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Govindasamy K, Gogoi H, Jebabli N, Bediri SM, Aljahni M, Parpa K, Clark CCT, Granacher U, Zouhal H. The effects of kettlebell training versus resistance training using the own body mass on physical fitness and physiological adaptations in obese adults: a randomized controlled trial. BMC Sports Sci Med Rehabil 2024; 16:106. [PMID: 38715134 PMCID: PMC11077891 DOI: 10.1186/s13102-024-00894-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
AIM OF STUDY This study aimed to explore the effects of different types of resistance training using kettlebells versus the own body mass, in comparison to a passive control, on key physical fitness and physiological parameters in young, obese adults. METHODS Data from 60 sedentary, obese male college students, aged 17-26, were used for final analyses. Participants were randomly assigned to one of three groups: a control group (CG, n = 20, no training), a kettlebell resistance training group (KRTG, n = 20), or a bodyweight resistance training group (BWRTG, n = 20). Selected measures of physical fitness were tested using the 12-minutes run test, the push-up test, the sit-up test, and the sit-and-reach test. Physiological measures included vital capacity, resting and maximum heart rate (HRmax), mean arterial blood pressure, breath holding time, and respiratory rate. Biochemical variables were measured in the morning, in a fasted state, and comprised high and low density lipoprotein, total cholesterol, and triglycerides. The 12-weeks progressive KRTG and BWRTG were specifically tailored using sets, repetitions, and intensity levels. RESULTS Notable findings include significant body fat reductions in BWRTG (p < 0.001; d = 1.53) and KRTG (p < 0.001; d = 1.43), and a substantial increase in VO2max for BWRTG (p < 0.001; d = 1.32) and KRTG (p < 0.001; d = 1.34) compared to CG. KRTG also showed significant improvements in vital capacity (p < 0.001; d = 1.61) and reductions in resting heart rate (p = 0.024, d = 1.05) and respiratory rate (p = 0.001, d = 1.55), with BWRTG showing similar trends (resting heart rate: p = 0.041, d = 1.35; respiratory rate: p = 0.001, d = 1.98). Both intervention groups significantly improved breath holding time (KRTG: p = 0.001, d = 1.58; BWRTG: p < 0.001, d = 1.98) and reduced total cholesterol and low-density lipoprotein levels compared to CG. CONCLUSIONS This study demonstrates that both KRTG and BWRTG are effective in improving body composition and selected fitness and physiological measures. Thus, resistance training using kettlebells or bodyweight training are recommended if the goal is to improve body composition and fitness in obese male adults. TRIAL REGISTRATION OSF, September, 28th 2023. https://doi.org/10.17605/OSF.IO/Z6Y9Gosf.io/2mb98.
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Affiliation(s)
- Karuppasamy Govindasamy
- Department of Physical Education and Sports Sciences, Faculty of Science and Humanities, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamilnadu, India.
| | - Hemantajit Gogoi
- Department of Physical Education, Rajiv Gandhi University, Itanagar, Arunachal Pradesh, 791112, India
| | - Nidhal Jebabli
- Research Unit: Sport Sciences, Health and Movement, Higher Institute of Sport and Physical Education of Kef, UR22JS01, University of Jendouba, Kef, 7100, Tunisia
| | | | - Mohammed Aljahni
- College of Arts and Humanities, Department of Educational Sciences, Jazan University, Jazan, 45142, Saudi Arabia
| | - Koulla Parpa
- Department of Sport and Exercise Science, UCLan University of Cyprus, Pyla, Cyprus
| | - Cain C T Clark
- Institute for Health and Wellbeing, Coventry University, Coventry, CV1 5FB, UK
- College of Life Sciences, Birmingham City University, Birmingham, B15 3TN, UK
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg Sandfangweg 4, 79102, Freiburg, Germany.
| | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Santé), EA 1274, Rennes, F-35000, France.
- Institut International des Sciences du Sport (2IS), Irodouer, 35850, France.
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García-Hermoso A, López-Gil JF, Izquierdo M, Ramírez-Vélez R, Ezzatvar Y. Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight: A Systematic Review and Network Meta-Analysis. JAMA Pediatr 2023; 177:1276-1284. [PMID: 37812414 PMCID: PMC10562991 DOI: 10.1001/jamapediatrics.2023.4038] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/10/2023] [Indexed: 10/10/2023]
Abstract
Importance Although benefits have been reported for most exercise modalities, the most effective exercise approaches for reducing insulin resistance in children and adolescents with excess weight and the optimal exercise dose remain unknown. Objective To compare exercise training modalities and their association with changes in insulin resistance markers among children and adolescents with excess weight and to establish the optimal exercise dose. Data Sources For this systematic review and network meta-analysis, 6 electronic databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and CINAHL) were searched for studies from inception to April 1, 2023. Study Selection Randomized clinical trials (ie, randomized controlled trials and randomized trials without a control group) were included if they reported outcomes associated with aerobic training, resistance training, high-intensity interval training (HIIT), or a combination of these interventions. Data Extraction and Synthesis Data extraction for this systematic review was conducted following a network meta-analysis extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Effect sizes were calculated as the mean difference (MD) with 95% CI using random-effects inverse-variance models with the Hartung-Knapp-Sidik-Jonkman method. The hierarchy of competing interventions was defined using the surface under the cumulative ranking curve. The Cochrane Risk-of-Bias tool, version 2 (RoB2), was used to independently assess the risk of bias of the included studies. The certainty of evidence in consistent networks was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. The study protocol was prospectively registered with PROSPERO. Data analyses were conducted between May and June 2023. Main Outcomes and Measures The primary outcomes were fasting glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). Results This analysis included 55 studies with a total of 3051 children and adolescents (mean [SD] age, 13.5 [2.3] years; 1537 girls [50.4%] and 1514 boys [49.6%]). Exercise was associated with reductions in fasting insulin (MD, -4.38 μU/mL [95% CI, -5.94 to -2.82 μU/mL]) and HOMA-IR (MD, -0.87 [95% CI, -1.20 to -0.53]). A nonlinear association in both markers was observed, with a required minimal exercise dosage of approximately 900 to 1200 metabolic equivalent of task minutes per week, especially in children and adolescents with insulin resistance at baseline. Combination HIIT and resistance training and concurrent training were the most effective approaches for reducing insulin resistance markers. On average, the certainty of evidence varied from low to moderate. Conclusions and Relevance These findings underscore the role of exercise interventions in enhancing insulin resistance markers among children and adolescents with overweight and obesity. It is advisable to include resistance exercises alongside aerobic and HIIT programs for a minimum of two to three 60-minute sessions per week.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
| | - José Francisco López-Gil
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Mikel Izquierdo
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
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Yang HJ, Hong YP, Yoon TY, Ryoo JH, Choi JM, Oh CM. Independent and Synergistic Associations of Aerobic Physical Activity and Resistance Exercise with Nonalcoholic Fatty Liver Disease. Gut Liver 2023; 17:600-609. [PMID: 36928126 PMCID: PMC10352066 DOI: 10.5009/gnl220345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 03/18/2023] Open
Abstract
Background/Aims This study aimed to examine the independent and synergistic association of aerobic physical activity and resistance exercise with nonalcoholic fatty liver disease (NAFLD) using a nationwide representative database. Methods This was a cross-sectional study using data from the Korea National Health and Nutritional Examination Survey between 2007 and 2010. Multiple logistic regression models were used to examine the independent and synergistic (additive interaction) associations of aerobic physical activity and resistance exercise with NAFLD after adjusting for multiple covariates. Results The prevalence of NAFLD was 26.2% for men and 17.6% for women. In the fully adjusted multiple logistic regression model to examine the independent association of aerobic physical activity or resistance exercise with NAFLD, the odds ratios for NAFLD were significantly decreased in both men (p=0.03) and women (p<0.01) who had highly active aerobic physical activity. Regarding the frequency of resistance exercise, the odds ratio for NAFLD was decreased in men who did resistance exercise ≥5 days per week (p=0.04), but not in women (p=0.19). However, when investigating the synergistic associations of aerobic physical activity and resistance exercise, the odds ratios for NAFLD significantly decreased when the frequency of both exercises increased together in both men (p for interaction <0.01) and women (p for interaction<0.01). Conclusions Combining aerobic physical activity and resistance exercise had a synergistic preventive association for NAFLD in Korean men and women.
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Affiliation(s)
- Hong Jun Yang
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Yeon Pyo Hong
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Tai-Young Yoon
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Jae-Hong Ryoo
- Departments of Occupational Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Joong-Myung Choi
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang-Mo Oh
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
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Mardyła M, Teległów A, Ptaszek B, Jekiełek M, Mańko G, Marchewka J. Effects of Rowing on Rheological Properties of Blood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5159. [PMID: 36982070 PMCID: PMC10049505 DOI: 10.3390/ijerph20065159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to analyze the selected hematological and rheological indices in female rowers during the competitive season. The study included 10 female rowers (aged 21.2 ± 2.6) and the control group consisted of 10 woman of corresponding age (non-athletes). The examination of athletes took place two times: at the beginning of the season during high endurance low intensity training period in January (baseline) and at the end of the competitive season in October (after). Blood samples taken from all woman were analyzed for hematological and rheological parameters. The training period of rowers during the 10 months resulted in decrease in red blood cell count and RBC deformability, in contrast to an improvement in some rheological functions such a decrease in fibrinogen concentration, plasma viscosity and aggregation index. The training program practice in rowing modulated some hematological and rheological indices. Some of them positively influenced the cardiovascular system and reduced potential risks connected with hard training and dehydration, but others may have followed from overtraining or not enough relaxation time between training units.
