ECSS Paris 2023: CP-MH08
INTRODUCTION: Improvements in cardiorespiratory fitness (CRF) have been shown to largely attenuate the negative health risks associated with obesity. To date literature in women with obesity has focused upon the evaluation of aerobic-based exercise interventions. Hence, there is a need to evaluate resistance and combined interventions with this cohort. This study aimed to evaluate feasibility and efficacy of three exercise modalities in women with obesity for improving CRF, strength, body composition and other health outcomes. METHODS: Sixty-seven women with obesity were randomised to the control (CON) or one of three exercise groups (aerobic [AE], resistance [RE], COM). Exercise groups trained x3 times/week for 12 weeks (up to 150-minutes/week). Feasibility outcomes included adherence, attendance, recruitment and retention rates and adverse events. Secondary outcomes were CRF (predicted VO2 max), body composition (body weight [BW], waist circumference [WC], body fat percentage [%BF], fat mass [FM] and lean mass [LM]) and strength (5RM bench press, leg dynamometry, grip strength) and self-reported measures of physical activity, mood, sleep, pain and quality of life. RESULTS: Findings support feasibility of all three exercise modalities in terms of adherence, attendance, and retention. Interventions with a resistance component (COM and RE) were associated with the greatest improvements across the broad range of health outcomes measured. Combined was the most promising for body composition outcomes including BMI (Effect size [ES]=0.79, p=0.04), BW (ES=0.75, P=0.05), %BF (ES=0.77, p=0.04), FM (ES=0.83, p=0.03) and WC (ES=0.90, p=0.02), physical activity (i.e. moderate PA [ES=0.69, p=0.07), mood (ES=0.83, p=0.03) and sleep (ES=0.78, p=0.04). Resistance was most promising for CRF (ES=1.47, p=0.002), strength (i.e. bench press [ES=2.88, p=<0.001]) and pain (i.e. pain severity [ES=0.40, p=0.31]). CONCLUSION: For health outcomes, these results indicate the importance of including a resistance component when prescribing exercise for women with obesity to achieve meaningful improvements.
Read CV Mary E. DavisECSS Paris 2023: CP-MH08
INTRODUCTION: To address the increasing prevalence of complications associated with severe childhood obesity, NHS England has established 21 Complications of Excess Weight (CEW) services. With the aim of improving physical activity (PA) provision within CEW services, our group developed an exercise specialist led, mHealth supported, exercise and PA intervention (MOTIVATE-CEW). A feasibility study to evaluate MOTIVATE-CEWs potential suggested it was well received by families and initial uptake and adherence to PA was good. However, there were concerns over the maintenance of PA. With the aim of improving long term engagement, we followed Medical Research Council (MRC) guidance on intervention development and utilised service users and stakeholder perspectives during a co-production process to refine the MOTIVATE-CEW intervention. METHODS: The study was conducted within the Alder Hey Children’s Hospital (AHCH) CEW service (England) and drew upon a conceptual model of healthcare service co-production to guide intervention development. An intervention co-production group was established, including young people receiving care from the AHCH CEW service, parents or guardians of young people and health care professionals (HCPs) from the multidisciplinary AHCH CEW team. Four workshops were conducted, with the intervention co-production group split to form separate young person and adult workshops. Workshop 1 refined the behaviour change techniques (BCTs) used in the original intervention. Workshop 2 introduced additional BCTs identified in the literature to enhance long-term PA maintenance. Workshop 3 focused on defining core research outcomes and study design. Workshop 4 invited feedback on the revised intervention and study procedures. Multiple qualitative methods documented the intervention development process, capturing audio and visual data. Emerging intervention components were iteratively mapped to a logic model. RESULTS: Twenty-three stakeholders participated (7 patients, 5 parents/guardians, and 11 HCPs, all from the AHCH CEW service). The co-production process highlighted two key principles that were used to underpin the refined intervention: 1) personalisation is essential since every young person and family is different, and 2) young people value autonomy and flexibility in shaping their exercise and PA plans. Based on stakeholder insights, we developed a refined logic model that guided updates to the intervention’s content, resources, and delivery. The revised intervention retained one original element, refined four elements, and introduced five new components. CONCLUSION: By utilising MRC guidance and integrating stakeholder perspectives with existing research, we have refined MOTIVATE-CEW into a tailored exercise and PA intervention designed to meet the specific needs of the young people and carers in CEW services. Future research will evaluate the feasibility of the revised intervention before progressing to a full-scale, multi-site RCT.
Read CV Andrew DaviesECSS Paris 2023: CP-MH08
INTRODUCTION: Excess adipose tissue influences metabolic efficiency, oxygen use and energy availability and therefore impacts endurance. Surplus fat, often seen as a limitation, may serve as an energy source during low-intensity exercise. In trained overweight individuals, higher fat oxidation delays fatigue by slowing glycogen depletion, depending on mitochondrial function and fatty acid availability. A lower insulin response improves fat mobilization for sustained energy. Despite an increased oxygen demand for basal physiological functions, overweight individuals often have high cardiopulmonary capacity, raising the question of whether these adaptations offer endurance advantages. This study aims to evaluate body composition and metabolic response to endurance performance in metabolically healthy overweight women. METHODS: Thirty-five metabolically healthy overweight women (BMI 32 kg/m² ± 4.2, age 27-58, mean 41 years) participated in a 12-week exercise program: 3 weekly 50-minute aerobic sessions (60-70% max HR) and 2 weekly bodyweight resistance sessions. Endurance was assessed via a 5-minute cycle ergometer test (60 rpm, 70W), measuring (1) post-exercise heart rate recovery, (2) lactate concentration, and (3) leg muscle endurance (15 reps on an isokinetic dynamometer). Body composition was evaluated using BMI, fat mass (kg, %), excess fat percentage, and visceral fat, measured with body composition analyser. Data analysis included descriptive statistics and Pearson’s correlation with SPSS. RESULTS: BMI reduction (0.8 kg/m² ± 1.8) correlated with baseline BMI (p < 0.05), excess fat percentage (15.4% ± 1.6, p < 0.05), and visceral fat change (0.1% ± 0.8, p < 0.05), indicating greater reductions in BMI with higher initial adiposity. Cardiovascular endurance improvements were linked to lactate reduction (-0.1 ± 1.4) and faster heart rate recovery at 2 and 4 minutes (Pulse2minsafter, 83.3 ± 12.9, p < 0.05; Pulse4minsafter, 80.1 ± 10.1, p < 0.01). Faster recovery was associated with lower pre-intervention fat percentage (38.2% ± 3.5) and better muscle endurance post-training (61.8% ± 7.2, p < 0.05). Muscle endurance improvements were influenced by visceral fat and total fat loss (0.7 kg ± 2.7, p < 0.01). Enhanced leg work output was linked to fat loss and lactate clearance (p < 0.05), with balanced improvements in both legs (p < 0.01). CONCLUSION: Body composition, rather than BMI alone, is a key factor in endurance improvements in overweight women. Visceral fat reduction most strongly correlated with cardiovascular recovery, lactate clearance, and muscle endurance. These findings suggest fat distribution, rather than total adiposity, drives metabolic and performance benefits. Future research should explore non-visceral fat stores as potential energy reserves and examine individual fat oxidation efficiency.
Read CV Austėja LetukienėECSS Paris 2023: CP-MH08