Physical activity and exercise for weight loss and maintenance in people living with obesity

Exercise and Sinonasal Diseases: Key Interactions and Management Pearls

The nose filters, moistens, and warms inspired air at rest and during activity. Exercise is associated with an increase in nasal airflow and a decrease in resistance to that flow. Mechanistically, changes in the nasal mucosa during exercise may increase neutrophilic infiltration, impair olfaction, and prolong mucociliary transport time. The increased exposure to substances in the exercise environment may also produce rhinitis. Clinically, the prevalence of rhinitis and upper airway infections is increased in athletes. Allergic and non-allergic rhinitis, and rhinosinusitis may be diagnosed clinically, with other studies supporting the diagnosis; their main treatments are topical steroids, antihistamines, and saline.

Long-Term Yo-Yo Dieting Exaggerates Liver Steatosis and Lesions but Preserves Muscle Performance in Male Zebrafish

Weight regain within one year after weight loss is frequently observed and is referred to as yo-yo dieting or weight cycling. In this study, we explore the effects of yo-yo dieting on the liver, adipose tissue, and muscle characteristics of male zebrafish. Four-month-old AB wild-type male zebrafish were randomly assigned to three groups: high-calorie intake (H, seven meals per day), low-calorie intake (L, two meals per day), and yo-yo diet (the low- and high-calorie alternation switched every two weeks) groups. Feeding the fish the H diet for over 8 weeks led to steatosis and damage to the liver. The yo-yo diet reduced liver lipid accumulation at week eight but caused a similar degree of lipid accumulation as the H diet thereafter. It was found that twenty weeks of yo-yo dieting actually exacerbated hepatic damage. Compared to the L diet, feeding the fish on the yo-yo and H diets for a period of 20 weeks significantly increased the size of muscle fibers, resulting in higher speed during burst swimming and a significant increase in the size and number of adipocytes in the abdominal tissue. To summarize, short-term yo-yo dieting was found to attenuate hepatosteatosis and maintain fast-twitch muscle function. Long-term yo-yo dieting preserved fast-twitch muscle function and muscle fiber size; however, it exacerbated the pathological changes in the liver.

Diet and physical exercise in elderly people with obesity: The state of the art

Obesity is a disease that is assuming pandemic proportions in recent decades. With the advancement of medicine and increased access to care, average survival has increased, resulting in a larger number of elderly people. As a result, the amount of elderly people living with obesity is increasing, and the morbidity and impact of obesity on ageing implies severe limitations for these people. The link between obesity and ageing is not only epidemiological, but also strictly pathophysiological. Obesity accelerates the ageing process and ageing is characterised by pathophysiological mechanisms shared by obesity itself. Some examples of alterations shared by ageing and obesity are metabolic changes, sarcopenia and reduced functional capacity related to both loss of muscle strength and reduced cardiorespiratory fitness, as well as a general reduction in the perception of quality of life. The specific ability to antagonize these mechanisms through non-pharmacological treatment based on nutrition and exercise has always been one of the focal points of the international literature. Therefore, this review provides the state of the art on scientific knowledge regarding the main effects of an adequate nutritional plan and an individualised exercise prescription on the general health of elderly with obesity. In particular, this paper addresses the effect of nutrition and physical exercise on pathophysiological changes peculiar of ageing and obesity, providing also the scientific rational for nutritional and exercise prescription in the population.

Regular meta-analysis of the impact of sports activities intervention on some items of the national student physical health standards for adolescents

Background

By using meta-analysis to evaluate the effects of exercise on adolescent body mass index (BMI), standing long jump, sit ups, lung capacity, sitting forward bending, 50 m running, and 800 m running, a large amount of literature will be reviewed to reveal the key role of exercise in the healthy development of adolescents. This study aims to promote the development of adolescent physical health and solve the common problem of declining physical fitness, comprehensively improve the physical fitness of adolescents, and provide decision-making support for policymakers. The research results will provide methodological references for precise and effective intervention practices, further improve adolescent physical fitness, and lay a solid physiological foundation for their comprehensive development.

Methods

A literature search was conducted on China National Knowledge Infrastructure (CNKI) and PubMed, collecting randomized controlled trials (RCTs) that investigated the effects of physical activity on adolescent physical fitness according to predefined criteria. The quality of these studies was assessed, and their outcome data were analyzed using RevMan 5.4 software. The analysis encompassed 13 articles with a total of 4,633 participants, examining measures such as mean difference (MD) and heterogeneity, followed by subgroup analyses.

