Effects of 12 weeks of combined training without caloric restriction on inflammatory markers in overweight girls

The Role of Nutraceuticals and Probiotics in Addition to Lifestyle Intervention in the Management of Childhood Obesity-Part 1: Metabolic Changes

Childhood obesity is a growing global health issue. Its rising prevalence is linked to genetic, environmental, and lifestyle factors. Obesity in children could lead to different comorbidities and complications with an increased risk of metabolic disorders, such as insulin resistance, dyslipidemia, type 2 diabetes mellitus (T2DM), and metabolic dysfunction-associated steatotic liver disease (MASLD). First-line treatment involves dietary modifications and lifestyle changes; however, adherence is often poor and remains a significant challenge. Pharmacotherapy, while a potential option, has limitations in availability and can cause side effects, leading to growing interest in alternative treatments, such as nutraceutical compounds. Derived from natural sources, these compounds have different anti-inflammatory, antiallergic, antioxidant, antibacterial, antifungal, neuroprotective, antiaging, antitumor, insulin-sensitizing, glucose, and lipid-lowering effects. This review describes commonly used nutraceutical compounds, such as omega-3 fatty acids, vitamin D, polyphenols (such as resveratrol and curcumin), berberine, white mulberry leaves and others, and pre- and probiotics in the management of obesity, evaluating the evidence on their mechanisms of action and efficacy in metabolic comorbidities. The evidence suggests that the integration of nutraceuticals into the diet may positively influence body mass index, glucose metabolism, lipid profiles, and gut microbiota composition and reduce inflammation in obese individuals. These effects may provide future practical guidance for clinical practice, contribute to metabolic health improvement, and potentially prevent obesity-related complications. In this first part, we discuss the effects of nutraceutical compounds on insulin sensitivity and insulin resistance, T2DM, dyslipidemia, and MASLD in addition to diet and lifestyle interventions.

Effects of different physical exercise programs on blood pressure in overweight children and adolescents: systematic review and meta-analysis

AIMS

The purpose of this meta-analysis was to systematically review studies in the literature that evaluated the effect of different exercise programs on blood pressure in overweight children and adolescents.

DATA SOURCES

In September 2024, studies were searched in six electronic databases (PubMed, Web of Science, Scopus, Sportdiscus, Lilacs, and Scielo) and in reference lists.

STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS

Randomized and non-randomized controlled trials with interventions involving physical exercise programs and assessment of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in children and adolescents with overweight and/or obesity were considered for synthesis.

STUDY APPRAISAL AND SYNTHESIS METHODS

The quality of studies was assessed using the PEDro scale for studies with randomized clinical trials. Meta-analysis was conducted using a random model in the Review Manager Software.

RESULTS

Seventeen studies were selected that involved 1,125 children and adolescents. The risk of bias score was considered moderate (five to eight points out of 11). The high-intensity interval training (HIIT) showed the largest effect, indicating a greater impact on BP reduction, while moderate-intensity continuous training (MICT) also had a significant effect, although with greater heterogeneity. No significant effects were found for the other types of exercise. For SBP, a summary effect of -0.44 (95% CI=-0.68; -0.20; I2 = 73%) was observed. For DBP, the metanalysis indicated - 0.52 (95% CI=-0.73; -0.31; I2 = 63%).

LIMITATIONS

There was a publication time limitation of ten years, and the search was restricted to articles published in journals indexed in databases, and there was also significant heterogeneity for the intervention subgroups, which can be explained by the moderate methodological quality of the studies.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

Considering the significant effects of exercise interventions on blood pressure, we suggest the development of more interventions based on physical exercise practice for overweight and obese children and adolescents, which may also add environmental elements, lasting at least 12 weeks, with three 60-minute sessions per week, better control of exercise intensity, as HIIT and MICT were more effective in promoting a reduction in blood pressure when compared to other types of exercise. The implementation of these programs must be carried out in a multicomponent and multiprofessional approach to guarantee the adherence of participants and promote significant and sustainable changes in the cardiovascular health of children and adolescents.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO no CRD42023469222.

Effects of very early exercise on inflammatory markers and clinical outcomes in patients with ischaemic stroke- a randomized controlled trial

BACKGROUND

Apart from the limited evidence of the effects of very early exercise (VEE) on clinical outcomes (COs) in stroke, better knowledge is required to understand the cellular action induced by VEE. This study investigated the effects of VEE on inflammatory markers (IMs) and COs. It further evaluated the association between acute changes in IMs and COs at follow-up in individuals with first-ever mild-to-moderate ischaemic stroke.

METHODS

A prospective, single-center, single-blind, randomized controlled trial (retrospectively registered: PACTR202406755848901; 10-06-2024) was conducted. Forty-eight patients randomized (1:1) into the VEE group (VEEG) and usual care group (UCG) completed the follow-up. Within 24 h of stroke onset, patients in VEEG underwent 45 min of VEE twice daily, amounting to 1.5 h/d, for seven days while patients in UCG received regular turning and positioning. The levels of IMs including interleukin-6 (IL-6), fibrinogen, leucocytes, neutrophils, lymphocytes, and monocytes were assessed at baseline, 4th, and 7th day for both groups. Thereafter, each patient received 90-min follow-up physiotherapy twice weekly for three months. Motor impairment, physical disability, functional independence, anxiety, depression, and cognition were evaluated at 1st and 3rd month of follow-up.

RESULTS

On the 4th and 7th day, patients in VEEG show trends of lower levels of IL-6, leucocytes, neutrophils, and monocytes and higher levels of lymphocytes. However, a non-linear effect of VEE on plasma fibrinogen was observed compared to UC. Furthermore, better improvement in motor impairment, physical disability, functional independence, anxiety, depression, and cognition were observed in VEEG. The positive modulation of IMs by VEE was associated with COs over time, including associations between changes in IL-6 at days 4 and 7 and 3-month functional independence (rs = -0.33; p = 0.019; rs = -0.33; p = 0.021), and at day 7 and 3-month motor impairment (rs = 0.30; p = 0.039).

CONCLUSIONS

Initiating moderate-intensity exercise within 24 h appears beneficial in positively modulating IMs, including IL-6, at the acute stage and improving the physical, motor, cognitive, and affective functions at 1-and 3-month follow-up. The association between exercise-induced acute changes in IMs and improved COs over time highlights the potential role of moderate-intensity VEE in enhancing stroke recovery through positive inflammatory modulation.

Molecular Mechanisms of Vascular Tone in Exercising Pediatric Populations: A Comprehensive Overview on Endothelial, Antioxidative, Metabolic and Lipoprotein Signaling Molecules

Vasoactive molecules are central regulators of vascular tone, angiogenesis and inflammation. Key molecular agents include nitric oxide (NO), endothelin-1 (ET-1), prostacyclin, free triiodothyronine (fT3), leptin, low-density lipoprotein (LDL), high-density lipoprotein (HDL), superoxide dismutase (SOD), and glutathione peroxidase (GPX). Dysregulation of these compounds can lead to endothelial dysfunction, an early predictor of atherosclerosis and cardiovascular diseases (CVD). Maintaining endothelial health is thus essential for vascular homeostasis and cardiovascular risk prevention. Regular exercise serves as a vital protective measure against CVD and the risk of cardiovascular conditions. However, young athletes often significantly exceed recommended levels of training load, engaging in highly intensive training that leads to substantial physiological adaptations. Despite this, research on the impact of exercise on vasoactive substances in children and adolescents, particularly young athletes, is limited and inconsistent. Most studies focus on those with pre-existing conditions, like obesity or diabetes mellitus. Existing findings suggest exercise may favorably affect vascular biomarkers in youth, but methodological variations hinder consistent conclusions. This literature review examines 68 studies on the effects of exercise on vascular molecules in children and adolescents, young athletes, and children and adolescents with pre-existing conditions, offering deeper insights into how exercise may influence vascular health at the molecular level.

Exercise improves body composition, physical fitness, and blood levels of C-peptide and IGF-1 in 11- to 12-year-old boys with obesity

Introduction

Exercise is vital in preventing and treating obesity. Despite its importance, the understanding of how exercise influences childhood obesity at the biochemical level is limited. In this study, we explore the effects of a 16-week exercise program (EP) on body composition, physical fitness, and the blood levels of hormones related to obesity.

Methods

Sixteen boys with obesity (n = 16) and seventeen boys without obesity (n = 17) took part in an EP comprising sports games and aerobic and resistance exercises. We examined alterations in body composition and physical fitness. In addition, we measured circulating hormone levels, including C-peptide, resistin, insulin-like growth factor 1 (IGF-1), and growth hormone (GH), in the blood.

Results

Body fat percentage (BFP) decreased from 37.61% at pre-EP to 29.16% at post-EP in the obese group, but not in the non-obese group. The EP decreased C-peptide (4.58 ng/mL vs. 2.96 ng/mL, p < 0.001) and resistin levels (14.05 ng/mL vs. 11.06 ng/mL, p < 0.001) in the obese group. After the EP, significant improvement in IGF-1 (non-obese: 265.56 ng/mL vs. 311.81 ng/mL, p < 0.001; obese: 224.74 ng/mL vs. 272.89 ng/mL, p < 0.001) and GH levels (non-obese: 3.91 ng/mL vs. 4.80 ng/mL, p < 0.05; obese: 1.76 ng/mL vs. 2.51 ng/mL, p < 0.05) were observed in both groups. Lower C-peptide levels were associated with BFP (r = 0.447, p = 0.009) and muscle mass (r = -0.385, p = 0.02), whereas enhanced IGF-1 levels correlated with increased muscle strength (r = 0.343, p = 0.05) and cardiovascular fitness (r = 0.347, p = 0.04). Multiple linear regression analysis revealed that cardiovascular fitness variability and BFP in the obese group were determined by C-peptide (β = -0.054, p < 0.001) and IGF-1 levels (β = -2.936, p < 0.05), respectively.

