Effects of upper-body resistance exercise training on serum nesfatin-1 level, insulin resistance, and body composition in obese paraplegic men

Effect of high-intensity interval training on cardiometabolic component risks in persons with paraplegia: Results of a randomized controlled trial

The aim of this work is to determine the effect of upper-body high intensity interval training (HIIT) on cardiometabolic risks in individuals with chronic paraplegia. Twenty-seven individuals (14 females, 13 males, mean ± SD age: 46 ± 9 years) with chronic paraplegia (spinal cord injury between T2 and L5 >1-year post-injury) took part in a randomized controlled trial and were included in the final analysis. Participants in the HIIT group (n = 18) performed ∼30 min of arm crank exercise (60 s intervals at 80%-90% peak heart rate) four times per week, for 6 weeks. Participants in the control (CON) group (n = 9) were asked to maintain their habitual diet and physical activity patterns over the study period. Outcome measures were taken at baseline and follow-up. The primary outcome measures were fasting insulin, peak power output (PPO) and peak aerobic capacity (V ̇ O 2 peak ${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{peak}}}}$ ). Secondary outcome measures included body composition, postprandial glycaemic control, fasting blood lipids, inflammatory biomarkers and resting blood pressure. Differences between groups were assessed by ANCOVA, using baseline values as a covariate. PPO was higher in the HIIT (101 W, 97-106) compared to the CON (90 W, 83-96) group at follow-up (P = 0.006). There were no differences in fasting insulin (P = 0.415) or relativeV ̇ O 2 peak ${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{peak}}}}$ (P = 0.417). Postprandial Matsuda insulin sensitivity index (ISIMatsuda) was higher in the HIIT (5.42, 4.69-6.15) compared to the CON (3.75, 2.46-5.04) group at follow-up (P = 0.036). Six weeks of upper-body HIIT increased PPO and ISIMatsuda, with no other beneficial effect on cardiometabolic component risks in persons with chronic paraplegia. HIGHLIGHTS: What is the central question of this study? What is the effect of upper-body high intensity interval training (HIIT) on cardiometabolic component risks in individuals with chronic paraplegia? What is the main finding and its importance? Six weeks of upper-body HIIT increased PPO and improved insulin sensitivity, but had no beneficial effect on other cardiometabolic component risks in persons with chronic paraplegia. The large effect size observed for insulin sensitivity may be important in terms of reducing the risk of type-2 diabetes in this population.

Strength training as a non-pharmacological alternative to improve body composition, and quality of life in people with spinal cord injury: A systematic review

INTRODUCTION

Spinal cord injuries (SCI) have physiological, emotional, and economic consequences in the lives of affected people. Resistance training (RT) is efficient in improving several physiological factors, quality of life, and body composition. Due to the scarce literature on the analysis of isolated RT, the objective of this systematic review is to evaluate the effects of RT without the association of other techniques, in aspects related to the quality of life and body composition of people with SCI.

EVIDENCE ACQUISITION

The research was carried out in databases such as Pubmed, Cochrane, and Web of Science using the terms ("Spinal cord injury") AND (("Resistance Training") OR ("Strength training")). Given the lack of evidence on the subject, no deadline was set for the study to be eligible for analysis.

EVIDENCE SYNTHESIS

The search for the articles was carried out in November of 2023 and returned 470 results, of which 315 remained after the elimination of duplicates, with 281 being excluded after title analysis. A total of 34 abstracts were analyzed and 29 studies were excluded, leaving 5 complete articles for thorough analysis.

CONCLUSIONS

After analyzing the main results, we concluded that RT promotes significant improvements in body composition, pain, stress and depression symptoms, increased functionality, physical awareness, and quality of life.

