Effekten af pædagogisk ernæring og motion på regulering af appetit gennem exosomer hos type 2-diabetikere (APETEX)
Effektiviteten af en ernæringsuddannelsesstrategi og fysisk trænings rolle i reguleringen af appetit og kropssammensætning gennem profilen af exosomer hos type 2-diabetikere (APETEX-projektet)
Vi antager, at kombinationen af en ernæringsuddannelsesintervention med et fysisk træningsprogram forbedrer appetitregulering medieret af exosomer hos personer med Type 2 Diabetes Mellitus (T2DM), hvilket fører til bedre glykæmi/insulinæmi, reduktion af kropsfedtmasse og livskvalitet.
Projektet er et randomiseret kontrolleret klinisk forsøg med 120 deltagere med T2DM og fedme, som har til formål at bestemme effektiviteten af et ernæringsuddannelsesprogram og hvilken rolle fysisk træningstype spiller på sundhedsrelaterede variabler. Deltagerne vil være af begge køn med en alder mellem 40 og 55 år, der tilhører provinsen Cádiz. Designet har to 12-ugers interventioner; hovedfaktoren har 2 niveauer: deltagere, der modtager ernæringsuddannelsen (EDU) og kontroller (CG); den anden faktor har 3 niveauer: høj intensitet intervaltræning (HIIT), moderat intensitet kontinuerlig træning (MICT) og kontrol (INACT). Derfor vil deltagerne blive randomiseret i 6 grupper (n=20), justeret efter køn (≈50% i hver gruppe): EDU+HIIT, EDU+MICT, EDU+INACT, CG+HIIT, CG+MICT, CG+INACT .
Resultatvariablerne, som vil blive målt før og efter interventionen, vil omfatte: vurdering af kostindtag, vurdering af fysisk aktivitet, livskvalitet, blodprøver, følelsesmæssig reaktivitet på madbilleder, blodtryk, vurdering af appetit, kropssammensætning og væsker, basal stofskifte, maksimal fedtoxidationstest og kardiorespiratorisk kondition.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Cirka 500 millioner mennesker har Type 2 Diabetes Mellitus (T2DM) i 2018, og det forventes at stige mellem 20% og 50% i løbet af de næste 10 år. T2DM kaldes også ikke-insulinafhængig eller voksendebut, og det skyldes kroppens ineffektive brug af insulin, der er resultatet af overskydende kropsvægt og fysisk inaktivitet. Diabetes er den 7 førende dødsårsag ved at øge risikoen for hjerte-kar-sygdomme og andre sygdomme, hvoraf mange (43%) opstår for tidligt og stort set kan forebygges gennem vedtagelse af politikker til at skabe understøttende miljøer for en sund livsstil.
Derfor er forbedring af implementeringen af sundhedsrelaterede uddannelsesprogrammer gennem ernæring og fysisk træning et nøgleværktøj til adfærdsændring. Kombinationen af fysisk træning og ernæringsrådgivning er kendt for at forbedre indvirkningen på både kropssammensætning og sundhed i den almindelige befolkning og i T2DM; dog er overholdelse af disse programmer kompromitteret, og selvom hele indgrebet udføres af patienten, kan vi finde ikke-responderere. De underliggende mekanismer, der bestemmer virkningen af uddannelsesprogram fokuseret på sund livsstil, kunne forklares ved molekylære og fysiologiske reaktioner på interventionerne. I denne forstand kan hormoner, der regulerer appetit og motion, påvirke madpræferencer, beslutningstagning og motions indvirkning på appetitten, og dermed ændre kostindtaget, kropssammensætning og sundhed.
Exosomer (EX) er blevet betragtet som nye og potente vehikler for intercellulær kommunikation og udøver de bemærkelsesværdige virkninger på lipidmetabolisme, herunder syntese, transport og nedbrydning af lipidet. EX er blevet foreslået som en mekanisme for de fysiologiske virkninger af fysisk træning hos patienter med T2DM.
Ifølge tidligere videnskabelig forskning antager vi, at kombinationen af en ernæringsuddannelsesintervention med et fysisk træningsprogram forbedrer appetitregulering medieret af exosomer hos mennesker med T2DM, hvilket fører til bedre glykæmi/insulinæmi niveauer, reduktion af kropsfedtmasse og livskvalitet.