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Affiliation(s)
- Mateusz Mardyła
- Department of Physiology and Biochemistry, Institute of Biomedical Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Aneta Teległów
- Department of Health Promotion, Institute of Basic Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Bartłomiej Ptaszek
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Małgorzata Jekiełek
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland
| | - Grzegorz Mańko
- Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Jagiellonian University Collegium Medicum, 31-126 Krakow, Poland
- ORNR “Krzeszowice”, Rehabilitation Center, Daszyńskiego 1, 32-065 Krzeszowice, Poland
| | - Jakub Marchewka
- Department of Rehabilitation in Traumatology, Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
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Oh DH, Lee JK. Effect of Different Intensities of Aerobic Exercise Combined with Resistance Exercise on Body Fat, Lipid Profiles, and Adipokines in Middle-Aged Women with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20053991. [PMID: 36901009 PMCID: PMC10001681 DOI: 10.3390/ijerph20053991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 05/27/2023]
Abstract
We aimed to investigate the effect of different intensities of aerobic exercise (VO2max: 50% vs. 80%) on body weight, body fat percentage, lipid profiles, and adipokines in obese middle-aged women after 8 weeks of combined aerobic and resistance exercise. The participants included 16 women aged >40 years with a body fat percentage of ≥30%; they were randomly assigned to the resistance and either moderate (RME, 50% VO2max, 200 kcal [n = 8]) or vigorous aerobic exercise groups (RVE, 80% VO2max, 200 kcal [n = 8]), respectively. After 8 weeks of exercise, we observed that body weight and body fat percentage decreased significantly in both groups (p < 0.01). The total cholesterol (p < 0.01) and LDL (p < 0.05) levels decreased significantly in the RME group, while triglyceride levels decreased significantly in both groups (p < 0.01). The HDL levels tended to increase only slightly in both groups. The adiponectin levels decreased significantly in the RVE group (p < 0.05), and the leptin levels decreased significantly in both groups (p < 0.05). To prevent and treat obesity in middle-aged women, combined exercise (aerobic and resistance) is deemed effective; additionally, aerobic exercise of moderate intensity during combined exercise could be more effective than that of vigorous intensity.
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Zhao L, Dong X, Gao Y, Jia Z, Han S, Zhang J, Gao Y. Effects of exercise combined with diet intervention on body composition and serum biochemical markers in adolescents with obesity: a systematic review and meta-analysis. J Pediatr Endocrinol Metab 2022; 35:1319-1336. [PMID: 36127305 DOI: 10.1515/jpem-2022-0193] [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: 04/08/2022] [Accepted: 08/30/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND This systematic review aims to evaluate the effects of exercise combined with diet (ECWD), exercise alone, diet alone, and no intervention on body composition and serum biochemical markers in adolescents with obesity to provide reference for solving the metabolic disorders of adolescents caused by obesity. CONTENTS Studies published before January 5, 2021 were retrieved from PubMed, Web of Science, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang data, VIP database, and SinoMed. Randomized controlled trials with an age between 10 and 20 years, body mass index (BMI) ≥28 kg/m2 or ≥95th percentiles, no history of endocrine and metabolic diseases, heart disease, hematologic disease, and so on before the trial were included. SUMMARY Fifteen of the 50,155 studies met the criteria. Meta-analysis showed that ECWD was more effective in reducing BMI (kg/m2) (-2.45 kg/m2, 95% CI: -3.06; -1.85) and fat thickness of back (-13.77 mm, 95% CI: -15.92; -11.62), abdomen (-11.56 mm, 95% CI: -14.04; -9.09), and upper arm (-14.81 mm, 95% CI: -16.74; -12.89) than other interventions; in reducing body fat (-7.03 kg, 95% CI: -9.77; -4.29) and thigh circumference (-4.05 cm, 95% CI: -5.58; -2.52), ECWD and diet alone were more effective than exercise alone; ECWD and exercise alone were more effective in reducing waist circumference (-6.05 cm, 95% CI: -8.37; -3.72), waist-to-hip ratio (WHR; -0.06, 95% CI: -0.11; -0.01), upper arm circumference (-2.57 cm, 95% CI: -3.70; -1.45), triglycerides (TG; -0.30 mmol/L, 95% CI: -0.45; -0.14), total cholesterol (TC; -0.30 mmol/L, 95% CI: -0.59; -0.01), and low density lipoprotein (LDL; -0.22 mmol/L, 95% CI: -0.40; -0.04) than diet alone. ECWD also had effects on tumor necrosis factor-α (TNF-α), interleukin-6, leptin, and so on. OUTLOOK ECWD is more effective than exercise alone, diet alone, or no intervention in solving the problems of body shape and metabolic disorder of adolescents with obesity.
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Affiliation(s)
- Liangyu Zhao
- School of Physical Education, Shandong University, Jinan, Shandong, P.R. China
| | - Xiaosheng Dong
- School of Physical Education, Shandong University, Jinan, Shandong, P.R. China
| | - Yan Gao
- School of Physical Education, Shandong University, Jinan, Shandong, P.R. China
| | - Zhihao Jia
- School of Physical Education, Shandong University, Jinan, Shandong, P.R. China
| | - Suyue Han
- School of Physical Education, Shandong University, Jinan, Shandong, P.R. China
| | - Juntao Zhang
- GE Healthcare, Precision Health Institution, Shanghai, P.R. China
| | - Yubo Gao
- School of Physical Education, Shandong University, Jinan, Shandong, P.R. China
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Wang R, Zhang X, Ren H, Zhou H, Yuan Y, Chai Y, Hou X. Effects of different exercise types on visceral fat in young individuals with obesity aged 6-24 years old: A systematic review and meta-analysis. Front Physiol 2022; 13:987804. [PMID: 36246116 PMCID: PMC9562999 DOI: 10.3389/fphys.2022.987804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction: The prevalence of pediatric obesity remains high all over the world. Various exercise interventions have been applied to decrease the visceral fat in young individuals with obesity. But the evidence remains controversial on the effect of the exercise on visceral fat. Moreover, it is unclear which type of the exercise is the most effective for young individuals with overweight or obesity to reduce visceral fat. Objective: The objective of this review and meta-analysis is to evaluate and compare the effectiveness of different exercise interventions on visceral fat in young individuals with overweight or obesity. Methods: Four databases consisting of PubMed, Web of Science, EBSCO, and Cochrane Library were searched prior to May 2022. Fifteen studies with a total of 30 data points involving 1,134 participants were included in this meta-analysis. And the interventions were limited to 4 exercise types [i.e., aerobic exercise (AE), resistance exercise (RE), aerobic exercise combined with resistance exercise (CE), and high-intensity interval training (HIIT)]. Data Synthesis: The results showed that AE (Standardized Mean Difference = -0.32; 95% CI = -0.50 to -0.13; p = 0.0007; I2 = 37%) and HIIT (SMD = -0.59; 95% CI = -0.87 to -0.31; p < 0.0001; I2 = 0%) had a significant reduction effect on visceral fat. And the effect of HIIT seemed better than AE. However, RE (SMD = -0.58; 95% CI = -1.34 to 0.17; p = 0.13; I2 = 76%) and CE (SMD = -0.21; 95% CI = -0.81 to 0.38; p = 0.48; I2 = 63%) had a non-significant effect on visceral fat decline. Additionally, compared with the control group, exercise interventions had a significant effect on reducing visceral fat in adolescents (SMD = -0.54; 95% CI = -0.82 to -0.26; p = 0.0001; I2 = 64%) and young adults (SMD = -0.42; 95% CI = -0.69 to -0.15; p = 0.003; I2 = 0%) rather than children (SMD = -0.15; 95% CI = -0.32 to 0.02; p = 0.08; I2 = 0%). And the gender-based subgroup analysis indicated that the effectiveness of the exercise on the reduction of visceral fat was more significant in males (SMD = -1.27; 95% CI = -1.67 to -0.87; p < 0.00001; I2 = 0%) than that in females (SMD = -0.31; 95% CI = -0.48 to -0.14; p = 0.0004; I2 = 0%). Conclusion: This review and meta-analysis demonstrates that exercise interventions are efficient to decrease visceral fat in adolescents (12-18 years old) and young adults (18-24 years old). Among different exercise types, AE and HIIT are helpful for young individuals with overweight or obesity to reduce visceral fat and HIIT appears to be the most effective exercise intervention. In addition, the effect of exercise interventions on the consumption of visceral fat is more significant in males than that in females. Systematic Review Registration: [http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022310878].
