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AL-Mhanna SB, Batrakoulis A, Wan Ghazali WS, Mohamed M, Aldayel A, Alhussain MH, Afolabi HA, Wada Y, Gülü M, Elkholi S, Abubakar BD, Rojas-Valverde D. 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. PeerJ 2024; 12:e17525. [PMID: 38887616 PMCID: PMC11182026 DOI: 10.7717/peerj.17525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/16/2024] [Indexed: 06/20/2024] Open
Abstract
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.
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Affiliation(s)
- Sameer Badri AL-Mhanna
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Abdulaziz Aldayel
- Exercise Physiology Department, King Saud University, Riyadh, Saudi Arabia
| | - Maha H. Alhussain
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, Riyadh, Saudi Arabia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Yusuf Wada
- Department of Zoology, Ahmadu Bello University, Zaria, Nigeria
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Turkey
| | - Safaa Elkholi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida Universidad Nacional de Costa Rica, Heredia, Costa Rica
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Ramos-Campo DJ, Rojo-Tirado MÁ, Benito-Peinado PJ. Investigating the Impact of Exercise Type Combined with Caloric Restriction on Quality of Life - The PRONAF Study. Physiol Behav 2024:114614. [PMID: 38866299 DOI: 10.1016/j.physbeh.2024.114614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/29/2024] [Accepted: 06/10/2024] [Indexed: 06/14/2024]
Abstract
The aim of this study was to analyse the impact of endurance training (E), strength training (S), or combined training (SE), along with caloric restriction diet, compared to only diet and physical activity recommendations (C, control), on the quality of life in individuals with obesity. One hundred and twenty obese participants (61 males), aged 18-50 years, were randomly assigned to the different experimental groups, with ninety-six completing the study. The intervention period spanned 22 weeks (3 times per week). All subjects followed a hypocaloric diet, and quality of life was assessed using the SF36 questionnaire before and after the training program. A significant improvement was observed in emotional role following the S (Baseline: 85.06 ± 30.32; Post: 96.00 ± 11.06; p=0.030) and SE (Baseline: 76.67 ± 35.18; Post: 91.30 ± 22.96; p=0.010) programs, but not after E (Baseline: 83.33 ± 29.40; Post: 78.26 ± 35.69; p=0.318) and C (Baseline: 77.01 ± 34.62; Post: 79.37 ± 37.23; p=0.516). No significant main effect was observed in any other outcome measured. Overall, all groups demonstrated improvements in quality-of-life outcomes. In conclusion, any physical exercise intervention combined with caloric restriction, physical activity recommendations, and nutritional habits resulted in an enhancement of quality of life.
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Affiliation(s)
- Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid..
| | - Miguel Ángel Rojo-Tirado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid
| | - Pedro J Benito-Peinado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid
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Giannakogeorgou A, Roden M. Role of lifestyle and glucagon-like peptide-1 receptor agonists for weight loss in obesity, type 2 diabetes and steatotic liver diseases. Aliment Pharmacol Ther 2024; 59 Suppl 1:S52-S75. [PMID: 38813830 DOI: 10.1111/apt.17848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/08/2023] [Accepted: 12/15/2023] [Indexed: 05/31/2024]
Abstract
BACKGROUND The current obesity pandemic has given rise to associated comorbidities and complications, including type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD). During the last decade, certain glucagon-like peptide 1 receptor agonists (GLP-1RA), originally developed as antihyperglycemic drugs, also demonstrated efficacy for weight loss. AIMS To review shared pathophysiologic features of common metabolic diseases and compare therapeutic strategies to reduce body weight and related complications. METHODS We performed an extensive literature research to describe the effects of lifestyle modification, first-generation anti-obesity drugs, and GLP-1RA on weight loss in humans with obesity, type 2 diabetes and MASLD. RESULTS Until recently, treatment of obesity has been limited to lifestyle modification, which offer moderate degree and sustainability of weight loss. The few approved first-generation anti-obesity drugs are either limited to short term use or to certain forms of obesity. Some GLP-1RA significantly decrease caloric intake and body weight. Liraglutide and semaglutide have therefore been approved for treating people with obesity. They also lead to a reduction of hepatic fat content and inflammation in people with biopsy-confirmed MASLD. Possible limitations comprise adverse effects, treatment adherence and persistence. CONCLUSION Certain GLP-1RA are superior to lifestyle modification and first-generation anti-obesity drugs in inducing weight loss. They have therefore markedly changed the portfolio of obesity treatment with additional beneficial effects on steatotic liver disease.
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Affiliation(s)
- Anna Giannakogeorgou
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, Neuherberg, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany
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Bermingham KM, Linenberg I, Polidori L, Asnicar F, Arrè A, Wolf J, Badri F, Bernard H, Capdevila J, Bulsiewicz WJ, Gardner CD, Ordovas JM, Davies R, Hadjigeorgiou G, Hall WL, Delahanty LM, Valdes AM, Segata N, Spector TD, Berry SE. Effects of a personalized nutrition program on cardiometabolic health: a randomized controlled trial. Nat Med 2024:10.1038/s41591-024-02951-6. [PMID: 38714898 DOI: 10.1038/s41591-024-02951-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/26/2024] [Indexed: 05/15/2024]
Abstract
Large variability exists in people's responses to foods. However, the efficacy of personalized dietary advice for health remains understudied. We compared a personalized dietary program (PDP) versus general advice (control) on cardiometabolic health using a randomized clinical trial. The PDP used food characteristics, individual postprandial glucose and triglyceride (TG) responses to foods, microbiomes and health history, to produce personalized food scores in an 18-week app-based program. The control group received standard care dietary advice (US Department of Agriculture Guidelines for Americans, 2020-2025) using online resources, check-ins, video lessons and a leaflet. Primary outcomes were serum low-density lipoprotein cholesterol and TG concentrations at baseline and at 18 weeks. Participants (n = 347), aged 41-70 years and generally representative of the average US population, were randomized to the PDP (n = 177) or control (n = 170). Intention-to-treat analysis (n = 347) between groups showed significant reduction in TGs (mean difference = -0.13 mmol l-1; log-transformed 95% confidence interval = -0.07 to -0.01, P = 0.016). Changes in low-density lipoprotein cholesterol were not significant. There were improvements in secondary outcomes, including body weight, waist circumference, HbA1c, diet quality and microbiome (beta-diversity) (P < 0.05), particularly in highly adherent PDP participants. However, blood pressure, insulin, glucose, C-peptide, apolipoprotein A1 and B, and postprandial TGs did not differ between groups. No serious intervention-related adverse events were reported. Following a personalized diet led to some improvements in cardiometabolic health compared to standard dietary advice. ClinicalTrials.gov registration: NCT05273268 .
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Affiliation(s)
- Kate M Bermingham
- Department of Nutritional Sciences, King's College London, London, UK
- Zoe Ltd, London, UK
| | - Inbar Linenberg
- Department of Nutritional Sciences, King's College London, London, UK
- Zoe Ltd, London, UK
| | | | - Francesco Asnicar
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | | | | | | | | | | | | | | | - Jose M Ordovas
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
- IMDEA Food Institute, Campus of International Excellence, Universidad Autónoma de Madrid, Consejo Superior de Investigaciones Científicas, Madrid, Spain
- Universidad Camilo José Cela, Madrid, Spain
| | | | | | - Wendy L Hall
- Department of Nutritional Sciences, King's College London, London, UK
| | - Linda M Delahanty
- Diabetes Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ana M Valdes
- School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham National Institute for Health and Care Research Biomedical Research Centre, Nottingham, UK
| | - Nicola Segata
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Tim D Spector
- Department of Nutritional Sciences, King's College London, London, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Sarah E Berry
- Department of Nutritional Sciences, King's College London, London, UK.
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Cuccurullo SJ, Fleming TK, Petrosyan H, Hanley DF, Raghavan P. Mechanisms and benefits of cardiac rehabilitation in individuals with stroke: emerging role of its impact on improving cardiovascular and neurovascular health. Front Cardiovasc Med 2024; 11:1376616. [PMID: 38756753 PMCID: PMC11096558 DOI: 10.3389/fcvm.2024.1376616] [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: 01/25/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Human and animal studies have demonstrated the mechanisms and benefits of aerobic exercise for both cardiovascular and neurovascular health. Aerobic exercise induces neuroplasticity and neurophysiologic reorganization of brain networks, improves cerebral blood flow, and increases whole-body VO2peak (peak oxygen consumption). The effectiveness of a structured cardiac rehabilitation (CR) program is well established and a vital part of the continuum of care for people with cardiovascular disease. Individuals post stroke exhibit decreased cardiovascular capacity which impacts their neurologic recovery and extends disability. Stroke survivors share the same risk factors as patients with cardiac disease and can therefore benefit significantly from a comprehensive CR program in addition to neurorehabilitation to address their cardiovascular health. The inclusion of individuals with stroke into a CR program, with appropriate adaptations, can significantly improve their cardiovascular health, promote functional recovery, and reduce future cardiovascular and cerebrovascular events thereby reducing the economic burden of stroke.
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Affiliation(s)
- Sara J. Cuccurullo
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute at Hackensack Meridian Health, Edison, NJ, United States
| | - Talya K. Fleming
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute at Hackensack Meridian Health, Edison, NJ, United States
| | - Hayk Petrosyan
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute at Hackensack Meridian Health, Edison, NJ, United States
| | - Daniel F. Hanley
- Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Preeti Raghavan
- Department of Physical Medicine and Rehabilitation and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Bagherzadeh-Rahmani B, Marzetti E, Karami E, Campbell BI, Fakourian A, Haghighi AH, Mousavi SH, Heinrich KM, Brazzi L, Jung F, Baker JS, Patel DI. Tirzepatide and exercise training in obesity. Clin Hemorheol Microcirc 2024:CH242134. [PMID: 38640145 DOI: 10.3233/ch-242134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
OBJECTIVES The purpose of this study was to investigate the effects of 6 weeks of resistance training (RT) combined with aerobic training (AT) and Tirzepatide supplementation on lipid profiles, insulin resistance, anthropometric characteristics and physical fitness in prediabetic obese soldiers. METHODS 61 obese men were randomly divided into six groups: Placebo; Tirzepatide 5 mg (T5); Tirzepatide 2.5 mg (T2.5); Hypertrophy, Strength, Power-Circuit Training+Placebo (Ex+P); Hypertrophy, Strength, Power-Circuit Training+Tirzepatide 5 mg (Ex+T5); Hypertrophy, Strength, Power-Circuit Training+Tirzepatide 2.5 mg (Ex+T2.5). All training groups performed aerobic training (AT) after resistance training. Subjects trained for six weeks, three sessions per week. Before and after the intervention period, the participants were evaluated for anthropometric measures, body composition [body weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and fat mass (FM)], cardiorespiratory fitness (VO2max), and muscle strength (chest press 1RM and leg press 1RM). Blood biochemistry evaluations included triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), insulin level and insulin resistance (HOMA-IR). To evaluate the differences between the groups, ANCOVA statistical method was used along with Bonferroni's post hoc test, and the significance level was P < 0.05. RESULTS Body weight, BMI, WC, FM, FBG, LDL-C, TC, TG and HOMA-IR were significantly decreased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo, T5 and T2.5 groups. WHR significantly decreased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo group. HDL-C, chest press and leg press significantly increased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo, T5 and T2.5 groups. VO2max significantly increased and insulin significantly decreased in Ex+P group compared to Placebo, T5 and T2.5 groups. FM, FBG and TG were significantly decreased in both the T2.5 and T5 groups compared to Placebo group. HOMA-IR, LDL-C and TC significantly decreased in the T5 group compared to Placebo group. Also, leg press significantly increased in Ex+P group compared to all other groups. CONCLUSIONS Performing six weeks of combined resistance and aerobic training in the form of RT+AT alone is more effective than the simultaneous use of Tirzepatide on cardiorespiratory fitness, strength, and modulating insulin levels. Taking Tirzepatide in doses of 5 mg and 2.5 mg in combination with exercise training did not have a significant advantage over exercise training alone. Finally, taking Tirzepatide in doses of 5 mg or 2.5 mg in combination with exercise training is not significantly superior to each other.
