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Sabag A, Patten RK, Moreno-Asso A, Colombo GE, Dafauce Bouzo X, Moran LJ, Harrison C, Kazemi M, Mousa A, Tay CT, Hirschberg AL, Redman LM, Teede HJ. Exercise in the management of polycystic ovary syndrome: A position statement from Exercise and Sports Science Australia. J Sci Med Sport 2024; 27:668-677. [PMID: 38960811 DOI: 10.1016/j.jsams.2024.05.015] [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: 03/04/2024] [Revised: 05/02/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024]
Abstract
Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition amongst females of reproductive age, leading to lifelong cardiometabolic, reproductive, psychological, and dermatologic symptoms as well as a reduced quality of life. Lifestyle interventions, which can include structured exercise programmes delivered by appropriately trained exercise professionals such as clinical exercise physiologists, are considered first-line strategies in PCOS management due to their therapeutic effects on various health outcomes and quality of life. This position statement builds on the 2023 International Evidence-based Guideline for the Assessment and Management of PCOS and describes the role of the exercise professional in the context of the multidisciplinary care team which includes physicians and allied health professionals. This position statement aims to equip exercise professionals with a broad understanding of the pathophysiology of PCOS, how it is diagnosed and managed in clinical practice, and evidence- and consensus-based recommendations for physical activity and exercise in PCOS management. In line with the physical activity recommendations for the general public, individuals with PCOS should aim to undertake between 150 to 300min of moderate-intensity or 75 to 150min of vigorous-intensity aerobic activity per week, or an equivalent combination of both spread throughout the week. Additionally, muscle-strengthening activities on two non-consecutive days per week are recommended to maintain health and prevent weight gain. For further health benefits and to achieve modest weight loss, individuals with PCOS should aim for a minimum of 250min of moderate-intensity or 150min of vigorous-intensity aerobic activity per week, or an equivalent combination of both spread throughout the week, plus muscle-strengthening activities on two non-consecutive days per week. Adolescents with PCOS should aim for a minimum of 60min moderate- to vigorous-intensity activity each day, incorporating muscle- and bone-strengthening activities three times per week. Finally, exercise professionals should consider the significant psychological burden, including weight stigma, and the high prevalence of comorbidities amongst individuals with PCOS and take appropriate measures to deliver safe and efficacious exercise interventions.
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Affiliation(s)
- Angelo Sabag
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; Charles Perkins Centre, The University of Sydney, Australia.
| | - Rhiannon K Patten
- Institute for Health and Sport (iHeS), Victoria University, Australia
| | - Alba Moreno-Asso
- Institute for Health and Sport (iHeS), Victoria University, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Australia
| | - Giorgia E Colombo
- Department of Obstetrics and Gynecology, Ospedale Regionale di Lugano, Switzerland
| | - Xela Dafauce Bouzo
- Centre for Health, Activity and Wellbeing Research (CAWR), School of Sport and Health Sciences, Cardiff Metropolitan University, UK
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, Monash University, Australia
| | - Cheryce Harrison
- Monash Centre for Health Research and Implementation, Monash University, Australia
| | - Maryam Kazemi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, USA
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, Monash University, Australia
| | - Chau Tien Tay
- Monash Centre for Health Research and Implementation, Monash University, Australia
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institute, Sweden; Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Sweden
| | | | - Helena J Teede
- Monash Centre for Health Research and Implementation, Monash University, Australia
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Chartrand DJ, Murphy-Després A, Lemieux I, Larose E, Poirier P, Després JP, Alméras N. Effects of 1,144 km of road cycling performed in 7 days: a cardiometabolic imaging study. Am J Physiol Endocrinol Metab 2024; 327:E344-E356. [PMID: 39046280 DOI: 10.1152/ajpendo.00098.2024] [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: 03/04/2024] [Revised: 07/15/2024] [Accepted: 07/15/2024] [Indexed: 07/25/2024]
