Preventing metabolic syndrome in morbid obesity with resistance training: Reporting interindividual variability

Serum Metabolites Associated with Muscle Hypertrophy after 8 Weeks of High- and Low-Load Resistance Training

The mechanisms responsible for the similar muscle growth attained with high- and low-load resistance training (RT) have not yet been fully elucidated. One mechanism is related to the mechanical stimulus and the level of motor unit recruitment; another mechanism is related to the metabolic response. We investigated the electromyographic signal amplitude (sEMG) and the general metabolic response to high-load RT (HL) and low-load resistance training (LL). We measured muscle thickness by ultrasound, sEMG amplitude by electromyography, and analysis of metabolites expressed through metabolomics. No differences were observed between the HL and LL groups for metabolic response and muscle thickness. A greater amplitude of sEMG was observed in the HL group. In addition, a correlation was observed between changes in muscle thickness of the vastus lateralis muscle in the HL group and levels of the metabolites carnitine, creatine, 3-hydroxyisovalerate, phenylalanine, asparagine, creatine phosphate, and methionine. In the LL group, a correlation was observed between changes in muscle thickness of the vastus lateralis muscle and levels of the metabolites acetoacetate, creatine phosphate, and oxypurinol. These correlations seem to be related to the characteristics of activated muscle fibers, the metabolic demand of the training protocols used, and the process of protein synthesis.

Association of muscle strength and body mass index with risk factors for metabolic syndrome and its prevalence in Korean adult women

Background

The aim of this study was to investigate the effects of muscle strength and BMI (body Mass Index) on Metabolic syndrome (MetS) risk factors and prevalence in Korean adult women, using data from the Korea National Health and Nutrition Examination Survey.

Methods

A total of 3189 Korean adults women participated in the cross-sectional study. Participants were measured BMI, MetS risk factors including waist-circumference (WC), fasting glucose (FG), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and handgrip strength as muscle strength.

Results

As a result ‘high BMI & Low muscle strength’, ‘low BMI & low muscle strength’, and ‘high BMI & high muscle strength’ groups had a significantly higher prevalence of Mets [OR (Odd ratio): 1.49, 95% CI (confidence interval): 1.01 2.20; OR: 5.77, 95% CI: 4.32 7.17; OR: 10.46, 95% CI: 8.05 13.59] than ‘low BMI & high muscle strength’ group; and after adjusting smoking, menstruation status, and drinking rate, the OR were 1.07 (95% CI: 0.71–1.61), 4.89 (95% CI: 3.60–6.55), and 7.38 (95% CI: 5.63–9.68), respectively.

Conclusions

These findings indicated that increasing muscle strength and lowering BMI through regular physical activity and exercise are effective methods to reduce the prevalence of risk factors for Mets.

The Social Distance Impacts from COVID-19 Pandemic on the Development of Two Orders of a Concurrent Training Programme for Morbidly Obese Patients

BACKGROUND

Although there is relevant information regarding the consequences of the coronavirus SARS-CoV-2 (COVID-19), little is known about the impact of the imposed social confinement (at home) on the development of exercise training programmes in populations with morbid obesity.

AIM

To describe the effects of the imposed COVID-19 confinement on the cardiometabolic health benefits acquired through a concurrent training programme that started before the pandemic in populations with morbid obesity.

METHODS

This was an experimental randomized clinical study, in which sedentary morbidly obese women were assigned 1:1 to a high-intensity interval training (HIIT) plus resistance training (RT) group (HIIT + RT; n = 11; BMI 42.1 ± 6.6) or to the same exercise dose, but in different order group of RT plus HIIT group (RT + HIIT; n = 7; BMI 47.5 ± 8.4). Both groups undertook two sessions/week. When COVID-19 confinement at home started, a post-test was applied in January 2020 (Post1) and after 20 months (Post2). The main outcomes were waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), high-density lipids (HDL-c), triglycerides (Tg), and fasting plasma glucose (FPG).

RESULTS

In the HIIT + RT group, the WC showed significant increases from Post1 to Post2 (Δ + 3.1 cm, p = 0.035); in the RT + HIIT group, it decreased from Post1 to Post2 (Δ - 4.8 cm, p = 0.028). In the HIIT + RT group, SBP showed significant increases from Post1 to Post2 (Δ + 6.2 mmHg, p = 0.041); the RT + HIIT group decreased SBP from Pre0 to Post1 (Δ - 7.2 mmHg, p = 0.026) and increased DBP from Pre0 to Post1 (Δ + 8.1 mmHg, p = 0.015). Tg in the HIIT + RT group decreased from Pre0 to Post1 (Δ - 40.1 mg/dL, p = 0.023) but increased from Post1 to Post2 (Δ + 86.3 mg/dL, p < 0.0001).

