Razi Journal of Medical Sciences

fa اثر هم‌افزایی تمرین تناوبی شدید و مکمل‌ اسید الاژیک بر وضعیت التهابی زنان دارای اضافه وزن و چاق: مطالعه بالینی دوسو کور تصادفی Randomized Double-Blind Clinical Trial Examining the High Intensity Interval Training and Ellagic Acid Effects on Antioxidant, and Inflammatory Status in Obese Women فیزیولوژی ورزش Exercise Physiology پژوهشي Research <div style="text-align: justify;">زمینه و هدف: چاقی از مهمترین دغدغهها و مشکلات تهدید کنندهی سلامتی در سرتاسر جهان است و فعالیت ورزشی و رژیم غذایی سالم از مهم ترین راههای درمان و پیشگیری از آن میباشند. بنابراین، هدف از اجرای تحقیق بررسی تاثیر 12 هفته تمرین تناوبی شدید (HIIT-High intensity interval training) همراه با مکملسازی اسید الاژیک (EA-Ellagic acid) بر شرایط التهابی زنان چاق بود. روش کار: در یک کارآزمایی بالینی تصادفی سازی شده دوسو کور، 56 زن چاق به 4 گروه تمرین ورزشی تناوبی شدید (HIIT)، گروه مکملدهی اسید الاژیک (EA)، گروه مکمل- تمرین (EA+HIIT) و گروه دارونما تقسیم شدند. ﺷﺮﮐﺖﮐﻨﻨﺪﮔﺎن گروه HIIT به مدت دوازده هفته، تمرین مورد نظر را بصورت 4 وهله 4 دقیقه‌ای دویدن اینتروال در  95-85 درصد ضربان قلب اوج (HRpeak) انجام دادند. همچنین مکملدهی اسید الاژیک بصورت یک کپسول 50 میلیگرمی /روز مصرف شد. نمونه‌های خونی قبل از انجام مداخله و 48 ساعت پس از آخرین جلسه تمرینی 12 هفته HIIT برای برسی سطوح سرمی TNF-α و IL-6 انجام شد. به منظور تجزیه و تحلیل دادهها از آزمون تحلیل کواریانس تک متغیره و آزمونهای تعقیبی بونفرونی برای مقایسه تغییرات بین گروهها استفاده شد. یافته ها: نتایج آزمون بونفرونی نشان داد بین گروههای "EA+HIIT" و "EA"، "EA+HIIT" و "PLA"، گروه "HIIT" و "PLA" (0001/0=P)، و "HIIT" و "EA" (045/0=P) در متغیر TNF-α زنان چاق تفاوت معناداری وجود دارد. از طرفی، بین گروههای "EA+HIIT" و "HIIT" (056/0=P) و "EA" و "PLA" در متغیر TNF-α زنان چاق تفاوت معناداری وجود ندارد (239/0=P). نتایج آزمون بونفرونی نشان داد که بین دو گروه "EA+HIIT" و "HIIT" در متغیر IL-6 زنان چاق تفاوت معناداری وجود ندارد (99/0=P). بین دو گروه "EA+HIIT" و "EA" (003/0=P)، بین دو گروه "EA+HIIT" و "PLA" (019/0=P)، بین دو گروه "HIIT" و "EA" (006/0=P) و بین دو گروه "HIIT" و "PLA" (038/0=P) در متغیر IL-6 زنان چاق تفاوت معناداری وجود دارد. از طرفی، بین دو گروه "EA" و "PLA" در متغیر IL-6 زنان چاق تفاوت معناداری وجود ندارد (99/0=P). نتیجه گیری: یافته های مطالعه حاضر نشان داد که انجام تمرین تناوبی شدید همراه با مکملدهی اسید الاژیک سبب بهبود وضعیت التهابی زنان چاق میشود؛ هر چند که انجام تمرینات شدید نتایجی بهتری نسبت به مکمل یاری داشت.  </div> Background & Aims: Obesity increases the risk of various diseases, such as type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), cardiovascular diseases and some cancers (1). The reports of the World Health Organization show that the occurrence of 4 million deaths per year may be directly related to overweight or obesity (1). Obesity is a low-grade chronic inflammatory condition that is closely related to atherosclerosis, high blood pressure, and insulin resistance (4). Also, thermodynamically, obesity is the result of the relationship between more energy intake and less energy consumption. Therefore, finding ways to increase energy expenditure may help fight obesity. Ellagic acid (EA) is one of the types of polyphenols in which the strong hydrogen bond network acts as an electron acceptor, which enables it to participate in a number of reactions. This polyphenol is found naturally in many fruits and vegetables, including strawberries, red raspberries, pomegranates, and grapes (11). EA can reduce the symptoms of chronic diseases such as dyslipidemia, insulin resistance in type 2 diabetes and NAFLD (12). Most of the conducted studies showed that in addition to saving time, HIIT compared to MICT leads to more weight loss, especially visceral fat mass and more improvement in