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Oppert JM, Ciangura C, Bellicha A. Physical activity and exercise for weight loss and maintenance in people living with obesity. Rev Endocr Metab Disord 2023; 24:937-949. [PMID: 37142892 DOI: 10.1007/s11154-023-09805-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
Physical activity and exercise training programs are integral part of a comprehensive obesity management approach. In persons with overweight or obesity, exercise training, specifically aerobic (i.e. endurance) training, is associated with significant additional weight loss compared to the absence of training. However the magnitude of effect remains modest amounting to only 2-3 kg additional weight loss on average. Comparable effects have been observed for total fat loss. Exercise training, specifically aerobic training, is also associated with decreased abdominal visceral fat as assessed by imaging techniques, which is likely to benefit cardiometabolic health in persons with obesity. Based on data from controlled trials with randomization after prior weight loss, the evidence for weight maintenance with exercise training is as yet not conclusive, although retrospective analyses point to the value of relatively high-volume exercise in this regard. Resistance (i.e. muscle-strengthening) training is specifically advised for lean mass preservation during weight loss. Given the relatively limited effect of exercise training on weight loss as such, the changes in physical fitness brought about by exercise training cannot be overlooked as they provide major health benefits to persons with obesity. Aerobic, as well as combined aerobic and resistance training, increase cardiorespiratory fitness (VO2max) while resistance training, but not aerobic training, improves muscle strength even in the absence of a significant change in muscle mass. Regarding the overall management strategy, adherence in the long term to new lifestyle habits remains a challenging issue to be addressed by further research.
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Affiliation(s)
- Jean-Michel Oppert
- Department of Nutrition, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France.
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, F-93017, France.
- Department of Nutrition, Pitié-Salpêtrière hospital, 47-83 boulevard de l'Hôpital, Paris, 75013, France.
| | - Cécile Ciangura
- Department of Nutrition, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France
- Department of Diabetology, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France
| | - Alice Bellicha
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, F-93017, France
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2
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Stults-Kolehmainen MA, Bond DS, Richardson LA, Herring LY, Mulone B, Garber CE, Morton J, Ghiassi S, Duffy AJ, Balk E, Abolt CJ, Howard MC, Ash GI, Williamson S, Marcon ER, De Los Santos M, Bond S, Huehls J, Alowaish O, Heyman NB, Gualano B. Role of the exercise professional in metabolic and bariatric surgery. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.20.23288698. [PMID: 37645986 PMCID: PMC10462198 DOI: 10.1101/2023.04.20.23288698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Background Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined. Objectives To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform? Setting Clinical and academic exercise settings worldwide. Methods This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model. Results The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being: supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and post-operative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care". Conclusions The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.
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Affiliation(s)
- Matthew A. Stults-Kolehmainen
- Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - Dale S. Bond
- Departments of Surgery and Research, Hartford Hospital/HealthCare, Hartford, CT, United States
| | | | - Louisa Y. Herring
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, England, United Kingdom
- NIHR Leicester Biomedical Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, England, United Kingdom
| | - Bethany Mulone
- Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
| | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - John Morton
- Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Saber Ghiassi
- Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Andrew J. Duffy
- Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Ethan Balk
- Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
- Department of Nutrition and Food Studies, New York University, New York, NY, United States
| | - Charles J. Abolt
- Earth and Environmental Sciences Division, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Matt C. Howard
- Department of Marketing & Quantitative Methods, University of South Alabama, Mobile, AL, United States
| | - Garrett I. Ash
- Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
- Center for Pain, Research, Informatics, Medical Comorbidities and Education Center (PRIME), VA Connecticut Healthcare System, West Haven, CT, United States
| | - Susannah Williamson
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, United States
- Army Educational Outreach Program, Rochester Institute of Technology, United States
| | - Emilian Rejane Marcon
- Department of Bariatric Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Melissa De Los Santos
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - Samantha Bond
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Janet Huehls
- UMass Memorial Weight Center, UMASS Memorial Medical Center, Worchester, MA, United States
| | - Osama Alowaish
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - Nina Brojan Heyman
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, School of Medicine, University of São Paulo, São Paulo, Brazil
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Vibarel-Rebot N, Asselin M, Amiot V, Collomp K. Short-Term Effect of Bariatric Surgery on Cardiorespiratory Response at Submaximal, Ventilatory Threshold, and Maximal Exercise in Women with Severe Obesity. Obes Surg 2023; 33:1528-1535. [PMID: 36952099 DOI: 10.1007/s11695-023-06550-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE People with obesity have varying degrees of cardiovascular, pulmonary, and musculoskeletal dysfunction that affect aerobic exercise testing variables. Short time after bariatric surgery, these dysfunctions could affect both peak oxygen consumption ([Formula: see text] O2 peak), the gold standard for assessing cardiorespiratory fitness (CRF) and aerobic capacity evaluated with ventilatory threshold (VT1). The purpose of this study was to evaluate the short-term effect of bariatric surgery, i.e. before the resumption of physical activity, on submaximal, at VT1 and maximal cardiorespiratory responses in middle-aged women with severe obesity. MATERIALS AND METHODS Thirteen middle-aged women with severe obesity (age: 36.7 ± 2.3 years; weight: 110.5 ± 3.6 kg, BMI: 41.8 ± 1.1 kg/m2) awaiting bariatric surgery participated in the study. Four weeks before and 6 to 8 weeks after surgery, body composition was determined by bioelectrical impedance. The participants performed an incremental cycling test to [Formula: see text] O2 peak. RESULTS After bariatric surgery, all body composition parameters were reduced, absolute [Formula: see text] O2 peak and peak workload decline with a lower VT1. Relative [Formula: see text] O2 at peak and at VT1 (ml/min/kg or ml/min/kg of FFM) remained unchanged. Ventilation was lower after bariatric surgery during exercise with no change in cardiac response. CONCLUSION Our results showed that weight loss alone at short-term after bariatric surgery decreased CRF as seen by a decrease in absolute [Formula: see text] O2 peak, and peak workload with lower VT1, whereas relative [Formula: see text] O2 (ml/min/kg or ml/min/kg of FFM) during exercise remained unchanged in women with obesity. Rapid FFM loss affects cardiorespiratory responses at submaximal and maximal.
