Hybrid Neuromuscular Training Improves Cardiometabolic Health and Alters Redox Status in Inactive Overweight and Obese Women: A Randomized Controlled Trial

Alexios Batrakoulis, Athanasios Z Jamurtas, Dimitrios Draganidis, Kalliopi Georgakouli, Panagiotis Tsimeas, Athanasios Poulios, Niki Syrou, Chariklia K Deli, Konstantinos Papanikolaou, Symeon Tournis, Ioannis G Fatouros, Alexios Batrakoulis, Athanasios Z Jamurtas, Dimitrios Draganidis, Kalliopi Georgakouli, Panagiotis Tsimeas, Athanasios Poulios, Niki Syrou, Chariklia K Deli, Konstantinos Papanikolaou, Symeon Tournis, Ioannis G Fatouros

Abstract

This randomized controlled trial investigated the effects of a 5-month high-intensity hybrid-type neuromuscular training program with nontraditional implements on cardiometabolic health, redox status, and cardiovascular disease (CVD) risk in inactive overweight and obese women. Forty-nine inactive female participants with overweight and obesity (age: 36.4 ± 4.4 years; BMI: 29.1 ± 2.9 kg/m2) were randomly assigned to either a control (C, n = 21) or a training group (TR, n = 28). TR followed a 20-week supervised, progressive, time-efficient (3 days/week; 6-15 min net exercise time) program implementing loaded fundamental movement patterns with prescribed work-to-rest time intervals (20-40 s, 1:2, 1:1, 2:1) in a circuit fashion (2-3 rounds). Cardiometabolic risk factors were measured at baseline and post-training as secondary outcomes of a larger randomized controlled trial. At post-intervention, TR demonstrated favorable changes in resting heart rate (-7%, p = 0.043), high-density lipoprotein (+18.1%, p = 0.029), atherogenic index (-17%, p = 0.045), mean arterial pressure (-4.5%, p = 0.03), waist circumference (-6.2%, p = 0.005), waist-to-hip ratio (-4.6%; p = 0.015), metabolic syndrome severity score (-222%, p = 0.024), full 30-year CVD risk (-15.8%, p = 0.002) and hard 30-year CVD risk (-17.6%, p = 0.01), vascular age (-7.8%, p = 0.002), protein carbonyls (-45.7%, p = 0.001), catalase activity (+15.2%, p = 0.023), and total antioxidant capacity (+11.4%, p = 0.002) relative to C. Additionally, TR induced beneficial changes in fasting glucose (-3.4%, p = 0.002), homeostatic model assessment for insulin resistance (-15.7%, p < 0.001), diastolic blood pressure (-5.6%, p < 0.001), reduced glutathione (+39.8%, p < 0.001), 10-year CVD risk (-17.4%, p = 0.011), and total bilirubin (-21.7%, p < 0.001) compared to baseline. These results suggest that hybrid-type neuromuscular training may improve aspects of cardiometabolic health and antioxidant status in inactive overweight and obese women providing a time-efficient (~100 min/week) exercise approach in a real-world gym setting.

Keywords: antioxidant capacity; blood lipids; glycemic control; interval exercise training; metabolic syndrome severity.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CONSORT flow diagram of the study.
Figure 2
Figure 2
Experimental flowchart. BP: blood pressure; C: control group; DoIT: exercise training program; HR: heart rate; PA: physical activity; TR: training group. 1 for C and TR (4-week adaptive period); 2 only for TR; 3 for C and TR.
Figure 3
Figure 3
Percentage changes [Δ% = (Post − Pre)/Pre*100] in cardiometabolic health, redox status, and oxidative stress indicators in TR following a 5-month intervention. AI: atherogenic index; CAT: catalase; CVD-10: 10-year cardiovascular disease risk; CVD-30: full 30-year cardiovascular disease risk; DBP: diastolic blood pressure; FG: fasting glucose; FI: fasting insulin; GSH: glutathione; HDL: high-density lipoprotein; HOMA-IR: homeostatic model assessment of insulin resistance; LDL: low-density lipoprotein; MAP: mean arterial pressure; PC: protein carbonyls; RHR: resting heart rate; SBP: systolic blood pressure; TAC: total antioxidant capacity; TBIL: total bilirubin; TC: total cholesterol; TG: triglycerides; VA: vascular age; WC: waist circumference; WHR: waist-to-hip ratio. * Significant differences with baseline levels (p < 0.05).
Figure 4
Figure 4
Multiple differential responder groups to exercise in TR following a 5-month intervention. AI: atherogenic index; CAT: catalase; CVD-10: 10-year cardiovascular disease risk; CVD-30: full 30-year cardiovascular disease risk; DBP: diastolic blood pressure; FG: fasting glucose; FI: fasting insulin; GSH: glutathione; HDL: high-density lipoprotein; HOMA-IR: homeostatic model assessment of insulin resistance; LDL: low-density lipoprotein; MAP: mean arterial pressure; PC: protein carbonyls; RHR: resting heart rate; SBP: systolic blood pressure; TAC: total antioxidant capacity; TBIL: total bilirubin; TC: total cholesterol; TG: triglycerides; VA: vascular age; WC: waist circumference; WHR: waist-to-hip ratio.

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