Abstract
This cardiometabolic imaging study was designed to document the adaptation of middle-aged recreational cyclists to a large exercise prescription not aiming at weight loss. Eleven middle-aged recreational male cyclists traveled 1,144 km over seven consecutive days. A comprehensive cardiometabolic profile including visceral and ectopic adiposity assessed by magnetic resonance imaging was obtained at baseline and following the exercise week. Cardiorespiratory fitness (CRF) was measured using maximal cardiopulmonary exercise testing. During the week, heart rate was monitored to calculate individual energy expenditure. Baseline characteristics of cyclists were compared with 86 healthy males in the same age range. Cyclists presented higher baseline CRF (+9.2 mL/kg/min, P < 0.0001) and lower subcutaneous (-56.2 mL, P < 0.05) and liver (-3.3%, P < 0.05) fat compared with the reference group. Despite the large energy expenditure during the cycling week, the increase in energy intake limited decreases in body weight (-0.8 ± 0.9 kg, P < 0.05) and body mass index (-0.3 ± 0.3 kg/m2, P < 0.05). Loss of fat mass (-1.5 ± 1.0 kg, P < 0.001) and a trend toward an increased lean mass (+0.8 ± 1.2 kg, P < 0.07) were observed. Visceral adiposity (-14.1 ± 14.2 mL, P < 0.01) and waist circumference (-3.2 ± 1.7 cm, P < 0.0001) decreased, whereas subcutaneous (-2.7 ± 5.1 mL, NS), liver (-0.5 ± 0.9%, NS), and cardiac (-0.3 ± 2.3 mL, NS) fat remained unchanged. This cardiometabolic imaging study documents middle-aged recreational cyclists' subcutaneous and visceral adiposity as well as cardiac and liver fat responses to a large volume of endurance exercise despite an increase in energy intake aimed at limiting weight loss.NEW & NOTEWORTHY Even when being accompanied by a substantial increase in energy intake to compensate energy expenditure and limit weight loss, a large volume of endurance exercise performed within a short period of time is associated with a significant reduction in visceral adiposity. High cardiorespiratory fitness is associated with low levels of liver fat in middle-aged males.
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Affiliation(s)
- Dominic J Chartrand
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Adrien Murphy-Després
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Isabelle Lemieux
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada
| | - Eric Larose
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Paul Poirier
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada
- Faculty of Pharmacy, Université Laval, Québec, Québec, Canada
| | - Jean-Pierre Després
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada
- VITAM-Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Québec, Québec, Canada
| | - Natalie Alméras
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada
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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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Heinle JW, DiJoseph K, Sabag A, Oh S, Kimball SR, Keating S, Stine JG. Exercise Is Medicine for Nonalcoholic Fatty Liver Disease: Exploration of Putative Mechanisms. Nutrients 2023; 15:nu15112452. [PMID: 37299416 DOI: 10.3390/nu15112452] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Exercise remains a key component of nonalcoholic fatty liver disease (NAFLD) treatment. The mechanisms that underpin improvements in NAFLD remain the focus of much exploration in our attempt to better understand how exercise benefits patients with NAFLD. In this review, we summarize the available scientific literature in terms of mechanistic studies which explore the role of exercise training in modulating fatty acid metabolism, reducing hepatic inflammation, and improving liver fibrosis. This review highlights that beyond simple energy expenditure, the activation of key receptors and pathways may influence the degree of NAFLD-related improvements with some pathways being sensitive to exercise type, intensity, and volume. Importantly, each therapeutic target of exercise training in this review is also the focus of previous or ongoing drug development studies in patients with nonalcoholic steatohepatitis (NASH), and even when a regulatory-agency-approved drug comes to market, exercise will likely remain an integral component in the clinical management of patients with NAFLD and NASH.