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Affiliation(s)
- Rong Wang
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Xiaoyuan Zhang
- Department of Physical Education, Peking University, Beijing, China
| | - Hong Ren
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Huixuan Zhou
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Yaqing Yuan
- College of Sports and Health, Shandong Sport University, Shandong, China
| | - Yunlong Chai
- Department of Physical Education, Peking University, Beijing, China
| | - Xiao Hou
- School of Sport Science, Beijing Sport University, Beijing, China,*Correspondence: Xiao Hou,
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Effects of Strength Training on Body Fat in Children and Adolescents with Overweight and Obesity: A Systematic Review with Meta-Analysis. CHILDREN 2022; 9:children9070995. [PMID: 35883978 PMCID: PMC9319224 DOI: 10.3390/children9070995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/20/2022] [Accepted: 06/25/2022] [Indexed: 11/27/2022]
Abstract
Childhood overweight and obesity represent a growing public health problem worldwide. Since the 1980s, the global prevalence of overweight and obesity in childhood and adolescence has increased by 47%. The promotion of exercise is an important intervention to reduce the physical damage of obesity. The meta-analysis was conducted in accordance with the general guidelines for the reporting of systematic reviews and meta-analyses (PRISMA). The PubMed, SciELO, ScienceDirect and Google Scholar databases were searched from August to December 2021. The search yielded 722 titles published between 2000 and 2021. After screening the titles and abstracts, 64 duplicate articles were detected, and 27 articles were ultimately included in the systematic review, including 26 articles published in English and one published in Spanish. There was a statistically significant effect of the strength training interventions on the percentage of body fat, Test of 0 i = (p = 0.00, z = 6.92), Test of 0 = (p = 0.00, Q (9) = 42.63). The findings reveal that strength training has a positive impact on the treatment of body fat in children and adolescents with overweight and obesity.
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Lavin KM, Coen PM, Baptista LC, Bell MB, Drummer D, Harper SA, Lixandrão ME, McAdam JS, O’Bryan SM, Ramos S, Roberts LM, Vega RB, Goodpaster BH, Bamman MM, Buford TW. State of Knowledge on Molecular Adaptations to Exercise in Humans: Historical Perspectives and Future Directions. Compr Physiol 2022; 12:3193-3279. [PMID: 35578962 PMCID: PMC9186317 DOI: 10.1002/cphy.c200033] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situation, the study of exercise as a preventative or therapeutic treatment has never been more interdisciplinary, or more impactful. During the early stages of the NIH Common Fund Molecular Transducers of Physical Activity Consortium (MoTrPAC) Initiative, the field is well-positioned to build substantially upon the existing understanding of the mechanisms underlying benefits associated with exercise. Thus, we present a comprehensive body of the knowledge detailing the current literature basis surrounding the molecular adaptations to exercise in humans to provide a view of the state of the field at this critical juncture, as well as a resource for scientists bringing external expertise to the field of exercise physiology. In reviewing current literature related to molecular and cellular processes underlying exercise-induced benefits and adaptations, we also draw attention to existing knowledge gaps warranting continued research effort. © 2021 American Physiological Society. Compr Physiol 12:3193-3279, 2022.
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Affiliation(s)
- Kaleen M. Lavin
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Human Health, Resilience, and Performance, Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Paul M. Coen
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Liliana C. Baptista
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Margaret B. Bell
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Devin Drummer
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sara A. Harper
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Manoel E. Lixandrão
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jeremy S. McAdam
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Samia M. O’Bryan
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sofhia Ramos
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Lisa M. Roberts
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Rick B. Vega
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Bret H. Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Marcas M. Bamman
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Human Health, Resilience, and Performance, Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Thomas W. Buford
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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10
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Hancke J, Srivastava S, Caceres DD, Burgos RA, Alarcon P. An exploratory double-blind, randomized, placebo-controlled study to assess the efficacy of CitruSlim on body composition and lipid parameters in obese individuals. Phytother Res 2021; 35:7039-7049. [PMID: 34794202 DOI: 10.1002/ptr.7331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/02/2021] [Accepted: 10/23/2021] [Indexed: 12/11/2022]
Abstract
The prevalence of obesity in developing and developed countries has been well recognized, and the worldwide obesity rates have nearly tripled since 1975, according to the World Health Organization. CitruSlim, a standardized product containing a blend of Citrus bergamia and Eurycoma longifolia, can reduce cortisol, cholesterol, triglycerides, and hyperglycemia. These properties can contribute to reduction in body weight or body mass index (BMI) in obese patients. A randomized, double-blind, placebo-controlled clinical study was designed to evaluate the efficacy and tolerability of CitruSlim in body weight management in obese individuals, and the results were compared with that of placebo. A total of 97 participants were allocated, randomized, and treated with CitruSlim high-dose (HD, 400 mg), CitruSlim low-dose (LD, 200 mg), and placebo for 112 days. At the end of the study, CitruSlim HD and CitruSlim LD significantly reduced BMI compared to the placebo group and were well tolerated; however, it did not improve parameters associated with dyslipidemia and metabolic disturbances. The study findings suggested that CitruSlim was effective in reducing body weight in obese patients.
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Affiliation(s)
- Juan Hancke
- Laboratory of Immunometabolism, Institute of Pharmacology and Morphophysiology, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
| | | | - Dante D Caceres
- Environmental Health Programme, School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Faculty of Health Sciences, University of Tarapacá, Arica, Chile
| | - Rafael A Burgos
- Laboratory of Immunometabolism, Institute of Pharmacology and Morphophysiology, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
| | - Pablo Alarcon
- Laboratory of Immunometabolism, Institute of Pharmacology and Morphophysiology, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
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11
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Headid Iii RJ, Park SY. The impacts of exercise on pediatric obesity. Clin Exp Pediatr 2021; 64:196-207. [PMID: 32777917 PMCID: PMC8103043 DOI: 10.3345/cep.2020.00997] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/10/2020] [Indexed: 12/17/2022] Open
Abstract
Over the last few decades, the rates of pediatric obesity have more than doubled regardless of sociodemographic categorization, and despite these rates plateauing in recent years there continues to be an increase in the severity of obesity in children and adolescents. This review will discuss the pediatric obesity mediated cardiovascular disease (CVD) risk factors such as attenuated levels of satiety and energy metabolism hormones, insulin resistance, vascular endothelial dysfunction, and arterial stiffness. Additionally, early intervention to combat pediatric obesity is critical as obesity has been suggested to track into adulthood, and these obese children and adolescents are at an increased risk of early mortality. Current suggested strategies to combat pediatric obesity are modifying diet, limiting sedentary behavior, and increasing physical activity. The effects of exercise intervention on metabolic hormones such as leptin and adiponectin, insulin sensitivity/resistance, and body fat in obese children and adolescents will be discussed along with the exercise modality, intensity, and duration. Specifically, this review will focus on the differential effects of aerobic exercise, resistance training, and combined exercise on the cardiovascular risks in pediatric obesity. This review outlines the evidence that exercise intervention is a beneficial therapeutic strategy to reduce the risk factors for CVD and the ideal exercise prescription to combat pediatric obesity should contain both muscle strengthening and aerobic components with an emphasis on fat mass reduction and long-term adherence.
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Affiliation(s)
- Ronald J Headid Iii
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Song-Young Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
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12
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Atakan MM, Koşar ŞN, Güzel Y, Tin HT, Yan X. The Role of Exercise, Diet, and Cytokines in Preventing Obesity and Improving Adipose Tissue. Nutrients 2021; 13:nu13051459. [PMID: 33922998 PMCID: PMC8145589 DOI: 10.3390/nu13051459] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 12/17/2022] Open
Abstract
The prevalence of obesity continues to rise worldwide despite evidence-based public health recommendations. The promise to adopt a healthy lifestyle is increasingly important for tackling this global epidemic. Calorie restriction or regular exercise or a combination of the two is accepted as an effective strategy in preventing or treating obesity. Furthermore, the benefits conferred by regular exercise to overcome obesity are attributed not only to reduced adiposity or reduced levels of circulating lipids but also to the proteins, peptides, enzymes, and metabolites that are released from contracting skeletal muscle or other organs. The secretion of these molecules called cytokines in response to exercise induces browning of white adipose tissue by increasing the expression of brown adipocyte-specific genes within the white adipose tissue, suggesting that exercise-induced cytokines may play a significant role in preventing obesity. In this review, we present research-based evidence supporting the effects of exercise and various diet interventions on preventing obesity and adipose tissue health. We also discuss the interplay between adipose tissue and the cytokines secreted from skeletal muscle and other organs that are known to affect adipose tissue and metabolism.