Projektet er et randomiseret kontrolleret klinisk forsøg med 120 deltagere med T2DM og fedme, som har til formål at bestemme effektiviteten af et ernæringsuddannelsesprogram og hvilken rolle fysisk træningstype spiller på sundhedsrelaterede variabler. Deltagerne vil være af begge køn med en alder mellem 40 og 55 år, der tilhører provinsen Cádiz. Designet har to 12-ugers interventioner; hovedfaktoren har 2 niveauer: deltagere, der modtager ernæringsuddannelsen (EDU) og kontroller (CG); den anden faktor har 3 niveauer: høj intensitet intervaltræning (HIIT), moderat intensitet kontinuerlig træning (MICT) og kontrol (INACT). Derfor vil deltagerne blive randomiseret i 6 grupper (n=20), justeret efter køn (≈50% i hver gruppe): EDU+HIIT, EDU+MICT, EDU+INACT, CG+HIIT, CG+MICT, CG+INACT .
Resultatvariablerne, som vil blive målt før og efter interventionen, vil omfatte: vurdering af kostindtag, vurdering af fysisk aktivitet, livskvalitet, blodprøver, følelsesmæssig reaktivitet på madbilleder, blodtryk, vurdering af appetit, kropssammensætning og væsker, basal stofskifte, maksimal fedtoxidationstest og kardiorespiratorisk kondition.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Juan Corral Pérez, MsC
- Telefonnummer: 34690223121
- E-mail: juan.corral@uca.es
Undersøgelse Kontakt Backup
- Navn: Cristina Casals Vázquez, PhD
- Telefonnummer: 34677180597
- E-mail: cristina.casals@uca.es
Studiesteder
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Cadiz
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Puerto Real, Cadiz, Spanien, 11510
- Science of Education Faculty
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Ikkeryger
- Ikke-alkoholholdig (<3 standarddrikke pr. dag)
- Body mass index >25 kg/m opretholder de sædvanlige kostmønstre uden en kropsmassereduktion på mere end 2 % i løbet af de sidste 6 måneder
- Ikke at være insulinafhængig
- Fravær af skade, sygdom eller handicap eller anden kendt medicinsk tilstand, som kan påvirke evnen til at deltage i fysisk træningstest
- Fravær af kardiovaskulær sygdom (angina, perifer eller cerebrovaskulær sygdom osv.).
- Fravær af neurologiske og psykiatriske sygdomme.
- Fravær af luftvejssygdomme (pulmonal hypertension, KOL osv.).
- Fravær af andre stofskiftesygdomme (hyper/hypo parathyroidisme, hyper/hypothyroidisme, Cushings sygdom, Type 1 diabetes osv.)
- Fravær af aktiv inflammatorisk tarmsygdom
- Fravær af nyresygdom
- Fravær af tumorer
- Fravær af koagulationsdysfunktion
- Ikke under behandling med medicin k kendt for at påvirke glukosemetabolismen, nylig steroidbehandling (inden for 6 måneder) eller hormonsubstitutionsterapi
- Kunne forstå en kommunikation på spansk eller engelsk.
Ekskluderingskriterier:
- De deltager ikke i mere end 2 eller 4 på hinanden følgende sessioner med henholdsvis ernæringsrådgivning eller fysisk træning.
- De mister mere end 4 eller 6 sessioner i alt af henholdsvis ernæringsrådgivning eller fysisk træning.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Aktiv komparator: Moderat intensitet kontinuerlig træning (ND-MICT)
Deltagere, der ikke modtog ernæringsmæssig intervention, men som var tilmeldt et moderat intensivt kontinuerligt træningsprogram.
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Participants assigned to the MICT completed 3 weekly sessions, with 1-2 days of rest between sessions, on a cycle ergometer for 12 weeks.
The MICT program consisted of 50 minutes of continuous pedaling at an intensity approximately 10% above the lactate threshold, with cadence maintained between 60-80 rpm.
The training load (TL) was increased by 10% if these two conditions were met: 1) no increase of at least 2 beats of heart rate from minute 20 to minute 40 of the training session, and 2) lactate levels below 2 mmol/L in minute 48 of the session.
The TL for the first session was determined by an adjustment test consisting of an incremental test with five consecutive 10-minute phases at a constant cadence (60-80 RPM) from 90% to 130% of the ventilatory threshold power, calculated from the FatOx test data, with 10% increments in each step.
The TL was determined by the phase in which HR increased by ≥ 3 beats between phases and blood lactate levels increased by ≥ 1 mmol/L between phases.
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Aktiv komparator: Højintensiv intervaltræning (ND-HIIT)
Deltagere, der ikke modtog ernæringsmæssig intervention, men var tilmeldt et højintensitetsintervaltræningsprogram.
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Participants assigned to the HIIT completed 3 weekly sessions, with 1-2 days of rest between sessions, on a cycle ergometer for 12 weeks.
The training load (TL) was determined from an incremental test until volitional exhaustion with one-minute work intervals (from 85% to 165% of maximal power output during VO2max test [Wmax] and with 10% increments) separated by 1.5-minute rest periods (at 20% Wmax).