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Affiliation(s)
- James Westley Heinle
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Kara DiJoseph
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Angelo Sabag
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Sechang Oh
- Department of Physical Therapy, Faculty of Rehabilitation, R Professional University of Rehabilitation, Tsuchiura 300-0032, Ibaraki, Japan
| | - Scot R Kimball
- Department of Cellular and Molecular Physiology, College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA
| | - Shelley Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Jonathan G Stine
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA
- Fatty Liver Program, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
- Liver Center, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
- Cancer Institute, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
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Colombo GE, Pirotta S, Sabag A. Diet and Exercise in the Management of Polycystic Ovary Syndrome: Practical Considerations for Person-Centered Care. Semin Reprod Med 2023; 41:26-36. [PMID: 38040023 DOI: 10.1055/s-0043-1777116] [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: 12/03/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a complex multisystem condition associated with life-long reproductive, metabolic, and psychological symptoms. Individuals with PCOS are at an increased risk of cardiovascular disease and type 2 diabetes, with approximately 70% of all PCOS cases presenting with insulin resistance. Lifestyle interventions have historically been recommended as first-line therapies for the management of PCOS-related cardiometabolic disorders. The term "lifestyle management" incorporates a multifaceted approach to dietary, exercise, and behavioral strategies, aiming to promote a healthy lifestyle. This approach has been commonly employed in practice, in particular through exercise and dietary modulation, due to its effect on cardiometabolic outcomes as well as its tolerability. Furthermore, there is evidence to suggest that combining dietary change with exercise may yield the greatest improvements in clinical outcomes. However, such practices require careful consideration and coordination, as there are instances where certain exercise and/or dietary prescriptions may compromise the effectiveness of the respective interventions. Thus, this review aims to provide practical guidance on diet and exercise planning in the routine care of PCOS. Such recommendations include emphasizing realistic and achievable goals, as well as minimizing barriers to lifestyle changes in order to increase the long-term sustainability of this treatment strategy.
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Affiliation(s)
- Giorgia E Colombo
- Department of Obstetrics and Gynecology, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Stephanie Pirotta
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Angelo Sabag
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Supports and Barriers to Lifestyle Interventions in Women with Gestational Diabetes Mellitus in Australia: A National Online Survey. Nutrients 2023; 15:nu15030487. [PMID: 36771195 PMCID: PMC9921280 DOI: 10.3390/nu15030487] [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: 11/29/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) affects approximately one in six pregnancies, causing a significant burden on maternal and infant health. Lifestyle interventions are first-line therapies to manage blood glucose levels (BGLs) and prevent future cardiometabolic complications. However, women with GDM experience considerable barriers to lifestyle interventions; thus, the aim of this study was to determine how women with GDM manage their condition and to identify the primary supports and barriers to lifestyle intervention participation. METHODS An online cross-sectional survey of women in Australia with a history of GDM was conducted. Questions included participant demographics, strategies used to manage BGLs, physical activity and dietary habits, and barriers and supports to lifestyle interventions. RESULTS A total of 665 individuals consented and responded to the advertisement, of which 564 were eligible and provided partial or complete responses to the survey questions. Most respondents were between 35 and 39 years of age (35.5%), not pregnant (75.4%), working part-time (26.7%), university-educated (58.0%), and had only one child (40.1%). Most respondents managed their BGLs through diet (88.3%), with "low-carbohydrate" diets being the most popular (72.3%), and 46.2% of respondents were undertaking insulin therapy. Only 42.2% and 19.8% of respondents reported meeting the aerobic and strengthening exercise recommendations, respectively. Women with one child or currently pregnant expecting their first child were 1.51 times more likely (95% CI, 1.02, 2.25) to meet the aerobic exercise recommendations than those with two or more children. The most common reported barriers to lifestyle intervention participation were "lack of time" (71.4%) and "childcare" commitments (57.7%). Lifestyle interventions delivered between 6 and 12 months postpartum (59.0%), involving an exercise program (82.6%), and delivered one-on-one were the most popular (64.9%). CONCLUSION Most women report managing their GDM with lifestyle strategies. The most common strategies reported involve approaches not currently included in the clinical practice guidelines such as reducing carbohydrate consumption. Furthermore, despite being willing to participate in lifestyle interventions, respondents report significant barriers, including lack of time and childcare commitments, whereas mentioned supports included having an online format. Lifestyle interventions for women with a history of GDM should be designed in a manner that is both tailored to the individual and considerate of existing barriers and supports to participation.
