Comparison of Time-matched Aerobic, Resistance or Combined Exercise Training in Women Living with Obesity: The EXOFFIT Study

Overview

Journal Obes Sci Pract

Date 2024 Apr 3

PMID 38567266

Authors

Mary E Davis

Catherine Blake

Grainne ODonoghue

Affiliations

Soon will be listed here.

Abstract

Background: Improvements in cardiorespiratory fitness (CRF) have been shown to largely attenuate the negative health risks associated with obesity. To date, literature on women with obesity has focused upon the evaluation of aerobic-based exercise interventions. Hence, there is a need to evaluate resistance and combined interventions with this cohort.

Objective: This study aimed to evaluate the feasibility and efficacy of three exercise modalities in women with obesity for improving CRF, strength, body composition and other health outcomes.

Methods: Sixty-seven women with obesity were randomly assigned to the control (CON) or one of three exercise groups (aerobic [AE], resistance [RE], COM). Exercise groups were trained x3 times/week for 12 weeks (up to 150-min/week). Feasibility outcomes included adherence, attendance, recruitment and retention rates and adverse events. Secondary outcomes were CRF (predicted VO2 max), body composition (body weight [BW], waist circumference [WC], body fat percentage [%BF], fat mass [FM] and lean mass) and strength (5RM bench press, leg dynamometry, grip strength) and self-reported measures of physical activity, mood, sleep, pain and quality of life.

Results: Findings support the feasibility of all three exercise modalities in terms of adherence, attendance, and retention. Interventions with a resistance component (COM and RE) were associated with the greatest improvements across the broad range of health outcomes measured. Combined was the most promising for body composition outcomes including body mass index (Effect size [ES] = 0.79, = 0.04), BW (ES = 0.75, = 0.05), %BF (ES = 0.77, = 0.04), FM (ES = 0.83, = 0.03) and WC (ES = 0.90, = 0.02), physical activity (i.e., moderate physical activity [ES = 0.69, = 0.07), mood (ES = 0.83, = 0.03) and sleep (ES = 0.78, = 0.04). Resistance was most promising for CRF (ES = 1.47, = 0.002), strength (i.e., bench press [ES = 2.88, =<0.001]) and pain (i.e., pain severity [ES = 0.40, = 0.31]).

Conclusions: For health outcomes, these results indicate the importance of including a resistance component when prescribing exercise for women with obesity to achieve meaningful improvements.

Clinical Trial Registration: ISRCTN13517067.

Citing Articles

Exploring the acceptability of three time-matched exercise interventions for increasing fitness in women living with obesity: A mixed-methods evaluation of the EXOFFIT study.

Davis M, Cunningham C, Blake C, ODonoghue G Obes Sci Pract. 2024; 10(4):e70003.

PMID: 39144066 PMC: 11324091. DOI: 10.1002/osp4.70003.

Comparison of time-matched aerobic, resistance or combined exercise training in women living with obesity: The EXOFFIT study.

Davis M, Blake C, ODonoghue G Obes Sci Pract. 2024; 10(2):e749.

PMID: 38567266 PMC: 10986633. DOI: 10.1002/osp4.749.

References

Liu Y, Chu J, Yan T, Zhang Y, Chen Y, Chang R . Short-term resistance exercise inhibits neuroinflammation and attenuates neuropathological changes in 3xTg Alzheimer's disease mice. J Neuroinflammation. 2020; 17(1):4. PMC: 6942350. DOI: 10.1186/s12974-019-1653-7. View

Thivel D, Tremblay A, Genin P, Panahi S, Riviere D, Duclos M . Physical Activity, Inactivity, and Sedentary Behaviors: Definitions and Implications in Occupational Health. Front Public Health. 2018; 6:288. PMC: 6182813. DOI: 10.3389/fpubh.2018.00288. View

Cooke R, Jones A . Recruiting adult participants to physical activity intervention studies using sport: a systematic review. BMJ Open Sport Exerc Med. 2017; 3(1):e000231. PMC: 5530105. DOI: 10.1136/bmjsem-2017-000231. View

Balke B, WARE R . An experimental study of physical fitness of Air Force personnel. U S Armed Forces Med J. 1959; 10(6):675-88. View