CONCLUSIONS

The COVID-19 social confinement worsened metabolic syndrome (MetS) outcomes that had improved from 20 weeks' RT + HIIT during the training period, such as WC, SBP, and Tg from HIIT + RT, when, worryingly, SBP increased to another more serious clinical classification in both groups.

Investigaciones realizadas en Colombia relacionadas con actividad física y obesidad 2010-2020

Introducción: La obesidad es un problema de salud pública mundial. La actividad física es una herramienta importante de promoción y prevención de este problema. Se desconoce las investigaciones realizadas en Colombia al respecto, lo cual es necesario para implementar políticas públicas eficientes. Objetivo: analizar las investigaciones colombianas encontradas en bases de datos científicas sobre la actividad física y obesidad. Metodología: revisión sistemática de artículos de investigación realizados en Colombia del año 2010 al 2020, en las bases de datos PubMed y SciELO.  Resultados: de 87 artículos encontrados, 23 cumplieron los criterios de inclusión. El 91,3 % publicados en revistas indexadas internacionalmente. 69,5% estudios observacionales, 17,4% ensayos clínicos y 8,7% revisiones sistemáticas. Conclusiones: poca producción en Colombia. La mayoría en revistas indexadas, tuvieron diseño observacional y encontraron asociación entre poca actividad física con sobrepeso/obesidad. Alta prevalencia de sobrepeso/obesidad. Pocos autores fueron profesionales en el área del deporte y el entrenamiento. Introduction: Obesity is a global public health problem. Physical activity and exercise are important tools for promoting and preventing. The research carried out in Colombia in this regard is unknown, which is necessary to implement efficient public policies. Objective: to analyze Colombian research found in scientific databases on physical activity or exercise in overweight and obesity. Methodology: literary review of research articles carried out in Colombia from 2010 to 2020, in the PubMed and SciELO databases. Results: Of 87 articles found, 23 met the inclusion criteria. 91.3% published in internationally indexed journals. 69.5% observational studies, 17.4% clinical trials and 8.7% systematic reviews. Conclusions: little production in Colombia. Most of the indexed journals had an observational design and found an association between little physical activity and overweight/obesity. High prevalence of overweight/obesity. Few authors were professionals in the area of training.

Concurrent training and interindividual response in women with a high number of metabolic syndrome risk factors

The non-responders (NRs) after exercise training have been poorly studied in populations with morbid obesity. The purpose of this study was to determine the NR prevalence after 20 weeks of concurrent training of morbidly obese women with a high or low number of metabolic syndrome (MetS) risk factors. Twenty-eight women with morbid obesity participated in an exercise training intervention and were allocated into two groups distributed based on a high (≥3, n = 11) or low number (<3, n = 17) of MetS risk factors. The main outcomes were waist circumference (WC), fasting plasma glucose (FPG), high-density lipids (HDL-c), triglycerides (Tg), and systolic (SBP) and diastolic (DBP) blood pressure, and secondary outcomes were body composition, anthropometric and physical fitness, determined before and after 20 weeks of concurrent training. NRs were defined as previously used technical error cut-off points for the MetS outcomes. Significantly different (all p < 0.05) prevalences of NRs between the H-MetS vs. L-MetS groups (respectively) in WC (NRs 18.2 % vs. 41.1 %, p < 0.0001), SBP (NRs 72.7 % vs. 47.0 %, p = 0.022), DBP (NRs 54.5 % vs. 76.4 %, p < 0.0001), FPG (NRs 100% vs. 64.8 %, p < 0.0001), and HDL-c (NRs 90.9 % vs. 64.7 %, p = 0.012) were observed. In addition, the H-MetS group evidenced significant changes on ΔSBP (−10.2 ± 11.4 mmHg), ΔFPG (−5.8 ± 8.2 mg/dl), ΔHDL-c (+4.0 ± 5.9 mg/dl), and ΔTg (−8.8 ± 33.8 mg/dl), all p < 0.05. The L-MetS group only showed significant changes in ΔWC (−3.8 ± 5.0 cm, p = 0.009). Comparing H-MetS vs. L-MetS groups, significant differences were observed in ∆FPG (−5.8 ± 8.2 vs. +0.3 ± 3.2 mg/dl, p = 0.027), but not in other MetS outcomes. In conclusion, 20 weeks of concurrent training promotes greater beneficial effects in morbidly obese patients with a high number of MetS risk factors. However, the NR prevalence for improving MetS outcomes was significantly superior in these more-diseased groups in SBP, FPG, and HDL-c, independent of their major training-induced effects.