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Affiliation(s)
- Nancy Vibarel-Rebot
- CIAMS, EA 4532, Université Orléans, Orléans, France.
- CIAMS, EA 4532, Université Paris-Saclay, Orsay, France.
- Research Group Sport, Physical Activity, Rehabilitation and Movement for Performance and Health, University of Orleans, Orléans, France.
| | - Marine Asselin
- CIAMS, EA 4532, Université Orléans, Orléans, France
- CIAMS, EA 4532, Université Paris-Saclay, Orsay, France
| | - Virgile Amiot
- Research Group Sport, Physical Activity, Rehabilitation and Movement for Performance and Health, University of Orleans, Orléans, France
- Service de Médecine du Sport, CHR Orléans, 45067, Orléans, France
| | - Katia Collomp
- CIAMS, EA 4532, Université Orléans, Orléans, France
- CIAMS, EA 4532, Université Paris-Saclay, Orsay, France
- Research Group Sport, Physical Activity, Rehabilitation and Movement for Performance and Health, University of Orleans, Orléans, France
- Laboratoire AntiDopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
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Mahmoud AM, da Silva ALG, André LD, Hwang CL, Severin R, Sanchez-Johnsen L, Borghi-Silva A, Elokda A, Arena R, Phillips SA. Effects of Exercise Mode on Improving Cardiovascular Function and Cardiorespiratory Fitness After Bariatric Surgery: A Narrative Review. Am J Phys Med Rehabil 2022; 101:1056-1065. [PMID: 35034058 PMCID: PMC9279514 DOI: 10.1097/phm.0000000000001946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
ABSTRACT Obesity affects 600 million people globally and increases the risk of developing cardiovascular disease, stroke, diabetes, and cancer. Bariatric surgery is an increasingly popular therapeutic intervention for morbid obesity to induce rapid weight loss and reduce obesity-related comorbidities. However, some bariatric surgery patients, after what is considered a successful surgical procedure, continue to manifest obesity-related health issues, including weight gain, reduced physical function, persistent elevations in blood pressure, and reduced cardiorespiratory fitness. Cardiorespiratory fitness is a strong predictor of mortality and several health outcomes and could be improved by an appropriate exercise prescription after bariatric surgery. This review provides a broad overview of exercise training for patients after bariatric surgery and discusses cardiorespiratory fitness and other potential physiological adaptations in response to exercise training.
