Summary: In adults with obesity, 16 weeks of fixed-intensity combined training reduced the Visceral Adiposity Index more than progressive-intensity training or no training, but did not change metabolic phenotype classification.
PICO Summary
| Element | Detail |
|---|---|
| Population | 59 adults with obesity (BMI ≈33, mean age ≈34), metabolically healthy and unhealthy phenotypes. |
| Intervention | Periodized combined aerobic-resistance training at fixed intensity for 16 weeks. |
| Comparison | Combined training with linear intensity increase, and a non-training control. |
| Outcome | Fixed-intensity arm reduced VAI (p<0.001) in per-protocol and intention-to-treat analyses, outperforming both comparators. No significant change in metabolic phenotype classification. |
Fixed vs progressive training for visceral fat in obesity
RCT · obesity · 16 weeks
Fixed-intensity combined training lowered the Visceral Adiposity Index while progressive-intensity training did not, but neither shifted metabolic phenotype. The benefit is on a calculated surrogate, not a hard outcome.
Expert Commentary
This trial asks a question I rarely see tested directly, whether how you periodize exercise intensity matters, and that practical angle interests me more than another confirmation that exercise helps. The suggestion that a fixed-intensity structure beat progressive escalation for reducing visceral adiposity is useful, partly because a fixed prescription is easier to teach, standardise, and stick to, which is half the battle in real life. I hold the finding loosely, though, for two honest reasons. First, the outcome that moved was the Visceral Adiposity Index, a calculated surrogate from waist, BMI, and lipids, not imaging, and the metabolic phenotype, the thing that actually reflects health, did not change at all. Second, this is a young cohort of 59 people over sixteen weeks, so the periodization claim needs replication before I lean on it. Can I use this with my patients? Yes, in a modest way: it reassures me that a steady, fixed-intensity combined programme is a reasonable, adherence-friendly choice rather than insisting on ever-increasing intensity. But exercise stays one part of a plan that includes diet and, where needed, medication, not a standalone fix for cardiometabolic risk.
References
Ronsani JEF, Gabiatti MP, Streb AR, Delevatti RS, Del Duca GF, Hansen F. Effects of combined training on visceral adiposity index and metabolic phenotype in obesity: a randomized clinical trial. Int J Environ Res Public Health. 2025;22(9):1462. doi:10.3390/ijerph22091462