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Affiliation(s)
- Behnam Bagherzadeh-Rahmani
- Department of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, UniversitÀ Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Esmail Karami
- Department of Physiology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Bill I Campbell
- University of South Florida, Performance & Physique Enhancement Laboratory, Tampa, FL, USA
| | - Ali Fakourian
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Amir Hossein Haghighi
- Department of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Seyyed Hossein Mousavi
- Department of Cardiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Katie M Heinrich
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
| | - Luca Brazzi
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Friedrich Jung
- Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Julien S Baker
- Department of Sport, Physical Education and Health; Hong Kong Baptist University, Kowloon, Hong Kong
| | - Darpan I Patel
- School of Nursing, University of Texas Medical Branch, Galveston, TX, USA
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Davis ME, Blake C, O’Donoghue G. Comparison of time-matched aerobic, resistance or combined exercise training in women living with obesity: The EXOFFIT study. Obes Sci Pract 2024; 10:e749. [PMID: 38567266 PMCID: PMC10986633 DOI: 10.1002/osp4.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/01/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
Background Improvements in cardiorespiratory fitness (CRF) have been shown to largely attenuate the negative health risks associated with obesity. To date, literature on women with obesity has focused upon the evaluation of aerobic-based exercise interventions. Hence, there is a need to evaluate resistance and combined interventions with this cohort. Objective This study aimed to evaluate the feasibility and efficacy of three exercise modalities in women with obesity for improving CRF, strength, body composition and other health outcomes. Methods Sixty-seven women with obesity were randomly assigned to the control (CON) or one of three exercise groups (aerobic [AE], resistance [RE], COM). Exercise groups were trained x3 times/week for 12 weeks (up to 150-min/week). Feasibility outcomes included adherence, attendance, recruitment and retention rates and adverse events. Secondary outcomes were CRF (predicted VO2 max), body composition (body weight [BW], waist circumference [WC], body fat percentage [%BF], fat mass [FM] and lean mass) and strength (5RM bench press, leg dynamometry, grip strength) and self-reported measures of physical activity, mood, sleep, pain and quality of life. Results Findings support the feasibility of all three exercise modalities in terms of adherence, attendance, and retention. Interventions with a resistance component (COM and RE) were associated with the greatest improvements across the broad range of health outcomes measured. Combined was the most promising for body composition outcomes including body mass index (Effect size [ES] = 0.79, p = 0.04), BW (ES = 0.75, p = 0.05), %BF (ES = 0.77, p = 0.04), FM (ES = 0.83, p = 0.03) and WC (ES = 0.90, p = 0.02), physical activity (i.e., moderate physical activity [ES = 0.69, p = 0.07), mood (ES = 0.83, p = 0.03) and sleep (ES = 0.78, p = 0.04). Resistance was most promising for CRF (ES = 1.47, p = 0.002), strength (i.e., bench press [ES = 2.88, p=<0.001]) and pain (i.e., pain severity [ES = 0.40, p = 0.31]). Conclusions For health outcomes, these results indicate the importance of including a resistance component when prescribing exercise for women with obesity to achieve meaningful improvements. CLINICAL TRIAL REGISTRATION ISRCTN13517067.
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Affiliation(s)
- Mary E. Davis
- School of Public Health, Physiotherapy and Sports ScienceHealth Sciences BuildingUniversity College DublinDublinIreland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports ScienceHealth Sciences BuildingUniversity College DublinDublinIreland
| | - Gráinne O’Donoghue
- School of Public Health, Physiotherapy and Sports ScienceHealth Sciences BuildingUniversity College DublinDublinIreland
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Komnenov D, Al-Hadidi M, Ali H, Al-Jamal M, Salami K, Shelbaya S, Tayeb K, Domin D, Elhamzawy R. Dietary Fructose and Sodium Consumed during Early Mid-Life Are Associated with Hypertensive End-Organ Damage by Late Mid-Life in the CARDIA Cohort. Nutrients 2024; 16:913. [PMID: 38612947 PMCID: PMC11013729 DOI: 10.3390/nu16070913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
We aimed to investigate how dietary fructose and sodium impact blood pressure and risk of hypertensive target organ damage 10 years later. Data from n = 3116 individuals were obtained from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Four groups were identified based on the four possible combinations of the lower and upper 50th percentile for sodium (in mg) and fructose (expressed as percent of total daily calories). Differences among groups were ascertained and logistic regression analyses were used to assess the risk of hypertensive target organ damage (diastolic dysfunction, coronary calcification and albuminuria). Individuals in the low-fructose + low-sodium group were found to have lower SBP compared to those in the low-fructose + high-sodium and high-fructose + high-sodium groups (p < 0.05). The highest risk for hypertensive target organ damage was found for albuminuria only in the high-fructose + high-sodium group (OR = 3.328, p = 0.006) while female sex was protective across all groups against coronary calcification. Our findings highlight that sodium alone may not be the culprit for hypertension and hypertensive target organ damage, but rather when combined with an increased intake of dietary fructose, especially in middle-aged individuals.
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Affiliation(s)
- Dragana Komnenov
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
- John D. Dingell VA Medical Center, Detroit, MI 48201, USA
| | - Mohammad Al-Hadidi
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
| | - Hamza Ali
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
| | - Malik Al-Jamal
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
| | - Kassim Salami
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
| | - Samy Shelbaya
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
| | - Kareem Tayeb
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
| | - Daniel Domin
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
| | - Rana Elhamzawy
- Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA; (M.A.-H.); (H.A.); (M.A.-J.); (K.S.); (K.T.); (R.E.)
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Nunes PRP, Castro-E-Souza P, de Oliveira AA, Camilo BDF, Cristina-Souza G, Vieira-Souza LM, Carneiro MADS. Effect of resistance training volume on body adiposity, metabolic risk, and inflammation in postmenopausal and older females: Systematic review and meta-analysis of randomized controlled trials. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:145-159. [PMID: 37788790 PMCID: PMC10980902 DOI: 10.1016/j.jshs.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/25/2023] [Accepted: 08/14/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE This meta-analytical study aimed to explore the effects of resistance training (RT) volume on body adiposity, metabolic risk, and inflammation in postmenopausal and older females. METHODS A systematic search was performed for randomized controlled trials in PubMed, Scopus, Web of Science, and SciELO. Randomized controlled trials with postmenopausal and older females that compared RT effects on body adiposity, metabolic risk, and inflammation with a control group (CG) were included. Independent reviewers selected the studies, extracted the data, and performed the risk of bias and certainty of the evidence (Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)) evaluations. Total body and abdominal adiposity, blood lipids, glucose, and C-reactive protein were included for meta-analysis. A random-effects model, standardized mean difference (Hedges' g), and 95% confidence interval (95%CI) were used for meta-analysis. RESULTS Twenty randomized controlled trials (overall risk of bias: some concerns; GRADE: low to very low) with overweight/obese postmenopausal and older females were included. RT groups were divided into low-volume RT (LVRT, ∼44 sets/week) and high-volume RT (HVRT, ∼77 sets/week). Both RT groups presented improved body adiposity, metabolic risk, and inflammation when compared to CG. However, HVRT demonstrated higher effect sizes than LVRT for glucose (HVRT = -1.19; 95%CI: -1.63 to -0.74; LVRT = -0.78; 95%CI:-1.15 to -0.41) and C-reactive protein (HVRT = -1.00; 95%CI: -1.32 to -0.67; LVRT = -0.34; 95%CI, -0.63 to -0.04)) when compared to CG. CONCLUSION Compared to CG, HVRT protocols elicit greater improvements in metabolic risk and inflammation outcomes than LVRT in overweight/obese postmenopausal and older females.
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Affiliation(s)
- Paulo Ricardo Prado Nunes
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; University Center of Planalto de Araxá (UNIARAXA), 38180-129 Araxá, MG, Brazil; Physical Activity, Health and Ageing Research Group (GPASE), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil.
| | - Pâmela Castro-E-Souza
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University (UEL), 86050-070 Londrina, PR, Brazil
| | | | - Bruno de Freitas Camilo
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Physical Activity, Health and Ageing Research Group (GPASE), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil
| | - Gislaine Cristina-Souza
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil
| | - Lucio Marques Vieira-Souza
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Postgraduate Program in Physical Education, Federal University of Sergipe (UFS), 49107-230 São Cristóvão, SE, Brazil
| | - Marcelo Augusto da Silva Carneiro
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University (UEL), 86050-070 Londrina, PR, Brazil
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10
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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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11
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Zhang H, Guo Y, Hua G, Guo C, Gong S, Li M, Yang Y. Exercise training modalities in prediabetes: a systematic review and network meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1308959. [PMID: 38440785 PMCID: PMC10911289 DOI: 10.3389/fendo.2024.1308959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/19/2024] [Indexed: 03/06/2024] Open
Abstract
Background Lifestyle modification based on exercise intervention is still the primary way to delay or reverse the development of diabetes in patients with prediabetes. However, there are still challenges in setting up a detailed exercise prescription for people with prediabetes. This study mainly ranks exercise prescriptions by comparing the improvement of glucose and lipid metabolism and the level of weight loss in patients. Method All studies on exercise intervention in prediabetes were identified by searching five electronic databases. Risk assessment and meta-analysis were performed on eligible studies. Results Twenty-four studies involving 1946 patients with prediabetes and seven exercise intervention models were included in the final analysis. The meta-analysis showed that exercise of any type was more effective for glycemic control in prediabetes than no exercise. However, the changes in blood glucose were moderate. In prediabetes, combining moderate-intensity aerobic exercise with low-to moderate-load resistance training showed the most significant improvements in glycosylated hemoglobin (HbA1c), body mass index (BMI), body weight (BW), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) (P-score=0.82; 0.70; 0.87; 1; 0.99), low-to moderate-load resistance training showed the most significant improvements in fasting blood glucose (FBG) (P-score=0.98), the vigorous-intensity aerobic exercise showed the most significant improvements in 2-hour post-meal blood glucose (2hPG) and systolic blood pressure (SBP) (P-score=0.79; 0.78), and moderate-intensity aerobic exercise showed the most significant improvements in diastolic blood pressure (DBP) (P-score=0.78). Conclusion In summary, moderate-intensity aerobic exercise, low-to moderate-load resistance training and the combination of both have beneficial effects on glycemic control, weight loss, and cardiovascular health in patients with prediabetes. These findings provide valuable guidance for rehabilitation clinicians and patients alike to follow. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD 42021284922.
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Affiliation(s)
- Hang Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuting Guo
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guangshun Hua
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chenyang Guo
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Simiao Gong
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Min Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yan Yang
- Medical Department of The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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12
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Paez DC, Cortés-Corrales S, Jimenez-Mora MA, Gutiérrez A, Arango-Paternina CM, Duperly J. Health-related fitness in medical students: a curricular intervention in Bogota, Colombia. BMC Public Health 2024; 24:320. [PMID: 38287350 PMCID: PMC10826255 DOI: 10.1186/s12889-024-17748-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE To evaluate the impact of a curricular intervention to promote health-related fitness (HRF) among medical students in Bogota, Colombia. METHOD The study was conducted between May 2014 and December 2015 as part of the medical physiology course, in which 208 medical students were enrolled.The curricular intervention included two lectures on physical activity (PA) and student-led group presentations on the physiological effects of exercise on human physiology. An academic incentive (10% of final grade) was given to students who reported and documented regular PA practice during the semester. This study assessed students' HRF variables, perceptions of the curriculum intervention, and PA practices using quantitative and qualitative approaches. RESULTS 55% of the students were female, with a mean age of 19.5 years. Body fat, estimated maximum oxygen consumption (VO2max), handgrip, and sit-up strength showed statistically significant improvements at the end of the intervention. Students reported that PA practice was positively influenced by the curriculum intervention, particularly the academic incentive and the HRF tests. Students reported a wide variety of PA practices, which were mainly done with friends, classmates, or family members. Lack of time was the main reported barrier to PA practice. CONCLUSION The curricular intervention was effective in improving HRF and promoting PA. It remains to be investigated whether these gains are sustained over time.
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Affiliation(s)
- Diana C Paez
- School of Medicine, Universidad de los Andes, Bogotá, Colombia.
| | | | | | - Agustín Gutiérrez
- Department of Social Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Carlos M Arango-Paternina
- Instituto Universitario de Educación Física y Deportes, Universidad de Antioquia, Medellín, Colombia
| | - John Duperly
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
- Institute of Exercise Medicine and Rehabilitation, Fundación Santa Fe de Bogotá, Bogotá, Colombia
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13
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Guo D, Wu Z, Xue F, Chen S, Ran X, Zhang C, Yang J. Association between the triglyceride-glucose index and impaired cardiovascular fitness in non-diabetic young population. Cardiovasc Diabetol 2024; 23:39. [PMID: 38245734 PMCID: PMC10800072 DOI: 10.1186/s12933-023-02089-8] [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: 10/26/2023] [Accepted: 12/09/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index has been linked to the onset, progression, and prognosis of cardiovascular disease (CVD) in middle-aged and elderly individuals. Nevertheless, the relationship between the TyG index and impaired cardiovascular fitness (CVF) remains unexplored in non-diabetic young population. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES) study (1999-2004) to conduct a cross-sectional study of 3364 participants who completed an examination of CVF. Impaired CVF was defined as low and moderate CVF levels determined by estimated maximal oxygen consumption (Vo2max), based on sex- and age-specific criteria. The TyG index was calculated by [Formula: see text]. RESULTS The age (median with interquartile range) of the study population was 28 (19-37) years, and the TyG index (median ± standard deviation) was 8.36 ± 0.52. A significant association between the TyG index and impaired CVF was found in multivariable logistical regression analysis (per 1-unit increase in the TyG index: OR, 1.46; 95% Cl 1.13-1.90). A dose‒response relationship between the TyG index and impaired CVF was presented by restricted cubic splines (RCS). A significant interaction (p = 0.027) between sex and the TyG index for impaired CVF was found in the population aged < 20 years. CONCLUSIONS In non-diabetic young population, individuals with higher TyG index values are at an increased likelihood of encountering impaired CVF. Furthermore, sex may exert an impact on CVF, as males tend to be more susceptible to impaired CVF under comparable TyG index conditions.
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Affiliation(s)
- Dachuan Guo
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Zhenguo Wu
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Fei Xue
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Sha Chen
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Xiangzhen Ran
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Cheng Zhang
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China.
| | - Jianmin Yang
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China.
