|
1
|
Gorini S, Camajani E, Feraco A, Armani A, Karav S, Filardi T, Aulisa G, Cava E, Strollo R, Padua E, Caprio M, Lombardo M. Exploring Gender Differences in the Effects of Diet and Physical Activity on Metabolic Parameters. Nutrients 2025; 17:354. [PMID: 39861484 PMCID: PMC11768364 DOI: 10.3390/nu17020354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2024] [Revised: 01/13/2025] [Accepted: 01/14/2025] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults. METHODS A prospective cohort study was conducted in an obesity clinic in Rome, Italy, involving overweight adults (BMI ≥ 25 kg/m2) motivated to improve their lifestyle. Participants (n = 205; 107 men and 98 women) self-selected into physical activity groups (aerobic, anaerobic, combined or no activity). Gender-specific metabolic changes were assessed, including lipid profiles, liver markers and fasting glucose. RESULTS Significant gender differences in metabolic results were observed. Men showed greater reductions in total cholesterol (TC) and LDL, as well as significant reductions in alanine aminotransferase (ALT). Women showed a significant increase in HDL cholesterol. Fasting blood glucose decreased significantly in both sexes, with no differences between the sexes. Activity-specific analysis revealed that anaerobic activity significantly improved lipid metabolism in men, while aerobic activity produced the greatest benefits in women, including increased HDL and improved liver marker profiles. CONCLUSIONS Therapeutic strategies combining MD and physical activity must take into account gender-specific physiological differences and the type of sport activity to optimise metabolic benefits. Personalised approaches may improve the management of cardiovascular risk factors in overweight individuals. STUDY REGISTRATION This study is registered on ClinicalTrials.gov (NCT06661330).
Collapse
Affiliation(s)
- Stefania Gorini
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Elisabetta Camajani
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Alessandra Feraco
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Andrea Armani
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Sercan Karav
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University, Canakkale 17000, Türkiye;
| | - Tiziana Filardi
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
| | - Giovanni Aulisa
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
| | - Edda Cava
- Clinical Nutrition and Dietetics, San Camillo Forlanini Hospital, cir.ne Gianicolense 87, 00152 Rome, Italy;
| | - Rocky Strollo
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
| | - Elvira Padua
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
| | - Massimiliano Caprio
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Mauro Lombardo
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (S.G.); (E.C.); (A.F.); (A.A.); (T.F.); (G.A.); (R.S.); (E.P.); (M.C.)
| |
Collapse
|
|
2
|
Alkali NH, Uloko AE, Chiroma I, Mugana A, Garba MA, Okpe IO, Gargah ET, Abdullahi UF, Shadrach L, Haladu IA. Cardiovascular Risk Awareness, Exercise Practices and Metabolic Outcomes among Patients with Diabetes Mellitus in Northern Nigeria: A Cross-sectional, Multicentre Study. Niger Postgrad Med J 2024; 31:139-146. [PMID: 38826017 DOI: 10.4103/npmj.npmj_54_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/04/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Physical exercise helps to mitigate cardiovascular risks in people with diabetes mellitus (DM), but there are limited data in Nigeria. This study aimed to assess cardiovascular risk awareness, exercise practices and metabolic outcomes among Nigerians with diabetes. MATERIALS AND METHODS We conducted a cross-sectional study at five tertiary hospitals using questionnaire interviews and clinical assessments. Participants' knowledge of cardiovascular risk factors and knowledge of exercise were assessed on 12- and 5-item scores, while exercise practices were classed as adequate if performed regularly on 3 or more days weekly for a total of 150 min or more based on the American Diabetes Association recommendations. Mean body mass index (BMI), blood pressure (BP), fasting blood glucose, serum haemoglobin A1C (HbA1c), lipid profile, urea, creatinine and uric acid were then compared among participant groups. RESULTS We studied 426 participants with DM, 58.7% females. The mean age was 52.9 ± 13.1 years, with males significantly older than females (54.6 ± 12.2 vs. 51.8 ± 13.5 years; 95% confidence interval: 0.27-5.28, P = 0.03). The mean age at diabetes diagnosis was 44.8 ± 11.7 years, and the median duration of diabetes was 84 months. There was low knowledge of cardiovascular risk factors and low knowledge of exercise (mean scores of 2.94 and 2.31, respectively). Forty-three per cent of participants reported adequate exercise, which was significantly associated with younger age (P = 0.007), male gender (P = 0.001) and formal education (P = 0.021). Participants with adequate exercise had lower systolic BP and serum urea compared to those with inadequate exercise, but there were no significant differences in BMI, fasting glucose, HbA1c, serum lipids, creatinine or uric acid. CONCLUSION Participants had low knowledge of cardiovascular risks and the appropriate exercise practices for diabetes patients. There is a need for better patient education on diabetes self-care and exercise at clinic visits.
