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Chen X, He H, Xie K, Zhang L, Cao C. Effects of various exercise types on visceral adipose tissue in individuals with overweight and obesity: A systematic review and network meta-analysis of 84 randomized controlled trials. Obes Rev 2024; 25:e13666. [PMID: 38031812 DOI: 10.1111/obr.13666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023]
Abstract
The purpose of this systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) was to investigate the effects of various exercise categories on visceral adipose tissue (VAT) and other anthropometric variables in individuals with overweight and obesity. A total of 84 RCTs (4836 patients) were included. Aerobic exercise (AE) of at least moderate intensity, resistance training (RT), AE combined with RT (AE + RT), and high-intensity interval training (HIIT) were beneficial for reducing VAT. A subgroup analysis showed that RT improves VAT in males and those with BF% < 40% but not in females and those with body fat percentage (BF%) ≥ 40%. AE, RT, AE + RT, and HIIT significantly improved weight (except RT), total body fat (TBF), body mass index (BMI), waist circumference (WC), and subcutaneous adipose tissue (SAT). Surface under the cumulative ranking curve (SUCRA) probability ranking showed that AE with vigorous intensity and HIIT have the highest probability of being the best exercise intervention for improving VAT, weight, TBF, BMI, WC, and SAT. These findings suggest that regular exercise can improve VAT in individuals with overweight and obesity. AE of vigorous intensity and HIIT may be the best exercise treatment, and RT is the least effective intervention.
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Affiliation(s)
- Xiaoke Chen
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Hui He
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Kejia Xie
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Lingtao Zhang
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Chunmei Cao
- Department of Physical Education, Tsinghua University, Beijing, China
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Huang Z, Li J, Liu Y, Zhou Y. Effects of different exercise modalities and intensities on body composition in overweight and obese children and adolescents: a systematic review and network meta-analysis. Front Physiol 2023; 14:1193223. [PMID: 37497435 PMCID: PMC10366610 DOI: 10.3389/fphys.2023.1193223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction: Childhood and adolescent overweight and obesity are global public health issues. Previous studies on exercise and overweight and obese children have produced inconsistent findings and lacked comparisons between different exercise modalities and intensities. Therefore, a network meta-analysis is necessary to provide evidence-based intervention programs. This study aims to identify the effects of different exercise modalities and intensities on changes in body composition in overweight and obese children and adolescents. Methods: A search for randomized controlled trials was conducted on Web of Science, PubMed, Scopus, and Embase involving exercise interventions aimed at improving body composition (body fat percentage, BMI, fat mass, fat-free mass, body weight) in overweight and obese children and adolescents. A random effects network meta-analysis was performed using STATA 14.0 software within a frequentist framework. The literature quality was assessed using the Cochrane Risk of Bias Tool 2.0. Results: Thirty-two papers involving 1,452 participants were included. There were six types of intervention involved in the study, including moderate intensity aerobic exercise, high-intensity aerobic exercise, moderate intensity resistance exercise, high-intensity resistance exercise, moderate intensity combined exercise, and high-intensity combined exercise. The network meta-analysis results revealed that high-intensity combined exercise was the best exercise mode for improving BMI [mean difference in kg/m2 = -1.65, 95% CI (-3.27, -0.02)] and reducing fat mass [mean difference in kg = -2.87, 95% CI (-4.84, -0.91)]. Moderate intensity combined exercise was the best mode for weight loss [mean difference in kg = -4.58, 95% CI (-5.94, -3.22)] and improvement in body fat percentage [mean difference in% = -2.52, 95% CI (-3.83, -1.20)]. High-intensity resistance exercise had the optimal effect in increasing fat-free mass [mean difference in kg = 1.10, 95% CI (0.22, 1.99)]. Conclusion: In conclusion, the study found that combined exercise, whether moderate or high intensity, was more effective than any other exercise modality in improving body fat percentage and BMI, reducing fat mass and weight. Resistance exercise was the most effective in increasing fat-free mass.