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Affiliation(s)
- Muhammed Mustafa Atakan
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Şükran Nazan Koşar
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Yasemin Güzel
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Hiu Tung Tin
- Institute for Health and Sport (iHeS), Victoria University, P.O. Box 14428, Melbourne 8001, Australia;
| | - Xu Yan
- Institute for Health and Sport (iHeS), Victoria University, P.O. Box 14428, Melbourne 8001, Australia;
- Sarcopenia Research Program, Australia Institute for Musculoskeletal Sciences (AIMSS), Melbourne 3021, Australia
- Correspondence: ; Tel.: +61-3-9919-4024; Fax: +61-3-9919-5615
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13
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Khammassi M, Miguet M, Julian V, Cardenoux C, Boirie Y, Duclos M, Pereira B, Thivel D. Psycho-Physiological Responses to a 4-Month High-Intensity Interval Training-Centered Multidisciplinary Weight-Loss Intervention in Adolescents with Obesity. J Obes Metab Syndr 2020; 29:292-302. [PMID: 33132226 PMCID: PMC7789023 DOI: 10.7570/jomes20074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/31/2020] [Accepted: 09/10/2020] [Indexed: 12/28/2022] Open
Abstract
Background To evaluate the impact of 4 months of a high-intensity interval training (HIIT)-centered weightmanagement intervention on health-related quality of life (HR-QOL), health perception (HP) and physical selfperception (PSP) in adolescents with obesity. Methods Fifty-six adolescents with obesity (28 girls; mean body mass index [BMI], 35±4.89 kg/m2; z-BMI, 2.3±0.3; 11?17 years) followed a multidisciplinary weight-management intervention composed of nutritional counseling, HIIT program, and health-related therapeutic education. Anthropometric parameters, body composition (dual X-ray absorptiometry), and maximal aerobic capacities (maximal oxygen consumption [VO2peak]) were assessed, and self-reported questionnaires were used to assess HR-QOL (36-item short form survey), HP and PSP at baseline (T0) and post-intervention (T1). Results Body weight (92.6±18.9 to 85.9±16.2 kg), BMI (35.0±4.8 to 32.1±4.5 kg/m2), z-BMI (2.3±0.3 to 2.1±0.3) and fat mass percentage (36.0%±9.1% to 30.4%±7.8%) were significantly decreased (P<0.001) between T0 and T1. There was a tendency for VO2peak to increase from 26.35±5.81 mL/kg/min at T0 to 28.79±6.59 mL/kg/min at T1 (P=0.06). Physical functioning (P=0.002), physical limitation (P=0.048), general health (P<0.001) and bodily pain (P=0.030) were improved at T1. A significant improvement occurred in dimensions of HP such as physical condition (P=0.001), adiposity (P<0.001), alimentation (P<0.001), general health (P=0.038), and perceived general health (P=0.001). In addition, there was an improvement in items of PSP such as self-perceived coordination (P=0.022), endurance (P=0.001) and activity (P=0.001), global self-concept (P=0.015), and appearance (P=0.016). Physical but not mental HR-QOL domains, HP and PSP were associated with weight reduction. Conclusion While HIIT favors improved HR-QOL, HP status and PSP in adolescents with obesity, physical but not mental HR-QOL, HP and PSP were associated with weight reduction.
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Affiliation(s)
- Marwa Khammassi
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France.,Research Unit, Sportive Performance and Physical Rehabilitation, High Institute of Sports and Physical Education of Kef, University of Jendouba, Tunisia.,Faculty of Science of Bizerte, University of Carthage, Zarzouna, Tunisia
| | - Maud Miguet
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France
| | - Valérie Julian
- CHU med du sport CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Yves Boirie
- INRA/UMR 1019, Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France.,University Clermont 1, UFR Medicine, Clermont-Ferrand, France.,Departments of Human Nutrition and Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France
| | - Martine Duclos
- INRA/UMR 1019, Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France.,University Clermont 1, UFR Medicine, Clermont-Ferrand, France.,Departments of Human Nutrition and Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - David Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France
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14
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Kim JY, Jeon JY. Role of exercise on insulin sensitivity and beta-cell function: is exercise sufficient for the prevention of youth-onset type 2 diabetes? Ann Pediatr Endocrinol Metab 2020; 25:208-216. [PMID: 33401879 PMCID: PMC7788350 DOI: 10.6065/apem.2040140.070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/19/2020] [Indexed: 12/16/2022] Open
Abstract
Parallel with the current pediatric obesity epidemic, the escalating rates of youthonset type 2 diabetes mellitus (T2DM) have become a major public health burden. Although lifestyle modification can be the first-line prevention for T2DM in youths, there is a lack of evidence to establish optimal specific exercise strategies for obese youths at high risk for T2DM. The purpose of this narrative review is to summarize the potential impact of exercise on 2 key pathophysiological risk factors for T2DM, insulin sensitivity and β-cell function, among obese youths. The studies cited are grouped by use of metabolic tests, i.e., direct and indirect measures of insulin sensitivity and β-cell function. In general, there are an increasing number of studies that demonstrate positive effects of aerobic exercise, resistance exercise, and the 2 combined on insulin sensitivity. However, a lack of evidence exists for the effect of any exercise modality on β-cell functional improvement. We also suggest a future direction for research into exercise medical prevention of youth-onset T2DM. These suggestions focus on the effects of exercise modalities on emerging biomarkers of T2DM risk.
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Affiliation(s)
- Joon Young Kim
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Justin Y. Jeon
- Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients, ICONS Yonsei University, Seoul, Korea,Address for correspondence: Justin Y. Jeon, PhD Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients, ICONS Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul 03722, Korea Tel: +82-2-2123-6197 E-mail:
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15
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Effects of an Indoor Cycling Program on Cardiometabolic Factors in Women with Obesity vs. Normal Body Weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238718. [PMID: 33255278 PMCID: PMC7727675 DOI: 10.3390/ijerph17238718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 11/20/2020] [Indexed: 12/31/2022]
Abstract
The study aimed to provide evidence on the impact of indoor cycling (IC) in reducing cardiometabolic risk factors. The study compares the effects of a 3 month IC program involving three 55 min sessions per week on women aged 40–60 years, with obesity (OW, n = 18) vs. women with normal body weight (NW, n = 8). At baseline and at the end of the study, anthropometric parameters, oxygen uptake (VO2 peak), and serum parameters: glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), insulin, human anti-oxidized low-density lipoprotein antibody (OLAb), total blood antioxidant capacity (TAC), thiobarbituric acid reactive substances (TBARS), endothelial nitric oxide synthase (eNOS), C-reactive protein (CRP), lipid accumulation product (LAP), and homeostasis model assessment of insulin resistance index (HOMA IR) were determined. Before the intervention, VO2 peak and HDL-C levels were significantly lower and levels of TG, LAP, insulin, HOMA-IR, and CRP were significantly higher in the OW group compared to those in the NW group. After the intervention, only the OW group saw a decrease in body mass, total cholesterol, OLAb, TBARS, and CRP concentration and an increase in total body skeletal muscle mass and HDL-C concentration. In response to the IC training, measured indicators in the OW group were seen to approach the recommended values, but all between-group differences remained significant. Our results demonstrate that IC shows promise for reducing cardiometabolic risk factors, especially dyslipidemia. After 12 weeks of regular IC, the metabolic function of the OW group adapted in many aspects to be more like that of the NW group.
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16
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Duft RG, Castro A, Bonfante ILP, Lopes WA, da Silva LR, Chacon-Mikahil MPT, Leite N, Cavaglieri CR. Altered metabolomic profiling of overweight and obese adolescents after combined training is associated with reduced insulin resistance. Sci Rep 2020; 10:16880. [PMID: 33037261 PMCID: PMC7547065 DOI: 10.1038/s41598-020-73943-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/24/2020] [Indexed: 12/12/2022] Open
Abstract
Exercise training and a healthy diet are the main non-pharmacological strategies for treating chronic conditions, such as obesity and insulin resistance (IR), in adolescents. However, the isolated metabolic changes caused by exercise training without dietary intervention have not yet been established. We investigated how combined training (CT) without dietary intervention altered the concentrations of serum metabolites, biochemical, anthropometric and functional parameters in overweight and obese adolescents. Thirty-seven adolescents (14.6 ± 1.05 years), of both sexes, were randomly assigned to the control group (CG, n = 19) or the training group (TG, n = 18). The CT was composed by resistance training and aerobic training performed in the same session (~ 60 min), three times a week, for 12 weeks. All assessments were performed pre and post-intervention. Metabolomics analyses were conducted using nuclear magnetic resonance spectroscopy (1H NMR) in a 600 MHz spectrometer. There was a decrease in body weight (BW), body mass index (BMI), waist circumference (WC), % body fat (%BF), fasting glucose, insulin levels, and insulin resistance (IR), by HOMA-IR, in the TG. An increase in fat-free mass (FFM) was also observed in the CG. The metabolic changes were given mainly by changes in the levels of metabolites 2-oxoisocaproate (↓TG), 3-hydroxyisobutyrate (↑CG and ↓TG), glucose (↓TG), glutamine (↓CG and ↑TG) and pyruvate (↓TG). These findings demonstrate the positive effects of CT program without dietary intervention on metabolomic profile, body composition, biochemical markers, and glucose metabolism in overweight and obese adolescents.
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Affiliation(s)
- Renata G Duft
- Laboratory of Exercise Physiology, Faculty of Physical Education, University of Campinas (UNICAMP), Av. ÉricoVeríssimo, 701, Campinas, São Paulo, Brazil.
| | - Alex Castro
- Laboratory of Exercise Physiology, Faculty of Physical Education, University of Campinas (UNICAMP), Av. ÉricoVeríssimo, 701, Campinas, São Paulo, Brazil
| | - Ivan L P Bonfante
- Laboratory of Exercise Physiology, Faculty of Physical Education, University of Campinas (UNICAMP), Av. ÉricoVeríssimo, 701, Campinas, São Paulo, Brazil
| | - Wendell A Lopes
- Department of Physical Education, State University of Maringa, Maringa, Brazil
| | - Larissa R da Silva
- Department of Physical Education, University of Parana, Curitiba, Brazil
| | - Mara P T Chacon-Mikahil
- Laboratory of Exercise Physiology, Faculty of Physical Education, University of Campinas (UNICAMP), Av. ÉricoVeríssimo, 701, Campinas, São Paulo, Brazil
| | - Neiva Leite
- Department of Physical Education, University of Parana, Curitiba, Brazil
| | - Cláudia R Cavaglieri
- Laboratory of Exercise Physiology, Faculty of Physical Education, University of Campinas (UNICAMP), Av. ÉricoVeríssimo, 701, Campinas, São Paulo, Brazil.