Results

The meta-analysis revealed that physical activity had a moderate to high effect on adolescent performance in sit-ups (MD = 4.91, 95% CI = 3.41-6.41), vital capacity (MD = 120.66, 95% CI = 48.67-194.46), sit-and-reach test (MD = 0.82, 95% CI = 0.09-1.56), 50-meter dash (MD = -1.05, 95% CI = -1.48 to -0.62), and 800-meter run (MD = -18.48, 95% CI = -24.98 to -11.97). Conversely, its influence on BMI (MD = -0.31, 95% CI = -1.87 to 1.24) and standing long jump (MD = 0.1, 95% CI = 0.05-0.15) was relatively low.

Conclusion

Engaging in physical activities significantly improves adolescent physical fitness. The most effective regimen involves a combination of aerobic and anaerobic exercises, with each session lasting 30 min, performed three times per week for at least 2 months. The extent of improvement in various fitness indicators, reflecting different aspects of physical fitness, is influenced by factors such as the nature of the physical activity, intervention duration, exercise frequency, and age.

Systematic Review Registration

PROSPERO, identifier CRD42024568197.

Health-enhancing physical activity in obesity management: the need to (seriously) go beyond weight loss

There are many false hopes around the impact of physical activity and exercise in obesity management, especially regarding weight loss. Narrowly focusing on weight loss only leads to disappointment for patients and practitioners. Indeed, in persons with overweight or obesity, exercise training, specifically aerobic (i.e. endurance) training, is associated with significant additional weight and fat loss compared to the absence of training. However the magnitude of this effect remains modest, amounting to only 2-3 kg additional weight or fat loss on average. We therefore argue that this conversation needs to be re-oriented towards the many potential health benefits of physical activity that can be seen beyond weight loss. Exercise training has been shown to improve the cardiometabolic risk profile by effects including decreasing abdominal visceral fat and improving insulin sensitivity. Aerobic, as well as combined aerobic and resistance (i.e. strength) training, increase cardiorespiratory fitness, a major risk factor for ill health. Resistance training improves muscle strength, another major component of physical fitness, even in the absence of a significant change in muscle mass. Beyond body mass loss, recognizing the broad value of physical activity/exercise in improving health and quality of life of people with obesity is a crucial perspective shift.

Combined Aerobic Exercise Training and Chlorella Intake Reduces Arterial Stiffness through Enhanced Arterial Nitric Oxide Production in Obese Rats

This study aimed to assess the effect of a combination of aerobic exercise training (ET) and Chlorella (CH) intake on arterial nitric oxide (NO) production and arterial stiffness in obese rats. Twenty-week-old obese male rats were randomly grouped into four (n = 6): OBESE-SED (sedentary control), OBESE-ET (treadmill 25 m/min, 1 h, 5 d/week), OBESE-CH (0.5% Chlorella powder in normal diet), and OBESE-ET+CH (combination of ET and CH intake) groups. The carotid-femoral pulse wave velocity (cfPWV), an index of arterial stiffness, was significantly lesser in the OBESE-ET, OBESE-CH, and OBESE-ET+CH groups than in the OBESE-SED group, and in the OBESE-ET+CH group significantly further enhanced these effects compared with the OBESE-ET and OBESE-CH groups. Additionally, arterial nitrate/nitrite (NOx) levels were significantly greater in the OBESE-ET, OBESE-CH, and OBESE-ET+CH groups than in the OBESE-SED group, and the OBESE-ET+CH group compared with the OBESE-ET and OBESE-CH groups. Furthermore, arterial NOx levels were positively correlated with arterial endothelial NO synthase phosphorylation levels (r = 0.489, p < 0.05) and negatively correlated with cfPWV (r = -0.568, p < 0.05). In conclusion, a combination of ET and CH intake may reduce arterial stiffness via an enhancement of the arterial NO signaling pathway in obese rats.

Bi-directional associations of core affect and physical activity in adults with higher body weight: An ecological momentary assessment study

Affect is known to be predictive of and enhanced by higher physical activity (PA) levels in the general population. This secondary analysis aimed to increase the understanding of the bi-directional relationship between PA and core affect (i.e. valence, energetic arousal, and calmness) among adults with higher body weight. Affect and PA were assessed in naturalistic settings via ecological momentary assessment using a mixed sampling scheme from 157 participants (body mass index: 32.99 ± 3.78 kg/m2). Multilevel models revealed that being more physically active in the 15 minutes prior to the assessment predicted an increase in energetic arousal and a decrease in calmness. Subsequently, feeling more energetic and agitated was associated with increased PA within the following 15 minutes. Valence (i.e. pleasure-displeasure) was not associated with PA nor predictive of subsequent PA. Digital PA interventions may target the enhancement of feelings of energy and present psychoeducation about these distinct psychological benefits.

