ECSS Paris 2023: OP-MH06
INTRODUCTION: Metabolic bariatric surgery (MBS) effectively reduces weight and obesity-related comorbidities, yet preserving fat-free mass (FFM) post-surgery remains a challenge. Physical activity may enhance body composition, but the optimal exercise modalities for MBS patients are unclear. Understanding the effects of different exercise regimens on body composition, cardiometabolic health, and physical function can inform post-surgical intervention strategies. METHODS: This randomized controlled trial included 58 adults (aged 18–65 years, 70% women, BMI 41.7±4.4 kg/m²) undergoing MBS. Participants were randomized into four groups: aerobic (n=15), resistance (n=13), combined (n=14), and control (n=16). Exercise groups completed a 26-week supervised program, performing three progressive-intensity sessions per week. Primary outcomes included changes in FFM and fat mass (FM), assessed by Dual-Energy X-Ray Absorptiometry (DXA). Secondary outcomes encompassed abdominal fat distribution (using and magnetic resonance imaging, MRI), cardiometabolic markers (glucose regulation, lipid profiles), and physical function (walking distance, handgrip strength). Measurements included cardiometabolic blood markers and physical performance tests. RESULTS: After 26 weeks, 91% of participants completed the study. The combined exercise group preserved more FFM (-5.1±2.8 kg vs. -7.7±2.8 kg, control) and exhibited greater FM reduction (-11.9±5.7% vs. -10.1±4.9%, control). Weekly physical activity showed a dose-response correlation with FFM preservation, with the strongest effects in the combined group. All groups demonstrated significant reductions in abdominal and hepatic fat, correlating with improved glucose regulation, lipid profiles, and blood pressure. Physical function improved across all groups, with better handgrip strength preservation in the combined group. Strength positively correlated with protein intake, while walking distance improvements were similar across groups and correlated with weight loss. CONCLUSION: Combined aerobic and resistance training optimizes body composition post-MBS by preserving FFM and reducing FM. These findings underscore the importance of structured exercise interventions in enhancing long-term metabolic health and functional outcomes in MBS patients.
Read CV Yftach GepnerECSS Paris 2023: OP-MH06
INTRODUCTION: Obesity and the metabolic syndrome (MetS) are major global health concerns, increasing the risk for morbidity and mortality. Recent research highlights the gut microbiome as a key regulator of metabolic health, with short-chain fatty acids (SCFAs) produced in the intestinal tract playing a crucial role in cardiometabolic health [1]. There is evidence that exercise may alter gut metabolites [2], but findings of previous studies remain inconsistent. We hypothesized that these discrepancies stem from differences in exercise intensity, with higher-intensity exercise leading to more pronounced microbial adaptations. This study examined the effects of a low-volume interval training plus single-set resistance training (RT) program, performed at either high intensity (HIGH-EX) or moderate intensity (MOD-EX), on gut SCFAs and cardiometabolic health indices in obese individuals with MetS. METHODS: A total of 113 subjects (53±12 yrs, BMI: 39±5) were randomized into three groups: HIGH-EX (5×1 min cycling at 80–95% HRmax, followed by progressive RT, 5 exercises, 50–80% 1-RM), MOD-EX (5×1 min cycling at <80% HRmax, followed by moderate RT, 50–60% 1-RM), and a non-exercising control group (CON). Training was performed twice weekly for 12 weeks. Stool samples were collected pre- and post-intervention to analyze SCFA concentrations. Additionally, VO2max, muscle strength, cardiometabolic risk markers, and MetS severity (MetS Z-score) were assessed. RESULTS: HIGH-EX and MOD-EX improved MetS-Z-Score (–1.1 units, p<0.01; and –0.5 units, p<0.05, respectively), VO2max (+4.2 mL/kg/min, p<0.01; and +2.7 mL/kg/min, p<0.05, respectively) and 1-RM strength values in major muscle groups (19–26%, all p<0.001; and 22–29%, all p<0.001, respectively). Both exercise groups also significantly reduced inflammation (hs-CRP, HIGH-EX: –2.2 mg/L, p=0.013; MOD-EX: –1.3 mg/L, p=0.01). Only HIGH-EX significantly increased total fecal SCFA concentration (+29%, p<0.001), including acetate (+27%, p<0.001), propionate (+24 %, p<0.001), and butyrate (+39%, p<0.001). None of the parameters changed in CON. CONCLUSION: This study indicates that low-volume interval training combined with single-set RT (70 min/week) improves physical fitness and cardiometabolic health in obese MetS patients at both high and moderate intensities. However, improvements in SCFA production were only observed in HIGH-EX. This suggests that exercise intensity plays a critical role in gut microbial adaptations, potentially mediated by higher lactate production, which has been linked to increased SCFA production [3]. Future research should further explore the mechanistic links between exercise intensity and gut microbiota metabolism to optimize exercise prescriptions for metabolic health improvements. References: 1) Koh A et al. (2016) Cell 165: 1332-1345. 2) Sales KM, Reimer RA (2023) J Sport Health Sci 12: 36-44. 3) Scheiman J et al. (2019) Nat Med 25:1104-1109.
Read CV Dejan ReljicECSS Paris 2023: OP-MH06
INTRODUCTION: This study focused on the phenotypic characteristics of youth with metabolically unhealthy obesity (MUO)and metabolically healthy obesity (MHO). It aimed to evaluate the metabolic characteristics of combined training modalities, resistance training followed by moderate-intensity continuous training (RT+MICT), on the transition from MUO to MHO in young adults. METHODS: This randomized clinical trial, conducted from September 2024 to November 2024, involved 50 obese college students (ages 18-25) from China Agricultural University in Beijing. Of these, 30 participants were classified as MUO, while 20 were classified as MHO based on their phenotypic characteristics. Participants underwent a combined intervention of resistance training and MICT (50-75% HRmax), which was performed twice a week for a duration of 8 weeks. RESULTS: There were 33 differential metabolites identified between MUO and MHO individuals prior to exercise intervention. After an 8-week combined exercise program, 52% of the MUO participants transitioned to the MHO state, while 20 MHO participants remained in the MHO state. RT+MICT intervention significantly improved body composition, with reductions in body weight, body mass index (BMI), and percent body fat (PBF). Regarding metabolic health indicators, blood pressure remained unchanged, whereas blood glucose levels decreased in both groups. Following the 8-week combined exercise, there were 374 differential metabolites observed in the MUO group transitioning to the MHO state, and 342 differential metabolites identified in the MHO group that remained in the MHO state. Key metabolic indicators related to the combined training modalities that facilitated the transition of MUO in youth included tetradecanedioic acid, 4-Ethylphenylsulfate, p-Cresol, p-Cresol sulfate, Cholic acid, 1,4-dihydroxyheptadec-16-en-2-yl acetate, 7a-Hydroxy-cholestene-3-one, and Hypocrellin A. CONCLUSION: Combined exercise intervention effectively improves the metabolic abnormalities associated with MUO and promote its transition to the MHO state.
Read CV Li YanchunECSS Paris 2023: OP-MH06