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    Conccurent Training Can Improve the Physical Health in Diabesity Individuals: a Meta-analysis
    LU Donglei, YANG Fengying, FENG Zhanpeng, CAO Liquan, TAN Sijie
    Chinese General Practice    2025, 28 (27): 3410-3421.   DOI: 10.12114/j.issn.1007-9572.2024.0211
    Abstract496)   HTML6)    PDF(pc) (1090KB)(455)       Save
    Background

    Obesity and type 2 diabetes, both associated with chronic metabolic dysfunction, are characterized by insulin resistance and heightened cardiovascular risk. Concurrent training emerges as an effective intervention to improve physical health in these patients, though the specific impacts warrant further exploration.

    Objective

    This study systematically evaluates the impact of concurrent training on body composition and other health metrics in obese type 2 diabetic patients.

    Methods

    We reviewed randomized controlled trials from databases like PubMed, Web of Science, Ebsco, CNKI, VIP, Wanfang Data, and SinoMed focusing on trials conducted between January 2001 and March 2024. These trials measured the effects of concurrent training on various health outcomes. Quality assessments were performed using the Cochrane risk of bias tool, and data were analyzed using Stata 16.0.

    Results

    Twelve randomized controled trials involving 967 participants showed that concurrent training significantly improves body composition [BMI: WMD=-0.46, P<0.001; body fat percentage (BF%) : WMD=-3.49, P<0.001; fat-free mass (FFM%) : WMD=3.26, P<0.001; waist circumference (WC) : WMD=-2.73, P<0.001; hip circumference (HC) : WMD=-2.78, P<0.001], cardiorespiratory fitness [maximal oxygen uptake (VO2max) : WMD=5.13, P<0.001) ], and metabolic profiles [Triglycerides (TG) : SMD=-1.48, P=0.007; total cholesterol (TC) : SMD=-1.66, P=0.002; high-density lipoprotein cholesterol (HDL-C) : SMD=1.10, P=0.011; low-density lipoprotein cholesterol (LDL-C) : SMD=-1.26, P=0.018; glycated hemoglobin percentage (HbA1c) : WMD=-0.86, P<0.001; homeostasis model assessment of insulin resistance (HOMA-IR) : SMD=-0.97, P=0.004; Glucose: SMD=-1.32, P=0.014], and inflammation markersα (TNF-α) : SMD=-1.98, P<0.001.

    Conclusion

    Concurrent training markedly improves key health outcomes in obese type 2 diabetes patients. The outcomes vary based on the volume and order of training sessions.

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    Research on the Improvement Effect of Exercise Modes on the Executive Function of Overweight or Obese Children or Adolescents: a Network Meta-analysis
    QUAN Jialin, ZHU Lin, SU Yu, CHEN Zekai, CHEN Ziqi, ZHANG Zhuofan
    Chinese General Practice    2025, 28 (27): 3422-3431.   DOI: 10.12114/j.issn.1007-9572.2024.0626
    Abstract428)   HTML3)    PDF(pc) (1195KB)(438)       Save
    Background

    Overweight or obese children and adolescents have been shown to exhibit executive function deficits when compared to healthy populations with normal body mass. These deficits may serve to exacerbate existing overweight or obesity and, in some cases, may serve to predispose the individual to the development of other diseases. A growing body of research has demonstrated that exercise can positively impact executive function; however, the specific benefits and drawbacks of different exercise modalities require further investigation.

    Objective

    To explore the most effective exercise methods for improving executive function in overweight or obese children and adolescents.

    Methods

    A comprehensive search of the CNKI, Wanfang Data, Cochrane Library, PubMed, Embase, and Web of Science databases was conducted to identify randomized controlled trials of exercise interventions for executive function in adolescents and young adults with overweight or obesity. This search was conducted from database construction to October 2024. The literature was screened and the data was extracted by two independent researchers. A network meta-analysis was performed using RevMan 5.4 and Stata 18.0 software to compare the differences between exercise modalities as well as to calculate and rank cumulative probability ranked area under the curve (SUCRA) values. The standardized mean difference (SMD) and its 95% confidence interval (CI) were used as an effect indicator. The Cochrane risk of bias assessment tool was used for risk of bias assessment, and Egger's test was used for publication bias analysis.

    Results

    A total of 10 papers in English and Chinese were included, encompassing 675 overweight or obese children and adolescents, aged 8 to 15 years old, with outcome indicators of inhibitory control, working memory, and cognitive flexibility. A total of four movement style groups (sports games, ball games, martial arts practice, and physical training) were included with the no-exercise group. With respect to the enhancement of inhibitory control, sports games (SMD=-1.75, 95%CI=-2.83 to -0.68, P<0.05), ball games (SMD=-1.93, 95%CI=-3.87 to -0.10, P<0.05), and physical training (SMD=-1.20, 95%CI=-2.40 to -0.05, P<0.05) all significantly increased the level of inhibitory control in overweight or obese children and adolescents, with ball sports having the largest SUCRA value (82.8) and being ranked first. In terms of enhancing working memory, ball sports demonstrated superiority over physical training (SMD=-1.02, 95%CI=-1.68 to -0.36, P<0.05). Similarly, in the context of promoting cognitive flexibility, ball sports exhibited greater efficacy in comparison to physical training (SMD=-1.22, 95%CI=-1.90 to -0.54, P<0.05) .