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Mast A, Peña A, Bolch CA, Shaibi G, Vander Wyst KB. Sex differences in response to lifestyle intervention among children and adolescents: Systematic review and meta-analysis. Obesity (Silver Spring) 2023; 31:665-692. [PMID: 36762579 PMCID: PMC10352023 DOI: 10.1002/oby.23663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Little is known about sex differences in response to lifestyle interventions among pediatric populations. The purpose of this analysis was to evaluate sex differences in adiposity following lifestyle interventions among children and adolescents with overweight or obesity aged 6 to 18 years old. METHODS Searches were conducted in PubMed, Web of Science, and MEDLINE (from inception to March 2021), and references from included articles were examined. Eligibility criteria included children and adolescents aged 6 to 18 years with overweight or obesity, randomization to a lifestyle intervention versus a control group, and assessment of at least one adiposity measure. Corresponding authors were contacted to obtain summary statistics by sex (n = 14/49). RESULTS Of 89 full-text articles reviewed, 49 (55%) were included, of which 33 (67%) reported statistically significant intervention effects on adiposity. Only two studies (4%) evaluated sex differences in response to lifestyle intervention, reporting conflicting results. The results of the meta-regression models demonstrated no significant differences in the treatment effect between male and female youth for weight (beta = -0.05, SE = 0.18, z = -0.28, p = 0.8), BMI (beta = 0.03, SE = 0.14, z = 0.19, p = 0.85), BMI z score (beta = -0.04, SE = 0.18, z = -0.23, p = 0.82), percentage body fat (beta = -0.11, SE = 0.16, z = -0.67, p = 0.51), and waist circumference (beta = -0.30, SE = 0.25, z = -1.18, p = 0.24). CONCLUSIONS The meta-analysis revealed that youth with overweight or obesity do not demonstrate a differential response to lifestyle intervention in relation to adiposity-related outcomes.
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Affiliation(s)
- Alexis Mast
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ
| | - Armando Peña
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Charlotte A. Bolch
- Office of Research and Sponsored Programs, Midwestern University, Glendale, AZ
| | - Gabriel Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
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Wilson A, MacLean SBM. Fatty infiltration in the intact supraspinatus tendon; a normal physiological response with increasing age and female gender. Shoulder Elbow 2022; 14:510-514. [PMID: 36199502 PMCID: PMC9527490 DOI: 10.1177/17585732211024504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 01/17/2023]
Abstract
Background Fatty infiltration and muscle atrophy of supraspinatus are used as markers of chronicity in rotator cuff tears and are known to both be independently related to poorer outcomes following surgical repair.1 We hypothesized that supraspinatus muscle atrophy and fatty infiltration increases with age irrespective of whether the rotator cuff is intact and therefore cannot be used as accurate markers for chronicity. Method Retrospective review of 280 patients who underwent 3.0 T shoulder MRI's with either a normal scan or rotator cuff tear. Two independent observers reviewed the images. Data collected included intact rotator cuff tendons looking specifically at supraspinatus muscle height/length: suprascapular fossa ratio, tangent sign and Goutallier grade for fatty infiltration. Results There were 90 scans with intact rotator cuff tendons. Mean age was 51 years (range 17-86); 52 males, 38 females. On multiple regression analysis, there was a positive correlation of age with fatty infiltration and muscle atrophy on all parameters in the normal intact cuff. Females were significantly more likely than males to have a higher grade of fatty infiltration. Conclusion Age and female gender are risk factors for rotator cuff atrophy and fatty infiltration in patients with normal rotator cuffs. Therefore, these parameters should be used with caution by surgeons when deciding on tear chronicity and the potential to repair the torn rotator cuff.
