Exercise for Fat Tissue Health

Overseen By Rachel Passehl

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mayo Clinic

Disqualifiers: Smoking, Alcohol abuse, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to explore how exercise impacts fat tissue and how these changes might benefit health as people age or in cases of obesity. Researchers will take a fat tissue biopsy (a small sample from the body) from participants before and after exercise to observe the effects on this tissue. The trial seeks adults with a stable weight who do not frequently engage in structured physical activity. Participants can be young or older adults, with or without obesity. As an unphased trial, this study offers a unique opportunity to contribute to understanding the health benefits of exercise.

Will I have to stop taking my current medications?

The trial requires that you do not use medications known to influence the main outcomes of the study. It's best to discuss your current medications with the study team to see if they are allowed.

What prior data suggests that adipose tissue biopsy and exercise are safe for participants?

Research shows that exercise is generally safe and manageable for most people. Studies have found that exercise can help reduce body weight and fat, particularly around the belly, which benefits heart health and metabolism. Evidence also suggests that exercise alters fat tissue in a way that may help the body store less fat, promoting overall health.

The adipose tissue biopsy, a procedure where a small sample of fat tissue is taken, is common and safe. Researchers perform it carefully to prevent major issues for participants.

Overall, past research considers both exercise and the biopsy safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how exercise affects fat tissue health, which hasn't been deeply studied in this way before. Unlike typical obesity treatments that focus on diet changes, medications, or surgeries to reduce weight, this trial examines how regular physical activity directly influences the condition of adipose tissue itself. By taking adipose tissue biopsies before and after exercise, researchers hope to uncover new insights into how exercise can improve fat tissue function and overall metabolic health, potentially leading to innovative approaches for managing obesity and related conditions.

What evidence suggests that exercise might be an effective treatment for improving fat tissue health in aging and obesity?

This trial will explore how exercise affects fat tissue health in different groups. Research has shown that exercise can significantly impact fat tissue, particularly by reducing fat mass. Studies have found that various types of exercise, such as high-intensity interval training (HIIT) and sprint interval training (SIT), can lower fat levels even if they don't burn much fat during the workout itself. One study discovered that aerobic exercise is linked to decreases in both visceral fat (fat around the organs) and subcutaneous fat (fat under the skin). Exercise also alters fat tissue function, potentially improving health by influencing fat storage. Overall, exercise appears highly effective in transforming fat tissue and may benefit individuals dealing with obesity and aging. Participants in this trial will undergo adipose tissue biopsies before and after exercise to assess these effects. ^{1 6 7 8 9}

Who Is on the Research Team?

Hawley Kunz, PhD

Principal Investigator

Mayo Clinic

Are You a Good Fit for This Trial?

This trial is for sedentary adults who are either normal weight or obese. It includes older adults (65-85 years) and young adults (18-35 years). Participants should not be active smokers, heavy drinkers, pregnant, or have chronic diseases that could interfere with the study.

Inclusion Criteria

I lead a mostly inactive lifestyle.

I am a young adult with a normal weight.

I am an older adult with a BMI between 18.5 and 28.

Exclusion Criteria

Participation in ≥ 30 minutes of structured physical activity ≥ 2 days per week

You currently smoke or use tobacco products.

You have a history of alcohol or drug abuse.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Baseline measurements including HbA1c, white blood count, body fat percentage, cardiorespiratory fitness, fasting plasma insulin, and fasting plasma glucose are taken

1 week

1 visit (in-person)

Exercise Intervention

Participants undergo a 30-minute bout of cycling exercise at 70% of VO2max. Adipose tissue biopsies and various measurements are taken pre-exercise, immediately post-exercise, and 3 hours post-exercise

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in adipose tissue and systemic responses post-exercise

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Adipose Tissue Biopsy
• Exercise

Trial Overview

The study is looking at how exercise affects fat tissue in both aging and obesity. Participants will undergo an exercise regimen and have their adipose tissue biopsied to see the changes that occur due to physical activity.

How Is the Trial Designed?

Group I: Young adults without obesity Experimental Treatment 2 Interventions

Participants with obesity as determined by the principal investigator and aged 18-35 years will have an adipose tissue biopsy taken from the abdomen before and after exercise.

Group II: Young adults with obesity Experimental Treatment 2 Interventions

Participants with obesity as determined by the principal investigator and aged 18-35 years will have an adipose tissue biopsy taken from the abdomen before and after exercise.

Group III: Older adults without obesity Experimental Treatment 2 Interventions

Participants with obesity as determined by the principal investigator and aged 65-85 years will have an adipose tissue biopsy taken from the abdomen before and after exercise.

Group IV: Older adults with obesity Experimental Treatment 2 Interventions

Participants with obesity as determined by the principal investigator and aged 65-85 years will have an adipose tissue biopsy taken from the abdomen before and after exercise.

