ORIGINAL ARTICLE

Effect of Regular Physical Activity on Metabolic Parameters and Anthropometric Indices in Obese Military Personnel: A Quasi-Experimental Study
Obez Askerî Personelde Düzenli Fiziksel Aktivitenin Metabolik Parametreler ve Antropometrik İndeksler Üzerine Etkisi: Yarı-Deneysel Bir Çalışma
Received Date : 03 Mar 2021
Accepted Date : 18 Oct 2021
Doi: 10.25179/tjem.2021-82847 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:361-369
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: In recent decades, the world has witnessed a rapid rise in obesity, which has also become a problem in military health care systems. This study aimed to determine the changes in blood lipid profile, blood glucose levels, and anthropometric indices upon regular physical activity in obese men among military personnel. Material and Methods: This study involves quasi-experimental research conducted on 265 military personnel. The subjects underwent physical activities continuously for 2 months under coach supervision. The mean values of blood lipid and blood glucose profiles, as well as the anthropometric indices of these individuals before and after the study period, were compared. To make comparisons, the statistical t-test and standardized mean difference (SMD) with 95% confidence interval were used. Results: Results of this study indicate that after regular physical activity, the mean values of triglyceride levels [SMD=- 0.390, p<0.001], total cholesterol [SMD=-0.259, p=0.003], high-density lipoprotein [SMD=0.387, p<0.001], low-density lipoprotein [SMD=-0.369, p<0.001], and fasting blood sugar [SMD=-0.338, p<0.001] significantly decreased. Based on the test results, the weight [SMD=-0.218, p=0.013] and body mass index [SMD=-0.587, p<0.001] of the individuals had also decreased. Moreover, the waist circumference [SMD=-0.416, p<0.001], hip circumference [SMD=-0.249, p=0.005] and waist-to-hip ratio [SMD=-0.566, p<0.001] also showed a decrease. Conclusion: It is seen in this study that regular physical activity can improve anthropometric indices, blood glucose, and blood lipid profile. It is hence suggested that managers of organizations take adequate measures to encourage employees to exercise and participate in physical sports daily or even make it mandatory, if necessary, for administrative personnel who do not have any physical activity.
ÖZET
Amaç: Son yıllarda dünya, askerî sağlık sistemlerinde de sorun hâline gelen hızlı bir obezite artışına tanık olmuştur. Bu çalışmada, askerî personel arasındaki obez erkeklerde düzenli fiziksel aktivite sonrası kan lipid profili, kan glukoz seviyeleri ve antropometrik indekslerdeki değişiklikleri belirlemek amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma, 265 askerî personel üzerinde yürütülen yarı-deneysel bir araştırmayı içermektedir. Katılımcılara, antrenör gözetiminde 2 ay boyunca sürekli fiziksel aktivite yaptırılmıştır. Çalışma periyodundan önce ve sonra bu bireylerde, kan lipid ve kan glukoz profilleri ile antropometrik indekslerin ortalama değerleri karşılaştırılmıştır. Karşılaştırmalarda istatistiksel t-testi ve %95 güven aralığı ile standardize ortalama fark [standardized mean difference (SMD)] kullanılmıştır. Bulgular: Bu çalışmanın sonuçları, düzenli fiziksel aktiviteden sonra, trigliserid [SMD=-0,390, p<0,001], total kolesterol [SMD=-0,259, p=0,003], yüksek yoğunluklu lipoprotein [SMD=0,387, p<0,001], düşük yoğunluklu lipoprotein [SMD=-0,369, p<0,001] ve açlık kan şekeri [SMD=-0,338, p<0,001] düzeyleri ortalama değerlerinin anlamlı olarak azaldığını göstermiştir. Test sonuçlarına göre bireylerin ağırlığı [SMD=-0,218, p=0,013] ve beden kitle indeksi [SMD=-0,587, p<0,001] de azalmıştır. Ayrıca bel çevresi [SMD=-0,416, p<0,001], kalça çevresi [SMD=-0,249, p=0,005] ve bel-kalça oranı [SMD=-0,566, p<0,001] da düşüş göstermiştir. Sonuç: Bu çalışmada, düzenli fiziksel aktivitenin antropometrik indeksleri, kan şekerini ve kan lipid profilini iyileştirebileceği görülmektedir. Bu nedenle kurum yöneticilerinin, çalışanları günlük olarak egzersiz yapmaya ve fiziksel aktivitelere katılmaya teşvik edecek yeterli önlemleri almaları, hatta herhangi bir fiziksel aktivite yapmayan idari personel için gerekirse bunu zorunlu hâle getirmeleri önerilmektedir.
