Effects of a Multi-Disciplinary Lifestyle Intervention on Cardiometabolic Risk Factors in Young Women with Abdominal Obesity: A Randomised Controlled Trial

<div><p>Background</p><p>Young women are under-represented in cardiovascular disease research, with obesity and cardiometabolic risk factor interventions generally targeting older adults. Furthermore, appropriate study designs for young women remain uncertain. This study aimed to assess the impact of a 12 week multi-disciplinary lifestyle intervention on cardiometabolic risk factors in premenopausal women with abdominal obesity.</p><p>Methods</p><p>Women aged 18–30 y with abdominal obesity [waist circumference (WC) ≥ 80 cm] were randomised to a 12 week lifestyle intervention (n = 26) of physical activity, nutrition education and cognitive behavioural therapy, or a wait-list control group (n = 17). Both groups completed anthropometric, biochemical, nutrition and fitness testing, at pre (0 weeks) and post (12 weeks), with intervention participants completed follow-up testing at 24 weeks.</p><p>Results</p><p>Results from a linear mixed model showed no between-group differences, other than increased physical activity in the intervention group, at post. In the intervention group alone, positive within-group changes were observed in WC, waist-hip-ratio (WHR), waist-height-ratio (WHtR), resting heart rate, blood pressure, predicted VO_2max, and total energy intake. Most changes were maintained at 24 weeks post-intervention. Similar within-group improvements were observed in control participants in WC, WHR, WHtR, and systolic blood pressure but no changes were detected in physical activity and nutrition.</p><p>Conclusions</p><p>Cardiometabolic risk factors were decreased as a result of a lifestyle intervention in young women with abdominal obesity. It is difficult to describe observations in the control group without greater understanding of the behaviour of wait-list participants.</p><p>Trial Registration</p><p>Australian New Zealand Clinical Trials Registry <a href="http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12612001017819&ddlSearch=Registered" target="_blank">ACTRN12612001017819</a></p></div

CONSORT participant flow-chart of intervention and control participants.

<p>CONSORT participant flow-chart of intervention and control participants.</p

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

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

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

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