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Kazeminasab F, Bahrami Kerchi A, Behzadnejad N, Belyani S, Rosenkranz SK, Bagheri R, Dutheil F. The Effects of Exercise Interventions on Ectopic and Subcutaneous Fat in Patients with Type 2 Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression. J Clin Med 2024; 13:5005. [PMID: 39274218 PMCID: PMC11396734 DOI: 10.3390/jcm13175005] [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: 07/18/2024] [Revised: 08/15/2024] [Accepted: 08/21/2024] [Indexed: 09/16/2024] Open
Abstract
Background/Objectives: The aim of the present study was to determine the effects of exercise training on ectopic and subcutaneous fat in patients with type 2 diabetes mellitus (T2DM). Methods: Web of Science, PubMed, and Scopus were searched for original articles published through November 2023 that included exercise versus control interventions on body mass (BM), liver fat percentage, visceral fat area (VFA), subcutaneous fat area (SFA), and intramuscular fat volume or mass (IMF) in patients with T2DM. Weighted mean differences (WMDs) for liver fat and BM, standardized mean differences (SMDs) for VFA, SFA, and IMF, and 95% confidence intervals (95% CIs) were determined using random-effects models. Results: Thirty-six studies comprising 2110 patients with T2DM were included in the present meta-analysis. Exercise training effectively reduced BM [WMD = -2.502 kg, p = 0.001], liver fat% [WMD = -1.559%, p = 0.030], VFA [SMD = -0.510, p = 0.001], and SFA [SMD = -0.413, p = 0.001] in comparison to the control. The IMF [SMD = 0.222, p = 0.118] remained unchanged compared to the controls. Subgroup analyses showed that the type of exercise, duration, and body mass index (BMI) of participants were sources of heterogeneity. Conclusions: The current meta-analysis provides strong evidence that exercise training, particularly aerobic and combined (aerobic and resistance) exercise programs, is effective for reducing BM, VFA, and SFA in patients with T2DM. However, aerobic exercise was more effective for reducing liver fat than combined exercise. The beneficial effects of exercise on VFA and SFA reduction, but not liver fat, are associated with weight loss. These findings highlight the importance of including consistent exercise as a key management component for T2DM and associated ectopic fat deposition, with potential long-term benefits for metabolic health.
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Affiliation(s)
- Fatemeh Kazeminasab
- Department of Physical Education and Sports Science, Faculty of Humanities, University of Kashan, Kashan 87317-53153, Iran
| | - Ali Bahrami Kerchi
- Department of Exercise Physiology, Faculty of Sports Science, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan P.O. Box 81551-39998, Iran
| | - Nasim Behzadnejad
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan P.O. Box 81746-73441, Iran
| | - Saba Belyani
- Human Nutrition Program, Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Reza Bagheri
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan P.O. Box 81746-73441, Iran
| | - Fred Dutheil
- University Hospital of Clermont-Ferrand, Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, F-63000 Clermont-Ferrand, France
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Edwards S, Foster M, Ahmed SF, Lucas-Herald AK. Preventative interventions that target cardiovascular dysfunction in children and young people: a systematic review of their effectiveness and an investigation of sexual dimorphism. J Hum Hypertens 2023; 37:726-734. [PMID: 36463360 PMCID: PMC10403341 DOI: 10.1038/s41371-022-00780-z] [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: 08/01/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022]
Abstract
Given that cardiovascular diseases remain a primary cause of mortality and morbidity, there is a need to consider preventative strategies to improve vascular function from early in life. The aims of this study were therefore to investigate which interventions may improve endothelial function, intima media thickness and arterial stiffness in children and young people and to assess whether these interventions differ in boys and girls. A systematic literature search of Science Direct, Pubmed, Google Scholar and the Cochrane Library by two independent reviewers was performed to source articles. Inclusion criteria were any studies including any child ≤18 years of age receiving an intervention, which measured vascular function other than blood pressure. Exclusion criteria were studies assessing children with chronic medical conditions. A total of 72 studies were identified, which met the inclusion criteria. A measurable change in outcome was more likely to be reported in studies investigating endothelial function (p = 0.03). Interventions which improved vascular function included physical activity and dietary programmes. Under 10% of studies considered sex differences. In conclusion, school-based physical activity interventions are most likely to result in improvements in vascular function. Endothelial function may be the first variable of vascular function to change secondary to an intervention. Standardisation of reporting of differences between the sexes is essential to be able to ensure interventions are equally effective for boys and girls.
