Adding resistance training to diet and exercise program may aid adults with obesity, HFpEF
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CHICAGO — Adding resistance training to caloric restriction and aerobic exercise training was safe and did not adversely impact cardiac or arterial structure and function in older adults with obesity and HF with preserved ejection fraction.
“Clinicians should consider adding supervised resistance training to improve skeletal muscle strength and muscle quality of older patients with obesity and HFpEF,” Peter H. Brubaker, PhD, professor and chair of the department of health and exercise science at Wake Forest University, told Healio.
Researchers conducted a randomized controlled, single-blind, 20-week trial that evaluated the impact of supervised resistance training added to caloric restriction and aerobic exercise training compared with caloric restriction and aerobic exercise only. The study included 88 adults with chronic HFpEF and a BMI of 28 kg/m2 or greater. Of those, 77 patients completed the trial.
“Our 2016 study in JAMA showed that caloric-restricted diet and aerobic exercise training produced significant improvements in exercise capacity and quality of life, as well as significant weight loss in older patients with obesity and HFpEF. However, approximately 35% of the weight loss was skeletal muscle mass, which is undesirable, as we would like to lose fat and not muscle,” Brubaker told Healio.
The results were presented at the American Heart Association Scientific Sessions and simultaneously published in Circulation: Heart Failure.
The primary outcome was improvement in peak exercise oxygen consumption, which improved from baseline to 20 weeks in the resistance training group by 108 mL per minute (P = .001) and by 80 mL per minute in the caloric restriction and aerobic exercise-only group (P = .002).
Both strategies yielded weight loss at 20 weeks, with a mean loss of 8 kg in the resistance training group and 9 kg in the caloric restriction and aerobic exercise-only group. The researchers also reported reductions in body fat, with a mean reduction of 6.5 kg and 7.4 kg, respectively.
In other results, skeletal muscle was reduced at 20 weeks by 2.1 kg in both groups. Increases were greater in the resistance training group for leg muscle strength (4.9 Nm vs. –1.1 Nm; P = .05) and leg muscle quality (0.07 Nm/cm2 vs. 0.02 Nm/cm2; P = .04). Kansas City Cardiomyopathy Questionnaire score also improved in both groups. The researchers also reported reduced left ventricle mass and arterial stiffness in both groups.
“The results of this study suggest that supervised resistance training, when added to caloric restriction and aerobic exercise training, appears to have no adverse effect on cardiac or arterial structure and function, is safe and was not associated with any exercise-related adverse events. Finally, improved LV mass, end-diastolic volume and arterial stiffness with caloric restriction and exercise are highly relevant to HFpEF, where abnormalities in each of these contribute to the pathogenesis and severity of the disorder,” Brubaker told Healio.
The researchers plan to conduct further studies to determine the optimal resistance training program for older adults with obesity and HFpEF, Brubaker said.
Reference:
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Brubaker PH, et al. Abstract 348. Presented at: American Heart Association Scientific Sessions; Nov. 5-7, 2022; Chicago (hybrid meeting).
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