An overview of the contribution of fatness and fitness factors, and the role of exercise, in the formation of health status for individuals who are overweight

A small switch in perspective: Comparing weight loss by nutrient balance versus caloric balance

The establishment of a Caloric balance has been classically discussed as the means to induce weight loss. Recently, the idea of nutrient balance as opposed to Caloric balance has emerged as a better means to induce weight loss. This investigation compared differences in weight loss between a diet based on a nutrient balanced diet compared to a Caloric balance diet. 53 (27M/26F) active overfat individuals (30.7+/- 7.1 years) were randomly (matched for age, gender, training history) assigned within an 8-week intervention to follow either a self-selected diet (control) or a diet based on following a Caloric balance (%Cal/day) or a nutrient balance (g/kg/day) in conjunction with a periodized exercise regimen to determine effectiveness for each diet to induce weight loss. Nutrient balance group had significantly different changes (p < 0.05) in fat-free mass (2.26 (2.02, 2.49) kg versus 0.42 (-0.40, 1.24) kg) and fat mass (-5.96 (-5.34, -6.58) kg versus -4.08 (-3.92, -5.92) kg) relative to the Caloric balance group and was more effective at meeting nutritional requirements for protein (ES = 0.65 (0.48, 0.85)) and lipids (ES = 0.24 (-0.09, 0.98)) than the Caloric balance group. Nutrient balance was subjectively scored as easier to follow and more likely to be self-selected. Using a nutrient balance diet may be more effective at inducing beneficial body compositional changes and shows being a more self-selected dietary method when compared to a Caloric balance diet. Therefore, it may be a better choice for advice when offering treatments to those who are attempting to lose weight or maintain weight loss.

The impact of bias on developing healthy lifestyles, understanding if personal perspectives impact modeling and recommendations of diet and exercise by educators to their students

Purpose

Educators have an ability to imprint healthy behavior in children. Yet, little is known about how a bias by educators might impact imprinting on students. Therefore, we examined if educators' bias in opinions about diet and exercise influence the manner they are discussed with students.

Methods

340 (144 F/196 M) educators from over 14 states (USA) provided responses regarding: personal opinions about and history of following diets or using exercise regimens; perspective on commonly held beliefs regarding diet, exercise, body image and morphology; and who should provide recommendations. Responses were tabulated for average and percentage with subsequent analysis by Pearson correlations or keyword frequencies of responses.

Results

Almost all (97%) understand social pressures related to body image and need to portray healthy behaviors to students. Bias was evident based on history of recommending or discouraging a specific diet (r = 0.77) or a dietary supplement (r = 0.66), recommending exercise they used (r = 0.89) or discouraging ones not used (r = 0.65). Most (85%) understand that social and mass media are not reliable sources, yet, relied on the same sources for information that reinforced their opinions.

Conclusion

Findings indicate (1) portrayal of healthy behaviors to students exist but expressed opinion that families have a greater influence than educators on healthy lifestyles, (2) there appears to be an unawareness of personal bias or expression of implicit bias toward behaviors projected to students, and (3) health/physical education and life science teachers may be able to act as a source of unbiased information to provide resources to a school site to aid in developing healthy lifestyles.

Aerobic Training Modulates the Increase in Plasma Concentrations of Cytokines in response to a Session of Exercise

Acute physical exercise can modulate immune function. For example, acute exercise is known to increase the circulating concentration of cytokines. Exercise is also known to modulate immune function chronically. It is not known whether exercise training can result in training of the immune system. Here, we investigated the effects of six weeks of aerobic training on cytokine responses induced by acute exercise until fatigue. Twelve healthy men performed a fatiguing exercise at the anaerobic threshold (AT) intensity. After the training period, the participants performed another bout of acute exercise at the same duration and intensity of the pretraining situation. The analysis was made at the beginning, end, and at 10, 30, and 60 minutes during the recovery period. Training at AT induced a gain of 11.2% of exercise capacity. Before training, a single bout of acute exercise induced a significant increase in plasma levels of cytokines, including IL-6, TNF-α, sTNFR1, IL-10, CXCL10, BDNF, leptin, resistin, and adiponectin. After six weeks of aerobic training, levels of IL-6, sTNFR1, BDNF, and leptin increased to a lesser extent after an acute bout exercise at the same absolute intensity as the pretraining period. Responses to the same relative exercise intensity were similar to those observed before exercise. These results show that aerobic training is associated with training of acute immune responses to acute exercise until fatigue.

