High intensity, circuit-type integrated neuromuscular training alters energy balance and reduces body mass and fat in obese women: A 10-month training-detraining randomized controlled trial

Abstract

This randomized controlled trial examined body mass, body composition, energy balance and performance responses of previously sedentary overweight/obese women to a circuit-type integrated neuromuscular training program with alternative modalities. Forty-nine healthy overweight or class I obese females (36.4±4.4 yrs) were randomly assigned to either a control (N = 21), training (N = 14) or training-detraining (N = 14) group. In weeks 1–20, the training groups trained three times/week using 10–12 whole-body exercises of progressively increased intensity/volume, organized in timed interval circuit form. In weeks 21–40, the training group continued training whereas the training-detraining group not. Heart rate, perceived exertion, blood lactate, exertion, oxygen consumption and excess post-exercise oxygen consumption were measured for one session/phase/person and exercise energy expenditure was calculated. Energy intake, habitual physical activity, resting metabolic rate, body composition, body mass, strength and maximal oxygen consumption were measured at baseline, mid-intervention and post-intervention. A two-way repeated measures ANOVA was used to determine differences between three time points and three groups. In C, VO2max declined (p<0.013) and body fat (p<0.008), waist (p<0.059) and hip (p<0.012) circumferences increased after 40 weeks compared to baseline. Training reduced body mass (6%, p<0.001), body fat (~5.5%, p<0.001) and increased fat-free mass (1.2–3.4%, p<0.05), strength (27.2%, p<0.001) and endurance (26.8%, p<0.001) after a 10-month implementation period using a metabolic overload of only 5–12 metabolic equivalents of task-hours per week. Training induced a long-term negative energy balance during an exercise and a non-exercise day due to an elevation of resting metabolic rate (6%-10%, p<0.05) and exercise-related energy expenditure. Training had an 8% and 94% attrition and attendance rates, respectively. Training-induced gains were attenuated but not lost following a 5-month detraining. A 10-month implementation of a high-intensity interval type training program elicited both endurance and musculoskeletal gains and resulted in a long-term negative energy balance that induced a progressive and sustained reduction of body and fat mass.Trial Registration: ClinicalTrials.gov NCT03134781

Dose-response effects of high-intensity interval neuromuscular exercise training on weight loss, performance, health and quality of life in inactive obese adults: Study rationale, design and methods of the DoIT trial

“…Recently, implementation of a new of HIIT-type, integrated neuromuscular training modality that uses resistance exercises that incorporate whole-body movements in overweight/obese adult women, induced a ∼6% loss of body mass and fat (∼0.6% loss per month), which was associated with an increase of fat free mass (∼3.5%), RMR (∼10%), strength (∼22%), and CRF (∼24%) [ 15 ]. These beneficial adaptations were obtained using a metabolic overload of only 5–12 MET-hours/week and total exercise time/week of ∼100 min/week [ 15 ]. These training-induced gains were not attenuated by a 5-month detraining [ 15 ].…”

“…Exercise energy cost and excess post-exercise oxygen consumption (EPOC) will be measured using portable indirect calorimetry (VmaxST, Sensormedics, Yorba Linda, CA) as described [ 15 , 36 ]. Total energy expenditure of an exercise session will be estimated by summing a) the aerobic energy expenditure during exercise which will be estimated using a constant value of 21.14 kJ (5.05 kcal/)/liter oxygen [ 15 , 38 ], b) the anaerobic energy expenditure using resting and post-exercise blood lactate concentration measurements [ 15 , 39 ], and c) excess post-exercise oxygen consumption. Blood lactate will be measured using blood samples that will be collected pre-, mid- and post-exercise session (3 min post-exercise).…”

“…In order to avoid any potential contamination due to interference with sweat, researchers will collect the blood sample after they will have thoroughly cleaned, disinfected and dried subjects' whole hands and the single finger that will be used for blood sampling. Thereafter, a lancet will be used to puncture participants’ skin at the finger, the first blood drop will be directed on the measurement strip and the blood lactate concentration will be analyzed using a hand-portable analyzer (Accutrend Plus, Roche Diagnostics, Switzerland) within a few seconds following collection [ 15 ].…”

“…Lack of time is one of the most common personal barriers for exercise participation in adults [ 13 ]. Non-traditional, HIIT training protocols have recently become more popular among adults and improve health and physical performance in a more time-efficient manner [ [14] , [15] , [16] , [17] ]. HIIT protocols appear to be equally effective in increasing CRF as traditional moderate-intensity CET protocols in adults with chronic cardiometabolic lifestyle diseases [ 18 , 19 ].…”

“…We have recently shown [ 15 ] that an injury-free, HIIT-type protocol that incorporates integrated neuromuscular training (the DoIT protocol) using whole-body movements with alternative portable exercise equipment [ 24 , 25 ] and performed in a real-world setting, can provoke a considerably body mass and fat loss, increase RMR, strength and CRF in previously inactive overweight/obese women. Here we describe the proposed rationale, design, and methodology for a randomized clinical trial aiming to determine the dose-response effects of DoIT on body mass, body composition, health, performance and quality of life in sedentary male and female obese adults during a 1-year supervised training intervention.…”