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Impact of Exercise on Body Composition and Cardiometabolic Risk Factors in Patients Awaiting Bariatric Surgery

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Abstract

Background

The role of exercise to achieve weight reductions in patients awaiting bariatric surgery has been little studied. The aim of this study was to describe the effects of an exercise program on body composition and cardiometabolic risk factors in patients awaiting bariatric surgery.

Methods

Twenty-three patients awaiting bariatric surgery were divided into two groups: (a) an exercise group (EG, n = 12) and (b) a control group (CG, n = 11). Both groups received the usual care prior to surgery, but the EG also performed a 12-week exercise program which combined endurance and resistance training. Body composition, cardiometabolic risk factors, physical fitness, basal metabolic rate, and quality of life were assessed at baseline and at the end of the study.

Results

After the exercise program, the EG achieved significant reductions in total weight (− 7.3 ± 4.1 kg, P < 0.01), fat mass (− 7.1 ± 4.7 kg, P < 0.01), and waist circumference (− 5.3 ± 2.1 cm, P < 0.01), while they maintained their fat-free mass and basal metabolic rate levels. Only the EG showed reductions in HbA1c (− 0.4 ± 0.45%, P < 0.05), systolic (− 10.5 ± 12.7 mmHg), and diastolic blood pressure (− 3.9 ± 5.2 mmHg, P < 0.05), as well as a decrease in waist-to-height ratio (− 0.032 ± 0.12, P < 0.01) and an improvement in quality of life.

Conclusions

The implementation of an exercise program prior to bariatric surgery reduces fat mass and central obesity and improves cardiometabolic risk factors and quality of life, especially in the physical scales.

Trial registration

The study was registered at ClinicalTrials.gov (NCT03613766).

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References

  1. Martins-Filho ED, Câmara-Neto JB, Ferraz ÁAB, et al. Evaluation of risk factors in superobese patients submitted to conventional Fobi-Capella surgery. Arq Gastroenterol. 2008;45:3–10.

    Article  PubMed  Google Scholar 

  2. Benotti P, Wood GC, Winegar DA, et al. Risk factors associated with mortality after Roux-en-Y gastric bypass surgery. Ann Surg. 2014;259:123–30.

    Article  PubMed  Google Scholar 

  3. Losekann A, Weston AC, De Carli LA, et al. Nonalcoholic fatty liver disease in severe obese patients, subjected to bariatric surgery. Arq Gastroenterol. 2013;50:285–9.

    Article  PubMed  Google Scholar 

  4. Martínez-Ramos D, Salvador-Sanchis JL, Escrig-Ros J. Pérdida de peso preoperatoria en pacientes candidatos a cirugía bariátrica. Recomendaciones basadas en la evidencia. Cir Esp. 2012;90:147–55.

    Article  PubMed  Google Scholar 

  5. Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84:304–11.

    Article  CAS  PubMed  Google Scholar 

  6. Tarnoff M, Kaplan LM, Shikora S. An evidenced-based assessment of preoperative weight loss in bariatric surgery. Obes Surg. 2008;18:1059–61.

    Article  PubMed  Google Scholar 

  7. Nielsen LV, Nielsen MS, Schmidt JB, et al. Efficacy of a liquid low calorie formula diet in achieving preoperative target weight loss before bariatric surgery. J Nutr Sci. 2016;5:e22.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Parr EB, Coffey VG, Hawley JA. “Sarcobesity”: a metabolic conundrum, vol. 74. Maturitas: Elsevier Ireland Ltd; 2013. p. 109–13.

    Google Scholar 

  9. Browning MG, Franco RL, Cyrus JC, et al. Changes in resting energy expenditure in relation to body weight and composition following gastric restriction: a systematic review. Obes Surg. 2016;26:1607–15.

    Article  PubMed  Google Scholar 

  10. McCullough PA, Gallagher MJ, DeJong AT, et al. Cardiorespiratory fitness and short-term complications after bariatric surgery. Chest The American College of Chest Physicians. 2006;130:517–25.

