Effects of combined training or moderate intensity continuous training during a 3-week multidisciplinary body weight reduction program on cardiorespiratory fitness, body composition, and substrate oxidation rate in adolescents with obesity.

This study aimed to investigate the effects of combined training (COMB, a combination of moderate-intensity continuous training-MICT and high-intensity interval training-HIIT) vs. continuous MICT administered during a 3-week in-hospital body weight reduction program (BWRP) on body composition, physical capacities, and substrate oxidation in adolescents with obesity. The 3-week in-hospital BWRP entailed moderate energy restriction, nutritional education, psychological counseling, and two different protocols of physical exercise. Twenty-one male adolescents with obesity (mean age: 16.1 ± 1.5 years; mean body mass index [BMI] 37.8 ± 4.5 kg m-2) participated in this randomized control trial study (n:10 for COMB, n:11 MICT), attending ~ 30 training sessions. The COMB group performed 3 repetitions of 2 min at 95% of peak oxygen uptake (V'O2 peak) (e.g., HIIT ≤ 20%), followed by 30 min at 60% of V'O2 peak (e.g., MICT ≥ 80%). Body composition, V'O2 peak, basal metabolic rate (BMR), energy expenditure, and substrate oxidation rate were measured during the first week (W0) and at the end of three weeks of training (W3). The two training programs were equivalent in caloric expenditure. At W3, body mass (BM) and fat mass (FM) decreased significantly in both groups, although the decrease in BM was significantly greater in the MICT group than in the COMB group (BM: - 5.0 ± 1.2 vs. - 8.4 ± 1.5, P < 0.05; FM: - 4.3 ± 3.0 vs. - 4.2 ± 1.9 kg, P < 0.05). V'O2 peak increased only in the COMB by a mean of 0.28 ± 0.22 L min-1 (P < 0.05). The maximal fat oxidation rate (MFO) increased only in the COMB group by 0.04 ± 0.03 g min-1 (P < 0.05). COMB training represents a viable alternative to MICT for improving anthropometric characteristics, physical capacities, and MFO in adolescents with obesity during a 3-week in-hospital BWRP.

Differences in spinal postures and mobility among adults with Prader-Willi syndrome, essential obesity, and normal-weight individuals.

Introduction: Spinal kinematics/motion are reported to be altered in adolescents and adults with essential obesity, while no information is available in patients with Prader-Willi syndrome so far. The aim of this study was to examine cross-sectionally the characteristics of spinal postures and mobility in 34 patients with PWS, in 35 age- and sex-matched adults with essential obesity, and in 37 normal-weight individuals. Methods: Spinal posture and mobility were assessed using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Differences in spinal posture and mobility between the three groups were determined using a two-way analysis of variance. Results: Adults with Prader-Willi syndrome had greater thoracic kyphosis [difference between groups (Δ) = 9.60, 95% CI 3.30 to 15.60, p = 0.001], less lumbar lordosis (Δ = -6.50, 95% CI -12.70 to -0.30, p = 0.03) as well as smaller lumbar and hip mobility than those with normal weight. Discussion: Although the characteristics of the spine in patients with Prader-Will syndrome appear to be similar to that found in subjects with essential obesity, Prader-Willi syndrome was found to influence lumbar movements more than thoracic mobility. These results provide relevant information about the characteristics of the spine in adults with Prader-Willi syndrome to be taken into careful consideration in the management of spinal conditions. These findings also highlight the importance of considering the musculoskeletal assessment of spinal postures and approaches targeting spinal and hip flexibility in adults with Prader-Willi syndrome.

Differences in spinal posture and mobility between adults with obesity and normal weight individuals.