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Affiliation(s)
- Sophie Edwards
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - Murray Foster
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - S Faisal Ahmed
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - Angela K Lucas-Herald
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK.
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Sequi-Dominguez I, Mavridis D, Cavero-Redondo I, Saz-Lara A, Martinez-Vizcaino V, Núñez de Arenas-Arroyo S. Comparative effectiveness of different types of exercise in reducing arterial stiffness in children and adolescents: a systematic review and network meta-analysis. Br J Sports Med 2023:bjsports-2022-106285. [PMID: 36963807 DOI: 10.1136/bjsports-2022-106285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE Arterial stiffness is an early and detectable marker of vascular changes leading to atherosclerotic cardiovascular disease (ACVD). Our objective was to compare the effectiveness of different types of exercise in reducing arterial stiffness in children and adolescents. DESIGN A systematic review and network meta-analysis (NMA) was conducted including experimental studies reporting the effects of exercise interventions on pulse wave velocity (PWV) in children and adolescents. DATA SOURCES Cochrane Central Register of Controlled Trials, EMBASE (via Scopus), PubMed (via Medline) and Web of Science from database inception to 25 March 2022. ELIGIBILITY CRITERIA Experimental studies reporting the effects of exercise interventions on PWV in children and adolescents. RESULTS Fourteen studies were included in the NMA, all of them were randomised controlled trials except one quasi-experimental study, with an overall risk of bias of some concern. Regarding PWV reduction, all exercise modalities were more effective than control, with standardised mean difference ranging from -1.93 (95% CI: -2.84 to -1.02) and -1.11 (95% CI: -2.01 to -0.21) for aerobic exercise and high intensity interval training (HIIT), respectively, to -0.59 (95% CI: -1.39 to 0.22) for combined exercise. Only sensorimotor training was not superior to the control group 0.11 (95% CI: -1.10 to 1.32). CONCLUSION Our results support that exercise interventions, especially aerobic exercise or HIIT, can improve arterial stiffness at early ages. The potential to address ACVD early and mitigate long-term consequences via exercise interventions in children and adolescents with higher arterial stiffness requires further investigation. PROSPERO REGISTRATION NUMBER CRD42022322536.
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Affiliation(s)
- Irene Sequi-Dominguez
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha - Campus de Albacete, Albacete, Spain
| | - Dimitris Mavridis
- Department of Primary Education, University of Ioannina, Ioannina, Greece
- Faculty of Medicine, Université Paris Descartes BU, Paris, France
| | - Iván Cavero-Redondo
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
| | - Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
| | - Vicente Martinez-Vizcaino
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
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Machado E, Jannuzzi F, Telles S, Oliveira C, Madeira I, Sicuro F, Souza MDG, Monteiro A, Bouskela E, Collett-Solberg P, Farinatti P. A Recreational Swimming Intervention during the Whole School Year Improves Fitness and Cardiometabolic Risk in Children and Adolescents with Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17093. [PMID: 36554976 PMCID: PMC9778733 DOI: 10.3390/ijerph192417093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The benefits of swimming as a treatment for overweight children are undefined. We investigated the effects of recreational swimming on cardiometabolic risk in children/adolescents with normal and excess weight. Participants (n = 49, 26 girls, 10.3 ± 1.8 y) were grouped as 'eutrophic swimming' (EU-Swim, n = 14); 'excess weight swimming' (EW-Swim, n = 20) with an 'obese swimming' subgroup (OB-Swim, n = 10); and 'excess weight sedentary' (EW-Sed, n = 15) with an 'obese sedentary' subgroup (OB-Sed, n = 11). Swimming (50 min, twice/week, moderate-vigorous intensity) was an extra activity during the school year (6 + 3 months with a 3-month school break). Nutritional status, blood pressure (BP), physical activity, cardiorespiratory fitness, biochemical variables, autonomic modulation, endothelial function, abdominal fat, and carotid thickness were assessed at baseline, 6, and 12 months. Greater improvements (p < 0.05) occurred in EW-Swim vs. EW-Sed in body mass index (z-BMI, -16%, d+ 0.52), waist-to-height ratio (W/H, -8%, d+ 0.59-0.79), physical activity (37-53%, d+ 1.8-2.2), cardiorespiratory fitness (30-40%, d+ 0.94-1.41), systolic BP (SBP, -6-8%, d+ 0.88-1.17), diastolic BP (DBP, -9-10%, d+ 0.70-0.85), leptin (-14-18%, d+ 0.29-0.41), forearm blood flow (FBF, 26-41%, d+ 0.53-0.64), subcutaneous fat (SAT, -6%, d+ 0.18), and intra-abdominal fat (VAT, -16%, d+ 0.63). OB-Swim showed improvements vs. OB-Sed in TNFα (-17%, d+ 1.15) and adiponectin (22%, d+ 0.40). Swimming improved fitness and cardiometabolic risk in children/adolescents with overweight/obesity. (TCTR20220216001).