The program consisted of a 3 minutes warm-up with the first 2 minutes at 20% and last minute at 40% of the TL, followed by 10 series of 1 min duration at 90% of TL, with 1 minute of rest between sets at 20% of TL and ending with 2 minutes of cool-down at 20% of TL (estimated total time of the session: 25 minutes).
A 5% increase in workload was applied when, for two consecutive sessions, the first three intervals failed to exceed 85% of maximal HR and at least five did not reach 90% of maximal HR.
Participants were asked to maintain a cadence above 80RPM.
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Eksperimentel: Ernæringsmæssig Intervention Højintensiv intervaltræning (D-HIIT)
Deltagere, der modtog ernæringsmæssig intervention og blev tilmeldt et højintensivt intervaltræningsprogram.
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The nutritional intervention was conducted through biweekly (± 3 days) in-person consultations with a nutritionist or dietitian.
Firstly, the patient's diet was analyzed.
Then, participants were guided to follow a mildly calorie-restricted diet (-250-500 kcal/day deficit), with the primary goal of achieving a 5 % reduction in body weight and reducing blood glucose levels.
Meal plans were created using Nutrium® software , personalized to each participant's lifestyle and food preferences, and reviewed at each biweekly consultation.
The dietary plan included at least 4 or 5 meals per day, ensuring a well-distributed intake of carbohydrates, a balanced distribution of macro- and micronutrients, and the inclusion of foods rich in prebiotics and probiotics.
Moreover, some suggestions about the combination of foods and culinary techniques were provided.
Only one session through the intervention was allowed to be attended telephonically.
Participants assigned to the HIIT completed 3 weekly sessions, with 1-2 days of rest between sessions, on a cycle ergometer for 12 weeks.
The training load (TL) was determined from an incremental test until volitional exhaustion with one-minute work intervals (from 85% to 165% of maximal power output during VO2max test [Wmax] and with 10% increments) separated by 1.5-minute rest periods (at 20% Wmax).
The program consisted of a 3 minutes warm-up with the first 2 minutes at 20% and last minute at 40% of the TL, followed by 10 series of 1 min duration at 90% of TL, with 1 minute of rest between sets at 20% of TL and ending with 2 minutes of cool-down at 20% of TL (estimated total time of the session: 25 minutes).
A 5% increase in workload was applied when, for two consecutive sessions, the first three intervals failed to exceed 85% of maximal HR and at least five did not reach 90% of maximal HR.
Participants were asked to maintain a cadence above 80RPM.
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Ingen indgriben: ND-INACT
Participants who did not receive either nutritional intervention or an exercise program.
They were instructed to maintain their normal life habits with respect to physical activity and diet.
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Aktiv komparator: Nutritional Intervention (D-INACT)
Participants who received nutritional intervention but not an exercise program.
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The nutritional intervention was conducted through biweekly (± 3 days) in-person consultations with a nutritionist or dietitian.
Firstly, the patient's diet was analyzed.
Then, participants were guided to follow a mildly calorie-restricted diet (-250-500 kcal/day deficit), with the primary goal of achieving a 5 % reduction in body weight and reducing blood glucose levels.
Meal plans were created using Nutrium® software , personalized to each participant's lifestyle and food preferences, and reviewed at each biweekly consultation.
The dietary plan included at least 4 or 5 meals per day, ensuring a well-distributed intake of carbohydrates, a balanced distribution of macro- and micronutrients, and the inclusion of foods rich in prebiotics and probiotics.
Moreover, some suggestions about the combination of foods and culinary techniques were provided.
Only one session through the intervention was allowed to be attended telephonically.
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Eksperimentel: Nutritional Intervention Moderate-intensity continuous training (D-MICT)
Participants who received nutritional intervention and were enrolled in a moderate-intensity continuous training exercise program.
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The nutritional intervention was conducted through biweekly (± 3 days) in-person consultations with a nutritionist or dietitian.
Firstly, the patient's diet was analyzed.
Then, participants were guided to follow a mildly calorie-restricted diet (-250-500 kcal/day deficit), with the primary goal of achieving a 5 % reduction in body weight and reducing blood glucose levels.
Meal plans were created using Nutrium® software , personalized to each participant's lifestyle and food preferences, and reviewed at each biweekly consultation.
The dietary plan included at least 4 or 5 meals per day, ensuring a well-distributed intake of carbohydrates, a balanced distribution of macro- and micronutrients, and the inclusion of foods rich in prebiotics and probiotics.
Moreover, some suggestions about the combination of foods and culinary techniques were provided.
Only one session through the intervention was allowed to be attended telephonically.