KAYNAKLAR
  1. Hruby A, Hu FB. The epidemiology of obesity: A big picture. Pharmacoeconomics. 2015;33:673-689. [Crossref] [PubMed] [PMC] 
  2. Vaisi-Raygani A, Mohammadi M, Jalali R, Ghobadi A, Salari N. The prevalence of obesity in older adults in Iran: A systematic review and meta-analysis. BMC Geriatr. 2019;19:371. [Crossref] [PubMed] [PMC] 
  3. Wu LT, Shen YF, Hu L, Zhang MY, Lai XY. Prevalence and associated factors of metabolic syndrome in adults: A population-based epidemiological survey in Jiangxi province, China. BMC Public Health. 2020;20:133. [Crossref] [PubMed] [PMC] 
  4. Lee CH, Cheung B, Yi GH, Oh B, Oh YH. Mobile health, physical activity, and obesity: Subanalysis of a randomized controlled trial. Medicine (Baltimore). 2018;97:e12309. [Crossref] [PubMed] [PMC] 
  5. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United states, 2017-2018. NCHS Data Brief. 2020: 1-8. [PubMed] 
  6. Djalalinia S, Qorbani M, Peykari N, Kelishadi R. Health impacts of Obesity. Pak J Med Sci. 2015;31: 239-242. [PubMed] [PMC] 
  7. Stone TW, McPherson M, Gail Darlington L. Obesity and cancer: Existing and new hypotheses for a causal connection. EBioMedicine. 2018;30:14-28. [Crossref] [PubMed] [PMC] 
  8. Leitner DR, Frühbeck G, Yumuk V, Schindler K, Micic D, Woodward E, Toplak H. Obesity and Type 2 diabetes: Two diseases with a need for combined treatment strategies - EASO can lead the way. Obes Facts. 2017;10:483-492. [Crossref] [PubMed] [PMC] 
  9. Aronow WS. Association of obesity with hypertension. Ann Transl Med. 2017;5:350. [Crossref] [PubMed] [PMC] 
  10. Mirahmadizadeh A, Fathalipour M, Mokhtari AM, Zeighami S, Hassanipour S, Heiran A. The prevalence of undiagnosed type 2 diabetes and prediabetes in Eastern Mediterranean region (EMRO): A systematic review and meta-analysis. Diabetes Res Clin Pract. 2020;160:107931. Erratum in: Diabetes Res Clin Pract. 2021;176:108276. [Crossref] [PubMed] 
  11. Zeleke Negera G, Charles Epiphanio D. Prevalence and predictors of nonadherence to diet and physical activity recommendations among Type 2 diabetes patients in Southwest Ethiopia: A cross-sectional study. Int J Endocrinol. 2020;2020:1512376. [Crossref] [PubMed] [PMC] 
  12. Taghdir M, Rezaianzadeh A, Sepandi M, Abbaszadeh S, Alimohamadi Y. Determine the prevalence of overweight and obesity and effective factors in Iranian females: A population-based cross-sectional study. Acta Medica Iranica. 2020;58:73-77. [Crossref] 
  13. Zhang Y, Gu Y, Wang N, Zhao Q, Ng N, Wang R, Zhou X, Jiang Y, Wang W, Zhao G. Association between anthropometric indicators of obesity and cardiovascular risk factors among adults in Shanghai, China. BMC Public Health. 2019;19:1035. [Crossref] [PubMed] [PMC] 
  14. Ononamadu CJ, Ezekwesili CN, Onyeukwu OF, Umeoguaju UF, Ezeigwe OC, Ihegboro GO. Comparative analysis of anthropometric indices of obesity as correlates and potential predictors of risk for hypertension and prehypertension in a population in Nigeria. Cardiovasc J Afr. 2017;28:92-99. [Crossref] [PubMed] [PMC] 
  15. Zeinalian R, Farhangi MA, Shariat A, Saghafi-Asl M. The effects of spirulina platensis on anthropometric indices, appetite, lipid profile and serum vascular endothelial growth factor (VEGF) in obese individuals: a randomized double blinded placebo controlled trial. BMC Complement Altern Med. 2017;17:225. [Crossref] [PubMed] [PMC] 