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14
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Wang H, Cheng R, Xie L, Hu F. Comparative efficacy of exercise training modes on systemic metabolic health in adults with overweight and obesity: a network meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne) 2024; 14:1294362. [PMID: 38288474 PMCID: PMC10823366 DOI: 10.3389/fendo.2023.1294362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024] Open
Abstract
Objective This network meta-analysis (NMA) was conducted to compare and rank the effects of training interventions including aerobic exercise (AE), resistance training (RT), combined aerobic and resistance training (CT), and high-intensity interval training (HIIT) on vital metabolic indicators in adults with overweight and obesity. Methods PubMed, Cochrane, Embase, and Web of Science were searched from 1990 to February 2023. Articles were included if they described randomized controlled trials (RCTs) examining the effects of exercise training on anthropometry parameters, lipid profiles, glucose metabolism, blood pressure, and cardiorespiratory fitness in adults with overweight and obesity. Weighted mean difference with 95% CI was calculated. Results A total of 28 studies with 1,620 patients were included. Results revealed that AE exerts best effects on weight loss (-2.35 [-4.05, -0.64]) and body mass index (-0.9 [-1.38, -0.42]), while HIIT is the most effective in reducing waist circumference (-5.93 [10.71, -1.15]), percentage body fat (-3.93 [-5.73, -2.12]), serum triglycerides (-20.55 [-37.20, -3.91]), and fasting blood glucose (-14.31 [-22.47, -6.16]) and improving VO2 max (7.41 [4.37, 10.45]). However, no significant benefit was observed in terms of total cholesterol and blood pressure. Conclusions AE is the optimal exercise type for reducing body weight and BMI, while HIIT exerts the most beneficial effects on improving body composition, cardiorespiratory fitness, and metabolic abnormalities in adults with overweight and obesity. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023444322, identifier CRD42023444322.
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Affiliation(s)
- Huiying Wang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ruitang Cheng
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lijun Xie
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Fang Hu
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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15
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Keating SE, Sabag A, Hallsworth K, Hickman IJ, Macdonald GA, Stine JG, George J, Johnson NA. Exercise in the Management of Metabolic-Associated Fatty Liver Disease (MAFLD) in Adults: A Position Statement from Exercise and Sport Science Australia. Sports Med 2023; 53:2347-2371. [PMID: 37695493 PMCID: PMC10687186 DOI: 10.1007/s40279-023-01918-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/12/2023]
Abstract
Metabolic-associated fatty liver disease (MAFLD) is the most prevalent chronic liver disease worldwide, affecting 25% of people globally and up to 80% of people with obesity. MAFLD is characterised by fat accumulation in the liver (hepatic steatosis) with varying degrees of inflammation and fibrosis. MAFLD is strongly linked with cardiometabolic disease and lifestyle-related cancers, in addition to heightened liver-related morbidity and mortality. This position statement examines evidence for exercise in the management of MAFLD and describes the role of the exercise professional in the context of the multi-disciplinary care team. The purpose of these guidelines is to equip the exercise professional with a broad understanding of the pathophysiological underpinnings of MAFLD, how it is diagnosed and managed in clinical practice, and to provide evidence- and consensus-based recommendations for exercise therapy in MAFLD management. The majority of research evidence indicates that 150-240 min per week of at least moderate-intensity aerobic exercise can reduce hepatic steatosis by ~ 2-4% (absolute reduction), but as little as 135 min/week has been shown to be effective. While emerging evidence shows that high-intensity interval training (HIIT) approaches may provide comparable benefit on hepatic steatosis, there does not appear to be an intensity-dependent benefit, as long as the recommended exercise volume is achieved. This dose of exercise is likely to also reduce central adiposity, increase cardiorespiratory fitness and improve cardiometabolic health, irrespective of weight loss. Resistance training should be considered in addition to, and not instead of, aerobic exercise targets. The information in this statement is relevant and appropriate for people living with the condition historically termed non-alcoholic fatty liver disease (NAFLD), regardless of terminology.
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Affiliation(s)
- Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Room 534, Bd 26B, St Lucia, Brisbane, QLD, 4067, Australia.
| | - Angelo Sabag
- Faculty of Medicine and Health, Discipline of Exercise and Sport Science, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
| | - Kate Hallsworth
- NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Liver Unit, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, PA-Southside Clinical Unit, The University of Queensland, Brisbane, QLD, Australia
| | - Graeme A Macdonald
- Faculty of Medicine, PA-Southside Clinical Unit, The University of Queensland, Brisbane, QLD, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Jonathan G Stine
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Public Health Sciences, The Pennsylvania State University- College of Medicine, Hershey, PA, USA
- Liver Center, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Cancer Institute, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jacob George
- Storr Liver Centre, The Westmead Institute for Medical Research and Westmead Hospital, University of Sydney, Sydney, NSW, Australia
| | - Nathan A Johnson
- Faculty of Medicine and Health, Discipline of Exercise and Sport Science, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
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16
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Castro EA, Silva E, Benito PJ, Neiva CM, Pessôa Filho DM. Effects of Training on Running Cost and Aerobic Capacity in Individuals with Obesity. Int J Sports Med 2023; 44:1075-1085. [PMID: 37827497 DOI: 10.1055/a-2156-7142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
This study investigated running cost (CRun), peak oxygen consumption (V̇ O2peak), and ventilatory threshold (VT1) responses to exercise programs for individuals with obesity. Ninety-four individuals (38.2±7.7 years; 33.4±2.9 kg/m²) were assigned into strength (n=24), endurance (n=26), combined (n=22), and physical activity (control, n=22) groups for 22 weeks, plus diet recommendation. The V̇ O2peak, VT1, and CRun were assessed through a maximal incremental step test. The change of V̇ O2peak in combined (9.9%) differed from the other groups, with lower values in women than men (0.7% vs. 6.2%). The VT1 change in combined (16.4%) differed from the strength (4.9%) and physical activity (1.2%) groups, with the change in endurance (12.7%) also being higher than the physical activity group. Only men in the combined group increased absolute V̇ O2peak, while both sexes increased VT1 in the endurance and combined groups. No effects for groups and sex were significant for CRun in moderate (VT1) running zones, despite CRun changes in VT1 zones correlated with the alterations of V̇ O2peak and VT1 (r²=0.29-0.59). Therefore, moderate aerobic exercise stimulus is suitable for VT1 improvement in individuals with obesity, with the increase in CRun associated to the chances of increasing V̇ O2peak in men and when combining strength with aerobic exercises.
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Affiliation(s)
- Eliane Aparecida Castro
- Department of Physical Education, Faculty of Science (FC), São Paulo State University (UNESP) at Bauru, Brazil
- LFE Research Group, Department of Health and Human Performance. Faculty of Physical Activity and Sport Science-INEF. Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Elisangela Silva
- Federal Institute of Education, Science and Technology of South of Minas Gerais - IFSULDEMINAS at Muzambinho, Brazil
| | - Pedro J Benito
- LFE Research Group, Department of Health and Human Performance. Faculty of Physical Activity and Sport Science-INEF. Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Cassiano Merussi Neiva
- Department of Physical Education, Faculty of Science (FC), São Paulo State University (UNESP) at Bauru, Brazil
- Graduate Program in Human Developmental and Technologies, Biosciences Institute (IB), São Paulo State University (UNESP) at Rio Claro, Brazil
- College of Medicine, Ribeirão Preto University, Ribeirão Preto, Brazil
| | - Dalton Müller Pessôa Filho
- Department of Physical Education, Faculty of Science (FC), São Paulo State University (UNESP) at Bauru, Brazil
- Graduate Program in Human Developmental and Technologies, Biosciences Institute (IB), São Paulo State University (UNESP) at Rio Claro, Brazil
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17
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Schultes B, Ernst B, Hallschmid M, Bueter M, Meyhöfer SM. The 'Behavioral Balance Model': A new perspective on the aetiology and therapy of obesity. Diabetes Obes Metab 2023; 25:3444-3452. [PMID: 37694802 DOI: 10.1111/dom.15271] [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: 05/22/2023] [Revised: 08/13/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
Obesity is a debilitating disease of global proportions that necessitates refined, concept-driven therapeutic approaches. Policy makers, the public and even health care professionals, but also individuals with obesity harbour many misconceptions regarding this disease, which leads to prejudice, negative attitudes, stigmatization, discrimination, self-blame, and failure to provide and finance adequate medical care. Decades of intensive, successful scientific research on obesity have only had a very limited effect on this predicament. We propose a science-based, easy-to-understand conceptual model that synthesizes the complex pathogenesis of obesity including biological, psychological, social, economic and environmental aspects with the aim to explain and communicate better the nature of obesity and currently available therapeutic modalities. According to our integrative 'Behavioral Balance Model', 'top-down cognitive control' strategies are implemented (often with limited success) to counterbalance the increased 'bottom-up drive' to gain weight, which is triggered by biological, psycho-social and environmental mechanisms in people with obesity. Besides offering a deeper understanding of obesity, the model also highlights why there is a strong need for multimodal therapeutic approaches that may not only increase top-down control but also reduce a pathologically increased bottom-up drive.
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Affiliation(s)
- Bernd Schultes
- Metabolic Center St. Gallen, friendlyDocs Ltd, St. Gallen, Switzerland
| | - Barbara Ernst
- Metabolic Center St. Gallen, friendlyDocs Ltd, St. Gallen, Switzerland
| | - Manfred Hallschmid
- Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen (IDM), Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Marco Bueter
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
- Department of Surgery, Spital Männedorf, Männedorf, Switzerland
| | - Sebastian M Meyhöfer
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany
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18
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Kudiarasu C, Lopez P, Galvão DA, Newton RU, Taaffe DR, Mansell L, Fleay B, Saunders C, Fox-Harding C, Singh F. What are the most effective exercise, physical activity and dietary interventions to improve body composition in women diagnosed with or at high-risk of breast cancer? A systematic review and network meta-analysis. Cancer 2023; 129:3697-3712. [PMID: 37788151 DOI: 10.1002/cncr.35043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/28/2023] [Accepted: 09/07/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Obesity has been recognized as a risk factor in the development and recurrence of breast cancer and is also associated with poor prognostic outcomes. This systematic review and network meta-analysis aimed to identify the most effective exercise, physical activity, and dietary interventions to reduce fat mass, body fat percentage and body weight as well as potentially increase lean mass in women diagnosed with or at high risk of breast cancer. METHODS A systematic search of databases was performed up to May 2022. Eligible randomized controlled trials examined the effects of exercise, physical activity and/or dietary interventions on fat mass and lean mass in women diagnosed with or at high risk of breast cancer. A random-effects network meta-analysis was conducted to determine the effects of different interventions across outcomes when sufficient studies were available. RESULTS Eighty-four studies (n = 6428) were included in this review. Caloric restriction and combined exercise + caloric restriction significantly reduced fat mass (range, -3.9 to -3.7 kg) and body weight (range, -5.3 to -4.7 kg), whereas physical activity + caloric restriction significantly reduced body fat percentage (-2.4%; 95% confidence interval [CI], -3.4% to -13%) and body mass index (-2.2 kg × m-2 ; 95% CI, -3.0 to -1.4 kg × m-2 ) in breast cancer patients. Resistance exercise was the most effective intervention to increase lean mass (0.7 kg; 95% CI, 0.5-1.0 kg) in breast cancer patients. CONCLUSION Multimodal exercise and diet programs were the most effective interventions to reduce fat mass, body fat percentage, and body weight and increase and/or preserve lean mass.
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Affiliation(s)
- Christine Kudiarasu
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Pedro Lopez
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lorna Mansell
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Brianna Fleay
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Christobel Saunders
- Department of Surgery, University of Melbourne (Royal Melbourne Hospital), Parkville, Victoria, Australia
| | - Caitlin Fox-Harding
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Favil Singh
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Gavilán-Carrera B, Ruiz-Cobo A, Amaro-Gahete FJ, Soriano-Maldonado A, Vargas-Hitos JA. No Changes in Body Composition and Adherence to the Mediterranean Diet after a 12-Week Aerobic Training Intervention in Women with Systemic Lupus Erythematosus: The EJERCITA-LES Study. Nutrients 2023; 15:4424. [PMID: 37892499 PMCID: PMC10609990 DOI: 10.3390/nu15204424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease linked to high cardiovascular risk. To reach an adequate body composition status while maintaining proper dietary habits are effective strategies for reducing cardiovascular risk, both being potentially modified through exercise. This study aimed to evaluate the effects of a 12-week aerobic training intervention on anthropometry, body composition and adherence to the Mediterranean diet in women with SLE. A total of 58 women with SLE were assigned to either an exercise group (EG; n = 26) or a comparison group (CG; n = 32) in this non-randomized controlled trial. The EG comprised 12 weeks of aerobic exercise (two sessions/week) between 40-75% of the individual's heart rate reserve (calculated as maximum heart rate - resting heart rate) and the CG received usual care. At baseline and after the intervention, the anthropometry (i.e., weight, waist circumference, waist-to-hip ratio, and body mass index) and body composition (i.e., fat mass and lean mass) were assessed using a stadiometer, an anthropometric tape, and a bioimpedance device, respectively. Dietary habits were assessed with the Mediterranean Diet score. There were no between-group differences in neither anthropometric nor body composition parameters (all p > 0.05). Similarly, no between-group differences were obtained in the adherence to the Mediterranean diet after the exercise intervention (all p > 0.05). Contrary to the initial hypothesis, these results suggest that the 12-week aerobic training intervention performed in this study did not improve anthropometry, body composition or adherence to the Mediterranean diet in women with SLE.