Participants assigned to the MICT completed 3 weekly sessions, with 1-2 days of rest between sessions, on a cycle ergometer for 12 weeks.
The MICT program consisted of 50 minutes of continuous pedaling at an intensity approximately 10% above the lactate threshold, with cadence maintained between 60-80 rpm.
The training load (TL) was increased by 10% if these two conditions were met: 1) no increase of at least 2 beats of heart rate from minute 20 to minute 40 of the training session, and 2) lactate levels below 2 mmol/L in minute 48 of the session.
The TL for the first session was determined by an adjustment test consisting of an incremental test with five consecutive 10-minute phases at a constant cadence (60-80 RPM) from 90% to 130% of the ventilatory threshold power, calculated from the FatOx test data, with 10% increments in each step.
The TL was determined by the phase in which HR increased by ≥ 3 beats between phases and blood lactate levels increased by ≥ 1 mmol/L between phases.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Glycated hemoglobin
Tidsramme: Pre and Post the 12-week Intervention
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Glycated hemoglobin (HbA1c, %) was measured using high-performance liquid chromatography (HPLC) with the automated ADAMS™ HA-8180V analyzer (ARKRAY, Kyoto, Japan).
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Pre and Post the 12-week Intervention
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Vurderede ændringer i insulinresistens: HOMA-IR
Tidsramme: Før og efter 12-ugers intervention
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Insulinresistens blev estimeret ved hjælp af Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), beregnet som fastende insulin (µU/mL) ganget med fastende glukose (mg/dL) divideret med 405.
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Før og efter 12-ugers intervention
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Vurderede ændringer i insulinsensitivitet: Matsuda-indeks
Tidsramme: Før og efter 12-ugers intervention
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Hele krops insulinfølsomhed blev estimeret gennem Matsuda-indekset, beregnet som 10.000 / √[(fastende glukose (mg/dL) × fastende insulin (µU/mL)) × (gennemsnitlig glukose under Oral Glukose Tolerance Test (mg/dL) × gennemsnitlig insulin under Oral Glukose Tolerance Test (µU/mL))].
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Før og efter 12-ugers intervention
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Vurderede ændringer i Insulinfølsomhed: Quicki
Tidsramme: Før og efter 12-ugers intervention
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Insulinfølsomhed blev estimeret gennem den Kvantitative Insulinfølsomheds Kontrolindeks (QUICKI), beregnet som 1 / [log(fastende insulin (µU/mL)) + log(fastende glukose (mg/dL))].
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Før og efter 12-ugers intervention
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Vurderede ændringer i Body Mass Index
Tidsramme: Før og efter 12-ugers intervention
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Body Mass Index (BMI) i kilogram per kvadratmeter (kg/m²) blev beregnet som kropsvægt (kg) divideret med højden i anden potens (m²).
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Før og efter 12-ugers intervention
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Vurderede ændringer i antropometri: Omkredse
Tidsramme: Pre og Post 12-ugers intervention
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Taljemål (cm) blev målt på midtpunktet mellem den nederste laterale margin af den 10. ribben og iliac-kammen, vinkelret på kroppens længdeakse.
Maveomkreds (cm) blev målt på niveau med navlen, vinkelret på kroppens længdeakse.
Hofteomkreds (cm) blev målt på niveau med den største posteriore fremspring på ballerne, vinkelret på kroppens længdeakse.
Låromkreds (cm) blev målt på midtpunktet mellem trochanter major og den laterale tibia condyle.
Alle målinger blev udført med deltageren stående oprejst og afslappet.
Hver måling blev foretaget to gange, og en tredje måling blev udført, hvis forskellen oversteg 1%.
Gennemsnittet af de to mest ens målinger blev registreret.
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Pre og Post 12-ugers intervention
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Vurderede ændringer i antropometri: Talje-hofte-forhold
Tidsramme: Før og efter 12-ugers intervention
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Talje-hofte-forholdet (WHR) blev beregnet som taljeomkreds (cm) divideret med hofteomkreds (cm).
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Før og efter 12-ugers intervention
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Vurderede ændringer i maksimal fedtforbrænding
Tidsramme: Før og efter 12-ugers interventionen
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Den maksimale fedtforbrænding blev bestemt gennem en gradvis test på en cykelergometer (Lode Excalibur, Groningen, Holland).
Gasudveksling (VO2, VCO2, RER) blev registreret ved hjælp af indirekte kalorimetri (Jaeger MasterScreen CPX®), og hjertefrekvens blev målt kontinuerligt under testen med Polar Team 2 (Polar Electro Inc., Lake Success, NY).
Testen bestod af en startbelastning på 15W med stigninger på 15W hver 3. minut, indtil respirationskvotienten nåede en stabil værdi på 1.