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Affiliation(s)
- Elisabeth Machado
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Fernanda Jannuzzi
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Silvio Telles
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Cecilia Oliveira
- Institute of Nutrition, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Isabel Madeira
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Fernando Sicuro
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
- Centre for Environment and Marine Studies, Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Maria das Graças Souza
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Alexandra Monteiro
- Department of Radiology, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Eliete Bouskela
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Paulo Collett-Solberg
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
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Mohammadrezaei A, Kavakeb A, Abbasalizad-Farhangi M, Mesgari-Abbasi M. Effects of hemp seed alone and combined with aerobic exercise on metabolic parameters, oxidative stress, and neurotrophic factors in young sedentary men. J Food Biochem 2022; 46:e14417. [PMID: 36114824 DOI: 10.1111/jfbc.14417] [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: 03/18/2022] [Revised: 08/04/2022] [Accepted: 08/16/2022] [Indexed: 01/13/2023]
Abstract
Hemp seed and physical activity (PA) have many benefits for the metabolic and brain health of the body. This study investigated the effects of hemp seed alone and aerobic exercise on metabolic markers, oxidative stress, and neurotrophic factors in young sedentary men. This double-blind, placebo-controlled, randomized clinical trial was conducted on 48 sedentary young men in Tabriz, Iran, from April to August. The researcher in this study randomized all participants into four groups, including (1) hemp seed, (2) hemp seed + PA, (3) PA + placebo, and (4) placebo. Hemp seed supplement was administered in two 1-g capsules daily, and aerobic PA was performed a week thrice. Levels of anthropometric indices, dietary intake, antioxidant markers, lipid profile, fasting blood sugar (FBS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), brain-derived neurotrophic factor (BDNF), neuropeptide Y (NPY), balance, reaction time, and sit-ups were evaluated for all participants at baseline and post-intervention. We used ANOVA and ANCOVA analysis to compare oxidative stress and neurotropic factors in all intervention groups. If the distribution of the response variable was not normal, the non-parametric equivalent of these tests was used (Wilcoxon and Kruskal-Wallis tests). We performed all statistical analyzes using SPSS software version 23, and the significance level was considered 0.05 in all the statistical tests. Aerobic PA with hemp seed consumption caused a significant difference in weight, body mass index, fat mass, high-density lipoprotein, catalase, and BDNF compared with baseline. Also, aerobic PA alone caused significant changes in body weight, fat mass, and triglyceride compared with baseline. Consumption of hemp seeds alone caused a significant increase in high-density lipoprotein levels compared with baseline. At the end of the study, fat mass, total cholesterol, low-density lipoproteins, and BDNF were significantly different between the groups. According to our results, aerobic PA combined with hemp seed consumption may improve anthropometric indices, lipid profile, and BDNF and improve health outcomes like cardiovascular comorbidities, oxidative stress, and insulin resistance. PRACTICAL APPLICATIONS: A sedentary lifestyle has numerous health-threatening consequences like cardiovascular comorbidities, oxidative stress, and insulin resistance. The importance of physical activity (PA) in improving these clinical manifestations is well-known; however, the potential benefits of herbal therapy combined with PA in reducing the side effects of a sedentary lifestyle have not been well studied. In the current research, we evaluated the benefits of hemp seed alone and combined with aerobic exercise on metabolic markers, oxidative stress, and neurotrophic factors in young sedentary men for the first time. According to our results, aerobic PA combined with hemp seed consumption improved anthropometric indices, lipid profile, and brain-derived neurotrophic factor among young sedentary men.