Physical exercise in liver diseases

Liver diseases contribute to ~2 million deaths each year and account for 4% of all deaths globally. Despite various treatment options, the management of liver diseases remains challenging. Physical exercise is a promising nonpharmacological approach to maintain and restore homeostasis and effectively prevent and mitigate liver diseases. In this review, we delve into the mechanisms of physical exercise in preventing and treating liver diseases, highlighting its effects on improving insulin sensitivity, regulating lipid homeostasis, and modulating immune function. In addition, we evaluate the impact of physical exercise on various liver diseases, including liver ischemia/reperfusion injury, cardiogenic liver disease, metabolic dysfunction-associated steatotic liver disease, portal hypertension, cirrhosis, and liver cancer. In conclusion, the review underscores the effectiveness of physical exercise as a beneficial intervention in combating liver diseases.

Effects of physical activity and exercise on Nucleobindin-2 gene expression and Nesfatin-1 concentration: A rapid review

The aim of this rapid review is to examine the research evidence that presents the effects of physical activity and exercise on Nucleobindin-2 (NUCB2) gene expression and Nesfatin-1 concentration. Five databases (PubMed, Science Direct, Springer, Wiley, and Google Scholar) were searched for eligible studies from the earliest available date to August 2023. In human studies, Nesfatin-1 concentration either remains unchanged or increases after exercise training. It appears that higher exercise intensity and longer duration of training accentuate the increase of blood Nesfatin-1 concentration. The few human studies that have examined the acute response of exercise on Nesfatin-1 concentration from blood draws show conflicting results. There is a severe lack of biopsy studies in humans which warrants attention. All published animal studies have used the mouse model. The majority show that regular exercise training increases tissue NUCB2/Nesfatin-1. In some animal studies, where the effects of exercise on tissue Nesfatin-1 concentration has been seen as significant, there has been no significant effect of exercise on plasma Nesfatin-1 concentration. All animal studies evaluated the effect of endurance training except one which used resistance training. No animal studies have investigated the effects of acute exercise, which warrants investigation. In conclusion, human and animal studies have shown that physical training can increase NUCB2/Nesfatin-1, but research evidence examining the effect of acute exercise is in its infancy. In addition, future comparative studies are needed to compare the effects of different training protocols on NUCB2/Nesfatin-1 in humans and animals.

The role of astrocytes response triggered by hyperglycaemia during spinal cord injury

Objective: This manuscript aimed to provide a comprehensive overview of the physiological, molecular, and cellular mechanisms triggered by reactive astrocytes (RA) in the context of spinal cord injury (SCI), with a particular focus on cases involving hyperglycaemia.Methods: The compilation of articles related to astrocyte responses in neuropathological conditions, with a specific emphasis on those related to SCI and hyperglycaemia, was conducted by searching through databases including Science Direct, Web of Science, and PubMed.Results and Conclusions: This article explores the dual role of astrocytes in both neurophysiological and neurodegenerative conditions within the central nervous system (CNS). In the aftermath of SCI and hyperglycaemia, astrocytes undergo a transformation into RA, adopting a distinct phenotype. While there are currently no approved therapies for SCI, various therapeutic strategies have been proposed to alleviate the detrimental effects of RAs following SCI and hyperglycemia. These strategies show promising potential in the treatment of SCI and its likely comorbidities.

Feasibility of an Upper Limb Strength Training Program in Persons with Spinal Cord Injury during Primary Rehabilitation-An Uncontrolled Interventional Study

Data concerning the outcomes of standardized strength-training programs in people with acute spinal cord injury (SCI) are scarce. The present study evaluated the feasibility and effects of a clinic-internal strength-training concept in people with paraplegia during the course of primary rehabilitation. For this purpose, participants followed a 10-12 week standardized supervised strength-training program (30 training sessions) during primary rehabilitation. At the beginning, 5-6 weeks and 10-12 weeks later, maximal strength based on indirect one-repetition maximum (1RM) measurements for two specific exercises (triceps press; horizontal rowing pull) was determined. Twelve out of 17 participants successfully completed the study. Maximal weights for 1RM significantly increased over the 10-12 week training program for the triceps press (+30%; p = 0.018) and the horizontal rowing pull (+41%; p = 0.008). Training compliance was 95%. Reasons for study exclusion were urgent surgery (n = 2), cardio-respiratory complications (n = 1), shoulder pain (n = 1) and a training compliance of less than 50% (n = 1). In conclusion, a supervised and standardized strength-training program during primary rehabilitation of people with paraplegia is feasible and leads to significant increases in maximal strength. Although study participants showed a high training compliance, factors such as medical complications may impede the proper implementation of a strength-training concept into daily clinical practice.