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Jamiel AA, Ardah HI, Ahmed AM, Al-Mallah MH. Prognostic value of exercise capacity in incident diabetes: a country with high prevalence of diabetes. BMC Endocr Disord 2022; 22:297. [PMID: 36451187 PMCID: PMC9710054 DOI: 10.1186/s12902-022-01174-5] [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: 12/15/2021] [Accepted: 08/30/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is a fast-growing health problem that imposes an enormous economic burden. Several studies demonstrated the association between physical inactivity and predicting the incidence of diabetes. However, these prediction models have limited validation locally. Therefore, we aim to explore the predictive value of exercise capacity in the incidence of diabetes within a high diabetes prevalence population. METHODOLOGY A retrospective cohort study including consecutive patients free of diabetes who underwent clinically indicated treadmill stress testing. Diabetic patients at baseline or patients younger than 18 years of age were excluded. Incident diabetes was defined as an established clinical diagnosis post-exercise testing date. The predictive value of exercise capacity was examined using Harrell's c-index, net reclassification index (NRI), and integrated discrimination index (IDI). RESULTS A total of 8,722 participants (mean age 46 ± 12 years, 66.3% were men) were free of diabetes at baseline. Over a median follow-up period of 5.24 (2.17-8.78) years, there were 2,280 (≈ 26%) new cases of diabetes. In a multivariate model adjusted for conventional risk factors, we found a 12% reduction in the risk of incident diabetes for each METs achieved (HR, 0.9; 95% CI, 0.88-0.92; P < 0.001). Using Cox regression, exercise capacity improved the prediction ability beyond the conventional risk factors (AUC = 0.62 to 0.66 and c-index = 0.62 to 0.68). CONCLUSION Exercise capacity improved the overall predictability of diabetes. Patients with reduced exercise capacity are at high risk for developing incidence diabetes. Improvement of both physical activity and functional capacity represents a preventive measure for the general population.
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Affiliation(s)
- Abdelrahman A. Jamiel
- King Abdulaziz Cardiac Center - Adult Cardiology, King Abdulaziz Medical City for National Guard, 1413 P.O. Box 22490, 11426 Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Specialties, Riyadh, Saudi Arabia
| | - Husam I. Ardah
- Department of Biostatistics and bioinformatics, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Amjad M. Ahmed
- King Abdulaziz Cardiac Center - Adult Cardiology, King Abdulaziz Medical City for National Guard, 1413 P.O. Box 22490, 11426 Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Specialties, Riyadh, Saudi Arabia
| | - Mouaz H. Al-Mallah
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX USA
- Houston Methodist Academic Institute, Houston, TX USA
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Nasiri M, Monazzami A, Alavimilani S, Asemi Z. The Effect of High Intensity Intermittent and Combined (Resistant and Endurance) Trainings on Some Anthropometric Indices and Aerobic Performance in Women with Polycystic Ovary Syndrome: A Randomized Controlled Clinical Trial Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2022; 16:268-274. [PMID: 36273312 DOI: 10.22074/ijfs.2022.551096.1279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Indexed: 03/30/2023]
Abstract
BACKGROUND Overweight and obesity are associated with cardiometabolic risk in polycystic ovary syndrome (PCOS). Lifestyle adjustment, such as increasing physical activity, is a first-line strategy to treat PCOS. The current study aims to compare and examine the effect of high intensity intermittent training (HIIT) and combined (COM) training on some anthropometric indices and aerobic performance in PCOS females. MATERIALS AND METHODS This randomized controlled clinical trial was conducted on 45 women with PCOS divided into three groups receiving HIIT (n=15), COM interventions (n=15) or control group (n=15) for eight weeks. Some anthropometric indices factors including weight, body mass index (BMI), waist to hip ratio (WHR), body fat percent (FP), and visceral adipose tissue (VAT) as well as VO2max were measured at the baseline at the eighth week. Data were analyzed by one-way ANOVA test. Tukey post hoc tests were used to compare the pair differences. RESULTS After eight-week intervention, weight, BMI, WHR, FP, and VAT decreased significantly in both groups of COM and HIIT (P<0.05) relative to the control group. There were no differences between HIIT group and COM group in terms of these variables (P>0.05). VO2max increased significantly after COM and HIIT interventions relative to the control group (P=0.001); however, HIIT was statically more effective than COM (P=0.011). CONCLUSION The current study revealed that both HIIT and COM trainings could be beneficial in improving some anthropometric indices in addition to aerobic capacity, although HIIT was more effective on aerobic performance (registration number: IRCT20130812014333N143).
