|Year : 2020 | Volume
| Issue : 1 | Page : 1-4
Efficacy of Pilates exercises and supplementation with Camellia sinensis extract in body composition of female patients diagnosed with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial
Silvana Junges1, Aline Veigas2, Maria Gabriela Valle Gottlieb3
1 Institute for Geriatrics and Gerontology of the Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
2 Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
3 Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
|Date of Submission||04-May-2019|
|Date of Decision||14-May-2019|
|Date of Acceptance||20-Oct-2019|
|Date of Web Publication||13-Apr-2020|
Institute for Geriatrics and Gerontology of the Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS
Source of Support: None, Conflict of Interest: None
Background and objective: Evidence suggests that the intake of functional foods, such as Camellia sinensis extract (CSE), and Pilates exercises could play a key role in reducing the risk for metabolic syndrome. This study aimed to explore the efficacy of Pilates exercises and supplementation with CSE in body composition of female patients diagnosed with metabolic syndrome.
Subjects and methods: A placebo-controlled, double-blind, randomized clinical trial was conducted with postmenopausal participants meeting the diagnostic criteria for metabolic syndrome. A total of 50 participants were randomized into four groups: Pilates + CSE (n = 14); Pilates + Placebo (n = 11); CSE (n = 11), and Placebo (n = 14). Intervention groups (CSE and Pilates + CSE) were given a capsule containing 500 mg of CSE every day for 24 weeks. The placebo group received one capsule containing placebo for 24 weeks. The 60-minute Pilates exercises were performed twice a week for 24 weeks. Body composition at baseline and after intevention was assessed. This study protocol was approved by the Institutional Ethics Committee of Pontifical Catholic University.
Results: The mean lean mass and percentage lean mass of the Pilates + CSE and Pilates + Placebo groups were significantly higher than those of the CSE and Placebo groups (P < 0.05). There was a reduction in percentage fat mass and fat mass in the Pilates + CSE and Pilates + Placebo groups compared with the Placebo group (P < 0.05).
Conclusion: Pilates exercises with or without supplementation with CSE can improve the body composition in postmenopausal women with metabolic syndrome.
Trial registration: N° registro ReBEC:RBR-2sgtn2.
Keywords: body composition; Camellia sinensis; cardiometabolic risk factor; diet; dietary; metabolic syndrome; physical exercises; Pilates exercises; randomized controlled trial
|How to cite this article:|
Junges S, Veigas A, Valle Gottlieb MG. Efficacy of Pilates exercises and supplementation with Camellia sinensis extract in body composition of female patients diagnosed with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. Clin Trials Degener Dis 2020;5:1-4
|How to cite this URL:|
Junges S, Veigas A, Valle Gottlieb MG. Efficacy of Pilates exercises and supplementation with Camellia sinensis extract in body composition of female patients diagnosed with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. Clin Trials Degener Dis [serial online] 2020 [cited 2020 Aug 12];5:1-4. Available from: http://www.clinicaltdd.com/text.asp?2020/5/1/1/274077
| Introduction|| |
Metabolic syndrome (MetS) is a complex multifactorial disorder determined by a plethora of cardiometabolic risk factors, increasing the morbidity and mortality rates of cardiovascular diseases.,,, The major cardiometabolic risks for MetS are abdominal obesity, hypertension, diabetes, and dyslipidemia which, in isolation or combination, have a strong impact on health and quality of life. MetS is associated with a higher prevalence (22% to 69%) among postmenopausal women, depending on the diagnostic criteria used. This is closely related to low levels of estrogen, which is deemed to be a protective factor of the cardiovascular system in premenopausal women. Reduction in the levels of this hormone may trigger metabolic changes and increase visceral fat deposition and oxidative stress, thereby resulting in endothelial dysfunction, reduction of parasympathetic tonus, and increase in renin-angiotensin system activity.