The aim of this study was to cross-sectionally investigate the relationships between obesity and spinal posture as well as mobility by comparing the spinal parameters between adults with obesity and normal-weight individuals. The spinal parameters were measured in 71 adults with obesity and 142 normal-weight individuals using a radiation-free back scan, the Idiag M360. Differences in spinal posture and movements between the two groups were determined using a two-way analysis of variance. Adults with obesity had greater thoracic kyphosis [difference between groups (Δ) = 6.1°, 95% CI 3.3°-8.9°, p < 0.0001] and thoracic lateral flexion (Δ = 14.5°, 95% CI 5.1°-23.8°, p = 0.002), as well as smaller thoracic flexion (Δ = 3.5°, 95% CI 0.2°-6.9°, p = 0.03), thoracic extension (Δ = 4.1°, 95% CI 1.1°-7.1°, p = 0.008), lumbar flexion (Δ = 10.4°, 95% CI 7.7°-13.5°, p < 0.0001), lumbar extension (Δ = 4.8°, 95% CI 2.2°-7.4°, p = 0.0003) and lumbar lateral flexion (Δ = 12.8°, 95% CI 9.8°-15.7°, p = < 0.0001) compared to those with normal weight. These findings provide relevant information about the characteristics of the spine in adults with obesity to be taken into careful consideration in the prescription of adapted physical activities within integrated multidisciplinary pathways of metabolic rehabilitation.

Corrigendum: Effects of a 3-week inpatient multidisciplinary body weight reduction program on body composition and physical capabilities in adolescents and adults with obesity.

[This corrects the article DOI: 10.3389/fnut.2022.840018.].

Changes in the Oswestry Disability Index after a 3-Week In-Patient Multidisciplinary Body Weight Reduction Program in Adults with Obesity.

The aim of this study was to examine the short-term changes in disability after an inpatient, multidisciplinary body weight reduction program (BWRP) in adults with obesity. A total of 160 individuals (males: 52, females: 108, BMI > 35 kg/m2) hospitalized for a 3-week multidisciplinary BWRP were recruited into the study. Body composition, lower limb muscle power, fatigue severity, and disability were measured at the beginning and end of the intervention by means of bioimpedance analysis, a stair climbing test (SCT), the Fatigue Severity Scale (FSS), and the Oswestry disability index (ODI), respectively. At the end of the 3-week BWRP, an average body weight reduction of 5.0 kg (CI 95% −5.3; −4.6, p < 0.001) was determined, as well as an improvement in all parameters measured. Clinically meaningful reductions in disability were observed in the moderate disability (Δ = −11.8% CI 95% −14.3; −9.3, p < 0.001) and severe disability (Δ = −15.9% CI 95% −19.6; −12.2, p < 0.001) groups. Reductions in disability were explained only by improvements in the SCT (Δ = −2.7 CI 95% −4.1; −1.4, p < 0.001) and the FSS (Δ = −0.3% CI 95% −0.4; −0.1, p < 0.001). These findings demonstrate the importance of incorporating approaches into a BWRP that increase lower limb muscle power and decrease fatigue severity and thus reduce disability in adults with obesity.

Effects of a 3-Week Inpatient Multidisciplinary Body Weight Reduction Program on Body Composition and Physical Capabilities in Adolescents and Adults With Obesity.

Background: The aim of the present study was to examine the short-term changes in body composition and physical capabilities in subjects with obesity during a multidisciplinary inpatient body weight reduction program (BWRP). Methods: One hundred thirty-nine adolescents (56 boys and 83 girls; BMI: 37.1 ± 6.5 kg/m2; Fat Mass, FM: 45.3 ± 7.2%) and 71 adults (27 males and 44 females; BMI: 44 ± 4.7 kg/m2; FM: 51.4 ± 4.7%) followed a 3-week inpatient BWRP consisting of regular physical activity, moderate energy restriction, nutritional education and psychological counseling. Before (T0) and after the end of the BWRP (T21), body composition was assessed with an impedancemeter, lower limb muscle power with Margaria Stair Climbing Test (SCT), lower limb functionality with Short Physical Performance Battery (SPPB), and the capacity of performing activity of daily living (ADL) with Physical Performance Test (PPT). Results: At T21, obese adolescents showed a 4% reduction in body mass (BM) (p < 0.001), associated with a FM reduction in boys (-10%) and girls (-6%) (p < 0.001) and with a 3% reduction in fat-free mass (FFM) recorded only in boys (p = 0.013). Obese adults showed a 5% BM reduction (p < 0.001), associated with a 2% FFM and 9% FM reduction (p < 0.001) in males, and 7% FM reduction in females (p < 0.001). Regarding physical capabilities, at T21 in obese adolescents, PPT score increased by 4% (p < 0.001), SCT decreased by -5% (boys) and -7% (girls) (p < 0.001), while SPPB score did not change significantly. In obese adults at T21, PPT score increased by 9% (p < 0.001), SCT decreased by -16% (p < 0.001) only in females, and SPPB score increased by 7% (males) and 10% (females) (p < 0.01). Conclusion: In conclusion, moderate energy restriction and regular physical activity determine a 4-5% BM reduction during a 3-week inpatient BWRP, improve physical capabilities and induce beneficial changes in body composition in adolescents and adults with obesity. Trial registration: This study was approved by the Ethical Committee of the Istituto Auxologico Italiano (Milan, Italy; research code: 01C124; acronym: PRORIPONATFIS). Registered 11 November 2020 - Retrospectively registered.

