Additional file 2: of Myocardial function at the early phase of traumatic brain injury: a prospective controlled study

Additional analyses. (DOC 161 kb

Multilevel Approach of a 1-Year Program of Dietary and Exercise Interventions on Bone Mineral Content and Density in Metabolic Syndrome – the RESOLVE Randomized Controlled Trial

<div><p>Background</p><p>Weight loss is a public health concern in obesity-related diseases such as metabolic syndrome (MetS). However, restrictive diets might induce bone loss. The nature of exercise and whether exercise with weight loss programs can protect against potential bone mass deficits remains unclear. Moreover, compliance is essential in intervention programs. Thus, we aimed to investigate the effects that modality and exercise compliance have on bone mineral content (BMC) and density (BMD).</p><p>Methods</p><p>We investigated 90 individuals with MetS who were recruited for the 1-year RESOLVE trial. Community-dwelling seniors with MetS were randomly assigned into three different modalities of exercise (intensive resistance, intensive endurance, moderate mixed) combined with a restrictive diet. They were compared to 44 healthy controls who did not undergo the intervention.</p><p>Results</p><p>This intensive lifestyle intervention (15–20 hours of training/week + restrictive diet) resulted in weight loss, body composition changes and health improvements. Baseline BMC and BMD for total body, lumbar spine and femoral neck did not differ between MetS groups and between MetS and controls. Despite changes over time, BMC or BMD did not differ between the three modalities of exercise and when compared with the controls. However, independent of exercise modality, compliant participants increased their BMC and BMD compared with their less compliant peers. Decreases in total body lean mass and negative energy balance significantly and independently contributed to decreases in lumbar spine BMC.</p><p>Conclusion</p><p>After the one year intervention, differences relating to exercise modalities were not evident. However, compliance with an intensive exercise program resulted in a significantly higher bone mass during energy restriction than non-compliance. Exercise is therefore beneficial to bone in the context of a weight loss program.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT00917917" target="_blank">NCT00917917</a></p></div

Changes (360 days) on total body bone mineral content (BMC) and density (BMD), lumbar spine BMC and BMD and femoral neck BMC and BMD for <i>re</i>, <i>Re</i> and <i>rE</i> groups.

<p><i>re</i>: moderate-resistance-moderate-endurance; <i>Re</i>: high-Resistance-moderate-endurance; <i>rE</i>: moderate-resistance-high-Endurance. There were no significant differences in BMD and BMC parameters between <i>re</i>, <i>Re</i> and <i>rE</i> participants across the intervention. Participants in the intervention did not have significantly greater or lower bone mass or density development than controls.</p

Compliance effect (360 days) on total body bone mineral content (BMC), lumbar spine BMC and femoral neck BMC for <i>re</i>, <i>Re</i> and <i>rE</i> groups.

<p><i>re</i>: moderate-resistance-moderate-endurance; <i>Re</i>: high-Resistance-moderate-endurance; <i>rE</i>: moderate-resistance-high-Endurance. * Compliant participants significantly different from non-compliants (p<0.05). ‡ Non-compliant participants significantly different from controls.</p

Multilevel regression analysis of total body, lumber spine and femoral neck bone mineral content (BMC) aligned by days from study entry.

<p>Abbreviations: <i>re</i>, moderate-resistance-moderate-endurance; <i>Re</i>, high-Resistance-moderate-endurance; <i>rE</i>, moderate-resistance-high-Endurance.</p><p>Fixed effect values are presented as estimated mean coefficients ± SEE (standard error of estimate) of BMC in grams. Random effects values presented as estimated mean variance ± SEE (BMC) in grams². Days from start was centered around 180 days. Changes in total body lean mass, total body fat mass and central fat mass (g) from study entry.</p><p>Multilevel regression analysis of total body, lumber spine and femoral neck bone mineral content (BMC) aligned by days from study entry.</p

Compliance effect (360 days) on total body bone mineral density (BMD), lumbar spine BMD and femoral neck BMD for <i>re</i>, <i>Re</i> and <i>rE</i> groups.

<p><i>re</i>: moderate-resistance-moderate-endurance; <i>Re</i>: high-Resistance-moderate-endurance; <i>rE</i>: moderate-resistance-high-Endurance. *Compliant participants significantly different from non-compliants (p<0.05).</p

Flow chart of participants.

<p><i>re</i>: moderate-resistance-moderate-endurance; <i>Re</i>: high-Resistance-moderate-endurance; <i>rE</i>: moderate-resistance-high-Endurance.</p