Immediate and long-term effects of addition of exercise to a 16-week very low calorie diet on low-grade inflammation in obese, insulin-dependent type 2 diabetic patients
ABSTRACT To assess the short- and long-term effects of addition of exercise to a very low calorie diet (VLCD) on low-grade inflammation in obese patients with type 2 diabetes mellitus (T2DM).
Twenty seven obese, insulin-dependent T2DM patients followed a 4-month VLCD with (n=13) or without (n=14) exercise and were followed up to 18 months. Anthropometric measurements, metabolic and inflammatory parameters were assessed before, directly after the intervention and at 6 and 18 months follow-up. The same measurements were performed only once in 56 healthy lean and 56 healthy obese controls.
At baseline hsCRP, IL10 and IL8 were significantly elevated in obese T2DM compared to lean healthy controls. After 4 months, despite substantial weight loss (-25.4 ± 1.3 kg), neither the VLCD nor VLCD+exercise had an effect on plasma cytokines. At 6 months, in the weight-stabilizing period, measures of low-grade inflammation had decreased substantially and equally in both intervention groups. Despite subsequent weight regain, beneficial effect was sustained up to 18 months in both groups, except for IL1 and hsCRP which had returned to baseline in the VLCD-only group.
Our findings suggest that severe caloric restriction increases cytokine production by adipose tissue macrophages and that the beneficial effects of weight loss become apparent only in the eucaloric state.
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ABSTRACT: Xanthorrhizol, a natural compound isolated from Curcuma xanthorrhiza Roxb. (Java turmeric), has been reported to possess antioxidant and anticancer properties; however, its effects on metabolic disorders remain unknown. The aim of the present study was to evaluate the effects of xanthorrhizol (XAN) and C. xanthorrhiza extract (CXE) with standardized XAN on hyperglycemia and inflammatory markers in high-fat diet- (HFD-) induced obese mice. Treatment with XAN (10 or 25 mg/kg/day) or CXE (50 or 100 mg/kg/day) significantly decreased fasting and postprandial blood glucose levels in HFD-induced obese mice. XAN and CXE treatments also lowered insulin, glucose, free fatty acid (FFA), and triglyceride (TG) levels in serum. Epididymal fat pad and adipocyte size were decreased by high doses of XAN (26.6% and 20.1%) and CXE (25.8% and 22.5%), respectively. XAN and CXE treatment also suppressed the development of fatty liver by decreasing liver fat accumulation. Moreover, XAN and CXE significantly inhibited production of inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), and C-reactive protein (CRP) in adipose tissue (27.8-82.7%), liver (43.9-84.7%), and muscle (65.2-92.5%). Overall, these results suggest that XAN and CXE, with their antihyperglycemic and anti-inflammatory activities, might be used as potent antidiabetic agents for the treatment of type 2 diabetes.Evidence-based Complementary and Alternative Medicine 06/2014; 2014:205915. DOI:10.1155/2014/205915 · 2.18 Impact Factor
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ABSTRACT: The number of people who are overweight or obese is increasing worldwide and the quality of life of these people can be affected by their condition. Physical training has been studied in obese patients and is correlated with low-grade inflammation and alterations in the immune system. This study investigated the effect of concurrent training on anthropometric, inflammatory, and immunological parameters in overweight and obese adults. Fourteen sedentary volunteers (men and women) with a body mass index between 25 kg/m2 and 39.9 kg/m2 from Porto Alegre, Brazil attended a 12-week course of concurrent training. We analyzed: prior to and after training, anthropometric parameters, cytokine serum levels (interleukin 6, tumor necrosis factor α, interferon γ, interleukin 17A and interleukin 10; measured by enzyme-linked immunosorbent assay), high-sensitive C reactive protein (measured by turbidimetry), and the frequency of T lymphocytes and monocytes (CD3+CD4+, CD3+CD8+, and HLA-DR+) in peripheral blood (measured by flow cytometry). The sample consisted of ten women and four men with a mean ± SD age of 47.58 ± 3.01 years. After 12 weeks of training we observed a reduction in body weight, body mass index, waist, abdomen, and hip circumferences, the percentage mass of fat, and an increase in the time taken to reach exhaustion (p < 0.05). The participants had increased frequencies of CD3+CD4+ and CD3+CD8+ T lymphocytes and a reduction in the frequencies of HLA-DR+ monocytes (p < 0.05). Interestingly, the levels of tumor necrosis factor α and high-sensitive C reactive protein increased (p < 0.05). Our data suggest that concurrent training can improve body composition as well as increasing T cell proliferation in overweight and obese patients. However, the progression of the exercises can be physiologically stressful to these patients, as demonstrated by the inflammatory markers.Journal of exercise science and fitness (JESF) 07/2014; 12(2). DOI:10.1016/j.jesf.2014.06.002 · 0.53 Impact Factor
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ABSTRACT: Very low calorie diets (VLCD) with and without exercise programs lead to major metabolic improvements in obese type 2 diabetes patients. The mechanisms underlying these improvements have so far not been elucidated fully. To further investigate the mechanisms of a VLCD with or without exercise and to uncover possible biomarkers associated with these interventions, blood samples were collected from 27 obese type 2 diabetes patients before and after a 16-week VLCD (Modifast ∼450 kcal/day). Thirteen of these patients followed an exercise program in addition to the VCLD. Plasma was obtained from 27 lean and 27 obese controls as well. Proteomic analysis was performed using mass spectrometry (MS) and targeted multiple reaction monitoring (MRM) and a large scale isobaric tags for relative and absolute quantitation (iTRAQ) approach. After the 16-week VLCD, there was a significant decrease in body weight and HbA1c in all patients, without differences between the two intervention groups. Targeted MRM analysis revealed differences in several proteins, which could be divided in diabetes-associated (fibrinogen, transthyretin), obesity-associated (complement C3), and diet-associated markers (apolipoproteins, especially apolipoprotein A-IV). To further investigate the effects of exercise, large scale iTRAQ analysis was performed. However, no proteins were found showing an exercise effect. Thus, in this study, specific proteins were found to be differentially expressed in type 2 diabetes patients versus controls and before and after a VLCD. These proteins are potential disease state and intervention specific biomarkers. Controlled-Trials.com ISRCTN76920690.PLoS ONE 11/2014; 9(11):e112835. DOI:10.1371/journal.pone.0112835 · 3.53 Impact Factor