Effect of Combined Resistance and Endurance Exercise Training On Regional Fat Loss

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COPYRIGHT 2017 EDIZIONI MINERVA MEDICA
© 2016 EDIZIONI MINERVA MEDICA The Journal of Sports Medicine and Physical Fitness 2017 June;57(6):794-801
Online version at http://www.minervamedica.it DOI: 10.23736/S0022-4707.16.06358-1
ORIGINAL ARTICLE
BODY COMPOSITION, NUTRITION
Effect of combined resistance and endurance

exercise training on regional fat loss
Alessandro SCOTTO di PALUMBO 1, Enrico GUERRA 2, Carmine ORLANDI 3,
Ilenia BAZZUCCHI 1, Massimo SACCHETTI 1 *
1Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Rome, Italy; 2ELAV Institute, Città di
Castello, Perugia, Italy; 3Tor Vergata University of Rome, Rome, Italy
*Corresponding author: Massimo Sacchetti, Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Piazza Lauro De
Bosis 6, 00135 Rome, Italy. E-mail: massimo.sacchetti@uniroma4.it
A B S T RAC T
BACKGROUND: The present study tested the possibility of a localized fat mass (FM) reduction by means of training programmes focusing on
specific bodily regions.
METHODS: Sixteen physically inactive women (age: 31±4; BMI: 27.5±2.1), randomly allocated to two groups, completed an 8 week train-
ing programme. In one group (UpBdResist) training sessions consisted of upper body resistance exercises followed by 30-minute cycling at
50%VO2max, while the other group (LwBdResist) performed lower body resistance exercises followed by 30 minutes on an arm-ergometer.
Regional body composition was assessed by DEXA and skin fold measures.
RESULTS: Regardless of a similar reduction in both groups, UpBdResist training elicited a greater reduction of the upper limbs (UL) FM as
compared to the lower limbs (LL) (Δ% UL vs. LL: -12.1±3.4 vs. -4.0±4.7; P=0.02). Conversely, in the LwBdResist group, FM loss was more
pronounced in the LL as compared to the UL (Δ% UL vs. LL: -2.3±7.0 vs. -11.5±8.2, P=0.02). Likewise, LwBdResist elicited a larger effect on
lean mass (LM) of the LL as compared to UL (Δ% LL vs. UL: +8.4±5.8 vs. -2.7±5.0, P<0.01), yet no differences between upper and lower limb
LM changes were detected in UpBdResist group.
CONCLUSIONS: The present data suggest that a training programme entailing localized explosive resistance exercise, prior to an endurance
exercise bout, may target specific adipose tissue sites eliciting localised fat mass loss in the upper and lower limbs.
(Cite this article as: Scotto di Palumbo A, Guerra E, Orlandi C, Bazzucchi I, Sacchetti M. Effect of combined resistance and endurance exercise train-
ing on regional fat loss. J Sports Med Phys Fitness 2017;57:794-801. DOI: 10.23736/S0022-4707.16.06358-1)
Key words: Weight loss - Exercise - Physical conditioning, human.
A dipose tissue distribution on human body appears