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Affiliation(s)
- Masoud Nasiri
- Department of Sport Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, Iran
| | - Amirabbas Monazzami
- Department of Sport Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, Iran
| | - Solmaz Alavimilani
- Department of Obstetrics and Gynecology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zatollah Asemi
- The Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
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Kim S. Association between Cardiorespiratory Fitness and Metabolic Syndrome in Korean Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3671. [PMID: 35329357 PMCID: PMC8950222 DOI: 10.3390/ijerph19063671] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Little is known about the relationship between non-exercise-based estimation of cardiorespiratory fitness (eCRF) and metabolic syndrome (MetS) in Korea. The current study examined the prognostic role of eCRF in the risk stratification of MetS in a representative sample of Korean older adults (1822 men and 3069 women). METHODS The data used in the current study were extracted from the Korea National Health and Nutrition Examination Surveys IV and V. eCRF was obtained using a previously validated algorithm. MetS was defined according to the National Cholesterol Education Program definition with the acceptance of a Korean-specific waist circumference cutoff point. RESULTS Lower eCRF was significantly correlated with abnormalities in several components of MetS, including abdominal obesity, elevated glucose, elevated triglycerides, and decreased high-density lipoprotein cholesterol. Furthermore, there was an inverse linear relationship between MetS prevalence and eCRF levels; higher eCRF was significantly and independently associated with lower prevalence of MetS. CONCLUSION The current findings suggest that eCRF can be adopted as a prognostic measure in determining the risk for MetS for elderly persons.
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Affiliation(s)
- Shinuk Kim
- Department of Smart Information Communication Engineering, Sangmyung University, Cheonan 330-720, Korea
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Sabag A, Barr L, Armour M, Armstrong A, Baker CJ, Twigg SM, Chang D, Hackett DA, Keating SE, George J, Johnson NA. The Effect of High-intensity Interval Training vs Moderate-intensity Continuous Training on Liver Fat: A Systematic Review and Meta-Analysis. J Clin Endocrinol Metab 2022; 107:862-881. [PMID: 34724062 DOI: 10.1210/clinem/dgab795] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Non-alcoholic fatty liver disease, characterized by excess fat accumulation in the liver, is considered the hepatic manifestation of metabolic syndrome. Recent findings have shown that high-intensity interval training (HIIT) can reduce liver fat but it is unclear whether this form of exercise is superior to traditional moderate-intensity continuous training (MICT). OBJECTIVE The aim of this systematic review was to determine the effect of HIIT vs MICT on liver fat in adults. A secondary aim was to investigate the interaction between total weekly exercise volume and exercise-related energy expenditure and change in liver fat. METHODS Relevant databases were searched up to December 2020 for randomized trials, comparing HIIT to control, MICT to control, or HIIT to MICT. Studies were excluded if they did not implement 2 or more weeks' intervention or assess liver fat using magnetic resonance-based techniques. Weighted mean differences and 95% CIs were calculated. Regression analyses were undertaken to determine the interaction between weekly exercise volume in minutes and kilocalories (kcal) with change in liver fat content. RESULTS Of the 28 268 studies screened, 19 were included involving 745 participants. HIIT and MICT both elicited moderate reductions in liver fat content when compared to control (HIIT: -2.85%, 95% CI, -4.86 to -0.84, P = .005, I2 = 0%, n = 114, low-certainty