Respiratory Muscle Interval Training Improves Exercise Capacity in Obese Adolescents during a 3-Week In-Hospital Multidisciplinary Body Weight Reduction Program.

The purpose of this study was to determine whether a novel approach of interval training targeted to the respiratory muscles (RMIT; normocapnic hyperpnea with resistance) in addition to a multidisciplinary in-hospital body weight reduction program (BWRP) was able to improve the integrative response to exercise in young patients with obesity. Nine male patients (17.9 ± 4.9 (x ± SD) years; 113.8 ± 16.3 kg) underwent 12 sessions of RMIT and eight age-and sex-matched patients underwent 12 sessions of a sham protocol (CTRL) during the same 3-week BWRP. Before and after the interventions the patients performed an incremental and a heavy-intensity constant work-rate (CWR>GET) cycling exercise to voluntary exhaustion. Body mass decreased by ~4.0 kg after both RMIT (p = 0.0001) and CTRL (p = 0.0002). Peak pulmonary O2 uptake (V˙O2) increased after RMIT (p = 0.02) and CTRL (p = 0.0007). During CWR>GET at ISO-time, V˙O2 (p = 0.0007), pulmonary ventilation (p = 0.01), heart rate (p = 0.02), perceived respiratory discomfort (RPER; p = 0.03) and leg effort (p = 0.0003) decreased after RMIT; only RPER (p = 0.03) decreased after CTRL. Time to exhaustion increased after RMIT (p = 0.0003) but not after CTRL. In young patients with obesity, RMIT inserted in a 3-week BWRP reduced the cardiorespiratory burden, the metabolic cost, the perceived effort, and improved exercise tolerance during heavy-intensity cycling.

Obese Patients Decrease Work Rate in Order to Keep a Constant Target Heart Rate.

PURPOSE: "Slow components" of heart rate (HR) kinetics, occurring also during moderate-intensity constant work rate exercise, represent a problem for exercise prescription at fixed HR values. This problem, described in young healthy subjects, could be more pronounced in obese patients. METHODS: Sixteen male obese patients (age, 22 ± 7 yr; body mass, 127 ± 19 kg; body mass index, 41.6 ± 3.9 kg·m-2) were tested before (PRE) and after (POST) a 3-wk multidisciplinary body mass reduction program, entailing moderate-intensity exercise. They performed on a cycle ergometer an incremental exercise to voluntary exhaustion (to determine peak pulmonary oxygen uptake (V˙O2peak) and gas exchange threshold (GET)) and constant work rate exercises: moderate-intensity (MODERATE; 80% of GET determined in PRE), heavy-intensity (HEAVY; 120% of GET determined in PRE), and "HRCLAMPED" exercise, in which work rate was continuously adjusted to maintain a constant HR corresponding to that at 120% of GET. Breath-by-breath V˙O2 and HR were determined. RESULTS: V˙O2peak and GET (expressed as a percent of V˙O2peak) were not significantly different in PRE versus POST. In POST versus PRE, the HR slow component disappeared (MODERATE) or was reduced (HEAVY). In PRE, work rate had to decrease by ~20% over a 15-min task in order to keep HR constant; this decrease was significantly smaller (~5%) in POST. CONCLUSIONS: In obese patients, a 3-wk multidisciplinary body mass reduction intervention i) increased exercise tolerance by eliminating (during MODERATE) or by reducing (during HEAVY) the slow component of HR kinetics, and ii) facilitated exercise prescription by allowing to translate a fixed submaximal HR value into a work rate slightly above GET.

