Effects of 12-Week Combined Strength and Endurance Circuit Training Program on Insulin Sensitivity and Retinol-Binding Protein 4 in Women with Insulin-Resistance and Overweight or Mild Obesity: A Randomized Controlled Trial.

Background: Circuit training is an exercise mode, that may include both endurance and resistance components. There are premises that a combination of these two modalities brings additional benefits, particularly in improving insulin sensitivity. The retinol-binding protein 4 (RBP4) may inhibit signaling from insulin metabolic pathways in skeletal muscles, thus developing insulin resistance. This study aimed to evaluate whether moderate intensity circuit training combining strength and endurance exercise induces changes in tissue insulin sensitivity, carbohydrate and lipid metabolism, and serum RBP4 levels in insulin-resistant women. Methods: In this clinical controlled trial women diagnosed with insulin-resistance were randomly divided into two groups. The training group (T) performed circuit training combining strength (50%-80%1RM) and endurance (50%-75%HRR) exercise on five weight and two cardio machines, for 33 minutes, three times per week, for 3 months. Women from the control non-training group (NT) did not change their previous physical activity. At the beginning of the study and after the intervention period, a one-repetition maximum, body mass, and composition, resting heart rate (HR), blood pressure, glucose, insulin, blood lipids, thyroid-stimulating hormone (TSH), insulin-like growth factor-1 (IGF-1), RBP4, and insulin resistance (HOMA-IR) were measured. The results of 27 patients were analyzed using a two-way repeated measures ANOVA. Results: Significant differences in the pattern of change over time between the groups for resting HR (p < 0.010) and total lean mass (p < 0.039) were found. No differences in HOMA-IR, and RBP4 were observed post-study compared to pre-study in the T group. A significant correlation between RBP4 and TSH concentration was found. Conclusion: Twelve-week circuit training combining strength and endurance exercise has minor effects on HOMA-IR, glucose and lipid metabolism, IGF-1, TSH, and RBP4. Although moderate-intensity circuit training is considered safe, its effectiveness in patients with overweight and mild obesity may be insufficient to reduce insulin resistance. Trial Registration: ClinicalTrials.gov: NCT04528693, registered August 23, 2020.

In search of biomarkers for low back pain: can traction therapy effectiveness be prognosed by surface electromyography or blood parameters?

Background: Lumbar traction therapy is a common method to reduce low back pain (LBP) but is not always effective. The search for biomarkers that would prognose the effectiveness of LBP management is one priority for improving patients' quality of life. Objectives: 1) To determine the phenotype of patients benefiting most from lumbar traction therapy. 2) To correlate systemic and electromyographic biomarkers with pain and pain-related disability. Methods: Data on muscle bioelectrical activity (surface electromyography [SEMG]) in the flexion-extension task, the concentrations of twelve systemic biochemical factors, LBP intensity (Visual Analog Scale), the Oswestry Disability Index, and the Roland-Morris Disability Questionnaire (RMDQ) were collected before and 72 h after 20 sessions of lumbar traction therapy. Patients were divided into responders and nonresponders based on the criterion of a 50% reduction in maximal pain. Results: The responders had lower maximal muscle bioactivity in the extension phase on the left side (p < 0.01) and higher flexion-extension ratios on both sides of the body in the SEMG (left: p < 0.05; right: p < 0.01), and higher adipsin, interleukin-2, interleukin-4, and interleukin-10 concentrations (p < 0.05) than nonresponders. Patients with higher interleukin-4 concentrations before therapy achieved greater reductions in maximal pain in the sitting position, bioelectrical muscle activity in flexion, and flexion-relaxation ratio on the left side of the body. Changes in adipsin and interleukin-4 concentrations correlated with changes in LBP intensity (r = 0.68; r = -0.77). Changes in stem cell growth factor and interleukin-17A correlated with changes in RMDQ (R = 0.53) and bioelectrical muscle activity in extension (left: R = -0.67; right: R = -0.76), respectively. Conclusion: Responders to traction therapy had SEMG indices of less favorable muscle activity in the flexion-extension task and elevated indices of inflammation before the study. For the first time, interleukin-4 was indicated as a potential biomarker for prognosing post-therapy changes in pain intensity and muscle activity.

