Dr. Peter Janiszewski's presentation from the 2008 Annual Meeting of the Canadian Society for Exercise Physiology

4. Abdominal and Lower Body Fat Loss and Changes in Health Risk: Longitudinal Observations From: Fujioka et al. 1991, Ross et al. 2000 Δ Health Risk Abdominal Fat Loss Δ Health Risk Lower Body Fat Loss Good Bad ?

5. Objective During weight loss, is the reduction of lower body fat for a given amount of abdominal (visceral and subcutaneous) fat reduction associated with an exacerbation in cardiometabolic profile? Janiszewski et al. Diabetologia (2008) 51:1475-1482

7. Body Composition by MRI Janiszewski et al. Diabetologia (2008) 51:1475-1482

8. Body Composition by MRI Janiszewski et al. Diabetologia (2008) 51:1475-1482

9. Body Composition by MRI Janiszewski et al. Diabetologia (2008) 51:1475-1482

10. Effects of Treatment: Anthropometric Body Weight (kg) Men Women Pre Post Janiszewski et al. Diabetologia (2008) 51:1475-1482 * * * Significantly different from baseline (P < 0.05) Waist Circumference (cm) Men Women * *

11. Effects of Treatment: Abdominal AT Visceral AT (kg) Men Women Pre Post Janiszewski et al. Diabetologia (2008) 51:1475-1482 * * * Significantly different from baseline (P < 0.05)

12. Effects of Treatment: Lower Body AT Lower body SAT (kg) Men Women Pre Post Janiszewski et al. Diabetologia (2008) 51:1475-1482 * * * Significantly different from baseline (P < 0.05)

13. Effects of Treatment: Cardiometabolic Risk Factors OGTT Glucose AUC (mmol/L •2Hr ) Men Women Pre Post Janiszewski et al. Diabetologia (2008) 51:1475-1482 * * Significantly different from baseline (P < 0.05) * Triglycerides (mmol/L) Men Women * * LDL-cholesterol (mmol/L) Men Women * * Fasting Insulin (pmol/L) Men Women * *

14. Abdominal AT Loss and Changes in Cardiometabolic Risk Abdominal Fat Loss Controlled for: age, gender, treatment group, and change in VO 2 max Janiszewski et al. Diabetologia (2008) 51:1475-1482 Δ Glucose Δ OGTT glucose Δ OGTT insulin Δ Cholesterol Δ LDL-C Good β = 0.21 to 0.24, p < 0.05

15. Abdominal AT Loss and Changes in Cardiometabolic Risk Abdominal Fat Loss Good Controlled for: age, gender, treatment group, and change in VO 2 max + Δ lower body SAT β = 0.19 to 0.24, p < 0.05 Δ OGTT glucose Δ Cholesterol Δ LDL-C Janiszewski et al. Diabetologia (2008) 51:1475-1482 =

16. Lower Body AT Loss and Changes in Cardiometabolic Risk Janiszewski et al. Diabetologia (2008) 51:1475-1482 Δ Health Risk Lower Body Fat Loss Bad ?

17. Lower Body AT Loss and Changes in Cardiometabolic Risk Δ OGTT Insulin AUC Lower Body SAT Loss Good Controlled for: age, gender, treatment group, and change in VO 2 max β = 0.23, p < 0.05 Janiszewski et al. Diabetologia (2008) 51:1475-1482

18. Lower Body AT Loss and Changes in Cardiometabolic Risk Δ Cardiometabolic Risk Factors Lower Body SAT Loss Controlled for: age, gender, treatment group, and change in VO 2 max + Δ in abdominal VAT and SAT = β = -0.07 to 0.19, p > 0.05 Not Bad Janiszewski et al. Diabetologia (2008) 51:1475-1482

20. Thank You

21. Energy Surplus Dysfunctional adipokine secretion FFA spillover ↑ Glucose production ↑ VLDL ↑ Lipolysis ↑ ‘ Bad’ adipokines ↓ Insulin Clearance ↓ Glucose Uptake ↓ Insulin Secretion ↑ β -cell death ↑ heart cell death Cardiometabolic Risk Healthy adipokine secretion FFA buffering (no spillover) Healthy Cardiometabolic Profile Functional SAT Dysfunctional SAT

22. Protective Lower-body Fat: Possible Mechanism (Lemieux, 2004)

23. ‘ Protective’ Thigh Fat in the media