Discussion

Exercise may induce positive effects on improvements in body composition and physical fitness, as well as on blood levels of metabolic biochemicals such as C-peptide and IGF-1, in adolescent boys with obesity.

Effects of different supervised and structured physical exercise on the physical fitness trainability of children and adolescents: a meta-analysis and meta-regression : Physical fitness trainability in children and adolescents' health

BACKGROUND

Physical fitness has been considered an important health indicator. Several factors can impact the increase in physical fitness in children and adolescents, including chronological age, sex and BMI, in addition to training variables such as weekly frequency, session and intervention duration, and types of exercises performed. To know the importance of variables that can impact physical fitness, it is important for health professionals to identify the most efficient way of prescribing physical exercises for children and adolescents. The aim is review and meta-analyses of the effects of supervised and structured physical exercise on the physical fitness trainability of children and adolescents.

METHODS

Relevant articles were searched in the PubMed, Cochrane Library, Embase and Scopus platform databases and selected based on the following criteria: children and adolescents aged between 7 and 17 years who performed any type of structured physical exercise compared to a control group without exercise and evaluating physical fitness (strength or muscular power, cardiorespiratory fitness (CRF) or speed. The results are reported in accordance with PRISMA 2020.

RESULTS

Eighty studies were included with a total of 5769 participants. Strength exercises (ES: 1.073; 95% CI, 0.612-1.533; P < 0.001; I2: 74%), concurrent (ES: 1.054; 95% CI, 0.255-1.853; P < 0.010; I2: 72%) and sports (ES: 0.573; 95% CI, 0.015 to 1.132; P < 0.044; I2: 34%) seem to be the most effective in increasing muscular strength. Aerobic activities (ES: 0.400; 95% CI, 0.258-0.542; P < 0.001; I2: 74%), sports (ES: 0.271; 95% IC, 0.148-0.394; P < 0.001; I2: 15), or HIIT (ES: 0.668; 95% IC, 0.333-1.003; P < 0.001; I2: 29%) resulted in increased CRF (ES: 0.514; 95% IC, 0.220-1.808; P < 0.001; I2: 66%). The practice of physical exercise increased muscular power (ES: 0.241; 95% CI, 0.053-0.429; P = 0.012; I2: 0%). The practice of HIIT impacts MAS gains (ES: 0.048; 95% CI, 0.050 - 0.026; P = 0.029; I2: 44%).

CONCLUSION

Supervised and structured physical exercise can improve muscular strength (15-35%), CRF (5.4-8.5%), muscular power (5.6-11.8%), and MAS (5.4%) trainability in children and adolescents. Sex, BMI of the subjects and type of exercise performed (aerobic activities, exclusive to strength, HIIT or sports) should be considered when prescribing the exercise.

How Can Promoting Skeletal Muscle Health and Exercise in Children and Adolescents Prevent Insulin Resistance and Type 2 Diabetes?

Skeletal muscle secretome, through its paracrine and endocrine functions, contributes to the maintenance and regulation of overall physiological health. We conducted a narrative review on the role of skeletal muscle and exercise in maintaining glucose homeostasis, driving insulin resistance (IR), and preventing type 2 diabetes in pediatric populations, especially in the context of overweight and obesity. Myokines such as interleukin (IL)-6, IL-8, and IL-15, as well as irisin, myonectin, and myostatin, appear to play a crucial role in IR. Skeletal muscle can also become a target of obesity-induced and IR-induced inflammation. In the correlation between muscle, IR, and inflammation, the role of infiltration of the immune cells and the microvasculature may also be considered. It remains unclear which exercise approach is the best; however, combining aerobic exercise with resistance training seems to be the most effective strategy for managing IR, with high-intensity activities offering superior metabolic benefits and long-term adherence. Encouraging daily participation in enjoyable and engaging exercise is key for long-term commitment and effective glucose metabolism management. Promoting physical activity in children and adolescents must be a top priority for public health, not only in terms of individual quality of life and well-being but also for community health.

Effects of aerobic exercise combined with resistance training on body composition and metabolic health in children and adolescents with overweight or obesity: systematic review and meta-analysis

Background

To systematically review the effects of aerobic exercise and resistance training on Metabolic Health in children and adolescents with overweight/obesity.

Methods

Employing a retrieval strategy that combines subject terms and free terms, searches were conducted in the CNKI, WanFangData, VIP, PubMed, Web of Science, Embase, and Cochrane Library databases up to October 31, 2023.

Results

A total of 29 studies involving 2,195 subjects were included. The combination of aerobic and resistance training significantly reduces body composition and metabolic health in children and adolescents with overweight or obesity, as evidenced by changes in various parameters (BMI, WC, FM, BF%, VO2max, TG, TC, HDL-C, LDL-C, HOMA-IR, FPG, INS). However, there were no significant differences observed in hs-CRP. Subgroup analyses further showed that changes in intervention measurement had a significant effect on the effectiveness of the intervention.

Conclusion

Aerobic exercise combined with resistance training has a positive impact on the physical health of children and adolescents with overweight/obesity. The recommended exercise prescription is at least three sessions of more than 60 min per week for 12 weeks or more for better health benefits.

Effects of combined aerobic and resistance training on glycemic control, blood pressure, inflammation, cardiorespiratory fitness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis

Background

Structured aerobic or resistance training alone seems to be a beneficial tool for improving glucose homeostasis, chronic systemic inflammation, resting cardiovascular function, and mental health in people with obesity and type 2 diabetes mellitus (T2DM). The aim of the present study was to synthesize the available data on the effectiveness of combined aerobic and resistance training (CART) on glycemic control, blood pressure, inflammation, cardiorespiratory fitness (CRF), and quality of life (QoL) in overweight and obese individuals with T2DM.

Methods

A database search was carried out in PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar from inception up to May 2023. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the reliability of evidence. A random-effects model was used, and data were analyzed using standardized mean differences and 95% confidence intervals. The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42022355612).

Results

A total of 21,612 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants (mean age: 57 ± 7 years) who met the eligibility criteria. CART demonstrated significant improvements in body mass index, glycated hemoglobin, systolic and diastolic blood pressure, C-reactive protein, tumor necrosis factor-alpha, interleukin-6, CRF, and QoL compared to ST. These findings highlight the significance of exercise interventions such as CART as essential elements within comprehensive diabetes management strategies, ultimately enhancing overall health outcomes in individuals with T2DM and overweight/obesity.No differences were found in resting heart rate between CART and ST. An uncertain risk of bias and poor quality of evidence were found among the eligible studies.

Conclusion

These outcomes show clear evidence considering the positive role of CART in inducing beneficial changes in various cardiometabolic and mental health-related indicators in patients with T2DM and concurrent overweight/obesity. More studies with robust methodological design are warranted to examine the dose-response relationship, training parameters configuration, and mechanisms behind these positive adaptations.

The effects of exercise training on inflammatory markers in children and adolescents: A systematic review and meta-analysis

INTRODUCTION AND AIM

Exercise training is effective for improving cardiometabolic health in children and adolescents, but less is known about its impact on inflammatory markers. We therefore, undertook a systematic review and meta-analysis to investigate the role of exercise training on pro-inflammatory cytokines including interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) in children and adolescents.

METHOD

A comprehensive search was conducted in three electronic databases including PubMed, Web of Science, and Scopus, from inception to December 2023 to identify exercise trials with and without control groups, involving participants with mean ages ranging from ≥ 6 to < 18 years, of age with measurements of at least one of the following pro-inflammatory cytokines IL-6, TNF-α, or CRP. Standardized mean differences (SMD) and 95 % confidence interval (ICs) were calculated using random effects models.

RESULTS

Thirty-eight studies involving 2043 children and adolescents were included. The results show that exercise training resulted in significant reductions in IL-6 [SMD: -0.44; 95 % CI: -0.68, -0.21; P = 0.001] and CRP [SMD: -0.28; 95 % CI: -0.41, -0.16; P = 0.001], but not TNF-α [SMD: -0.15; 95 % CI: -0.38, -0.07; P = 0.19]. Subgroup analyses showed that IL-6 and CRP were reduced with aerobic training in adolescents, as was CRP with high-intensity interval training.

CONCLUSION

These results provide evidence that exercise training is effective for reducing IL-6 and CRP in adolescents, but not in children, and any benefits may be modulated by the type of exercise performed.

Lower adiponectin is associated with higher anthropometry and insulin resistance but not with low cardiorespiratory fitness in adolescents

PURPOSE

The aim of this study was to analyze the relationship between adiposity, cardiometabolic risk and cardiorespiratory fitness (CRF) according to different groups of adiponectin concentration.

METHODS

255 adolescents of both sexes, aged 11-17 years old, participated. Anthropometric and biochemical parameters such as body mass, height, abdominal circumference (AC), waist circumference (WC), fat mass, fat-free mass, total cholesterol (TC), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), triglycerides (TG), glucose, insulin, adiponectin, blood pressure, peak oxygen consumption (VO2peak) were measured. Body mass index (BMI), z-score BMI (BMI-z), triponderal mass index (TMI), waist-to-height ratio (WHtR), homeostasis model to assessment insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were calculated. Adiponectin was categorized: low adiponectin concentration (LAC  ≤ 5.18 µg/mL-1), intermediate (IAC = 5.18 and 7.63 µg/mL-1) and high (HAC ≥ 7.63 µg/ml-1).