Impact of COVID-19 Lockdown on Anthropometric Variables, Blood Pressure, and Glucose and Lipid Profile in Healthy Adults: A before and after Pandemic Lockdown Longitudinal Study

In December 2019, 27 cases of pneumonia were reported in Wuhan. In 2020, the causative agent was identified as a virus called SARS-CoV-2. The disease was called “coronavirus disease 2019” (COVID-19) and was determined as a Public Health Emergency. The main measures taken to cope with this included a state of lockdown. The aim of this study was to assess how the unhealthy lifestyles that ensued influenced different parameters. A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. Anthropometric, clinical, and analytical measurements were performed, revealing differences in the mean values of anthropometric and clinical parameters before and after lockdown due to the pandemic, namely increased body weight (41.1 ± 9.9–43.1 ± 9.9), BMI (25.1 ± 4.7–25.9 ± 4.7), and percentage of body fat (24.5 ± 9.1–26.9 ± 8.8); higher total cholesterol levels, with a statistically significant increase in LDL levels and a reduction in HDL; and worse glucose levels (90.5 ± 16.4–95.4 ± 15.8). Lockdown can be concluded to have had a negative effect on health parameters in both sexes in all age ranges, causing a worsening of cardiovascular risk factors.

Similar Adaptations to 10 Weeks Concurrent Training on Metabolic Markers and Physical Performance in Young, Adult, and Older Adult Women

It has been proposed that the combination of high-intensity aerobic exercises and resistance training (RT) known as concurrent training (CT) could improve metabolic syndrome (MetS) markers, and that the exercise mixture in CT could dampen muscle anaerobic pathways, a result known as the interference effect. However, there is scarce evidence on its effects in women across different ages. Therefore, we sought to determine the effects of a 10-week CT intervention on MetS markers and endurance performance in adult women and compared age-related differences between young, adult, and older participants. A total of 112 women with >1 MetS risk factors were included in the study. Participants were allocated to different groups according to the following cutoff age ranges: 20-29years (y), n = 25; 30-39y, n = 35; 40-49y, n = 43; and 50-59y, n = 53. Participants performed 10 weeks of CT, including resistance training (RT), involving six major muscle groups, and high-intensity interval training (HIIT) in a cycle ergometer. Anthropometric, cardiovascular, metabolic, and performance outcomes were assessed before and after the intervention. The CT induced significant improvements in waist circumference (WC) (20-29y: -2.5; 30-39y: -4.1; 40-49y: -4.2; 50-59y: -2.8 Δcm) and the distance achieved in the six-minute walking test (6Mwt) (20-29y: +47.6; 30-39y: +66.0; 40-49y: +43.0; 50-59y: +58.6 Δm) across all age groups, without significant differences between groups. In addition, a significant correlation was found between 6Mwt and WC, independent of age. In conclusion, our results showed that a 10-week CT intervention improved MetS risk factors in women, suggesting that the beneficial effects promoted by CT are independent of age and confirming CT as an effective, age-independent training regimen to improve metabolic health in women.

A Systematic Review Examining the Approaches Used to Estimate Interindividual Differences in Trainability and Classify Individual Responses to Exercise Training

Background: Many reports describe statistical approaches for estimating interindividual differences in trainability and classifying individuals as "responders" or "non-responders." The extent to which studies in the exercise training literature have adopted these statistical approaches remains unclear. Objectives: This systematic review primarily sought to determine the extent to which studies in the exercise training literature have adopted sound statistical approaches for examining individual responses to exercise training. We also (1) investigated the existence of interindividual differences in trainability, and (2) tested the hypothesis that less conservative thresholds inflate response rates compared with thresholds that consider error and a smallest worthwhile change (SWC)/minimum clinically important difference (MCID). Methods: We searched six databases: AMED, CINAHL, EMBASE, Medline, PubMed, and SportDiscus. Our search spanned the aerobic, resistance, and clinical or rehabilitation training literature. Studies were included if they used human participants, employed standardized and supervised exercise training, and either: (1) stated that their exercise training intervention resulted in heterogenous responses, (2) statistically estimated interindividual differences in trainability, and/or (3) classified individual responses. We calculated effect sizes (ES_IR) to examine the presence of interindividual differences in trainability. We also compared response rates (n = 614) across classification approaches that considered neither, one of, or both errors and an SWC or MCID. We then sorted response rates from studies that also reported mean changes and response thresholds (n = 435 response rates) into four quartiles to confirm our ancillary hypothesis that larger mean changes produce larger response rates. Results: Our search revealed 3,404 studies, and 149 were included in our systematic review. Few studies (n = 9) statistically estimated interindividual differences in trainability. The results from these few studies present a mixture of evidence for the presence of interindividual differences in trainability because several ES_IR values lay above, below, or crossed zero. Zero-based thresholds and larger mean changes significantly (both p < 0.01) inflated response rates. Conclusion: Our findings provide evidence demonstrating why future studies should statistically estimate interindividual differences in trainability and consider error and an SWC or MCID when classifying individual responses to exercise training. Systematic Review Registration: [website], identifier [registration number].