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Affiliation(s)
- Blanca Gavilán-Carrera
- Departamento de Medicina Interna, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain;
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, University of Granada, 18071 Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, 18071 Granada, Spain
| | - Alba Ruiz-Cobo
- Department of Physiology, Faculty of Medicine, University of Granada, 18001 Granada, Spain;
| | - Francisco José Amaro-Gahete
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain;
- Department of Physiology, Faculty of Medicine, University of Granada, 18001 Granada, Spain;
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Granada, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain;
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, 04120 Almería, Spain
| | - José Antonio Vargas-Hitos
- Departamento de Medicina Interna, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain;
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Tao D, Awan-Scully R, Ash GI, Gu Y, Pei Z, Gao Y, Cole A, Supriya R, Sun Y, Xu R, Baker JS. Health policy considerations for combining exercise prescription into noncommunicable diseases treatment: a narrative literature review. Front Public Health 2023; 11:1219676. [PMID: 37849722 PMCID: PMC10577435 DOI: 10.3389/fpubh.2023.1219676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
Objectives In this review, we aim to highlight the evidence base for the benefits of exercise in relation to the treatment of noncommunicable diseases (NCDs), draw on the Health Triangular Policy Framework to outline the principal facilitators and barriers for implementing exercise in health policy, and make concrete suggestions for action. Methods Literature review and framework analysis were conducted to deal with the research questions. Results Exercise prescription is a safe solution for noncommunicable diseases prevention and treatment that enables physicians to provide and instruct patients how to apply exercise as an important aspect of disease treatment and management. Combining exercise prescription within routine care, in inpatient and outpatient settings, will improve patients' life quality and fitness levels. Conclusion Inserting exercise prescription into the healthcare system would improve population health status and healthy lifestyles. The suggestions outlined in this study need combined efforts from the medical profession, governments, and policymakers to facilitate practice into reality in the healthcare arena.
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Affiliation(s)
- Dan Tao
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Medicine Combining Sports, Ningbo No.2 Hospital, Ningbo, China
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Roger Awan-Scully
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Garrett I. Ash
- Section of General Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, United States
- Center for Pain, Research, Informatics, Medical Comorbidities and Education Center (PRIME), VA Connecticut Healthcare System, West Haven, CT, United States
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Medicine Combining Sports, Ningbo No.2 Hospital, Ningbo, China
| | - Zhong Pei
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yang Gao
- Department of Sports, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Alistair Cole
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Rashmi Supriya
- Department of Sports, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Yan Sun
- Department of Sports, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Rui Xu
- School of Sports and Health, Nanjing Sport Institute, Nanjing, China
| | - Julien S. Baker
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Medicine Combining Sports, Ningbo No.2 Hospital, Ningbo, China
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
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Yin M, Chen Z, Nassis GP, Liu H, Li H, Deng J, Li Y. Chronic high-intensity interval training and moderate-intensity continuous training are both effective in increasing maximum fat oxidation during exercise in overweight and obese adults: A meta-analysis. J Exerc Sci Fit 2023; 21:354-365. [PMID: 37701124 PMCID: PMC10494468 DOI: 10.1016/j.jesf.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
Objective to (1) systematically review the chronic effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on maximal fat oxidation (MFO) in overweight and obese adults, and (2) explore MFO influencing factors and its dose-response relationships with HIIT and MICT. Methods Studies using a between-group design involving overweight and obese adults and assessing the effect of HIIT and MICT on MFO were included. A meta-analysis on MFO indices was conducted, and the observed heterogeneities were explored through subgroup, regression, and sensitivity analyses. Results Thirteen studies of moderate to high quality with a total of 519 overweight and obese subjects were included in this meta-analysis (HIIT, n = 136; MICT, n = 235; Control, n = 148). HIIT displayed a statistically significant favorable effect on MFO compared to no-training (MD = 0.07; 95%CI [0.03 to 0.11]; I2 = 0%). Likewise, MICT displayed a statistically significant favorable effect on MFO compared to no-training (MD = 0.10; 95%CI [0.06 to 0.15]; I2 = 95%). Subgroup and regression analyses revealed that exercise intensity (Fatmax vs. non-Fatmax; %VO2peak), exercise mode, BMI, and VO2peak all significantly moderated MICT on MFO. When analyzing studies that have directly compared HIIT and MCIT in obese people, it seems there is no difference in the MFO change (MD = 0.01; 95%CI [-0.02 to 0.04]; I2 = 64%). No publication bias was found in any of the above meta-analyses (Egger's test p > 0.05 for all). Conclusion Both HIIT and MICT are effective in improving MFO in overweight and obese adults, and they have similar effects. MCIT with an intensity of 65-70% VO2peak, performed 3 times per week for 60 min per session, will optimize MFO increases in overweight and obese adults. Given the lack of studies examining the effect of HIIT on MFO in overweight and obese adults and the great diversity in the training protocols in the existing studies, we were unable to make sound recommendations for training.
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Affiliation(s)
- Mingyue Yin
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Zhili Chen
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - George P. Nassis
- Department of Physical Education, College of Education, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
| | - Hengxian Liu
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Hansen Li
- Department of Physical Education, Southwest University, Chongqing, China
| | - Jianfeng Deng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Yongming Li
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
- China Institute of Sport Science, Beijing, China
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22
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Oppert JM, Ciangura C, Bellicha A. Physical activity and exercise for weight loss and maintenance in people living with obesity. Rev Endocr Metab Disord 2023; 24:937-949. [PMID: 37142892 DOI: 10.1007/s11154-023-09805-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
Physical activity and exercise training programs are integral part of a comprehensive obesity management approach. In persons with overweight or obesity, exercise training, specifically aerobic (i.e. endurance) training, is associated with significant additional weight loss compared to the absence of training. However the magnitude of effect remains modest amounting to only 2-3 kg additional weight loss on average. Comparable effects have been observed for total fat loss. Exercise training, specifically aerobic training, is also associated with decreased abdominal visceral fat as assessed by imaging techniques, which is likely to benefit cardiometabolic health in persons with obesity. Based on data from controlled trials with randomization after prior weight loss, the evidence for weight maintenance with exercise training is as yet not conclusive, although retrospective analyses point to the value of relatively high-volume exercise in this regard. Resistance (i.e. muscle-strengthening) training is specifically advised for lean mass preservation during weight loss. Given the relatively limited effect of exercise training on weight loss as such, the changes in physical fitness brought about by exercise training cannot be overlooked as they provide major health benefits to persons with obesity. Aerobic, as well as combined aerobic and resistance training, increase cardiorespiratory fitness (VO2max) while resistance training, but not aerobic training, improves muscle strength even in the absence of a significant change in muscle mass. Regarding the overall management strategy, adherence in the long term to new lifestyle habits remains a challenging issue to be addressed by further research.
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Affiliation(s)
- Jean-Michel Oppert
- Department of Nutrition, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France.
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, F-93017, France.
- Department of Nutrition, Pitié-Salpêtrière hospital, 47-83 boulevard de l'Hôpital, Paris, 75013, France.
| | - Cécile Ciangura
- Department of Nutrition, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France
- Department of Diabetology, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France
| | - Alice Bellicha
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, F-93017, France
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23
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Borst F, Reuss-Borst M, Boschmann J, Schwarz P. Can mobile-health applications contribute to long-term increase in physical activity after medical rehabilitation?-A pilot-study. PLOS DIGITAL HEALTH 2023; 2:e0000359. [PMID: 37844024 PMCID: PMC10578577 DOI: 10.1371/journal.pdig.0000359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/25/2023] [Indexed: 10/18/2023]
Abstract
Due to the positive effects of rehabilitation declining over time, the aim of this study was to investigate the long-term physical activity level (PAL) following inpatient rehabilitation in relation to the use of a smartphone-based after-care program. 202 patients (mean Body Mass Index (BMI): 30,8 kg/m2; 61% female) with chronic diseases (e.g., diabetes mellitus, obesity, chronic low back pain, depression) were recruited between 08/2020 and 08/2021 in this single-arm observational study. All patients underwent a 3-week inpatient rehabilitation program. PAL (in total activity minutes/week) was measured with a validated (online) questionnaire (Freiburger Questionnaire on PA) after 3, 6, 9, and 12 months. App usage (online time, completion of a course) was recorded automatically and used to evaluate the app user behavior (adherence). A variety of socio-economic factors (age, sex, education level, income etc.) were collected to identify possible barriers of app use. Except for sex, no significant difference was observed for socio-economic factors regarding app usage behavior. Median PAL significantly increased after rehabilitation in the total cohort from 360 min/week (before rehabilitation) to 460 min/week 6 months after rehabilitation, then declined to 420 min/week 9 months after rehabilitation before falling below baseline level after 12 months. There was no significant difference in PAL between app users (45%, 91/202) and non-users (55%, 111/202), although app users tended to retain higher activity levels after 3 and 6 months, respectively. Overall, our study emphasizes the effectiveness of a 3-week rehabilitation program on PAL and the acceptance and usability of a smartphone-based after-care program in this patient group. The adherence to this 3-months after-care app program was acceptable (30%), with modest evidence supporting the effectiveness of app use to sustain PAL in the short term.
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Affiliation(s)
| | - Monika Reuss-Borst
- HESCURO Clinics, Bad Bocklet, Germany
- Department for Nephrology and Rheumatology, Faculty of Medicine Georg-August-Universität Göttingen, Göttingen, Germany
| | | | - Peter Schwarz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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He Z, Qiang L, Liu Y, Gao W, Feng T, Li Y, Yan B, Girard O. Effect of Hypoxia Conditioning on Body Composition in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2023; 9:89. [PMID: 37747653 PMCID: PMC10519915 DOI: 10.1186/s40798-023-00635-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/09/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND The effects of hypoxia conditioning, which involves recurrent exposure to hypoxia combined with exercise training, on improving body composition in the ageing population have not been extensively investigated. OBJECTIVE This meta-analysis aimed to determine if hypoxia conditioning, compared to similar training near sea level, maximizes body composition benefits in middle-aged and older adults. METHODS A literature search of PubMed, EMBASE, Web of Science, Scopus and CNKI (China National Knowledge Infrastructure) databases (up to 27th November 2022) was performed, including the reference lists of relevant papers. Three independent reviewers extracted study characteristics and health outcome measures. Search results were limited to original studies of the effects of hypoxia conditioning on body composition in middle-aged and older adults. RESULTS Twelve studies with a total of 335 participants were included. Hypoxia conditioning induced greater reductions in body mass index (MD = -0.92, 95%CI: -1.28 to -0.55, I2 = 0%, p < 0.00001) and body fat (SMD = -0.38, 95%CI: -0.68 to -0.07, I2 = 49%, p = 0.01) in middle-aged and older adults compared with normoxic conditioning. Hypoxia conditioning improved lean mass with this effect not being larger than equivalent normoxic interventions in either middle-aged or older adults (SMD = 0.07, 95%CI -0.12 to 0.25, I2 = 0%, p = 0.48). Subgroup analysis showed that exercise in moderate hypoxia (FiO2 > 15%) had larger effects than more severe hypoxia (FiO2 ≤ 15%) for improving body mass index in middle-aged and older adults. Hypoxia exposure of at least 60 min per session resulted in larger benefits for both body mass index and body fat. CONCLUSION Hypoxia conditioning, compared to equivalent training in normoxia, induced greater body fat and body mass index improvements in middle-aged and older adults. Adding hypoxia exposure to exercise interventions is a viable therapeutic solution to effectively manage body composition in ageing population.
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Affiliation(s)
- Zhijian He
- China Institute of Sport and Health Science, Beijing Sport University, No. 48 Xinxi Road, Haidian District, Beijing, 100084, China
- Department of Sports Teaching and Research, Lanzhou University, Lanzhou, China
| | - Lijun Qiang
- China Institute of Sport and Health Science, Beijing Sport University, No. 48 Xinxi Road, Haidian District, Beijing, 100084, China
- Ningxia Vocational College of Sports, Ningxia, China
| | - Yusheng Liu
- China Institute of Sport and Health Science, Beijing Sport University, No. 48 Xinxi Road, Haidian District, Beijing, 100084, China
- Tsinghua University High School (Guanghua), Beijing, China
| | - Wenfeng Gao
- Department of Sports Teaching and Research, Lanzhou University, Lanzhou, China
| | - Tao Feng
- Department of Sports Teaching and Research, Lanzhou University, Lanzhou, China
| | - Yang Li
- Department of Sports Teaching and Research, Lanzhou University, Lanzhou, China
| | - Bing Yan
- China Institute of Sport and Health Science, Beijing Sport University, No. 48 Xinxi Road, Haidian District, Beijing, 100084, China.
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
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López-López CO, Montes Castillo MDLL, Aguilar-Serralde CA, Torres-Cruz MN, Rojas-Stevenson A, Bólivar-Tellería I. Usefulness of an Easy, Structured, and Home-Based Exercise Program to Improve Physical Performance and Quality of Life in a Patient's Cohort with Obesity. Obes Facts 2023; 16:507-513. [PMID: 37598666 PMCID: PMC10601622 DOI: 10.1159/000533639] [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: 01/04/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023] Open
Abstract
INTRODUCTION The benefits of exercise in patients with obesity are clear; physical performance and quality of life improve after exercise programs in patients with obesity. Our aim was to evaluate the usefulness of an easy, structured, and home-based exercise program to improve physical performance and quality-of-life in patients with obesity. METHODS A cohort of patients with obesity (BMI ≥30 kg/m2) was recruited during 2017-2020. Patients who met the inclusion criteria were invited and those who accepted signed informed consent. Patients were evaluated by the same team of physicians who performed the 6-min walking test and collected the clinical and biochemical variables, also applied quality-of-life questionnaire at baseline and 3 months after starting the exercise program that was divided in two levels: level 1: active mobilization of four limbs (15 min) + cardiovascular exercise (15 min walking), 5 days/week; level 2: eight strengthening exercises for upper and lower limbs with an elastic band + cardiovascular exercise (15 min walking), 5 days/week. This study used means (SD), frequencies (percent), Student's t test, and Pearson correlation test. RESULTS We included 151 patients, mostly women (81.5%), age 46.3 ± 9.8 years old, BMI 40.3 ± 8.56 kg/m2, 34.4% performed some type of exercise, and the most frequents comorbidities were dyslipidemia and diabetes. After 3 months, 86 patients (57%) remained in the study and attended the final evaluation. Evident changes in physical performance were reported (distance traveled, speed walking and VO2max); however, improvement in quality of life was remarkable. CONCLUSION An easy, structured, and home-based exercise program improves physical performance and quality of life in patients with obesity, without losing its benefits for the health.
