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Descripción
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| Introduction: Obesity is a metabolic pathology that has become a complex public health problem. In most cases, it occurs when the caloric intake exceeds the energy expenditure, although there are multiple factors that are influencing the increase in body weight. However, the mechanisms that drive intake and expenditure, in the so-called obesogenic environment, are extremely complicated, and have been attributed to lifestyle and changes in eating habits. Obesity is accompanied by a decrease in physical condition and resting metabolic rate, in addition to being associated with cardiovascular and eating disorders, such as high blood pressure and inadequate caloric intake. Physical activity plays an important role in the prevention and treatment of many changes and disorders caused by obesity. Understanding how exercise contributes to reducing the consequences of these changes could help coaches and public health professionals in management of this disease. Objective: In this context, the general aim of this doctoral thesis was to verify the influence of a physical activity and nutrition program in cardiorespiratory (Study I), hemodynamic (Study III), metabolic (Study IV) and eating behavior (Study V) parameters, as well as to develop prediction equations for estimating peak oxygen consumption (VO2peak) in individuals with weight excess (Study II). Methods: Data for this doctoral thesis were derived from PRONAF proyect: ?PROgramas de Nutrición y Actividad Física para el tratamiento de la obesidad?, a randomized trial developed in overweight and obese Spanish population during three years. Subjects included were randomly assigned to one of the four intervention groups: strength training, endurance training, combined strength + endurance training and a guideline-based physical activity, assuring a homogeneous distribution of age and gender among groups. The guideline-based physical activity group followed general physical activity recommendations from the American College of Sports Medicine. Subjects of training groups trained three times per week. All training sessions were carefully supervised by certified personal trainers with Sports Science degrees. All participants underwent an individualized dietary intervention based on a hypocaloric diet prescribed by expert dieticians. The diet aimed at a 25-30% reduction on the total daily energy expenditure. The intervention lasted 22 weeks and all assessments for the variables utilized in this thesis took place one week before (baseline) and after (post) the intervention. Resultados: The main results were: VO2peak improved in overweight and obese males (pre and post values in L/min, respectively; overweight = 3.2 ± 0.6 vs. 3.7 ± 0.5, p < 0.001; obese = 3.6 ± 0.6 vs. 3.8 ± 0.6, p = 0.013) as well as in overweight females (2.0 ± 0.3 vs. 2.3 ± 0.4, p < 0.001), without interaction between intervention groups and time (Study I). The following equation presented the highest determination coefficient (R2 = 0.885), using effort test data for active subjects: VO2peak (L/min) = -5.017 + (0.040 × body weight) + (0.127 × time of exercise) + (0.046 × lean body mass percentage) + (-0.010 × age) (Study II). In men, systolic BP (SBP) and mean arterial pressure (MAP) decreased in overweight (SBP: -7.9%, p < 0.001; MAP: -9.6%, p < 0.001) and obese (SBP: -3.0%, p = 0.033; MAP: -4.9%, p = 0.001). Diastolic blood pressure (DBP) also reduced in males (-8.3%, p < 0.001). In women no interactions were found for body mass category or groups and SBP, MAP, DBP, pulse pressure decreased significantly about 5% (p < 0.05), without interaction between intervention groups and time (Study III). Cardiovascular risk calculated by Framingham-REGICOR function reduced only in males (-25.7%, p < 0.001) (Study III). Resting metabolic rate decreased in women without interaction between intervention groups and time (pre: 1592.8 ± 272.3, post: 1461.2 ± 266.6, p = 0.001) and men did not change it (Study IV). | |
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Internacional
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Si |
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ISBN
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Tipo de Tesis
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Doctoral |
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Calificación
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Sobresaliente cum laude |
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Fecha
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18/07/2017 |