evidence; MICT: -3.14%, 95% CI, -4.45 to -1.82, P < .001, I2 = 5.2%, n = 533, moderate-certainty evidence). There was no difference between HIIT and MICT (-0.34%, 95% CI, -2.20 to 1.52, P = .721, I2 = 0%, n = 177, moderate-certainty evidence). Neither total exercise volume in minutes (β = .0002, SE = 0.0017, Z = 0.13, P = .89) nor exercise-related energy expenditure in kcal (β = .0003, SE = 0.0002, Z = 1.21, P = .23) were related to changes in liver fat content. CONCLUSION HIIT elicits comparable improvements in liver fat to MICT despite often requiring less energy and time commitment. Further studies should be undertaken to assess the relative importance of aerobic exercise prescription variables, such as intensity, on liver fat.
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Affiliation(s)
- Angelo Sabag
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales 2145, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales 2560, Australia
| | - Loren Barr
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales 2560, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales 2145, Australia
- Medical Research Institute of New Zealand (MRINZ), Newtown, Wellington 6021, New Zealand
| | - Alex Armstrong
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales 2006, Australia
| | - Callum J Baker
- Greg Brown Diabetes & Endocrinology Research Laboratory, Charles Perkins Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales 2006Australia
| | - Stephen M Twigg
- Greg Brown Diabetes & Endocrinology Research Laboratory, Charles Perkins Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales 2006Australia
- Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales 2145, Australia
| | - Daniel A Hackett
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales 2006, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research and Westmead Hospital, The University of Sydney, Westmead, New South Wales 2145, Australia
| | - Nathan A Johnson
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales 2006, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales 2006, Australia
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The Effect of Exercise on Cardiometabolic Risk Factors in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031386. [PMID: 35162403 PMCID: PMC8835550 DOI: 10.3390/ijerph19031386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 01/06/2023]
Abstract
Background: Polycystic Ovary Syndrome (PCOS), a common endocrine disorder in women of reproductive age, increases the risk for cardiometabolic morbidity. While regular exercise is effective in reducing cardiometabolic risk, women with PCOS may experience condition-specific barriers to exercise thereby limiting its efficacy. Aim: To determine the effect of exercise on cardiometabolic risk factors in women with PCOS. Methods: Five databases (Cochrane, EMBASE, Medline, Scopus and SPORTDiscus) were searched up to December of 2021. Eligible studies included: a randomised controlled design; participants with a diagnosis of PCOS; aerobic and/or resistance exercise intervention lasting ≥4 weeks; cardiometabolic outcomes. Meta-analyses were performed to determine the effect of exercise versus non-exercising control on cardiometabolic outcomes. Results: Of the 4517 studies screened, 18 studies were analysed involving 593 participants. When compared with control, exercise significantly improved cardiorespiratory fitness (weighted mean difference {WMD} = 4.00 mL/kg/min, 95% CI: 2.61 to 5.40, p < 0.001) and waist circumference (WMD = −1.48 cm, 95% CI: −2.35 to −0.62, p = 0.001). Systolic blood pressure, fasting blood glucose, insulin resistance, and lipid profiles remained unchanged. Conclusions: Regular exercise may improve cardiorespiratory fitness and waist circumference in women with PCOS. Further large-scale studies are required to determine whether exercise interventions improve various biochemical and anthropometric parameters in women with PCOS and more severe cardiometabolic abnormalities.