Collapse
Affiliation(s)
- Nura Hamidu Alkali
- Department of Medicine, Abubakar Tafawa Balewa University, Bauchi, Nigeria
| | - Andrew E Uloko
- Department of Medicine, Bayero University Kano and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Ijuptil Chiroma
- Department of Medicine, University of Maiduguri, Maiduguri, Borno, Nigeria
| | - Ayuba Mugana
- Department of Medicine, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | | | | | | | | | - Lumsami Shadrach
- Department of Medicine, Modibbo Adama University Teaching Hospital, Yola, Adamawa, Nigeria
| | | |
Collapse
|
|
3
|
Nweke M, Ejiroghene E, Fawole HO, Mshunqane N. Characterization and critical appraisal of physiotherapy intervention research in Nigeria: a systematic review. BMC Musculoskelet Disord 2024; 25:27. [PMID: 38166778 PMCID: PMC10763218 DOI: 10.1186/s12891-023-06986-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/23/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES Clinical research is the bedrock of clinical innovation, education and practice. We characterized and critically appraised physiotherapy clinical research to avoid implementing misleading research findings into practice and to task the Nigerian physiotherapy societies on responsible conduct of clinical research. METHODS This is a systematic review of articles published in English between 2009 and 2023. We started with 2009 because at least few Nigerian Physiotherapy school had commenced postgraduate (research) training by then. We searched Pubmed, Medline, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO and African Journal Online, and reference lists of relevant articles. We Data were selected and extracted according to predesigned eligibility criteria and using a standardized data extraction table. Where appropriate, the Pedro and Cochrane ROBINS1 were used to examine the risk of bias. RESULTS A total of 76 Nigerian studies were included in this study. The mean age of the study participants was 46.7 ± 8.6 years. Approximately, 45% of the participants were males. Of the clinical experiments, the randomized controlled trial (RCT) was the most common design (87.5%). Musculoskeletal conditions (39.3%) were the most studied disorder. Approximately 86% of the RCT had studies possessed fair to good quality. Interventions constituted exercise therapy (76.3%), manual therapy (8.5%) and electrotherapy (8.5%). More than half (67.8%) of the studies recorded medium to large effect sizes. A fair proportion (48.2%) of the studies had a confounding-by-indication bias. Approximately 43% of the clinical experiments were underpowered, and a few studies conducted normality tests (10.9%) and intention-to-treat analysis (37.5%). CONCLUSIONS RCT is the most frequent clinical experiment, with majority of them possessing fair to good quality. The most important flaws include improper computation of sample size, statistical analysis, absent intention-to-treat approach, among others. The magnitude of effects of Physiotherapy interventions varies from nil effect to large effect. Musculoskeletal condition is the most prevalent disorder and exercise is the most important intervention in Nigerian physiotherapy practice. TRIAL REGISTRATION We registered the protocol with PROSPERO. The registration number: CRD42021228514.