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Affiliation(s)
- Carlos Omar López-López
- Applied Research and Technology Institute (InIAT), Universidad Iberoamericana–Ciudad de México, Mexico City, Mexico
| | | | | | - Mónica Nohemí Torres-Cruz
- Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Isabel Bólivar-Tellería
- Applied Research and Technology Institute (InIAT), Universidad Iberoamericana–Ciudad de México, Mexico City, Mexico
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Tao D, Awan-Scully R, Cole A, Gao Y, Ash GI, Gu Y, Dutheil F, Sun Y, Baker JS. Integration of exercise prescription into medical provision as a treatment for non-communicable diseases: A scoping review. Front Public Health 2023; 11:1126244. [PMID: 37501942 PMCID: PMC10369190 DOI: 10.3389/fpubh.2023.1126244] [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: 12/17/2022] [Accepted: 03/22/2023] [Indexed: 07/29/2023] Open
Abstract
Background The purpose of this scoping review is to stimulate interest and to raise awareness, among researchers, healthcare practitioners, and policymakers regarding the current scientific literature related to exercise prescription for non-communicable diseases (NCDs). Exercise prescription is a safe and cost-effective method that enables physicians to use exercise as a complementary addition to NCDs management and treatment. Methods This scoping review followed the PRISMA Extension Guidelines for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Using this framework, we considered information from qualitative and quantitative studies to identify research gaps. We provide feasible suggestions to guide future research for the implementation of exercise prescription in the healthcare environment. The literature search was conducted using SPIDER and PICO tools for qualitative, quantitative, and mixed-study designs. Inclusion criteria included articles that investigated patients with NCDs and considered exercise interventions. Systematic searches of PubMed, Web of Science, MEDLINE, EMBASE, and ScienceDirect were undertaken on 26 July 2022 and all reference lists were manually searched. Data processing was performed using EndNote 2.0 software and data charts were used for numerical summary and thematic analysis. Results There were 10,951 articles retrieved, of which 28 met the inclusion criteria. Based on the evidence, exercise was a feasible, safe, and acceptable method to prevent and manage non-communicable diseases in inpatient and outpatient settings. Six research directions were identified and discussed. In addition, implementation evidence and suggestions for policy-reconfiguration are also provided. Conclusion This scoping review summarizes the current evidence for the effectiveness of exercise in the treatment of non-communicable diseases. The review provides key findings supporting exercise prescription for the inpatient and outpatient healthcare service. We suggest that governments and healthcare policymakers globally advocate the inclusion of structured exercise prescription within the NCDs treatment setting.
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Affiliation(s)
- Dan Tao
- Research Academy of Medicine Combining Sports, Ningbo No. 2 Hospital, Ningbo, China
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Roger Awan-Scully
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Alistair Cole
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Yang Gao
- Centre for Health and Exercise Science Research, Population Health and Medical Informatics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Garrett I. Ash
- Center for Medical Informatics, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Yaodong Gu
- Research Academy of Medicine Combining Sports, Ningbo No. 2 Hospital, Ningbo, China
| | - Frederic Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, University Clermont Auvergne, Clermont-Ferrand, France
| | - Yan Sun
- Centre for Health and Exercise Science Research, Population Health and Medical Informatics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Population Health and Medical Informatics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, 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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Khalil N, Pinti A, El Hage R. The Effects of a 1-Year Recreational Kung Fu Protocol on Bone Health Parameters in a Group of Healthy Inactive Young Men. J Clin Densitom 2023; 26:101418. [PMID: 37356377 DOI: 10.1016/j.jocd.2023.101418] [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: 05/23/2023] [Accepted: 06/05/2023] [Indexed: 06/27/2023]
Abstract
The main aim of the current study was to explore the effects of a 1-year recreational Kung Fu protocol on bone health parameters (bone mineral content (BMC), bone mineral density (BMD), femoral neck geometry and composite indices of femoral neck strength) in a group of healthy inactive young men. 54 young inactive men voluntarily participated in this study, but only 51 of them completed it. The participants were assigned to 2 different groups: control group (n=31) and Kung Fu group (n=20). The Kung Fu group performed two sessions of recreational Kung Fu per week; the duration of each session was 45 minutes. The current study has demonstrated that whole body (WB) BMC, ultra-distal (UD) radius BMD, 1/3 radius BMD, total radius BMD, total forearm BMD, maximal strength, maximum oxygen consumption and jumping performance increased in the Kung Fu group but not in the control group. The percentages of variations in WB BMC, forearm BMD and physical performance parameters were significantly different between the two groups. In conclusion, this study suggests that recreational Kung Fu is an effective method to improve WB BMC, forearm BMD and physical performance parameters in young inactive men.
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Affiliation(s)
- Nour Khalil
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon; Université Polytechnique Hauts-de-France, INSA Hauts-de-France, LARSH - Laboratoire de Recherche Sociétés & Humanités, F-59313 Valenciennes, France
| | - Antonio Pinti
- Université Polytechnique Hauts-de-France, INSA Hauts-de-France, LARSH - Laboratoire de Recherche Sociétés & Humanités, F-59313 Valenciennes, France
| | - Rawad El Hage
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon.
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Xie Z, Yu L, Li S, Li J, Liu Y. Comparison of therapies of white spot lesions: a systematic review and network meta-analysis. BMC Oral Health 2023; 23:346. [PMID: 37264364 DOI: 10.1186/s12903-023-03076-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE White spot lesions (WSLs), the earliest evidence of enamel demineralization, are considered amenable to intervention to achieve a remineralized or arrested state of caries. The management of WSLs is quite challenging, and there is no definitive cure as yet. We performed a network meta-analysis to assess the efficacy of seven therapies for WSLs and gave a hierarchy of them. MATERIALS AND METHODS We systematically searched the PubMed, EMBASE, Cochrane, and Web of Science databases (last search: July 2022) to identify all relevant studies. We limited our search to studies published in English. Randomized controlled designed in vitro/clinical trials related to the efficacy of the seven therapies for WSLs were included. Data extraction was performed independently by two reviewers. The risk of bias (ROB) 2.0 tool from Cochrane and a previous in vitro methodological tool will be used for the quality assessment. Variations in quantitative light-induced fluorescence (QLF), laser fluorescence (LF), and lesions area were the primary outcome measures. Standard mean difference (SMD) was used as the effect size for the Network meta-analysis (NMA). Consistency and inconsistency tests were conducted. The hierarchy of 7 treatment effects was evaluated using surface probabilities under cumulative ranking (SUCRA). Publication bias was evaluated using a bias plot. RESULTS Forty-two articles were included in the systematic review. Thirty-one of them, with a total of 1906 participants, were included in the network meta-analysis. The studies owned a low and moderate risk of bias. This analysis does not suffer from significant inconsistency. The difference between 4 groups 'self-assembled peptide (SAP) P11-4', 'P11-4 + Fluoride Varnish (FV)', 'Resin Infiltration (RI)', 'casein phosphor peptides-amorphous calcium fluoride phosphate (CPP-ACFP)' and the 'Control' group was found to be statistically significant. Compared to the 'FV' and 'casein phosphor peptides-amorphous calcium phosphate (CPP-ACP)' groups, the 'P11-4 + FV" group and 'RI" group made a significant difference. The hierarchy was evident in the SUCRA values of 7 therapies. P11-4 + FV and RI were considered effective therapies compared to the control group or the FV group (gold standard group). CONCLUSIONS The available evidence suggests that resin infiltration and P11-4 in combination with fluoride varnish had advantages over gold standard (FV). The effect of tricalcium phosphate-based drugs and fluoride is not very noticeable. Overall, drugs based on P11-4 and resin infiltration will be better therapies. Using more than two drugs in combination also would increase efficacy.
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Affiliation(s)
- Zunxuan Xie
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Lei Yu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Sining Li
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Jianing Li
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Yuyan Liu
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China.
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Zhu H, Jin J, Zhao G. The effects of water-based exercise on body composition: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 52:101766. [PMID: 37167802 DOI: 10.1016/j.ctcp.2023.101766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Abstract
AIMS This study aimed to investigate the effects of water-based exercise (WBE) on body composition. METHODS Trials published up to October 28, 2022 were searched using the PubMed, EMBASE, Web of Science, Cochrane, Scopus, and Ovid databases. Randomized controlled trials of healthy adults published in English, comparing WBE and control groups, were included. Other studies with different research designs and participants with medical diagnoses were excluded. The main outcome measures were body weight (BW), body fat mass (BFM), body fat percentage (BFP), lean mass (LM), and skeletal muscle mass (SMM). RESULTS Overall, 17,458 potential studies were identified. After a closer inspection, 79 full-length articles were considered for further screening. Finally, 20 studies, involving 565 participants, were included in the meta-analysis. The WBE was beneficial in reducing BW, BFM, and BFP and increasing LM and SMM. Subgroup analyses were conducted based on different exercise intensities and times per week. Moderate- or moderate-vigorous-intensity exercise helped improve body composition, while lower-intensity WBE or aquatic high-intensity interval training (HIIT) seemed less helpful. Training for <120 min/week was insufficient to improve body composition. Training for >120 min/week was associated with improvements in body composition. CONCLUSIONS Moderate- or moderate-vigorous-intensity WBE helps improve body composition. Adults are encouraged to exercise for >120 min/week.
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Affiliation(s)
- Haifeng Zhu
- Taizhou People's Hospital, Taizhou City, Jiangsu Province, China
| | - Jing Jin
- Taizhou People's Hospital, Taizhou City, Jiangsu Province, China
| | - Gaonian Zhao
- Taizhou People's Hospital, Taizhou City, Jiangsu Province, China.
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Jaramillo-Osorno AF, Giraldo-García JC. Impacto de los diferentes tipos de entrenamiento físico sobre la composición corporal en mujeres adultas con obesidad: una revisión bibliográfica. REVISTA POLITÉCNICA 2023. [DOI: 10.33571/rpolitec.v19n37a10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Introducción: La obesidad sigue siendo uno de los problemas más grandes de salud pública en todo el mundo. Se conoce que está asociada con una gran variedad de enfermedades; en mujeres obesas, aún se desconoce la forma idónea para realizar una adecuada prescripción física. Objetivo: revisar los tipos de entrenamientos físicos de ensayos controlados aleatorizados publicados en la base de datos PubMed entre los años 2015 a 2022 sobre los cambios en la composición corporal en mujeres adultas de 18 a 65 años con obesidad. Metodología: se utilizó a modo de filtro la “Herramienta de Evaluación de Calidad Validada para Estudios Cuantitativos”. Resultados: la búsqueda arrojó 586 artículos, de los cuales el 93.85% fueron eliminados; 6.14% pasaron por un filtro que dejó un total de 1.7%. Conclusión: en mujeres adultas con obesidad, se ha demostrado que todos los tipos de entrenamiento físico sirven para generar cambios en la composición corporal.
Introduction: Obesity continues to be one of the biggest public health problems worldwide. It is known to be associated with a wide variety of diseases; in obese women, the ideal way to carry out an adequate physical prescription is still unknown. Objective: to review the types of physical training in randomized controlled trials published in the PubMed database between 2015 and 2022 on changes in body composition in adult women aged 18 to 65 with obesity. Methodology: the "Validated Quality Assessment Tool for Quantitative Studies" was used as a filter. Outcomes: the search yielded 586 articles, of which 93.85% were eliminated; 6.14% went through a filter that left a total of 1.7%. Conclusion: in adult women with obesity, it has been shown that all types of physical training serve to generate changes in body composition.
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Guo Z, Li M, Cai J, Gong W, Liu Y, Liu Z. Effect of High-Intensity Interval Training vs. Moderate-Intensity Continuous Training on Fat Loss and Cardiorespiratory Fitness in the Young and Middle-Aged a Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4741. [PMID: 36981649 PMCID: PMC10048683 DOI: 10.3390/ijerph20064741] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/26/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES This systematic review is conducted to evaluate the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on body composition and cardiorespiratory fitness (CRF) in the young and middle-aged. METHODS Seven databases were searched from their inception to 22 October 2022 for studies (randomized controlled trials only) with HIIT and MICT intervention. Meta-analysis was carried out for within-group (pre-intervention vs. post-intervention) and between-group (HIIT vs. MICT) comparisons for change in body mass (BM), body mass index (BMI), waist circumference (WC), percent fat mass (PFM), fat mass (FM), fat-free mass (FFM), and CRF. RESULTS A total of 1738 studies were retrieved from the database, and 29 studies were included in the meta-analysis. Within-group analyses indicated that both HIIT and MICT can bring significant improvement in body composition and CRF, except for FFM. Between-group analyses found that compared to MICT, HIIT brings significant benefits to WC, PFM, and VO2peak. CONCLUSIONS The effect of HIIT on fat loss and CRF in the young and middle-aged is similar to or better than MICT, which might be influenced by age (18-45 years), complications (obesity), duration (>6 weeks), frequency, and HIIT interval. Despite the clinical significance of the improvement being limited, HIIT appears to be more time-saving and enjoyable than MICT.