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17
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de Souza F, Lanzendorf FN, de Souza MMM, Schuelter-Trevisol F, Trevisol DJ. Effectiveness of martial arts exercise on anthropometric and body composition parameters of overweight and obese subjects: a systematic review and meta-analysis. BMC Public Health 2020; 20:1246. [PMID: 32807119 PMCID: PMC7433112 DOI: 10.1186/s12889-020-09340-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/03/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Obesity is considered a top public health concern, and its prevalence is growing every day. Thus, interventions to address this problem should be encouraged and further studied. In this regard, the aim of this review was to summarize the evidence of martial arts interventions to evaluate their effectiveness on the anthropometric and body composition parameters of overweight and obese subjects. METHODS A systematic literature search was conducted on January 26, 2020 using the PubMed, Medline, Lilacs, Cochrane, and Scielo databases. Reference lists of eligible articles and relevant reviews have also been examined. All randomized clinical trials on martial arts that evaluated the anthropometric and body composition parameters of overweight and obese subjects were included, and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines. The Downs & Black checklist was used to assess the quality of the studies. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42018086116). RESULTS A total of 82 articles were identified from the initial search strategy. A further 2 articles were identified from the review of relevant bibliographies. Six studies encompassing 258 participants who were overweight or obese were included. Four studies reported Tai Chi practice, one study reported Kung Fu exercise, and another study reported martial arts exercise. The examined meta-analyses did not reveal significant benefits from martial arts practice over control groups after the experiment period for body mass index (- 1.34 kg/m2; 95% CI: - 2.72, 0.05), waist circumference (1.41 cm; 95% CI: - 0.72, 3.54) and percentage of body fat (- 0.75%; 95% CI: - 5.58, 4.08). CONCLUSION The scarcity, heterogeneity, short intervention time, small sample size, and significant methodological limitations of the available studies do not allow to conclude whether martial arts are effective in the anthropometric and body composition parameters of overweight and obese individuals. This study highlights the need for more research to assess the benefits of martial arts for overweight and obese individuals.
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Affiliation(s)
- Fabricio de Souza
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Avenida José Acácio Moreira, 787, Bairro Dehon, Tubarão, Santa Catarina Caixa Postal 370 Brazil
| | - Felipe Nunes Lanzendorf
- Degree in Biological Sciences, Leonardo da Vinci University Center, Capivari de Baixo, Santa Catarina Brazil
| | | | - Fabiana Schuelter-Trevisol
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Avenida José Acácio Moreira, 787, Bairro Dehon, Tubarão, Santa Catarina Caixa Postal 370 Brazil
- Clinical Research Center, Hospital Nossa Senhora da Conceição, Tubarão, Santa Catarina Brazil
| | - Daisson José Trevisol
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Avenida José Acácio Moreira, 787, Bairro Dehon, Tubarão, Santa Catarina Caixa Postal 370 Brazil
- Clinical Research Center, Hospital Nossa Senhora da Conceição, Tubarão, Santa Catarina Brazil
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18
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Interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet in obese women. NUTR HOSP 2020; 34:456-464. [PMID: 32207312 DOI: 10.20960/nh.02777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: obesity is a chronic disease associated with inadequate eating habits and reduced levels of physical activity. Because of obesity, the risk for comorbidities is increased, especially for cardiovascular diseases, insulin resistance, and increased pro-inflammatory factors. The aim of the present investigation was to analyze potential correlations between pro/anti-inflammatory adipokines, glycemic index, and other markers of diet quality using a metabolic profile in women undergoing interdisciplinary weight loss therapy. Methods: thirty-two women with obesity were enrolled in a 12-week program of interdisciplinary therapy combining a clinical, nutritional, and physical exercise approach. Body composition, quality of diet, metabolic profile, and pro/anti-inflammatory adipokines were analyzed. Results: the therapy showed to be effective in reducing body weight, body mass index, and body fat. There was also an improvement in lipid profile, including total cholesterol, non-HDL-cholesterol, VLDL-cholesterol, triglycerides and glucose metabolism, including glucose, and insulin. As for food intake, there was a decrease in calorie consumption, carbohydrates, lipids, and glycemic load, and an increased consumption of proteins. Positive correlations were demonstrated between insulin concentration and waist circumference; leptin and body fat and abdominal circumference; and LDL-cholesterol fraction and total cholesterol consumption. Negative correlations were demonstrated between leptin and monosaturated fat consumption; and adiponectin and liver enzyme GGT levels. Conclusions: interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet. Our findings suggest the effectiveness and clinical relevance of the interdisciplinary clinical therapy applied for obesity.
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19
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Munhoz da Silveira Campos R, Moreira CE, Leão da Silva P, Landi Masquio DC, Campos Corgosinho F, Pelissari Kravchychyn AC, de Castro Ferreira Vicente SE, Tock L, Tufik S, de Mello MT, Dâmaso AR. The effect of aerobic plus resistance training associated with a long-term interdisciplinary weight loss program on visceral fat and isokinetic parameters in adolescents with obesity. J Sports Med Phys Fitness 2019; 60:855-863. [PMID: 31640311 DOI: 10.23736/s0022-4707.19.09857-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obesity can lead to a number of alterations in biomechanical structures. We aimed to assess the effect of aerobic plus resistance training associated with an interdisciplinary approach on visceral fat and isokinetic parameters in a long-term weight loss therapy program. METHODS Forty-four postpubertal obese adolescents were involved in the 1-year interdisciplinary weight loss therapy program (clinical, nutritional, psychological and physical training). Body composition, and visceral and subcutaneous fat were measured by DXA absorptiometry and ultrasonography, respectively. Peak torque was analyzed using an isokinetic dynamometer. Statistical analysis was performed using t-tests to assess the effect of the intervention. RESULTS There was a significant reduction in body fat with an inverse increase in lean mass. Positive correlations were observed between peak torque and lean body mass and negative correlations with visceral fat, gynoid fat mass, arm fat mass and subcutaneous fat. CONCLUSIONS An interdisciplinary weight loss program can reduce body fat and increase peak torque and improve muscle strength. The results reinforce the importance of this kind of approach to treat obesity and improve the quality of life in this population.
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Affiliation(s)
- Raquel Munhoz da Silveira Campos
- Department of Biosciences, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos, Brazil - .,Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos, Brazil -
| | - Carlos E Moreira
- Post Graduate Program of Nutrition, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, Brazil
| | | | | | | | | | | | - Lian Tock
- Obesity Study Group, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, SP, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marco T de Mello
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ana R Dâmaso
- Post Graduate Program of Nutrition, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, Brazil
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Streb AR, da Silva RP, Leonel LDS, Tozetto WR, Gerage AM, Benedet J, Delevatti RS, Turnes T, Del Duca GF. Comparison of linear periodized and non-periodized combined training in health markers and physical fitness of adults with obesity: Clinical trial protocol. Contemp Clin Trials Commun 2019; 15:100358. [PMID: 31049461 PMCID: PMC6484285 DOI: 10.1016/j.conctc.2019.100358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/22/2019] [Accepted: 04/05/2019] [Indexed: 12/31/2022] Open
Abstract
The literature discusses that combined training, aerobic more resistance exercises in the same session, is a suitable strategy for people with obesity and that exercise periodization leads to positive health outcomes; however, the implication of different periodizations of combined training for health outcomes in obese adults requires further investigation. The aim of the study will be to describe the methodology used to compare the effect of linear periodized and non-periodized combined training on health markers and health-related physical fitness in adults with obesity. This is a blinded randomized controlled clinical trial investigating adults with obesity in the age group 20-50 years. The sample will be non-probabilistic, and participants will be allocated randomly into one of three groups: control group (CG), non-periodized group (NG), and periodized group (PG). The intervention will occur in 60-min sessions, 3 days a week for 16 weeks, with 1 week dedicated to familiarization with the training and 15 weeks of combined training (aerobic followed by resistance in the same session). The PG group will perform three mesocycles of 5 weeks each, progressing in intensity throughout the intervention [aerobic: from 40-49% to 60-69% of heart rate reserve (HRR); strength: from 12 to 14 maximum repetitions (MR) to 8 to 10MR]; the NG group will maintain the same relative intensity throughout the study (aerobic: 50-59% of HRR; strength: 2 sets of 10-12 MR). Participants in the CG group will maintain their usual activities without the proposed intervention. Pre- and post-intervention assessments will be performed for biochemical markers, body composition, cardiovascular parameters, cardiorespiratory fitness, maximum upper and lower limb strength, flexibility, and subjective health-related parameters. This project was approved by the Committee of Ethics and Research with Human Beings of the institution of origin (protocol 2,448,674) and registered in the Brazilian Registry of Clinical Trials (RBR-3c7rt3).