Collapse
Affiliation(s)
- Martins Nweke
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin, Edo State, Nigeria.
| | - Emeriewen Ejiroghene
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin, Edo State, Nigeria
| | - Henrietta O Fawole
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin, Edo State, Nigeria
| | - Nombeko Mshunqane
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
|
4
|
Rao CR, Chandrasekaran B, Ravishankar N, Rutebemberwa E, Okello D. Physical activity interventions for glycaemic control in African adults - A systematic review and meta-analysis. Diabetes Metab Syndr 2022; 16:102663. [PMID: 36459907 DOI: 10.1016/j.dsx.2022.102663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Growing evidence indicates that increasing physical activity may aid in regulating altered glycaemic control, thereby mitigating the risk of diabetes. However, the evidence summarising the efficacy of physical activity on glycaemic control among African adults remains unconsolidated. Our objective was to provide an amalgamated summary of the empirical evidence that explored the effectiveness of physical activity interventions on glycaemic control among African adults. METHODS A systematic search of six journal databases for the studies exploring the efficacy of physical activity on glycaemic control among African adults until March 21, 2022, was administered. Two independent reviewers screened the citations based on a priori set eligibility criteria. Data were analysed using inverse variance method and a summary of findings was synthesised using the Grading of Recommendations, Assessment, Development and Evaluations approach. RESULTS Of the 14,624 citations retrieved, 26 articles with 1474 participants were included for final analysis. Most of the included trials had a high risk of bias (N = 20; 76.92%). Our review found a significant reduction in fasting blood glucose (FBG, -2.18 [ 95% CI -3.18, -1.18] mmol/L), insulin (-0.99 [-2.71, 0.74] μU/L), Glycosylated haemoglobin (HbA1C) (-0.53% [-0.88, -0.19]), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (-0.74% [-1.10, -0.38]) and insulin sensitivity (-0.90 μU/l/min [-1.75, -0.06]) following physical activity interventions. The review reports low certainty of evidence across all outcome measures. DISCUSSION AND CONCLUSION Physical activity interventions were found to improve glycaemic control among African adults. However, the optimal physical activity dose for demonstrating meaningful benefits on glucose tolerance still remains unclear due to the limited number of primary studies available.
Collapse
Affiliation(s)
- Chythra R Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Baskaran Chandrasekaran
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - N Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of New Delhi, Delhi, India.
| | - Elizeus Rutebemberwa
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.
| | - David Okello
- African Centre for Global Health and Social Transformation (ACHEST), Kampala, Uganda.
| |
Collapse
|
|
5
|
Glezeva N, Chisale M, McDonald K, Ledwidge M, Gallagher J, Watson CJ. Diabetes and complications of the heart in Sub-Saharan Africa: An urgent need for improved awareness, diagnostics and management. Diabetes Res Clin Pract 2018; 137:10-19. [PMID: 29287838 DOI: 10.1016/j.diabres.2017.12.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 11/21/2017] [Accepted: 12/21/2017] [Indexed: 12/24/2022]
Abstract
Type 2 diabetes mellitus is no longer a disease of high income countries but a global health pandemic. With the continued and rapid increase in its prevalence worldwide it is forecasted that diabetes will be a leading cause of morbidity and mortality. A major concern stems from its role in development and progression of cardiovascular disease, including cardiac dysfunction and heart failure. Within low- and middle-income areas such as Sub-Saharan Africa the burden of diabetes is already significant driven by many factors, including, socioeconomic (urbanisation), nutritional (high-calorie "western-diet", obesity) and lifestyle (physical inactivity) changes. Insufficient economic and community resources, poor health care system development and chronic disease management, poor education, and a lack of preventative and diagnostic measures further aggravate the severity of the diabetes problem. This review outlines the burden of type 2 diabetes mellitus in Sub-Saharan Africa and highlights the need for improved community health care and regulations to reduce its epidemiological spread and devastating impact on health.
Collapse
Affiliation(s)
- Nadezhda Glezeva
- gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | | | - Kenneth McDonald
- gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - Mark Ledwidge
- gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - Joe Gallagher
- gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - Chris J Watson
- Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, United Kingdom.