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Son H, Koo BK, Joo SK, Lee DH, Jang H, Park JH, Chang MS, Kim W. PNPLA3 genotypes modify the adverse effect of the total energy intake on high-risk nonalcoholic steatohepatitis development. Am J Clin Nutr 2023; 117:910-917. [PMID: 36878430 DOI: 10.1016/j.ajcnut.2023.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/07/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The relationship between diet and risk genotypes in nonalcoholic steatohepatitis (NASH) development and fibrosis progression in patients with nonalcoholic fatty liver disease (NAFLD) remains unclear. OBJECTIVE We aimed to investigate the effects of diet on NASH development and fibrosis progression in patients with NAFLD stratified by the PNPLA3 genotype. METHODS We performed a prospective study in a cohort of patients with biopsy-confirmed NAFLD. Histologic deterioration was obtained using serial transient elastography at every 1 or 2 y. The primary outcome was fibrosis progression, and the secondary outcome was development of high-risk NASH, defined as FibroScan-aspartate aminotransferase score ≥0.67 during the follow-up of patients with nonalcoholic fatty liver at the baseline. Dietary intake was evaluated using a semiquantitative food frequency questionnaire. RESULTS The primary outcome was observed in 42 (29.0%) of the 145 patients during a median follow-up of 49 mo; neither the total energy intake nor each macronutrient intake significantly affected the primary outcome occurrence. Conversely, the total energy intake (HR per 1-SD: 3.03; 95% CI: 1.31, 7.01) and the PNPLA3 rs738409 genotype [HR per 1 risk allele (G): 2.06; 95% CI: 1.11, 3.83)] were independent risk factors for high-risk NASH. The significant interaction between the total energy intake and PNPLA3 genotype was noted in developing high-risk NASH (P = 0.044). As the number of PNPLA3 risk alleles decreased, the effect of the total energy intake on high-risk NASH increased; the HR per 1-SD increment in total energy intake was 1.52 (95% CI: 0.42, 5.42), 3.54 (95% CI: 1.23, 10.18), and 8.27 (95% CI: 1.20, 57.23) for the GG, CG, and CC genotypes, respectively. CONCLUSIONS The total energy intake adversely affected the development of high-risk NASH in patients with biopsy-confirmed NAFLD. The effect was more prominent in patients without the PNPLA3 risk allele, highlighting the importance of personalized dietary interventions in NAFLD treatment.
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Affiliation(s)
- Heejun Son
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Division of Endocrinology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Sae Kyung Joo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Dong Hyeon Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Heejoon Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Jeong Hwan Park
- Department of Pathology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Mee Soo Chang
- Department of Pathology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Won Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.
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Guo L, Chen J, Yuan W. The effect of HIIT on body composition, cardiovascular fitness, psychological well-being, and executive function of overweight/obese female young adults. Front Psychol 2023; 13:1095328. [PMID: 36743598 PMCID: PMC9891140 DOI: 10.3389/fpsyg.2022.1095328] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose To evaluate the effect of a short-term HIIT program on the selected health-related parameters for overweight/obese young adult women in a university context. Methods A total of 48 participants were randomly divided into two groups. The exercise group (HIIT) received a HIIT intervention of aerobics for 4 weeks, while the control group (CON) received no training. Body composition including waist circumference (WC), body fat percentage (BF %), Cardiorespiratory fitness (VO2max), the score of Self-Rating Depression Scale (SDS), and Stroop word-color test (SCWT) results were assessed before and after the intervention along with within- and between-group comparisons. Results All the indices were significantly improved in HIIT group (p < 0.01) after 4 weeks of intervention. No significant changes were found in CON. There were significant differences between HIIT and CON in cardiovascular fitness (p < 0.01), SDS (p < 0.01) and SCWT (p < 0.05) before and after 4 weeks. In addition, weekly measurements of HIIT effects showed significant changes (p < 0.01) from the second week in the variables of body composition, VO2max, SDS and SCWT when compared with the baseline and maintained the tendency till the end of program. Conclusion The short-term HIIT aerobics of the campus program conducted in a non-lab setting induced significant improvements in body composition, cardiovascular fitness, psychological well-being and executive function in overweight young female adults.
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The effects of low-volume combined training on health-related physical fitness outcomes in active young adults. A controlled clinical trial. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:74-80. [PMID: 36994175 PMCID: PMC10040378 DOI: 10.1016/j.smhs.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/09/2022] [Accepted: 12/31/2022] [Indexed: 01/04/2023] Open
Abstract
The effects of combined training (CT) on improving general health are well known, however, few studies have investigated the effects of low-volume CT. So, the aim of this study is to investigate the effects of 6 weeks of low-volume CT on body composition, handgrip strength (HGS), cardiorespiratory fitness (CRF) and affective response (AR) to exercise. Eighteen healthy, active young adult man (mean ± SD, [20.06 ± 1.66] years; [22.23 ± 2.76] kg/m2) performed either a low-volume CT (EG, n = 9), or maintained a normal life (CG, n = 9). The CT was composed of three resistance exercises followed by a high intensity-interval training (HIIT) on cycle ergometer performed twice a week. The measures of the body composition, HGS, maximal oxygen consumption ( V ˙ O2max) and AR to exercise were taken at baseline and after training for analysis. Furthermore, an ANOVA test of repeated measures and t-test paired samples were used with a p ≤ 0.05. The results showed that EG improved HGS (pre: [45.67 ± 11.84] kg vs. post: [52.44 ± 11.90] kg, p < 0.01) and V ˙ O2max (pre: [41.36 ± 5.16] ml⋅kg-1⋅min-1 vs. post: [44.07 ± 5.98] ml⋅kg-1⋅min-1, p < 0.01). Although, for all measures the body composition had not significant differences between weeks (p > 0.05), nevertheless the feeling scale was positive in all weeks and without significant differences between them (p > 0.05). Lastly, for active young adults, the low-volume CT improved HGS, CRF and had a positive outcome in AR, with less volume and time spent than traditional exercise recommendations.
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Grannell A. Reframing the need for exercise therapy in the clinical management of people living with obesity. Clin Obes 2022; 12:e12554. [PMID: 36161706 DOI: 10.1111/cob.12554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 01/06/2023]
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Xu R, Huang QT, Chen YT, Wang PY. Effects and dose-response relationships of exercise intervention on weight loss in overweight and obese children: a meta-regression and system review. J Pediatr Endocrinol Metab 2022; 35:1117-1131. [PMID: 35933324 DOI: 10.1515/jpem-2022-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022]
Abstract
The aim of this study was to determine the effect of different exercise doses on weight loss in obese/overweight children. PubMed, Embase, SPORTDiscus, and the Cochrane library were searched from inception to November 2020 for randomized controlled trials. Fourty six trials involving 2,599 obese/overweight children were finally included. Different exercise dose interventions had different impacts. Exercise intervention reduce body weight (BW) by 1.46 kg (95% CI, -2.35 to -0.56, p=0.001), body fat percentage (BF%) by 2.24 (95% CI, -2.63 to -1.84, p<0.001) and body mass index (BMI) by 1.09 kg/m2 (95% CI, -1.45 to -0.73, p<0.001). Each MET-h/week was association with 0.147 kg (95% CI, -0.287 to -0.007, p=0.039) decrease in BW, 0.060 (95% CI, -0.118 to -0.002, p=0.042) decrease in BF%, and 0.069 kg/m2 (95% CI, -0.125 to -0.014, p=0.015) decrease in BMI. The findings suggest that there is a positive liner between exercise dose and weight loss, each MET-h/week associated with 0.147 kg, 0.060 and 0.069 kg/m2 decrease in body weight, BF%, BMI, respectively.
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Affiliation(s)
- Rui Xu
- School of Sports and Health, Nanjing Sport Institute, Nanjing, P.R. China.,Laboratory of Kinesiology, Nanjing Sport Institute, Nanjing, P.R. China
| | - Qiao-Ting Huang
- College of Physical Education, Chengdu University, Chengdu, P.R. China
| | - Yu-Ting Chen
- School of Sports and Health, Nanjing Sport Institute, Nanjing, P.R. China
| | - Peng-Yin Wang
- School of Sports and Health, Nanjing Sport Institute, Nanjing, P.R. China
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Xiong X, Zeng B, Zhang S, Du J, Liao X, Hu S, Su X, Qiu S, Yang L. Which Type of Exercise During Radiation Therapy Is Optimal to Improve Fatigue and Quality of Life in Men with Prostate Cancer? A Bayesian Network Analysis. EUR UROL SUPPL 2022; 43:74-86. [PMID: 36353065 PMCID: PMC9638772 DOI: 10.1016/j.euros.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 11/29/2022] Open
Abstract
Context Physical exercise in men with prostate cancer (CaP) has shown benefits in improving cancer-related fatigue (CRF) and quality of life (QoL) during radiation therapy. However, types of exercises that are more effective are not well understood. Evidence acquisition We searched PubMed, Web of Science, and ClinicalTrials.gov up to November 2021 to identify potentially relevant studies. Randomized controlled trials (RCTs) testing the effects of exercise training on CRF, QoL, and treatment-related toxicities in patients with CaP undergoing radiation therapy were included. The quality of individual studies was evaluated using the Tool for the assEssment of Study qualiTy and reporting in Exercise (TESTEX) scale. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation method. A meta-regression analysis was conducted to test the study-level covariates. A random-effect network meta-analysis was conducted based on a Bayesian model. Evidence synthesis Eight RCTs with 466 participants were included. Exercise achieved significant improvements in CRF (standardized mean difference [SMD] = 1.24, 95% confidence interval or CI [0.43, 2.06], I2 = 93%) and QoL (SMD = 1.40, 95% CI [0.05, 2.75], I2 = 95%). Based on the meta-regression and Bayesian model, combined moderate-intensity continuous training aerobic exercise and resistance exercise (MICT/RES) showed the highest probability of ranking first in terms of CRF and QoL improvement, but the results of QoL were unstable. Exercise training also had a positive effect on urinary toxicities (SMD = –0.53, 95% CI [–0.79, –0.27], I2 = 0%). A subgroup analysis indicated that MICT/RES might be the most promising exercise modality for reducing intestinal toxicities (SMD = –1.76, 95% CI [–2.32, –1.20]). Conclusions MICT/RES might be superior to any other types of exercise at reducing CRF. MICT/RES was more effective on significantly mitigating urinary and intestinal toxicities. Patient summary In prostate cancer (CaP) survivors during radiation therapy, exercise training is an effective and safe intervention to reduce cancer-related fatigue (CRF) and improve quality of life (QoL), and should be prescribed as a rehabilitation option for clinical management. As for the types of exercises, moderate-intensity continuous training aerobic exercise and resistance exercise seem to be the most effective interventions to reduce CRF, improve QoL, and mitigate treatment-related symptoms.
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Herrera-Santelices A, Argüello-Florencio G, Westphal G, Nardo Junior N, Zamunér AR. Effects of Supervised Physical Exercise as Prehabilitation on Body Composition, Functional Capacity and Quality of Life in Bariatric Surgery Candidates: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11175091. [PMID: 36079027 PMCID: PMC9457213 DOI: 10.3390/jcm11175091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/19/2022] [Accepted: 08/26/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Prehabilitation is a strategy used aiming to reduce the risk factors and complications of surgery procedures, but there is no consensus on the effectiveness of supervised physical exercise and its optimal prescription during this phase. Objectives: To determine the effects of exercise prehabilitation on body composition, functional capacity and quality of life in candidates for bariatric surgery. Search methods: A search was conducted in PubMed, Web of Science, SciELO, Scopus, MEDLINE and CINAHL. Selection criteria: Only randomized clinical trials that examined the effectiveness of supervised physical exercise were included. The main outcomes were body composition, functional capacity, quality of life and surgical outcomes. Data collection and analysis: Two researchers independently selected the literature, extracted the data and evaluated the risk of bias. A third researcher was consulted when a consensus was not reached. The risk of bias was assessed by the tool recommended by the Cochrane Collaboration, the quality of the evidence by GRADE, and to analyze the effects of prehabilitation on the primary objectives, RevMan software, version 5.3 was used. Main results: The search resulted in 4550 articles, of which 22 met the eligibility criteria, leaving 5 articles selected for this review. One article was assessed as a high bias risk and four as an uncertain risk, which included 139 candidates for bariatric surgery. Most of the studies evaluated the body composition, functional capacity and quality of life; none reported surgical outcomes. Conclusions: Supervised physical exercise has positive effects on the body composition, functional capacity and quality of life; there was no evidence for surgical outcomes, which opens up a field of study for future research of this population.