Gennem hele testen blev en kadence på 60 omdr./min. opretholdt.
Fedtforbrændingsværdier (g/min) blev estimeret fra ilt- og kulhydratdata gennemsnitligt over det sidste minut af hvert 3-minutters trin ved hjælp af Frayns støkiometriske ligning, hvorefter den højeste fedtforbrændingsværdi blev registreret.
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Før og efter 12-ugers interventionen
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Vurderede ændringer i relativ intensitet af maksimal fedtforbrænding under træning
Tidsramme: Før og efter den 12-ugers intervention
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Den relative intensitet af maksimal fedtforbrænding (FatMax) afspejler træningsintensiteten (% af maksimalt iltoptag (VO2max)), hvor fedtforbrændingen når sit højdepunkt.
FatMax blev bestemt fra den graduerede maksimale fedtforbrændingstest (MFO) på en cykelergometer (Lode Excalibur, Groningen, Holland).
Testen startede ved 15 W med 15 W forøgelser hvert 3. minut, indtil respiratorisk kvotient nåede 1, mens der blev opretholdt 60 omdrejninger pr. minut.
Gasudveksling (VO2, VCO2, RER) blev målt via indirekte kalorimetri (Jaeger MasterScreen CPX®), og pulsen blev kontinuerligt overvåget (Polar Team 2, Polar Electro, NY).
Efter MFO-testen blev en anden trinstest udført med 15 W/min forøgelser indtil udmattelse fra den sidste belastning af MFO-testen for at bestemme VO2max.
Fedtforbrændingshastigheder (g/min) blev beregnet ved hjælp af Frayn-ligningen og plottet mod relativ VO2 (%VO2max).
Den VO2, der svarer til maksimal fedtforbrænding, blev identificeret som FatMax.
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Før og efter den 12-ugers intervention
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Vurderede ændringer i kardiorespiratorisk kondition
Tidsramme: Før og efter den 12-ugers intervention
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Maksimalt iltforbrug (VO2max, ml/min) blev vurderet ved hjælp af en trinvis test på en cykelergometer (Lode Excalibur) efter testen for maksimal fedtforbrænding (MFO). Gasskifte (VO2, VCO2 og RER) blev registreret ved hjælp af en indirekte kalorimeter (Jaeger MasterScreen CPX®), og hjertefrekvens blev målt kontinuerligt under testen med Polar Team 2 (Polar Electro Inc). Efter en 5-minutters hvile efter MFO-testen startede VO2max-fasen ved den sidste arbejdsbelastning, der blev opnået i MFO-trinnet, og steg med 15 W hvert minut, mens en pedalhastighed på 70-90 rpm blev opretholdt indtil frivillig udmattelse. Maksimal indsats blev bekræftet, når mindst tre af følgende kriterier blev opfyldt: et VO2-plateau (VO2-tidshældning <0,05 L·min-1 i løbet af de sidste 30 s), ≥90 % af aldersforudsagt maksimal hjertefrekvens, en respiratorisk udvekslingsrate (RER) ≥1,10, opfattet anstrengelse på 8-10 på Borg-skalaen og frivillig træthed. Hvis færre end tre kriterier blev opnået, blev VO2-værdien registreret som VO2peak.
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Før og efter den 12-ugers intervention
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Vurderet højde
Tidsramme: Før og efter 12-ugers intervention
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Højde (meter, m) blev målt ved hjælp af en vægmonteret stadiometer (TANITA-LEICESTER HR-001, Tanita Corp., Tokyo, Japan) med deltagerne stående i henhold til producentens instruktioner.
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Før og efter 12-ugers intervention
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Assessed changes in Body Weight
Tidsramme: Pre and Post the 12-week intervention
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Body weight (kilograms, kg) was measured using a multifrequency bioelectrical impedance device (TANITA-MC780MA, Tanita Corp., Tokyo, Japan) after at least 8 hours of fasting.
Participants were instructed the day before testing to maintain their usual lifestyle, refrain from alcohol or caffeine for 24 hours, and avoid vigorous physical activity for at least 48 hours.
Participants wore light clothing and were asked to urinate immediately before the measurement.
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Pre and Post the 12-week intervention
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Assessed changes in Fat Mass (kilograms of Fat Mass)
Tidsramme: Pre and Post 12-week Intervention
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Fat mass (kilograms, kg) was estimated using multifrequency bioelectrical impedance with an 8-electrode device (TANITA-MC780MA, Tanita Corp., Tokyo, Japan) after at least 8 hours of fasting.
Participants were instructed the day before testing to maintain their usual lifestyle, refrain from alcohol or caffeine for 24 hours, and avoid vigorous physical activity for at least 48 hours.