Mackenzie R, Ells L, Simpson S, Logue J . Core outcome set for behavioural weight management interventions for adults with overweight and obesity: Standardised reporting of lifestyle weight management interventions to aid evaluation (STAR-LITE). Obes Rev. 2019; 21(2):e12961. PMC: 7050499. DOI: 10.1111/obr.12961. View

Guess N . A qualitative investigation of attitudes towards aerobic and resistance exercise amongst overweight and obese individuals. BMC Res Notes. 2012; 5:191. PMC: 3490848. DOI: 10.1186/1756-0500-5-191. View

Franklin R, Franklin J, Swinbourne J, Manson E, Loughnan G, Markovic T . Understanding the confluence of injury and obesity in a Grade 2 obesity and above population. Aust N Z J Public Health. 2023; 47(1):100008. DOI: 10.1016/j.anzjph.2022.100008. View

Strasser B, Schobersberger W . Evidence for resistance training as a treatment therapy in obesity. J Obes. 2010; 2011. PMC: 2931407. DOI: 10.1155/2011/482564. View

Lopez P, Taaffe D, Galvao D, Newton R, Nonemacher E, Wendt V . Resistance training effectiveness on body composition and body weight outcomes in individuals with overweight and obesity across the lifespan: A systematic review and meta-analysis. Obes Rev. 2022; 23(5):e13428. PMC: 9285060. DOI: 10.1111/obr.13428. View

10.

Davis M, Blake C, Perrotta C, Cunningham C, ODonoghue G . Impact of training modes on fitness and body composition in women with obesity: A systematic review and meta-analysis. Obesity (Silver Spring). 2022; 30(2):300-319. DOI: 10.1002/oby.23305. View

11.

Mendham A, Goedecke J, Fortuin-de Smidt M, Phiri L, Clamp L, Swart J . Improved Sleep Quality and Depressive Symptoms With Exercise Training in Obese Women From a Low Socioeconomic Community: A Randomized Controlled Trial. J Phys Act Health. 2021; 18(4):440-449. DOI: 10.1123/jpah.2020-0648. View

12.

Davis M, Blake C, Cunningham C, Carson B, ODonoghue G . Comparison of time-matched aerobic, resistance or combined exercise training in women living with obesity: a protocol for a pilot randomised controlled trial-the EXOFFIT (Exercise for Obesity in Females to increase Fitness) study. Pilot Feasibility Stud. 2022; 8(1):42. PMC: 8862268. DOI: 10.1186/s40814-022-01003-5. View

13.

Thomas D, Kyle T, Stanford F . The gap between expectations and reality of exercise-induced weight loss is associated with discouragement. Prev Med. 2015; 81:357-60. PMC: 6820851. DOI: 10.1016/j.ypmed.2015.10.001. View

14.

Warren M, Schmitz K . Safety of strength training in premenopausal women: musculoskeletal injuries from a two-year randomized trial. Am J Health Promot. 2009; 23(5):309-14. DOI: 10.4278/ajhp.07081584. View

15.

Kokkinos P, Kaminsky L, Arena R, Zhang J, Myers J . New Generalized Equation for Predicting Maximal Oxygen Uptake (from the Fitness Registry and the Importance of Exercise National Database). Am J Cardiol. 2017; 120(4):688-692. DOI: 10.1016/j.amjcard.2017.05.037. View

16.

Pollock M, Foster C, Schmidt D, Hellman C, Linnerud A, Ward A . Comparative analysis of physiologic responses to three different maximal graded exercise test protocols in healthy women. Am Heart J. 1982; 103(3):363-73. DOI: 10.1016/0002-8703(82)90275-7. View

17.

Wagoner C, Hanson E, Ryan E, Brooks R, Wood W, Jensen B . Two weeks of lower body resistance training enhances cycling tolerability to improve precision of maximal cardiopulmonary exercise testing in sedentary middle-aged females. Appl Physiol Nutr Metab. 2019; 44(11):1159-1164. DOI: 10.1139/apnm-2018-0623. View

18.

ODonoghue G, Blake C, Cunningham C, Lennon O, Perrotta C . What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta-analysis. Obes Rev. 2020; 22(2):e13137. PMC: 7900983. DOI: 10.1111/obr.13137. View

19.

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

20.

Basem J, White R, Chen S, Mauer E, Steinkamp M, Inturrisi C . The effect of obesity on pain severity and pain interference. Pain Manag. 2021; 11(5):571-581. PMC: 9008601. DOI: 10.2217/pmt-2020-0089. View