    Article  PubMed  Google Scholar 

  11. Clark JE. Diet, exercise or diet with exercise: comparing the effectiveness of treatment options for weight-loss and changes in fitness for adults (18–65 years old) who are overfat, or obese; systematic review and meta-analysis. J Diabetes Metab Disord. 2015;14:31.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Keating SE, Hackett DA, Parker HM, et al. Effect of aerobic exercise training dose on liver fat and visceral adiposity. J Hepatol European Association for the Study of the Liver. 2015;63:174–82.

    Article  PubMed  Google Scholar 

  13. Batacan RB, Duncan MJ, Dalbo VJ, et al. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies. Br J Sports Med. 2016;51:494–503.

    Article  PubMed  Google Scholar 

  14. Blackwell JEM, Doleman B, Herrod PJJ, et al. Short-term (<8 wk) high-intensity interval training in diseased cohorts. Med Sci Sport Exerc. 2018;50:1740–9.

    Article  Google Scholar 

  15. ASMBS. Public and professional education committee bariatric surgery: postoperative concerns. 2008;1–7.

  16. Goodpaster BH, DeLany JP, Otto AD, et al. Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults. JAMA. 2010;304:1795–802.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Marcon ER, Baglioni S, Bittencourt L, et al. What is the best treatment before bariatric surgery? Exercise, exercise and group therapy, or conventional waiting: a randomized controlled trial. Obes Surg. 2017;27:763–73.

    Article  PubMed  Google Scholar 

  18. Brzycki M. Strength Testing—predicting a one-rep max from reps-to-fatigue. J Phys Educ Recreat Danc. Taylor & Francis Group. 1993;64:88–90.

    Article  Google Scholar 

  19. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–81.

    CAS  PubMed  Google Scholar 

  20. Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis - part II: utilization in clinical practice. Clin Nutr. 2004;23:1430–53.

    Article  PubMed  Google Scholar 

  21. Stewart A, Marfell-Jones M, Olds T, et al. International standards for anthropometric assessment. International Society for the Advancement of Kinanthropometry; 2011.

  22. National Institutes of Health. National Heart, Lung and BI. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. The Evidence Report. Obes Res. 1998;6:51S–209S.

    Article  Google Scholar 

  23. Deitel M, Greenstein R. Recommendations for reporting weight loss. Obes Surg. 2003;13:159–60.

    Article  PubMed  Google Scholar 

  24. Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1948;109:1–9.

    Article  Google Scholar 

  25. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.

    Article  CAS  PubMed  Google Scholar 

  26. Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the subcommittee of professional and public education of the American Heart Association Cou. Hypertension. 2005;45:142–61.

    Article  CAS  PubMed  Google Scholar 

  27. Shen S, Lu Y, Qi H, et al. Waist-to-height ratio is an effective indicator for comprehensive cardiovascular health. Sci Rep. 2017;7:43046.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Achten J, Gleeson M, Jeukendrup AE. Determination of the exercise intensity that elicits maximal fat oxidation. Med Sci Sports Exerc. 2002;34:92–7.

    Article  PubMed  Google Scholar 

  29. Symons TB, Vandervoort AA, Rice CL, et al. Effects of maximal isometric and isokinetic resistance training on strength and functional mobility in older adults. J Gerontol A Biol Sci Med Sci. 2005;60:777–81.

    Article  PubMed  Google Scholar 

  30. Alonso J, Prieto L, Antó JM. La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin. 1995;104:771–6.

    CAS  Google Scholar 

  31. Alonso J, Regidor E, Barrio G, et al. Valores poblacionales de referencia de la versión Española del cuestionario de salud SF-36. Med Clin (Barc). 1998;111:410–6.

    CAS  Google Scholar 

  32. Cohen J. Statistical power analysis for the behavioral sciences: Routledge; 2013.

  33. Patel NS, Doycheva I, Peterson MR, et al. Effect of weight loss on magnetic resonance imaging estimation of liver fat and volume in patients with nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2015;13:561–568.e1.

    Article  PubMed  Google Scholar 

  34. Ho L, Yen C, Chao C, et al. Visceral fat area is associated with HbA1c but not dialysate-related glucose load in nondiabetic PD patients. Sci Rep. 2015;1–8.

  35. Li W, Chen I, Chang Y, et al. Waist-to-height ratio, waist circumference, and body mass index as indices of cardiometabolic risk among 36, 642 Taiwanese adults. Eur J Nutr. 2013;52:57–65.

