The effects of aquatic exercise on body composition, physical fitness, and vascular compliance of obese elementary students

Effectiveness of behavioural and psychological interventions for managing obesity in children and adolescents: A systematic review and meta-analysis framed using minimal important difference estimates based on GRADE guidance to inform a clinical practice guideline

OBJECTIVE

Conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) of behavioural and psychological interventions for managing paediatric obesity.

METHODS

Eligible studies, published between 1985 and 2022, included 0 to 18 year olds with outcomes reported ≥3 months post-baseline, including patient-reported outcome measures (PROMs), cardiometabolic and anthropometric outcomes, and adverse events (AEs). We pooled data using a random effects model and assessed certainty of evidence (CoE) related to minimally important difference estimates for outcomes using GRADE.

RESULTS

We included 73 unique RCTs (n = 6305 participants, 53% female). Intervention types included physical activity (n = 1437), nutrition (n = 447), psychological (n = 1336), technology-based (n = 901) or multicomponent (≥2 intervention types, n = 2184). Physical activity had a small effect on health-related quality of life (HRQoL), varying effects ranging from moderate to very large on blood pressure, lipids and insulin resistance, and a small effect on BMIz. Nutrition had a small effect on lipids, insulin resistance and BMIz. Psychological interventions showed a small effect on HRQoL and triglycerides and moderate benefits on depressive symptoms, while technology interventions showed small benefits on blood pressure and BMIz. Multicomponent interventions had a large benefit on anxiety, small benefit on depressive symptoms, with large to very large benefits on lipids, and small benefits for diastolic blood pressure, insulin resistance and BMIz. AEs were reported infrequently, and when reported, were described as mild.

CONCLUSION

Physical activity and multicomponent interventions showed improvements in PROMs, cardiometabolic and anthropometric outcomes. Future trials should consistently measure PROMs, evaluate outcomes beyond the intervention period, and study children <6 years of age.

Can resisted swimming exercise substitute for the protective effects of estrogen on cardiometabolic risk factors in obese postmenopausal rat model?

Objectives

Following our previous studies on the anti-obesity and cardioprotective effects of 17-beta estradiol (E2), this study was designed to determine the effects of Resisted swimming (RSW) training and E2 (alone and in combination) on cardiometabolic risk factors in an obese postmenopausal rat model.

Materials and Methods

Female ovariectomized rats (OVX) were given a standard diet (SD) or a 60% high-fat diet (HFD) for 16 weeks and were divided into two groups: SD and HFD. The rats were divided into ten groups to assess the effects of 8 weeks of E2 (1 mg/kg, IP) administration and RSW (5 days a week) on cardiometabolic risk factors. Parameters including body weight, BMI, visceral fat, blood glucose (BG), and cardiac oxidative stress were assessed 72 hr after the last swimming session.

Results

HFD increased body weight, BMI, visceral fat, and BG levels in OVX rats. Additionally, it negatively affected the lipid profile and cardiac oxidative stress, but both E2 and RSW reduced these parameters in HFD-fed OVX rats. Although RSW and E2 equally prevented these changes, swimming was more effective than estrogen in increasing HDL levels in the SD group. The combination of E2 and RSW had a more significant effect on modulating glucose, TAC, TG, and HDL indices than the individual treatments.

Conclusion

Overall, RSW ameliorates cardiometabolic risk factors in postmenopausal conditions caused by obesity, probably by modulating cardiac oxidative stress. It is also an effective non-pharmacological treatment for E2 substitution.

Identifying the benefits of recovery programs of aquatic gymnastics, aquatic ludotherapy and therapeutic swimming on human motor, kinetotherapeutic and mental capacity

Introduction

This study aimed to evaluate the motor, kinetotherapeutic, and psychological benefits of three aquatic therapeutic programs-aquagym recovery (AG), aquatic ludotherapy (ALT), and therapeutic swimming (TS)-for students specializing in balneo-physio-kinetotherapy.

Methods

The study group consisted of 101 students, out of which 43 students from the balneo-physiokinetotherapy study program (BFKT) and 67 master's degree students from physical therapy and functional rehabilitation (PTFR). The questionnaire was named Questionnaire regarding the benefits of therapeutic aquatic programs (QBTAP), and included 3 subscales according to the typology of the targeted objectives, namely: motor, kinetotherapeutic and psychological. The items of each subscale correspond to the objectives identified in the content of the 3 aquatic programs stipulated in the content of the courses corresponding to the disciplines in the education plans of academic study programs (BFK, TRFR). The motor subscale included 8 items, the kinetotherapeutic subscale included 16 items, and the psychological subscale included 10 items. The evaluation of the QBTAP questionnaire 5-point Likert scale. The three evaluated programs were: recovery aquagym (AG), aquatic ludotherapy (ALT) and therapeutic swimming (TS).