RESULTS

LAC showed higher BMI, BMI-z and TMI than the other groups (p < 0.05) and higher AC, WC and WHtR that the HAC (p < 0.05). IAC showed lower values of TC, LDL-c and TG, and the LAC presented the highest values of insulin, HOMA-IR and QUICKI (p < 0.05) to the IAC and HAC. HAC presented the lower VO2peak than the other groups (p < 0.01). BMI, TMI, glucose, insulin, HOMA-IR showed inverse, and QUICKI a direct and weak correlation with adiponectin (p < 0.05). No significant association was found between adiponectin and VO2peak (p > 0.05).

CONCLUSION

The LAC group had higher means in the anthropometric variables and the worst results related to insulin resistance and sensitivity. Thus, adiponectin may play an important role in obesity and reduced concentration may be a factor in the development of obesity-associated morbidities.

Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis

BACKGROUND

Lifestyle modifications involving diet and exercise are recommended for patients diagnosed with obesity and type 2 diabetes mellitus (T2DM). The purpose of this review was to systematically evaluate the effects of combined aerobic exercise and diet (AEDT) on various cardiometabolic health-related indicators among individuals with obesity and T2DM.

METHODOLOGY

A comprehensive search of the PubMed/Medline, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases was conducted for this meta-analysis. The Cochrane risk of bias tool was used to evaluate eligible studies, and the GRADE tool was used to rate the certainty of evidence. A random-effects model for continuous variables was used, and the results were presented as mean differences or standardised mean differences with 95% confidence intervals.

RESULTS

A total of 16,129 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants. The findings revealed significant improvements in body mass index, body weight, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, fasting blood glucose, fasting plasma insulin, glycated hemoglobin, leptin, interleukin-6, C-reactive protein, and adiponectin (p < 0.05) compared to the standard treatment (ST) group. No significant differences were observed between the AEDT and ST groups in fat mass, hip circumference, waist-to-hip ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and tumor necrosis factor-alpha. The present findings are based on low- to moderate-quality evidence.

CONCLUSIONS

AEDT may be a critical behavior for holistic cardiometabolic health-related benefits as a contemporary anti-obesity medication due to its significant positive impact on patients with obesity and T2DM. Nevertheless, further robust evidence is necessary to determine whether AEDT is an effective intervention for lowering cardiovascular and metabolic risk factors among individuals with obesity and T2DM.

Moderate intensity walking exercises reduce the body mass index and vascular inflammatory factors in postmenopausal women with obesity: a randomized controlled trial

Postmenopause, the secretion of female hormones changes, causing excessive fat accumulation in the body and leading to chronic inflammation, which increases the incidence of cardiovascular diseases (CVD). Walking is an easily accessible daily exercise and effective non-pharmacological treatment for reducing obesity and the incidence of CVD. The aim of this study was to investigate the effect of moderate intensity walking exercises on body composition, vascular inflammatory factors, and vascular endothelial growth factor (VEGF) in postmenopausal women with obesity. Twenty-six older postmenopausal women with obesity (ages 68-72) were randomly assigned to control (n = 12, BMI 26.06 ± 1.37) or exercise (n = 14, BMI 26.04 ± 1.94) groups. Following a 12-week moderate intensity walking exercise program, we measured the participants' body composition with an InBody S10 analyzer and assessed blood sera using enzyme-linked immunosorbent assays. There was a significant clustering by weight (p < 0.01), body mass index (p < 0.01), percentage body fat (p < 0.001), high-sensitivity C-reactive protein (p < 0.05), interleukin-6, and tumor necrosis factor-α (p < 0.05) being significantly decreased in the exercise group. Although VEGF levels did not change significantly, a tendency to increase was observed in participants that exercised. Our results indicate that walking exercise may help prevent CVD in postmenopausal women with obesity by reducing obesity and vascular inflammatory factors.

The effects of exercise training on insulin resistance in children and adolescents with overweight or obesity: a systematic review and meta-analysis

Aim

The aim of present meta-analysis was to determine the effects of exercise training (Exe) on insulin resistance (IR) and body weight in children and adolescents with overweight or obesity.

Methods

PubMed, Web of Science, and Scopus were searched for original articles, published through October 2022 that included exercise versus control interventions on fasting glucose, insulin, HOMA-IR, and body weight outcomes in children and adolescents with overweight or obesity. Standardized mean differences (SMD) for fasting insulin, and weighted mean differences (WMD) for fasting glucose, HOMA-IR, body weight (BW), and 95% confidence intervals were determined using random effects models.

Results

Thirty-five studies comprising 1,550 children and adolescents with overweight and obesity were included in the present meta-analysis. Exercise training reduced fasting glucose (WMD=-2.52 mg/dL, p=0.001), fasting insulin (SMD=-0.77, p=0.001), HOMA-IR (WMD=-0.82, p=0.001), and BW (WMD=-1.51 kg, p=0.001), as compared to a control. Subgroup analyses showed that biological sex, intervention duration, type of exercise training, BMI percentile, and health status (with or without diagnosed condition), were sources of heterogeneity.

Conclusion

Exercise training is effective for lowering fasting glucose, fasting insulin, HOMA-IR, and BW in children and adolescents with overweight or obesity and could provide an important strategy for controlling IR and related factors. With clear evidence for the effectiveness of exercise interventions in this vulnerable population, it is important to determine effective approaches for increasing exercise training in children and adolescents with overweight or obesity.

The Positive Effect of Four-Week Combined Aerobic-Resistance Training on Body Composition and Adipokine Levels in Obese Females

Obesity is a metabolic disease that is caused by a lack of physical activity and is associated with an increased risk of chronic inflammation. A total of 40 obese adolescent females with an average age of 21.93 ± 1.35 years and average body mass index (BMI) of 30.81 ± 3.54 kg/m² were enrolled in this study, randomized, and divided into four groups, i.e., control (CTL; n = 10), moderate intensity aerobic training (MAT; n = 10), moderate intensity resistance training (MRT; n = 10), and moderate intensity combined aerobic-resistance training (MCT; n = 10). The enzyme-linked immunosorbent assay (ELISA) kits method was used to analyze the adiponectin and leptin levels between pre-intervention and post-intervention. Statistical analysis was conducted using a paired sample t-test, while correlation analysis between variables used the Pearson product-moment correlation test. Research data showed that MAT, MRT, and MCT significantly increased adiponectin levels and decreased leptin levels compared to the CTL (p ≤ 0.05). The results of the correlation analysis of delta (∆) data showed that an increase in adiponectin levels was significantly negatively correlated with a decrease in body weight (BW) (r = -0.671, p ≤ 0.001), BMI (r = -0.665, p ≤ 0.001), and fat mass (FM) (r = -0.694, p ≤ 0.001) and positively correlated with an increase in skeletal muscle mass (SMM) (r = 0.693, p ≤ 0.001). Whereas, a decrease in leptin levels was significantly positively correlated with a decrease in BW (r = 0.744, p ≤ 0.001), BMI (r = 0.744, p ≤ 0.001), and FM (r = 0.718, p ≤ 0.001) and negatively correlated with an increase in SMM (r = -0.743, p ≤ 0.001). In summary, it can be concluded that our data show that adiponectin levels increased and leptin levels decreased after the intervention of aerobic, resistance, and combined aerobic-resistance training.

Effects and individual response of continuous and interval training on adiponectin concentration, cardiometabolic risk factors, and physical fitness in overweight adolescents

This study aimed to evaluate the effect and individual responsiveness after 12 weeks of high-intensity interval training (HIIT) and moderate-intensity of continuous training (MICT) on adiponectin, cardiometabolic risk factors and physical fitness in overweight adolescents. This study was participated by 52 adolescents, both sexes, 11 and 16 years old, separated into HIIT (n = 13), MICT (n = 15), and control group (CG, n = 24). Body mass, height, waist circumference (WC), fat mass (FM), fat-free mass (FFM), blood pressure, high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), triglycerides, glucose, insulin, adiponectin, and C-reactive protein (CRP) were evaluated. Body mass index z-score (BMI-z), waist-to-height ratio (WHtR), insulin resistance, and insulin sensitivity were calculated. Resting heart rate (HR_rest), peak oxygen consumption (VO_2peak), right handgrip strength (HGS-right), left handgrip strength (HGS-left), and abdominal resistance (ABD) was evaluated. HIIT session lasted around 35 min and MICT of 60 min of exercises on stationary bicycle, three times a weekday for 12 weeks. ANOVA, effect size, and prevalence of responders were used for statistical analysis. HIIT reduced BMI-z, WHtR, LDL-c, and CRP, while increased of physical fitness. MICT reduced HDL-c, while increased of physical fitness. CG reduced FM, HDL-c, and CRP, while increased FFM and HR_rest. Frequencies of respondents in HIIT were observed for CRP, VO_2peak, HGS-right, and HGS-left. Frequencies of respondents in MICT were observed for CRP and HGS-right. Frequencies of no-respondents in CG were observed for WC, WHtR, CRP, HR_rest, and ABD.  Conclusion: Interventions with exercises were effective to adiposity, metabolic health, and physical fitness improvements. Individual responses were observed in inflammatory process and physical fitness, important changes in overweight adolescent's therapy.  Trial registration number and date of registration: This study was registered with the Brazilian Registry of Clinical Trials (REBEC), the number RBR-6343y7, date of registration May 3, 2017. What is Known: • Effect of regular physical exercise positively affects overweight, comorbidities, and metabolic diseases, recommended mainly for children and adolescents. What is New: • Due to the great inter-individual variability, the same stimulus can provide different responses; adolescents who benefit from the stimulus are considered responsive. • Intervention of HIIT and MICT did not alter the concentrations of adiponectin; however, the adolescents presented responsiveness to the inflammatory process and physical fitness.