Participants wore light clothing and were asked to urinate immediately before the measurement.
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Pre and Post 12-week Intervention
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Assessed changes in Fat Mass (percentage of Fat Mass)
Tidsramme: Pre and Post 12-week Intervention
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Fat mass (percentage of total body weight, %) was estimated using multifrequency bioelectrical impedance with an 8-electrode device (TANITA-MC780MA, Tanita Corp., Tokyo, Japan) after at least 8 hours of fasting.
Participants were instructed the day before testing to maintain their usual lifestyle, refrain from alcohol or caffeine for 24 hours, and avoid vigorous physical activity for at least 48 hours.
Participants wore light clothing and were asked to urinate immediately before the measurement.
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Pre and Post 12-week Intervention
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Assessed changes in Fat-free Mass (kilograms of Fat-free Mass)
Tidsramme: Pre and Post 12-week Intervention
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Fat-free mass (kilograms, kg) was estimated using multifrequency bioelectrical impedance with an 8-electrode device (TANITA-MC780MA, Tanita Corp., Tokyo, Japan) after at least 8 hours of fasting.
Participants were instructed the day before testing to maintain their usual lifestyle, refrain from alcohol or caffeine for 24 hours, and avoid vigorous physical activity for at least 48 hours.
Participants wore light clothing and were asked to urinate immediately before the measurement.
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Pre and Post 12-week Intervention
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Assessed changes in Fat-free Mass (percentage of Fat-free Mass)
Tidsramme: Pre and Post 12-week Intervention
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Fat-free mass (percentage of total body weight, %) was estimated using multifrequency bioelectrical impedance with an 8-electrode device (TANITA-MC780MA, Tanita Corp., Tokyo, Japan) after at least 8 hours of fasting.
Participants were instructed the day before testing to maintain their usual lifestyle, refrain from alcohol or caffeine for 24 hours, and avoid vigorous physical activity for at least 48 hours.
Participants wore light clothing and were asked to urinate immediately before the measurement.
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Pre and Post 12-week Intervention
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Assessed changes in Anthropometry: Skinfold thickness
Tidsramme: Pre and Post 12-week Intervention
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Thigh skinfold thickness was measured at two-thirds of the distance from the iliospinale point (the lowest part of the anterior superior iliac spine) to the superolateral border of the patella, over the belly of the vastus lateralis muscle.
Measurements were taken on the dominant leg.
Two measurements were obtained, and a third was taken if the difference between the first two exceeded 1mm.
The mean of the two most similar records was recorded.
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Pre and Post 12-week Intervention
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Assessed changes in Glucose concentration
Tidsramme: Pre and Post the 12-week intervention
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Glucose concentration (mg/dL) was measured from blood samples collected from the antecubital vein after at least 8 hours of fasting and at 30, 60, 90, 120, 150 and 180 minutes after the ingestion of 75 grams of glucose (Nuter-tec, 75 g/200 mL, orange flavor).
Participants were instructed the day before testing to maintain their usual lifestyle, refrain from alcohol or caffeine consumption for 24 hours, and avoid vigorous physical activity for at least 48 hours.
Blood samples were centrifuged and plasma was analysed using the colorimetric method performed on the Alinity CI system (Abbott Laboratories, Abbott Park, IL, USA).
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Pre and Post the 12-week intervention
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Assessed changes in Insulin concentration
Tidsramme: Pre and Post the 12-week intervention
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Insulin concentration (µU/mL) was measured from blood samples collected from the antecubital vein into serum separator tubes after at least 8 hours of fasting and at 30, 60, 90, 120, 150 and 180 minutes after the ingestion of 75 grams of glucose (Nuter-tec, 75 g/200 mL, orange flavor).
Participants were instructed the day before testing to maintain their usual lifestyle, refrain from alcohol or caffeine consumption for 24 hours, and avoid vigorous physical activity for at least 48 hours.
Blood samples were centrifuged at 4000 rpm for 7 minutes, and serum was analyzed.
Insulin concentrations were determined by chemiluminescent immunoassays performed on the Alinity CI system (Abbott Laboratories, Abbott Park, IL, USA).
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Pre and Post the 12-week intervention
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Assessed changes in Appetite assessment.
Tidsramme: Pre and Post the 12-week intervention
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Since appetite feelings modulate nutritional behavior, evaluating appetite among the intervention groups can improve the study's quality from a comprehensive perspective.
After an 8-10 hour fasting period, a Visual Analogue Scale (VAS) was completed to measure the participant's morning appetite.
Likewise, they were evaluated 90 minutes into the Oral Glucose Tolerance Test (OGTT) and at the end of it.
The VAS is a valid measurement instrument for assessing the feeling of appetite.