    Conclusion

    A comparison of ball games with other exercise modalities has demonstrated that the former is superior in improving executive function in overweight or obese children and adolescents. A comprehensive consideration of the synergistic integration of ball games with intensity, periodization, frequency, and volume is imperative during practice interventions. Further evidence is necessary to develop more accurate and efficient exercise prescriptions for overweight or obese children and adolescents.

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    Effects of Frequent Diets on Glucolipid Metabolism and Biorhythmic Expression in Humans
    YANG Jun, MAIBUBAIMU· Aisikaer, YANG Qianqian, LI Kai, YIN Gaojun, CAI Huizhen
    Chinese General Practice    2025, 28 (27): 3432-3440.   DOI: 10.12114/j.issn.1007-9572.2024.0684
    Abstract341)   HTML5)    PDF(pc) (1089KB)(240)       Save
    Background

    Prevalence of glycolipid metabolism disorders is rising annually. Dietary patterns are recognized as key modulators of their pathogenesis. Improper eating habits cause circadian disruption, which can be mediated by multiple genes. Clarifying the role of different dietary methods is crucial to preventing the occurrence of metabolic diseases. However, relevant epidemiological data and data of population studies are scant.

    Objective

    To investigate the effects of dietary frequency on human glycolipid metabolism and circadian gene expressions, thereby providing insights into the relationship between dietary frequency and disease risk in healthy populations.

    Methods

    Healthy volunteers aged 18-29 years with regular sleep-wake cycles, regular dietary, and moderate snack intake were recruited between April and May 2022. Twenty eligible participants were randomized into two groups: a three-meal group (n=10) and a six-meal group (n=10) for a crossover intervention. Participants in the three-meal group consumed main meals at 7: 00, 12: 00, and 18: 00. Those in the six-meal group received three additional glucose challenges (75 g anhydrous glucose dissolved in 300 mL of water) at 10: 00, 15: 00, and 20: 00. Each intervention lasted 24 hours. Blood samples were collected at eight timepoints (7: 00, 8: 00, 10: 00, 12: 00, 13: 00, 16: 00, 20: 00, 2: 00) to analyze serum metabolic markers, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glucose, insulin, and leptin. The mRNA expression levels of circadian genes were detected (Clock, Bmal 1, Per 2, Cry 1, Ppar α, Sirt 1) .

    Results

    A significant interaction effect between group and time was observed on TG levels (Finteraction =2.277, Pinteraction =0.032). A significant main effect of group presented on LDL-C levels (Fgroup=4.803, Pgroup=0.030), while time exhibited a significant main effect on TC levels (Ftime=2.092, Ptime=0.048). No significant differences in TC, TG, LDL-C, or HDL-C levels were observed between the two groups at any time points (P>0.05). A significant interaction effect between group and time was identified for blood glucose levels (Finteraction =3.926, Pinteraction =0.001). The group showed a significant main effect on insulin levels (Fgroup=12.240, Pgroup<0.001), and time demonstrated significant main effects on blood glucose, insulin, and leptin levels (Ftime=10.840, 2.399, and 4.347, respectively; Ptime<0.05). Participants in the six-meal group exhibited higher blood glucose levels at 12: 00 and 20: 00, elevated insulin levels at 10: 00 and 16: 00, and lower leptin levels at 16: 00 compared to the three-meal group (P<0.05). A significant interaction effect between group and time was observed for the mRNA expression of Cry 1 (Finteraction =30.250, Pinteraction<0.001). Significant main effects of group were detected for the mRNA expressions of Clock, Bmal 1, Per 2, Cry 1, Ppar α, and Sirt 1 (Pgroup<0.05), while significant main effects of time were noted for the mRNA expressions of Bmal 1, Per 2, Cry 1, and Sirt 1 (Ptime<0.05). Participants in the six-meal group displayed significantly higher mRNA expressions of Clock at 8: 00 and 13: 00, Per 2 at 8: 00, 16: 00, and 2: 00, and Cry 1 at 7: 00, 8: 00, and 10: 00 compared to the three-meal group (P<0.05). Conversely, significantly lower expressions of Bmal 1 at 10: 00, 12: 00, and 13: 00, and Cry 1 at 20: 00 and 2: 00 were observed in the six-meal group (P<0.05). No significant differences in the mRNA expressions of Ppar α and Sirt 1 were detected between groups at any time points (P>0.05) .

    Conclusion

    Frequent six-meal consumption elevates insulin and glucose levels, disrupts metabolic homeostasis, and alters circadian clock gene expression in phase and amplitude. These changes induce glucose metabolism dysregulation, leading to circadian rhythm disruption.

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