metabolic profile and cardiorespiratory health in obese people (17, 18). Previous researches did not examine pro-inflammatory factors and due to the lack of clinical studies on the effects of EA supplementation on metabolic diseases and the lack of studies on the simultaneous effect of HIIT and antioxidant supplements on the immune system status of people. increasing obesity in Iranian women due to lifestyle and diets, the current research tries to answer the question of whether doing intense intermittent exercise and supplementing with ellagic acid at the same time has an effect on the inflammatory status of overweight and obese women. Methods: This study was a double-blind randomized clinical trial on overweight and obese women who were randomly assigned to four different groups: HIIT, EA supplement, EA+HIIT and control group. The statistical population of the present study was obese and overweight women in Tehran, and the participants was 56 people. Inactive women (those who do not do enough moderate to vigorous physical activity during the week), people with BMI≥25 kg/m2, people with no history of taking supplements or anti-inflammatory drugs, and people with minimal weight changes in one year. The latter were invited to this study. Exclusion criteria also include women with cognitive impairment, acute phase inflammatory diseases, cancer history in the last 5 years, users of immune system enhancing drugs, having fractures or joint problems of the lower body in the last six months, having a disease. Nervous people or people participating in regular sports programs. To check the biochemical variable, before starting the 12-week program, 5 cc of brachial vein blood was taken from each subject in a 12-hour fasting state (between 07:00-08:00). After the initial blood sampling, the intervention groups implemented the selected protocols for 12 weeks. Then, two days after the last training session and taking the supplement, exactly the same as the pre-test period, blood sampling was done to measure TNF-α and IL-6 plasma levels. The training protocol and supplement intake both lasted for 12 weeks. In general, they performed the training protocol 3 times a week in 4 steps of 4-minute interval running at 85-95% HRpeak, which is accompanied by 3 minutes of walking at 50-60% HRpeak and 7 minutes of rest. In the first 3 weeks of training, 4 minutes of running at a lower range (85% HRpeak) of training intensity was performed. The speed of running until the training intensity reached 90% of HRpeak was performed in the fourth and fifth weeks, and in the sixth week it increased to above 95% of HRpeak. The final running speed and intensity did not change in the following weeks of training (30). Also, the subjects of the EA supplement group and the EA+HIIT group randomly received 50 mg of EA (once a day in the morning) or placebo (cellulose) (31). In order to analyze the data, descriptive and inferential statistics were used using SPSS 22 software. Mean and standard deviation were used to describe the collected data and inferential statistics were used to test the hypotheses. The Shapiro-Wilk test was used to check the normality of the data distribution, and the Lune test was used to determine the equality of the data distribution. In order to test the hypothesis of the effect of HIIT along with EA on the serum levels of biochemical factors (IL-6 and TNF-α), one-variable analysis of covariance and post hoc Bonferroni tests were used to compare changes between groups. The power of the test was calculated using G*power 3.0 software, which was at least 0.90 in different comparisons. A significance level of P<0.05 was considered. Results: The result of