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Pre and Post the 12-week intervention
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Assessed changes in task of emotional reactivity to food images
Tidsramme: Pre and Post the 12-week intervention
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Emotional reactivity to food images was measured using a high-density 128-channel EEG system (HydroCel Sensor Net, EGI, Inc.) during both resting state and a visual-attentional cognitive task.
EEG caps were fitted according to standardized landmarks (GND at the forehead, REF at the vertex, lateral electrodes at the eyebrows and top of ears, posterior electrode at the occipital bone), with impedance checked and adjusted by pipetting or gentle repositioning.
Participants were seated 60-70 cm from a 15'' monitor in dim lighting, with eyes aligned to the center of the screen.
A 4-minute eyes-open resting-state recording was conducted to assess baseline alpha activity (8-14 Hz).
The experimental task presented images in blocks with breaks, including high- and low-calorie foods, non-food controls, and, in a separate task, images categorized as beneficial or harmful for gut microbiota based on fiber, prebiotic/probiotic content, caloric density, fat, and meat content.
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Pre and Post the 12-week intervention
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Assessed changes in Appetite hormones
Tidsramme: Pre and Post the 12-week intervention
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Appetite-regulating hormones were assessed from blood samples collected after an 8-10-hour overnight fast, with participants seated at rest for 15 minutes.
Fasting samples were drawn from the antecubital vein using EDTA tubes for appetite hormones and CAT tubes for serum cortisol.
EDTA tubes were inverted, centrifuged at 1500 × g for 15 minutes at 4 °C, and plasma aliquoted into 500 µL tubes with 5 µL protease inhibitors, then stored at -80 °C.
Ghrelin, leptin, GLP-1, and GIP were measured fasting and 90 minutes post-75 g glucose using the MILLIPLEX® Metabolic Hormone Panel V3 with a Luminex® xMap system; intra- and inter-assay CVs <10% and <20%.
Cortisol from CAT tubes allowed to clot 30 minutes, centrifuged at 2000 × g for 10 minutes at 4 °C, aliquoted into 200 µL tubes, stored at -80 °C, and quantified using one-step CMIA on Alinity CI; emitted light inversely reflects cortisol, range 1-59.8 µg/dL, intra- and inter-assay variation <10%.
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Pre and Post the 12-week intervention
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Assessed changes in Plasma Exosomal miRNA expression
Tidsramme: Pre and Post the 12-week intervention
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Fasting blood samples (fast 8-10 hours) were centrifuged (1500×g, 15 min, 4 °C) and the resulting plasma was divided into aliquots (500 µL) and stored at -80°C.
Exosomes were isolated from 600 µL of plasma using the miRCURY Exosome Kits (Qiagen, Netherlands).
Total RNA was extracted from 200 μL of exosome samples using the miRNeasy Serum/Plasma Advanced Kit (Qiagen).
Reverse transcription was performed with the miRCURY LNA RT Kit, incubated at 42°C for 60 min, 95°C for 5 min, and stored at -20°C.
Quantitative PCR was carried out using the miRCURY LNA SYBR Green PCR Kit and miRNA-specific assays on a CFX Connect System (Bio-Rad).
MiRNA expression was normalized to validated endogenous reference miRNAs, and relative expression and pre-to-post fold-changes were calculated to ensure accurate quantification of exosomal miRNA expression.
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Pre and Post the 12-week intervention
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Assessed changes in dietary intake: Frequency of consumption
Tidsramme: Pre and post the 12-week intervention
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One week before laboratory measurements, participants completed a 5-day weighed food record, including one weekend days, to capture habitual dietary intake.
Additionally, dietary habits were assessed through a 137-item semi-quantitative Food Frequency Questionnaire (FFQ), previously validated in a Mediterranean Spanish population.
The FFQ was administered in face-to-face interviews by trained nutritionists and included information on vitamin/mineral supplements and alcohol consumption.
Participants reported their habitual intake over the previous year using a 9-level frequency scale (ranging from "never or almost never" to ">6 times/day").
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Pre and post the 12-week intervention
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Assessed changes in dietary intakes: 24 hours dietary recalls
Tidsramme: Pre and post the 12-week intervention
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Nutrient intakes were estimated using the DIAL software (version 3.15; Alce Ingeniería, Madrid, Spain), a validated tool for quantitative and qualitative assessment of dietary intake in the Spanish population.
The software converted food consumption into daily energy and nutrient values, expressed absolute intake (g/day), percentage of Recommended Intake (RI) coverage, and the energy distribution profile (percentage of total energy from proteins, fats, carbohydrates, and alcohol).