Scientific evidence has demonstrated that a sedentary lifestyle in conjunction with dietary excesses and poor diet quality, in addition to genetic predisposition, are important etiologic factors, perhaps playing a decisive role in the global incidence and higher prevalence of MetS.,,, A previous study on lifestyle modification, including balanced and healthy diet and regular physical exercise practice, has yielded excellent results for weight loss and control of MetS. It has been shown that a sedentary lifestyle is one of the main risk factors for developing metabolic disorders and cardiovascular diseases, in addition to severely reducing muscle strength and muscle mass, especially among postmenopausal women. Therefore, regular physical exercise practice combined with a diet rich in bioactive compounds is of great importance, not only as adjuvant therapy, but also as a way to prevent components of the MetS and the increase in cardiovascular risk. Another study has revealed that both physical exercises and dietary bioactive compounds can maintain the oxidative process within physiological limits, thus controlling injury to macromolecules, which often lead to irreparable systemic damage. Accordingly, Pilates exercises have attracted a large band of followers in several countries, with special emphasis on postural correction and on strengthening back and abdominal muscles, thereby mitigating or preventing risk factors for cardiovascular diseases and metabolic diseases. One of the mainstays of the Pilates method is the use of respiratory maneuvers that require a constant energy expenditure in all movements, avoiding excessive cardiac stress, thus improving hemodynamic parameters. Moreover, a study on the Pilates method has demonstrated its efficacy in improving body composition among postmenopausal women. However, Pilates exercises should be combined with the consumption of functional foods rich in bioactive compounds, such as green tea, obtained from Camellia sinensis, for the prevention and treatment of MetS and its components. Camellia sinensis has a high flavonoid (catechin) content, which produces a thermogenic effect and oxidizes body fat, leading to weight loss and reduction of abdominal obesity, thus being regarded as a powerful adjunct in the prevention of health problems caused by MetS components., Green tea also contains carotenoids, tocopherol, ascorbic acid, and minerals (Zn, Ca, K, and Mn), which enhance its antioxidant potential. Green tea polyphenols have in vitro antioxidant activity that neutralizes reactive oxygen species and reactive nitrogen species. They can also chelate metals (e.g., iron), precluding its participation in free radical-generating reactions such as the Fenton and Haber-Weiss ones, which are extremely harmful to lipids, proteins, and DNA.
The aim of the present study was to check the efficacy of Pilates exercises and supplementation with Camellia sinensis extract (CSE) (green tea) in the body composition of postmenopausal women.
| Participants and Methods|| |
A randomized, double-blind, placebo-controlled clinical trial.
The study population comprised postmenopausal women from Porto Alegre, state capital of Rio Grande do Sul, southern Brazil, who had at least two MetS components and no cardiovascular event until the beginning of the study. Estimated sample size was initially 60 women, but 50 volunteers were eventually included. The trial was reported in line with the CONsolidated Standards Of Reporting Trials (CONSORT) 2010 guidelines [Figure 1] and performed in accordance with the Declaration of Helsinki. This study protocol was approved by the Institutional Ethics Committee of Pontifical Catholic University. All participants provided the written informed consent.
The study recruited 50 volunteers, with a mean age of 61.3 ± 6.6 years (range from 51 to 77 years), who met the diagnostic criteria for MetS. All participants were randomly assigned to four groups: (1) Pilates + CSE (n = 14); (2) Pilates + Placebo (n = 11); (3) CSE (n = 11); and (4) Placebo (n = 14) using a box from which the numbers corresponding to each participant (simple randomization method).
Mean age (years) did not differ among the groups: 60.5 ± 6.2 for the Pilates + CSE group, 62.6 ± 6.7 for the Pilates + Placebo group, 59.1 ± 4.7 for the CSE group, and 62.9 ± 8.0 for the Placebo group (P = 0.462).
Both the placebo and CSE capsules were the same size, contained the same amount of substances (500 mg), and were administered once a day for 24 weeks.
Pilates exercises were performed in 25 women in the Pilates + CSE (n = 14) and Pilates + Placebo (n = 11) groups. Intervention consisted of 60-minute sessions for 24 weeks, twice a week. The exercises were carried out on the following equipment: Reformer, Cadillac, Wall Unit, Ladder Barrel, and Chair. Basic-level mat exercises were also performed. All exercises were done in a progressive and easy-to-follow (didactic) manner, in compliance with the fundamental principles of the Pilates method.