Subjective assessment and biochemical evaluation of traction therapy in women with chronic low back pain: does body mass index matter? A clinical study.

BACKGROUND: Apart from the positive effect of lumbar traction on structural changes within the spine in patients with low back pain, it is likely that therapeutic effects are correlated with pain biomarkers in the blood. Among them, systemic metabolic factors related to obesity may play an important role. This is the first study designed to examine the effectiveness of traction therapy in two experimental groups with considerably different BMI and to assess relationships between blood biomarkers and low back pain intensity. METHODS: In the prospective clinical trial, women suffering from chronic low back pain were allocated into the normal-weight or obesity groups. Patients in both groups underwent twenty sessions of lumbar traction therapy (30 min a day, continuous mode with a force level of 25-30% of body weight). Before and after therapy subjective assessments of pain (VAS and PPT) were performed, and serum concentrations of aggrecan chondroitin sulfate 846 epitope (CS-846), neuropeptide Y, leptin, adipsin and growth and differentiation factor 15 (GDF-15) were determined. The data were statistically evaluated for 28 women. RESULTS: After therapy, the maximal low back pain decreased in both groups, GDF-15 concentration was reduced in the normal-weight group and increased in the obesity group, and CS-846 concentration decreased in the obesity group. The sensation of PPT in the lumbar spine and mean concentrations of neuropeptide Y, leptin and adipsin did not change in both groups. However, the relationships of GDF-15, leptin, and adipsin concentrations with the perception of pain were revealed. CONCLUSION: Distinct differences between the normal-weight and obesity groups pointed on the role of excessive adipose tissue in aggravating the inflammatory processes and in the development of low back pain. Adipsin, CS-846 and GDF-15 aspire to be the low back pain biomarkers in women with obesity, but there is a need for further research to answer whether they might be considered reliable biomarkers for the prognosis and monitoring of chronic low back treatment. TRIAL REGISTRATION: NCT04507074, registered prospectively on July 6, 2020.

Type of Physical Training and Selected Aspects of Psychological Functioning of Women with Obesity: A Randomised Trial.

OBJECTIVE: We conducted a prospective randomised trial to assess whether a specific type of regular physical training performed by women with obesity is related to obtaining specific psychological benefits. METHODS: Forty-four women qualified for the study and were divided into two groups. The applied intervention consisted of regular three-month physical exercises in the form of endurance training (group A) or endurance strength training (group B). Initially, and after the completed intervention, we examined anthropometric measurements and the level of: stress (PSS-10), general self-esteem (SES), body self-report (BSQ-34, FRS), and behaviours associated with diet (TFEQ-18). RESULTS: As a result of the intervention, both groups had significantly lower anthropometric parameters and FRS scores with regard to the current figure (gr. A:δ FRS CS -0.90 ± 0.83, p < 0.001; gr. B:δ FRS CS -0.41 ± 0.50, p = 0.01) and BSQ-34 results (gr. A:δ BSQ-34 -14.90 ± 13.5, p = 0.001; gr. B:δ BSQ-34 - 18.64 ± 25.4, p = 0.01). Additionally, an increase in cognitive restraint (δ TFEQ-18 CR1.65 ± 2.06, p = 0.01) and a decrease in emotional eating (δ TFEQ-18 EE -0.82 ± 1.28, p = 0.01) were observed in group B. There were no between-group differences in terms of the magnitude of changes achieved due to the intervention, except for asignificant improvement in the perception of their current figure (FRS) (δ FRSCS -0.90 ± 0.83, p = 0.03) in group A. CONCLUSIONS: Regular physical activity over a three-month period by women with obesity promotes the perception of their own body as slimmer and lowers body shape concerns. The change in body shape perception was more pronounced under the influence of endurance training than endurance strength training. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT04793451.

Effects of an Indoor Cycling Program on Cardiometabolic Factors in Women with Obesity vs. Normal Body Weight.