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Affiliation(s)
- Andrea Herrera-Santelices
- Facultad de Ciencias de la Salud, Universidad Católica de Maule, Talca 3480112, Chile
- Servicio de Medicina Física y Rehabilitación, Hospital San Juan de Dios, Curicó 3343005, Chile
| | - Graciela Argüello-Florencio
- Department of Health Sciences, Nutrition and Dietetics Career, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Greice Westphal
- Multidisciplinary Center of Obesity Studies, Department of Physical Education, Sate University of Maringa, Maringá 87020-900, Brazil
| | - Nelson Nardo Junior
- Multidisciplinary Center of Obesity Studies, Department of Physical Education, Sate University of Maringa, Maringá 87020-900, Brazil
| | - Antonio Roberto Zamunér
- Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Talca 3480112, Chile
- Correspondence: ; Tel.: +56-71-2203100
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Schweda S, Munz B, Burgstahler C, Niess AM, Roesel I, Sudeck G, Krauss I. Proof of Concept of a 6-Month Person-Oriented Exercise Intervention 'MultiPill-Exercise' among Patients at Risk of or with Multiple Chronic Diseases: Results of a One-Group Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9469. [PMID: 35954825 PMCID: PMC9368673 DOI: 10.3390/ijerph19159469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/03/2022]
Abstract
Physical exercise has been shown to be effective in the treatment of non-communicable chronic diseases. However, patients with multiple chronic diseases (multimorbidity) have received little attention in health policy. This pilot trial served as a proof of concept of a 6-months person-oriented exercise intervention for people at risk of or with diagnosed cardiovascular diseases, diabetes mellitus type 2, overweight and/or hip/knee osteoarthritis, regarding effects on health outcomes as well as adherence and safety. The intervention (‘MultiPill-Exercise’) was designed to promote physical exercise participation, considering an individual perspective by addressing personal and environmental factors. Outcomes were assessed at baseline (t0) and after three- (t3) and six-months (t6). The primary outcome was self-reported physical exercise participation in minutes/week comparing t3 and t6 vs. t0. Secondary outcomes included cardio-respiratory fitness (maximum oxygen uptake VO2peak during incremental cycling ergometry), isometric peak torque of knee extensors and flexors, health-related quality of life (Veterans Rand 12 with its subscales of perceived general health (GH), mental health (MCS), and physical health (PCS)) and blood levels. Adherence to exercise (% of attended sessions during the first 12-weeks of the intervention) and adverse events were monitored as well. Data were analyzed using a non-parametric procedure for longitudinal data, estimating rank means (MRank) and relative treatment effects (RTE) as well as linear-mixed effect models for parametric data. The primary endpoint of physical exercise participation was significantly higher at t3 and t6 compared to baseline (t3 vs. t0: MRank = 77.1, p < 0.001, RTE: 0.66; t6 vs. t0: MRank = 70.6, p < 0.001, RTE = 0.60). Improvements at both follow-up time points compared to t0 were also found for relative VO2peak (t3 vs. t0 = 2.6 mL/kg/min, p < 0.001; t6 vs. t0 = 2.0 mL/kg/min, p = 0.001), strength of knee extensors (t3 vs. t0 = 11.7 Nm, p = 0.007; t6 vs. t0= 18.1 Nm, p < 0.001) and GH (t3 vs. t0 = 16.2, p = 0.003; t6 vs. t0 = 13.4, p = 0.008). No changes were found for MCS, PCS and for blood levels. Overall exercise adherence was 77%. No serious adverse events were recorded. Results of this pilot trial represent a first proof of concept for the intervention ‘MultiPill-Exercise’ that will now be implemented and evaluated in a real-world health care setting.
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Affiliation(s)
- Simone Schweda
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
| | - Barbara Munz
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
| | - Christof Burgstahler
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
| | - Andreas Michael Niess
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
| | - Inka Roesel
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
- Institute for Clinical Epidemiology and Applied Biostatistics, University of Tuebingen, 72074 Tuebingen, Germany
| | - Gorden Sudeck
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
- Institute of Sports Science, Eberhard Karls University, 72076 Tuebingen, Germany
| | - Inga Krauss
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
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Armstrong A, Jungbluth Rodriguez K, Sabag A, Mavros Y, Parker HM, Keating SE, Johnson NA. Effect of aerobic exercise on waist circumference in adults with overweight or obesity: A systematic review and meta-analysis. Obes Rev 2022; 23:e13446. [PMID: 35383401 PMCID: PMC9540641 DOI: 10.1111/obr.13446] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/07/2022] [Accepted: 03/01/2022] [Indexed: 12/14/2022]
Abstract
Excess visceral adiposity contributes to elevated cardiometabolic risk, and waist circumference is commonly used as a surrogate measure of visceral adipose tissue. Although regular aerobic exercise is known to improve abdominal obesity, its effect on waist circumference is unclear. A systematic review and meta-analysis was performed to determine (1) the effect of aerobic exercise on waist circumference in adults with overweight or obesity; (2) the association between any change in waist circumference and change in visceral adipose tissue and/or bodyweight with aerobic exercise interventions; and (3) if reductions in waist circumference with exercise are moderated by clinical characteristics or components of aerobic exercise prescription. Twenty-five randomized controlled trials (1686 participants) were included. Regular aerobic exercise significantly reduced waist circumference by 3.2 cm (95% confidence interval [CI] -3.86, -2.51, p ≤ 0.001) versus control. Change in waist circumference was associated with change in visceral adipose tissue (β = 4.02; 95% CI 1.37, 6.66, p = 0.004), and vigorous intensity produced superior reduction (-4.2 cm, 95% CI -4.99, -3.42, p < 0.0001) in waist circumference compared with moderate intensity (-2.50 cm, 95% CI -3.22, -1.79, p = 0.058). These findings suggest regular aerobic exercise results in modest reductions in waist circumference and associated visceral adipose tissue and that higher intensity exercise may offer superior benefit to moderate intensity.
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Affiliation(s)
- Alex Armstrong
- Faculty of Medicine and Health, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales.,Charles Perkins Centre, University of Sydney, Camperdown, New South Wales
| | - Klaus Jungbluth Rodriguez
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Angelo Sabag
- NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Yorgi Mavros
- Faculty of Medicine and Health, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales.,Charles Perkins Centre, University of Sydney, Camperdown, New South Wales
| | - Helen M Parker
- Faculty of Medicine and Health, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Nathan A Johnson
- Faculty of Medicine and Health, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales.,Charles Perkins Centre, University of Sydney, Camperdown, New South Wales
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Magutah K, Mbuthia G, Akiruga JA, Haile D, Thairu K. Effect of fixed 7.5 minutes' moderate intensity exercise bouts on body composition and blood pressure among sedentary adults with prehypertension in Western-Kenya. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000806. [PMID: 36962441 PMCID: PMC10021634 DOI: 10.1371/journal.pgph.0000806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 06/24/2022] [Indexed: 06/18/2023]
Abstract
Prehypertension is a modifiable risk factor for cardiovascular disease observed to affect an estimated 25-59% of global population and closely associated with body composition. Without appropriate interventions, one-third of individuals with prehypertension would develop full-blown hypertension within 4 years. The existing exercise recommendations need substitutes that appeal more yet accord similar or better outcomes in desire to halt this progression. This study evaluated the effect of Fixed 7.5-minute Moderate Intensity Exercise (F-7.5m-MIE) bouts on Body Composition and Blood Pressure (BP) among sedentary adults with prehypertension in Western-Kenya in a Randomized Control Trial (RCT) performed throughout the day compared to the single-continuous 30-60-minute bouts performed 3 to 5 times weekly. This RCT, with three arms of Experimental Group1 (EG1) performing the F-7.5m-MIE bouts, Experimental Group 2 (EG2) performing current World Health Organization (WHO) recommendation of ≥30-min bouts, and, control group (CG), was conducted among 665 consenting pre-hypertensive sedentary adults enrolled from western Kenya. EG1 and EG2 performed similar weekly cumulative minutes of moderate intensity exercises. Adherence was determined using activity monitors and exercise logs. Data regarding demographic characteristics, heart rate, BP, and anthropometric measures were collected at baseline and 12th week follow-up. Data regarding univariate, bivariate and multivariate (repeated measurements between and within groups) analysis were conducted using STATA version 13 at 5% level of significance. The study revealed that males (92.1% in EG1, 92% in EG2 and 96.3% in CG) and females (94.6% in EG1, 89.3% in EG2 and 95% in CG) in the three arms completed the exercise at follow-up respectively. At 12th week follow-up from all exercise groups, males' and females' measurements for waist-hip-ratio, waist-height-ratio, systolic BP (SBP), heart rate and pulse pressure showed significant drops from baseline, while diastolic BP (DBP) and body mass index (BMI) reported mixed results for males and females from the various treatments. Both treatments demonstrated favourable outcomes. However, differences in the change between baseline and endpoint yielded mixed outcomes (SBP; p<0.05 for both males and females, DBP; p<0.05 for males and females, waist-height-ratio; p = 0.01 and <0.05 for males and females respectively, waist-hip-ratio; P = 0.01 and >0.05 for males and females respectively, BMI; p>0.05 for both males and females, heart rate; p<0.05 for males and females and pulse pressure; p = 0.01 and >0.05 for males and females respectively). The study design however could not test for superiority. The study demonstrated that the F-7.5m- MIE treatment programme and the WHO recommended 3-5 times weekly bouts of 30-60 minutes regime produced comparably similar favourable outcomes in adherence and BP reductions with improved body composition. Trial registration: Trial registered with Pan African Clinical Trial Registry (www.pactr.org): no. PACTR202107584701552. (S3 Text).
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Affiliation(s)
- Karani Magutah
- Department of Medical Physiology, School of Medicine, Moi University, Eldoret, Kenya
| | - Grace Mbuthia
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - James Amisi Akiruga
- Department of Family Medicine, Medical Education and Community Health, Moi University School of Medicine, Eldoret, Kenya
| | - Diresibachew Haile
- Department of Medical Physiology, School of Medicine, Moi University, Eldoret, Kenya
| | - Kihumbu Thairu
- Department of Medical Physiology, School of Medicine, University of Nairobi, Nairobi, Kenya
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COVID-19 and Cardiometabolic Health: Lessons Gleaned from the Pandemic and Insights for the Next Wave. Curr Atheroscler Rep 2022; 24:607-617. [PMID: 35773565 PMCID: PMC9247906 DOI: 10.1007/s11883-022-01033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/24/2022]
Abstract
Purpose of Review
To review the current evidence regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiometabolic health, with a focus on strategies to help mitigate adverse effects on population health. Recent Findings Individuals with cardiometabolic disease are particularly vulnerable to worse outcomes with COVID-19 infection. In addition, the pandemic itself has had significant deleterious impact on the cardiometabolic health of the population, including declines in physical activity, increases in smoking and alcohol use, worsening blood pressure and glycemic control, and detrimental effects on mental health. Targeted interventions at the patient and community level will be needed to mitigate the long-term consequences of the COVID-19 pandemic on population cardiometabolic health. Summary The COVID-19 pandemic has worsened cardiometabolic health, but there are several opportunities and enhanced tools available to counteract these changes.
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Wang S, Zhou H, Zhao C, He H. Effect of Exercise Training on Body Composition and Inflammatory Cytokine Levels in Overweight and Obese Individuals: A Systematic Review and Network Meta-Analysis. Front Immunol 2022; 13:921085. [PMID: 35812437 PMCID: PMC9260601 DOI: 10.3389/fimmu.2022.921085] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/25/2022] [Indexed: 12/13/2022] Open
Abstract
ObjectiveThis 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).MethodsWe 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.ResultsA 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.ConclusionThe 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 Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022303165.
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Affiliation(s)
- Shengya Wang
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
| | - Huayi Zhou
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
| | - Changtao Zhao
- Department of Physical Health and Arts Education, Ministry of Education, Beijing, China
| | - Hui He
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
- *Correspondence: Hui He,
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Associations between Objectively Determined Physical Activity and Cardiometabolic Health in Adult Women: A Systematic Review and Meta-Analysis. BIOLOGY 2022; 11:biology11060925. [PMID: 35741446 PMCID: PMC9220764 DOI: 10.3390/biology11060925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this systematic review and meta-analysis was to qualitatively synthesize and quantitatively assess the evidence of the relationship between objectively determined volumes of physical activity (PA) and cardiometabolic health in women. Four databases (PubMed, Web of Science, Scopus, and the Cochrane library) were searched and, finally, 24 eligible studies were included, with a total of 2105 women from eight countries. A correlational meta-analysis shows that moderate-to-vigorous intensity physical activity (MVPA) was favorably associated with high-density lipoprotein (r = 0.16; 95% CI: 0.06, 0.25; p = 0.002); however, there was limited evidence for the effects of most of the other cardiometabolic biomarkers recorded from steps, total physical activity, light- and moderate-intensity physical activity and MVPA. It is most compelling and consistent that being more physically active is beneficial to the metabolic syndrome. Overall, PA levels are low in adult women, suggesting that increasing the total volume of PA is more important than emphasizing the intensity and duration of PA. The findings also indicate that, according to the confounding effects of body composition and cardiorespiratory fitness, meeting the minimal level of 150 min of moderate-intensity physical activity recommended is not enough to obtain a significant improvement in cardiometabolic indicators. Nonetheless, the high heterogeneity between studies inhibits robust conclusions.