to strictly affect the pathophysiology of obesity
and related metabolic abnormalities.1 Along with the at-
of exercise as compared to gluteal 3 and clavicular SCAT,
even when aerobic exercise was conducted with the up-
per limb.4 Mechanisms underpinning such regional dif-
tainment of a chronic energy deficit, physical activity, ferences have been identified in a site-specific sensitivity
in the component of exercise training, exerts a pivotal to exercise-induced catecholamine stimulation, which
role in the prevention and treatment of weight gain and suggests an independent regulation of regional adipose
obesity, by promoting the mobilisation and oxidation of tissue depots.5 Hence, owing the consequent metabolic
or other proprietary information of the Publisher.
fatty acid stored in the adipose tissue (AT).2 However, implications of fat distribution modifications, along with
AT sites located in different body regions do not equally the attraction of aesthetic body sculpting the hypothe-
respond to exercise. For instance, abdominal subcutane- sis of localised fat mass loss by targeted exercise (also
ous AT (SCAT) has been shown to be a preferential target known as “spot slimming”) has gained interest overtime.
794 The Journal of Sports Medicine and Physical Fitness June 2017
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, log
©
EXERCISE AND REGIONAL FAT LOSS SCOTTO di PALUMBO
The question has been matter of debate for long. limbs) on body composition, with particular regard to
The early observations of Olson and Eldelstein,6 who fat mass (FM) distribution.
detected a reduced skinfold in the arm undergoing re-
sistance exercise compared to the control arm, were not Materials and methods
supported by subsequent investigations.7-9 Neverthe-
less, the interest was renewed and supported by studies Subjects
adopting more accurate investigation techniques. Ko- Twenty-two young women were enrolled according
stek et al.10 for instance, failed to detect any significant to the following inclusion criteria: 1) age between 25
regional SCAT reduction, as assessed by magnetic reso- and 40 years; 2) BMI between 23 and 30 kg/m2; 3) not
nance imaging, after 12 weeks of resistance training of physically active (less than 1hr/week); subjects were
the non-dominant arm, in spite of a significant skinfold also excluded if they were smokers, had high alcohol
reduction. In contrast, data supporting the possibility of intake, presented any chronic cardiovascular, metabol-
regional lipolysis were reported by Stallknecht et al.,4 ic, pulmonary disease, or assumed any medications or
who found that during one-leg endurance exercise, adi- supplements.
pose tissue blood flow and interstitial glycerol concen- Six subjects (3 per groups) did not complete the study.
tration were greater in the AT adjacent to the contracting Therefore, the entire protocol was completed by 8 sub-
muscles, compared to the AT in the resting muscles. jects per group. Subjects characteristics are reported in
Interestingly, in such a contradicted scenario, the im- Table I.
pact of different exercise types has not been thoroughly The study was approved by the Local Ethics Com-
investigated. Indeed, it is logic to assume that by re- mittee. Participants gave their written consent after be-
sponding to the entity of the stressing stimulus, physi- ing informed of the purpose of the research, the experi-
ological adjustments to exercise are specific, i.e. the di- mental procedure, and the possible related benefits and
verse components of exercise (duration, intensity, type, risks of the study.
modality, timing, nutritional status), differently and
specifically affect metabolic pathways. As an instance, Experimental design
high intensity resistance exercise elicits a large release
of catecholamines and other lipolytic mediators,11 yet A randomised controlled trial with two intervention
lower energy expenditure and fat oxidation,12 as com- groups was designed in order to determine the effect of
pared to aerobic endurance exercise. Moreover, differ- two different exercise training protocols on regional fat
ent exercise combinations/sequences may induce differ- distribution.
ent responses in terms of lipid utilisation. Indeed, it was After a preliminary analysis, subjects were randomly
shown that lipolysis and fat oxidation were augmented assigned to the two groups, which performed a 12-week
when aerobic exercise was preceded by a resistance training programme conducted 3 times per week. The
exercise bout,13 whereas a blunted growth hormone retraining session of the first group (UpBdResist, resis-
sponse occurred when resistance exercise followed aer- tance exercise for upper body) entailed a combination
obic exercise.14 Furthermore, Kang et al.15 highlighted of resistance exercises for the upper body, followed by
the role of exercise intensity, by demonstrating that fat an aerobic exercise bout for the lower body. The sec-
oxidation during aerobic exercise was greater when pri- ond group session (LwBdResist, resistance exercise for
or resistance exercise intensity was high. lower body) consisted in a combination of resistance
Based on the abovementioned observations, it could exercises for the lower body, followed by an aerobic ex-
be hypothesized that the combination of diverse exer- ercise bout for the upper body.
cise types, when performed in different bodily region,
may induce different effects on regional body compo- Procedures
sition. The aim of the present study was thus to elu- Preliminary analysis
cidate the effect of combining explosive resistance ex-
ercise with steady state endurance exercise, performed Subjects performed two preliminary sessions, 2 to 4
separately in different body regions (lower limbs/upper days apart. The first session was held in the laboratory,
Vol. 57 - No. 6 The Journal of Sports Medicine and Physical Fitness 795
©
SCOTTO di PALUMBO EXERCISE AND REGIONAL FAT LOSS
whilst the second in the gym where training sessions lowed by 18 W increase in power output every minute
were delivered. until either the criteria for documentation of VO2max
where met (plateau in VO2 despite increasing work
First session rate; reaching 95% of the age-predicted maximal HR)
or volitional exhaustion was reached. The pedal ca-
Participants were instructed to refrain from exercise dence was kept constant at 60 rpm for the entire test
since two days preceding the first experimental trial. duration.
They arrived at the laboratory between 08.00 and 09.00
a.m. after an overnight fast. Second session
Anthropometry Subjects arrived at the gym between 9.00 and 10.00