Results

The results and conclusion sections should highlight the main findings succinctly. For example: "The QBTAP showed high internal consistency (Cronbach's Alpha >0.9) across all subscales and programs, with significant differences identified between the three programs (p < 0.05).

Conclusion

The study concludes that aquagym most effectively improves motor capacity, aquatic ludotherapy enhances psychological function, and therapeutic swimming is most beneficial for recovery and rehabilitation.

Is Type 2 Diabetes Mellitus a Behavioural Disorder? An Evidence Review for Type 2 Diabetes Mellitus Prevention and Remission through Lifestyle Modification

The prevalence of type 2 diabetes mellitus (T2DM) is steadily rising worldwide due to an increasingly sedentary lifestyle combined with unhealthy food habits. Currently, the burden of diabetes on healthcare systems is unprecedented and rising daily. Several observational studies and randomized controlled trials provide clinical evidence that T2DM remission is possible by adopting dietary interventions and a strict exercise training protocol. Notably, these studies provide ample evidence for remission in patients with T2DM or for prevention in those with risk factors for the disease through various non-pharmacological behavioural interventions. In this article, we present two clinical cases of individuals who showed remission from T2DM/prediabetes via behavioural changes, especially through the adoption of a low-energy diet and exercise. We also discuss the recent advances in T2DM and obesity research, focusing on nutritional interventions and exercise and their benefits for weight loss, improved metabolic profile, enhanced glycaemic control and remission of diabetes.

A Recreational Swimming Intervention during the Whole School Year Improves Fitness and Cardiometabolic Risk in Children and Adolescents with Overweight and Obesity

The benefits of swimming as a treatment for overweight children are undefined. We investigated the effects of recreational swimming on cardiometabolic risk in children/adolescents with normal and excess weight. Participants (n = 49, 26 girls, 10.3 ± 1.8 y) were grouped as 'eutrophic swimming' (EU-Swim, n = 14); 'excess weight swimming' (EW-Swim, n = 20) with an 'obese swimming' subgroup (OB-Swim, n = 10); and 'excess weight sedentary' (EW-Sed, n = 15) with an 'obese sedentary' subgroup (OB-Sed, n = 11). Swimming (50 min, twice/week, moderate-vigorous intensity) was an extra activity during the school year (6 + 3 months with a 3-month school break). Nutritional status, blood pressure (BP), physical activity, cardiorespiratory fitness, biochemical variables, autonomic modulation, endothelial function, abdominal fat, and carotid thickness were assessed at baseline, 6, and 12 months. Greater improvements (p < 0.05) occurred in EW-Swim vs. EW-Sed in body mass index (z-BMI, -16%, d+ 0.52), waist-to-height ratio (W/H, -8%, d+ 0.59-0.79), physical activity (37-53%, d+ 1.8-2.2), cardiorespiratory fitness (30-40%, d+ 0.94-1.41), systolic BP (SBP, -6-8%, d+ 0.88-1.17), diastolic BP (DBP, -9-10%, d+ 0.70-0.85), leptin (-14-18%, d+ 0.29-0.41), forearm blood flow (FBF, 26-41%, d+ 0.53-0.64), subcutaneous fat (SAT, -6%, d+ 0.18), and intra-abdominal fat (VAT, -16%, d+ 0.63). OB-Swim showed improvements vs. OB-Sed in TNFα (-17%, d+ 1.15) and adiponectin (22%, d+ 0.40). Swimming improved fitness and cardiometabolic risk in children/adolescents with overweight/obesity. (TCTR20220216001).

Exergaming and Aquatic Exercises Affect Lung Function and Weight Loss in Obese Children

We investigated the effect of exergames and aquatic exercises on lung function and weight loss in obese children. Sixty-one obese male primary-school children were randomly allocated to video game, aquatic exercise, and control groups. Lung functions and anthropometric variables were measured before and after the intervention and after one month (follow-up). In the video game group, an Xbox Kinect game was played for 60 min during three sessions a week. The aquatic aerobic exercise was performed three times per week and consisted of a warm-up, main exercises, and a cool down phase. For the video game group, there was a significant reduction in body weight between (i) pre- and (ii) post-intervention and follow-up. In the aquatic exercise group, there was a significant reduction in body weight between pre- and post-intervention and between pre-intervention and follow-up. Both exercise groups improved the waist/hip ratio index compared to the control group. Forced vital capacity was significantly improved in the follow-up of the video game group and the aquatic exercise group compared to the control group. A significant improvement was found in forced expiratory volume in the first second at post-intervention and follow-up in the video game and the aquatic exercise groups. Exergames and aquatic exercises improved weight loss and lung function in obese children.