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St Aubin CR, Fisher AL, Hernandez JA, Broderick TL, Al-Nakkash L. Mitigation of MAFLD in High Fat-High Sucrose-Fructose Fed Mice by a Combination of Genistein Consumption and Exercise Training. Diabetes Metab Syndr Obes 2022; 15:2157-2172. [PMID: 35911503 PMCID: PMC9329575 DOI: 10.2147/dmso.s358256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/13/2022] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Metabolic dysfunction-associated fatty liver disease (MAFLD) is fueled by escalations in both sedentary behavior and caloric intake and is noted in obese type 2 diabetic (T2DM) patients. This study aimed to examine the effects of exercise and the phytoestrogen genistein in mice fed a high fat (60% fat) high sugar (55% fructose with 45% sucrose), HFHS diet. METHODS Male C57BL/6J mice were assigned to five groups: HFHS, HFHS with genistein (600 mg/kg diet, HFHS+Gen), HFHS with moderate exercise (HFHS+Ex), and HFHS with combined genistein and moderate exercise (HFHS-Gen+Ex). Control lean mice were fed standard chow and water. Exercise consisted of 30-minute sessions of treadmill running five days/week for the 12-week study duration. Body weight was assessed weekly. Liver, kidney, fecal pellets and serum were extracted at the end of the study and maintained at -80°C. RESULTS After 12 weeks of treatment, mice in the HFHS group had the highest hepatic lipid content. Plasma levels of glucose, insulin, leptin, cholesterol, amylin, and total fat content were significantly elevated in HFHS mice compared to control mice. HFHS feeding increased protein expression of carnitine palmitoyltransferase 1b (CPT-1b isoform) in gastrocnemius, CPT1a, glucose transporter protein 2 (GLUT2), glucocorticoid receptor (GR), and fructose 1,6-bisphosphate 1 (FBP1) expression in liver. Exercise alone had minor effects on these metabolic abnormalities. Genistein alone resulted in improvements in body weight, fat content, amylin, insulin sensitivity, and liver histopathology, GR, FBP1, and acetyl-CoA carboxylase 1 (ACC1). Combination treatment resulted in additional metabolic improvements, including reductions in hepatic lipid content and lipid area, alanine transferase activity, CPT1b, and CPT1a. CONCLUSION Our results indicate that a HFHS diet is obesogenic, inducing metabolic perturbations consistent with T2DM and MAFLD. Genistein alone and genistein combined with moderate intensity exercise were effective in reducing MAFLD and the aberrations induced by chronic HFHS feeding.
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Affiliation(s)
- Chaheyla R St Aubin
- Department of Biomedical Sciences, College of Graduate Studies, Midwestern University, Glendale, AZ, 85308, USA
| | - Amy L Fisher
- Department of Biomedical Sciences, College of Graduate Studies, Midwestern University, Glendale, AZ, 85308, USA
| | - Jose A Hernandez
- Department of Biochemistry and Molecular Genetics, College of Graduate Studies, Midwestern University, Glendale, AZ, 85308, USA
| | - Tom L Broderick
- Department of Physiology, College of Graduate Studies Midwestern University, Glendale, AZ, 85308, USA
- Laboratory of Diabetes and Exercise Metabolism, College of Graduate Studies, Midwestern University, Glendale, AZ, 85308, USA
| | - Layla Al-Nakkash
- Department of Physiology, College of Graduate Studies Midwestern University, Glendale, AZ, 85308, USA
- Correspondence: Layla Al-Nakkash, Department of Physiology, College of Graduate Studies, Midwestern University, 19555 North 59th Avenue, Glendale, AZ, 85308, USA, Tel +1 623 572 3719, Fax +1 623 572 3673, Email