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Affiliation(s)
- Anne Ribeiro Streb
- Federal University of Santa Catarina, Graduate Program in Physical Education, School of Sports, Federal University of Santa Catarina, Florianópolis, Brazil
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Lee S, Kim Y, Kuk JL. What Is the Role of Resistance Exercise in Improving the Cardiometabolic Health of Adolescents with Obesity? J Obes Metab Syndr 2019; 28:76-91. [PMID: 31294340 PMCID: PMC6604849 DOI: 10.7570/jomes.2019.28.2.76] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 06/05/2019] [Accepted: 06/07/2019] [Indexed: 12/21/2022] Open
Abstract
Traditionally, individuals with obesity have been encouraged to participate in aerobic exercise for long-term weight management and improved obesity-related health outcomes. Recently, resistance exercise has become a popular mode of exercise among youth with obesity. However, to date, the literature is mixed as to whether resistance exercise training alone improves body weight, fat free mass, body composition, cardiovascular risk factors, or atherogenic lipoprotein profiles. The limited research in this area suggests potential sex differences in response to resistance training in youth. The literature is more consistent in demonstrating improvements in muscular fitness and insulin resistance independent of caloric restriction and weight loss. Although major health organizations recommend combining aerobic and resistance training, little research has examined the effects of their combination versus their individual effects, thus it is unclear whether their combination is associated with benefits that extend beyond those of either exercise modality alone. The purpose of this review is to examine the effects of resistance exercise on body composition and the health risk factors associated with cardiovascular disease and type 2 diabetes in youth with obesity.
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Affiliation(s)
- SoJung Lee
- Division of Sports Medicine, Graduate School of Physical Education, Kyung Hee University, Yongin, Korea
| | - YoonMyung Kim
- University College, Yonsei University International Campus, Incheon, Korea
| | - Jennifer L Kuk
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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Green tea consumption reduces apelin and orexin-A in overweight and obese women with different training modalities. SPORT SCIENCES FOR HEALTH 2018. [DOI: 10.1007/s11332-018-0462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Jung HC, Jeon S, Lee NH, Kim K, Kang M, Lee S. Effects of exercise intervention on visceral fat in obese children and adolescents. J Sports Med Phys Fitness 2018; 59:1045-1057. [PMID: 30035473 DOI: 10.23736/s0022-4707.18.08935-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION This meta-analysis study was aimed to assess the effects of exercise intervention on visceral fat in obese children and adolescents. EVIDENCE ACQUISITION Electronic database searches were performed in Academic Search Complete, CINAHL, Healthsource, MEDLINE, and SportDiscus, and from the earliest record to November 2017. Keywords included "exercise or training," "visceral fat," and "child or adolescent or youth." The inclusion criteria for eligible studies were as follows: 1) subjects were obese at baseline; 2) aged 6-19 years; 3) visceral fat was reported at baseline and after an intervention; and 4) studies were published in peer-reviewed journals written in English. EVIDENCE SYNTHESIS A total of 207 studies were observed at the initial search and 73 effect sizes (ESs) were derived from the 34 selected studies. The overall exercise intervention effect was large (Cohen's d [ES]=-1.003, 95% CI=-1.114, -0.892). Moderator analyses results showed that gender (Qb=8.23, df=2, P=0.016), exercise type (Qb=10.68, df=2, P=0.005), and intervention length (Qb=24.71, df=2, P<0.001) influenced the overall ES. CONCLUSIONS The group of both boys and girls (ES=-0.95) who participated combined exercise program (Aerobic + Resistance training; ES=-1.17) for 12 months (ES=-1.24) appeared to be the most effective exercise strategy for reducing visceral fat in obese youth.
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Affiliation(s)
- Hyun C Jung
- Department of Kinesiology, College of Health Sciences, University of Louisiana Monroe, Monroe, LA, USA
| | - Soeun Jeon
- Department of Counseling, Health, and Kinesiology, College of Education and Human Development, Texas A&M University-San Antonio, San Antonio, TX, USA
| | - Nan H Lee
- School of Biological Sciences, College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Kyungun Kim
- Department of Nutrition and Kinesiology, College of Health, Science & Technology, University of Central Missouri, Warrensburg, MO, USA
| | - Minsoo Kang
- Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, MS, USA
| | - Sukho Lee
- School of Biological Sciences, College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA -
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Kravchychyn A, Campos R, Corgosinho F, Masquio D, Vicente S, Ferreira Y, Silva P, Ganen A, Oyama L, Tock L, de Mello M, Tufik S, Dâmaso A. The Long-Term Impact of High Levels of Alpha-Melanocyte-Stimulating Hormone in Energy Balance Among Obese Adolescents. ANNALS OF NUTRITION AND METABOLISM 2018; 72:279-286. [DOI: 10.1159/000488005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 02/25/2018] [Indexed: 12/18/2022]
Abstract
Background: Deregulation of orexigenic and anorexigenic pathways occurs among adolescents with obesity. Alpha-melanocyte-stimulating hormone (α-MSH) is a key catabolic mediator of energy homeostasis and an important anorexigenic neuropeptide in the control of energy balance and thermogenesis. However, it was not well explored if α-MSH can modulate long-term weight loss therapy responses in a dependent manner according to its concentration. Our hypothesis is that a high α-MSH concentration at baseline promotes better modulation of anorexigenic/orexigenic pathways in obese adolescents. Methods: One hundred ten post-pubertal obese adolescents (body mass index >95th percentile) were submitted to 1 year of interdisciplinary therapy (clinical, nutritional, psychological, physical exercise, and physiotherapy support). Body composition and plasma levels of α-MSH, neuropeptide Y (NPY), melanin-concentrating hormone, and agouti-related peptide (AgRP) were measured before and after therapy. The volunteers were grouped on the basis of Tertiles of α-MSH concentration: Low (<0.75 ng/mL), Medium (≤0.76 to ≥1.57 ng/mL), and High (>1.57 ng/mL). Significance was set as p < 0.05. Results: The treatment promoted a significant improvement in body adiposity and fat free mass for all groups. It is important to note that only in the high α-MSH group, a significant increase of the α-MSH/NPY ratio and decrease NPY/AgRP ratio post treatment were observed. Conclusion: The high α-MSH concentration promotes better modulation of anorexigenic/orexigenic pathways in obese adolescents following long-term weight loss therapy and this is important in clinical practice.
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Yanai H, Adachi H, Masui Y, Katsuyama H, Kawaguchi A, Hakoshima M, Waragai Y, Harigae T, Hamasaki H, Sako A. Exercise Therapy for Patients With Type 2 Diabetes: A Narrative Review. J Clin Med Res 2018; 10:365-369. [PMID: 29581797 PMCID: PMC5862082 DOI: 10.14740/jocmr3382w] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/26/2018] [Indexed: 01/01/2023] Open
Abstract
To achieve excellent glycemic control in patients with type 2 diabetes, an adequate prescription of exercise therapy is required. The meta-analyses proposed that high-intensity training improves metabolic parameters in patients with pre-diabetes or type 2 diabetes and low physical activity is associated with an increased risk of incident type 2 diabetes. Here, we would introduce literatures about effects of physical activity on mortality, cardiovascular events, and metabolic parameters, to encourage understanding of exercise therapy, and then describe how to prescribe exercise therapy for patients with type 2 diabetes. We also show the usefulness of non-exercise activity thermogenesis for diabetic patients who cannot perform volitional sporting-like exercise because of diabetic complication and/or comorbidity, by presenting results of our previous studies.
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Affiliation(s)
- Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hiroki Adachi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Yoshinori Masui
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hisayuki Katsuyama
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Akiko Kawaguchi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Mariko Hakoshima
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Yoko Waragai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Tadanao Harigae
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Akahito Sako
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
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Legerlotz K. The Effects of Resistance Training on Health of Children and Adolescents With Disabilities. Am J Lifestyle Med 2018; 14:382-396. [PMID: 33281519 DOI: 10.1177/1559827618759640] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/16/2018] [Accepted: 01/26/2018] [Indexed: 11/15/2022] Open
Abstract
Many parents still hesitate to encourage their children to participate in resistance training programs. This is unfortunate since recent research shows that resistance training can positively affect children's health. This narrative review aims to present an overview of the health-associated effects resistance training can provide particularly in children and adolescents with disabilities by describing its effects on muscle strength, physical function, mental health, self-concept, obesity, and injury prevention. To illustrate the variety of possible fields of application, the effects of resistance training in children and adolescents suffering from Charcot-Marie-Tooth disease, cerebral palsy, Down syndrome, Ehlers-Danlos syndrome, joint hypermobility, juvenile idiopathic arthritis, obesity, and spina bifida are discussed. Although randomized controlled trials with a sufficiently large sample size are rare, the research presented in this review indicates that this mode of training might be a potent tool to improve mental and physical health by improving muscle strength, body composition, self-concept or functionality, reducing pain or injury risk, and strengthening bone or tendons even in the most vulnerable groups of children with physical or mental disability. Furthermore, it has to be emphasized that compared with other types of treatment resistance training is considered to be without adverse effects.