Fitness-related benefits: land-based versus aqua-base

BACKGROUND

It is well documented that individuals participating in land-based aerobic activities receive several fitness-related benefits. Given its virtual weightlessness, thermoregulatory comfort, and ease of movements, aqua-based aerobic activities are commonly perceived as a simpler form of exercise, therefore, lacking the fitness-related benefits equivalent to that of land-based aerobic activities. The purpose of this study was to compare fitness-related benefits between land-based (LAND) versus aqua-based (AQUA) aerobic activity classes within a 15-week period.

METHODS

One hundred and fifty-four volunteers participating in LAND (N.=76) and AQUA (N.=78) exercise groups were required to exercise 2 days per week, 50 minutes per day, for 15 weeks. Pre- and post-fitness assessments obtained were body composition, muscular endurance, muscular strength, cardiorespiratory endurance, and flexibility.

RESULTS

Mixed ANOVA showed a main effect and interaction for body composition in which, overall, participants decreased more body fat percentage in the land group. A main effect for both muscular strength and muscular endurance was revealed, but no interactions. There were no significant main effects or interactions for neither cardiorespiratory endurance nor flexibility.

CONCLUSIONS

Individuals participating in land-based aerobic activities displayed greater decreases in percent body fat when compared to aqua-based aerobic activities, whereas both land- and aqua-based displayed improvements in muscular strength and muscular endurance. There were no changes in cardiorespiratory endurance and flexibility within both groups.

Impact of deep water running in interval training (DWR-IT) on body composition, functional capacity, and quality of life in overweight adults: study protocol for a randomized controlled trial

Background

Interval training in deep water running (DWR-IT) is a training method to improve cardiovascular fitness, functional health, and quality of life and to help control body weight. Its main advantages are the reduction of joint overload and a low risk of musculoskeletal injuries. The aim of the study is to investigate the influence of DWR-IT on functional capacity, body composition, and quality of life of overweight middle-aged adults.

Methods

This is a randomized controlled, two-arm, open, parallel clinical trial with overweight adults. Volunteers will be allocated to a water group (WG), which will be submitted to the intervention, or a control group, which will not be subjected to any kind of intervention. The evaluation will be composed of anamnesis, electrical bioimpedance, six-minute walk test (6MWT), questionnaire on the Impact of Weight on Quality of Life-lite (IWQOL-LITE), Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, chair stand test, arm curl test, and food frequency questionnaire. The DWR-IT will last for 12 weeks, systematically increasing the intensity and training volume.

Discussion

The objective of this clinical trial is to evaluate the effect of DWR-IT on overweight adults. The study is guided through practice based on scientific evidence for the use of training and aquatic rehabilitation. It is expected that after 12 weeks of aquatic intervention there will be a decrease in body fat by about 10%, evaluated by electrical bioimpedance, an increase of about 25% of cardiorespiratory endurance, evaluated by 6MWT, and an improvement of about 25% of physical function domains, self-esteem, distress in public places, and work, analyzed by IWQOL-LITE in the WG.

Trial registration

The study protocol was published in the Brazilian Registry of Clinical Trials (ReBEC) on June 16, 2016. Registration number: RBR-6dmh7d.

Electronic supplementary material

The online version of this article (10.1186/s13063-019-3618-7) contains supplementary material, which is available to authorized users.

Effect of circuit training on body composition, physical fitness, and metabolic syndrome risk factors in obese female college students

The purpose of this study was to investigate the effect of a 12-week circuit training program on health-related physical fitness and metabolic syndrome risk factors in obese female college students. Twenty subjects with over 30% of accumulated body fat voluntarily participated and were randomly allocated to the control group (n=10) or circuit training group (n=10). The circuit training program consisted of 10 types of resistance and aerobic exercise and was performed 3 times per week for 12 weeks. Health-related physical fitness and metabolic syndrome risk factors were analyzed to elucidate the effect of the circuit training. Significant differences between groups were determined with two-way repeated analysis of variance and paired t-test. As a result of this study, body weight, % body fat, and body mass index in the circuit training group was significantly decreased compared to the control group. All health-related physical fitness indicators such as back strength, sit-up, sit-and-reach, and 1,600 m running time showed relative effects between groups or over time. Among the metabolic syndrome risk factors, waist measurement, triglyceride, and total cholesterol were significantly decreased but blood glucose, high-density lipo-protein cholesterol and low-density lipoprotein cholesterol did not show any significant difference. Therefore, the present data suggested that circuit training for 12 weeks may be effective in improving physical fitness and preventing metabolic diseases.