Effects of 12-week moderate aerobic exercise on ROCK2 activity, hs-CRP and glycemic index in obese patients with impaired glucose tolerance

BACKGROUND

Obesity is a chronic low-grade inflammatory state that is related to prediabetes, increased Rhoassociated kinase 2 (ROCK2) activity and concentration of high-sensitivity C-reactive protein (hs-CRP). Therefore, the study was conducted to investigate the effects of 12-week moderate aerobic exercise on ROCK2 activity, hs-CRP, glycosylated hemoglobin A1C (HbA1c), and glycemic index in obese patients with impaired glucose tolerance.

METHODS

In a quasi-experimental design with pre and post-test, 42 obese men with prediabetes [mean±SD, age: 44.73 ± 3.30 years, body mass index (BMI): 33.22 ± 2.05 kg/m², HbA1c: 6.29 % ± 0.75] were allocated into two randomized homogeneous groups: Aerobic training group (AT, n=22) or control group (C, n=20). Exercise group performed a moderate aerobic exercise program three sessions per week, 60 minutes per session for 12 weeks. Body mass, BMI, maximal oxygen consumption (VO₂max), serum levels of fasting blood glucose (FBG), insulin, insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-B); HbA1c, hs-CRP, or ROCK2 activity were measured before and after the study period. The data were analyzed using repeated measures ANOVA 2×2 and paired sample t test at a significant level of p < 0.05.

RESULTS

AT caused a significant reduction in body mass (p≤ 0.001), BMI (p= 0.04), HOMA-B (p=0.003), serum levels of FBG (p= 0.002), HbA1c (p= 0.039), hs-CRP (p≤ 0.0001), and ROCK2 activity (p= 0.001). In contrast, in the same group, a significant increase was observed in VO₂max (p= 0.04).

CONCLUSION

The results of this study showed that moderate aerobic exercise was an effective and safe method to prevent type 2 diabetes and cardiovascular diseases in obese men with prediabetes by improving glucose metabolism, reduction of body mass, ROCK2 activity and serum levels of hs-CRP.

Cardio-Hypothalamic-Pituitary Coupling during Rest and in Response to Exercise

The objective of this study was to examine cardio hypothalamic-pituitary coupling and to better understand how the temporal relations between these systems are altered during rest and exercise conditions. An intensive within subjects study design was used. Seven adult males completed two visits, each consisting of either a 24 h period of complete rest or a 24 h period containing a high-intensity exercise bout. An intravenous catheter was used to collect serum samples every 10 min throughout the 24 h period (i.e., 145 samples/person/condition) to assess growth hormone (GH) dynamics throughout the 24 h period. Cardiac dynamics were also collected throughout the 24 h period and epoched into 3 min windows every 10 min, providing serial short-time measurements of heart rate variability (HRV) concurrent to the GH sampling. The standard deviation of the normal RR interval (SDNN), the root mean square of successive differences (rMSSD), and sample entropy (SampEn) was calculated for each epoch and used to create new profiles. The dynamics of these profiles were individually quantified using SampEn and recurrence quantification analysis (RQA). To address our central question, the coupling between these profiles with GH was assessed using cross-SampEn and cross-RQA (cRQA). A comparison between the epoched HRV profiles indicated a main effect between profiles for sample entropy (p < 0.001) and several measures from RQA. An interaction between profile and condition was observed for cross-SampEn (p = 0.04) and several measures from cRQA. These findings highlight the potential application of epoched HRV to assess changes in cardiac dynamics, with specific applications to assessing cardio hypothalamic-pituitary coupling.