Effects of exercise combined with diet intervention on body composition and serum biochemical markers in adolescents with obesity: a systematic review and meta-analysis

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.

A Meta-Analysis of the Effects of Different Training Modalities on the Inflammatory Response in Adolescents with Obesity

The aim of this study was to investigate the effect of different training modalities on improving the inflammatory response in adolescents with obesity. For the study methodology, the databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data, Pubmed, Web of Science, and EBSCO were selected for searching. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias (ROB) tool, and statistical analysis was performed by applying RevMan 5.4.1 analysis software. A total of 14 studies with 682 subjects were included. The results of this meta-analysis showed that aerobic training (AT) and aerobic plus resistance training (AT + RT) reduced the levels of IL-6 and CRP in adolescents with obesity. Among them, AT + RT was more effective than other training modalities in reducing IL-6 and CRP in adolescents with obesity. Different training modalities have no effect on the TNF-α level in adolescents with obesity. However, regarding the increase in IL-6, CRP, and TNF-α in adolescents with obesity, resistance training (RT) did not lead to significant differences. In conclusion, long-term regular AT, AT + RT, and HIIT are all helpful in improving the inflammatory state of adolescents with obesity, with AT + RT being the best training modality to combat inflammation in adolescents with obesity.

Effect of Exercise Training on Body Composition and Inflammatory Cytokine Levels in Overweight and Obese Individuals: A Systematic Review and Network Meta-Analysis

Objective

This study aimed to compare and rank the effectiveness of aerobic exercise (AE), resistance training (RT), combined aerobic and resistance training (CT), and high-intensity interval training (HIIT) on body composition and inflammatory cytokine levels in overweight and obese individuals by using network meta-analysis (NMA).

Methods

We searched the PubMed, Cochrane, Embase, Web of Science, and EBSCO databases to identify randomized controlled trials investigating the effects of exercise training on inflammatory cytokines in overweight and obese patients. The retrieval period was from inception to November 2021. Two reviewers independently screened the retrieved articles, extracted the pertinent data, and assessed the risk of bias of the included studies; then, they used Stata 16.0 and Review Manager 5.3 to perform an NMA.

Results

A total of 38 studies involving 1317 patients were included in this study. The results of the NMA indicated that AE had the greatest effect on weight loss (SUCRA=78.3; SMD=−0.51, 95% CI: −0.70, −0.33); CT had the greatest effect on reducing body mass index (SUCRA=70.7; SMD=−0.46, 95% CI: −0.81, −0.10), waist circumference (SUCRA=93.4; SMD=−1.86, 95% CI: −2.80, −0.93), percentage body fat (SUCRA=79.6; SMD=−1.38, 95% CI: −2.29, −0.48), interleukin-6 level (SUCRA=86.4; SMD=−1.98, 95% CI: −3.87, −0.09), and tumor necrosis factor-α level (SUCRA=79.4; SMD=−2.08, 95% CI: −3.75, −0.42); AE (SMD=0.51, 95% CI: −1.68, 2.69), RT (SMD=0.15, 95% CI: −3.01, 3.32), CT (SMD=1.78, 95% CI: −1.35, 4.92), and HIIT (SMD=2.29, 95% CI: −1.27, 5.86) did not significantly increase the adiponectin level.

Conclusion

The current results suggest that CT is the best exercise modality for improving body composition and inflammatory status in overweight and obese individuals. More rigorous randomized control trials are needed for further validation.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42022303165.

Effects of Physical Exercise on Cardiometabolic Biomarkers and Inflammatory Markers in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

The prevalence of obesity among children as well as the beneficial effects of physical exercise (PE) on weight loss has been determined by modulating the secretory factors of adipose tissue. PE has also been shown to have beneficial effects on obesity.

OBJECTIVE

The objective of this systematic review and meta-analysis was to investigate the effects of physical exercise (PE) on adiponectin and other important health markers in children.

DATA SOURCES

We searched 6 electronic databases (PubMed/Medline, Embase, Cochrane Library, Cinahl, Scopus, and Web of Science) and Google Scholar for randomized controlled trials from inception to December 15, 2021. We used random-effects models to estimate weighted mean difference (WMD) with 95% confidence intervals (CI).

STUDY SELECTION

Fourteen studies were included (N = 468 participants; mean age: 14 years).

RESULTS

In general, PE increased adiponectin (WMD: 0.91 µg/mL; 95% CI, 0.27 to 1.55, p = 0.005), high-density lipoprotein cholesterol (HDL-C) (WMD: 1.01 mg/dL; 95% CI, 0.33 to 1.69, p = 0.004), and VO₂max (WMD: 2.52 mL.kg.min; 95% CI, 1.41 to 3.62, p = 0.00,001). The levels of c-reactive protein (WMD: -0.37 mg/L; 95% CI, -0.57 to -0.17, p = 0.0003), insulin (WMD: -4.61 μIU/ml; 95% CI, -5.46 to -3.76, p = 0.00,001), fasting glucose (WMD: -5.11 mg/dL; 95% CI, -7.88 to -2.34, p = 0.0003), and insulin resistance index (WMD: -1.44; 95% CI, -1.92 to -0.96, p = 0.00,001), decreased significantly.

CONCLUSION

Our study showed that PE may increase the level of adiponectin, HDL-C, and VO₂max in children.

Karate Training Improves Metabolic Health in Overweight and Obese Adolescents: A Randomized Clinical Trial

PURPOSE

This study evaluated the effects of 12 weeks of karate training on cardiometabolic parameters, oxidative stress, and inflammation in adolescents with overweight and obesity.

METHOD

Seventy adolescents were randomized into 2 groups: control received nutritional and psychological interventions once a week for 12 weeks, and treatment received nutritional and psychological interventions once a week, plus 3 karate sessions per week, for 12 weeks. The main outcome measure was improvement in cardiometabolic parameters, oxidative stress, and inflammation.

RESULTS

After the intervention period, the treatment group showed a reduction in resting heart rate (77.86 [10.89]), high-density lipoprotein cholesterol (40.86 [8.31]), and triglycerides (75.18 [32.29]) and an increase in low-density lipoprotein cholesterol (95.64 [42.53]) in relation to pretraining. Regarding oxidative stress markers, there was a reduction in protein carbonylation (0.07 [0.06]) and nitric oxide (1.39 [1.11]) and an increase in superoxide dismutase (0.68 [0.31]) and glutathione (0.11 [0.08]) compared with pretraining. With respect to inflammation, adiponectin increased (14.54 [5.36]) after the intervention when compared with preintervention.

CONCLUSION

The study concluded that the intervention may improve cardiometabolic parameters, oxidative stress, and inflammation in adolescents with overweight and obesity. Long-term effects need to be evaluated.

Resistance training effectiveness on body composition and body weight outcomes in individuals with overweight and obesity across the lifespan: A systematic review and meta-analysis

To systematically review and analyze the effects of resistance-based exercise programs on body composition, regional adiposity, and body weight in individuals with overweight/obesity across the lifespan. Using PRISMA guidelines, randomized controlled trials were searched in nine electronic databases up to December 2020. Meta-analyses were performed using random-effects model. One-hundred sixteen articles describing 114 trials (n = 4184 participants) were included. Interventions involving resistance training and caloric restriction were the most effective for reducing body fat percentage (ES = -3.8%, 95% CI: -4.7 to -2.9%, p < 0.001) and whole-body fat mass (ES = -5.3 kg, 95% CI: -7.2 to -3.5 kg, p < 0.001) compared with groups without intervention. Significant results were also observed following combined resistance and aerobic exercise (ES = -2.3% and -1.4 kg, p < 0.001) and resistance training alone (ES = -1.6% and -1.0 kg, p < 0.001) compared with no training controls. Resistance training alone was the most effective for increasing lean mass compared with no training controls (ES = 0.8 kg, 95% CI: 0.6 to 1.0 kg, p < 0.001), whereas lean mass was maintained following interventions involving resistance training and caloric restriction (ES = ~ - 0.3 kg, p = 0.550-0.727). Results were consistently observed across age and sex groups (p = 0.001-0.011). Reductions in regional adiposity and body weight measures were also observed following combined resistance and aerobic exercise and programs including caloric restriction (p < 0.001). In conclusion, this study provides evidence that resistance-based exercise programs are effective and should be considered within any multicomponent therapy program when caloric restriction is utilized in individuals with overweight or obesity.

ADRB2 gene influences responsiveness to physical exercise programs: A longitudinal study applied to overweight or obese Brazilian children and adolescents

We aimed to investigate whether the expression levels and polymorphisms in the ADRB2 gene have influenced the anthropometric and cardiometabolic outcomes changes in obese/overweight children submitted to physical exercise programs. This longitudinal study included 197 overweight or obese children aged 10-16 years, submitted to physical exercise programs - three sessions per week for 12 weeks. Anthropometric and cardiometabolic profile was collected before and after interventions. The ADRB2 gene expression levels were also measured in these two moments in a small intervention group (n = 17) and a control group (n = 18). Arg16Gly and Gln27Glu polymorphisms were genotyped. A positive correlation between ADRB2 expression and loss of body fat (%) (p = 0.038) was observed, which remained after sex and BMI change corrections. Carriers of the Glu27Glu genotype presented a better response to physical exercise programs regarding their triglycerides levels and triglyceride-glucose index (p = 0.001 for both). The participants' responsiveness to physical exercise programs showed variation due to the ADRB2 gene expression and the Gln27Glu polymorphism. A more significant loss of body fat was associated with higher levels of ADRB2 expression, and the Glu27Glu genotype was associated with a better cardiometabolic response. The Arg16Gly polymorphism did not show interaction with the responsiveness to physical exercise.