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Pre and post the 12-week intervention
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Assessed changes in dietary intakes: Mediterranean Diet Adherence
Tidsramme: Pre and post the 12-week intervention
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Adherence to the Mediterranean Diet was evaluated using a validated 14-item questionnaire for the Spanish population, with scores ranging from 0 (lowest adherence) to 14 (highest adherence).
The resulting score was classified into three categories: low adherence (range: 0-5), moderate adherence (range: 6-9), and high adherence to MedDiet (range: 10-14).
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Pre and post the 12-week intervention
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Assessed changes in accelerometry: Physical activity time
Tidsramme: Pre and post the 12-week intervention
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Physical activity and inactivity were assessed using triaxial accelerometers (GENEActiv; ActivInsights Ltd., Kimbolton, UK) placed on the non-dominant wrist from 5 to 7 consecutive days (direct method).
Participants were instructed to wear the device at all times, including during sleep and water-based activities, to ensure comprehensive data capture.
Valid data were defined as a minimum wear of 16 hours per day for at least four days (three weekdays and one weekend day) following established protocols (10.1177/07334648231218095).
Accelerometers were set to 60 Hz (10.1111/sms.12795,
10.1249/MSS.0000000000000289).
Raw data were downloaded using GENEActiv software version 3.3 and processed using the GGIR package (version 3.0.9) in R (v4.1.1,
R Core Team, Vienna, Austria), which auto-calibrates the data based on local gravity and calculates the Euclidean Norm Minus One (ENMO) to minimize sensor calibration error (https://doi.org/10.1152/japplphysiol.00421.2014).
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Pre and post the 12-week intervention
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Assessed changes in physical activity and sedentary time
Tidsramme: Pre and post the 12-week intervention
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Physical activity, sedentary time, and sleep were also estimated through self-reported questionnaires, using the International Physical Activity Questionnaire Short Version (IPAQ-SF), previously validated in Spain.
The IPAQ-SF provides estimates of sedentary time, moderate and vigorous activity in minutes per week.
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Pre and post the 12-week intervention
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Assessed changes in Resting Energy Expenditure
Tidsramme: Pre and post the 12-week intervention
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After at least 8 hours of fasting, resting energy expenditure was estimated by indirect calorimetry.
Participants were instructed the day before testing to maintain their usual lifestyle, refrain from alcohol or caffeine for 24 hours, and avoid vigorous physical activity for at least 48 hours.
Participants lay supine for 30 minutes wearing a mask connected to a gas analyzer (open circuit, Jaeger MasterScreen CPX® (CareFusion, San Diego, USA)).
The resting rates of fat and carbohydrate oxidation were used to determine the resting energy expenditure in kcal per minute (kcal/min).
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Pre and post the 12-week intervention
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Assessed changes in self-reported quality of life
Tidsramme: Pre and post the 12-week intervention
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Self-reported quality of life was registered by applying the Short Form 36-health survey (SF-36) questionnaire previously validated in Spain.
The SF-36 is a generic measure of quality of life and has been evaluated for a wide variety of medical conditions, including diabetes.
The SF-36 includes 36 questions that evaluate 8 subscales, scores for each scale range from 0 to 100, with higher scores indicating higher level of function or wellbeing.
The physical component summary is derived from the 4 subscales of physical functioning, role physical, bodily pain, and general health; while the mental component summary is derived from the subscales of vitality, social functioning, role emotional, and mental health.
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Pre and post the 12-week intervention
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Assessed changes in blood pressure
Tidsramme: Pre and post the 12-week intervention
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Systolic and diastolic blood pressures were recorded three times by using the validated Omron HEM 742 blood pressure monitoring device with the participant seated, back supported in chair and feet flat on floor without legs crossed, after they rested 5 minutes.
The guidelines of the Hypertension and Cardiology European Societies and the Spanish ones were used to classify blood pressure stages of participants.
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Pre and post the 12-week intervention
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Cristina Casals, PhD, University of Cadiz
- Ledende efterforsker: Jesús Ponce González, PhD, University of Cadiz
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Sygdomme i det endokrine system
- Metaboliske sygdomme
- Glukosemetabolismeforstyrrelser
- Diabetes mellitus
- Hyperinsulinisme
- Ernæringsmæssige og metaboliske sygdomme
- Diabetes mellitus, type 2
- Insulin resistens
- Motorisk aktivitet
- Bevægelse
- Muskuloskeletale fysiologiske fænomener
- Muskuloskeletale og neurale fysiologiske fænomener
- Fysisk konditionering, menneske
- Øvelse
- Intervaltræning med høj intensitet
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- The APETEX project
- PID2020-120034RA-I00/AEI/10.13 (Andet bevillings-/finansieringsnummer: Ministerio de Ciencia e Innovación)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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