Psychological and Emotional Effects of Digital Technology on Digitods (14–18 Years): A Systematic Review

Background

The use of smartphones and other technologies has been increasing in digitods aged 14–18 years old. To further explain this relationship and explore the gap in research, this paper will appraise the available evidence regarding the relationship digital technology use and psychological/emotional outcomes and report on the strength of the associations observed between these variables.

Methodology

To select relevant studies, five separate computerized searches of online and electronic databases were performed. These included PubMed (MEDLINE, National Library of Medicine), ScienceDirect, Cochrane, Scopus, and Web of Science to attain literature from January 2017 to April 2022. The author independently reviewed studies for eligibility as per the inclusion/exclusion criteria and extracted the data according to a priori defined criteria. Risk of bias was assessed using the Agency for Healthcare Research and Quality (AHRQ) for healthcare studies and Cochrane Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) assessment tool.

Results

Seven studies were included in this review. A positive relationship was found between excessive digital technology usage and negative psychological and emotional outcomes in digitods aged 14–18 (p ≤ 0.005). A statistically significant difference was found between girls and boys, with girls experiencing more negative outcomes than boys.

Conclusions

As the evidence in this review is distinctive, it is imperative that further research be conducted to investigate any synergistic relationships among these variables on a larger scale in order to better advise public health initiatives to specifically target heightened digital technology usage in adolescents.

The Diagnosis and Management of Cardiometabolic Risk and Cardiometabolic Syndrome after Spinal Cord Injury

Individuals with spinal cord injuries (SCI) commonly present with component risk factors for cardiometabolic risk and combined risk factors for cardiometabolic syndrome (CMS). These primary risk factors include obesity, dyslipidemia, dysglycemia/insulin resistance, and hypertension. Commonly referred to as “silent killers”, cardiometabolic risk and CMS increase the threat of cardiovascular disease, a leading cause of death after SCI. This narrative review will examine current data and the etiopathogenesis of cardiometabolic risk, CMS, and cardiovascular disease associated with SCI, focusing on pivotal research on cardiometabolic sequelae from the last five years. The review will also provide current diagnosis and surveillance criteria for cardiometabolic disorders after SCI, a novel obesity classification system based on percent total body fat, and lifestyle management strategies to improve cardiometabolic health.

Effect of hybrid FES exercise on body composition during the sub-acute phase of spinal cord injury

OBJECTIVES

To determine the Effect of Hybrid functional electrically stimulated (FES) Exercise on Body Composition during the Sub-acute Phase of Spinal Cord Injury (SCI).

DESIGN

Randomized Clinical Trial.

SETTING

Rehabilitation Hospital.

PARTICIPANTS

Patients within sub-acute phase (3-24 months) of SCI.

INTERVENTIONS

We investigated if high-intensity exercise training via the addition of functional electrically stimulated (FES) leg muscles, provides sufficient stimulus to mitigate against body composition changes in the sub-acute phase after SCI.

MAIN OUTCOME MEASURES

We explored potential effects of FES row training (FESRT) on body fat gain, lean mass loss, and cardiometabolic parameters and compared the effects of 6-month of FESRT (n = 18) to standard of care (SOC, n = 13). Those in SOC were crossed over to FESRT.

RESULTS

FESRT resulted in greater exercise capacity and a tendency for lesser total body fat accumulation with a significant increase in total and leg lean mass (p<0.05). In addition pelvis and total bone mineral density declines were significantly less (p<0.05). Compared to SOC, FESRT did not lead to any significant difference in insulin sensitivity or serum lipids. However, HbA1C levels were significantly decreased in SOC participants who crossed over to 6-month FESRT.