Responsiveness on metabolic syndrome criteria and hepatic parameters after 12 weeks and 24 weeks of multidisciplinary intervention in overweight adolescents

PURPOSE

This study aimed to evaluate the effect and individual responsiveness after 12 (12wk) and 24 weeks (24wk) of physical exercise (PE) and nutritional guidance (NG) on metabolic syndrome (MetS) criteria and hepatic parameters in overweight adolescents.

METHODS

The study comprised 94 overweight adolescents, aged between 10 and 16 years old, from both sexes, allocated into groups: PE and NG (PENGG, n = 64) and control with NG (NGCG, n = 30). Variables were collected at baseline, 12wk, and 24wk. Weight, height, abdominal circumference (AC), blood pressure, and peak oxygen consumption (VO_2peak), as well as insulin, triglycerides (TAG), high-density lipoprotein (HDL-c), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were evaluated. HOMA-IR and QUICKI were calculated. PE session consisted of 45 min of indoor cycling, 45 min of walking, and 20 min of stretching, three times a week. The NG consisted of three collective sessions in the first 12wk. Anova, effect size, and prevalence of responders were used for statistical analysis.

RESULTS

The PENGG12wk reduced anthropometric and metabolic measurements, while increased VO_2peak and HDL-c. The PEG24wk promoted anthropometric, blood pressure, metabolic, and VO_2peak improvements, but participants without PE returned to pre-exercise status and presented worsening AST and ALT concentrations. Frequencies of respondents in PENGG12wk versus (vs) NGCG12wk were, respectively, AC (69.1% vs 17.6%, p < 0.01), HDL-c (87.2% vs 23.5%, p < 0.01), TAG (67.3% vs 41.7%, p = 0.05) and ALT (45.5% vs 5,9%; p = 0.003).

CONCLUSION

Interventions with PE were effective to reduce MetS components in 12wk and maintenance in 24wk, showing anthropometric, metabolic, and VO_2peak improvements. Higher individual responses were observed in 12wk and in 24wk, important changes in overweight adolescent's therapy.

LEVEL OF EVIDENCE

Level I, evidence obtained from well-designed controlled trials randomization.

TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION

Brazilian Registry of Clinical Trials (RBR-4v6h7b) and date of registration April 4th, 2020.

Effects of aerobic exercise combined with resistance training on health-related physical fitness in adolescents: A randomized controlled trial

Background

/Objective: This study aimed to compare the effects of two combined training methods on health-related physical fitness components in adolescents.

Methods

Seventy-six adolescents (16.1 ± 1.1 years, n = 44 female) were randomized into groups of moderate-intensity continuous training combined with resistance training (MICT + RT), high-intensity interval training combined with resistance training (HIIT + RT), or Control. The training sessions were performed twice weekly for 12 weeks. The health-related physical fitness components evaluated were: body composition, muscular and cardiorespiratory fitness.

Results

The intervention groups had a significant reduction in body fat percentage and improvement in abdominal repetitions and VO_2peak after 12 weeks of combined exercise program (p < 0.001). Intervention effects were found to significantly reduce body fat percentage for the MICT + RT and HIIT + RT groups compared to the control group (mean difference: −3.8; 95% CI: −6.2; −1 0.3; mean difference: −4.7; 95%CI: −7.1; −2.3, respectively). For muscle fitness, significant effects of the intervention were found in increasing the number of abdominal repetitions favoring the MICT + RT group compared to the control group (mean difference: 9.5; 95% CI: 4.4; 14.7) and HIIT + RT compared to the control group (mean difference: 14.1; 95% CI 9; 19.3). For cardiorespiratory fitness, significant effects of the intervention on improving VO_2peak were found in the experimental groups (MICT + RT vs Control group: mean difference: 4.4; 95% CI: 2.2; 6.6; and HIIT + RT vs. Control group: mean difference: 5.5, 95% CI: 3.3; 7.7).

Conclusion

The results suggest that 12 weeks of training using MCIT + RT or HIIT + RT showed a similar effect for health-related physical fitness components in adolescents.

Serum metabolites associated with increased insulin resistance and low cardiorespiratory fitness in overweight adolescents

BACKGROUND AND AIMS

Obesity affects metabolism, increasing the risk of developing non-communicable diseases in adolescence, due to excess adipose tissue and low cardiorespiratory fitness (CRF). The metabolomics approach allows the elucidation of metabolites, which may have the concentrations altered by several factors, such as body composition (BC). We aimed to analyze the metabolomic profile of normal-weight and overweight adolescents and associate the metabolites with clinical markers related to BC, insulin resistance (IR), and CRF.

METHODS AND RESULTS

The sample was composed of 57 adolescents and divided into two groups: the normal-weight group (NWG, n = 24) and the overweight group (OWG, n = 33). They underwent blood collection and anthropometric, BC, and CRF assessment. Blood serum samples were analyzed by ¹H-NMR spectroscopy (600 MHz). The OWG presented higher values of body weight (BW), body mass index (BMI), waist circumference (WC), fasting glucose, insulin, IR, cholesterol, and percentage of fat mass (%FM) and lower levels of peak oxygen consumption (VO₂ peak) compared with the NWG. The OWG presented lower concentrations of 3-hydroxyisovalerate, glutamate, and methionine as well as higher concentrations of aspartate, asparagine, creatine, glycerol, myo-inositol, proline, pyruvate, tyrosine, and valerate compared with the NWG. The concentrations of glutamate, myo-inositol, creatine, methionine, and valerate correlated with %FM; pyruvate and valerate positively correlated with IR; and glutamate, tyrosine, and valerate negatively correlated with CRF.

CONCLUSION

Changes in the BC lead to changes in the metabolomic profile of adolescents, and the altered metabolites are associated with increased IR and low CRF. These results indicate new targets for health monitoring and prevention of cardiovascular and metabolic diseases in adolescents.

Gender-related differences in the modulation of anthropometric, biochemical, and immune markers by physical activity in hypertensive and diabetic individuals

Systemic arterial hypertension (SAH) and type 2 diabetes mellitus (T2DM) compose the two major noncommunicable chronic inflammatory diseases. Physical activity has been shown as a promising complementary approach to control the systemic inflammation. However, it is still unclear whether this modulation is gender-dependent. The objective of this study was evaluate the gender-related influence of physical activity on the inflammatory response and biochemical profile of individuals with SAH and T2DM. An international physical activity questionnaire was applied to 376 individuals diagnosed with SAH and T2DM in order to access their exercises routine and was evaluated the influence of physical activity in biochemical, anthropometrical, and immunological markers involved in these disorders in men and women. Even though active individuals have exhibited lower serum levels of IL-1β, IFN-γ, TNF-α, and IL-17A, the ratios between IL-10 and all inflammatory cytokines were higher in men than in women. Physically active individuals also demonstrated increased HDL/LDL and HDL/VLDL ratios. Moreover, multiple correlations revealed that in active women both IL-10 and TNF-α serum levels positively correlate with fasting glucose levels, and were negatively associated with HDL levels. Our findings suggest that gender-related differences dictate a distinct crosstalk between inflammatory and biochemical markers in physically active individuals.

Impact of resistance training and basic ferritin on hepcidin, iron status and some inflammatory markers in overweight/obese girls

BACKGROUND

Exercise can reduce hepcidin, tumor necrosis factor (TNF)-α, and interleukin (IL)-6 and improve the iron status, but the intensity of exercises is very important. This study will compare the effect of resistance training (RT) intensity on hepcidin levels, iron status, and inflammatory markers in overweight/obese girls with and without iron stores deficient.

MATERIALS AND METHODS

In this quasi-experimental study, 40 students of the University of Isfahan (18-22-year old, with 35 > body mass index [BMI] ≥25) voluntarily participated in the study. Participants were divided into two groups with 20 participants, based on serum ferritin (>30 ng/ml or ≤30 ng/ml). Participants in each group were randomly and equally assigned to one of the moderate or high-intensity training groups. RT was performed 8 weeks, 4 days a week, and each session for 1 h, with an elastic band. The iron levels, hepcidin, total iron-binding capacity, ferritin, hemoglobin, TNF-α, and IL-6 before and after intervention were collected with the blood samples. Two-way analysis of variance was used to assess the impact of exercise and ferritin level and their interaction, and the paired test was utilized for test changes from baseline.

RESULTS

There are no significant interactions between ferritin levels and exercise intensity for the main outcomes (all P > 0.05). The significant impact of the mode of exercise was observed in TNF-α (P < 0.05), and a significant difference between low and high levels of ferritin was observed in hepcidin (P = 0.002). Besides, in all four groups, significant decreases were observed in BMI (28.00 ± 3.00 to 27.00 ± 3.00), hepcidin (1234.02 ± 467.00 to 962.06 ± 254.00), and TNF-α (223.00 ± 99.00 to 174.00 ± 77.00) compared to the baseline measurements (all P < 0.05).