  16. Bakhshi E, Koohpayehzadeh J, Seifi B, Rafei A, Biglarian A, Asgari F, Etemad K, Bidhendi Yarandi R. Obesity and related factors in Iran: The STEPS survey, 2011. Iran Red Crescent Med J. 2015;17: e22479. [Crossref] [PubMed] [PMC] 
  17. Ashtary-Larky D, Daneghian S, Alipour M, Rafiei H, Ghanavati M, Mohammadpour R, Kooti W, Ashtary-Larky P, Afrisham R. Waist circumference to height ratio: Better correlation with fat mass than other anthropometric indices during dietary weight loss in different rates. Int J Endocrinol Metab. 2018;16: e55023. [Crossref] [PubMed] [PMC] 
  18. Hosseini SRA, Rahimi GRM, Ghaemi J. Compare waist circumference, waist-to-hip ratio and waist-to-stature ratio in predicting overweight/obese male students. Razi Journal of Medical Sciences. 2017; 24:67-76. [Link] 
  19. Li G, Wu HK, Wu XW, Cao Z, Tu YC, Ma Y, Li BN, Peng QY, Cheng J, Wu B, Zhou Z. The feasibility of two anthropometric indices to identify metabolic syndrome, insulin resistance and inflammatory factors in obese and overweight adults. Nutrition. 2019;57:194-201. [Crossref] [PubMed] 
  20. Manafi A, Joharimoghadam A, Firouzabadi AD, Abdi H, Mousavi SH. The effects of phase 2 cardiac rehabilitation on changes in obesity anthropometric indices among military and non-military men with coronary artery disease referred to cardiac rehabilitation center. International Cardiovascular Research Journal. 2019;13:e85457. [Link] 
  21. Tanofsky-Kraff M, Sbrocco T, Theim KR, Cohen LA, Mackey ER, Stice E, Henderson JL, McCreight SJ, Bryant EJ, Stephens MB. Obesity and the US military family. Obesity (Silver Spring). 2013;21:2205-2220. [Crossref] [PubMed] [PMC] 
  22. Tran L, Tran P, Tran L. A cross-sectional examination of sociodemographic factors associated with meeting physical activity recommendations in overweight and obese US adults. Obes Res Clin Pract. 2020;14:91-98. [Crossref] [PubMed] 
  23. Dong J, Zhang S, Xia L, Yu Y, Hu S, Sun J, Zhou P, Chen P. Physical activity, a critical exposure factor of environmental pollution in children and adolescents health risk assessment. Int J Environ Res Public Health. 2018;15:176. [Crossref] [PubMed] [PMC] 
  24. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311:806-814. [Crossref] [PubMed] [PMC] 
  25. Jafari-Adli S, Jouyandeh Z, Qorbani M, Soroush A, Larijani B, Hasani-Ranjbar S. Prevalence of obesity and overweight in adults and children in Iran; a systematic review. J Diabetes Metab Disord. 2014;13:121. [Crossref] [PubMed] [PMC] 
  26. Pasiakos SM, Karl JP, Lutz LJ, Murphy NE, Margolis LM, Rood JC, Cable SJ, Williams KW, Young AJ, McClung JP. Cardiometabolic risk in US Army recruits and the effects of basic combat training. PLoS One. 2012;7:e31222. [Crossref] [PubMed] [PMC] 
  27. Du Z, Li Y, Li J, Zhou C, Li F, Yang X. Physical activity can improve cognition in patients with Alzheimer's disease: A systematic review and meta- analysis of randomized controlled trials. Clin Interv Aging. 2018;13:1593-1603. [Crossref] [PubMed] [PMC] 