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Affiliation(s)
- Ali Mohammadrezaei
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Kavakeb
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, University of Kharazmi, Tehran, Iran
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Cadenas-Sanchez C, Cabeza R, Idoate F, Osés M, Medrano M, Villanueva A, Arenaza L, Sanz A, Ortega FB, Ruiz JR, Labayen I. Effects of a Family-Based Lifestyle Intervention Plus Supervised Exercise Training on Abdominal Fat Depots in Children With Overweight or Obesity: A Secondary Analysis of a Nonrandomized Clinical Trial. JAMA Netw Open 2022; 5:e2243864. [PMID: 36441551 PMCID: PMC9706365 DOI: 10.1001/jamanetworkopen.2022.43864] [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] [Indexed: 11/29/2022] Open
Abstract
IMPORTANCE Excess abdominal fat is a major determinant in the development of insulin resistance and other metabolic disorders. Increased visceral adipose tissue (VAT) seems to precede the development of insulin resistance and is therefore a prime target of childhood lifestyle interventions aimed at preventing diabetes. OBJECTIVES To examine the effect of added exercise to a family-based lifestyle intervention program designed to reduce VAT plus subcutaneous (ASAT), intermuscular (IMAAT), and pancreatic (PAT) adipose tissue in children with overweight or obesity and to explore the effect of changes in VAT on insulin resistance. DESIGN, SETTING, AND PARTICIPANTS This 2-group, parallel-design clinical trial was conducted in Vitoria-Gasteiz, Spain. A total of 116 children with overweight or obesity participated and were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). Data were collected between September 1, 2014, and June 30, 2017, and imaging processing for fat depot assessments and data analysis were performed between May 1, 2019, and February 12, 2021. INTERVENTIONS The compared interventions consisted of a family-based lifestyle and psychoeducation program (two 90-minute sessions per month) and the same program plus supervised exercise (three 90-minute sessions per week). MAIN OUTCOMES AND MEASURES The primary outcome of this study was the change in VAT between baseline and 22 weeks as estimated by magnetic resonance imaging. The secondary outcomes were changes in ASAT, IMAAT, and PAT. The effect of changes in VAT area on insulin resistance was also recorded. RESULTS The 116 participants included in the analysis (62 girls [53.4%]) had a mean (SD) age of 10.6 (1.1) years, and 67 (57.8%) presented with obesity. Significantly greater reductions were recorded for the exercise group in terms of reduction in VAT (-18.1% vs -8.5% for the control group; P = .004), ASAT (-9.9% vs -3.0%; P = .001), and IMAAT (-6.0% vs -2.6%; P = .02) fat fractions compared with the control group. Changes in VAT explained 87.6% of the improvement seen in insulin resistance (β = -0.102 [95% CI, -0.230 to -0.002]). CONCLUSIONS AND RELEVANCE These findings suggest that the addition of exercise to a lifestyle intervention program substantially enhanced the positive effects on abdominal fat depots in children with overweight or obesity. In addition, the reduction in VAT seemed to largely mediate the improvement of insulin sensitivity. These results highlight the importance of including exercise as part of lifestyle therapies aimed at treating childhood obesity and preventing the development of type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02258126.
