Usefulness of combining intermittent hypoxia and physical exercise in the treatment of obesity

Abstract

SummaryObesity is an important public health problem worldwide and is a major risk factor for a number of chronic diseases such as type 2 diabetes, adverse cardiovascular events and metabolic syndrome related features. Different treatments have been applied to tackle body fat accumulation and its associated clinical manifestations. Often, relevant weight loss is achieved during the first six months under different dietary treatments. From this point, a plateau is reached, and a gradual recovery of the lost weight may occur.Therefore, new research approaches are being investigated to assure weight maintenance.Pioneering investigations have reported that oxygen variations in organic systems may produce changes in body composition. Possible applications of intermittent hypoxia to promote health and in various pathophysiological states have been reported.The hypoxic stimulus in addition to diet and exercise can be an interesting approach to lose weight, by inducing higher basal noradrenalin levels and other metabolic changes whose mechanisms are still unclear. Indeed, hypoxic situations increase the diameter of arterioles, produce peripheral vasodilatation and decrease arterial blood pressure. Furthermore, hypoxic training increases the activity of glycolytic enzymes, enhancing the number of mitochondria and glucose transporter GLUT-4 levels as well as improving insulin sensitivity. Moreover, hypoxia increases blood serotonin, decreases leptin levels while appetite is suppressed. These observations allow considering the hypothesis that intermittent hypoxia induces fat loss and may ameliorate cardiovascular health, which might be of interest for the treatment of obesity. This new strategy may be useful and practical for clinical applications in obese patients.Key Words: obesity, body weight loss, intermittent hypoxia, treatment. 1. Obesity: Prevalence, causes and complicationsObesity is an important public health problem in most countries [63], which is characterized by an excess of body fat, when amounting values higher than 20% in men and 30% in adult women [20,66].The World Health Organization (2009) warns that there are over 400 million obese adults, and that the situation will worsen in the future.The main etiological factors causing excess body weight for height are assigned to overeating and low physical activity, which lead to a positive energy balance, and result in a body fat increase [91]. Furthermore, there are other causes such as the genetic component, the distribution of energy intake throughout the day, the dietary composition of macronutrients, sleep rest, endocrine disruptions or the individual ability to oxidize energy substrates [26,70,93]. Thus, obesity is a chronic multifactorial disease resulting from the interaction between genotype, environment and physical activity patterns [14,91,95].Obesity is considered one of the major risk factors in the onset of associated chronic diseases, such as hypercholesterolemia, type II diabetes (T2D), cardiovascular disorders and metabolic syndrome features [1...

Hypoxia: a consequence of obesity and also a tool to treat excessive weight loss

“…Thus, one of the mechanisms triggering inflammation has been associated with adipose tissue hypoxia [4] or increased oxygen tension [5], which affect a number of genes such as HIF-1a, MCP-1, IL-6, GLUT-1, ANGPTL-4 and PPAR-γ [6] that could be involved as a cause or as a consequence reaction to pathologically low or high oxygen conditions. Interestingly, as we hypothesized previously [3] and Kong et al have nicely demonstrated in their article [1], hypoxia is not only an ethological factor or a manifestation of disease, but also a therapeutic tool following different patterns (hypoxic exposure, hypoxic training, intermittent hypoxia under hyperbaric and normobaric conditions), which has been used for pre-acclimation in climbers, or to improve athletes performance as well as for heart, respiratory and nervous system diseases or to regulate body weight [7]. Thus, putative compensatory mechanisms and responses to hypoxia has been described for the respiratory system (hyperventilation, improvement in respiratory function and increase in lung diffusion capacity), in the cardiovascular system (increase in basal heart rate, peripheral vasodilation, normalization of blood pressure or cardiovascular protection), in cellular and metabolic phenomena (angiogenesis, insulin sensitivity enhancement, enzymatic activation or mitochondrial biogenesis), as well as on body weight management (hypoleptinemia, adrenergic system activation, appetite suppression or serotonin production).…”

Impact of intermittent hypoxia and exercise on blood pressure and metabolic features from obese subjects suffering sleep apnea-hypopnea syndrome

“…In this context, intermittent hypoxia may be a tool to manage some obesity-associated risk factors such as cardiovascular disease [32]. Normoxic and hypoxic training have been related to important improvements in specific metabolic risk factors and exercise capacity [50]. Moreover, the stimulus of intermittent normobaric hypoxia, which has been cited as an additive cardioprotective effect, may have relevant clinical implications affecting insulin sensitivity or inflammation [21], while an enhancement of leptin secretion under a hypoxia milieu may also be involved [50].…”

Intermittent hypoxia training protects cerebrovascular function in Alzheimer's disease

“…IHT was found to augment the effects of exercise on obesity. 190 The beneficial effects of adaptation to hypoxia in ischemic cardiac disease have been recognized for many years. 179,180,191 In 1993, Ehrenbourg and Gorbachenkov described favorable effects of IHT on cardiac rhythm disorders in patients with neurocirculatory dysfunction.…”