Acute Effects of Whole-Body Vibration Exercises at 2 Different Frequencies Versus an Aerobic Exercise on Some Cardiovascular, Neuromotor and Musculoskeletal Parameters in Adult Patients With Obesity.

Whole-body vibration exercise (WBVE), a nonimpact, viable and safe type of exercise, has been reported to be useful in the physical rehabilitation of obesity. Aim of the study was to compare the acute effects of WBVE with a session of walking and running (AER) on cardiovascular, neuromotor and musculoskeletal parameters in obese subjects. Sixteen adult obese subjects performed 3 tests (WBVE at 30 and 45 Hz, AER) randomly in different days. An increase in heart rate was recorded after AER and 45 Hz WBVE (p < 0.001), while only AER increased systolic (p = 0.003) and diastolic blood pressure (p = 0.004) and ratings of perceived exertion (p < 0.001). All 3 exercises determined lactate increase [AER p < 0.001, 45 Hz (p = 0.04), 30 Hz (p = 0.03) WBVE] and sit-and-reach (AER p = 0.002, 45 and 30 Hz WBVE p < 0.001) and fingertip-to-floor improvements (AER p = 0.003, 30 and 45 Hz WBVE p < 0.001), while only 30 Hz WBVE determined improvement in stair climbing test (p < 0.05). Considering the lack of effects of 30 Hz WBVE on the cardiovascular system and fatigue and its positive effect on flexibility and muscle power, this procedure can be considered an appropriate exercise protocol for the obese population.

Acute respiratory muscle unloading improves time-to-exhaustion during moderate- and heavy-intensity cycling in obese adolescent males.

Obesity significantly impairs breathing during exercise. The aim was to determine, in male obese adolescents (OB), the effects of acute respiratory muscle unloading, obtained by switching the inspired gas from ambient air (AIR) to a normoxic helium + oxygen gas mixture (HeO2) (AIR → HeO2) during moderate [below gas exchange threshold (GET)] and heavy [above GET] constant work rate cycling. Ten OB [age 16.0 ± 2.0 years (mean ± SD); body mass index (BMI) 38.9 ± 6.1 kg/m2] and ten normal-weight age-matched controls (CTRL) inspired AIR for the entire exercise task, or underwent AIR → HeO2 when they were approaching volitional exhaustion. In OB time to exhaustion (TTE) significantly increased in AIR → HeO2 vs. AIR during moderate [1524 ± 480 s vs. 1308 ± 408 (P = 0.024)] and during heavy [570 ± 306 s vs. 408 ± 150 (P = 0.0154)] exercise. During moderate exercise all CTRL completed the 40-min task. During heavy exercise no significant differences were observed in CTRL for TTE (582 ± 348 s [AIR → HeO2] vs. 588 ± 252 [AIR]). In OB, but not in CTRL, acute unloading of respiratory muscles increased TTE during both moderate- and heavy-exercise. In OB, but not in CTRL, respiratory factors limit exercise tolerance during both moderate and heavy exercise.

A 3-Week Multidisciplinary Body Weight Reduction Program Improves Body Composition and Lower Limb Power Output in 3,778 Severely Obese Children and Adolescents.