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Affiliation(s)
- Cristina Cadenas-Sanchez
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
- PROFITH (Promoting Fitness and Health Through Physical Activity) Research Group, Sport and Health University Research Institute, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | - Fernando Idoate
- Department of Radiology, Mutua Navarra, Pamplona, Spain
- Department of Health Sciences, Public University of Navarre, Pamplona, Spain
| | - Maddi Osés
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - María Medrano
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Arantxa Villanueva
- Navarra Institute for Health Research, Pamplona, Spain
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
- Smart Cities Institute, Public University of Navarre, Pamplona, Spain
| | - Lide Arenaza
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Aritz Sanz
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | - Francisco B. Ortega
- PROFITH (Promoting Fitness and Health Through Physical Activity) Research Group, Sport and Health University Research Institute, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jonatan R. Ruiz
- PROFITH (Promoting Fitness and Health Through Physical Activity) Research Group, Sport and Health University Research Institute, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain
| | - Idoia Labayen
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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Wang R, Zhang X, Ren H, Zhou H, Yuan Y, Chai Y, Hou X. Effects of different exercise types on visceral fat in young individuals with obesity aged 6-24 years old: A systematic review and meta-analysis. Front Physiol 2022; 13:987804. [PMID: 36246116 PMCID: PMC9562999 DOI: 10.3389/fphys.2022.987804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction: The prevalence of pediatric obesity remains high all over the world. Various exercise interventions have been applied to decrease the visceral fat in young individuals with obesity. But the evidence remains controversial on the effect of the exercise on visceral fat. Moreover, it is unclear which type of the exercise is the most effective for young individuals with overweight or obesity to reduce visceral fat. Objective: The objective of this review and meta-analysis is to evaluate and compare the effectiveness of different exercise interventions on visceral fat in young individuals with overweight or obesity. Methods: Four databases consisting of PubMed, Web of Science, EBSCO, and Cochrane Library were searched prior to May 2022. Fifteen studies with a total of 30 data points involving 1,134 participants were included in this meta-analysis. And the interventions were limited to 4 exercise types [i.e., aerobic exercise (AE), resistance exercise (RE), aerobic exercise combined with resistance exercise (CE), and high-intensity interval training (HIIT)]. Data Synthesis: The results showed that AE (Standardized Mean Difference = -0.32; 95% CI = -0.50 to -0.13; p = 0.0007; I2 = 37%) and HIIT (SMD = -0.59; 95% CI = -0.87 to -0.31; p < 0.0001; I2 = 0%) had a significant reduction effect on visceral fat. And the effect of HIIT seemed better than AE. However, RE (SMD = -0.58; 95% CI = -1.34 to 0.17; p = 0.13; I2 = 76%) and CE (SMD = -0.21; 95% CI = -0.81 to 0.38; p = 0.48; I2 = 63%) had a non-significant effect on visceral fat decline. Additionally, compared with the control group, exercise interventions had a significant effect on reducing visceral fat in adolescents (SMD = -0.54; 95% CI = -0.82 to -0.26; p = 0.0001; I2 = 64%) and young adults (SMD = -0.42; 95% CI = -0.69 to -0.15; p = 0.003; I2 = 0%) rather than children (SMD = -0.15; 95% CI = -0.32 to 0.02; p = 0.08; I2 = 0%). And the gender-based subgroup analysis indicated that the effectiveness of the exercise on the reduction of visceral fat was more significant in males (SMD = -1.27; 95% CI = -1.67 to -0.87; p < 0.00001; I2 = 0%) than that in females (SMD = -0.31; 95% CI = -0.48 to -0.14; p = 0.0004; I2 = 0%). Conclusion: This review and meta-analysis demonstrates that exercise interventions are efficient to decrease visceral fat in adolescents (12-18 years old) and young adults (18-24 years old). Among different exercise types, AE and HIIT are helpful for young individuals with overweight or obesity to reduce visceral fat and HIIT appears to be the most effective exercise intervention. In addition, the effect of exercise interventions on the consumption of visceral fat is more significant in males than that in females. Systematic Review Registration: [http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022310878].