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Affiliation(s)
- Abeer M. Mahmoud
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Andréa Lúcia Gonçalves da Silva
- Department of Physical Education and Health, Physiotherapy‘ Course at University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
- Department of Physical Therapy, Integrative Physiologic Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Larissa Delgado André
- Department of Physical Therapy, Integrative Physiologic Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
- Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Chueh-Lung Hwang
- Department of Physical Therapy, Integrative Physiologic Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Richard Severin
- Department of Physical Therapy, Integrative Physiologic Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
- Graduate Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Lisa Sanchez-Johnsen
- Departments of Surgery, Psychiatry, and Psychology, College of Medicine, University of Illinois at Chicago (UIC), Chicago, IL, USA
- Department of Family Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Ahmed Elokda
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL
| | - Ross Arena
- Department of Physical Therapy, Integrative Physiologic Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
- Graduate Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Shane A. Phillips
- Department of Physical Therapy, Integrative Physiologic Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
- Graduate Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL, USA
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Ibacache-Saavedra P, Jerez-Mayorga D, Carretero-Ruiz A, Miranda-Fuentes C, Cano-Cappellacci M, Artero EG. Effects of bariatric surgery on cardiorespiratory fitness: A systematic review and meta-analysis. Obes Rev 2022; 23:e13408. [PMID: 34927337 DOI: 10.1111/obr.13408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/20/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Abstract
Although bariatric surgery (BS) is recognized as an effective strategy for body weight loss, its impact on cardiorespiratory fitness (CRF) is still unclear. We aimed to examine postoperative changes in CRF (VO2max/peak ) and its relationship with weight loss among adults undergoing BS. We systematically searched the WoS, PubMed, MEDLINE, and Scopus databases. Observational and intervention studies were selected reporting the presurgery and postsurgery CRF, measured by breath-by-breath VO2 or its estimation. Eleven articles (312 patients) revealed that BS leads to a reduction in absolute VO2max/peak in the short term (effect size, ES = -0.539; 95%CI = -0.708, -0.369; p < 0.001), and those patients who suffered a more significant decrease in BMI after BS also had a greater loss of absolute VO2max/peak . However, VO2max/peak relative to body weight increased after surgery (ES = 0.658; 95%CI = 0.473, 0.842; p < 0.001). An insufficient number of studies were found investigating medium and long-term changes in CRF after BS. This study provides moderate-quality evidence that the weight loss induced by BS can reduce CRF in the short term, which represents a therapeutic target to optimize BS outcomes. More high-quality studies are needed to evaluate the impact of BS on VO2max/peak in the short, medium, and long term including normalized values for fat-free mass.
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Affiliation(s)
- Paulina Ibacache-Saavedra
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Daniel Jerez-Mayorga
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Alejandro Carretero-Ruiz
- Department of Education and SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almeria, Spain
| | - Claudia Miranda-Fuentes
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | | | - Enrique G Artero
- Department of Education and SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almeria, Spain
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Carretero-Ruiz A, Martínez-Rosales E, Cavero-Redondo I, Álvarez-Bueno C, Martínez-Vizcaíno V, Gómez Navarro C, Reyes Parrilla R, Ferrer-Márquez M, Soriano-Maldonado A, Artero EG. Impact of exercise training after bariatric surgery on cardiometabolic risk factors: a systematic review and meta-analysis of controlled trials. Rev Endocr Metab Disord 2021; 22:891-912. [PMID: 33860904 DOI: 10.1007/s11154-021-09651-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 11/30/2022]
Abstract
The purpose of this systematic review was to provide updated evidence synthesis of the effectiveness of exercise training in patients with obesity undergoing bariatric surgery to improve cardio-metabolic risk. We systematically searched the MEDLINE, EMBASE, Scopus, Cochrane, and Web of Science databases. The studies selected were those in which an exercise-based intervention was performed after bariatric surgery, a control group was present, and at least one of the following outcomes was investigated: VO2max or VO2peak, resting heart rate (RHR), blood pressure, lipid profile, glucose, and insulin. The study quality was assessed using the PEDro scale and the data were meta-analyzed with a random effects model, comparing control groups to intervention groups using standardized measurements. Twenty articles were included in the systematic review and fourteen (70%) in the meta-analysis. Significant differences were observed between the control and intervention groups (always in favor of exercise) for absolute VO2max / VO2peak (ES = 0.317; 95% CI = 0.065, 0.569; p = 0.014), VO2max / peak relative to body weight (ES = 0.673; 95% CI = 0.287, 1.060; p = 0.001), HDL cholesterol (ES = 0.22; 95% CI = 0.009, 0.430; p = 0.041) and RHR (ES = -0.438; 95% CI = -0.753, -0.022; p = 0.007). No effects were observed for either systolic or diastolic blood pressure. Exercise training for patients undergoing bariatric surgery appears to be effective in improving absolute and relative VO2max / VO2peak, HDL cholesterol and reducing the RHR. More intervention studies using (better) exercise interventions are needed before discarding their effects on other cardiometabolic risk factors. This systematic review and meta-analysis has been registered in Prospero (CRD42020153398).
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Affiliation(s)
- Alejandro Carretero-Ruiz
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain.
