 5.6 W; P < 0.0001; lipid oxidation: + 68.5 +/- 15.4 mg-min(-1); P = 0.0001). No clear improvement in either lipid parameters or fibrinogen were observed. The surrogates of insulin sensitivity evidenced a decrease in insulin resistance: HOMA%S (software): + 72.93 +/- 32.64; p < 0.05; HOMA-IR (simplified formula): -2.42 +/- 1.07; P < 0.05; QUICKI: + 0.02 +/- 0.004; P < 0.01; SI = 40/1: + 3.28 +/- 1.5; P < 0.05. Significant correlations were found between changes in body weight and HOMA-IR and between changes in LIPOXmax and QUICKI. Conclusions: Individualized aerobic training improves lipid oxidation, body composition and insulin resistance.