Body composition measurement
Bio Tetrapolar Sanny, a four-electrode system placed on the skin surface, was used to record body fat (expressed both in kg and percentage), lean mass (expressed both in kg and percentage), whole-body mass, and total body water. All assessed participants were dressed in swimsuit, and all measurements were made in the supine position. Weight was checked using a calibrated anthropometric scale with a 150-kg capacity and 100-g increments. Minimum abdominal circumference or waist circumference was measured at the iliac crest level; and those with a circumference greater than 80 cm were considered to have central obesity.
The data were analyzed by IBM SPSS statistical package (version 21.0; IBM, Armonk, NY, USA). The continuous variables were described as the mean and SD/SE. One-way analysis of variance was used along with Tukey’s post hoc test for comparison of the means. Analysis of covariance was used with Bonferroni correction to adjust any differences from baseline values. Within-group comparisons were made by Student’s t-test for paired samples. The significance level was set at 5% (P < 0.05).
| Results|| |
As shown in [Table 1], the means for lean mass (kg) in the Pilates + CSE and Pilates + Placebo groups were significantly higher than those in the CSE and Placebo groups (P < 0.05). Percentage lean mass was significantly higher in the Pilates + CSE group than in the CSE + Placebo group (P < 0.05). Percentage lean mass of the Pilates + Placebo group was significantly higher only when compared with the Placebo group (P < 0.05). Percentage fat mass was significantly lower in the Pilates + CSE group than in the CSE and Placebo groups (P < 0.05). Percentage fat mass was significantly lower in the Pilates + Placebo group than in the Placebo group (P < 0.05).
[Table 2] shows the comparisons for the intra-group variables. There was a sharp reduction in fat mass and percentage fat mass in the Pilates + CSE group (P < 0.05), in addition to a significant increase in lean mass and percentage lean mass (P < 0.05). The Pilates + Placebo group showed a significant reduction of fat mass and percentage fat mass (P < 0.05) and a significant increase in lean mass and percentage lean mass (P < 0.05). Whole-body mass was significantly reduced in the CSE group (P < 0.05).
| Discussion|| |
The results obtained herein indicate that Pilates exercises and supplementation with CSE are efficient in improving body composition, reducing percentage fat mass and fat mass and increasing percentage lean mass and lean mass.
All authors contributed to the study design, paper writing and data analysis and approved the final version of the paper.
Conflicts of interest
The authors declare that they have no conflicts of interest.
Institutional review board statement
This study protocol was approved by the Institutional Ethics Committee of Pontifical Catholic University, and performed in accordance with the Declaration of Helsinki.
Declaration of participant consent
The authors certify that they have obtained all appropriate participant consent forms. In the forms the participants have given their consent for their images and other clinical information to be reported in the journal. The participants understand that their names and initials will not be published and due efforts will be made to conceal their identity.
This study followed the CONsolidated Standards Of Reporting Trials (CONSORT) guidelines.
The statistical methods of this study were reviewed by the biostatistician of the Pontifical Catholic University of Rio Grande do Sul in Brazil.
Copyright license agreement
The Copyright License Agreement has been signed by all authors before publication.
Data sharing statement
Individual participant data will not be available. However, the study protocol and informed consent form will be made available beginning 3 months and ending 5 years following article publication. In order to gain access, data requestors will need to sign a data access agreement. Proposals should be directed to email@example.com.
Checked twice by iThenticate.
Externally peer reviewed.