The aim of the present study was to investigate the effects of a 3-week in-hospital body weight reduction program (BWRP), entailing moderate energy restriction, physical activity, psychological counseling and nutritional education, on body composition and lower limb muscle power (LLP) output in obese children and adolescents. Three thousand seven hundred seventy-eight obese [BMI: 36.2 ± 5.9 kg⋅m-2; fat mass (FM): 42.7 ± 4.0%] children and adolescents (2,318 girls and 1,460 boys, aged 8-18 year) participated in this study. Before (T0) and after the end of the BWRP (21st day, T21), body composition was assessed by an impedancemeter and LLP by the Margaria stair climbing test. Body mass (BM) and FM significantly decreased in girls (-4.8 and -7.1%, p < 0.001) and in boys (-5.5 and -9.3%, p < 0.001) after 3-week BWRP, while fat-free mass (FFM) did not change significantly in both genders. LLP expressed in absolute values (W) significantly increased in girls (by mean 6.4% from age 13 to 18 year, P < 0.001) and in boys (by mean 7.2% from age 12 to 18 year, P < 0.001). LLP normalized to BM (W⋅kg-1BM) significantly increased in girls (by mean 11.3%, P < 0.001) and boys (by mean 12.6%, P < 0.001) from age 9 to 18 year. As well, LLP normalized to FFM (W⋅kg-1FFM) significantly increased in girls (by mean 9.1% from age 9 to 18 year, P < 0.001) and in boys (by mean 10.1% from age 10 to 18 year, P < 0.001). In conclusion, 3-week BWRP induces a significant decrease in FM and maintenance in FFM in obese children and adolescents, these effects being also associated with a significant increase of LLP both in absolute terms and when normalized to the BM or FFM.

Effects of an acute bout of exercise on circulating extracellular vesicles: tissue-, sex-, and BMI-related differences.

BACKGROUND: Exercise is recognized to evoke multisystemic adaptations that, particularly in obese subjects, reduce body weight, improve glucometabolic control, counteract sarcopenia, and lower the risk of cardiometabolic diseases. Understanding the molecular and cellular mechanisms of exercise-induced benefits is of great interest due to the therapeutic implications against obesity. OBJECTIVES AND METHODS: The aim of the present study was to evaluate time-related changes in size distribution and cell origin of extracellular vesicles (EVs) in obese and normal-weight subjects who underwent a moderate-intensity exercise on a treadmill (at 60% of their VO2max). Blood samples were drawn before, immediately at the end of the exercise and during the postexercise recovery period (3 and 24 h). Circulating EVs were analyzed by a nanoparticle tracking analysis and flow cytometry after labeling with the following cell-specific markers: CD14 (monocyte/macrophage), CD61 (platelet), CD62E (activated endothelium), CD105 (total endothelium), SCGA (skeletal muscle), and FABP (adipose tissue). RESULTS: In all subjects, acute exercise reduced the release of total (i.e., 30-700 nm) EVs in circulation, predominantly EVs in the microvesicle size range (i.e., 130-700 nm EVs). The postexercise release of microvesicles was higher in normal-weight than obese subjects; after exercise, circulating levels of exosomes (i.e., 30-130 nm EVs) and microvesicles were, respectively, lower and higher in females than males. In all experimental subgroups (males vs. females and obese vs. normal-weight subjects), acute exercise reduced and increased, respectively, CD61 + and SCGA + EVs, being the effect on CD61 + EVs prolonged up to 24 h after the end of the test with subjects in resting conditions. Total EVs, exosomes, and CD61 + EVs were associated with HOMA-IR. CONCLUSIONS: Though preliminary, the results of the present study show that a single bout of acute exercise modulates the release of EVs in circulation, which are tissue-, sex-, and BMI specific, suggesting that the exercise-related benefits might depend upon a complex interaction of tissue, endocrine, and metabolic factors.

Acute Effects of Whole-Body Vibration Alone or in Combination With Maximal Voluntary Contractions on Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Obese Male Adolescents.

Musculoskeletal and neuromotor fitness (MSMF) is reduced in obesity. Physical exercise (including whole-body vibration exercise [WBVE]) is reported to improve components related to MSMF. The aim of the study is to evaluate the acute effects of WBVE and maximal voluntary contraction (MVC), alone and in combination, on the cardiorespiratory and MSMF in obese adolescents. Eight obese adolescents performed 3 tests (WBVE, MVC, and MVC + WBVE) in different days and randomly. The outcome measures were diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (SpO2), handgrip strength (HS), one-leg standing balance (OLSB) test, sit-and-reach (SR) test, stair climbing test (time: T SCT and power: P SCT), and sit-to-stand test (time: T STSand power: P STS). No significant changes were observed in SBP, DBP, MAP, and SpO2 after the 3 tests, only an HR increase being observed after MVC + WBVE (P < .01) and MVC alone (P < .05). No significant differences were found in HS, OLSB, T STS, and P STS after the 3 different sessions. An increase in SR was found after MVC + WBVE, MVC, and WBVE (P < .01, P < .05, and P < .01, respectively), while a decrease in T SCT (P < .01) and an increase in P SCT were observed only after WBVE (P < .01). Taking into account the positive WBVE effects on cardiorespiratory and MSMF, WBVE might represent a nonimpact, viable, and safe exercise suitable for obese patients, which need MSMF improvement without overloading joints.