Comparing effectiveness of fat burners and thermogenic supplements to diet and exercise for weight loss and cardiometabolic health: Systematic review and meta-analysis

BACKGROUND

Those who are overfat face an onslaught of advice for losing weight, including using dietary supplements that purport to have fat burning capabilities to achieve a reduced body mass, fat mass and improvement in cardiometabolic health in combination with exercise or diet and exercise regimens.

AIM

To examine long-term effectiveness of supplements for both weight loss and improvements in cardiometabolic health for these individuals.

METHODS

A PRISMA methods of systematic review was conducted from August 2018 through January 2019 using Medline, PubChem, PubMed, EBOSCO CINHAL and SPORTDiscus, and Google Scholar yielding 23,441 returns of which 21 studies (duration greater than 8 weeks with participant populations of BMI greater than 24.9) were included for meta-analysis. Meta-analysis examined pooled effect size and 95% confidence interval for: body mass, fat mass, fat-free mass, total cholesterol, high-density lipoproteins, low-density lipoproteins, resting metabolic rate. Intra-study effect sizes were compared with previously reported results for diet or diet and exercise in a 2x2 chi-square analysis for the number of studies that induced effects greater than or less than the effect size.

RESULTS

There is a general trend to show effectiveness (effect size greater than 0.00) for obtaining beneficial changes from use of thermogenic dietary supplements, yet the 95% confidence interval for effect size crossed 0.00 (indicating no benefit). Chi-square comparison to exercise, or combination of diet and exercise, indicates that responses induced from weight-loss supplements were less effective than what is obtained from utilizing exercise, or diet and exercise, without additional weight-loss supplements.

CONCLUSION

There appears to be limited benefit that may be derived from the inclusion of thermogenic dietary supplements to reduce body mass and improve cardiometabolic health for individuals who are overfat.

The possible role of hydration in concussions and long-term symptoms of concussion for athletes. A review of the evidence

The purpose of this review is to address what is known, speculated, and hypothesized regarding the issue of hydration and concussions. Based on the question, “What impact does hydration have on the relative risk for suffering concussive injuries along with long-term ramifications that have been associated with concussive (and repeated subconcussive) traumas to the cerebral cortex?,” a search of available literature was performed through June 2019. Deducing from the available literature, we can stipulate that changes in hydration within the cerebral cortex increase the likelihood for disruption of neurofilament proteins, dysregulation of membrane dynamics of the neurons and exacerbate inflammation responses following head trauma. As such, it can be speculated that differences in incidence rates may be attributed to difference in tissue fluid based on athlete demographics, level of whole-body water balance, and degree of tissue dehydration more than selection of sport. Moreover, tissue hydration in combination with other inflammation factors provides the scaffolding for the development of long-term issues (e.g. chronic traumatic encephalopathy) associated with repetitive head trauma in athletes.

The impact of duration on effectiveness of exercise, the implication for periodization of training and goal setting for individuals who are overfat, a meta-analysis