Open access statement
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
C-Editor: Zhao M; S-Editor: Li CH; L-Editors: Qiu Y, Wang L; T-Editor: Jia Y
| References|| |
Badely M, Sepandi M, Samadi M, Parastouei K, Taghdir M. The effect of whey protein on the components of metabolic syndrome in overweight and obese individuals; a systematic review and meta-analysis. Diabetes Metab Syndr
Gyorkos A, Baker MH, Miutz LN, Lown DA, Jones MA, Houghton-Rahrig LD. Carbohydrate-restricted diet and high-intensity interval training exercise improve cardio-metabolic and inflammatory profiles in metabolic syndrome: a randomized crossover trial. Cureus
Castellino G, Nikolic D, Magán-Fernández A, et al. Altilix® supplement containing chlorogenic acid and luteolin improved hepatic and cardiometabolic parameters in subjects with metabolic syndrome: a 6 month randomized, double-blind, placebo-controlled study. Nutrients
. 2019. doi: 10.3390/nu11112580.
Nannini DR, Joyce BT, Zheng Y, et al. Epigenetic age acceleration and metabolic syndrome in the coronary artery risk development in young adults study. Clin Epigenetics
Carvalho LP, Di Thommazo-Luporini L, Mendes RG, et al. Metabolic syndrome impact on cardiac autonomic modulation and exercise capacity in obese adults. Auton Neurosci
Ho SC, Wu S, Chan SG, Sham A. Menopausal transition and changes of body composition: a prospective study in Chinese perimenopausal women. Int J Obes (Lond)
Takahashi M, Miyashita M, Park JH, et al. Low-volume exercise training and vitamin E supplementation attenuates oxidative stress in postmenopausal women. J Nutr Sci Vitaminol (Tokyo)
Schaan CW, Cureau FV, Salvo D, Kohl HW 3rd, Schaan BD. Unhealthy snack intake modifies the association between screen-based sedentary time and metabolic syndrome in Brazilian adolescents. Int J Behav Nutr Phys Act
Renninger M, Hansen BH, Steene-Johannessen J, et al. Associations between accelerometry measured physical activity and sedentary time and the metabolic syndrome: A meta-analysis of more than 6000 children and adolescents. Pediatr Obes
. 2019. doi: 10.1111/ijpo.12578.
Honda T, Chen S, Yonemoto K, et al. Sedentary bout durations and metabolic syndrome among working adults: a prospective cohort study. BMC Public Health
Dow CA, Lincenberg GM, Greiner JJ, Stauffer BL, DeSouza CA. Endothelial vasodilator function in normal-weight adults with metabolic syndrome. Appl Physiol Nutr Metab
Junges S, Jacondino CB, Gottlieb MG. Pilates effect on risk factors for cardiometabolic disease: a systematic review. Sci Med
Finelli C, Padula MC, Martelli G, Tarantino G. Could the improvement of obesity-related co-morbidities depend on modified gut hormones secretion? World J Gastroenterol
Yousaf S, Butt MS, Suleria HAR, Iqbala MJ. The role of green tea extract and powder in mitigating metabolic syndromes with special reference to hyperglycemia and hypercholesterolemia. Food Funct
Bergamin M, Gobbo S, Bullo V, et al. Effects of a Pilates exercise program on muscle strength, postural control and body composition: results from a pilot study in a group of post-menopausal women. Age (Dordr)
Vaquero-Cristóbal R, Alacid F, Esparza-Ros F, López-Plaza D, Muyor JM, López-Miñarro PA. The effects of a reformer Pilates program on body composition and morphological characteristics in active women after a detraining period. Women Health
Qian G, Xue K, Tang L, et al. Mitigation of oxidative damage by green tea polyphenols and Tai Chi exercise in postmenopausal women with osteopenia. PLoS One
Lin J, Della-Fera MA, Baile CA. Green tea polyphenol epigallocatequin Gallate inhibits adipogenesis and induces apoptosis in 3T3-L1 adipocytes. Obes Res
Vieira Senger AE, Schwanke CH, Gomes I, Valle Gottlieb MG. Effect of green tea (Camellia sinensis) consumption on the components of metabolic syndromein elderly. J Nutr Health Aging
Higdon JV, Frei B. Tea catechins and polyphenols: health effects, metabolism, and antioxidant functions. Crit Rev Food Sci Nutr
Schulz KF, Altman DG, Moher D, Group C. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. Trials
[Table 1], [Table 2]