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Affiliation(s)
- Ailsa Wilson
- Department of Orthopaedic Surgery, Bay of Plenty District Health Board, Tauranga, New Zealand
| | - Simon BM MacLean
- Department of Orthopaedic Surgery, Bay of Plenty District Health Board, Tauranga, New Zealand
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Yu F, Fan Y, Sun H, Li T, Dong Y, Pan S. Intermuscular adipose tissue in Type 2 diabetes mellitus: Non-invasive quantitative imaging and clinical implications. Diabetes Res Clin Pract 2022; 187:109881. [PMID: 35483545 DOI: 10.1016/j.diabres.2022.109881] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 12/25/2022]
Abstract
Intermuscular adipose tissue (IMAT) is an ectopic fat depot found beneath the fascia and within the muscles. IMAT modulates muscle insulin sensitivity and triggers local and systemic chronic low-grade inflammation by producing cytokines and chemokines, which underlie the pathogenesis of Type 2 diabetes mellitus (T2DM). Imaging techniques have been increasingly used to non-invasively quantify IMAT in patients with diabetes in research and healthcare settings. In this study, we systematically reviewed the cell of origin and definition of IMAT, and the use of quantitative and functional imaging technology pertinent to the etiology, risk factors, lifestyle modification, and therapeutic treatment of diabetes. The purpose of this article is to provide important insight into the current understanding of IMAT and future prospects of targeting IMAT for T2DM control.
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Affiliation(s)
- Fuyao Yu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yiping Fan
- Department of Nuclear Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - He Sun
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tianming Li
- Department of Gastroenterology and Medical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanbin Dong
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
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Truong K, Park S, Tsiros MD, Milne N. Physiotherapy and related management for childhood obesity: A systematic scoping review. PLoS One 2021; 16:e0252572. [PMID: 34125850 PMCID: PMC8202913 DOI: 10.1371/journal.pone.0252572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 05/18/2021] [Indexed: 11/19/2022] Open
Abstract
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.
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Affiliation(s)
- Kim Truong
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Sandra Park
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Margarita D. Tsiros
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Nikki Milne
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
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Vander Wyst KB, Olson ML, Keller CS, Soltero EG, Williams AN, Peña A, Ayers SL, Jager J, Shaibi GQ. Sex as a moderator of body composition following a randomized controlled lifestyle intervention among Latino youth with obesity. Pediatr Obes 2020; 15:e12620. [PMID: 32072749 PMCID: PMC9275591 DOI: 10.1111/ijpo.12620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/05/2020] [Accepted: 01/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Body composition differences between males and females emerge during adolescence and continue throughout adulthood; however, whether sex moderates body composition changes in adolescents with obesity after an intervention is unknown. OBJECTIVE To examine sex as a moderator of changes in adiposity following lifestyle intervention. METHODS A total of 136 Latino youth with obesity (BMI% 98.2 ± 1.3) aged 14 to 16 years old were randomized to either a 12-week lifestyle intervention (27 males/40 females) or control (35 males/34 females) group. The intervention included nutrition education (1 h/wk) and moderate-to-vigorous physical activity (3 h/wk). Anthropometric data (body mass index [BMI], BMI%, waist circumference, total body fat, and fat-free mass) were obtained pre- and post-intervention. Sex differences were examined by general linear models with significance determined at P < .05 for the F-statistic. RESULTS Sex did not moderate changes in BMI (F1,115 = 0.01, P = .9), BMI% (F1,115 = 0.14, P = .7), or waist circumference (F1,117 = 1.1, P = .3). Sex significantly moderated changes in body fat percent (F1,117 = 5.3, P = .02), fat mass (F1,116 = 4.5, P = .04), and fat-free mass (F1,116 = 4.3, P = .04). Intervention males compared with females had greater relative reductions in fat percent (-4.1 ± 0.8% vs -1.2 ± 0.7%, P = .02) and fat mass (-5.0 ± 1.1 kg vs -1.5 ± 0.9 kg, P = .02) and gained more fat free mass (3.6 ± 0.9 kg vs 0.5 ± 0.8 kg, P = .02) when compared with same sex controls. CONCLUSION Males and females exhibited a differential response to lifestyle intervention for percent fat, fat mass, and fat-free mass indicating that sex-specific improvements in body composition favours males over females.
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Affiliation(s)
- Kiley B. Vander Wyst
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Micah L. Olson
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children’s Hospital, Phoenix, Arizona
| | - Colleen S. Keller
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Erica G. Soltero
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Allison N. Williams
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Armando Peña
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Stephanie L. Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Phoenix, Arizona
| | - Gabriel Q. Shaibi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children’s Hospital, Phoenix, Arizona
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona
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