Time-Restricted Eating Benefits on Pulmonary Function and Postural Balance in Overweight or Obese Women

This study aimed to evaluate the impact of time-restricted eating (TRE) on neuro-physiological parameters, objective and subjective sleep, pulmonary capacity, and postural balance among women with excess body weight.

METHODS

Thirty-one participants were assigned to either a TRE group (n = 15, 28.74 ± 9.25 years, 88.32 ± 13.38 kg, and 32.71 ± 5.15 kg/m2), engaging in ad libitum 16 h fasting over a 12-week period, or a control group (CG, n = 16, 36.25 ± 11.52 years, 90.88 ± 19.01 kg, and 33.66 ± 6.18 kg/m2). The assessment of heart rate variability (HRV), spirometric parameters (forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/ FVC ratio, objective and subjective sleep assessments employing actigraphy and the Epworth Sleepiness Scale, and postural balance using the Y balance test (YBT) were conducted before and after the intervention.

RESULTS

No significant negative effects of TRE were observed for HRV and objective sleep parameters. Only the TRE group improved FEV1 in both sitting (p < 0.0005) and supine positions (p = 0.001). Furthermore, the TRE group showed improvement in postural balance performance compared to the CG in anterior (p = 0.03), postero-medial (p = 0.04), and postero-lateral directions (p = 0.003).

CONCLUSION

This study highlights TRE as a feasible and safe dietary intervention with significant improvements in postural balance and pulmonary function, without any negative impact on HRV or objective sleep assessments among overweight or obese women.

Level and limitations of physical activity in patients with excess body weight or diabetes

Physical activity (PA) is recommended to prevent or treat many diseases, but various factors may limit it. We analyse the level of PA and the barriers to undertaking it. Patients aged 18-64 with diabetes or at least overweight completed the following questionnaires: International Physical Activity Questionnaire (IPAQ) and Accompanying Survey (AS). For statistical analysis, non-parametric Mann-Whitney U, χ2-Pearson, correspondence analysis and meta-analysis (OR with ±95% CI) were used, and α=0.05 was assumed. Of 191 sets of questionnaires were analysed (67% from women). The median (MD) age for the group was 50.5 years, MD for metabolic equivalents (METs): 2079 (MET-min/week); 16.23% of subjects scored insufficient, 46.07% sufficient and 37.7% high PA according to the IPAQ scale. A relationship between the IPAQ and PA level results from the AS was confirmed (χ2; p=0.00047). The most common reasons indicated for not taking up PA were lack of time due to professional work (49%) and additional duties (32%) as well as fatigue from daily duties (44%). Participants <45 years were more likely to indicate additional duties (p=0.013), participants >45 years illnesses (p=0.04) and people with BMI (body mass index) ≥30 kg/m2, 'fatigue from daily duties' (p=0.019) as an obstacle to undertaking PA. 'Lack of suitable conditions to undertake PA' was indicated more often by patients with primary education (p<0.01), diabetes (p=0.037), after myocardial infarction (p=0.039) and those under psychiatric treatment (p=0.039). Women more often declared a lack of motivation (p=0.018). Residents of big cities and those with BMI ≥30 were more likely to assess their PA as 'insufficient' (p=0.0260 and p=0.0081, respectively). The overwhelming number of respondents who were in the age of professional activity had a sufficient level of PA. The most common barriers to undertaking PA were lack of time and fatigue, related to both work and non-work activities, but specific barriers were also found for women and patients with various diseases.

Effect of physical activity on anxiety, depression and obesity index in children and adolescents with obesity: A meta-analysis

FOR FULL-LENGTH ARTICLES

This study systematically identified the effects of physical activity (PA) on depression, anxiety and weight-related outcomes among children and adolescents with overweight/obesity. EMBASE, The Cochrane Library, Web of Science, and PubMed were searched from January 1, 2000 to August 1, 2022 for peer-reviewed papers. Meta-analyses were conducted to ascertain the effect of physical activity on symptoms of anxiety, depression and weight-related outcomes in overweight/obese children and adolescents. Twenty-five studies representing 2188 participants, with median age 12.08 years old (8.3 to 18.44 years) were included. Depressive and anxiety symptoms, BMI, BMI z-scores, weight, waist circumference and height were evaluated. After incorporating the effects of PA interventions on children and adolescents with overweight/obesity, PA could improve depressive and anxiety symptoms, but not obesity indexes except waist circumference. While, PA combined with other interventions have a significant effect both on anxiety symptoms and BMI compared to pure PA intervention. In terms of intervention duration, we observed that durations falling within the range of 8 to 24 weeks exhibited the most positive effects on reducing depressive symptoms.