a.m., three hours after consuming a standardized break-
Height and weight were measured by, respectively, fast. In order to evaluate maximal strength, one repeti-
a stadiometer and a medical scale. Skinfold thickness tion maximum (1RM) was assessed for each muscle
were measured at triceps and front thigh by a Harpen- group involved in the training programme according
den skinfold caliper. The average of three readings was to the following order: chest press, low row, arm curl,
recorded. Measurements were entirely conducted by the deltoids machine, triceps machine for UpBdResist, and
same investigator. gluteus machine, seated leg curl, abductor machine, leg
extension, adductor machine for LwBdResist. After a
DEXA analysis warm-up set of 10 repetitions at 50% of the predicted
1RM, the load was progressively increased by 5-10 kg
DEXA (Lunar iDXA, GE Healthcare, Little Chalfont, after each attempt until the subject was unable to per-
UK) was used to assess body composition. To define form a single lift. A rest interval of 2 minutes between
regional body composition, the trunk was divided from sets, and 5 minutes between different machines, was es-
the upper limb by a line passing through the humeral tablished.
head and the apex of the axilla, and from the lower limb After a 30-minute rest, subjects performed an incre-
by a line passing from the iliac crest to the perineum. mental submaximal exercise test in order to identify
At the end of the DEXA assessment, subjects consumed the workload corresponding to 50% VO2max previously
a standard snack (8 kJ*kg-1: 55% CHO, 20% protein, determined. UpBdResist group exercised on an elec-
25% fat). tromagnetically braked cycle-ergometer (Excite + Top,
Technogym, Gambettola, Forlì-Cesena, Italy) whereas
LwBdResist group exercised on electromagnetically
Incremental maximal test braked cycle ergometer (Excite + Bike, Technogym,
Thirty minutes after the snack, maximal aerobic Gambettola, Italy). Gas exchange were measured by a
power was measured adopting
��
a graded maximal aero- portable Gas Analyser (K4b2, Cosmed, Italy). Air tem-
bic power test performed on a mechanical braked cycle perature was kept constant among the different experi-
ergometer (Monark 894E, Monark Exercise, Vansbro, mental sessions.
Sweden). Throughout the test, respiratory gases were The testing session was replicated at the end of week
measured breath by breath usinga portable gas analy- 6, in order to adjust the relative exercise workload.
ser (K4b2, Cosmed, Cernusco sul Naviglio, Milan,
Italy). Before testing, the O2 and CO2 analyzers were Exercise training protocol
calibrated with gases of know concentrations (15.1%
oxygen, 5.0% carbon dioxide), and a 3-L syringe was Training sessions were performed under the supervi-
adopted to calibrate the turbine Environmental condi- sion of an exercise specialist. Subjects completed a re-
tions were monitored by a portable thermo-hygrometer sistance circuit training consisting of 5 exercises on the
(BAR208HG, Oregon Scientific, Taulatin, OR, USA). following isotonic machines (Technogym, Gambettola,
The test started with a 6-minute warm-up at 50 W, fol- Italy): chest press, low row, arm curl, deltoids machine,
©
triceps machine for the UpBdResist group; gluteus ma- way repeated measures ANOVA was used to determine
chine, seated leg curl, abductor machine, leg extension, main (training regime, bodily region) and interaction ef-
adductor machine for the LwBdResist group. For each fects. When interaction effects were observed, between
exercise, 3 sets of 10 repetitions at 60% 1RM were per- groups and between districts effects were detected by
formed requiring the subjects to provide the maximal one-way analysis of covariance (ANCOVA) with base-
contraction velocity, with a 30 seconds inter-set recov- line values as covariates, and within group (same dis-
ery, in an effort to induce the maximal power output for trict) effects were detected by paired samples T-test.
any specific movement 16 and to increase the metabolic Significance was set at α level of 0.05. Cohen’s d was
stress.11, 17 At the completion of the circuit, the same used to calculate the effect size between two means.
sequence was repeated for a second time. Values are reported as means±SD.
Resistance exercise was followed by a 30-minute
aerobic exercise conducted at an intensity correspond- Results
ing to 50% VO2max. UpBdResist exercised at the cycle-
ergometer whilst LwBdResist at the arm-ergometer. En- Subjects characteristics are reported in Table I. No
durance exercise intensity was set as reported to elicit significant difference between groups was detected at
maximal fat oxidation in untrained women.18 baseline.
In order to detect the regional effect of exercise type,
resistance exercise was performed with the UL by Up- Training compliance
BdResist, and with the LL by LwBdResist. Conversely,
endurance exercise was conducted with the UL by LwB- Of the 22 volunteers initially enrolled in the train-
dResist, and with the LL by UpBdResist at the same ing programme, 16 completed the post-treatment as-
exercise intensity (50% VO2max previously determined sessment (72%). Three subjects withdrew for personal
at the cycle-ergometer) to provoke similar energy ex- reasons, including lack of time and other concomitant
penditure between groups. A 10-minutes warm-up and commitments. One subject entered a hypo-caloric diet
a 5-minutes cool down period were performed at the and failed to comply with dietary activity pattern, and
beginning and at the end of each training session. two subjects were not compliant with the training pro-
gramme. Compliance was set at 85% of the session held.
Changes in body composition over the 12-week train-
Dietary intake and physical activity
ing period are reported in Table II.
Subjects were asked to maintain their usual dietary
pattern and physical activity level throughout the pro- Whole body
gramme. A four days food-diary (two week days and
two weekend days) and a physical activity log were ad- Total body mass did not change significantly after the
ministered at baseline, at week 6, and at week 12. training programme in both groups (Δ% UpBdResist vs.
LwBdResist -1.1±3.8; -1.0±4.5). FM significantly de-
creased after the training period in both groups with no
Post-training analysis effect of different training regime. Lean mass (LM) did
not change in both groups as compared to baseline.
Three days after the last training session, participants
replicated the pre-treatment assessment with the excep-
Table I.—Subjects characteristics at baseline.
tion of the maximal oxygen uptake test.
Variable UpBdResist LwBdResist
N. 8 8
Statistical analysis Age, yr 32±4 30±4
Height, m 1.63±0.04 1.64±0.09
Statistical analysis was performed using the Statis- Body Mass, kg 70.3±7.0 71.7±8.7
tical Package for the Social Sciences (SPSS for Mac, BMI, kg*m-2 27.7±2.3 27.4±1.9
VO2max, mL*kg*min-1 26.4±2.7 26.1±3.0
version 20). Baseline group differences were assessed
Values are reported as means±SD.
using a one-way analysis of variance (ANOVA). A two
©
Table II.—Changes in body composition over the 12-week training period.

