Different Order of Concurrent Training on Improving Visceral Adipose Tissue and Insulin Resistance.
Condition: Fat Burn; Aerobic Exercise; Resistance Exercise
MeSH terms: Insulin Resistance
Study type: Interventional

Summary: 
      Purposes: The purpose of one-year project is to compare the effect of different intrasession
      exercise order of AE and RE during concurrent training on reducing VAT and improving insulin
      resistance for inactive middle-age community residents with obesity.

      Methods: Purposive sampling will be used to enroll community residents aged 40-64 years with
      inactive habit and body fat percentage ≧ 25% for male and ≧ 30% for female in southern
      Taiwan. Eligible participants will be stratified by sex and age (40-55years and 56-64 years)
      then block randomly divided into training group of AE preceding RE, RE preceding AE or a
      control group. The exercise training program will under supervision lasting 16 weeks with 3
      times per week. The concurrent training prescription consist of AE 30 minutes and RE 15
      minutes per session. A 5-minute interval between two exercise modalities. All participants
      will be evaluated outcomes for two time points including baseline (T0) and after 16-week
      intervention (T1). The primary outcomes are VAT and insulin resistance. A two-way ANOVA with
      repeated measures will be performed to compare changes of outcome variables over the
      intervention period.

      Relevance to clinical practice: The results of this project can assist health professionals
      to know how to properly prescribe concurrent training of AE and RE to achieve the greatest
      effects on VATreduction and insulin resistance improvement for middle-age residents with
      obesity.
    

Detailed description: 
      Background: Visceral adipose tissue (VAT) accumulation is highly linking with cardiovascular
      diseases and insulin resistance. A combination of aerobic exercise (AE) and resistance
      exercise (RE) was an effective strategy to improve VAT and insulin resistance; however, no
      current evidence displayed whether the different orders of concurrent training (AE preceding
      RE or RE preceding AE) influence the effects on VAT reduction and insulin resistance
      improvement.

      Purposes: The purpose of one-year project is to compare the effect of different intrasession
      exercise order of AE and RE during concurrent training on reducing VAT and improving insulin
      resistance for inactive middle-age community residents with obesity.

      Methods: Purposive sampling will be used to enroll community residents aged 40-64 years with
      inactive habit and body fat percentage ≧ 25% for male and ≧ 30% for female in Tainan.
      Eligible participants will be stratified by sex and age (40-55years and 56-64 years) then
      block randomly divided into training group of AE preceding RE, RE preceding AE or a control
      group. The exercise training program will under supervision lasting 16 weeks with 3 times per
      week. The concurrent training prescription consist of AE 30 minutes and RE 15 minutes per
      session. A 5-minute interval between two exercise modalities. The control group will follow
      their primary lifestyle without exercise intervention. All participants will be evaluated
      outcomes for two time points including baseline (T0) and after 16-week intervention (T1). The
      primary outcomes are VAT and insulin resistance. VAT is measured by body composition analyzer
      and insulin resistance is calculate from fasting glucose and insulin level in blood samples.
      A two-way ANOVA with repeated measures will be performed to compare changes of outcome
      variables over the intervention period.

      Relevance to clinical practice: The results of this project can assist health professionals
      to know how to properly prescribe concurrent training of AE and RE to achieve the greatest
      effects on VATreduction and insulin resistance improvement for middle-age residents with
      obesity.
    

Intervention name(s): aerobic exercise; resistance exercise
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The main AE program will be designed and controlled for at least moderate intensity of heart rate reserve (HRR) lasting 30 minutes. The goal of intensity will be set at least 40% of HRR during the first two weeks, and then progressively increase the targeted intensity at the end of 16 weeks with 60% HRR. The motions will design by involving core muscle training (e.g., march, step touch, lunge, V-step, box step, twist, knee up, scoop, and scissors).; In the process, the participants will be instructed by resisting the weight smoothly, and peaking at hold. RE prescription consist of 2-4 sets with 10-15 repetitions per set with a rest interval of 1-2 minutes between sets to improve muscular fitness.
The first two weeks will start with two sets of 10-15 repetitions and then gradually progress on four sets of 15 repetitions at the end of 16 weeks. The total duration of RE will lasting around 15 minutes.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Prevention