| | - Elena Martínez-Rosales
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica Y Artística Del Paraguay, Asunción, Paraguay
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica Y Artística Del Paraguay, Asunción, Paraguay
| | - Vicente Martínez-Vizcaíno
- Universidad Politécnica Y Artística Del Paraguay, Asunción, Paraguay
- Facultad de Ciencias de La Salud, Universidad Autónoma de Chile, Talca, Chile
| | | | - Raúl Reyes Parrilla
- Unit of Cardiology, Torrecárdenas University Hospital Almería, Almería, Spain
| | - Manuel Ferrer-Márquez
- General and Bariatric Surgery Unit, Torrecárdenas University Hospital, Almería, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Enrique G Artero
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
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7
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Assessment of Cardiorespiratory and Metabolic Responses in Women with Obesity After Surgically Induced Weight Loss: Results from a Pilot Study. Obes Surg 2021; 32:318-324. [PMID: 34780025 DOI: 10.1007/s11695-021-05782-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Bariatric surgery is effective in controlling severe obesity. However, studies investigating the impact of surgically induced weight loss on cardiorespiratory and metabolic responses during maximal effort are controversial. The aim of this study was to assess cardiorespiratory and metabolic responses in women with obesity after bariatric surgery. MATERIALS AND METHODS We performed a secondary analysis on data from a pilot study with women with obesity submitted to bariatric surgery and who did not participate in a controlled physical training program. Anthropometry, pulmonary function (spirometry), and cardiorespiratory fitness (cardiopulmonary exercise testing [CPX]) were assessed before and after bariatric surgery. RESULTS Thirty-four women were included (38.7 ± 9.6 years, body mass index = 44.1 ± 6.3 kg/m2). Postoperative assessment was conducted 9.4 ± 2.7 months after surgery. After surgery, we observed a reduction in all anthropometric measurements (mean loss of 28.6 kg, p < 0.001), and improvement in spirometry values (p < 0.001). Relative VO2peak (mL/kg/min) increased slightly (Δ = 1.7; p = 0.06); however, absolute VO2peak (L/min) reduced significantly (Δ = - 0.398; p < 0.001). We also observed an increase of 1.3 min (p < 0.001) in CPX duration, a reduction of 11.3 bpm (p < 0.001) in resting heart rate, and a decrease of systolic (p = 0.02) and diastolic (p < 0.001) blood pressures at peak effort. CONCLUSION Surgically induced weight loss without exercise training improved cardiac reserve, ventilatory response, blood pressure, and resting heart rate. Cardiorespiratory fitness reflected by relative VO2peak increased slightly, despite increased tolerance to CPX.
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8
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Bellicha A, van Baak MA, Battista F, Beaulieu K, Blundell JE, Busetto L, Carraça EV, Dicker D, Encantado J, Ermolao A, Farpour-Lambert N, Pramono A, Woodward E, Oppert JM. Effect of exercise training before and after bariatric surgery: A systematic review and meta-analysis. Obes Rev 2021; 22 Suppl 4:e13296. [PMID: 34080281 PMCID: PMC8365633 DOI: 10.1111/obr.13296] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 12/21/2022]
Abstract
We aimed to assess the effectiveness of exercise training programs in adults with severe obesity undergoing bariatric surgery. A systematic search of controlled trials published up to October 2019 that assigned participants to either a preoperative or postoperative exercise training group or a nonexercise group was performed. Meta-analyses were conducted using random-effects models. Twenty-two training programs were assessed (18 performed after bariatric surgery). The effect of preoperative exercise training on postsurgery outcomes was reported in only one study. Compared with the control condition without exercise, postoperative exercise training led to higher weight loss (N = 14, mean difference [95% CI] = -1.8 [-3.2; -0.4] kg, P = 0.01), fat loss (N = 9, P = 0.01), increase in VO2 max (N = 8, P < 0.0001), and increase in muscle strength (N = 9, P < 0.0001). No significant effect was found on lean body mass (N = 11). Preliminary evidence suggests a beneficial effect of postoperative exercise training on bone mineral density (N = 3, P < 0.001) and weight maintenance after the end of the intervention (N = 2, P < 0.001) but no significant effect on quality of life (N = 2), habitual physical activity (N = 2), or cardiometabolic outcomes (N < 4). In conclusion, exercise training performed after bariatric surgery improves physical fitness and leads to a small additional weight and fat loss and may prevent bone loss and weight regain after bariatric surgery.
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Affiliation(s)
- Alice Bellicha
- INSERM, Nutrition and Obesities: Systemic Approaches, NutriOmics, Sorbonne University, Paris, France.,UFR SESS-STAPS, University Paris-Est Créteil, Créteil, France
| | - Marleen A van Baak
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Francesca Battista
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - John E Blundell
- Appetite Control and Energy Balance Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Luca Busetto
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO), London, UK.,Department of Medicine, University of Padova, Padova, Italy
| | - Eliana V Carraça
- CIDEFES, Faculdade de Educação Física e Desport, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Dror Dicker
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO), London, UK.,Department of Internal Medicine, Hasharon Hospital, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jorge Encantado
- APPsyCI - Applied Psychology Research Center Capabilities & Inclusion, ISPA - University Institute, Lisbon, Portugal
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Nathalie Farpour-Lambert
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO), London, UK.,Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology, Nutrition and Patient Education, Department of Internal Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Adriyan Pramono
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Euan Woodward
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO), London, UK
| | - Jean-Michel Oppert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France
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Pouragha H, Kazemi H, Pouryaghoub G, Mehrdad R. Association Between Body Composition and Pulmonary Function Tests Among Health Care Workers in Iran. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x17666210311143728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Why is bodyweight not a predictor of lung function, while height, sex,
race, and age are predictors of lung capacity and function? In this study, we want to investigate the
association between body composition and pulmonary function. And, as much as possible, answer
the question of why bodyweight is not predictive of lung function.
