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Impact of Different Training Modalities on Anthropometric and Metabolic Characteristics in Overweight/Obese Subjects: A Systematic Review and Network Meta-Analysis

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The aim of this systematic review of randomized controlled trials was to compare the effects of aerobic training (AET), resistance training (RT), and combined aerobic and resistance training (CT) on anthropometric parameters, blood lipids, and cardiorespiratory fitness in overweight and obese subjects. Electronic searches for randomized controlled trials were performed in MEDLINE, EMBASE and the Cochrane Trial Register. Inclusion criteria were: Body Mass Index: ≥25 kg/m(2), 19+ years of age, supervised exercise training, and a minimum intervention period of 8 weeks. Anthropometric outcomes, blood lipids, and cardiorespiratory fitness parameters were included. Pooled effects were calculated by inverse-variance random effect pairwise meta-analyses and Bayesian random effects network meta-analyses. 15 trials enrolling 741 participants were included in the meta-analysis. Compared to RT, AET resulted in a significantly more pronounced reduction of body weight [mean differences (MD): -1.15 kg, p = 0.04], waist circumference [MD: -1.10 cm, p = 0.004], and fat mass [MD: -1.15 kg, p = 0.001] respectively. RT was more effective than AET in improving lean body mass [MD: 1.26 kg, p<0.00001]. When comparing CT with RT, MD in change of body weight [MD: -2.03 kg, p<0.0001], waist circumference [MD: -1.57 cm, p = 0.0002], and fat mass [MD: -1.88 kg, p<0.00001] were all in favor of CT. Results from the network meta-analyses confirmed these findings. Evidence from both pairwise and network meta-analyses suggests that CT is the most efficacious means to reduce anthropometric outcomes and should be recommended in the prevention and treatment of overweight, and obesity whenever possible.
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... Instead of passive recovery (i.e., sitting) in between sets, players often needed to deploy in-game support "heroes", which could only be done by completing a series of virtual agility and aerobic movements such as karate chops. This active recovery may elicit an aerobic component to the IVR workouts that were not experienced by the SELF group, hence leading to higher energy expenditures and greater fat loss [30,31]. Ultimately, the demands of the game encouraged little 'downtime' in between sets of cable exercises-a stark contrast to typical weight training in which stationary rest periods are often practiced. ...
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Exergaming, combining elements of video game into the realm of exercise, has recently incorporated immersive virtual reality (IVR) with resistance training. Thirty-two participants (14 females, mean age = 24.3) were randomized to IVR or self-directed control group (SELF) and worked out thrice weekly for 12 weeks (for 36 sessions). The IVR group spent 14 fewer minutes per session (p < 0.001) while reporting the sessions “enjoyable’. Compared to SELF, the IVR group had significantly greater improvement in changes from baseline to post-training in upper-and-lower muscular strength (1-RM) and muscular endurance (85% 1-RM) (14.3 kg vs. 10.0 kg for 1-RM upper, 28.6 kg vs. 22.5 kg for 1-RM lower, 2.6 reps vs. 1.9 reps for 85% 1-RM of upper, 2.7 vs. 2.0 reps for 85% 1-RM of lower, all p < 0.001), peak leg power (1424 vs. 865 W, p < 0.001), body fat% (−3.7% vs. −1.9%, p < 0.001), heart rate variability (4.3 vs. 1.8 ms, p < 0.001), rVO2max (3.28 vs. 0.89 mL/min/kg, p < 0.001) with decreased systolic BP (−0.4 vs. −2.3 mmHg, p < 0.001), and level of perceived exertion during workouts (RPE 14 vs. 16, p < 0.001). With its high-paced and action-filled gaming coupled with superior fitness and cardiometabolic outcomes, this IVR exergaming platform should be considered as another exercise modality for performance and health-related training.
... included both RCTs and non-RCTs. For the comparison of three or more interventions, most NMAs used all possible comparisons among the different interventions, and two did not use a placebo (control) group as a common comparator [25,26]. The ability of NMAs to incorporate indirect evidence means that the inclusion of interventions that are not of direct interest to the review authors may provide additional information in the network. ...
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... Consistent with the results discussed above (e.g., increased maximum fat oxidation; increased VO 2 max; increased HOMA-IR), CT induced greater benefits compared to metformin on body mass, body mass index, and fat mass (p = 0.016, p = 0.08, p = 0.054, respectively). Some CT interventions reduced anthropometric scores in overweight and obese patients [47,48]. A randomized trial by Willis et al. (2012) in sedentary (exercise ≤ 1-2 times/week) overweight or moderately obese (body mass index 25-35 kg/m 2 ) adults (18-70 years) showed that 8 months of CT reduced total body mass and fat mass more than strength training alone (p < 0.05) [48]. ...
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... The practice of physical exercise alone or in combination with medications or dietary interventions, such as time-restricted feeding, has been shown to be effective for health and to present relevant effects on organs and tissues [13,[23][24][25]. Exercise training improves body weight and body composition in overweight or obese adults [26]. Although the effect on weight and fat loss is often of relatively small magnitude, the reduction in visceral fat already improves the cardiometabolic health of the patients [27]. ...
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... Combined aerobic and resistance training has been recommended to be the most efficacious exercise modality to reduce anthropometric outcomes and should be recommended in the prevention and treatment of overweight and obesity. 73 However, in the present study, a 12-week intervention comprising a combination of aerobic and resistance exercise did not generate significant improvements in the ARs and RTs in obese women when performing the Stroop task, suggesting that this type of chronic exercise intervention cannot promote specific behavioral effects on response inhibition/interference. These findings are compatible with previous findings of a significant behavioral improvement in a switching condition but not in an inhibition condition (Stroop task) after 3e5.7 months of aerobic/contemporary dance training. ...
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Objective. —To determine how multiple risk factors for osteoporotic fractures could be modified by high-intensity strength training exercises in postmenopausal women.Design. —Randomized controlled trial of 1-year duration.Setting. —Exercise laboratory at Tufts University, Boston, Mass.Population. —Forty postmenopausal white women, 50 to 70 years of age, participated in the study; 39 women completed the study. The subjects were sedentary and estrogen-deplete.Interventions. —High-intensity strength training exercises 2 days per week using five different exercises (n=20) vs untreated controls (n=19).Main Outcome Measures. —Dual energy x-ray absorptiometry for bone status, one repetition maximum for muscle strength, 24-hour urinary creatinine for muscle mass, and backward tandem walk for dynamic balance.Results. —Femoral neck bone mineral density and lumbar spine bone mineral density increased by 0.005±0.039 g/cm2 (0.9%±4.5%) (mean±SD) and 0.009±0.033 g/cm2 (10%±3.6%), respectively, in the strength-trained women and decreased by -0.022±0.035 g/cm2 (-2.5%±3.8%) and -0.019±0.035 g/cm2 (-1.8%±3.5%), respectively, in the controls (P=.02 and.04). Total body bone mineral content was preserved in the strength-trained women (+2.0±68 g; 0.0%±3.0%) and tended to decrease in the controls (-33+77 g; -1.2%±3.4%, P=.12). Muscle mass, muscle strength, and dynamic balance increased in the strength-trained women and decreased in the controls (P=.03 to <.001).Conclusions. —High-intensity strength training exercises are an effective and feasible means to preserve bone density while improving muscle mass, strength, and balance in postmenopausal women.(JAMA. 1994;272:1909-1914)