CONCLUSION

Basal ferritin levels appear to be effective on hepcidin levels, TNF-α, and IL-6 after the intervention. RT with two different intense can reduce BMI, hepcidin, ferritin, and TNF-α in all groups. It seems that performing RT reduces inflammation and hepcidin in obese/overweight participants with different iron stores.

Effects and Responsiveness of a Multicomponent Intervention on Body Composition, Physical Fitness, and Leptin in Overweight/Obese Adolescents

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.

Integrating needs-supportive delivery into a laboratory-based randomised controlled trial for adolescent girls with overweight and obesity: Theoretical underpinning and 12-week psychological outcomes

When designing efficacy trials, researchers have a responsibility to "do no harm" and to "do good". Given the psychological vulnerability of adolescent girls with overweight and obesity, it is important to consider the implications of participating in weight-related research studies. We investigated psychological outcomes from a 12-week laboratory-based randomised controlled trial aimed at improving body composition and bone health in adolescent girls with overweight and obesity. Sixty-three participants were randomised to three groups (Recommended dairy diet plus exercise (RDa, n = 24); Low dairy diet plus exercise (LDa, n = 25); no-intervention control (n = 14)). Self-Determination Theory-informed strategies were applied in both intervention groups to foster motivation and enhance psychological wellbeing. Motivation, perceived competence and self-perceptions were measured at 0 and 12 weeks. Fifty-four participants (24 RDa, 23 LDa, 7 Control) provided complete psychological data. There were no between group differences in 0- to 12-week change in motivation, perceived competence or global self-worth. Both intervention groups showed significant improvements in physical self-worth (p = 0.001), body satisfaction (p = 0.002) and perceived physical conditioning (p = 0.002), compared with the control group. A theory-informed, laboratory-based diet and exercise intervention produced favourable psychological outcomes for adolescent girls with overweight and obesity.

Physiotherapy and related management for childhood obesity: A systematic scoping review

INTRODUCTION

Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to manage children with obesity as they are experts in movement and physical activity. However, their role remains unclear due to a lack of physiotherapy-specific guidelines. This scoping review aims to explore existing literature, critically appraising and synthesising findings to guide physiotherapists in the evidence-based management of childhood overweight/obesity.

METHOD

A scoping review was conducted, including literature up to May 2020. A review protocol exists on Open Science Framework at https://osf.io/fap8g/. Four databases were accessed including PubMed, Embase, CINAHL, Medline via OVID, with grey literature searched through google via "file:pdf". A descriptive synthesis was undertaken to explore the impact of existing interventions and their efficacy.

RESULTS

From the initial capture of 1871 articles, 263 intervention-based articles were included. Interventions included qualitative focused physical activity, quantitative focused physical activity and multicomponent interventions. Various outcome measures were utilised including health-, performance- and behaviour-related outcomes. The general trend for physiotherapy involvement with children who are obese appears to favour: 1) multicomponent interventions, implementing more than one component with environmental modification and parental involvement and 2) quantitative physical activity interventions, focusing on the quantity of bodily movement. These approaches most consistently demonstrated desirable changes across behavioural and health-related outcome measures for multicomponent and quantitative physical activity interventions respectively.

CONCLUSION

When managing children with obesity, physiotherapists should consider multicomponent approaches and increasing the quantity of physical activity, given consistent improvements in various obesity-related outcomes. Such approaches are well suited to the scope of physiotherapists and their expertise in physical activity prescription for the management of childhood obesity. Future research should examine the effect of motor skill interventions and consider the role of environmental modification/parental involvement as factors contributing to intervention success.

The impacts of exercise on pediatric obesity

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.

Serum myokine levels after linear and flexible non-linear periodized resistance training in overweight sedentary women

This study compared the capacity of linear-(LP) and non-linear periodized (NLP) resistance training to improve select myokines and metabolic parameters in overweight sedentary women. An additional purpose was to compare these variables between the overweight and lean women. Fitness- and age-matched overweight women between 28 and 43 years old were randomly allocated to LP (body fat [BF]% = 38.7 ± 2.6, n = 10), NLP (BF% = 39.3 ± 2.4, n = 9) and control (BF% = 39.8 ± 2.6, n = 9) groups. Lean women (BF% = 29.1 ± 2.3, n = 16) matched for age and fitness were also included for baseline comparison. Resistance training programmes (12 weeks, 3 d.wk^-1, 9 exercises, 60-90% of 1-repetition maximum [1RM]) were performed with different periodization schemes. Glucose, insulin, interleukin (IL)-7, IL-15, and insulin-like growth factor (IGF)-1 levels were measured at baseline and after training. Overweight subjects had significantly lower IL-15, IGF-1 and higher insulin, glucose, and insulin resistance (homeostasis model assessment, HOMA-IR) than lean subjects at baseline (all, P < .05). IL-15 and VO₂max increased significantly after NLP compared with CON, which was accompanied by a significant decrease in HOMA-IR (all, P < .03). Muscular endurance improved significantly in both models after training compared to CON (all, P < .01), but it increased more in NLP than in LP (P = .01). Both training protocols were equally effective at reducing BF% and increasing IGF-1, IL-7, muscle mass and bench press 1RM (P < .01). It appears that LP and NLP are both effective strategies for improving health markers in overweight women, but LP is not as effective as NLP to improve IL-15, HOMA-IR and aerobic capacity.Highlights Overweight women had a significantly lower IL-15 and IGF-1 compared to lean encounters, but no significant difference was noted for maximal strength, aerobic capacity, muscle mass, IL-7 and neutrophil/lymphocyte ratio.Twelve weeks of either linear or flexible non-linear periodized resistance training resulted in reduction in BF% and neutrophil/lymphocyte ratio, and increased IGF-1, IL-7, muscle mass and bench press 1RM, with no difference between the two training protocols.Linear protocol is not as effective as non-linear protocol to improve IL-15, HOMA-IR and aerobic capacity.

A Multicomponent Intervention Program With Overweight and Obese Adolescents Improves Body Composition and Cardiorespiratory Fitness, but Not Insulin Biomarkers

Objective: To verify the effect of a multicomponent intervention with overweight/obese adolescents on physical fitness, body composition, and insulin biomarkers.

Methods: A quasi-experimental study with 37 adolescents, aged 10 to 17 years, of both sexes, overweight and obese, allocated in two groups (Intervention—IG Group, n = 17; Control—GC Group, n = 20). The IGs were submitted to a multicomponent intervention for 6 months (three weekly sessions) consisting of physical exercises (sports, functional circuit, recreational, and water activities) and nutritional and psychological guidance. Participants were assessed before and after intervention on body composition [body mass index (BMI), body fat, waist circumference, and waist-to-hip ratio (WHR)], physical fitness [cardiorespiratory fitness (CRF) and abdominal strength], and biomarkers of insulin (glucose, insulin, evaluation of the homeostasis model of insulin, and resistin resistance). The prevalence of responders in both groups was obtained according to the theoretical model applied in previous studies similar to this one to determine the cutoff points for response to intervention. Poisson regression was used to verify the difference in the prevalence ratio (PR) of the interviewees between the groups.

Results: The responders' prevalence between groups CG and IG showed significant differences for body fat (CG = 30.0%; IG = 70.6%; PR = 1.396; p < 0.001), WHR (CG = 30.0%; IG = 76.5%; PR = 1.730; p < 0.001), and CRF (CG = 15.0%; IG = 52.5%; PR = 1.580; p < 0.001).

Conclusions: A 6-month multicomponent intervention program improved certain body composition parameters and the CRF of overweight and obese adolescents but did not improve insulin biomarkers.

Clinical Trial Registration: Clinical Trials under Protocol ID: 54985316.0.0000.5343.

The effects of physical activity on adipokines in individuals with overweight/obesity across the lifespan: A narrative review

This narrative review summarizes current knowledge on the effects of physical activity (PA) on adipokine levels in individuals with overweight and obesity. Approximately 90 investigations including randomized control, cross-sectional and longitudinal studies that reported on the effects of a single session of PA (acute) or long-term PA (chronic) on adipokine levels in individuals with overweight/obesity were reviewed. The findings support the notion that there is consensus on the benefits of chronic exercise training-regardless of the mode (resistance vs. aerobic), intensity and cohort (healthy vs. diabetes)-on adipokine levels (such as tumour necrosis factor-alpha, interleukin-6, adiponectin, visfatin, omentin-1 and leptin). However, several confounding factors (frequency, intensity, time and type of exercise) can alter the magnitude of the effects of an acute exercise session. Available evidence suggests that PA, as a part of routine lifestyle behaviour, improves obesity complications by modulating adipokine levels. However, additional research is needed to help identify the most effective interventions to elicit the most beneficial changes in adipokine levels in individuals with overweight/obesity.

Altered metabolomic profiling of overweight and obese adolescents after combined training is associated with reduced insulin resistance

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.