CONCLUSION

FESRT early after SCI provides a sufficient stimulus to mitigate against detrimental body composition changes. This may lead to prevention of losses in lean mass, including bone.

Inflammatory mechanisms linking obesity and tendinopathy

Chronic tendinopathy is a debilitating tendon disorder with disappointing treatment outcomes. This review focuses on the potential roles of chronic low-grade inflammation in promoting tendinopathy in obesity. A systematic literature search was performed to identify all clinical studies supporting the actions of obesity-associated inflammatory mediators in the development of tendinopathy. The mechanisms of obesity-induced chronic inflammation in adipose tissue are firstly reviewed. Common inflammatory mediators potentially linking obesity and the development of tendinopathy, and their association with mechanical overuse, are discussed, along with pre-clinical evidences and a systematic literature search on clinical studies. The potential contribution of local adipose tissues in the promotion of inflammation, pain and tendon degeneration is then discussed. The future research directions are proposed.

Translational potential statement

Better understanding of the roles of obesity-associated inflammatory mediators on tendons will clarify the pathophysiological drivers of tendinopathy in patients with obesity and identify possible treatment targets. Further studies on the mechanisms of obesity-induced chronic inflammation on tendon are a promising direction for the treatment of tendinopathy.

Combined Effects of High-Intensity Aerobic Exercise Training and Ziziphus jujuba Extract on Tissue Nesfatin-1 in Rats

Nesfatin-1 is involved in metabolic/feeding regulation and prevention of cardiovascular disease. Previous studies have shown that exercise and herb supplementation can influence nesfatin-1 concentration. The present study investigated the effects of high-intensity training (HIT) and Ziziphus jujuba (ZJ) extract on tissue nesfatin-1 in rats. Twenty-eight female rats were randomly assigned to one of four groups i.e. 1) Saline-Control (SC), 2) Saline-High Intensity Training (ST), 3) Ziziphus jujuba-Control (ZJC), and 4) Ziziphus jujuba-High Intensity Training (ZJT). Rats performed exercise on a treadmill and/or administered supplements intragastrically for 6 weeks, depending on group category. Seventy-two hours after the last training session, rats were anesthetized. Blood, hypothafi 2lamus tissue, heart and gastrocnemius muscles were sent to the laboratory for analyses. Significantly higher nesfatin-1 gene expression and concentration and ATP concentration were found in trained rat. HIT increased plasma High Density Lipoprotein (HDL) and insulin concentration and reduced plasma Triglyceride (TG) and cortisol. ZJ increased tissue nesftain-1 gene expression and concentration while only increasing heart ATP. The combination of exercise and ZJ showed an additive effect compared to each intervention alone on hypothalamus, heart and gastrocnemius NUCB2 gene expression, heart and gastrocnemius nesfatin-1 concentration, plasma HDL and cortisol concentration. The authors recommend both interventions as a means to improve cardiovascular health in rats with further work needed to confirm similar findings in homo sapiens.

Effect of 6 weeks Pilates training along with dill supplementation on serum concentrations of nesfatin-1, lipocalin-2, and insulin resistance in females with overweight and obesity: A randomized controlled trial

Background:

This study aimed to investigate the effect of 6 weeks’ pilates training along with dill supplementation on serum concentrations of nesfatin-1, lipocaline-2, and insulin resistance in females with overweight and obesity.

Materials and Methods:

In this randomized controlled trial study, 45 overweight and obese females are randomly assigned to four groups: Pilates training + dill group (PDG) (n = 12), pilates training + placebo group (PPG) (n = 11), dill supplementation group (DG) (n = 11), and placebo group (PG) (n = 11). Participants of PDG and PPG performed pilates training for 6 weeks (60 min, 3 sessions per week). PDG and DG received dill tablet (three times a day, 6 weeks). Anthropometric measurements, glycemic markers, and blood samples were assessed before (pretest) and after (posttest) 6 weeks of intervention.