The study aimed to provide evidence on the impact of indoor cycling (IC) in reducing cardiometabolic risk factors. The study compares the effects of a 3 month IC program involving three 55 min sessions per week on women aged 40-60 years, with obesity (OW, n = 18) vs. women with normal body weight (NW, n = 8). At baseline and at the end of the study, anthropometric parameters, oxygen uptake (VO2 peak), and serum parameters: glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), insulin, human anti-oxidized low-density lipoprotein antibody (OLAb), total blood antioxidant capacity (TAC), thiobarbituric acid reactive substances (TBARS), endothelial nitric oxide synthase (eNOS), C-reactive protein (CRP), lipid accumulation product (LAP), and homeostasis model assessment of insulin resistance index (HOMA IR) were determined. Before the intervention, VO2 peak and HDL-C levels were significantly lower and levels of TG, LAP, insulin, HOMA-IR, and CRP were significantly higher in the OW group compared to those in the NW group. After the intervention, only the OW group saw a decrease in body mass, total cholesterol, OLAb, TBARS, and CRP concentration and an increase in total body skeletal muscle mass and HDL-C concentration. In response to the IC training, measured indicators in the OW group were seen to approach the recommended values, but all between-group differences remained significant. Our results demonstrate that IC shows promise for reducing cardiometabolic risk factors, especially dyslipidemia. After 12 weeks of regular IC, the metabolic function of the OW group adapted in many aspects to be more like that of the NW group.

Effects of Endurance and Endurance-Strength Training on Endothelial Function in Women with Obesity: A Randomized Trial.

Some investigations have demonstrated that a combined endurance-strength training is the most effective in the treatment of obesity. The aim of the research was to access how different trainings influence: endothelial function, lipid metabolism, and risk of atherosclerosis in women with obesity. In a randomized trial, 39 obese women aged 28-62 completed endurance (n = 22, 60-80% HRmax) or combined training (n = 17, 20 minutes of strength exercises, 50-60% 1RM and 25 minutes of endurance training, 60-80% HRmax). Before and after the intervention vascular endothelial function (endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF), thiobarbituric acid reactive substances (TBARS), blood total antioxidant capacity (TAC)), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides and C-reactive protein (CRP)as well as visceral adiposity index (VAI), total-body skeletal muscle mass and atherogenic index of plasma (AIP) were determined. After the trainings, in both groups total cholesterol and total-body skeletal muscle mass increased (p < 0.05). In the group undergoing combined training, lower (p < 0.05) VAI, AIP, CRP and LDL-C were noted. In the group undergoing endurance training TBARS concentration decreased (p < 0.01), while the HDL-C (p < 0.01) concentration as well as eNOS (p < 0.05) activity increased. No significant differences between groups were found, either before or after the programs. Both training programs led to the improvement of lipid metabolism, but only endurance training alone favorably changed indicators of endothelial functions in women with obesity.

Effects of Endurance and Endurance-strength Exercise on Renal Function in Abdominally Obese Women with Renal Hyperfiltration: A Prospective Randomized Trial.

OBJECTIVE: Obesity is associated with kidney defects. Physical activity is a key element in the treatment of obesity. The aim of this study was to compare the effect of endurance and endurance-strength training on kidney function in abdominally obese women. METHODS: Forty-four abdominally obese women were randomized to endurance training or endurance-strength training, three times a week for 3 months. Before and after the intervention, kidney function was assessed by measuring blood creatinine, urine creatinine, and urine albumin levels, and the albumin-to-creatinine ratio and glomerular filtration rate (GFR) were calculated. RESULTS: Renal hyperperfusion was present in both groups before the study. Following both types of physical activity, similar modifications of the investigated parameters were observed, but with no significant between-group differences. Both courses of training led to a significant increase in blood creatinine and a subsequent decrease in the GFR. A significant increase in urine creatinine and album levels, though not exceeding the range for microalbuminuria, was not accompanied by any difference in the albumin-to-creatinine ratio after endurance-strength training alone. CONCLUSION: Three months of either endurance or endurance-strength training has a favorable and comparable effect on renal function in abdominally obese women with renal hyperfiltration.

Effects of endurance and endurance-strength exercise on biochemical parameters of liver function in women with abdominal obesity.

