Moderate-intensity aerobic and resistance exercise is safe and favorably influences body composition in patients with quiescent Inflammatory Bowel Disease: a randomized controlled cross-over trial

Abstract

Background: Overweight and metabolic problems now add to the burden of illness in patients with Inflammatory Bowel Disease. We aimed to determine if a program of aerobic and resistance exercise could safely achieve body composition changes in patients with Inflammatory Bowel Disease.

Methods: A randomized, cross-over trial of eight weeks combined aerobic and resistance training on body composition assessed by Dual Energy X-ray Absorptiometry was performed. Patients in clinical remission and physically inactive with a mean age of 25 ± 6.5 years and Body Mass Index of 28.9 ± 3.8 were recruited from a dedicated Inflammatory Bowel Disease clinic. Serum cytokines were quantified, and microbiota assessed using metagenomic sequencing.

Results: Improved physical fitness was demonstrated in the exercise group by increases in median estimated VO2max (Baseline: 43.41mls/kg/min; post-intervention: 46.01mls/kg/min; p = 0.03). Improvement in body composition was achieved by the intervention group (n = 13) with a median decrease of 2.1% body fat compared with a non-exercising group (n = 7) (0.1% increase; p = 0.022). Lean tissue mass increased by a median of 1.59 kg and fat mass decreased by a median of 1.52 kg in the exercising group. No patients experienced a deterioration in disease activity scores during the exercise intervention. No clinically significant alterations in the α- and β-diversity of gut microbiota and associated metabolic pathways were evident.

Conclusions: Moderate-intensity combined aerobic and resistance training is safe in physically unfit patients with quiescent Inflammatory Bowel Disease and can quickly achieve favourable body compositional changes without adverse effects.

Trial registration: The study was registered at ClinicalTrials.gov; Trial number: NCT02463916 .

Keywords: Body composition; Clinical trials; Exercise; Microbiome.

Conflict of interest statement

Ethics approval and consent to participate

Before commencement, the study was approved by the Clinical Research Ethics Committee of the Cork Teaching Hospitals. All patients provided written informed consent before enrolment.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1

Study outline indicating the number of participants at each stage of the study and reasons for exclusion from the trial

Fig. 2

Comparison of body composition parameters (a: Total body fat percentage; b: Total lean tissue mass) before and after the combined aerobic and resistance exercise intervention in the EXERCISE group and in the non-exercising disease CONTROL group. ** Denotes p-value < 0.01 and ***denotes p-value < 0.001 as per Wilcoxon signed-rank test. Error bars denote 95% confidence intervals

Fig. 3

α-diversity of taxonomic profiling. (a-d) Shannon α-diversity H-index of Bacteria and Archaea species at week 0 (pre) and week 8 (post). (a and b) Subtle median increases of Archaea α-diversity for patients in both treatment. (c and d) Bacterial α-diversity was significantly raised in the control group (p-value = 0.015), while a moderate median decrease was shown in the exercise group. (e) Percent change (Δ) of α-diversity for Archaea species shows a slight increase in the control group compared to the exercise group (non-significant). (f) Both exercise and control groups show an increase in α-diversity for Bacteria species. P-values were calculated from the Wilcoxon signed-rank test