Given the assumption that all methods of exercise, e.g., endurance (ET), resistance (RT), or combination of both (E+R), can induce a beneficial effect size (ES) for changes in body composition and health status of individuals who are overfat. Thus the aim and purpose of this study is to evaluate the current body of knowledge to address the question as to the impact that the duration of exercise has on its relative effectiveness for inducing health and body compositional changes in individuals who are overfat to assist with developing periodized exercise protocols and establishing short and long term goals. A tiered meta-analysis of 92-studies and 200-exercise groupings were used for establishing pooled ES within and between groupings based on the increments of 4-week of duration and study designs of ≤8, 9-16, 17-23, 24-36, and ≥36 weeks. Analysis based on random-effect of response indicates a continuum of effectiveness within and between ET, RT and E+R based on duration. Where beneficial effectiveness is not indicated for any measures until after 8-weeks of continuous training with progressive effectiveness being noted in changes to cardiorespiratory fitness, inflammatory cytokines, and alteration of metabolic status from 12-weeks through 32-weeks of continuous training. Results indicate a greater ES for RT and E+R versus ET early in intervention that equalizes with longer durations. Supporting the use of RT and E+R within a periodized program. And secondarily, goals should be established first on performance gains and second body composition or health status modifications for the individual who is overfat.

Obese persons' physical activity experiences and motivations across weight changes: a qualitative exploratory study

BACKGROUND

Obese individuals are encouraged to participate in physical activity. However, few qualitative studies have explored obese individuals' motivations for and experiences with physical activity.

METHODS

The physical activity experiences of self-identified obese or formerly obese persons (n = 15) were explored through in-depth, semi-structured, audio-taped, repeated interviews and ethnography over one year. Participant observation occurred at multiple sites identified by participants as meaningful to them as obese persons. Data from interview transcripts and fieldnotes were analyzed via thematic content analysis.

RESULTS

Underlying goals for engaging in physical activity were diverse. Emergent motivation themes included: protection, pressure, and pleasure. Participants were protective of maintaining functional capacity, establishing fit identities, and achieving weight loss. Participants also discussed feelings of excessive pressure to continue progressing toward weight and fitness goals. Enjoyment in physical activity was often a by-product for all participants and could become a sought-after endpoint. Finding an environment in which participants felt safe, accepted, and encouraged to be active was extremely important for continual engagement.

CONCLUSIONS

Obese individuals enjoyed physical activity and were concerned about maintaining functional fitness. Stigmatization and untenable goals and monitoring could disrupt physical activity.

Diet, exercise or diet with exercise: comparing the effectiveness of treatment options for weight-loss and changes in fitness for adults (18-65 years old) who are overfat, or obese; systematic review and meta-analysis

There are number of means of methods to alter body composition, and metabolic issues, available for the adult who is overfat. The following is a systematic review and meta-analysis focused on comparing changes from treatment program for adults who are overfat based on analysis of aggregated effect size (ES) of inducing changes. So as to determine the relative effectiveness of such protocols and intervention plans of choice. This tiered meta-analysis of 66-population based studies, and 162-studywise groups, a clear pattern of ES being established across and within treatments. First, hypocaloric balance is necessary for changing body composition, but the effectiveness for establishing imbalance does not equate with the effectiveness for body compositional changes, or any biomarkers associated with metabolic issues. With analysis showing that there is a necessity to include exercise in combination with diet effectively elicit changes in body composition and biomarkers of metabolic issues. More importantly, the combination, resistance training (RT) was more effective than endurance training (ET) or combination of RT and ET, particularly when progressive training volume of 2-to-3 sets for 6-to-10 reps at an intensity of ≥75% 1RM, utilizing whole body and free-weight exercises, at altering body compositional measures (ES of 0.47, 0.30, and 0.40 for loss of BM, FM, and retention of FFM respectively) and reducing total cholesterol (ES = 0.85), triglycerides (ES = 0.86) and low-density lipoproteins (ES = 0.60). Additionally RT was more effective at reducing fasting insulin levels (ES = 3.5) than ET or ET and RT. Even though generally lower ES than RT, the inclusion of ET was more effective when performed at high intensity (e.g. ≥70% VO2max or HRmax for 30-minutes 3-4x's/wk), or in an interval training style than when utilizing the relatively common prescribed method of low-to-moderate (e.g., 50-70% VO2max or HRmax for at least equal time) steady state method, ES of 0.35, 0.39, and 0.13 for BM, FM, and FFM respectively. Thus indicating that focus of treatment should be on producing a large metabolic stress (as induced by RT or high levels of ET) rather than an energetic imbalance for adults who are overfat.