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Gallardo-Alfaro L, Bibiloni MDM, Argelich E, Angullo-Martinez E, Bouzas C, Tur JA. Metabolic Syndrome and Functional Fitness Abilities. J Clin Med 2021; 10:jcm10245840. [PMID: 34945135 PMCID: PMC8709084 DOI: 10.3390/jcm10245840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND It has been pointed out that moderate to vigorous exercise improves metabolic syndrome (MetS) criteria; however, studies on functional fitness in subjects with MetS are scarce. AIM This study aimed to assess functional fitness abilities in MetS and non-MetS subjects. METHODS Cross-sectional study. Participants living in the Balearic Islands (n = 477, 52% men, 55-80 years old) with MetS (n = 333) and without MetS (n = 144). Anthropometric, socioeconomic and lifestyle characteristics were measured, and blood samples were collected. Functional fitness tests included: one leg balance, standing and sitting handgrip, 30-s chair stand, arm curl, chair sit-and-reach, back scratch, 8-foot time up-and-go, 30-m walk, and 6-min walk tests. A Functional Fitness Score was created from tests that measured agility and dynamic balance, static balance, lower-and-upper body strength, lower-and-upper body flexibility, aerobic endurance, and speed. RESULTS All functional fitness tests were lower in MetS subjects, except for back scratch and standing handgrip test. After adjusting for possible confounders (sex, age, civil status, education level, leisure-time physical activity) MetS subjects were more likely to be below average for a sex and age specific cut-off value of one leg balance (Odds Ratio, OR: 2.37; 95% Confidence Interval, CI: 1.25-4.48), chair stand (OR: 2.30; 95% CI: 1.26-3.20), arm curl (OR: 3.43; 95% CI:1.90-6.26), back scratch (OR: 3.49; 95% CI: 2.31-5.91), 8-foot up-&-go (OR: 13.03; 95% CI: 6.66-25.55), 30-m walk (OR: 8.10; 95% CI: 4.33-15.57) and 6-min walk test (OR: 3.28; 95% CI: 1.76-6.52), whereas they were more likely to be above average for sitting handgrip test (OR:1.69; 95% CI:1.21-2.95). Functional Fitness Score was lower in MetS subjects (5.44 ± 2.40 vs. 7.04 ± 1.72, p < 0.001), independently of sex and age. CONCLUSION MetS participants showed lower functional fitness abilities and lower Functional Fitness Score than non-MetS peers, independently of sex, age, body mass index and waist circumference, showing lower ability to perform everyday activities safely and independently.
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Affiliation(s)
- Laura Gallardo-Alfaro
- Research Group on Community Nutrition & Oxidative Stress, Guillem Colom Building, Campus, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain; (L.G.-A.); (M.d.M.B.); (E.A.); (E.A.-M.); (C.B.)
| | - Maria del Mar Bibiloni
- Research Group on Community Nutrition & Oxidative Stress, Guillem Colom Building, Campus, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain; (L.G.-A.); (M.d.M.B.); (E.A.); (E.A.-M.); (C.B.)
| | - Emma Argelich
- Research Group on Community Nutrition & Oxidative Stress, Guillem Colom Building, Campus, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain; (L.G.-A.); (M.d.M.B.); (E.A.); (E.A.-M.); (C.B.)
- Hospital de Manacor, IBSalut, 07500 Manacor, Spain
| | - Escarlata Angullo-Martinez
- Research Group on Community Nutrition & Oxidative Stress, Guillem Colom Building, Campus, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain; (L.G.-A.); (M.d.M.B.); (E.A.); (E.A.-M.); (C.B.)
- Escola Graduada Primary Health Care Center, IBSalut, 07002 Palma de Mallorca, Spain
| | - Cristina Bouzas
- Research Group on Community Nutrition & Oxidative Stress, Guillem Colom Building, Campus, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain; (L.G.-A.); (M.d.M.B.); (E.A.); (E.A.-M.); (C.B.)
| | - Josep A. Tur
- Research Group on Community Nutrition & Oxidative Stress, Guillem Colom Building, Campus, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain; (L.G.-A.); (M.d.M.B.); (E.A.); (E.A.-M.); (C.B.)
- Correspondence: ; Tel.: +34-(97)-11731; Fax: +34-(97)-1173184
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