BACKGROUNDːObesity is a widespread problem within modern society, serving to increase the risk of cardiovascular, metabolic, and neurodegenerative disorders. Peroxisome proliferator-activated receptor gamma (PPARγ) and PPARγ coactivator 1 α (PGC1α) play a key role in the regulation of cellular energy metabolism and is implicated in the pathology of these diseases. This study examined the association between polymorphisms of the PPARG and PPARGC1A genes and individual variability in weight loss in response to physical activity intervention. METHODS AND RESULTSːThirty-nine obese Ukrainian women (44.4 ± 7.5 years, BMI > 30.0 kg/m 2 ) undertook a 3-month fitness program whilst following a hypocaloric diet (~1500 calories). Anthropometric and biochemical measurements took place before and after the program. Single nucleotide polymorphisms within or near PPARG (n=94) and PPARGC1A (n=138) were identified and expression of PPARG mRNA was measured via reverse transcription and amplification. The association between DNA polymorphisms and exercise-induced weight loss, initial body mass, biochemistry and PPARG expression was determined using one-way analysis of variance (ANOVA).The present intervention induced significant fat loss in all participants (total fat: 40.3±5.3 vs 36.4±5.7%; P<0.00001). Only one polymorphism (rs17650401 C/T) within the PPARGC1A gene was found to be associated with fat loss efficiency after correction for multiple testing, with T allele carriers showing the greatest reduction in body fat percentage (2.5-fold; P=0.00013) compared to non-carriers. CONCLUSIONSː PPARGC1A (rs17650401) is associated with fat loss efficiency of the fitness program in obese women. Further studies are warranted to test whether this variation is associated with fat oxidation.

This chapter reviews the issue of overweight management, which is one of the major challenges faced by most countries today. The causes of obesity include genetic and epigenetic factors, a lack of physical activity, eating disorders, and gut microbiota status. Physical exercise is the main means of prevention and management of overweight and obesity. The effectiveness of exercise programs for obese people typically varies around 80%, but it can be increased by taking into account biochemical, genetic, epigenetic, and microbiome markers, which allows choosing the most appropriate type of exercise according to individual characteristics. The pathogenetic preconditions for reducing exercise tolerance were examined based on the existing imbalance of adipokines, cytokines, and incretins. The association between genotype and weight loss induced by different diets and types of exercise was discussed along with obesity epigenetic markers. The effects of dietary choice on the microbiome composition and its contribution to the development of systemic inflammation in obese people were assessed. The weight management exercise program for middle-aged women was presented. The structure and value of the factors that determine the physical condition of overweight middle-aged women were described. These data provide the basis for designing a sound exercise program for weight management.