Methods:
This cross-sectional study was performed among 2967 employees of Tehran University
of Medical Sciences (TUMS) who participated in the TUMS Employees Cohort (TEC) study. The
body composition of the participants was measured using the Bioelectrical Impedance Analysis (BIA)
method. Anthropometric variables were also measured as a confounder. The pulmonary function
of participants was assessed by a forced spirometry test.
Results:
The correlation of BIA values including fat-free mass and total body water with a pulmonary
function such as FEV1, FVC, and FEF25-75is higher than most anthropometric values such as
weight, wrist circumference, and the waist to hip ratio. Also, in regression analysis, age and sex
had an association with pulmonary function, but the weight did not show a significant relationship.
On the other hand, fat-free mass and visceral fat were significantly associated with pulmonary function.
One is direct and the other is inverse.
Conclusion:
We observed a negative association between visceral fat and pulmonary function tests
and a direct association between Fat-free mass pulmonary function tests (FEV1 and FVC) adjusted
for age, sex, and anthropometric indices.
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Affiliation(s)
- Hamidreza Pouragha
- Department of Occupational Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Kazemi
- Occupational Medicine Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Pouryaghoub
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
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In G, Taskin HE, Al M, Alptekin HK, Zengin K, Yumuk V, Ikitimur B. Comparison of 12-Week Fitness Protocols Following Bariatric Surgery: Aerobic Exercise Versus Aerobic Exercise and Progressive Resistance. Obes Surg 2021; 31:1475-1484. [PMID: 33409974 DOI: 10.1007/s11695-020-05144-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/19/2020] [Accepted: 12/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Successful bariatric surgery outcomes are better maintained with an exercise program. This pilot study compared the effects on short-term functional capacity and body composition of 2 post-bariatric surgery home-based programs: aerobic exercise alone versus aerobic exercise combined with progressive resistance conditioning. METHODS Laboratory measures and self-assessments of post-bariatric surgery patients (BMI ≥ 30 kg/m2) undergoing either aerobic exercise (AE group) or aerobic + progressive-resistance exercise (AEPR group) were compared at postoperative months 1 and 3. Anthropometric characteristic changes were recorded, as well as changes in functional capacity (e.g., 6-min walking test), muscle strength (e.g., hand grip strength test; five-times-sit-to-stand test), and quality of life (i.e., Beck Depression Inventory). RESULTS Between July 2018 and March 2019, 35 patients completed the AE (n = 17) or AEPR (n = 18) program. The AEPR group lost statistically significantly more weight (mean 2.2 kg) relative to baseline than the AE group (p < 0.05). The AEPR group achieved significantly greater mean total muscle, liquid, and bone mass; upper-extremity muscle strength; uric acid levels; body fat loss; and performed better on the 6-min walking test (all p < 0.05). In month 3, the AEPR group achieved a greater mean walking distance (p = 0.029) and O2 saturation related to dyspnea (p = 0.001) than the AE group. Group quality of life scores were comparable. CONCLUSIONS In a comparative 12-week post-bariatric surgery study, both aerobic exercise alone and aerobic exercise plus progressive-resistance training were positively correlated with general health improvement. However, the progressive-resistance regimen resulted in significantly greater weight loss, functional capacity, muscle mass, and upper-body strength.
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Affiliation(s)
- Gozde In
- School of Health Sciences, Bahçeşehir University, Istanbul, Turkey
| | - Halit Eren Taskin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey.
