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Bellman J, Westerterp K, Wouters L, Johannesson M, Lundqvist N, Kullberg J, Larsson C, Gustafsson M, Pettersson S, Fridolfsson J, Arvidsson D, Börjesson M, Curiac D, Jansson JO, Jansson PA, Ohlsson C. Increased weight-load improves body composition by reducing fat mass and waist circumference, and by increasing lean mass in participants with obesity: a single-centre randomised controlled trial. BMC Med 2025; 23:317. [PMID: 40442671 PMCID: PMC12123769 DOI: 10.1186/s12916-025-04143-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2025] [Accepted: 05/16/2025] [Indexed: 06/02/2025] Open
Abstract
BACKGROUND To investigate the effects of increased weight-loading on body weight, body composition, fat mass distribution, physical activity and energy balance in individuals with obesity. METHODS This single-centre non-blinded randomised controlled trial was conducted from August 1, 2021, through February 28, 2022. Adults with obesity class 1 (body mass index, BMI 30-35 kg/m2) were assigned to wear either a heavy (high load; 11% of body weight, n = 28) or light (low load; 1% of body weight, n = 30) weight vest for 8 h per day over 5 weeks. RESULTS High-load treatment reduced fat mass (mean difference - 2.60%; 95% CI - 3.79, - 1.41) and increased lean mass (mean difference 1.40%; 95% CI 0.37, 2.42), with no significant effect on body weight. Fat mass reductions were primarily observed in weight-loaded regions but not in the non-weight-bearing regions such as the arms. Waist circumference decreased (mean difference - 2.26%; 95% CI - 3.81, - 0.71) in the high-load group compared to the low-load group. Despite these beneficial changes, sedentary time was higher in the high-load group (mean difference 4.69%; 95% CI 0.98, 8.39) compared to the low-load group, while energy expenditure and energy intake remained unchanged. CONCLUSIONS Increased weight-loading reduced fat mass and increased lean mass, resulting in a healthier body composition. These effects were achieved despite no increase in physical activity. The fat mass-reducing effect was primarily seen in weight-loaded regions, implying local adaptation to the increased loading. TRIAL REGISTRATION Registered at ClinicalTrials.gov (NCT04697238) in 2021.
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Affiliation(s)
- Jakob Bellman
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 11, SE-41390, Gothenburg, Sweden.
| | - Klaas Westerterp
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, NL-6200 MD, Maastricht, The Netherlands
| | - Loek Wouters
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, NL-6200 MD, Maastricht, The Netherlands
| | - Marit Johannesson
- Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, SE-41345, Gothenburg, Sweden
| | - Niklas Lundqvist
- Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, SE-41345, Gothenburg, Sweden
| | - Joel Kullberg
- Radiology, Department of Surgical Sciences, Uppsala University, SE-75185, Uppsala, Sweden
- Antaros Medical, SE-43153, Mölndal, Sweden
| | - Christel Larsson
- Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, SE-40530, Gothenburg, Sweden
| | - Mikael Gustafsson
- Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, SE-40530, Gothenburg, Sweden
| | - Stefan Pettersson
- Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, SE-40530, Gothenburg, Sweden
| | - Jonatan Fridolfsson
- Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, SE-40530, Gothenburg, Sweden
| | - Daniel Arvidsson
- Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, SE-40530, Gothenburg, Sweden
| | - Mats Börjesson
- Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, SE-40530, Gothenburg, Sweden
- Department of Medicine, Geriatric and Acute Medicine, Region Västra Götaland, Sahlgrenska University Hospital, SE-41685, Gothenburg, Sweden
| | - Dan Curiac
- Gothia Forum, Region Västra Götaland, Sahlgrenska University Hospital, SE-41346, Gothenburg, Sweden, Gothia Forum
| | - John-Olov Jansson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 11, SE-41390, Gothenburg, Sweden
| | - Per-Anders Jansson
- Gothia Forum, Region Västra Götaland, Sahlgrenska University Hospital, SE-41346, Gothenburg, Sweden, Gothia Forum
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-41345, Gothenburg, Sweden
| | - Claes Ohlsson
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-41345, Gothenburg, Sweden
- Department of Drug Treatment, Region Västra Götaland, Sahlgrenska University Hospital, SE-41345, Gothenburg, Sweden
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He C, An Y, Shi L, Huang Y, Zhang H, Fu W, Wang M, Shan Z, Du Y, Xie J, Huang Z, Sun W, Zhao Y, Zhao B. Xiasangju alleviate metabolic syndrome by enhancing noradrenaline biosynthesis and activating brown adipose tissue. Front Pharmacol 2024; 15:1371929. [PMID: 38576483 PMCID: PMC10993144 DOI: 10.3389/fphar.2024.1371929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
Metabolic syndrome (MetS) is a clinical condition associated with multiple metabolic risk factors leading to type 2 diabetes mellitus and other metabolic diseases. Recent evidence suggests that modulating adipose tissue to adaptive thermogenesis may offer therapeutic potential for MetS. Xiasangju (XSJ) is a marketed drug and dietary supplement used for the treatment of metabolic disease with anti-inflammatory activity. This study investigated the therapeutic effects of XSJ and the underlying mechanisms affecting the activation of brown adipose tissue (BAT) in MetS. The results revealed that XSJ ameliorated MetS by enhancing glucose and lipid metabolism, leading to reduced body weight and abdominal circumference, decreased adipose tissue and liver index, and improved blood glucose tolerance. XSJ administration stimulated catecholamine biosynthesis, increasing noradrenaline (NA) levels and activating NA-mediated proteins in BAT. Thus, BAT enhanced thermogenesis and oxidative phosphorylation (OXPHOS). Moreover, XSJ induced changes in gut microbiota composition, with an increase in Oscillibacter abundance and a decrease in Bilophila, Candidatus Stoquefichus, Holdemania, Parasutterella and Rothia. XSJ upregulated the proteins associated with intestinal tight junctions corresponding with lower serum lipopolysaccharide (LPS), tumor necrosis factor α (TNF-α) monocyte chemoattractant protein-1 (MCP-1) and interleukin-6 (IL-6) levels to maintain NA signaling transport. In summary, XSJ may alleviate MetS by promoting thermogenesis in BAT to ultimately boost energy metabolism through increasing NA biosynthesis, strengthening intestinal barrier integrity and reducing low-grade inflammation. These findings suggest XSJ has potential as a natural therapeutic agent for the treatment of MetS.
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Affiliation(s)
- Changhao He
- Department of Pharmacology of Chinese Materia Medica, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Yongcheng An
- Department of Pharmacology of Chinese Materia Medica, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Lu Shi
- Department of Pharmacology of Chinese Materia Medica, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
- Central Laboratories, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Yan Huang
- College of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Huilin Zhang
- Department of Pharmacology of Chinese Materia Medica, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Wanxin Fu
- College of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Menglu Wang
- Department of Pharmacology of Chinese Materia Medica, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Ziyi Shan
- College of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Yuhang Du
- Department of Pharmacology of Chinese Materia Medica, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Jiamei Xie
- Department of Pharmacology of Chinese Materia Medica, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Zhiyun Huang
- Guangzhou Baiyunshan Xingqun Pharmaceutical Co., Ltd, Guangzhou, China
| | - Weiguang Sun
- Guangzhou Baiyunshan Xingqun Pharmaceutical Co., Ltd, Guangzhou, China
| | - Yonghua Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, China
| | - Baosheng Zhao
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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