UpBdResist LwBdResist UpBdResist vs.
LwBdResist
Variable Pre Post Δ P Effect Pre Post Δ P Effect P Effect
size (d) size (d) size (d)
Body mass, kg 70.3±7.0 69.5±7.4 -0.7±2.6 0.48 -0.68 71.7±8.7 70.8±8.7 -0.9±3.1 0.45 -0.05 0.91 0.10
Fat mass, kg (DEXA)
Upper limb 3.1±0.9 2.8±0.9 -0.4±0.3 0.01 -0.33 3.5±1.3 3.4±1.3 -0.1±0.1 0.24 -0.07 0.03 1.34
Lower Limb 9.8±2.8 9.5±3.1 -0.3±0.9 0.49 -0.10 11.0±2.5 9.7±2.4 -1.3± 0.9 0.01 -0.53 0.05 1.11
Trunk 15.1±2.6 14.1±3.4 -1.0±1.4 0.09 -0.33 14.1±4.0 13.5±3.7 -0.6±1.1 0.19 -0.15 0.54 0.31
Whole Body 28.8±4.9 27.1±5.7 -1.7±1.8 0.05 -0.32 29.3±5.4 27.3±4.6 -2.0±2.0 0.04 -0.20 0.75 0.15
Lean mass, kg (DEXA)
Upper limb 4.4±0.6 4.7±0.5 0.3±0.4 0.06 0.54 4.7±1.3 4.6±1.2 -0.1±0.3 0.23 -0.07 0.02 1.13
Lower limb 13.6±0.9 14.0±1.0 0.4±0.2 0.40 0.42 14.0±3.1 15.1±3.0 1.1±0.7 0.01 0.36 0.20 1.35
Trunk 19.4±2.2 19.2±1.8 -0,2±0.8 0.63 -0.09 19.3±3.9 19.5±3.6 0.2±0.8 0.55 0.05 0.44 0.5
Total 39.2±3.5 40.4±3.1 1.2±2.3 0.23 0.36 39.9±6.6 41.2±6.2 1.2±1.6 0.09 0.20 0.93 0.04
Skinfold
Triceps 25.3±3.9 22.4±3.2 -2.9±2.6 <0.01 -0.81 25.9±2.1 24.7±2.0 -1.4±0.5 <0.01 -0.58 0.02 0.47
Thigh 24.9±3.4 23.6±3.6 -1.3±0.5 <0.01 -0.37 24.4±2.6 21.7±2.4 -2.7±1.2 <0.01 -1.07 0.02 1.52
Trunk nificantly decreased in both groups with a larger effect