Metabolic and muscular factors limiting aerobic exercise in obese subjects.

PURPOSE: The aim of the present study was to understand the role of central (cardiovascular O2 delivery) and peripheral factors (muscle level) in limiting the maximal aerobic performance in obese (OB) subjects. METHODS: Fifteen OB (mean age ± SD 25 ± 7 years; BMI 43 ± 7 kg/m2) and 13 lean sedentary subjects (CTRL, age 27 ± 7 years; BMI 22 ± 3 kg/m2) participated in this study. Oxygen uptake (VO2), hearth rate (HR) and cardiac output (CO) were measured during cycle ergometer (CE) and knee extension (KE) incremental tests. Maximal voluntary contractions (MVCs) of knee extensor muscles were performed before and immediately after the two tests. RESULTS: VO2peak, HR peak and CO peak were significantly higher in CE than KE (+ 126%, + 33% and + 46%, respectively, p < 0.001), both in OB and CTRL subjects, without differences between the two subgroups. Maximal work rate was lower in OB than CTRL (191 ± 38 vs 226 ± 39 W, p < 0.05) in CE, while it was similar between the two subgroups in KE. Although CE and KE determined a reduction of MVC in both subgroups, MVC resulted less decreased after CE than KE exercises (- 14 vs - 32%, p < 0.001) in OB, while MVC decrements were similar after the two exercises in CTRL (- 26% vs - 30%, p > 0.05, for CE and KE, respectively). CONCLUSIONS: The lower muscle fatigue observed in OB after CE compared to KE test suggests that central factors could be the most important limiting factor during cycling in OB.

Multidisciplinary Integrated Metabolic Rehabilitation in Elderly Obese Patients: Effects on Cardiovascular Risk Factors, Fatigue and Muscle Performance.

BACKGROUND: Obesity is a widespread problem in the elderly, being associated with severe comorbidities negatively influencing life expectancy. Integrated multidisciplinary metabolic rehabilitation aimed to reduce body weight (BW) and fatigue, increase physical autonomy and introduce healthy life style changes has been proposed as a useful intervention to improve the general health status and quality of life of the obese geriatric population. METHODS: Six hundred-eighty four severely obese subjects (F/M = 592/92; age range: 61-83 years; mean body mass index, BMI ± SD: 42.6 ± 5.6 kg/m2) were admitted to take part in a three-week in-hospital BW reduction program (BWRP), entailing energy restricted diet, psychological counselling, physical rehabilitation and nutritional education. Biochemical parameters, cardiovascular risk factors (throughout the Coronary Heart Disease Risk, CHD-R), fatigue (throughout the Fatigue Severity Scale, FSS) and lower limb muscle performance (throughout the Stair Climbing Test, SCT) were evaluated before and at the end of the BWRP. RESULTS: A 4% BW reduction was achieved at the end of the BWRP. This finding was associated with a significant improvement of the metabolic homeostasis (i.e., decrease in total cholesterol and glucose) and a reduction of systolic blood pressure in both females and males, thus resulting in a reduction of CHD-R in the male group. Total FSS score and SCT time decreased in female and male obese patients. The effects of BWPR were comparable among all age-related subgroups (>60, 60-69 and >70 years), apart from ΔCHD-R, which was higher in male subgroups. Finally, age was negatively correlated with ΔBMI and ΔFSS. CONCLUSIONS: Though only a relatively limited number of outcomes were investigated, the present study shows that a 4% BW reduction in severely elderly obese patients is associated with positive multisystemic effects, particularly, muscle-skeletal and cardiometabolic benefits, which can favorably influence their general well-being and improve the autonomy level in performing more common daily activities. The maintenance of a healthy life style, including controlled food intake and regular physical activity, after a BWRP is obviously recommended in all elderly obese patients to further improve their clinical condition.

