Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis.

BACKGROUND: Lifestyle modifications involving diet and exercise are recommended for patients diagnosed with obesity and type 2 diabetes mellitus (T2DM). The purpose of this review was to systematically evaluate the effects of combined aerobic exercise and diet (AEDT) on various cardiometabolic health-related indicators among individuals with obesity and T2DM. METHODOLOGY: A comprehensive search of the PubMed/Medline, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases was conducted for this meta-analysis. The Cochrane risk of bias tool was used to evaluate eligible studies, and the GRADE tool was used to rate the certainty of evidence. A random-effects model for continuous variables was used, and the results were presented as mean differences or standardised mean differences with 95% confidence intervals. RESULTS: A total of 16,129 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants. The findings revealed significant improvements in body mass index, body weight, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, fasting blood glucose, fasting plasma insulin, glycated hemoglobin, leptin, interleukin-6, C-reactive protein, and adiponectin (p < 0.05) compared to the standard treatment (ST) group. No significant differences were observed between the AEDT and ST groups in fat mass, hip circumference, waist-to-hip ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and tumor necrosis factor-alpha. The present findings are based on low- to moderate-quality evidence. CONCLUSIONS: AEDT may be a critical behavior for holistic cardiometabolic health-related benefits as a contemporary anti-obesity medication due to its significant positive impact on patients with obesity and T2DM. Nevertheless, further robust evidence is necessary to determine whether AEDT is an effective intervention for lowering cardiovascular and metabolic risk factors among individuals with obesity and T2DM.

Role of Mind-Body Fitness in Obesity.

Various mind-body fitness modalities such as Pilates, yoga, Tai Chi, and Qigong have become an accepted part of the physical activity, exercise, and leisure sector, serving several populations eligible for meditative movement activities. However, no robust evidence is present in the current literature supporting the efficacy of these meditative movement activities on health, fitness, and well-being markers among obese adults. Interestingly, the feasibility and safety of mind-body fitness programs in this cohort are still questionable. However, the limited available data show the beneficial role of such alternative exercise options in improving numerous physical fitness and cardiometabolic health-related indicators. The major role of mind-body fitness in obese individuals is to promote muscle control, body functionality, flexibility, and balance while reducing physical limitations, chronic pain, and stress through sessions integrating body postures, efficient breathing patterns, meditation, and relaxation. Such a bodily movement-based approach may be associated with increased physical performance and improved cardiometabolic as well as mental health. However, data on anthropometric characteristics, body composition and cardiovascular disease risk factors modification are somewhat equivocal. Future studies are needed to investigate a wider spectrum of physical fitness and cardiometabolic health parameters, since obese people are likely to demonstrate poor functional capacity, impaired glucose control, lipid disorder, and abnormal blood pressure levels.

Effect of whey vs. soy protein supplementation on recovery kinetics following speed endurance training in competitive male soccer players: a randomized controlled trial.

BACKGROUND: Soccer-specific speed-endurance training induces short-term neuromuscular fatigue and performance deterioration over a 72-h recovery period, associated with elevated markers of exercise-induced muscle damage. We compared the effects of whey vs. soy protein supplementation on field activity, performance, muscle damage and redox responses following speed-endurance training in soccer players. METHODS: Ten well-trained, male soccer players completed three speed-endurance training trials, receiving whey protein (WP), soy protein (SP) or an isoenergetic placebo (PL; maltodextrin) according to a randomized, double-blind, crossover, repeated-measures design. A pre-loading period was applied in each trial during which protein supplementation was individually adjusted to reach a total protein intake of 1.5 g/kg/day, whereas in PL protein intake was adjusted at 0.8-1 g/kg/day. Following pre-loading, two speed-endurance training sessions (1 and 2) were performed 1 day apart, over a 3-day experimental period. During each session, field activity and heart rate were continuously monitored using global positioning system and heart rate monitors, respectively. Performance (isokinetic strength of knee extensors and flexors, maximal voluntary isometric contraction, speed, repeated sprint ability, countermovement jump), muscle damage (delayed-onset of muscle soreness, creatine kinase activity) and redox status (glutathione, total antioxidant capacity, protein carbonyls) were evaluated at baseline (pre), following pre-loading (post-load), and during recovery from speed-endurance training. RESULTS: High-intensity and high-speed running decreased (P ≤ 0.05) during speed-endurance training in all trials, but WP and SP mitigated this response. Isokinetic strength, maximal voluntary isometric contraction, 30-m speed, repeated sprint ability and countermovement jump performance were similarly deteriorated during recovery following speed-endurance training in all trials (P ≤ 0.05). 10 m speed was impaired at 24 h only in PL. Delayed-onset of muscle soreness, creatine kinase, total antioxidant capacity and protein carbonyls increased and glutathione decreased equally among trials following speed-endurance training (P ≤ 0.05), with SP inducing a faster recovery of protein carbonyls only at 48 h (P ≤ 0.05) compared to WP and PL. CONCLUSIONS: In conclusion, increasing daily protein intake to 1.5 g/kg through ingestion of either whey or soy protein supplements mitigates field performance deterioration during successive speed-endurance training sessions without affecting exercise-induced muscle damage and redox status markers. TRIAL REGISTRATION: Name of the registry: clinicaltrials.gov. TRIAL REGISTRATION: NCT03753321 . Date of registration: 12/10/2018.

Protein-Based Supplementation to Enhance Recovery in Team Sports: What is the Evidence?

Protein supplementation is a major nutritional practice among professional and amateur team-sport athletes representing a market of $5 billion in the USA alone. This practice, however, may not be supported by evidence-based science. Our objective as to present a thorough review of literature investigating the effects of protein supplementation on performance recovery and exercise-induced muscle damage following team-sport activity. PubMed-derived, full English language articles investigating the effects of protein-based supplementation/feeding on skeletal muscle performance, muscle damage and inflammatory status during recovery following team-sport activity were included. Studies investigated professional or amateur team-sport athletes participating in regular training and competition as well as examining the impact of protein supplementation on performance, muscle damage/soreness and inflammatory markers after team-sport activity. Finally, ten articles (150 participants) met the inclusion criteria. Experimental designs were evaluated for confounders. All protocols employing team-sport activity increased systemic muscle damage indicators and inflammatory markers and deteriorated performance during recovery. Protein-based supplementation attenuated the rise in muscle damage markers and enhanced performance recovery in six (60% of the studies included) and three (30% of the studies included) out of 10 studies, respectively. In contrast, immunity and muscle soreness remained unaffected by protein ingestion, independent of dosage and distribution pattern. In conclusion, there are limited and inconsistent data showing that protein supplementation may enhance performance recovery following team-sport activity despite an attenuation of indirect markers of muscle damage. Interpretation of results is limited by small sample sizes, high variability in tested supplements, participants' training level, length of recovery periods, absence of direct measurement of myofibrillar disruption, protein turnover and protein metabolism, and lack of dietary monitoring during experimentation.