Abstract

BackgroundOverweight and metabolic problems now add to the burden of illness in patients with Inflammatory Bowel Disease. We aimed to determine if a program of aerobic and resistance exercise could safely achieve body composition changes in patients with Inflammatory Bowel Disease.MethodsA randomized, cross-over trial of eight weeks combined aerobic and resistance training on body composition assessed by Dual Energy X-ray Absorptiometry was performed. Patients in clinical remission and physically inactive with a mean age of 25 ± 6.5 years and Body Mass Index of 28.9 ± 3.8 were recruited from a dedicated Inflammatory Bowel Disease clinic. Serum cytokines were quantified, and microbiota assessed using metagenomic sequencing.ResultsImproved physical fitness was demonstrated in the exercise group by increases in median estimated VO2max (Baseline: 43.41mls/kg/min; post-intervention: 46.01mls/kg/min; p = 0.03). Improvement in body composition was achieved by the intervention group (n = 13) with a median decrease of 2.1% body fat compared with a non-exercising group (n = 7) (0.1% increase; p = 0.022). Lean tissue mass increased by a median of 1.59 kg and fat mass decreased by a median of 1.52 kg in the exercising group. No patients experienced a deterioration in disease activity scores during the exercise intervention. No clinically significant alterations in the α- and β-diversity of gut microbiota and associated metabolic pathways were evident.ConclusionsModerate-intensity combined aerobic and resistance training is safe in physically unfit patients with quiescent Inflammatory Bowel Disease and can quickly achieve favourable body compositional changes without adverse effects.Trial registrationThe study was registered at ClinicalTrials.gov; Trial number: NCT02463916.

Highlights

  • Overweight and metabolic problems add to the burden of illness in patients with Inflammatory Bowel Disease

  • Main findings and relevance The results show that favourable alterations in body composition can be achieved over a relatively short period of time with combined aerobic and resistance exercise in patients with Inflammatory Bowel Disease (IBD)

  • It is possible that exercise had additional anti-inflammatory properties that were not assessed in this study

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Summary

Introduction

Contrary to the classical phenotype of low body weight and malnourishment from earlier times, many patients with Inflammatory Bowel Disease (IBD) are overweight or obese [1]. This increases the risk of metabolic disorders such as type two diabetes mellitus and non-alcoholic fatty liver disease [2]. Known for its anti-inflammatory and multi-organ metabolic effects [3, 4], exercise represents first line treatment for patients with type two diabetes mellitus and non-alcoholic fatty liver disease [5, 6].

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