Abstract
ObjectivesLifestyle combined interventions are a key strategy for preventing type-2 diabetes (T2DM) in overweight or obese subjects. In this framework, LIPOXmax individualized training, based on maximal fat oxidation [MFO], may be a promising intervention to promote fat mass (FM) reduction and prevent T2DM. Our primary objective was to compare three training programs of physical activity combined with a fruit- and vegetable-rich diet in reducing FM in overweight or obese women.Design and settingA five months non-blinded randomized controlled trial (RCT) with three parallel groups in La Réunion Island, a region where metabolic diseases are highly prevalent.SubjectsOne hundred and thirty-six non-diabetic obese (body mass index [BMI]: 27–40 kg/m2) young women (aged 20–40) were randomized (G1: MFO intensity; G2: 60% of VO2-peak intensity; G3: free moderate-intensity at-home exercise following good physical practices).OutcomesAnthropometry (BMI, bodyweight, FM, fat-free mass), glucose (fasting plasma glucose, insulin, HOMA-IR) and lipid (cholesterol and triglycerides) profiles, and MFO values were measured at month-0, month-3 and month-5.ResultsAt month-5, among 109 women assessed on body composition, the three groups exhibited a significant FM reduction over time (G1: -4.1±0.54 kg; G2: -4.7±0.53 kg; G3: -3.5±0.78 kg, p<0.001, respectively) without inter-group differences (p = 0.135). All groups exhibited significant reductions in insulin levels or HOMA-IR index, and higher MFO values over time (p<0.001, respectively) but glucose control improvement was higher in G1 than in G3 while MFO values were higher in G1 than in G2 and G3. Changes in other outcome measures and inter-group differences were not significant.ConclusionIn our RCT the LIPOXmax intervention did not show a superiority in reducing FM in overweight or obese women but is associated with higher MFO and better glucose control improvements. Other studies are required before proposing LIPOXmax training for the prevention of T2DM in overweight or obese women.Trial RegistrationClincialTrials.gov NCT01464073
Highlights
Over the past three decades, the burden of obesity has nearly doubled worldwide [1]
All groups exhibited significant reductions in insulin levels or HOMA-IR index, and higher maximal fat oxidation (MFO) values over time (p
In our randomized controlled trial (RCT) the LIPOXmax intervention did not show a superiority in reducing fat mass (FM) in overweight or obese women but is associated with higher MFO and better glucose control improvements
Summary
Over the past three decades, the burden of obesity has nearly doubled worldwide [1]. according to a recent World Health Organization (WHO) report, 1.46 billion adults were overweight (body mass index [BMI]! 25 kg/m2) in 2008, and of these, 205 million men and 297 million women were obese (BMI! 30 kg/m2). [3] in our setting, sedentary lifestyle and the high prevalence of obesity may partially explain the high prevalence of T2DM in the 30–69 age group for women (17.3%) [2,4] In line with this picture, the literature dedicated to preventive strategies for obesity and related complications provides evidence that lifestyle interventions combining regular physical activity (PA) and diet were cost-effective [5,6,7,8]. “PA improves weight loss when diet restriction is modest but not when diet restriction is substantial” [9] In this framework, a growing body of evidence has shown that the benefits of PA in obese people are limited when it is not individualized, regular, and based on a “moderate intensity”. Salvadego and coll [12]. have proposed that PA prescription in obese people takes into account the "metabolic answer" to the effort, represented by the adaptation kinetics of several parameters including oxidative metabolism and exercise tolerance biomarkers, and the maximal oxygen consumption (VO2 peak) or the maximal heart rate (HR peak)
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