Combined Physical-cognitive Exercise and Dietary Intervention for Postmenopausal Obese Women

February 12, 2023 updated by: Somporn Sungkarat, Chiang Mai University

A Randomized Controlled Trial Investigating the Effects of Combined Physical-cognitive Exercise and Dietary Intervention on Cognitive Performance and Changes in Blood Biomarkers of Postmenopausal Obese Women

This study aims to examine the effects of dietary intervention combined with physical-cognitive exergaming on cognitive performance and circulating biomarkers of obese postmenopausal women. It is hypothesized that participants will demonstrate significant improvement in cognitive performance and circulating biomarkers after participating in this combined program compared to baseline and the dietary and control groups.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

An association between obesity and cognitive impairment has been consistently reported. The risk of having dementia in later life is about 74% higher for middle-aged obese individuals than those with normal BMI. Estrogen deprivation has also been found to impair cognition. Thus, obese postmenopausal women are likely to be at risk of having cognitive impairment. The common recommendation for obesity management is dietary and exercise intervention. Research evidence has demonstrated that either dietary intervention or moderate-vigorous intensity exercise enhance cognitive function in obese adults. This study aims to examine the effects of 12-week home-based dietary intervention combined with physical-cognitive exergaming on cognitive performance and circulating biomarkers of obese postmenopausal women through a randomised controlled trial. Participants will be randomly assigned to one of the four groups: 1) dietary intervention 2) combined physical-cognitive exergaming, 3) dietary intervention combined with physical-cognitive exergaming, and 4) control group. Outcome measures including cognitive performance (i.e. executive function, episodic memory, attention, language, and global cognition), circulating biomarkers (i.e. BDNF level, metabolic parameters, inflammation markers, and adiponectin levels) as well as physical performance will be determined at baseline and after 12-week intervention. Findings from this study may offer a feasible and effective intervention program to improve cognitive performance along with its responsible circulating biomarkers in obese postmenopausal women.

Study Type

Interventional

Enrollment (Actual)

92

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Thailand
      • Chiang Mai, Thailand, 50200
        • Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

45 years to 59 years (ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • obese women (body mass index (BMI) ≥ 25 kg/m2 with waist-to-hip ratio (WHR) ≥ 0.80)
  • post-menopausal (self-reported menstrual characteristics (last menstruation > 1 year) or confirmed by blood follicular stimulating hormone (FSH) level ( > 20 IU/L) and estradiol level ( ≤ 30 pg/ml))
  • sedentary lifestyle (exercise < 1 hr./wk.)
  • normal range of the Mental State Examination T10 (MSET10) score
  • at least 6 years of education
  • own a mobile phone that supports application platform
  • able to comply with the study schedule and procedures

Exclusion Criteria:

  • have medical conditions that would be unsafe to exercise or have been diagnosed with neurological conditions (e.g. Parkinson's disease, stroke, multiple sclerosis) that affect cognition and mobility
  • have weight variation ( > 5 kilogram in 3 months)
  • have other dietary restrictions (e.g. vegetarianism and veganism)
  • have depressive symptoms defined as a score ≥ 11 on Hospital Anxiety Depression Scale (HADS)
  • have an uncorrected visual or hearing impairment
  • receive hormonal replacement therapy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: OTHER
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
ACTIVE_COMPARATOR: Dietary intervention
Participants will consume a self-selected diet with 25-75% of estimated baseline energy requirements for 2 days/week (fast day) along with ad libitum for 5 days/week (feed day).
Behavioral: Dietary intervention
Intermittent Fasting (IF) [self-selected diet with 25-75% of estimated baseline energy requirements for 2 days/week (fast day) along with ad libitum for 5 days/week (feed day)].
ACTIVE_COMPARATOR: Physical-cognitive intervention
Participants will perform home-based physical-cognitive training for 60 minutes per session, 3 session a week.
Behavioral: Physical-cognitive intervention
Physical-cognitive exercise [60-70% of heart rate maximum for aerobic and 60-70% of 1 repetition maximum, 8-12 repetitions/set, 3 sets of each exercise for resistance exercise; memory, attention, and executive function for cognition], 60 minutes per session, 3 sessions per week for 12 weeks (36 sessions)].
EXPERIMENTAL: Physical-cognitive with dietary intervention
Participants will receive both dietary intervention and physical-cognitive training same as those in the dietary and physical-cognitive intervention groups.
Behavioral: Dietary intervention combined with physical-cognitive exergaming
Intermittent Fasting (IF) [self-selected diet with 25-75% of estimated baseline energy requirements for 2 days/week (fast day) along with ad libitum for 5 days/week (feed day)] combined with physical-cognitive exercise [60-70% of heart rate maximum for aerobic and 60-70% of 1 repetition maximum, 8-12 repetitions/set, 3 sets of each exercise for resistance exercise; memory, attention, and executive function for cognition], 60 minutes per session, 3 sessions per week for 12 weeks (36 sessions)].
NO_INTERVENTION: Control
Participants in the control group will be encouraged to continue their activities and calorie intakes as they usually would.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
change from baseline time to complete Trail Making B-A at 12 weeks
Time Frame: 12 weeks
Time to complete Trail Making B and A will be recorded in seconds. The difference between time to complete Trail B and A will be used to index the task switching ability, a subdomain of executive function. Smaller differences between B-A indicate better switching ability.
12 weeks
change from baseline Stroop Color and Word score at 12 weeks
Time Frame: 12 weeks
In Stroop Color and Word test, the number of items correctly identified in 45 seconds in each condition (i.e. word, color, color-word) will be recorded. Then the predicted score will be calculated. Score will be obtained from the different between the color-word and predicted scores. Lower scores indicate greater difficulty in inhibiting interference.
12 weeks
change from baseline Logical Memory score at 12 weeks
Time Frame: 12 weeks
In Logical Memory test, participants will be instructed to listen carefully to two stories and remember their contents. After a 30-delay, they will be asked to freely recall the passages (recall) and respond yes or no to the given questions (recognition). The possible scores are 0-75. Higher scores indicate better episodic memory.
12 weeks
change from baseline Brain-derived neurotrophic factor (BDNF) level at 12 weeks
Time Frame: 12 weeks
Level of plasma BDNF will be determined before and after the intervention.
12 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
change from baseline Montreal Cognitive Assessment (MoCA) score at 12 weeks
Time Frame: 12 weeks
The Montreal Cognitive Assessment will be used to index global cognitive function. The possible scores are 0-30. Higher scores indicate better cognitive function.
12 weeks
change from baseline Verbal Fluency score at 12 weeks
Time Frame: 12 weeks
Category fluency subtest (naming test) of Verbal Fluency will be used. Participants will be asked to produce as many words as possible in 60 seconds. Higher scores indicate better language ability.
12 weeks
change from baseline Digit Span score at 12 weeks
Time Frame: 12 weeks
In Digit Span test, lists of numbers will be presented orally to participants. They are asked to repeat the numbers immediately in ascending (forward) or reverse (backward) numerical order. The possible scores are 0-28. Higher scores indicate better attention.
12 weeks
change from baseline plasma adiponectin levels at 12 weeks
Time Frame: 12 weeks
Level of plasma adiponectin will be determined before and after intervention.
12 weeks
change from baseline plasma Interleukin 6 (IL-6) levels at 12 weeks
Time Frame: 12 weeks
Level of plasma IL-6 will be determined before and after intervention.
12 weeks
change from baseline insulin resistance levels at 12 weeks
Time Frame: 12 weeks
Level of insulin resistance will be assessed using the homeostasis model assessment (HOMA-IR) index [fasting glucose (mg/dL) X fasting insulin (µU/mL) / 405].
12 weeks
change from baseline Six-minute walk distance at 12 weeks
Time Frame: 12 weeks
The distance (in meters) participants walked in 6 minutes will be determined. Longer distance indicates better cardiorespiratory fitness.
12 weeks
change from baseline 30 seconds Chair Stand Test at 12 weeks
Time Frame: 12 weeks
The number of repetitions participants could perform sit-to-stand will be recorded. Higher number of repetitions indicates greater lower-body strength.
12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Chiang Mai University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

September 26, 2021

Primary Completion (ACTUAL)

December 3, 2022

Study Completion (ACTUAL)

December 5, 2022

Study Registration Dates

First Submitted

February 5, 2021

First Submitted That Met QC Criteria

February 22, 2021

First Posted (ACTUAL)

February 24, 2021

Study Record Updates

Last Update Posted (ESTIMATE)

February 14, 2023

Last Update Submitted That Met QC Criteria

February 12, 2023

Last Verified

February 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • AMS-PT CMU 2564

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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