News article

Exercising First, Dieting Later Protects Patients With Metabolic Syndrome From Muscle Loss

Posted:  Monday, June 30, 2014

New study says those strapped for time are better off to begin physical activity first and follow with healthy eating rather than the other way around as some weight-loss programs recommend.

Younger and older women tend to lose lean muscle mass, along with fat, unless they engage in physical activity before they attempt weight loss, a new study finds. "To preserve muscle in metabolic syndrome, irrespective of age, exercise should precede the initiation of weight loss and not be started at the same time as diet," said the lead study author. The results were presented at the joint meeting of the International Society of Endocrinology and the Endocrine Society.

"To preserve muscle in metabolic syndrome, irrespective of age, exercise should precede the initiation of weight loss and not be started at the same time as diet," said lead study author Yonit Marcus, MD, PhD, endocrinologist at the Institute of Endocrinology, Metabolism and Hypertension of Tel Aviv Medical Center in Tal Aviv, Israel.

Individuals who have metabolic syndrome should start weight loss attempts with exercise first, followed by dieting to prevent loss of lean muscle mass.

What is metabolic syndrome? Any 3 of the following criteria establish the diagnosis:

• Abdominal obesity (waist circumference more than 40 in in men and more than 35 in in women).

• A fasting triglyceride level of 150 mg/dL or higher.

• A fasting high-density lipoprotein cholesterol (HDL-C) level lower than 40 mg/dL in men and 50 mg/dL in women.

• Blood pressure (BP) of 130/85 mm Hg or higher.

• A fasting serum glucose level of 110 mg/dL or higher.

In individuals with metabolic syndrome periods of weight loss are often followed by periods of gain, making weight loss a continuing issue. During times of dieting, lean muscle mass is lost, and with each new weight loss attempt, they risk increased frailty and disability.

It appears that younger women loose more muscle mass than young men when attempting to diet and exercise at the same time. However, if individuals begin an exercise routine before dieting they lose less muscle mass.

While you can lose weight with diet alone, exercise is an important component. Dieting alone leads to both fat and muscle loss which can also strip away bone density. Working out stimulates the growth of muscle and bone density where by losing weight through exercise means burning mostly fat. The number on the scale may not appear as impressive, but because muscle takes up less space than fat does, you look smaller and your clothes fit better. Also, don’t forget that exercise can have other impressive health perks, like improving the quality of your sleep, lowering your cholesterol and reducing your stress level.

The recommended treatment for metabolic syndrome (MetS) patients is a combination of proper diet and exercise, yet most attempted weight loss periods end with later weight regain. Muscle loss often occurs during diet, so repeated weight loss attempts may lead to increasing loss of muscle mass, frailty and disability.

"The metabolic syndrome and obesity have become the pandemic of the 21st century," Dr. Marcus said, "and the only measures taken to counter this problem are exercise and diet. Exercise and diet are commonly started at the same time, but this should be reconsidered."

Strikingly, the authors wrote, all patients who gained or lost less than 2.9% of muscle mass were exclusively those who engaged in physical activity prior to beginning the program and continued throughout the year.