of UpBdResist training.
FM and LM, as assessed by DEXA, were not signifi-
cantly affected by time or by different training regimes Lower limbs
in the trunk region.
FM and LM were respectively augmented and attenu-
Upper limbs ated in LwBdResist as compared to baseline, whereas
no significant change was observed in UpBdResist.
UpBdResist training elicited a reduction in upper Thigh skinfold was reduced in both groups with a larger
limbs (UL) FM, along with a tendency toward an in- effect of LwBdResist training regime.
crease in UL LM (P=0.06), whilst no significant chang- Changes in total and regional FM and LM as results
es were observed in LwBdResist. Triceps skinfold sig- of the training program are depicted in Figures 1, 2.
Figure 1.—Changes in total and regional fat mass after the 12-week Figure 2.—Changes in total and regional lean mass after the 12-week
exercise training programme in the UpBdResist (black bars) and LwB- exercise training programme in the UpBdResist (black bars) and LwB-
dResist (gray bars) group. dResist (gray bars) group.
*Significant between-group difference; §significant within-group differ- *Significant between-group difference; §significant within-group differ-
ence compared to fat mass in the leg. ence compared to lean mass in the leg.
©
UL versus lower limbs Nevertheless, it is noteworthy that the exercise pro-

tocol adopted in the present investigation was different
UpBdResist training elicited a greater effect on FM from those used in the aforementioned studies, which
in the UL as compared to the lower limbs (LL) (P=0.02, may relate to the discrepancies observed. Indeed, the
d=1.97), whilst no regional differences were detected in specificity of the exercise response was highlighted in an
terms of LM (P=0.14) between UL and LL. Conversely, elegant study by Stallknecht et al.,4 comparing one-leg
in LwBdResist, LL FM and LL LM changed more pro- knee extension exercise at different exercise intensities
nouncedly as compared to UL (FM P=0.02, d=1.21; LM using the microdialysis and 133Xe washout technique, in
P<0.01 d=2.04). Arm skinfold variation, as compared which they showed that lipolysis in SCAT adjacent to
with thigh skinfold, was larger in UpBdResist (P=0.04
contracting muscle was acutely stimulated by exercise
d=1.48), yet smaller in LwBdResist (P=0.01 d=1.74).
and associated with an increased adipose tissue blood
flow. Notably, leg SCAT lipolysis was higher at the
Dietary intake highest exercise intensity (85% Wmax), along with an in-
creased arterial epinephrine concentration. In this vein,
No significant differences were detected in terms
Trapp et al.20 compared the effect of steady state cycling
of total energy intake in both groups after treatment
(UpBdResist, pre vs. post: 11899±1384 kJ*d-1 vs. 11673 exercise training at 60% VO2max with a high intensity
kJ±1950 kJ*d-1; LwBdResist, pre vs. post: 12200±1464 intermittent cycling exercise on adipose tissue and its
kJ*d-1 vs. 12473 kJ±1754 kJ*d-1). distribution in young women. DEXA analysis revealed
that leg adipose tissue was significantly reduced in the
high intensity exercise group, but not in the steady state
Discussion exercise as well as in the control group. These observa-
The main purpose of the present study was to test the tions seem to promote the role of exercise intensity as
effect of exercise type and localisation on regional fat a master switch of spot lypolisis. Supporting this hy-
distribution. We observed that upper and lower limb pothesis are the results of Wilmore et al.21 and Staron
subcutaneous adipose tissue was affected in a different et al.,22 who reported a regional SCAT loss after a re-
fashion by the different exercise regimes, with the resistance training intervention ranging from 70 to 90%
gions undergoing prior resistance exercise experiencing 1RM, apparently in contrast with Treuth et al.,23 train-
a greater fat mass reduction. ing at 50-67% 1RM, and Ramirez Campillo,19 training
In spite of a non-significant reduction in body weight, at 10-30% 1RM, who failed to detect differences.
whole body fat mass, measured by DEXA, decreased Investigation techniques adopted in the present work
similarly in both groups, albeit presenting different dis- do not enable to determine the mechanisms underpin-
tribution. Indeed, treatment effect was greater in body ning the described effects, yet sole speculations can be
districts performing resistance training and differed sig- advanced. It is currently known that the lypolitic stim-
nificantly between groups when matching according to ulus is mediated by a complex endocrine, paracrine,
body region, as well as within groups when comparing and autocrine response, with catecholamine, GH, and
the UL with the LL. atrial natriuretic peptide exerting a pivotal role, along