Suryanamaskar: An equivalent approach towards management of physical fitness in obese females

BACKGROUND

In India, obesity is highly prevalent in women as compared to men. As the obesity epidemic spreads, there are growing concerns about efficient obesity management.

AIMS

To compare between circuit training (CT), treadmill (TM) walking and suryanamaskar (SN) training in weight management and physical fitness enhancement in obese females.

SETTINGS AND DESIGNS

Comparative controlled study conducted in a community setting.

MATERIALS AND METHODS

119 females of age between 20 and 40 years of body mass index (BMI) between 25.1 and 34.9 kg/m(2). 87 participants completed the study. Group 1: CT; group 2: TM walking; group 3: Modified SN; group 4: Control.

OUTCOME MEASURES

Body composition, cardio-respiratory and muscle endurance, flexibility.

STATISTICAL ANALYSIS

Within-group data was analyzed with the paired t-test. P =0.05. Analysis between the groups was done using one way ANOVA test. Analysis between the groups was done using ANCOVA test controlling for baseline differences only for those variables that have significant differences at baseline. For those which do not have significant difference at baseline, RMANOVA was done at end of 8 weeks.

RESULTS

Reducation in mean body weight in CT group (2.2%), TM (1.7%) and SN (1.6%), (P < 0.05), BMI in all the three groups (P < 0.01), total body fat % in the CT (5%) and SN (3.7%), (P < 0.01), metabolic age with CT (2%) and TM (2%), (P = 0.001). Improvement in muscle mass in CT (4%, P = 0.009), VO2max in CT group by 17.2%, SN (14%), TM group (8%) (P < 0.05). Upper limb Muscle endurance in CT (51.3%), SN group (51.24%) and in TM group (40%), (P = 0.05), in lower limb TM (21.2%) and SN (24.5%) (P = 0.05), flexibility in SN (12.4%, P = 0.0001).

CONCLUSIONS

All three methods were effective in weight and physical fitness management. CT and SN were more effective in improving cardio-respiratory fitness and upper limb muscle endurance while only SN was effective in improving body flexibility.

Combined impact of cardiorespiratory fitness and visceral adiposity on metabolic syndrome in overweight and obese adults in Korea

Background

Obesity, especially visceral obesity, is known to be an important correlate for cardiovascular disease and increased mortality. On the other hand, high cardiorespiratory fitness is suggested to be an effective contributor for reducing this risk. This study was conducted to determine the combined impact of cardiorespiratory fitness and visceral adiposity, otherwise known as fitness and fatness, on metabolic syndrome in overweight and obese adults.

Methods

A total of 232 overweight and obese individuals were grouped into four subtypes according to their fitness level. This was measured by recovery heart rate from a step test in addition to visceral adiposity defined as the visceral adipose tissue area to subcutaneous adipose tissue area ratio (VAT/SAT ratio). Associations of fitness and visceral fatness were analyzed in comparison with the prevalence of metabolic syndrome.

Results

The high visceral fat and low fitness group had the highest prevalence of metabolic syndrome [Odds Ratio (OR) 5.02; 95% Confidence Interval (CI) 1.85–13.61] compared with the reference group, which was the low visceral adiposity and high fitness group, after adjustments for confounding factors. Viscerally lean but unfit subjects were associated with a higher prevalence of metabolic syndrome than more viscerally obese but fit subjects (OR 3.42; 95% CI 1.27–9.19, and OR 2.70; 95% CI 1.01–7.25, respectively).

Conclusions

Our study shows that visceral obesity and fitness levels are cumulatively associated with a higher prevalence of metabolic syndrome in healthy overweight and obese adults. This suggests that cardiorespiratory fitness is a significant modifier in the relation of visceral adiposity to adverse metabolic outcomes in overweight and obese individuals.