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Collaborator

Trials

2,513

Recruited

4,366,000+

Published Research Related to This Trial

Physical detraining in rats led to increased fat cell size (hypertrophy) and lipogenesis in both subcutaneous (SC) and visceral (RP) fat depots, indicating a potential risk for obesity after stopping exercise.

In the SC depot, detraining also resulted in increased adipogenesis (the formation of new fat cells) and reduced apoptosis (cell death), suggesting that the mechanisms of fat accumulation differ between fat depots.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The mechanisms involved in the increased adiposity induced by interruption of regular physical exercise practice. Sertie, RAL., Curi, R., Oliveira, AC., et al.[2019]

Stirred suspension culture (ATE-S) provides a more consistent and reliable method for extracting adipose tissue extract (ATE) compared to the traditional adherent culture (ATE-A), leading to stable yields and improved potency metrics.

ATE-S not only increased the adipogenic and angiogenic potential of the extract but also enhanced cell viability by reducing tissue necrosis and LDH activity, making it a superior method for future applications of ATE.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Optimizing adipose tissue extract isolation with stirred suspension culture. Zhang, Y., Yu, M., Zhao, X., et al.[2020]

In a study of 97 adults with prehypertension and varying diabetes status, a 26-week exercise program significantly improved fitness levels but showed that those with type 2 diabetes (T2DM) had a much smaller reduction in visceral adipose tissue (VAT) compared to non-diabetic participants (-3% vs -18%, p<0.001).

The findings suggest that individuals with T2DM may be resistant to the fat loss benefits of exercise, highlighting the importance of incorporating weight loss strategies alongside exercise to effectively reduce cardiovascular disease risk in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of exercise on abdominal fat loss in men and women with and without type 2 diabetes. Dobrosielski, DA., Barone Gibbs, B., Chaudhari, S., et al.[2021]

In a study of 152 participants over 24 weeks, higher amounts and intensities of exercise led to a greater proportion of individuals achieving significant reductions in visceral adipose tissue (AT) compared to a control group.

Clinically meaningful reductions in waist circumference or body weight were found to predict significant reductions in abdominal adiposity, with 76% to 93% of those achieving these changes also showing meaningful reductions in visceral AT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual Response to Standardized Exercise: Total and Abdominal Adipose Tissue. Brennan, AM., Day, AG., Cowan, TE., et al.[2021]

In a study of 153 adults over 24 weeks, those in high amount low intensity (HALI) and high amount high intensity (HAHI) exercise groups showed a significantly higher likelihood of achieving clinically meaningful reductions in adipose tissue compared to the control group.

The results suggest that increasing exercise amount and intensity can enhance the chances of individuals achieving significant fat loss, but using simple measurements like waist circumference or body weight to track these changes can be challenging.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual Response to Standardized Exercise: Total and Abdominal Adipose Tissue. Brennan, AM., Day, AG., Cowan, TE., et al.[2019]

Excess visceral fat is linked to cardiovascular diseases, and insulin resistance plays a key role in the metabolic issues associated with abdominal obesity, such as high triglycerides and low HDL cholesterol.

Regular exercise is highlighted as an effective non-drug approach to improve insulin sensitivity and lipid profiles, potentially counteracting the negative metabolic effects of abdominal obesity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of exercise training on abdominal obesity and related metabolic complications. Buemann, B., Tremblay, A.[2018]

A standardized surgical method for obtaining subcutaneous adipose tissue biopsies using a non-diathermy technique was successfully applied in 115 healthy men, demonstrating safety with only 2.61% experiencing excessive post-operation bleeding.

This non-diathermy approach minimizes side effects, such as flash fires and skin lesions, associated with traditional diathermy methods, making it a safer option for tissue sampling.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Technique for Subcutaneous Abdominal Adipose Tissue Biopsy via a Non-diathermy Method. Chachopoulos, V., Dinas, PC., Chasioti, M., et al.[2019]

Physical activity, including exercise, plays a crucial role in regulating energy balance and fat mass, with both acute and chronic effects on adipose tissue function.

Regular exercise enhances fat mobilization during workouts and may improve metabolic health by inducing beneficial changes in adipose tissue, although the specific impacts of exercise versus calorie restriction on fat distribution remain unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical activity and exercise in the regulation of human adipose tissue physiology. Thompson, D., Karpe, F., Lafontan, M., et al.[2022]

A systematic review of 27 trials (19 randomized controlled trials and 8 non-randomized) found that physical activity can significantly reduce abdominal and visceral fat in overweight or obese individuals, even without changes in overall body weight or waist circumference.

Imaging techniques were crucial in measuring these fat changes, but the review highlighted the need for more rigorous studies to confirm the benefits of exercise on abdominal fat reduction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The influence of physical activity on abdominal fat: a systematic review of the literature. Kay, SJ., Fiatarone Singh, MA.[2018]

Physical training (PT) in mice prevented insulin resistance (IR) and related metabolic issues, such as hyperglycemia and glucose intolerance, particularly in those on a cafeteria diet, indicating that exercise can counteract the negative effects of a poor diet.