| |
Collapse
|
|
6
|
Chair and Department of Rehabilitation, Physiotherapy and Balneotherapy, the Medical University of Lublin, Poland, Ginszt A, Ginszt M, Chair and Department of Rehabilitation, Physiotherapy and Balneotherapy, the Medical University of Lublin, Poland, Majcher P, 1 Chair and Department of Rehabilitation, Physiotherapy and Balneotherapy, the Medical University of Lublin, Poland, Tarkowski Z, Department of Pathology and Rehabilitation of Speech, Medical University of Lublin, Poland. Effects of exercise on blood glucose levels in type 2 diabetic patients – Literature review. POLISH ANNALS OF MEDICINE 2018. [DOI: 10.29089/2017.17.00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
|
|
7
|
Khalil S, Almobarak AO, Awadalla H, Elmadhoun WM, Noor SK, Sulaiman AA, Ahmed MH. Low levels of physical activity in Sudanese individuals with some features of metabolic syndrome: Population based study. Diabetes Metab Syndr 2017; 11 Suppl 2:S551-S554. [PMID: 28420573 DOI: 10.1016/j.dsx.2017.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 04/05/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the level of physical activity among Sudanese population. METHODS A descriptive cross sectional study composed of 323 participants from Khartoum state, Sudan. Data collected using pretested designed questionnaire based on previously validated Global Physical Activity Questionnaire. The demographic and physical measurement including blood glucose, anthropometric and blood pressure. RESULTS The Mean age of participants was 35.5. Males were 59.9% and females 47.1% and the prevalence of inactivity was 53.8%. Despite the fact that males are more active than females (P<0.000) physical activity tends to decrease with age but this not statistically significant. Physical activity is significantly decreased with obesity, higher education and doing sedentary jobs (P<0.018, P<0.000 and P<0.000 respectively). While majority of individuals with hypertension and pre-hypertension tend to do less physical activity (P<0.045 and P<0.008 respectively). Logistic regression analysis shown that gender is absolute risk factor for physical activity. Males have more than three times probability of being physically active than women OR3.82 (1.91-7.30). In this study, physical activity was not affected by central obesity (P<0.497), diabetes (P<0.378) and being married or not (P<0.135). CONCLUSION Physical activity in Sudanese women was significantly decreased in comparison with men.
Collapse
Affiliation(s)
- Samah Khalil
- Public and Tropical Health Program, University of Medical Sciences and Technology, Khartoum, Sudan
| | - Ahmed O Almobarak
- Department of Pathology, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan
| | - Heitham Awadalla
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Sudan
| | - Wadie M Elmadhoun
- Department of Pathology, Faculty of Medicine and Health Sciences, Nile Valley University, Sudan
| | - Sufian K Noor
- Department of Medicine, College of Medicine, Nile Valley University, Sudan
| | - Amel A Sulaiman
- Research & Information, Public Health Administration Unit-MOH, Qassim Region, Saudi Arabia
| | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
| |
Collapse
|
|
8
|
Afable A, Karingula NS. Evidence based review of type 2 diabetes prevention and management in low and middle income countries. World J Diabetes 2016; 7:209-229. [PMID: 27226816 PMCID: PMC4873312 DOI: 10.4239/wjd.v7.i10.209] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 01/28/2016] [Accepted: 03/09/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To identify the newest approaches to type 2 diabetes (T2DM) prevention and control in the developing world context.
METHODS: We conducted a systematic review of published studies of diabetes prevention and control programs in low and middle-income countries, as defined by the World Bank. We searched PubMed using Medical Subject Headings terms. Studies needed to satisfy four criteria: (1) Must be experimental; (2) Must include patients with T2DM or focusing on prevention of T2DM; (3) Must have a lifestyle intervention component; (4) Must be written in English; and (5) Must have measurable outcomes related to diabetes.
RESULTS: A total of 66 studies from 20 developing countries were gathered with publication dates through September 2014. India contributed the largest number of trials (11/66). Of the total 66 studies reviewed, all but 3 studies reported evidence of favorable outcomes in the prevention and control of type 2 diabetes. The overwhelming majority of studies reported on diabetes management (56/66), and among these more than half were structured lifestyle education programs. The evidence suggests that lifestyle education led by allied health professionals (nurses, pharmacists) were as effective as those led by physicians or a team of clinicians. The remaining diabetes management interventions focused on diet or exercise, but the evidence to recommend one approach over another was weak.
CONCLUSION: Large experimental diabetes prevention/control studies of dietary and exercise interventions are lacking particularly those that consider quality rather than quantity of carbohydrates and alternative exercise.
Collapse
|