| | - Muzaffer Al
- Faculty of Medicine, Department of Surgery, Near East University, Nicosia, Cyprus
| | | | - Kagan Zengin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Volkan Yumuk
- Cerrahpasa Medical Faculty, Department of Endocrinology and Metabolism, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Baris Ikitimur
- Cerrahpasa Medical Faculty, Department of Cardiology, Istanbul University Cerrahpasa, Istanbul, Turkey
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11
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Auclair A, Harvey J, Leclerc J, Piché ME, O'Connor K, Nadreau É, Pettigrew M, Haykowsky MJ, Marceau S, Biertho L, Hould FS, Lebel S, Biron S, Julien F, Bouvet L, Lescelleur O, Poirier P. Determinants of Cardiorespiratory Fitness After Bariatric Surgery: Insights From a Randomised Controlled Trial of a Supervised Training Program. Can J Cardiol 2020; 37:251-259. [PMID: 32738206 DOI: 10.1016/j.cjca.2020.03.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Severely obese patients have decreased cardiorespiratory fitness (CRF) and poor functional capacity. Bariatric surgery-induced weight loss improves CRF, but the determinants of this improvement are not well known. We aimed to assess the determinants of CRF before and after bariatric surgery and the impact of an exercise training program on CRF after bariatric surgery. METHODS Fifty-eight severely obese patients (46.1 ± 6.1 kg/m2, 78% women) were randomly assigned to either an exercise group (n = 39) or usual care (n = 19). Exercise training was conducted from the 3rd to the 6th months after surgery. Anthropometric measurements, abdominal and mid-thigh computed tomographic scans, resting echocardiography, and maximal cardiopulmonary exercise testing was performed before bariatric surgery and 3 and 6 months after surgery. RESULTS Weight, fat mass, and fat-free mass were reduced significantly at 3 and 6 months, without any additive impact of exercise training in the exercise group. From 3 to 6 months, peak aerobic power (V̇O2peak) increased significantly (P < 0.0001) in both groups but more importantly in the exercise group (exercise group: from 18.6 ± 4.2 to 23.2 ± 5.7 mL/kg/min; control group: from 17.4 ± 2.3 to 19.7 ± 2.4 mL/kg/min; P value, group × time = 0.01). In the exercise group, determinants of absolute V̇O2peak (L/min) were peak exercise ventilation, oxygen pulse, and heart rate reserve (r2 = 0.92; P < 0.0001), whereas determinants of V̇O2peak indexed to body mass (mL/kg/min) were peak exercise ventilation and early-to-late filling velocity ratio (r2 = 0.70; P < 0.0001). CONCLUSIONS A 12-week supervised training program has an additive benefit on cardiorespiratory fitness for patients who undergo bariatric surgery.
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Affiliation(s)
- Audrey Auclair
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada
| | - Jany Harvey
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Pharmacy, Laval University, Québec, Québec, Canada
| | - Jacinthe Leclerc
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Pharmacy, Laval University, Québec, Québec, Canada; Nursing Department, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Marie-Eve Piché
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Kim O'Connor
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Éric Nadreau
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada
| | - Myriam Pettigrew
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Pharmacy, Laval University, Québec, Québec, Canada
| | - Mark J Haykowsky
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Simon Marceau
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Laurent Biertho
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Frédéric-Simon Hould
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Stéfane Lebel
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Simon Biron
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - François Julien
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Léonie Bouvet
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Odette Lescelleur
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Paul Poirier
- Québec Heart and Lung Institute, Laval University, Québec, Québec, Canada; Faculty of Pharmacy, Laval University, Québec, Québec, Canada.
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12
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Marshall S, Mackay H, Matthews C, Maimone IR, Isenring E. Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post-operative weight loss, co-morbidities, and quality of life? A systematic review and meta-analysis. Obes Rev 2020; 21:e13012. [PMID: 32196906 DOI: 10.1111/obr.13012] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/30/2020] [Accepted: 02/08/2020] [Indexed: 12/14/2022]
Abstract
This systematic review and meta-analysis of intervention studies aims to evaluate the effect of preoperative and/or post-operative support for adults who elect bariatric surgery delivered by a multidisciplinary team (MDT) on post-operative body composition, mental health, co-morbidities, quality of life, and side effects. Six electronic databases were searched. Revman and GRADE were used to assess confidence in pooled effects. Included interventions (N = 1533 participants in total) focused on lifestyle counselling (n = 4 studies), psychology (n = 4 studies), or exercise (n = 10 studies); comparator groups were less intensive usual care. Intensive MDT interventions increased post-operative weight loss (SMD: -0.94; 95% CI: -1.27 to -0.61) if delivered post-operatively. Preoperative and post-operative intensive interventions improved symptoms of depression and anxiety, quality of life, diastolic blood pressure, and resting heart rate but not lipids or glycaemic measures. Whilst usual MDT care is important preoperatively, this review conditionally recommends intensive MDT interventions for enhanced post-operative weight loss if delivered in the post-operative period, led by any health professional, based on moderate evidence. This review also conditionally recommends preoperative and/or post-operative lifestyle, nutrition, or psychology counselling and/or physical activity for improved mental and physical health. Further randomized controlled trials are required, which aim to specifically evaluate the best use of MDT resources.
