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Additional information: What kind of exercise is best?
The ability of frequent aerobic exercise (30 minutes, three times a week) to lower cholesterol levels and improve insulin sensitivity in the general population is well established. However, two recent studies show that moderate resistance and aerobic exercise together may have more benefits.
A small study presented at the Fifth International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV involved 37 people with high insulin levels and/or impaired glucose tolerance and physical signs of lipodystrophy. Participants were randomised to exercise (one hour of aerobic and strength training, three times a week) plus the anti-diabetes drug metformin or metformin alone. Data on 25 people who completed 3 months of treatment found that the exercise/metformin group had a significantly greater reduction in waist-to-hip ratio, lower blood pressure, more thigh muscle, and significantly greater reductions in fasting insulin levels than the group who took medication only (16).
There is also evidence that whilst regular aerobic exercise or combined aerobic and resistance training appears to lower triglycerides and may reduce insulin resistance in people with lipodystrophy, it may also make facial or limb fat loss worse(17).