Effects of photobiomodulation on muscle strength in post-menopausal women submitted to a resistance training program

The aim of this study was to compare the effects of resistance training of low volume and high intensity with or without photobiomodulation (PBM) on muscle strength and functional performance in post-menopausal women. Thirty-four post-menopausal women were randomized into resistance training (RTG, n = 17) or resistance training plus PBM (PBMG, n = 17). Individuals from both groups received the same RT protocol consisting of leg-press 45°, front lat pulldown, leg curl, chest press, and squat performed in two sets of 10 repetitions with a workload of 75% of one repetition maximum (1RM), twice per week, during 8 weeks. PBMG individuals also received, prior to the exercise session, PBM through a cluster containing 7 visible diodes (630 nm) and 7 infrared diodes (850 nm) with power of 100 mW each and energy of 4 J per diode, applied to the quadriceps femoris muscle; individuals from RTG received placebo PBM prior to the sessions, applied with the same device switched off. Muscle strength (1RM; isometric dynamometer), functional performance (Time Up and Go; Berg Balance Scale; 6-min walk test), and quality of life (World Health Organization Quality of Life-Bref) were performed before and after 8 weeks. Both groups increased muscle strength (p < 0.001) for all exercises, without group differences (p = 0.651). Quality of life (p = 0.015) and balance (p = 0.006) increased only in the RTG. The results suggest that PBM were not able for inducing additional benefits to RT to improve muscle strength in post-menopausal women.

Multidisciplinary intervention in the treatment of mixed anxiety and depression disorder

Depression and anxiety disorders are one of the main limiting psychopathologies in the world today. This pathology is linked to an inflammatory state and a dysregulation of both neurotransmitters and autonomic nervous system. Various treatments from psychiatric and psychological areas have shown different degrees of efficacy in their treatment, being Cognitive Behavioral Therapy one of the most successful. In addition, various interventions from other areas of knowledge are showing significant improvements in this pathology. This research aimed to analyze the psychological and physiological modifications of a multidisciplinary intervention that combines psychological treatment (Cognitive Behavioral Therapy), physical activity and nutritional intervention in a mixed anxiety and depression disorder (DSM-V). We analyzed modifications in the HAM-D depression, STAI anxiety questionnaire, subjective perceptions of anxiety, happiness, sleep and motivation and the autonomous modulation before and after a 6 multidisciplinary sessions of cognitive behavioral therapy, aerobic physical activity and nutritional intervention in a subject with a mixed anxiety and depression disorder. The results showed a reduction in the values of depression in HAM-D until the classification of non-depression, a reduction in both state and trait anxiety, an increase in the subjective perceptions of sleep, happiness and motivation and a greater parasympathetic modulation after the six intervention sessions. The combination of psychological therapy with aerobic physical activity and nutritional recommendations to treat mixed anxiety and depression disorder produced an increased parasympathetic tone and a decreased anxiety and depression symptoms in six sessions. This is a novel research that allows us to open the study of a new multidisciplinary field in the treatment of this disease that is highly present today.

Interventions for preventing obesity in children

EDITORIAL NOTE

This Cochrane review is now out of date and should not be used for reference. It has been split into four age groups and updated. Please refer to the 5‐11 and 12‐18 age group Cochrane reviews which were published in May 2024: https://doi.org/10.1002/14651858.CD015328.pub2 https://doi.org/10.1002/14651858.CD015330.pub2 The 2‐4 age group Cochrane review is planned for publication in September 2024.

BACKGROUND

Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies to prevent obesity is very large and is accumulating rapidly. This is an update of a previous review.

OBJECTIVES

To determine the effectiveness of a range of interventions that include diet or physical activity components, or both, designed to prevent obesity in children.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, PsychINFO and CINAHL in June 2015. We re-ran the search from June 2015 to January 2018 and included a search of trial registers.

SELECTION CRITERIA

Randomised controlled trials (RCTs) of diet or physical activity interventions, or combined diet and physical activity interventions, for preventing overweight or obesity in children (0-17 years) that reported outcomes at a minimum of 12 weeks from baseline.

DATA COLLECTION AND ANALYSIS

Two authors independently extracted data, assessed risk-of-bias and evaluated overall certainty of the evidence using GRADE. We extracted data on adiposity outcomes, sociodemographic characteristics, adverse events, intervention process and costs. We meta-analysed data as guided by the Cochrane Handbook for Systematic Reviews of Interventions and presented separate meta-analyses by age group for child 0 to 5 years, 6 to 12 years, and 13 to 18 years for zBMI and BMI.

MAIN RESULTS

We included 153 RCTs, mostly from the USA or Europe. Thirteen studies were based in upper-middle-income countries (UMIC: Brazil, Ecuador, Lebanon, Mexico, Thailand, Turkey, US-Mexico border), and one was based in a lower middle-income country (LMIC: Egypt). The majority (85) targeted children aged 6 to 12 years.Children aged 0-5 years: There is moderate-certainty evidence from 16 RCTs (n = 6261) that diet combined with physical activity interventions, compared with control, reduced BMI (mean difference (MD) -0.07 kg/m2, 95% confidence interval (CI) -0.14 to -0.01), and had a similar effect (11 RCTs, n = 5536) on zBMI (MD -0.11, 95% CI -0.21 to 0.01). Neither diet (moderate-certainty evidence) nor physical activity interventions alone (high-certainty evidence) compared with control reduced BMI (physical activity alone: MD -0.22 kg/m2, 95% CI -0.44 to 0.01) or zBMI (diet alone: MD -0.14, 95% CI -0.32 to 0.04; physical activity alone: MD 0.01, 95% CI -0.10 to 0.13) in children aged 0-5 years.Children aged 6 to 12 years: There is moderate-certainty evidence from 14 RCTs (n = 16,410) that physical activity interventions, compared with control, reduced BMI (MD -0.10 kg/m2, 95% CI -0.14 to -0.05). However, there is moderate-certainty evidence that they had little or no effect on zBMI (MD -0.02, 95% CI -0.06 to 0.02). There is low-certainty evidence from 20 RCTs (n = 24,043) that diet combined with physical activity interventions, compared with control, reduced zBMI (MD -0.05 kg/m2, 95% CI -0.10 to -0.01). There is high-certainty evidence that diet interventions, compared with control, had little impact on zBMI (MD -0.03, 95% CI -0.06 to 0.01) or BMI (-0.02 kg/m2, 95% CI -0.11 to 0.06).Children aged 13 to 18 years: There is very low-certainty evidence that physical activity interventions, compared with control reduced BMI (MD -1.53 kg/m2, 95% CI -2.67 to -0.39; 4 RCTs; n = 720); and low-certainty evidence for a reduction in zBMI (MD -0.2, 95% CI -0.3 to -0.1; 1 RCT; n = 100). There is low-certainty evidence from eight RCTs (n = 16,583) that diet combined with physical activity interventions, compared with control, had no effect on BMI (MD -0.02 kg/m2, 95% CI -0.10 to 0.05); or zBMI (MD 0.01, 95% CI -0.05 to 0.07; 6 RCTs; n = 16,543). Evidence from two RCTs (low-certainty evidence; n = 294) found no effect of diet interventions on BMI.Direct comparisons of interventions: Two RCTs reported data directly comparing diet with either physical activity or diet combined with physical activity interventions for children aged 6 to 12 years and reported no differences.Heterogeneity was apparent in the results from all three age groups, which could not be entirely explained by setting or duration of the interventions. Where reported, interventions did not appear to result in adverse effects (16 RCTs) or increase health inequalities (gender: 30 RCTs; socioeconomic status: 18 RCTs), although relatively few studies examined these factors.Re-running the searches in January 2018 identified 315 records with potential relevance to this review, which will be synthesised in the next update.

AUTHORS' CONCLUSIONS

Interventions that include diet combined with physical activity interventions can reduce the risk of obesity (zBMI and BMI) in young children aged 0 to 5 years. There is weaker evidence from a single study that dietary interventions may be beneficial.However, interventions that focus only on physical activity do not appear to be effective in children of this age. In contrast, interventions that only focus on physical activity can reduce the risk of obesity (BMI) in children aged 6 to 12 years, and adolescents aged 13 to 18 years. In these age groups, there is no evidence that interventions that only focus on diet are effective, and some evidence that diet combined with physical activity interventions may be effective. Importantly, this updated review also suggests that interventions to prevent childhood obesity do not appear to result in adverse effects or health inequalities.The review will not be updated in its current form. To manage the growth in RCTs of child obesity prevention interventions, in future, this review will be split into three separate reviews based on child age.

Adiposity and adipocytokines: the moderator role of cardiorespiratory fitness and pubertal stage in girls

Background Cardiorespiratory fitness (CRF) and pubertal stages have been related to many health outcomes, including obesity and adipocytokines. Thus, the present study aimed to analyze the moderator role of CRF and pubertal stage in the relationship between adiposity and adipocytokines in girls. Method This cross-sectional study was performed with 42 pre-pubertal girls aged from 7 to 11 years and 54 post-pubertal girls aged from 13 to 17 years. Blood samples were collected to determine the serum levels of leptin and adiponectin, and then the leptin/adiponectin ratio (L/A ratio) was calculated. CRF, anthropometric and body composition indicators were assessed. For statistical analysis, descriptive statistics and several linear regression models were used. The moderation analysis was tested using the PROCESS macro. Results An interaction between body mass index (BMI) and CRF (β: -0.70; confidence interval [CI]: -1.29, -0.12), as well as between BMI and pubertal stage (β: 0.79; CI: 0.28, 1.30) with leptin, was found. Regarding the L/A ratio, an interaction was found only in BMI × CRF (β: -0.56; CI: -1.06, -0.06). Using a combined interaction (CRF and pubertal stage), the results showed a positive association between BMI with leptin and L/A ratio only in low CRF, pre-pubertal and post-pubertal stages. Conclusion This study suggests a protective role of high levels of CRF in the relationship between BMI and adipocytokines. Despite the effect of pubertal stage, the results suggest that youth should be engaged in physical activity in order to improve CRF levels and consequently improve cardiometabolic health.