FOR SHORT COMMUNICATIONS

We included 25 articles on the effects of physical activity on psychological states such as depression and anxiety, weight, BMI and other weight-related indicators in children and adolescents with overweight/obesity. We attempted to determine the most appropriate type of physical activity intervention for children and adolescents with overweight/obesity, as well as the most appropriate population characteristics and duration by combining the outcome data from each article. This has a great enlightening effect for health workers to carry out corresponding strategies in the future.

Italian Association of Hospital Cardiologists position paper-obesity in adults: a clinical primer

Obesity is a chronic and relapsing disease characterized by the interaction between individual predispositions and an obesogenic environment. Recent advances in understanding the mechanisms of energetic homoeostasis paved the way to more effective therapeutic approaches compared with traditional treatments. Since obesity is a complex disease, it necessitates a multi-disciplinary approach whose implementation remains challenging. Nonetheless, emerging pharmacological interventions appear promising. Currently, therapeutic success is discreet in the short term but often fails to maintain long-term weight loss due to a high likelihood of weight regain. Cardiologists play a key role in managing patients with obesity, yet often lack familiarity with its comprehensive management. The aim of this document is to summarize knowledge to consolidate essential knowledge for clinicians to effectively treat patients living with obesity. The paper emphasizes the pivotal role of a strong patient-clinician relationship in navigating successful treatment. We analyse the criteria commonly used to diagnose obesity and point out the strengths and limitations of different criteria. Furthermore, we discuss the role of obesiologists and the contributions of cardiologists. In addition, we detail key components of effective therapeutic strategies, including educational aspects and pharmacological options.

High-intensity combination exercise has the highest effect on increasing serum irisin and interleukin 6 levels in women with obesity

OBJECTIVES

Lifestyle, overnutrition, socioeconomic status, environmental conditions, and genetics are factors that cause obesity. Lifestyle modification with a nonpharmacological approach based on physical exercise is the starting point in overcoming obesity. However, physical exercise with the appropriate and effective intensity for obese subjects is still debated. Therefore, this study aims to prove the effect of intensity differences with aerobic-resistance combination exercise on increasing irisin and IL-6 levels in obese women.

METHODS

A total of 32 obese women were selected as subjects and administered the interventions of low-intensity combination exercise (Q2), moderate-intensity combination exercise (Q3), and high-intensity combination exercise (Q4). ELISA was used to measure irisin and IL-6 levels in all samples. Statistical analysis used one-way ANOVA and Turkey's-Honest Significant Difference (HSD) post hoc test.

RESULTS

The mean Δ IL-6 levels in the control groups (Q1), Q2, Q3, and Q4 were 0.27 ± 2.54, 2.07 ± 2.55, 5.99 ± 6.25, and 7.98 ± 2.82 pg/mL with (p=0.015). The mean Δ irisin levels were 0.06 ± 0.81 ng/mL in Q1, 0.59 ± 0.67 ng/mL in Q2, 1.99 ± 1.65 ng/mL in Q3, 4.63 ± 3.57 ng/mL in Q4 with (p=0.001).

CONCLUSIONS

This study proved that all three types of combined exercise intensity increased myokine levels, such as irisin and IL-6. However, high-intensity combination exercise provided the most optimal improvement in myokine levels in obese women. Future studies are needed to design long-term exercise programs specifically for obese adolescent women using the findings from this study.

Exercise mitigates age-related metabolic diseases by improving mitochondrial dysfunction

The benefits of regular physical activity are related to delaying and reversing the onset of ageing and age-related disorders, including cardiomyopathy, neurodegenerative diseases, cancer, obesity, diabetes, and fatty liver diseases. However, the molecular mechanisms of the benefits of exercise or physical activity on ageing and age-related disorders remain poorly understood. Mitochondrial dysfunction is implicated in the pathogenesis of ageing and age-related metabolic diseases. Mitochondrial health is an important mediator of cellular function. Therefore, exercise alleviates metabolic diseases in individuals with advancing ageing and age-related diseases by the remarkable promotion of mitochondrial biogenesis and function. Exerkines are identified as signaling moieties released in response to exercise. Exerkines released by exercise have potential roles in improving mitochondrial dysfunction in response to age-related disorders. This review comprehensive summarizes the benefits of exercise in metabolic diseases, linking mitochondrial dysfunction to the onset of age-related diseases. Using relevant examples utilizing this approach, the possibility of designing therapeutic interventions based on these molecular mechanisms is addressed.