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Affiliation(s)
- Rong Wang
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Xiaoyuan Zhang
- Department of Physical Education, Peking University, Beijing, China
| | - Hong Ren
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Huixuan Zhou
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Yaqing Yuan
- College of Sports and Health, Shandong Sport University, Shandong, China
| | - Yunlong Chai
- Department of Physical Education, Peking University, Beijing, China
| | - Xiao Hou
- School of Sport Science, Beijing Sport University, Beijing, China,*Correspondence: Xiao Hou,
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Physical function, body mass index, and fitness outcomes in children, adolescents, and emerging adults with craniopharyngioma from proton therapy through five years of follow-up. J Neurooncol 2022; 159:713-723. [PMID: 35987949 PMCID: PMC9392500 DOI: 10.1007/s11060-022-04116-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/16/2022] [Indexed: 12/04/2022]
Abstract
Purpose Children diagnosed with craniopharyngioma are vulnerable to adverse health outcomes. Characterization of body mass index (BMI), physical function, and cardiopulmonary fitness in those treated with proton radiotherapy (PRT) will serve to design interventions to improve outcomes. Methods Ninety-four children with craniopharyngioma completed physical function testing prior to PRT and annually for 5 years. For each outcome, age- and sex-specific z-scores were calculated using normative values. Participants with z-scores > 1.5 or < − 1.5 were classified as impaired. Those with z-scores > 2.0 or < − 2.0 were classified as significantly impaired. Descriptive statistics were used to describe study outcomes and change in prevalence of impairments from 2 to 5 years after treatment. Results Nearly half of participants [45.2%, 95% confidence interval (CI) 39.4, 51.0] had mean BMI z-scores > 1.5 at baseline, with prevalence increasing to 66.7% (95% CI 61.5, 71.9) at 5 years. More than half of participants (54.2%, 95% CI 48.4, 60.0) had knee extension strength z-scores < − 1.5 at baseline, with prevalence increasing to 81.3% (95% CI 77.7, 84.9) at 5 years. BMI and knee extension strength had the largest proportion of participants impaired at both 2 and 5 years (53.2% and 62.3%, respectively). Resting heart rate had the highest proportion of participants not impaired at 2 years but became impaired at 5 years (26.6%). Conclusions Children with craniopharyngioma have BMI and fitness abnormalities at diagnosis and continue 5 years after treatment. This cohort may benefit from interventions designed to improve BMI, strength, and resting indicators of cardiopulmonary fitness. Supplementary Information The online version contains supplementary material available at 10.1007/s11060-022-04116-2.
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Abstract
Physical activity and its sustained and purposeful performance-exercise-promote a broad and diverse set of metabolic and cardiovascular health benefits. Regular exercise is the most effective way to improve cardiorespiratory fitness, a measure of one's global cardiovascular, pulmonary and metabolic health, and one of the strongest predictors of future health risk. Here, we describe how exercise affects individual organ systems related to cardiometabolic health, including the promotion of insulin and glucose homeostasis through improved efficiency in skeletal muscle glucose utilization and enhanced insulin sensitivity; beneficial changes in body composition and adiposity; and improved cardiac mechanics and vascular health. We subsequently identify knowledge gaps that remain in exercise science, including heterogeneity in exercise responsiveness. While the application of molecular profiling technologies in exercise science has begun to illuminate the biochemical pathways that govern exercise-induced health promotion, much of this work has focused on individual organ systems and applied single platforms. New insights into exercise-induced secreted small molecules and proteins that impart their effects in distant organs ("exerkines") highlight the need for an integrated approach towards the study of exercise and its global effects; efforts that are ongoing.