Does Physical Activity-Based Intervention Improve Systemic Proinflammatory Cytokine Levels in Overweight or Obese Children and Adolescents? Insights from a Meta-Analysis of Randomized Control Trials

OBJECTIVES

The purpose of this research was to conduct a meta-analysis of the role that physical activity (PA) plays in influencing the critical proinflammatory cytokine levels associated with overweight/obese children and adolescents to explore the effectiveness of exercise intervention within this population.

METHODS

With searches of the PubMed, EMBASE, and CENTRAL databases, we updated our meta-analysis up to November 2018. The randomized controlled trials (RCT) evaluated the ability of exercise training to increase the following factors in children and/or adolescents classified as obese or overweight: tumor necrosis factor (TNF)-α, interleukin (IL)-6, and C-reactive protein (CRP).

RESULTS

Eleven RCT comprising 623 children and/or adolescents who were obese or overweight (i.e., 393 with PA and 230 controls) were suitable for use in this study. The meta-analysis showed that PA in general was associated with a significant reduction of CRP levels (mean difference = -0.45 mg/L, p = 0.02) in overweight/obese children and adolescents. Based on 115 overweight and obese youths, this study suggests that PA does not significantly mitigate IL-6 levels (mean difference = -0.39 pg/mL, p = 0.08), although there was a trend towards a reduction. Additionally, no close connection was observed between PA and TNF-α levels at 0.04 pg/mL (p = 0.78). Moreover, meta-regression analysis revealed a statistical association between CPR levels and changes in BMI or changes in adiponectin; likewise, IL-6 levels dramatically impacted the effect of exercise on changes in adiponectin.

CONCLUSIONS

PA was associated with significantly reduced CRP levels, whereas there was no significant association with IL-6 or TNF-α in overweight/obese children or adolescents; however, there was a trend towards a reduction of IL-6.

FTO rs9939609 Does Not Interact with Physical Exercise but Influences Basal Insulin Metabolism in Brazilian Overweight and Obese Adolescents

PURPOSE

The rs9939609 SNP (T > A) in FTO gene is associated with obesity and type 2 diabetes. The present study aimed at verifying whether this SNP influenced biochemical outcomes of children and adolescents who are overweight/obese submitted to a program of physical exercise and also if there was influence on basal levels of these biochemical variables.

METHODS

The sample was composed by 432 children and adolescents grouped in three ways (obese, overweight, and normal weight); of these, 135 children and adoloescents who are obese and overweight were submitted to a physical exercise program for 12 weeks. All were genotyped by TaqMan SNP genotyping assay.

RESULTS

The children and adolescents who are overweight/obese and carriers of AA genotype had higher levels of insulin (p=0.03) and HOMA (p=0.007) and lower levels of glucose (p=0.003), but the SNP did not modulate the response to physical exercise.

CONCLUSIONS

In our study, the rs9939609 AA genotype was associated with parameters related to insulin metabolism but did not interact with physical exercise.

FTO rs9939609 A allele influences anthropometric outcome in response to dietary intervention, but not in response to physical exercise program

PURPOSE

The fat mass and obesity-associated (FTO) gene is involved in energy homeostasis. The A allele of the rs9939609 (SNP; T>A) is associated with obesity and higher food intake, while its effect in energy expenditure remains unclear. The aim of this study is to examine whether FTO rs9939609 is associated with the anthropometric outcomes of a physical exercise program and a dietary intervention.

METHODS

We studied two independent samples. The first was composed by children and adolescents in which overweight and obese individuals were submitted to a physical exercise program (n = 136) and normal weight participants served as a control group (n = 172). The second sample was composed by obese women submitted to a hypocaloric dietary intervention (n = 126).

RESULTS

Physical exercise and dietary intervention were effective, independently of genotype. We found no association of FTO rs9939609 with obesity in children and adolescents (p = 0.67). The rs9939609 affected the response to dietary intervention in obese women: A allele carriers reduced 2.7 cm less of abdominal circumference (AC) than homozygous TT (p = 0.04), while no effect was observed in response to physical exercise in overweight and obese children and adolescents.

CONCLUSIONS

The A allele is associated with a worse outcome in response to the hypocaloric dietary intervention regarding abdominal circumference reduction; the same allele did not show interaction with any anthropometric outcomes in response to the exercise program applied.

Metabolomics Approach in the Investigation of Metabolic Changes in Obese Men after 24 Weeks of Combined Training

Obesity is associated with comorbidities related to metabolic disorders due to excess of adipose tissue. Physical exercise has a major role in the prevention of obesity. Combined training (CT), in particular, has been shown to improve markers of health. In this study, we used ¹H NMR-based metabolomics to investigate changes in the metabolism of obese men after 24 weeks of CT. Twenty-two obese (body mass index 31 ± 1.4 kg/m²), middle-aged men (48.2 ± 6.1 years) were randomly assigned to a control group (CG, n = 11) or CT group (n = 11). The CT was performed three times a week (resistance and aerobic training) for 24 weeks. Blood samples were collected before and after experimental period. There was an improvement in body composition and physical fitness indices after CT training. Multivariate PCA and PLS-DA models showed a distinct separation between groups. Twenty metabolites with importance for projection (VIP) >1.0 were identified, and four were classified as best discriminators (tyrosine, 2-oxoisocaproate, histidine, pyruvate). Some metabolites were correlated with strength, VO₂ peak, fat and lean body mass, waist circumference, and insulin. In conclusion, 24 weeks of CT was effective for functional improvements and metabolic changes in obese middle-aged men.

Adiponectin/TNF-α Ratio Following a Selected Aerobic Training in Sedentary Adult Obese Men

Background: Based on clinical studies, low adiponectin and high tumor necrosis factor alpha (TNF-α) are associated with obesity and related diseases such as type 2 diabetes and insulin resistance. Objectives: In this study, we aimed to investigate the effect of an aerobic training program on adiponectin, TNF-α, and adiponectin/TNF-α ratio in adult obese men. Patients and Methods: For this purpose, 24 sedentary adult obese men matched for age (38 ± 3.23 years) and body mass index (31.94 ± 3.26 kg/m2 ) were selected and divided into exercise (aerobic training) and control groups. Exercise subjects participated in an aerobic exercise training intervention for 12 weeks (3 times/week) and the control group did not participate in aerobic intervention. Anthropometric and biochemical data including fasting serum adiponectin, TNF-α, and adiponectin/TNF-α ratio were measured before and after aerobic training for each participant in each group. Data were analyzed by both independent and paired sample t test. Results: Compared to pre-training, fasting serum adiponectin decreased significantly (P = .019), but serum TNF-α was not changed by aerobic training (P = .057). A significant increase was observed in adiponectin/TNF-α ratio in exercise subjects after aerobic training (P = .008). Conclusions: Based on these data, we conclude that aerobic training intervention is associated with improved inflammatory profile in obese subjects.

Exercise, adipokines and pediatric obesity: a meta-analysis of randomized controlled trials

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.

Impact of endurance exercise training on adipocyte microRNA expression in overweight men

Adipocytes are major regulators of metabolism, and endurance exercise training improves adipocyte function; however, the molecular mechanisms that regulate chronic adaptive responses remain unresolved. microRNAs (miRNAs) influence adipocyte differentiation and metabolism. Accordingly, we aimed to determine whether adipocyte miRNA expression is responsive to exercise training and to identify exercise-responsive miRNAs that influence adipocyte metabolism. Next-generation sequencing was used to profile miRNA expression of adipocytes that were isolated from abdominal subcutaneous (ABD) and gluteofemoral (GF) adipose tissue of overweight men before and after 6 wk of endurance exercise training. Differentially expressed miRNAs were overexpressed or silenced in 3T3-L1 adipocytes, and lipid metabolism was examined. Next-generation sequencing identified 526 miRNAs in adipocytes, and there were no statistical differences in miRNA expression when comparing pre- and post-training samples for ABD and GF adipocytes. miR-10b expression was increased in ABD compared with GF adipocytes, whereas miR-204, miR-3613, and miR-4532 were more highly expressed in GF compared with ABD adipocytes. Blocking miR-10b in adipocytes suppressed β-adrenergic lipolysis but generally had a minor effect on lipid metabolism. Thus, unlike their critical role in adipogenesis, stable changes in miRNA expression do not play a prominent role in the regulation of adipocyte function in response to endurance exercise training.-Tsiloulis, T., Pike, J., Powell, D., Rossello, F. J., Canny, B. J., Meex, R. C. R., Watt, M. J. Impact of endurance exercise training on adipocyte microRNA expression in overweight men.

Inflammatory Mechanisms Associated with Skeletal Muscle Sequelae after Stroke: Role of Physical Exercise

Inflammatory markers are increased systematically and locally (e.g., skeletal muscle) in stroke patients. Besides being associated with cardiovascular risk factors, proinflammatory cytokines seem to play a key role in muscle atrophy by regulating the pathways involved in this condition. As such, they may cause severe decrease in muscle strength and power, as well as impairment in cardiorespiratory fitness. On the other hand, physical exercise (PE) has been widely suggested as a powerful tool for treating stroke patients, since PE is able to regenerate, even if partially, physical and cognitive functions. However, the mechanisms underlying the beneficial effects of physical exercise in poststroke patients remain poorly understood. Thus, in this study we analyze the candidate mechanisms associated with muscle atrophy in stroke patients, as well as the modulatory effect of inflammation in this condition. Later, we suggest the two strongest anti-inflammatory candidate mechanisms, myokines and the cholinergic anti-inflammatory pathway, which may be activated by physical exercise and may contribute to a decrease in proinflammatory markers of poststroke patients.