Skinfold data corroborate what detected by DEXA, with a reduction in insulin concentration.24 Overall, ly-
i.e. a significant greater reduction obtained at the triceps politic hormones release reflects the acute demand of
by UpBdResist, and at the thigh by LwBdResist. the stressor and is thus strictly related to exercise inten-
Such observations promote the suggestion that spe- sity.25 In the present work, resistance exercise program,
cific exercise programmes may affect adipose depots in entailing high velocity contractions with short rest pe-
a selective manner. Intriguingly, they appear in contrast riods, was designed to elicit a strong catecholamine re-
with the classical studies which negate the possibility sponse and, eventually, the lipolytic stimulus. However,
for a spot FM reduction by exercise training.7-10 Like- circulating hormones influence all adipose tissue depots
wise, a recent investigation 19 failed to detect differ- and not selectively adipose tissue adjacent to contract-
ences in FM of the non-dominant leg after 12 weeks of ing muscles. Indeed, it is ascribed to an increased blood
one-leg resistance training at 10% to 30% 1RM. flow in adipose tissue adjacent to contracting muscles
©
that a larger amount of circulating hormones are deliv- sity of 50%VO2max measured at the cycle-ergometer.
ered to the exercising districts, thus promoting regional Thus, as arm cranking exercise has been reported to
lipolysis.4 Nevertheless, lipolysis, along with a rise in elicit a ~20% lower maximal aerobic capacity 28 as
adipose tissue blood flow, is only part of fat mass loss compared to cycling, it is plausible that LwBdResist,
picture, as mobilised FFA are ultimately to be taken up maintained a relative intensity around 65% VO2peak of
and oxidised by skeletal muscle in order to avoid re- the arm cranking, which may have provoked a stronger
esterification. Thus, an elevated FFA availability is able adrenergic and glycolytic response.29 However, a com-
to enhance regional as well as total fat oxidation when pensatory mechanism in fat utilisation during recovery
total energy request is significantly augmented, while has been reported after after exercise at higher intensity,
during endurance exercise.26 Accordingly, it is possible i.e. the higher the exercise intensity, the greater the fat
to speculate that FFA released during high intensity re- oxidation during the following recovery period.25
sistance exercise, are not entirely oxidised, owing the
lower total energy expenditure.27 This may help ex- Conclusions
plaining the lack of regional SCAT alterations observed
by Kostek et al.10 between trained and untrained arm, In conclusion, the present data suggest that a train-
after 12 weeks of training of the non-dominant arm con- ing programme involving localized explosive resis-
ducted from 65% to 90% 1RM. In that investigation, the tance exercise, combined with subsequent endurance
exercise protocol entailed elbow flexion and extension exercise bout, may target specific adipose tissue sites,
of a single arm, which plausibly induced only a minor opening to the possibility that appendicular fat mass
rise in energy expenditure. Instead, in the present study, in young women may respond to combined resistance
resistance exercise was followed by a bout of moderate (explosive) and endurance exercise training depending
intensity endurance exercise, in an attempt to promote on where the former is applied. However, it remains to
the oxidation of mobilised FFA. We found that FM was be addressed whether the effect of exercise on spot fat
significantly reduced in the regions undergoing resist- reduction is related to specific body district targeted in
ance exercise, corroborating the role of high intensity the present investigation, or it may also occur in other
exercise, combined with substantial elevation of energy body regions.
expenditure, as a requirement for regional FM loss.
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Conflicts of interest.—The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Manuscript accepted: May 20, 2016. - Manuscript revised: May 6, 2016. - Manuscript received: December 16, 2015.

Effect of Combined Resistance and Endurance Exercise Training On Regional Fat Loss

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Effect of combined resistance and endurance

A dipose tissue distribution on human body appears

Anthropometry Subjects arrived at the gym between 9.00 and 10.00

Table II.—Changes in body composition over the 12-week training period.

Trunk nificantly decreased in both groups with a larger effect

UL versus lower limbs Nevertheless, it is noteworthy that the exercise pro-

and muscle tissue morphology, thickness, and enzymes. Eur J Appl

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