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Affiliation(s)
| | - Prashant Rao
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Cardiovascular Research Center, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jeremy M. Robbins
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Cardiovascular Research Center, Beth Israel Deaconess Medical Center, Boston, MA
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10
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Gong L, Liu Y. Effect of Exercise Training on Arterial Stiffness in Overweight or Obese Populations. Int J Sports Med 2022; 43:996-1012. [PMID: 35468651 PMCID: PMC9622304 DOI: 10.1055/a-1795-2940] [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] [Indexed: 11/21/2022]
Abstract
The purpose was to analyze the effects of exercise training (ET) on arterial
stiffness in all-age overweight or obese individuals. Sixty-one trials were
included with ET improving flow-mediated dilation (FMD), pulse wave velocity
(PWV), and intima-media thickness (IMT). In the subgroup analysis: (i) ET
improved FMD in overweight or obese children and adolescents with a large effect
size (SMD=0.83, 95% CI 0.42–1.25). PWV was decreased
after ET regardless of age. IMT was decreased by ET in participants younger than
60, (ii) ET improved FMD, PWV, and IMT in participants whose BMI were smaller
than 30 kg/m
2
, but ET only improved PWV of
participants whose BMI were larger than 30 kg/m
2
.
(iii) AE improved FMD, PWV, and IMT. High-intensity interval training (HIIT)
decreased IMT. (iv) The increase of FMD only happened when training duration was
longer than eight weeks. However, ET decreased PWV when the training duration
was no longer than 12 weeks. IMT was decreased when the training duration was
longer than eight weeks. ET instigated an improvement in endothelial function
and arterial stiffness in overweight or obese populations, but depending on the
different characteristics of exercise intervention and participants’
demographics.
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Affiliation(s)
- Lijing Gong
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China
| | - Yujia Liu
- Physical education, Jiangsu Normal University, Xuzhou, China
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11
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The feasibility and efficacy of the home-based exercise programs in patients with cognitive impairment: A pilot study. Geriatr Nurs 2022; 45:108-117. [PMID: 35395598 DOI: 10.1016/j.gerinurse.2022.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine the feasibility and efficacy of home-based aerobic and resistance exercise interventions for geriatric individuals with cognitive impairment. METHODS Fourteen participants with cognitive impairment were allocated to either the aerobic group (n = 8) or the resistance group (n = 6), after which they implemented a two-month home-based training program. Feasibility and efficacy outcomes were evaluated. A semi-structured interview was performed after the intervention. RESULTS All fourteen participants completed the two-month training program. The adherence rate was 0.94 for the aerobic group and 0.96 for the resistance group. No adverse events occurred. The results revealed a trend of group×time interaction effect on delayed recall. Significant group×time interaction effects were revealed on simple physical performance and body composition. Semi-structured interviews identified four motivators for participating in this program, four facilitators for and three barriers to keeping exercising, and some perceived benefits. CONCLUSION Home-based aerobic and resistance exercise programs are feasible for geriatric individuals with cognitive impairment. The efficacy needs to be further examined.
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12
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Flores-Ramírez AG, Tovar-Villegas VI, Maharaj A, Garay-Sevilla ME, Figueroa A. Effects of L-Citrulline Supplementation and Aerobic Training on Vascular Function in Individuals with Obesity across the Lifespan. Nutrients 2021; 13:nu13092991. [PMID: 34578869 PMCID: PMC8466140 DOI: 10.3390/nu13092991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/20/2022] Open
Abstract
Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial dysfunction, characterized by reduced nitric oxide (NO) production, precedes vascular abnormalities including atherosclerosis and arterial stiffness. Thus, early detection and treatment of cardiometabolic risk factors are necessary to prevent deleterious vascular consequences of obesity at an early age. Non-pharmacological interventions including L-Citrulline (L-Cit) supplementation and aerobic training stimulate endothelial NO mediated vasodilation, leading to improvements in organ perfusion, blood pressure, arterial stiffness, atherosclerosis and metabolic health (glucose control and lipid profile). Few studies suggest that the combination of L-Cit supplementation and exercise training can be an effective strategy to counteract the adverse effects of obesity on vascular function in older adults. Therefore, this review examined the efficacy of L-Cit supplementation and aerobic training interventions on vascular and metabolic parameters in obese individuals.