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Affiliation(s)
- Skye Marshall
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Nutrition & Dietetics, Mater Health Services, South Brisbane, Queensland, Australia
| | - Hannah Mackay
- Weightloss Solutions Australia, Gold Coast, Queensland, Australia
| | - Charlene Matthews
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | | | - Elizabeth Isenring
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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13
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Physical activity impacts insulin sensitivity post metabolic bariatric surgery in adolescents with severe obesity. Int J Obes (Lond) 2020; 44:1479-1486. [PMID: 32424268 PMCID: PMC7363050 DOI: 10.1038/s41366-020-0585-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 04/02/2020] [Accepted: 04/29/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES We hypothesized that physical activity (PA) improves insulin sensitivity in adolescents with severe obesity beyond that attributable to metabolic bariatric surgery (MBS). SUBJECTS/METHODS StepWatchTM monitors objectively measured PA in 88 participants in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. Primary outcomes included absolute change in fasting insulin, HOMA-IR, and fasting glucose from pre-surgery (baseline) to 6, 12, 24, and 36 months post-MBS. SAS PROC TRAJ generated activity trajectories based on probability and individual participant step count trajectories. Linear regression models were used, adjusted for baseline value, visit, surgical procedure, sex, and percent change in BMI. Additional models adjusted for percent change in iliac waist circumference (IWC) or percent body fat (BF), measured by bio-impedance. RESULTS Two activity trajectories were identified: more active (MA, n = 13) and less active (LA, n = 75). MA baseline mean daily step count was >6000, increasing to >9000 at 2 years. LA mean daily step count remained at ~4000. Few participants recorded moderate step activity (cadence >80 steps/minute). Still, fasting insulin and HOMA-IR differed in association with activity trajectoy. MA was associated with a greater absolute decrease in fasting insulin (-7.8 μU/ml [95% CI: (-11.8, -3.7)], p ≤ 0.001) and a greater decrease in HOMA-IR (-1.9 [95% CI: (-3.0, -0.7)], p = 0.001), when adjusted for percent change in BMI. The significant independent effect of MA remained when adjusted for percent change in IWC or percent BF. Clinically, 100% of MA trajectory participants normalized fasting insulin, HOMA-IR, and fasting glucose by 6 months and normalization remained throughout the 36 months follow up. In contrast, 76.3 and 65.8% of LA trajectory participants normalized fasting insulin and HOMA-IR, respectively, by 12 months with 28.6% of both remaining normalized at 36 months. CONCLUSIONS PA is independently associated with improved insulin sensitivity beyond that attributable to MBS in adolescents with severe obesity.
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14
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Abstract
Although exercise is recognized as an important component of the management for patients following bariatric surgery (BS), its effectiveness on cardiorespiratory fitness (CRF) is still unclear. To investigate this relationship between BS and CRF, a systematic review was conducted in the MEDLINE database. The literature search included studies involving exercise training in patients following BS. A total of 306 studies were identified, 7 met the criteria and were included in the meta-analysis. Exercise training was found to result in a moderate and significant increase in VO2max (SMD = 0.430, 95% CI 0.157; 0.704, p = 0.002) following BS. The results from this meta-analysis indicate that exercise training can significantly improve CRF. Further research is needed to determine the ideal training duration and exercise training parameters for patients following BS.
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15
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Ricci PA, Cabiddu R, Jürgensen SP, André LD, Oliveira CR, Di Thommazo-Luporini L, Ortega FP, Borghi-Silva A. Validation of the two-minute step test in obese with comorbibities and morbidly obese patients. ACTA ACUST UNITED AC 2019; 52:e8402. [PMID: 31482976 PMCID: PMC6720022 DOI: 10.1590/1414-431x20198402] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 06/10/2019] [Indexed: 11/22/2022]
Abstract
Cardiopulmonary fitness assessment is a valuable resource to obtain quantitative indicators of an individual's physical performance. The cardiopulmonary exercise test (CPX), considered the gold standard test for this evaluation, is costly and difficult to be accessed by the general population. In order to make this evaluation more accessible, and to better reflect the performance of daily life activities, alternative tests were proposed. Morbidly obese patients present limitations that impair physical performance assessment and could benefit from a test of shorter duration, provided it is validated. This observational study aimed to validate the two-minute step test (2MST) as a tool to evaluate functional capacity (FC) in obese with comorbidities and morbidly obese patients, compared the 2MST with CPX as a measure of physical performance, and developed a predictive equation to estimate peak oxygen uptake (VO2) in the 2MST. The CPX and the 2MST were performed and metabolic and ventilatory parameters were recorded in 31 obese individuals (BMI>35 kg/m2). Pearson correlation and multiple linear regression analyses were performed to evaluate the peak VO2 best predictors. Bland-Altman analysis was performed to assess the agreement between the two methods. Peak VO2 measured by CPX and 2MST showed a strong correlation (r=0.70, P<0.001) and there was a moderate correlation between peak VO2 of the 2MST and the number of up-and-down step cycles (UDS) (r=0.55; P=0.01). The reference equation obtained was: VO2 (mL·kg-1·min-1) = 13.341 + 0.138 × total UDS – (0.183 × BMI), with an estimated standard error of 1.3 mL·kg-1·min-1. The 2MST is a viable, practical, and easily accessible test for FC. UDS and BMI can predict peak VO2 satisfactorily.