  28. Rafie C, Ning Y, Wang A, Gao X, Houlihan R. Impact of physical activity and sleep quality on quality of life of rural residents with and without a history of cancer: Findings of the day and night study. Cancer Manag Res. 2018;10:5525-5535. [Crossref] [PubMed] [PMC] 
  29. Kitada M, Koya D. SIRT1 in Type 2 diabetes: Mechanisms and therapeutic potential. Diabetes Metab J. 2013;37:315-325. [Crossref] [PubMed] [PMC] 
  30. Kasch J, Schumann S, Schreiber S, Klaus S, Kanzleiter I. Beneficial effects of exercise on offspring obesity and insulin resistance are reduced by maternal high-fat diet. PLoS One. 2017;12:e0173076. Erratum in: PLoS One. 2017;12:e0175100. [Crossref] [PubMed] [PMC] 
  31. Naghii MR, Almadadi M, Zarchi AA. Regular physical activity as a basic component of lifestyle modification reduces major cardiovascular risk factors among male armored force personnel of Shabestar army installation in Iran. Work. 2011;40:217-227. [Crossref] [PubMed] 
  32. Hallsworth K, Fattakhova G, Hollingsworth KG, Thoma C, Moore S, Taylor R, Day CP, Trenell MI. Resistance exercise reduces liver fat and its mediators in non-alcoholic fatty liver disease independent of weight loss. Gut. 2011;60:1278-1283. [Crossref] [PubMed] [PMC] 
  33. Ong KW, Hsu A, Tan BK. Chlorogenic acid stimulates glucose transport in skeletal muscle via AMPK activation: a contributor to the beneficial effects of coffee on diabetes. PLoS One. 2012;7:e32718. [Crossref] [PubMed] [PMC] 
  34. Zaki M, Kamal S, Kholousi S, El-Bassyouni HT, Yousef W, Reyad H, Mohamed R, Basha WA. Serum soluble receptor of advanced glycation end products and risk of metabolic syndrome in Egyptian obese women. EXCLI J. 2017;16:973-980. [PubMed] [PMC] 
  35. Mousavian AS, Shakerian S, Namvar F, Ghanbarzadeh M. Comparing walking and a selected aerobic exercise effect on cardiovascular risk factors in non-athletic postmenopausal women after twelve weeks of training. International Research Journal of Applied and Basic Sciences. 2013;4:91-5. [Link] 
  36. Fathi R, Esmaeili B, Talebi-Garakani E, Saghebjoo M. The effect of 8-weeks of aerobic exercise training on plasma visfatin and lipid profile of overweight women. Iranian Journal of Health and Physical Activity. 2013;4:63. [Link] 
  37. Pooranfar S, Shakoor E, Shafahi M, Salesi M, Karimi M, Roozbeh J, Hasheminasab M. The effect of exercise training on quality and quantity of sleep and lipid profile in renal transplant patients: A randomized clinical trial. Int J Organ Transplant Med. 2014;5:157-165. [PubMed] [PMC] 
  38. Hagnäs MP, Cederberg H, Mikkola I, Ikäheimo TM, Jokelainen J, Laakso M, Härkönen P, Peitso A, Rajala U, Keinänen-Kiukaanniemi S. Reduction in metabolic syndrome among obese young men is associated with exercise-induced body composition changes during military service. Diabetes Res Clin Pract. 2012;98:312-319. [Crossref] [PubMed] 
  39. Varady KA, Bhutani S, Klempel MC, Kroeger CM. Comparison of effects of diet versus exercise weight loss regimens on LDL and HDL particle size in obese adults. Lipids Health Dis. 2011;10:119. [Crossref] [PubMed] [PMC] 
  40. Ho SS, Dhaliwal SS, Hills AP, Pal S. The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial. BMC Public Health. 2012;12:704. [Crossref] [PubMed] [PMC]