The Effects of Two Different Concurrent Training Configurations on Markers of Metabolic Syndrome and Fitness in Women With Severe/Morbid Obesity: A Randomised Controlled Trial

Concurrent training (CT), characterised by combining both aerobic and resistance training modalities within the same session, is recognised to improve metabolic syndrome (MetS) markers, but little is known about the effects of different configurations (i.e., order) of these exercise modalities on MetS markers and the interindividual responses. The purpose of the present study was to describe the effects, and the interindividual variability, of 20weeks of two CT configurations (i.e., high intensity interval training (HIIT) plus resistance training (RT), compared with RT plus HIIT) in women with severe/morbid obesity. Overall, 26 women with severe/morbid obesity were assigned either to HIIT+RT [n=14, mean and 95%CI, 45.79 (40.74; 50.83) or RT+HIIT (n=12), 33.6 (25.30; 41.79) years]. MetS-related outcomes were waist circumference (WC, cm), systolic (SBP, mmHg) and diastolic (DBP, mmHg) blood pressure, high-density lipoprotein cholesterol (HDL-c), triglycerides (Tg), and fasting plasma glucose (FPG). Secondary outcomes were other anthropometrics, body composition, lipids, muscle strength, and the six-minute walk test (6Mwt). There were significant differences in the prevalence of nonresponders (NRs) only for WC comparing HIIT+RT 2 (18.1%) vs. RT+HIIT group 5 (50.0%), p<0.0001, but not for SBP 4 (27.2%) vs. 4 (40.0%), DBP 8 (72.7%) vs. 7 (70.0%), FPG 8 (72.7%) vs. 9 (90.0%), HDL-c 7 (63.6%) vs. 8 (80.0%), and Tg 7 (63.6%) vs. 8 (80.0%), all p>0.05. Additionally, the RT+HIIT group showed significant reductions in WC (∆ –3.84cm, p=0.015), SBP (∆ –8.46mmHg, p=0.040), whereas the HIIT+RT group elicited significant reductions only in SBP (∆ –8.43mmHg, p=0.022). The HIIT+RT promoted a lower prevalence of NRs than the RT+HIIT configuration on WC, and overall, there were slightly more beneficial training-induced effects on markers of MetS in the RT+HIIT group compared to the HIIT+RT group.

The Effect of Public-Based Exercise Program Based on Exercise Frequency on the Metabolic Syndrome in Adult Women

OBJECTIVES The purpose of this study was to examine the difference in risk factors of the metabolic syndrome according to exercise frequency in adult women who participated in the 12-week exercise program and cut-off value of exercise participation rate to improve metabolic syndrome.METHODS The subjects of this study were 150 adult women aged 40 to 64 with metabolic syndrome. They were divided into three groups according to the frequency of exercise. The 12-week exercise program involved aerobic and resistance exercises with moderate intensity. All subjects were measured before and after the program for the percentage of body fat, physical fitness, and risk factors of metabolic syndrome. The differences in each measurement variable before and after the program were analyzed and the interaction between the time and the group was measured. Cut-off values of exercise participation rate for improvement of metabolic syndrome were calculated, and logistic regression analysis for calculated cut-off values was conducted.RESULTS As a result, the percentage of body fat, flexibility, sit-up, SBP, TG, and HDL-C showed interaction by time and group. Exercise participation rate cut-off value for improving metabolic syndrome was calculated 46 days of a total 60 days. This is equivalent to 3.8 times a week of average exercise frequency.CONCLUSION The frequency of exercise after the 12-week exercise program has been shown to affect some fitness factors and metabolic syndrome factors. In addition, a significant cut-off value was calculated for the improvement of metabolic syndrome, and the average frequency of exercise was 3.8 times a week, and participation above this cut-off value increased the probability of improving metabolic syndrome by 1.5 times through 12-week exercise programs.