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Affiliation(s)
- Kirsten Legerlotz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Germany
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Leite N, Silva LRD, Jesus ÍCD, Lopes WA, Cavaglieri CR, Consentino CL, Radominski RB, Souza RLRD, Tureck LV, Furtado-Alle L. ADRB2 Gln27Glu polymorphism influenced changes in leptin but not body composition or metabolic and other inflammatory parameters after twelve weeks of combined training in overweight adolescents. MOTRIZ: REVISTA DE EDUCACAO FISICA 2018. [DOI: 10.1590/s1980-6574201700si0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Abstract
PURPOSE This systematic review evaluates the relationship between resistance training and metabolic function in youth. METHODS PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and ClinicalTrials. gov were searched for articles that (1): studied children (2); included resistance training (3); were randomized interventions; and (4) reported markers of metabolic function. The selected studies were analyzed using the Cochrane Risk-of-Bias Tool. RESULTS Thirteen articles met inclusion criteria. Mean age ranged from 12.2 to 16.9 years, but most were limited to high school (n = 11) and overweight/obese (n = 12). Sample sizes (n = 22-304), session duration (40-60min), and intervention length (8-52 wks) varied. Exercise frequency was typically 2-3 d/wk. Resistance training was metabolically beneficial compared with control or resistance plus aerobic training in 5 studies overall and 3 out of the 4 studies with the fewest threats to bias (p ≤ .05); each was accompanied by beneficial changes in body composition, but only one study adjusted for change in body composition. CONCLUSIONS Limited evidence suggests that resistance training may positively affect metabolic parameters in youth. Well-controlled resistance training interventions of varying doses are needed to definitively determine whether resistance training can mitigate metabolic dysfunction in youth and whether training benefits on metabolic parameters are independent of body composition changes.
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García-Hermoso A, Ceballos-Ceballos RJM, Poblete-Aro CE, Hackney AC, Mota J, Ramírez-Vélez R. Exercise, adipokines and pediatric obesity: a meta-analysis of randomized controlled trials. Int J Obes (Lond) 2017; 41:475-482. [PMID: 28017965 PMCID: PMC5382285 DOI: 10.1038/ijo.2016.230] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/14/2016] [Accepted: 11/20/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVE Adipokines are involved in the etiology of diabetes, insulin resistance, and the development of atherosclerosis and other latent-onset complications. The objective of this meta-analysis was to determine the effectiveness of exercise interventions on adipokines in pediatric obesity. SUBJECTS/METHODS A computerized search was made using three databases. The analysis was restricted to studies that examined the effect of exercise interventions on adipokines (adiponectin, leptin, resistin and visfatin) in pediatric obesity (6-18 years old). Fourteen randomized controlled trials (347 youths) were included. Weighted mean difference (WMD) and 95% confidence intervals were calculated. RESULTS Exercise was associated with a significant increase in adiponectin (WMD=0.882 μg ml-1, 95% CI, 0.271-1.493) but did not alter leptin and resistin level. Likewise, exercise intensity and change in body fat; as well as total exercise program duration, duration of the sessions, and change in body fat all significantly influenced the effect of exercise on adiponectin and leptin, respectively. CONCLUSIONS Exercise seems to increase adiponectin levels in childhood obesity. Our results also suggested that exercise on its own, without the concomitant presence of changes in body composition levels, does not affect leptin levels.
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Affiliation(s)
- A García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - R J M Ceballos-Ceballos
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - C E Poblete-Aro
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - A C Hackney
- Endocrine Section-Applied Physiology Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Mota
- CIAFEL–Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - R Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C., Colombia
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Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med 2017; 2:e000143. [PMID: 28879026 PMCID: PMC5569266 DOI: 10.1136/bmjsem-2016-000143] [Citation(s) in RCA: 295] [Impact Index Per Article: 42.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE AND METHODS This review presents established knowledge on the effects of physical activity (PA) on whole-body insulin sensitivity (SI) and summarises the findings of recent (2013-2016) studies. DISCUSSION AND CONCLUSIONS Recent studies provide further evidence to support the notion that regular PA reduces the risk of insulin resistance, metabolic syndrome and type 2 diabetes, and SI improves when individuals comply with exercise and/or PA guidelines. Many studies indicate a dose response, with higher energy expenditures and higher exercise intensities, including high intensity interval training (HIIT), producing greater benefits on whole-body SI, although these findings are not unanimous. Aerobic exercise interventions can improve SI without an associated increase in cardiorespiratory fitness as measured by maximal or peak oxygen consumption. Both aerobic and resistance exercise can induce improvements in glycaemic regulation, with some suggestions that exercise regimens including both may be more efficacious than either exercise mode alone. Some studies report exercise-induced benefits to SI that are independent of habitual diet and weight loss, while others indicate an association with fat reduction, hence the debate over the relative importance of PA and weight loss continues. During exercise, muscle contraction stimulated improvements in SI are associated with increases in AMPK activity, which deactivates TCB1D1, promoting GLUT4 translocation to the cell membrane and thereby increasing glucose uptake. Postexercise, increases in Akt deactivate TCB1D4 and thereby increase GLUT4 translocation to the cell membrane. The reduction in intramuscular saturated fatty acids and concomitant reductions in ceramides, but not diacylglycerols, provide a potential link between intramuscular lipid content and SI. Increased skeletal muscle capillarisation provides another independent adaptation through which SI is improved, as does enhanced β cell activity. Recent studies are combining exercise interventions with dietary and feeding manipulations to investigate the potential for augmenting the exercise-induced improvements in SI and glycaemic control.
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Affiliation(s)
- Stephen R Bird
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - John A Hawley
- Mary MaKillop Institute for Health Research, Centre for Exercise and Nutrition, Australian Catholic University, Melbourne, Victoria, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Abstract
Objective The Nagasaki Kunchi Festival is one of the most famous festivals in Nagasaki. The bearers the floats that are used in this festival undergo long-term training for the performance. However, there have not been any studies on the effects of this training on the health of the float bearers. Methods Thirty-four men ranging in age from 20 to 49 years (mean age: 35.77.6 years) were included in the study. We examined the following parameters before and after the training: body weight (BW), body mass index (BMI), body fat percentage, muscle volume, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), pulse pressure (PP), bearing power, arterial pressure volume index (API), and arterial velocity pulse index (AVI). Results For all participants, the BW, BMI, body fat percentage, and PR were significantly decreased, and the muscle volume and bearing power were significantly increased after the training; however, there were no significant changes in the SBP, DBP, PP, API, or AVI. In the participants with hypertension, in addition to decreases in BW, BMI, body fat percentage, PR, and PP, the SBP, DBP, and API were significantly decreased after the training. Conclusion Training for bearing a float during Nagasaki Kunchi effectively improved the body structure of all participants and reduced the BP and API in participants with hypertension.
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Crouter SE, Salas C, Wiecha J. Effects of an afterschool community center physical activity program on fitness and body composition in obese youth. J Sports Sci 2016; 35:1034-1040. [PMID: 27433781 DOI: 10.1080/02640414.2016.1209305] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Physical activity (PA) promotes health in obese youth and is an important adjunct to medical weight management. Access to structured fitness programmes for obese, low-income youth is limited and potential benefits of such programmes are poorly understood. We describe an urban afterschool fitness programme for obese youth and participants' changes in fitness and body composition. A case series of 30 youth (age: 11.5 ± 2.5 years) with BMI ≥95th percentile and physician referral received a 24-wk programme scholarship. The programme, offered 4 times a week for 90-min.session, included aerobic, strength, and self-organised PA. Primary outcomes, measured at baseline (BL) time 1 (4-8 wk) and time 2 (12-16 wk) were BMI, per cent body fat (%BF), fat-free mass (FFM), heart rate during a treadmill test, and muscular strength (one repetition maximum (1RM)) and endurance (reps at 70% of 1RM) on the leg press (LP) and chest press (CP). Average participation was 1.5 ± 0.6 visits per week for 18.7 ± 6.5 weeks. Between BL and time 2, LP and CP 1RM and endurance significantly improved (P < 0.05). Additionally, there was a significant interaction for %BF with boys losing 5.2% (P > 0.05) while girls lost 0% (>0.05). Obese youth attending an urban fitness programme for at least three months improved strength and body composition, but average attendance was below planned levels.
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Affiliation(s)
- Scott E Crouter
- a Department of Kinesiology, Recreation, and Sport Studies , The University of Tennessee , Knoxville , TN , USA
| | - Carlos Salas
- b Department of Exercise and Health Sciences , University of Massachusetts Boston , Boston , MA , USA
| | - Jean Wiecha
- b Department of Exercise and Health Sciences , University of Massachusetts Boston , Boston , MA , USA.,c RTI International , Research Triangle Park , NC , USA
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Fidelix YL, Farias Júnior JCD, Lofrano-Prado MC, Guerra RLF, Cardel M, Prado WLD. Multidisciplinary intervention in obese adolescents: predictors of dropout. EINSTEIN-SAO PAULO 2016; 13:388-94. [PMID: 26466062 PMCID: PMC4943784 DOI: 10.1590/s1679-45082015ao3339] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/21/2015] [Indexed: 11/24/2022] Open
Abstract
Objective To identify biological and psychosocial factors associated with dropout in a multidisciplinary behavioral intervention in obese adolescents. Methods A total of 183 adolescents (15.4±1.6 years), pubertal (Tanner stage 3 or 4) and obese (34.7±4.0kg/m2), were enrolled in a 12-week behavioral intervention, which included clinical consultations (monthly), nutritional and psychological counseling (once a week), and supervised aerobic training (three times/week). The studied variables were weight, height, body mass index, body composition (skinfold), cardiorespiratory fitness (direct gas analysis), blood lipids and self-reported symptoms of eating disorders (bulimia, anorexia and binge eating), anxiety, depression, body image dissatisfaction and quality of life. Statistical analysis included binary logistic regression and independent t-tests. Results Of the adolescents, 73.7% adhered to the program. The greatest chance for dropout was observed among adolescents older than 15 years (odds ratio of 0.40; 95%CI: 0.15-0.98), with more anorexia symptoms (odds ratio of 0.35; 95%CI: 0.14-0.86) and hypercholesterolemia (odds ratio of 0.40; 95%CI: 0.16-0.91) at baseline. Conclusion Older adolescents, with more symptoms of eating disorders and total cholesterol have less chance to adhere to multidisciplinary treatments.