INTRODUCTION: Obesity is a risk factor of nonalcoholic fatty liver disease. Although the standard therapy for obesity involves physical exercise, well-planned studies of the changes in liver function in response to different exercise intensities in obese subjects are scarce. The aim of the present study was to examine a question of how does exercise mode affect the liver function. MATERIAL AND METHODS: 44 women with abdominal obesity were randomized into two exercise groups: endurance (group A) and endurance-strength (group B). Women in each group exercised for 60min 3 times/week for a 3-month period. Markers of liver function: serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT), alkaline phosphatase (ALP) activities, and bilirubin levels were quantified. RESULTS: We found significant differences in ALT (p<0.01) and AST (p<0.05) activities between group A and B after training exercise. Blood ALT and AST tended to decrease in group B, increase in group A. Significant reduction in serum GGT level after exercise in both groups was observed (p<0.001, group A; p<0.01, group B). Neither endurance nor endurance-strength exercise led to changes in serum ALP activity and total or direct bilirubin level. However, endurance-strength training resulted in significant decreases in serum indirect bilirubin (p<0.05). Strong positive correlations between serum indirect bilirubin and body mass (r=0.615; p=0.0085) and BMI (r=0.576; p=0.0154) were found after endurance-strength exercise (group B). CONCLUSION: The mode of exercise does matter: endurance-strength exercise led to a greater improvement, compared to endurance exercise, in the liver function in women with abdominal obesity.

Effects of Endurance and Endurance Strength Training on Body Composition and Physical Capacity in Women with Abdominal Obesity.

AIMS: To compare the effects of endurance training with endurance strength training on the anthropometric, body composition, physical capacity, and circulatory parameters in obese women. METHODS: 44 women with abdominal obesity were randomized into groups A and B, and asked to perform endurance (A) and endurance strength training (B) for 3 months, 3 times/week, for 60 min. Dual-energy X-ray absorptiometry and Graded Exercise Test were performed before and after training. RESULTS: Significant decreases in body mass, BMI, total body fat, total body fat mass, and waist and hip circumference were observed after both types of intervention. Marked increases in total body lean and total body fat-free mass were documented in group B. In both groups, significant increases in peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at ventilatory threshold were accompanied by noticeably decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure. No significant differences were noticed between groups for the investigated parameters. CONCLUSION: Our findings demonstrate evidence for a favorable and comparable effect of 3-month endurance and endurance strength training on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity.

Food behaviour and attitude towards nutritional knowledge in female fitness instructors and female fitness participants.

BACKGROUND: Fitness has recently become a very popular form of physical activity among women. Since more and more fitness clubs are founded, more and more women take up the job of a fitness instructor or participate in fitness classes. Therefore, the studies on female fitness instructors and participants are of great relevance. OBJECTIVE: The objective of this study was to compare food behaviour and attitude towards nutritional knowledge in fitness instructors and fitness participants. MATERIAL AND METHODS: The studied population comprised 200 women, including 100 fitness instructors and 100 fitness participants from fitness clubs in Poznan and the vicinity. The studied women filled in questionnaires on food behaviour and attitude towards nutritional knowledge. Statistical analysis was carried out by means of the IBM SPSS Statistics 19 computer programme. RESULTS: Statistically significant differences were observed in the studied women's age, education, the period of working as a fitness instructor or attending fitness classes and the frequency of teaching fitness classes or attending fitness classes, as well as avoiding poultry. Fitness instructors were older than fitness participants and a higher percentage of them had higher education. The period of working as a fitness instructor was almost twice as long as the period of attending fitness classes. The highest percentage of fitness instructors taught fitness classes more than four times a week, while the highest percentage of fitness participants attended fitness classes three times a week. More fitness participants than fitness instructors avoided poultry. CONCLUSIONS: Unfavourable food behaviour observed in the studied women, both fitness instructors and fitness participants, may increase the risk of diet-related diseases. The observed inadequacies in the studied women's food behaviour, along with their conviction that their diets were adequate and that their nutritional knowledge was sufficient, suggest the necessity to implement education programme to popularise basic dietary recommendations.