Effect of High-Intensity Interval Training on Body Composition, Cardiorespiratory Fitness, Blood Pressure, and Substrate Utilization During Exercise Among Prehypertensive and Hypertensive Patients With Excessive Adiposity

Regular exercise training is a recognized lifestyle strategy to lower resting blood pressure (BP), but little is known about substrate metabolism in population with high BP. Thus, the purpose of this study was to investigate the effects of 16-weeks of HIIT on body composition, BP, cardiorespiratory fitness by V . O2 max , and substrate utilization during exercise among prehypertensive and hypertensive patients with excessive adiposity. We also aimed to test the potential association between changes in cardiorespiratory fitness, substrate utilization during exercise and BP. Forty-two physically inactive overweight/obese participants participated in 16-weeks of HIIT intervention. The HIIT frequency was three times a week (work ratio 1:2:10, for interval cycling: rest period: repeated times; 80-100% of the maximum heart rate). Groups were distributed based on their baseline BP: HIIT-hypertensive (H-HTN: age 47.7 ± 12.0 years; body mass index [BMI] 30.3 ± 5.5 kg/m2; systolic [SBP]/diastolic BP [DBP] 151.6 ± 10/81.9 ± 4.2 mmHg), HIIT-pre-hypertensive (H-PreHTN: age 37.6 ± 12.0 years; BMI 31.9 ± 5.3 kg/m2; SBP/DBP 134.4 ± 3.2/74.9 ± 7.0 mmHg), and a normotensive control group (H-CG: age 40.7 ± 11.0 years; BMI 29.5 ± 4.2 kg/m2; SBP/DBP 117.0 ± 6.2/72.4 ± 4.1 mmHg). Anthropometry/body composition, BP, and metabolic substrate utilization during exercise (fat [FATox], carbohydrate [CHOox] oxidation, respiratory exchange ratio [RER], and V . O2 max), were measured before and after the 16-week HIIT intervention. Adjusted mixed linear models revealed a significant improved in V . O2 max were + 3.34 in the H-CG, + 3.63 in the H-PreHTN, and + 5.92 mL⋅kg-1⋅min-1, in the H-HTN group, however, the Time × Group interaction were not significant (p = 0.083). All the exercise types induced similar decreases on SBP (-8.70) in the H-HTN, (-7.14) in the H-CG, and (-5.11) mmHg in the H-PreHTN, as well as DBP levels (-5.43) mmHg in H-CG group (p = 0.032 vs. H-HTN group). At 16-week, no significant correlations were noted for the changes of blood pressure, cardiorespiratory fitness or exercise metabolism substrates outcomes. In conclusion, our results suggest that a 16-week HIIT-intervention improved V . O2 max and blood pressure BP, but these changes are independent of substrate utilization during exercise in normotensive and hypertensive participants with excessive adiposity.

Poor Sleep Quality Decreases Concurrent Training Benefits in Markers of Metabolic Syndrome and Quality of Life of Morbidly Obese Patients

Background: Sleep quality (SQ) plays a role in multiple activities of daily living, but little is known about its role in concurrent training [CT, high-intensity interval (HIIT) plus resistance training (RT)] adaptations for metabolic syndrome (MetS) and health-related quality of life (HRQoL) markers. The aim of the present study was to determine the effects of a 20-week CT programme on MetS and HRQoL markers according to the SQ of morbidly obese patients. Methods: Twenty-nine morbidly obese patients were allocated to one of two groups: good sleep quality (GSQ, n = 15, 38.07 ± 12.26 years) and poor sleep quality (PSQ, n = 14, 40.79 ± 11.62 years). HRQoL, body mass index, waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP, respectively), and plasma outcomes were measured. Results: The GSQ group reported significant changes (pre- vs. post-intervention) in WC (114.0 ± 3.1 vs. 110.4 ± 3.4 cm, p = 0.012), SBP (137.0 ± 4.3 vs. 125.6 ± 1.8 mmHg, p = 0.006), and HRQoL general health (51.33 ± 21.08 vs. 64.33 ± 16.24, p = 0.020). By contrast, the PSQ group showed significant changes only in SQ (9.00 ± 2.42 vs. 5.36 ± 2.84, p = 0.004). Conclusions: Morbidly obese PSQ patients showed a lower response for improving MetS and HRQoL markers after a 20-week CT programme than GSQ peers. However, there was a greater effect size for decreasing WC and SBP in favour of the GSQ compared with the PSQ group, suggesting that there are limitations to CT benefits on these outcomes in the PSQ group. These results call for more complex future studies.