The Skinny on Fatness, Part 3: The Interplay of Hormones and VAT

Part 3 of this series examines the role of exercise in countering metabolic syndrome.

Trying to figure out “a given cause” to Metabolic Syndrome would prove fruitless because of the large number of factors involved and how they actually have mutual influences. Exercise, itself, has several very positive effects in the body including a release of testosterone primarily in response to muscle building activities and an increased fatty acid uptake and oxidation primarily in response to endurance training. Both of these mechanisms operate in the other exercise modality but to a lesser degree. It seems that the hormone testosterone has opposite effects in men and women in regards to VAT obesity. In men, both the plasma total and free testosterone, and sex-hormone binding globulin (SHBG) concentrations are all significantly negatively correlated to VAT amounts. Young men below 30 have high testosterone and low amounts of VAT. As men age, the “pot belly” can often kick in and so does their risk of CHD. In women, however, the levels of the same three factors negatively associated with testerone are positively associated with it.

Weight loss in both sexes has been shown to reverse testosterone abnormalities and testosterone administration in men significantly lowers the VAT.27,28 Research shows testosterone secretion occurs in proportion to the intensity, not volume or duration of exercise.29 Another study found increases in testosterone with high intensity exercise resistance training but no response of cortisol. This same study observed certain dietary changes to also affect resting (pre-exercise) testosterone levels but not cortisol. The nutritional variables associated with testosterone is almost the exact opposite of many body builder regimens. They found the amount of monosaturated, polyunsaturated fatty acids, total fat to be positively associated and percent protein, protein/ CHO ratio, and poly to mono FA ratio to be negatively correlated. Investigators felt due to variability in dietary intake further research would be needed to confirm the findings.30

A “hormonal cousin” to testosterone is growth hormone. While growth hormone is responsible for growth during childhood and puberty, it fulfills several roles throughout our lives including the deposition of muscle and the oxidation of fat. It is the best of both worlds in this regard. Many studies have shown GH to increase Another key player in this metabolic syndrome game is an enzyme which is responsible for converting inactive cortisone into the active form-cortisol. The enzyme 11-ß- hydroxysteroid dehydrogenase type 1 (11-ß-HSD1) is much more active in VAT vs. SCAT. It just so happens that cortisol is also a major inhibitor of testosterone. This is literally a “double whammy” to increase the VAT which further increases the potential cortisol conversion.32

Finally, exercise may have a role by combating the fat deposited in muscle known as intramyocellular lipid- IMCL) which affects the capacity of muscle to oxidize fats thus contributing to weight gain, and potentially insulin resistance. Research showed that the amount of VAT, not SCAT, was related to the amount of skeletal muscle insulin resistance, in type 2 diabetics.33

Another study confirmed this in pre-menopausal women.34 Researchers insulin sensitivity and FFA utilization or oxidation by muscle were reduced in relation to VAT. This findings confirmed the role IMCL deposition and VAT may play in impaired oxidation of nonadipose tissue and insulin resistance and metabolic syndrome. Exercise training is associated with decreased ICML, increased FFA uptake and utilization and VAT reduction.


Figure 3-1 shows the inter-related effects of exercise on potential causes of VAT accumulation and metabolic syndrome onset.

As one can clearly see, there is no single answer to resolving the obesity problem in the U.S. or throughout the world.

However, there are some tips and directions we can steer our clients to reduce the risk of mortality associated with obesity and metabolic syndrome. The influences of proper exercise and diet are absolutely critical in this fight.

The higher the intensity the exercise the greater release of testosterone, growth hormone which are considered beneficial in the fight against VAT. As intensity increases so does carbohydrate oxidation which enhances the bodies capacity to store more as glycogen and lowers blood glucose in the long-term.

Likewise, diets lower in carbohydrate and in particular glycemic index or load seem to be beneficial as well. Many new developments constantly arise on this topic, so stay tuned and stay informed.


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Mark P. Kelly has a doctorate in Exercise Physiology and Education Administration, he has specialties in kinesiology, exercise and nutritional biochemistry, weight management, and endurance athletic physiology. He was a nationally ranked duathlete, body building contest winner, trainer of professional athletes, and personal trainer for 20 years. He is a primary writer for the NFPT certification programs, a teacher in universities, and runs Principle Centered Health Human Performance Services, which specializes in assessments and corporate wellness. He can be reached at [email protected].


These resources are for the purpose of personal trainer growth and development through Continuing Education which advances the knowledge of fitness professionals. This article is written for NFPT Certified Personal Trainers to receive Continuing Education Credit (CEC). Please contact NFPT at 800.729.6378 or [email protected] with questions or for more information.