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Affiliation(s)
- Anaisa Genoveva Flores-Ramírez
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
| | - Verónica Ivette Tovar-Villegas
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
| | - Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
| | - Ma Eugenia Garay-Sevilla
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
- Correspondence: (M.E.G.-S.); (A.F.)
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
- Correspondence: (M.E.G.-S.); (A.F.)
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13
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Van Eyck A, Eerens S, Trouet D, Lauwers E, Wouters K, De Winter BY, van der Lee JH, Van Hoeck K, Ledeganck KJ. Body composition monitoring in children and adolescents: reproducibility and reference values. Eur J Pediatr 2021; 180:1721-1732. [PMID: 33481106 PMCID: PMC8105252 DOI: 10.1007/s00431-021-03936-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 11/29/2022]
Abstract
There is an increasing need for suitable tools to evaluate body composition in paediatrics. The Body Composition Monitor (BCM) shows promise as a method, but reference values in children are lacking. Twenty children were included and measured twice by 4 different raters to asses inter- and intra-rater reproducibility of the BCM. Reliability was assessed using the Bland-Altman method and by calculating intraclass correlation coefficients (ICCs). The intra-rater ICCs were high (≥ 0.97) for all parameters measured by BCM as were the inter-rater ICCs for all parameters (≥ 0.98) except for overhydration (0.76). Consequently, a study was set up in which BCM measurements were performed in 2058 healthy children aged 3-18.5 years. The age- and gender-specific percentile values and reference curves for body composition (BMI, waist circumference, fat mass and lean tissue mass) and fluid status (extracellular and intracellular water and total body water) relative to age were produced using the GAMLSS method for growth curves.Conclusion: A high reproducibility of BCM measurements was found for fat mass, lean tissue mass, extracellular water and total body water. Reference values for these BCM parameters were calculated in over 2000 children and adolescents aged 3 to 18 years. What is Known • The 4-compartment model is regarded as the 'gold standard' of body composition methods, but is inappropriate for regular follow-up or screening of large groups, because of associated limitations. • Body Composition Monitor® is an inexpensive field method that has the potential to be an adequate monitoring tool. What is New • Good reproducibility of BCM measurements in children provides evidence to use the device in longitudinal follow-up, multicentre and comparative studies. • Paediatric reference values relative to age and sex for the various compartments of the body are provided.
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Affiliation(s)
- Annelies Van Eyck
- Laboratory of Experimental Medicine and Pediatrics and member of the Infla-Med Centre of Excellence, University of Antwerp, Wilrijk, Belgium ,Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Sofie Eerens
- Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Dominique Trouet
- Laboratory of Experimental Medicine and Pediatrics and member of the Infla-Med Centre of Excellence, University of Antwerp, Wilrijk, Belgium ,Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Eline Lauwers
- Laboratory of Experimental Medicine and Pediatrics and member of the Infla-Med Centre of Excellence, University of Antwerp, Wilrijk, Belgium
| | - Kristien Wouters
- Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital, Edegem, Belgium ,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Benedicte Y. De Winter
- Laboratory of Experimental Medicine and Pediatrics and member of the Infla-Med Centre of Excellence, University of Antwerp, Wilrijk, Belgium ,Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
| | - Johanna H. van der Lee
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Clinical Research Office, AMC, Amsterdam, The Netherlands
| | - Koen Van Hoeck
- Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Kristien J. Ledeganck
- Laboratory of Experimental Medicine and Pediatrics and member of the Infla-Med Centre of Excellence, University of Antwerp, Wilrijk, Belgium ,University of Antwerp, Universiteitsplein 1, T3.34, 2610 Antwerp, Belgium
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