Results:

Results showed a significant increase in serum concentrations of nesfatin-1 in PDG compared to pretest (P = 0.001). Differences in the serum concentrations of nesfatin-1 in PDG were greater than PPG, DG, and PG (P = 0.01). Furthermore, results found in significant reduction in serum concentrations of lipocalin-2, body mass index (BMI), and waist-hip ratio (WHR) in PDG, PPG, and DG as compared to pretest (P > 0.05). Fasting glucose plasma (FGP) was significantly decreased in all three intervention groups PDG (P < 0.001), PPG (P < 0.001), and DG (P < 0.001) as compared to pretest. Differences in FGP were significantly higher in PDG than PPG, DG, and PG (P = 0.001). A significant reduction was found for insulin only in PDG after 6 weeks of intervention as compared to pretest (P = 0.03). Insulin resistance significantly decreased in PDG (P = 0.03) and PPG (P = 0.04) as compared to pretest. Body fat percent (BFP) was significantly decreased in PDG (P = 0.003), PPG (P = 0.006), and DG (P = 0.01). However, there were no significant inter-group differences in insulin resistance, insulin, serum concentrations of lipocalin-2, BMI, BFP, and WHR after 6 weeks of Pilates training along with dill supplementation (P > 0.05).

Conclusion:

We concluded that 6 weeks of Pilates training along with dill may be beneficial for improvements in serum concentrations of nesfatin-1 and FGP.

Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury

OBJECTIVE

To understand the benefits and harms of physical activity in people who may require a wheelchair with a focus on people with multiple sclerosis (MS), cerebral palsy (CP), and spinal cord injury (SCI).

DATA SOURCES

Searches were conducted in MEDLINE, Cumulative Index to Nursing and Allied Health, PsycINFO, Cochrane CENTRAL, and Embase (January 2008 through November 2020).

STUDY SELECTION

Randomized controlled trials, nonrandomized trials, and cohort studies of observed physical activity (at least 10 sessions on 10 days) in participants with MS, CP, and SCI.

DATA EXTRACTION

We conducted dual data abstraction, quality assessment, and strength of evidence. Measures of physical functioning are reported individually where sufficient data exist and grouped as "function" where data are scant.

DATA SYNTHESIS

No studies provided evidence for prevention of cardiovascular conditions, development of diabetes, or obesity. Among 168 included studies, 44% enrolled participants with MS (38% CP, 18% SCI). Studies in MS found walking ability may be improved with treadmill training and multimodal exercises; function may be improved with treadmill, balance exercises, and motion gaming; balance is likely improved with balance exercises and may be improved with aquatic exercises, robot-assisted gait training (RAGT), motion gaming, and multimodal exercises; activities of daily living (ADL), female sexual function, and spasticity may be improved with aquatic therapy; sleep may be improved with aerobic exercises and aerobic fitness with multimodal exercises. In CP, balance may be improved with hippotherapy and motion gaming; function may be improved with cycling, treadmill, and hippotherapy. In SCI, ADL may be improved with RAGT.

CONCLUSIONS

Depending on population and type of exercise, physical activity was associated with improvements in walking, function, balance, depression, sleep, ADL, spasticity, female sexual function, and aerobic capacity. Few harms of physical activity were reported in studies. Future studies are needed to address evidence gaps and to confirm findings.