The study found that PT led to beneficial changes in white adipose tissue (WAT) metabolism, enhancing lipolysis and fat oxidation while reducing fat storage, which helps explain how exercise improves insulin sensitivity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Remodeling of white adipose tissue metabolism by physical training prevents insulin resistance. Higa, TS., Spinola, AV., Fonseca-Alaniz, MH., et al.[2014]

Physical activity plays a crucial role in treating obesity not just by reducing overall body weight or fat mass, but also by targeting harmful fat deposits in the abdomen, liver, and muscle, which are linked to obesity-related health risks.

This review emphasizes that physical activity can be beneficial for obesity treatment even when there is minimal or no weight loss, highlighting its importance beyond just weight management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical activity in the treatment of obesity: beyond body weight reduction. Janiszewski, PM., Ross, R.[2016]

Subcutaneous adipose tissue can be safely and efficiently obtained in a non-clinical setting using a specific biopsy technique, allowing researchers to study metabolic conditions with accessible samples.

The technique is safe for participants, allowing them to resume most activities shortly after the procedure, and enables the collection of sufficient tissue for research, including the possibility of two biopsies in one day for before-after studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Human Subcutaneous Adipose Tissue Sampling using a Mini-liposuction Technique. MacGregor, KA., Rodriguez-Sanchez, N., Barwell, ND., et al.[2021]

A systematic review of 24 studies involving 1383 participants found that exercise significantly reduces visceral fat in adults with type 2 diabetes, with a notable effect size of -0.21, indicating that exercise is beneficial for managing ectopic fat associated with metabolic complications.

Aerobic exercise was specifically effective in reducing visceral fat (effect size -0.23), while resistance training did not show significant benefits, suggesting that aerobic activities should be prioritized in exercise programs for individuals with obesity-related type 2 diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise and ectopic fat in type 2 diabetes: A systematic review and meta-analysis. Sabag, A., Way, KL., Keating, SE., et al.[2018]

A new mini-liposuction technique allows for the safe and efficient removal of larger adipose tissue samples (3-15 g) from obese patients with minimal scarring and quick recovery, compared to traditional open surgical biopsies.

The procedure maintains the viability of isolated adipocytes, which can effectively transport glucose, making it suitable for extensive assays in research on adipose tissue.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Percutaneous adipose tissue biopsy by mini-liposuction for metabolic studies. Bastard, JP., Cuevas, J., Cohen, S., et al.[2017]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC8497689/

Effect of Exercise Training on Fat Loss—Energetic ...

These observations imply that HIIT and SIT can reduce fat mass during bouts of exercise despite being associated with lower levels of fat oxidation. In this ...

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC9285060/

Resistance training effectiveness on body composition and ...

Exercise modalities excluded due to insufficient evidence for trunk fat mass: COMB + Amino acids, ES = 0.0 kg (95% CI: −1.2 to 1.2); COMB + Fatty acids, ES = − ...

3.

jamanetwork.com

jamanetwork.com/journals/jamanetworkopen/fullarticle/2828487

Aerobic Exercise and Weight Loss in Adults: A Systematic ...

The dose-dependent associations of aerobic exercise with areas of visceral and subcutaneous adipose tissues are indicated in eFigures 15 and 16 ...

4.

clinicaltrials.gov

clinicaltrials.gov/study/NCT04812314

Exercise Effects on Adipose Tissue Structure and Function

Overall, the researchers believe that exercise training modifies key processes in subcutaneous fat tissue that may contribute to an increase body fat storage ...

5.

sciencedirect.com

sciencedirect.com/science/article/pii/S155041312300459X

Exercise induces tissue-specific adaptations to enhance ...

A reduction in the rate of fat oxidation occurs as a result of reduced adipose tissue blood flow and an impaired transport of long-chain fatty ...

6.

onlinelibrary.wiley.com

onlinelibrary.wiley.com/doi/10.1111/obr.13256

Effect of exercise training on weight loss, body composition ...

... exercise include reductions of body weight, total body fat and visceral adipose tissue. ... fat is likely to enhance cardiometabolic health ...

7.

withpower.com

withpower.com/trial/phase-healthy-subjects-hs-8-2023-07bab

Exercise for Fat Tissue Health

What data supports the effectiveness of the treatment involving exercise and adipose tissue biopsy for fat tissue health? Research shows that exercise can ...

8.

sciencedirect.com

sciencedirect.com/science/article/pii/S1043276025001511

Exercise pills for cardiometabolic health cannot mimic the ...

... tissue of high fat diet (HFD)-fed mice [26]. ... Nascimento, et al. Nicotinamide riboside enhances in vitro beta-adrenergic brown adipose tissue ...

9.

link.springer.com

link.springer.com/article/10.1007/s40279-024-02070-9

Efficacy of Interval Training in Improving Body Composition ...

Significant reductions in fat mass, visceral adipose tissue, subcutaneous abdominal fat ... training in the management of body fat reduction.