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Batrakoulis A, Jamurtas AZ, Metsios GS, Perivoliotis K, Liguori G, Feito Y, Riebe D, Thompson WR, Angelopoulos TJ, Krustrup P, Mohr M, Draganidis D, Poulios A, Fatouros IG. Comparative Efficacy of 5 Exercise Types on Cardiometabolic Health in Overweight and Obese Adults: A Systematic Review and Network Meta-Analysis of 81 Randomized Controlled Trials. Circ Cardiovasc Qual Outcomes 2022; 15:e008243. [PMID: 35477256 DOI: 10.1161/circoutcomes.121.008243] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although regular exercise is recommended for preventing and treating overweight/obesity, the most effective exercise type for improving cardiometabolic health in individuals with overweight/obesity remains largely undecided. This network meta-analysis aimed to evaluate and rank the comparative efficacy of 5 exercise modalities on cardiometabolic health measures in individuals with overweight/obesity. METHODS A database search was conducted in MEDLINE, Embase, Scopus, and Web of Science from inception up to September 2020. The review focused on randomized controlled trials involving exercise interventions consisting of continuous endurance training, interval training, resistance training, combined aerobic and resistance training (combined training), and hybrid-type training. Exercise interventions aimed to improve somatometric variables, body composition, lipid metabolism, glucose control, blood pressure, cardiorespiratory fitness, and muscular strength. The Cochrane risk of bias tool was used to evaluate eligible studies. A random-effects network meta-analysis was performed within a frequentist framework. The intervention ranking was carried out using a Bayesian model where mean and SD were equal to the respective frequentist estimates. RESULTS A total of 4331 participants (59% female; mean age: 38.7±12.3 years) from 81 studies were included. Combined training was the most effective modality and hybrid-type training the second most effective in improving cardiometabolic health-related outcomes in these populations suggesting a higher efficacy for multicomponent exercise interventions compared to single-component modalities, that is, continuous endurance training, interval training, and resistance training. A subgroup analysis revealed that the effects from different exercise types were mediated by gender. CONCLUSIONS These findings corroborate the latest guidelines on exercise for individuals with overweight/obesity highlighting the importance of a multicomponent exercise approach to improve cardiometabolic health. Physicians and healthcare professionals should consider prescribing multicomponent exercise interventions to adults with overweight/obesity to maximize clinical outcomes. REGISTRATION URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42020202647.
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Affiliation(s)
- Alexios Batrakoulis
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece (A.B., A.Z.J., D.D., A.P., I.G.F.)
| | - Athanasios Z Jamurtas
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece (A.B., A.Z.J., D.D., A.P., I.G.F.)
| | - Georgios S Metsios
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece (G.S.M.).,Russells Hall Hospital, Rheumatology, Dudley Group NHS Foundation Trust, Dudley, United Kingdom (G.S.M.).,Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom (G.S.M.)
| | | | - Gary Liguori
- College of Health Sciences, University of Rhode Island, Kingston (G.L., D.R.)
| | - Yuri Feito
- American College of Sports Medicine, Indianapolis, IN (Y.F.)
| | - Deborah Riebe
- College of Health Sciences, University of Rhode Island, Kingston (G.L., D.R.)
| | - Walter R Thompson
- College of Education and Human Development, Georgia State University, Atlanta (W.R.T.)
| | - Theodore J Angelopoulos
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington (T.J.A.)
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics (P.K.), University of Southern Denmark, Odense.,Section of Sport and Health Sciences and Danish Institute for Advanced Study (DIAS) (P.K.), University of Southern Denmark, Odense.,Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, United Kingdom (P.K.)
| | - Magni Mohr
- Department of Sports Science and Clinical Biomechanics (M.M.), University of Southern Denmark, Odense.,Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn (M.M.)
| | - Dimitrios Draganidis
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece (A.B., A.Z.J., D.D., A.P., I.G.F.)
| | - Athanasios Poulios
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece (A.B., A.Z.J., D.D., A.P., I.G.F.)
| | - Ioannis G Fatouros
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece (A.B., A.Z.J., D.D., A.P., I.G.F.)
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Effting PS, Thirupathi A, Müller AP, Pereira BC, Sepa-Kishi DM, Marqueze LFB, Vasconcellos FTF, Nesi RT, Pereira TCB, Kist LW, Bogo MR, Ceddia RB, Pinho RA. Resistance Exercise Training Improves Metabolic and Inflammatory Control in Adipose and Muscle Tissues in Mice Fed a High-Fat Diet. Nutrients 2022; 14:nu14112179. [PMID: 35683979 PMCID: PMC9182921 DOI: 10.3390/nu14112179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 12/13/2022] Open
Abstract
This study investigates whether ladder climbing (LC), as a model of resistance exercise, can reverse whole-body and skeletal muscle deleterious metabolic and inflammatory effects of high-fat (HF) diet-induced obesity in mice. To accomplish this, Swiss mice were fed for 17 weeks either standard chow (SC) or an HF diet and then randomly assigned to remain sedentary or to undergo 8 weeks of LC training with progressive increases in resistance weight. Prior to beginning the exercise intervention, HF-fed animals displayed a 47% increase in body weight (BW) and impaired ability to clear blood glucose during an insulin tolerance test (ITT) when compared to SC animals. However, 8 weeks of LC significantly reduced BW, adipocyte size, as well as glycemia under fasting and during the ITT in HF-fed rats. LC also increased the phosphorylation of AktSer473 and AMPKThr172 and reduced tumor necrosis factor-alpha (TNF-α) and interleukin 1 beta (IL1-β) contents in the quadriceps muscles of HF-fed mice. Additionally, LC reduced the gene expression of inflammatory markers and attenuated HF-diet-induced NADPH oxidase subunit gp91phox in skeletal muscles. LC training was effective in reducing adiposity and the content of inflammatory mediators in skeletal muscle and improved whole-body glycemic control in mice fed an HF diet.
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Affiliation(s)
- Pauline S. Effting
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
- Graduate Program in Health Science, Medical School, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, SC, Brazil;
| | - Anand Thirupathi
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
- Correspondence: (A.T.); (R.A.P.)
| | - Alexandre P. Müller
- Graduate de Pós-graduação em Farmacologia, Universidade Federal de Santa Catarina, Florianópolis 88020-302, SC, Brazil;
| | - Bárbara C. Pereira
- Graduate Program in Health Science, Medical School, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, SC, Brazil;
| | - Diane M. Sepa-Kishi
- Health Research Centre, School of Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada; (D.M.S.-K.); (R.B.C.)
| | - Luis F. B. Marqueze
- Laboratory of Exercise Biochemistry in Health, Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, PR, Brazil; (L.F.B.M.); (F.T.F.V.); (R.T.N.)
| | - Franciane T. F. Vasconcellos
- Laboratory of Exercise Biochemistry in Health, Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, PR, Brazil; (L.F.B.M.); (F.T.F.V.); (R.T.N.)
| | - Renata T. Nesi
- Laboratory of Exercise Biochemistry in Health, Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, PR, Brazil; (L.F.B.M.); (F.T.F.V.); (R.T.N.)
| | - Talita C. B. Pereira
- Graduate Program in Cellular and Molecular Biology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil; (T.C.B.P.); (L.W.K.); (M.R.B.)
| | - Luiza W. Kist
- Graduate Program in Cellular and Molecular Biology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil; (T.C.B.P.); (L.W.K.); (M.R.B.)
| | - Maurício R. Bogo
- Graduate Program in Cellular and Molecular Biology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil; (T.C.B.P.); (L.W.K.); (M.R.B.)
- Graduate Program in Medicine and Health Sciences, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil
| | - Rolando B. Ceddia
- Health Research Centre, School of Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada; (D.M.S.-K.); (R.B.C.)
| | - Ricardo A. Pinho
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
- Laboratory of Exercise Biochemistry in Health, Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, PR, Brazil; (L.F.B.M.); (F.T.F.V.); (R.T.N.)
- Correspondence: (A.T.); (R.A.P.)
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48
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Bouamra M, Zouhal H, Ratel S, Makhlouf I, Bezrati I, Chtara M, Behm DG, Granacher U, Chaouachi A. Concurrent Training Promotes Greater Gains on Body Composition and Components of Physical Fitness Than Single-Mode Training (Endurance or Resistance) in Youth With Obesity. Front Physiol 2022; 13:869063. [PMID: 35669575 PMCID: PMC9164296 DOI: 10.3389/fphys.2022.869063] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/19/2022] [Indexed: 12/24/2022] Open
Abstract
The prevalence of obesity in the pediatric population has become a major public health issue. Indeed, the dramatic increase of this epidemic causes multiple and harmful consequences, Physical activity, particularly physical exercise, remains to be the cornerstone of interventions against childhood obesity. Given the conflicting findings with reference to the relevant literature addressing the effects of exercise on adiposity and physical fitness outcomes in obese children and adolescents, the effect of duration-matched concurrent training (CT) [50% resistance (RT) and 50% high-intensity-interval-training (HIIT)] on body composition and physical fitness in obese youth remains to be elucidated. Thus, the purpose of this study was to examine the effects of 9-weeks of CT compared to RT or HIIT alone, on body composition and selected physical fitness components in healthy sedentary obese youth. Out of 73 participants, only 37; [14 males and 23 females; age 13.4 ± 0.9 years; body-mass-index (BMI): 31.2 ± 4.8 kg·m-2] were eligible and randomized into three groups: HIIT (n = 12): 3-4 sets×12 runs at 80–110% peak velocity, with 10-s passive recovery between bouts; RT (n = 12): 6 exercises; 3–4 sets × 10 repetition maximum (RM) and CT (n = 13): 50% serial completion of RT and HIIT. CT promoted significant greater gains compared to HIIT and RT on body composition (p < 0.01, d = large), 6-min-walking test distance (6 MWT-distance) and on 6 MWT-VO2max (p < 0.03, d = large). In addition, CT showed substantially greater improvements than HIIT in the medicine ball throw test (20.2 vs. 13.6%, p < 0.04, d = large). On the other hand, RT exhibited significantly greater gains in relative hand grip strength (p < 0.03, d = large) and CMJ (p < 0.01, d = large) than HIIT and CT. CT promoted greater benefits for fat, body mass loss and cardiorespiratory fitness than HIIT or RT modalities. This study provides important information for practitioners and therapists on the application of effective exercise regimes with obese youth to induce significant and beneficial body composition changes. The applied CT program and the respective programming parameters in terms of exercise intensity and volume can be used by practitioners as an effective exercise treatment to fight the pandemic overweight and obesity in youth.
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Affiliation(s)
- Marwa Bouamra
- Tunisian Research Laboratory “Sports Performance Optimization”, National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
- High Institute of Sport and Physical Education, Ksar-Saïd, Manouba University, Tunis, Tunisia
| | - Hassane Zouhal
- M2S (Laboratoire Mouvement, Sport, Santé) EA 1274, University of Rennes, Rennes, France
- Institut International des Sciences du Sport (2I2S), Irodouer, France
- *Correspondence: Urs Granacher, ; Hassane Zouhal,
| | - Sébastien Ratel
- AME2P, EA 3533, Clermont-Auvergne University, Clermont-Ferrand, France
| | - Issam Makhlouf
- Tunisian Research Laboratory “Sports Performance Optimization”, National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
- High Institute of Sport and Physical Education, Ksar-Saïd, Manouba University, Tunis, Tunisia
| | - Ikram Bezrati
- Tunisian Research Laboratory “Sports Performance Optimization”, National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
| | - Mokhtar Chtara
- Tunisian Research Laboratory “Sports Performance Optimization”, National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
| | - David G. Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Urs Granacher
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
- *Correspondence: Urs Granacher, ; Hassane Zouhal,
| | - Anis Chaouachi
- Tunisian Research Laboratory “Sports Performance Optimization”, National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
- High Institute of Sport and Physical Education, Sfax University, Sfax, Tunisia
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
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49
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Lopez P, Taaffe DR, Galvão DA, Newton RU, Nonemacher ER, Wendt VM, Bassanesi RN, Turella DJP, Rech A. 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. Obes Rev 2022; 23:e13428. [PMID: 35191588 PMCID: PMC9285060 DOI: 10.1111/obr.13428] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/09/2022] [Accepted: 01/09/2022] [Indexed: 12/23/2022]
Abstract
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.
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Affiliation(s)
- Pedro Lopez
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Dennis R. Taaffe
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Daniel A. Galvão
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Robert U. Newton
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | | | | | | | - Douglas J. P. Turella
- Centro Clínico UCSUniversidade de Caxias do SulCaxias do SulBrazil
- Curso de Educação FísicaUniversidade de Caxias do SulCaxias do SulBrazil
| | - Anderson Rech
- Curso de Educação FísicaUniversidade de Caxias do SulCaxias do SulBrazil
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50
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Sinha MK, Maiya GA, Moga AM, K N S, Shankar N R, K V. Exercise dose-response relationship with heart rate variability in individuals with overweight and obesity: protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2022; 12:e047821. [PMID: 35470179 PMCID: PMC9039408 DOI: 10.1136/bmjopen-2020-047821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Obesity is a chronic relapsing disease process and serious public health concern that can lead to chronic diseases, medical complications and a higher risk of disability. Another significant feature of obesity is dysfunction in cardiac autonomic function, which leads to changes in parasympathetic and sympathetic regulation, which can be measured using heart rate variability (HRV). The objective of this review is to estimate the extent to which exercise doses impacts on HRV among individuals living with overweight and obesity class I and II. METHODS AND ANALYSIS A systematic literature search will be performed using PubMed/Medline, Scopus, EMBASE, ProQuest, CINAHL, Web of Science and the Cochrane Library for articles dating from 1965 to December 2021. Inclusion criteria include studies designed as parallel-arm randomised trials, enrolling adolescent and adult individuals with overweight (body mass index, BMI≥25 to ≤29.9) and obesity (class I BMI: 30-34.9 and class II BMI: 35-39.9) undergoing aerobic or resistance training or concurrent exercise training. For data synthesis, sensitivity analysis, subgroup analysis and risk of bias assessment, Stata V.13.0 software will be used. ETHICS AND DISSEMINATION Formal ethical approval is not required. This systematic review will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42019104154.
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Affiliation(s)
- Mukesh Kumar Sinha
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - G Arun Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ana Maria Moga
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Shivashankar K N
- Department of Medicine, Kasturba Medical college, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ravi Shankar N
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Vaishali K
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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