SCIENTIFIC TRAINING OF SPORTS MEDICINE FOR BALANCE OF KNEE JOINT MUSCLE STRENGTH OF ATHLETES

ABSTRACT Introduction: As skiers need to complete their movements in high mountains and snow, the athlete's landing's stability is directly related to the movement's success. The stable landing action wins high scores for the athletes’ participating actions and protects their safety. Objective: This article analyzes the characteristics of lower limb muscle strength and static balance ability of female freestyle skiing aerials athletes to provide athletes with targeted strength training, evaluation of muscle effects after training, and athlete selection to provide a scientific basis valuable Theoretical reference. Methods: The paper uses isokinetic testing and balance testing methods to study the characteristics of the hip and knee flexor and extensor strengths of the Chinese great female freestyle skiing aerials athletes and the static balance characteristics in four standing positions. Results: The right flexor-extensor force, flexor-extensor force ratio, and average power value of the right hip joint were slightly greater than the left flexor power. The left and right knee joint extensor unit peak weight moments and the left and right average power values were all four indicators. Greater than the flexor, at different test speeds of 60°/s (slow speed) and 240°/s (fast), the peak flexion and extension torque per unit weight, the average power of flexion and extension, the force of flexion and extension, and the average power appear with the increase of the test speed as a significant difference. Conclusions: The research in the thesis recommends reasonable weight control and balanced training of muscle strength, using the condition of moderately increasing exercise speed, to strengthen the training of lower limb extensor strength, provide targeted strength training for athletes, evaluate the muscle effect after training and providing the scientific basis and valuable theoretical reference. Level of evidence II; Therapeutic studies - investigation of treatment results.

Strategies used by providers to support individuals with spinal cord injury in weight management: a qualitative study of provider perspectives

STUDY DESIGN

This is a descriptive qualitative study.

OBJECTIVES

To explore recommended strategies employed by healthcare providers to support individuals with SCI in weight management.

SETTING

Fourteen veteran administration hospitals in the United States and the Shirley Ryan AbilityLab (SRALab) SCI Model Systems in Illinois.

METHODS

Semi-structured interviews were conducted with interprofessional SCI providers involved in weight management with individuals living with SCI. Thematic analysis methods were used.

RESULTS

A total of 25 interprofessional providers were interviewed. Providing clinical expertise to assist in weight management included (1) checking progress or status of weight over time, (2) monitoring and tracking other health-related indicators, (3) stressing weight-related health risks, (4) providing education, (5) encouraging healthy behaviors, and (6) identifying and accessing resources. Fostering provider-patient relationships included (1) establishing and maintaining rapport and (2) tailoring/individualizing weight management treatment. Coordinating a team approach included (1) involving a dietitian or nutritionist, (2) communicating the same message, and (3) involving the informal caregiver/family.

CONCLUSION

Weight management strategies should incorporate patient preferences and goals, informed through provider expert and personalized clinical advice, and supported within the context of interprofessional team collaboration that includes caregivers and family.

The effects of spirulina under high-intensity interval training on levels of nesfatin-1, omentin-1, and lipid profiles in overweight and obese females: A randomized, controlled, single-blind trial

BACKGROUND

We investigated the effects of spirulina under high-intensity interval training (HIIT) on levels of nesfatin-1, omentin-1, and lipid profiles in overweight and obese females.

MATERIALS AND METHODS

This is a randomized, quasi-experimental controlled, single-blind with a pre- and post-test design, in which twenty overweight and obese women (body mass index = 29.32 ± 3.01 kg/m², age = 21.55 ± 1.76 years), were randomly divided into the following groups: HIIT + spirulina (n = 10) and HIIT + placebo (n = 10). Running anaerobic sprint test was used for HIIT protocol consisting of six intervals at 35 m maximal speed runs, with a rest of 10 s in each trial (3 times/week, 4 weeks). HIIT + spirulina group received 500 mg of the spirulina pills twice daily for 4 weeks and the second group took placebo.

RESULTS

There was a significant increase in serum levels of nesfatin-1 in HIIT + spirulina (P < 0.0001) but not in HIIT + placebo (P = 0.61) group. Furthermore, results indicated a significant difference between two groups with respect to serum levels of nesfatin-1 (P = 0.04). Serum levels of omentin-1 significantly increased in both groups (P < 0.05). However, there was no significant difference between two groups (P = 0.49). In addition, results showed no significant inter- and intra-group differences in total cholesterol levels, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol between groups (P > 0.05).