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Affiliation(s)
- P A Ricci
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - R Cabiddu
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - S P Jürgensen
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - L D André
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C R Oliveira
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - L Di Thommazo-Luporini
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - F P Ortega
- Santa Casa de Misericórdia de São Carlos, São Carlos, SP, Brasil
| | - A Borghi-Silva
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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16
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Carretero-Ruiz A, Olvera-Porcel MDC, Cavero-Redondo I, Álvarez-Bueno C, Martínez-Vizcaíno V, Ferrer-Márquez M, Soriano-Maldonado A, Arter EG. Effects of Exercise Training on Weight Loss in Patients Who Have Undergone Bariatric Surgery: a Systematic Review and Meta-Analysis of Controlled Trials. Obes Surg 2019; 29:3371-3384. [DOI: 10.1007/s11695-019-04096-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Bellicha A, Ciangura C, Poitou C, Portero P, Oppert JM. Effectiveness of exercise training after bariatric surgery-a systematic literature review and meta-analysis. Obes Rev 2018; 19:1544-1556. [PMID: 30156007 DOI: 10.1111/obr.12740] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/18/2018] [Accepted: 06/09/2018] [Indexed: 12/18/2022]
Abstract
We aimed to conduct a systematic review and meta-analysis of controlled trials assessing exercise training programs in patients with obesity undergoing bariatric surgery. We systematically searched exercise training studies performed after bariatric surgery published up to June 2017. Studies reporting changes in body composition, physical fitness, functional capacity, objectively measured physical activity, quality of life or relevant health outcomes were included. The review protocol is available from PROSPERO (CRD42017069380). Meta-analyses were conducted using random-effects models when data were available from at least five articles. Twenty articles were included, describing 16 exercise training programs, of which 15 were included in the meta-analysis. Overall, exercise training was associated with higher weight loss (mean difference: -2.4 kg, 95% CI: -4.2; -0.6, I2 = 49%, n = 12), higher fat mass loss (-2.7 kg, 95% CI: -4.5; -1.0, I2 = 50%, n = 8) and improved VO2 max and functional walking (standardized mean difference: 0.86, 95% CI: 0.29; 1.44, I2 = 57%, n = 6; 1.45, 95% CI: 0.32; 2.58, I2 = 89%, n = 6, respectively). Exercise training was not associated with lean body mass changes. In conclusion, exercise training programs performed after bariatric surgery were found effective to optimize weight loss and fat mass loss and to improve physical fitness, although no additional effect on lean body mass loss was found.
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Affiliation(s)
- A Bellicha
- Laboratory Bioengineering, Tissues and Neuroplasticity (BIOTN EA7377), University Paris-Est, Créteil, France.,Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, Paris, France
| | - C Ciangura
- Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, Paris, France.,AP-HP, Pitie-Salpetriere University Hospital, Department of Nutrition, Sorbonne University, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France
| | - C Poitou
- Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, Paris, France.,AP-HP, Pitie-Salpetriere University Hospital, Department of Nutrition, Sorbonne University, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France.,INSERM, UMRS NutriOmics Team, Paris, France
| | - P Portero
- Laboratory Bioengineering, Tissues and Neuroplasticity (BIOTN EA7377), University Paris-Est, Créteil, France
| | - J-M Oppert
- Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, Paris, France.,AP-HP, Pitie-Salpetriere University Hospital, Department of Nutrition, Sorbonne University, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France
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18
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English WJ, Williams DB. Metabolic and Bariatric Surgery: An Effective Treatment Option for Obesity and Cardiovascular Disease. Prog Cardiovasc Dis 2018; 61:253-269. [PMID: 29953878 DOI: 10.1016/j.pcad.2018.06.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 01/07/2023]
Abstract
Obesity is a chronic and debilitating disease that has become a global epidemic. Especially severe in the Unites States, obesity currently affects almost 40% of the population. Obesity has a strong causal relationship with numerous serious comorbidities that impair quality of life, shorten life expectancy, and carry a major economic burden. Obesity has particular relevance to cardiologists because it contributes directly to several major cardiovascular diseases and, consequently, increases overall cardiovascular mortality. Multiple treatment options are available, but metabolic and bariatric surgery offers the most effective and durable treatment for obesity. Moreover, metabolic and bariatric operations alleviate and often completely eliminate numerous comorbidities, particularly type 2 diabetes and other cardiovascular risk factors, such as hypertension and dyslipidemia. With their low risk of complications and morbidity, metabolic and bariatric operations significantly improve quality of life and overall survival, particularly reducing death due to cardiovascular disease.
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Affiliation(s)
- Wayne J English
- Vanderbilt University Medical Center, 1161 21(st) Avenue South, Room D5203 MCN, Nashville, TN 37232-2577, United States of America.
| | - D Brandon Williams
- Vanderbilt University Medical Center, 1161 21(st) Avenue South, Room D5203 MCN, Nashville, TN 37232-2577, United States of America.
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