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Bennie JA, Pedisic Z, van Uffelen JGZ, Gale J, Banting LK, Vergeer I, Stamatakis E, Bauman AE, Biddle SJH. The descriptive epidemiology of total physical activity, muscle-strengthening exercises and sedentary behaviour among Australian adults--results from the National Nutrition and Physical Activity Survey. BMC Public Health 2016; 16:73. [PMID: 26809451 PMCID: PMC4727339 DOI: 10.1186/s12889-016-2736-3] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/14/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The current Australia's Physical Activity and Sedentary Behaviour Guidelines recommend that adults engage in regular moderate-to-vigorous-intensity physical activity (MVPA) and strength training (ST), and minimise time spent in sedentary behaviours (SB). However, evidence about the specific individual and concurrent distribution of these behaviours in Australia is scarce. Therefore, the aim of this study was to determine the prevalence and sociodemographic correlates of MVPA, ST and SB in a national-representative sample of Australian adults. METHODS Data were collected using face-to-face interviews, as part of the National Nutrition and Physical Activity Survey 2011-12. The population-weighted proportions meeting the MVPA (≥ 150 min/week), ST (≥ 2 sessions/week) and combined MVPA-ST guidelines, and proportions classified as having 'low levels of SB' (< 480 min/day) were calculated, and their associations with selected sociodemographic and health-related variables were assessed using multiple logistic regression analyses. This was also done for those at potentially 'high-risk', defined as insufficient MVPA-ST and 'high-sedentary' behaviour. RESULTS Out of 9345 participants (response rate = 77.0 %), aged 18-85 years, 52.6 % (95 % CI: 51.2 %-54.0 %), 18.6 % (95 % CI: 17.5 %-19.7 %) and 15.0 % (95 % CI: 13.9 %-16.1 %) met the MVPA, ST and combined MVPA-ST guidelines, respectively. Female gender, older age, low/medium education, poorer self-rated health, being classified as underweight or obese, and being a current smoker were independently associated with lower odds of meeting the MVPA, ST and combined MVPA-ST guidelines. A total of 78.9 % (95 % CI: 77.9 %-80.0 %) were classified as having low levels of SB. Females, older adults and those with lower education were more likely to report lower levels of SB, whilst those with poor self-rated health and obese individuals were less likely to report lower levels of SB (i.e. SB = ≥ 480 min/day). A total of 8.9 % (95 % CI: 8.1 %-9.6 %) were categorised as individuals at potentially 'high-risk'. Those with poorer self-rated health, obese individuals, those aged 25-44, and current smokers were more likely to be in the 'high risk' group. CONCLUSIONS The large majority of Australian adults do not meet the full physical activity guidelines and/or report excessive SB. Our results call for public health interventions to reduce physical inactivity and SB in Australia, particularly among the subgroups at the highest risk of these unhealthy behaviours.
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Affiliation(s)
- Jason A Bennie
- Active Living and Public Health Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
| | - Zeljko Pedisic
- Active Living and Public Health Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
| | - Jannique G Z van Uffelen
- Active Living and Public Health Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
| | - Joanne Gale
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
| | - Lauren K Banting
- Active Living and Public Health Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
| | - Ineke Vergeer
- Active Living and Public Health Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
| | - Emmanuel Stamatakis
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
- Exercise and Sport Sciences, University of Sydney, Sydney, NSW, Australia.
| | - Adrian E Bauman
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
| | - Stuart J H Biddle
- Active Living and Public Health Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
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Sene-Fiorese M, Duarte FO, de Aquino Junior AE, Campos RMDS, Masquio DCL, Tock L, de Oliveira Duarte ACG, Dâmaso AR, Parizotto NA, Bagnato VS. The potential of phototherapy to reduce body fat, insulin resistance and "metabolic inflexibility" related to obesity in women undergoing weight loss treatment. Lasers Surg Med 2015. [PMID: 26220050 DOI: 10.1002/lsm.22395] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE The metabolic flexibility is often impaired in diseases associated with obesity, and many studies are based on the hypothesis that dysfunction in peripheral tissues such as skeletal muscle, liver and adipose tissue represent the etiology of development of metabolic inflexibility. Experimental evidence shows that the use of phototherapy combined with exercise was effective in controlling the lipid profile, reducing the mass of adipose tissue, suggesting increased metabolic activity and changes in lipid metabolism. However, we found few data in the literature involving the use of phototherapy in association to physical training in the obese population. Thus, our objective was to evaluate the effects of exercise training (aerobic plus resistance exercises) plus phototherapy (laser, 808 nm) on metabolic profile and adiponectinemia in obese women. STUDY DESIGN/MATERIALS AND METHODS Sixty-four obese women (BMI 30-40 kg/m2 , age between 20 and 40 years old) were randomly assigned in two groups: Exercise Training plus SHAM group (ET-SHAM, n = 32) and Exercise Training plus Phototherapy group (ET-PHOTO, n = 32). The treatment consisted in physical exercise intervention and the individual application of phototherapy immediately after the end of the training session. However, in the ET-SHAM group the device was turned off simulating the phototherapy application (placebo effect). The study protocol lasted for 20 weeks and comprised of three weekly sessions of aerobic plus resistance training and application of phototherapy (when applicable). The body composition and metabolic parameters were assessed (HOMA, adiponectin, insulin, glucose). RESULTS Comparing the magnitude of effects between groups (ET-PHOTO vs. ET-SHAM), we observed that physical training plus phototherapy was more effective than physical training in reducing the delta of percentage of fat mass (%; -5.60 ± 1.59 vs. -4.33 ± 1.5; P < 0.04); fat mass (kg; -11.26 ± 2.82 vs. -5.80 ± 2.82; P < 0.0002); HOMA-IR index (-38.08 ± 9.23 vs. -20.91 ± 14.42; P < 0.0001). In addition, we observed an increase in delta (%) of total skeletal muscle mass (kg; 0.60 ± 1.09 vs. -1.38 ± 1.70; P < 0.003), adiponectin concentration (ng/ml; 1.08 (0.04-3.62) vs. -0.42 (-3.15 to 2.26); P < 0.03) in the same comparison. CONCLUSION Our results demonstrated for the first time that phototherapy enhances the physical exercise effects in obese women undergoing weight loss treatment promoting significant changes in inflexibility metabolic profile.
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Affiliation(s)
- Marcela Sene-Fiorese
- São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil
| | - Fernanda Oliveira Duarte
- Department of Physiotherapy, Therapeutic Resources Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Antonio Eduardo de Aquino Junior
- São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil.,Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | | | | | - Lian Tock
- Weight Science, São Paulo, São Paulo, Brazil
| | - Ana Claudia Garcia de Oliveira Duarte
- Department of Physical Education, Nutrition and Metabolism Applied to Exercise Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Ana Raimunda Dâmaso
- Post-Graduated Program of Nutrition, Federal University of São Paulo (UNIFESP), 04021-001 São Paulo, São Paulo, Brazil
| | - Nivaldo Antonio Parizotto
- Department of Physiotherapy, Therapeutic Resources Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil.,Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Vanderlei Salvador Bagnato
- São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil.,Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
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36
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Schmidt S, Monk JM, Robinson LE, Mourtzakis M. The integrative role of leptin, oestrogen and the insulin family in obesity-associated breast cancer: potential effects of exercise. Obes Rev 2015; 16:473-87. [PMID: 25875578 PMCID: PMC4691342 DOI: 10.1111/obr.12281] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/06/2015] [Accepted: 02/24/2015] [Indexed: 12/13/2022]
Abstract
Obesity is an established risk factor for postmenopausal breast cancer. The mechanisms through which obesity influences the development and progression of breast cancer are not fully elucidated; however, several factors such as increased oestrogen, concentrations of various members of the insulin family and inflammation that are associated with adiposity are purported to be important factors in this relationship. Emerging research has also begun to focus on the role of adipokines, (i.e. adipocyte secreted factors), in breast cancer. Leptin secretion is directly related to adiposity and is believed to promote breast cancer directly and independently, as well as through involvement with the oestrogen and insulin signalling pathways. As leptin is secreted from white adipose tissue, any intervention that reduces adiposity may be favourable. However, it is also important to consider that energy expenditure through exercise, independent of fat loss, may improve leptin regulation. The purpose of this narrative review was to explore the role of leptin in breast cancer development and progression, identify key interactions with oestrogen and the insulin family, and distinguish the potential effects of exercise on these interactions.
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Affiliation(s)
- S Schmidt
- Department of Kinesiology, University of Waterloo, Waterloo, Canada
| | - J M Monk
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - L E Robinson
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - M Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, Canada
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