Three weeks of respiratory muscle endurance training improve the O2 cost of walking and exercise tolerance in obese adolescents.

Obese adolescents (OB) have an increased O2 cost of exercise, attributable in part to an increased O2 cost of breathing. In a previous work a short (3-week) program of respiratory muscle endurance training (RMET) slightly reduced in OB the O2 cost of high-intensity cycling and improved exercise tolerance. We hypothesized that during treadmill walking the effects of RMET would be more pronounced than those observed during cycling. Sixteen OB (age 16.0 ± 0.8 years; body mass [BM] 127.7 ± 14.2 kg; body mass index 40.7 ± 4.0 kg/m2 ) underwent to 3-week RMET (n = 8) superimposed to a multidisciplinary BM reduction program, or (CTRL, n = 8) only to the latter. Heart rate (HR) and pulmonary O2 uptake ( V ˙ O2 ) were measured during incremental exercise and 12-min constant work rate (CWR) walking at 60% (moderate-intensity, MOD) and 120% (heavy-intensity, HEAVY) of the gas exchange threshold (GET). The O2 cost of walking (aerobic energy expenditure per unit of covered distance) was calculated as V ˙ O2 /velocity. BM decreased (~4-5 kg) both in CTRL and in RMET. V ˙ O2 peak and GET were not affected by both interventions; the time to exhaustion increased following RMET. During MOD and HEAVY RMET decreased V ˙ O2, the O2 cost of walking (MOD: 0.130 ± 0.033 mL/kg/m [before] vs. 0.109 ± 0.027 [after], P = 0.03; HEAVY: 0.196 ± 0.031 [before] vs. 0.180 ± 0.025 [after], P = 0.02), HR and rates of perceived exertion; no significant changes were observed in CTRL. In OB a short RMET program lowered the O2 cost of MOD and HEAVY walking and improved exercise tolerance. RMET could represent a useful adjunct in the control of obesity.

Acute administration of capsaicin increases resting energy expenditure in young obese subjects without affecting energy intake, appetite, and circulating levels of orexigenic/anorexigenic peptides.

Although capsaicin has been reported to reduce energy intake and increase energy expenditure in an adult (normal weight or overweight) population, thus resulting in a net negative energy balance and weight loss, these beneficial effects have not been investigated in young obese subjects. We hypothesize that capsaicin acutely administered in young obese subjects exerts the same effects on energy balance and that these effects are mediated by changes in gastrointestinal peptides regulating appetite. Thus, the aim of the present study was to evaluate the acute effects of capsaicin (2 mg) or placebo on energy intake, hunger, and satiety in obese adolescents and young adults (female-male ratio: 4:6, age: 21.0 ± 5.8 years; body mass index: 41.5 ± 4.3 kg/m2) provided an ad libitum dinner. Furthermore, circulating levels of some orexigenic (ghrelin) and anorexigenic (glucagon-like peptide 1 and peptide YY) peptides were measured after a meal completely consumed (lunch), together with the evaluation of hunger and satiety and assessment of resting energy expenditure (REE) through indirect computerized calorimetry. When compared to placebo, capsaicin did not significantly change either energy intake or hunger/satiety 6 hours after its administration (dinner). No differences in circulating levels of ghrelin, glucagon-like peptide 1, and peptide YY and in hunger/satiety were found in the 3 hours immediately after food ingestion among obese subjects treated with capsaicin or placebo (lunch). By contrast, the meal significantly increased REE in the capsaicin- but not placebo-treated group (capsaicin: from 1957.2 ± 455.1 kcal/d up to 2342.3 ± 562.1 kcal/d, P < .05; placebo: from 2060.1 ± 483.4 kcal/d up to 2296.0 ± 484.5 kcal/d). The pre-post meal difference in REE after capsaicin administration was significantly higher than that observed after placebo (385.1 ± 164.4 kcal/d vs 235.9 ± 166.1 kcal/d, P < .05). In conclusion, although capsaicin does not exert hypophagic effects, these preliminary data demonstrate its ability as a metabolic activator in young obese subjects.