univariate analysis of covariance shows that after 12 weeks of EA+HIIT, there was a significant difference in TNF-α level with a significance of 0.0001 and an effect size of 0.66. The results of the Bonferroni test showed that between the two groups "EA+HIIT" and "EA", between the two groups "EA+HIIT" and "PLA" (P=0.0001), between the two groups "HIIT" and "EA" (045 There is a significant difference between the two groups "HIIT" and "PLA" (P=0.0001) in TNF-α variable of obese women. The results showed that after 12 weeks of EA+HIIT with a significance of 0.0001 and an effect size of 0.399, there was a significant difference in the level of IL-6. The results of the inference test showed that there was a correlation between the two groups "EA+HIIT" and "EA" (P=0.003), between the two groups "EA+HIIT" and "PLA" (P=0.019), between the two groups "HIIT" " and "EA" (P=0.006) and between the two groups "HIIT" and "PLA" (P=0.038) there is a significant difference in TNF-α variable of obese women. Conclusion: The results of the present study showed that a 12-week period of intense interval training with ellagic acid supplementation has a significant effect on the serum levels of TNF-α and IL-6 in obese and overweight women. This study was conducted for the first time to investigate the synergistic effect of HIIT and ellagic acid consumption on inflammatory status in obese women. In general, the results of this study showed that 12 weeks of HIIT activity with the addition of EA (50 mg/day) decreased the activity of pro-inflammatory factors IL-6 and TNF-α and generally improved the inflammatory condition in these people. He gets fat. These results confirm the evidence that the antioxidant group of polyphenols and exercise can play an important role in controlling weight and obesity by reducing the complications of obesity. However, more studies are needed to provide sufficient evidence. چاقی, التهاب, الاژیک اسید, تمرین تناوبی شدید Obesity, Inflammation, Ellagic Acid, High Intensity Interval Training 1 12 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8115-1&slc_lang=fa&sid=1 Aylar Birar آیلار بیرار 3900319475328460087421 0009-0001-4448-8269 No PhD in Exercise Physiology, Dept. of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran دکتری، گروه فیزیولوژی ورزش، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران Roghayyeh Afroundeh رقیه افرونده 3900319475328460087422 3900319475328460087422 No Associate Professor, Dept. of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran دانشیار فیزیولوژی ورزش، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران Saleh Afraseyabi صالح افراسیابی 3900319475328460087423 0009-0008-0201-0081 No Assistant Professor, Department of Sport Sciences, Faculty of Human Science, Persian Gulf University, Bushehr, Bushehr, Iran استادیار، گروه علوم ورزشی، دانشکده علوم انسانی، دانشگاه خلیج فارس بوشهر، بوشهر، ایران Alireza Shafeei Sarcheshmeh علیرضا شفاهی 3900319475328460087424 3900319475328460087424 No Department of Exercise Physiology, Faculty of Sport Sciences & Health, University of Tehran, Tehran, Iran گروه فیزیولوژی ورزش، دانشکده علوم ورزشی و تندرستی، دانشگاه تهران، تهران، ایران Fereshteh Taherkhani فرشته طاهرخانی 3900319475328460087425 0009-0000-9982-6790 No Department of Exercise Physiology, Faculty of Sport Sciences & Health, University of Tehran, Tehran, Iran گروه فیزیولوژی ورزش، دانشکده علوم ورزشی و تندرستی، دانشگاه تهران، تهران، ایران Marjan Mansooridara مرجان منصوری دارا mrj.md@yahoo.com 3900319475328460087426 3900319475328460087426 Yes Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran گروه فیزیولوژی ورزش، دانشکده ادبیات، علوم انسانی و اجتماعی، دانشگاه آزاد اسلامی واحد علوم و تحقیقات، تهران، ایران