    Article  PubMed  Google Scholar 

  36. Stanford KI, Goodyear LJ. Exercise and type 2 diabetes: molecular mechanisms regulating glucose uptake in skeletal muscle. Adv Physiol Educ. 2014;38:308–14.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Delgado Floody P, Jerez Mayorga D, Caamano Navarrete F, et al. Effectiveness of comprehensive treatment on the preoperative conditions of obese women candidates for bariatric surgery. Nutr Hosp. 2015;32:2570–5.

    PubMed  Google Scholar 

  38. Marcon ER, Gus I, Neumann CR. Impacto de um programa mínimo de exercícios físicos supervisionados no risco cardiometabólico de pacientes com obesidade mórbida. Arq Bras Endocrinol Metabol. 2011;55:331–8.

    Article  PubMed  Google Scholar 

  39. Marcon ER, Baglioni S, Bittencourt L, et al. What is the best treatment before bariatric surgery? Exercise, exercise and group therapy, or conventional waiting: a randomized controlled trial. Obes Surg. 2016;27:763–73.

    Article  Google Scholar 

  40. Kalarchian MA, Marcus MD, Courcoulas AP, et al. Preoperative lifestyle intervention in bariatric surgery: initial results from a randomized, controlled trial. Obesity. 2013;21:254–60.

    Article  CAS  PubMed  Google Scholar 

  41. Hennis PJ, Meale PM, Grocott MPW. Cardiopulmonary exercise testing for the evaluation of perioperative risk in non-cardiopulmonary surgery. Postgrad Med J. 2011;87:550–7.

    Article  PubMed  Google Scholar 

  42. Julia C, Ciangura C, Capuron L, et al. Quality of life after Roux-en-Y gastric bypass and changes in body mass index and obesity-related comorbidities. Diabetes Metab. 2013;39:148–54.

    Article  CAS  PubMed  Google Scholar 

  43. Jepsen R, Aadland E, Robertson L, et al. Physical activity and quality of life in severely obese adults during a two-year lifestyle intervention programme. J Obes. 2015;2015:1–11.

    Article  Google Scholar 

  44. Kroes M, Osei-Assibey G, Baker-Searle R, et al. Impact of weight change on quality of life in adults with overweight/obesity in the United States: a systematic review. Curr Med Res Opin. 2016;32:485–508.

    Article  PubMed  Google Scholar 

  45. Anderin C, Gustafsson UO, Heijbel N, et al. Weight loss before bariatric surgery and postoperative complications. Ann Surg. 2015;261:909–13.

    Article  PubMed  Google Scholar 

  46. Santa Mina D, Clarke H, Ritvo P, et al. Effect of total-body prehabilitation on postoperative outcomes: a systematic review and meta-analysis. Physiotherapy. 2014;100:196–207.

    Article  CAS  PubMed  Google Scholar 

  47. Santa Mina D, Scheede-Bergdahl C, Gillis C, et al. Optimization of surgical outcomes with prehabilitation. Appl Physiol Nutr Metab. 2015;40:966–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Laboratory of Training Analysis and Optimization, Sport Research Center, Miguel Hernandez University, Elche, Spain

    A. Marc-Hernández, S. Guillén & Manuel Moya-Ramón

  2. Center of Excellence for the Diagnosis and Treatment of Obesity and Diabetes, Valladolid, Spain

    J. Ruiz-Tovar

  3. Department of Sport Sciences, Sport Research Center, Miguel Hernandez University, Elche, Spain

    A. Aracil & Manuel Moya-Ramón

  4. Instituto de Neurociencias, UMH-CSIC, Sant Joan d’Alacant, Spain

    A. Aracil

  5. Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Miguel Hernandez University, Alicante, Spain

    Manuel Moya-Ramón

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  1. A. Marc-Hernández
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  4. S. Guillén
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  5. Manuel Moya-Ramón
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Correspondence to Manuel Moya-Ramón.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Marc-Hernández, A., Ruiz-Tovar, J., Aracil, A. et al. Impact of Exercise on Body Composition and Cardiometabolic Risk Factors in Patients Awaiting Bariatric Surgery. OBES SURG 29, 3891–3900 (2019). https://doi.org/10.1007/s11695-019-04088-9

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  • DOI: https://doi.org/10.1007/s11695-019-04088-9

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