CONCLUSION

The spirulina under HIIT increased levels of nesfatin-1 and omentin-1 with no effects on the levels of lipid profiles in overweight and obese females.

A Randomized Controlled Trial on the Effects of 12 Weeks of Aerobic, Resistance, and Combined Exercises Training on the Serum Levels of Nesfatin-1, Irisin-1 and HOMA-IR

Background/objective: This study aimed to investigate the impacts of a 12-week training of the aerobic exercise (AE), resistance exercise (RE), and combined exercise (CE) on the serum levels of nesfatin-1, irisin-1 and some other metabolic and anthropometric indices in overweight women with metabolic syndrome. Methods: Sixty overweight women with metabolic syndrome were assigned equally into four groups: aerobic exercise (AE, n = 15), resistance exercise (RE, n = 15), combined exercise (CE, n = 15), and control (n = 15). All groups underwent 12 weeks of intervention. The study variables were measured before and 24 h after the intervention period. Results: Twelve weeks of training resulted in an increase of irisin-1 in the AE and CE groups and nesfatin-1 in all the intervention groups. As expected, all the trained groups exhibited a positive alteration in anthropometric indices and lipid profile in comparison with the control group. Besides, compared with the control group, insulin resistance (based on the homeostatic model assessment) in AE (p = 0.022), RE (p = 0.032), and CE (p < 0.001) groups were reduced significantly. According to the observed changes in the measured indices, serum irisin-1 was significantly correlated with body weight, BMI, body fat percentage, fasting insulin, and HOMA-IR. However, with regard to nesfatin-1, only a negative correlation was observed with body fat percentage and LDL-cholesterol. Conclusions: The 12-week systematic training program changed circulating irisin-1 and nesfatin-1. Also, change in the serum irisin-1 and nesfatin-1 were correlated with the change in glycemic and anthropometric indices in addition to LDL-cholesterol. Also, exercise training significantly reduced fasting insulin and HOMA-IR in all the intervention groups. RCT Registration Code: IRCT20180806040721N2.

Eccentric resistance training and β-hydroxy-β-methylbutyrate free acid affects muscle PGC-1α expression and serum irisin, nesfatin-1 and resistin in rats

The hypothalamus controls metabolism and feeding behaviour via several signals with other tissues. Exercise and supplements can change hypothalamic signalling pathways, so the present study investigated the influence of eccentric resistance training and β-hydroxy-β-methylbutyrate free acid supplementation on PGC-1α expression, serum irisin, nesfatin-1 and resistin concentrations. Thirty-two male rats (8 weeks old, 200±17 g body mass) were randomly allocated to control, β-hydroxy-β-methylbutyrate free acid supplementation (HMB), eccentric resistance training (ERT), and β-hydroxy-β-methylbutyrate free acid supplementation plus eccentric resistance training (HMB+ERT) groups. Training groups undertook eccentric resistance training (6 weeks, 3 times a week) and supplement groups consumed β-hydroxy-β-methylbutyrate free acid (HMB-FA) orally (76 mg kg^-1 day^-1). Twenty-four hours after the last training session, serum and triceps brachii muscle samples were collected and sent to the laboratory for analysis. Two-way ANOVA and Pearson correlation were employed (significance level: P<0.05). The results showed that eccentric resistance training increases skeletal muscle PGC-1α gene expression, as well as serum levels of irisin and nesfatin-1 (P=0.001). Eccentric resistance training decreased the serum concentration of resistin (P=0.001). HMB-FA supplementation increased skeletal muscle PGC-1α gene expression (P=0.002), as well as the serum concentration of irisin and nesfatin-1 (P=0.001), but decreased the serum concentration of resistin (P=0.001). Significant correlations were observed between PGC-1α gene expression and serum concentrations of irisin, nesfatin-1 and resistin. HMB-FA supplementation with eccentric resistance training may induce crosstalk between peptide release from other tissues and increases maximal muscle strength. The combination of the two interventions had a more substantial effect than each in isolation.