The authors declare that they have no competing interests.
PDF: significant manuscript write and review, study concept and design; PGF: study concept and design, manuscript review; AS: psychological therapy concept and design, manuscript review; SMLT: nutritional therapy concept and design, manuscript review; RS: study concept and design, manuscript review; AC: study concept and design, manuscript review; RMCP: study concept and design, manuscript review; JMS: pulmonary function and cardiopulmonary exercise test support, manuscript review; FLAF: pulmonary function and cardiopulmonary exercise test support, manuscript review; MCM: study concept and design; bioelectrical impedance support, manuscript review; MAM: project supervision, manuscript review; CRFC: project supervision, manuscript write and review, study concept and design; overall study coordination. All authors have read and approved the final version of the manuscript.
Asthma and obesity are public health problems with increasing prevalence worldwide. Clinical and epidemiologic studies have demonstrated that obese asthmatics have worse clinical control and health related quality of life (HRQL) despite an optimized medical treatment. Bariatric surgery is successful to weight-loss and improves asthma control; however, the benefits of nonsurgical interventions remain unknown.
This is a randomized controlled trial with 2-arms parallel. Fifty-five moderate or severe asthmatics with grade II obesity (BMI ≥ 35 kg/m2) under optimized medication will be randomly assigned into either weight-loss program + sham (WL + S group) or weight-loss program + exercise (WL + E group). The weight loss program will be the same for both groups including nutrition and psychological therapies (every 15 days, total of 6 sessions, 60 min each). Exercise program will include aerobic and resistance muscle training while sham treatment will include a breathing and stretching program (both programs twice a week, 3 months, 60 min each session). The primary outcome variable will be asthma clinical control. Secondary outcomes include HRQL, levels of depression and anxiety, lung function, daily life physical activity, body composition, maximal aerobic capacity, strength muscle and sleep disorders. Potential mechanism (changes in lung mechanical and airway/systemic inflammation) will also be examined to explain the benefits in both groups.
This study will bring a significant contribution to the literature evaluating the effects of exercise conditioning in a weight loss intervention in obese asthmatics as well as will evaluate possible involved mechanisms.
Global Initiative for Asthma (GINA): Global Strategy for Asthma Management and Prevention, 2014. In http://www.ginasthma.org/. Accessed in February, 2015.
Global Initiative fos ashtma (GINA): Global Burden of asthma, 2014. In http://www.ginasthma.org/. Accessed in February, 2015.
World Health Organization (WHO). Obesity: preventing and managing the global epidemic, WHO technical report series 894. Geneva: World Health Organization; 2000.
NHLBI / WHO. The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in adults. National Institutes of health; National Heart, Lung and Blood Institut of Health; North American Association for the Study of Obesity (updated 2013).
World Health Organization (WHO). Obesity and Overweight. In Http: www.who.int/mediacentre/factsheets/fs311/en/index.html. Accessed in November, 2014.
Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985–3023. CrossRefPubMed
Adeniyi FB, Young T. Weight loss interventions for chronic asthma. Cochrane Database Syst Rev. 2012;7:CD009339. PubMed
Hernandez Romero A, Matta Campos J, Mora Nieto A, del Rivero L, Andres Dionicio AE, Aguilar Ramirez P, et al. [Clinical symptom relief in obese patients with persistent moderate asthma secondary to decreased obesity]. Rev Alerg Mex. 2008;55(3):103–11. PubMed
Laquatra I. Nutrition for weight management. In: Mahan LK, Escott-Stump S, editors. Krause’s: food, nutrition and diet therapy. 10th ed. Philadelphia: Saunders Company; 2000.
Programa de Apoio a Nutrição - NutWin [software]. Departamento de informática em saúde. Universidade Federal de São Paulo. In http://www2.unifesp.br/dis/produtos/nutwin/index2.htm. Accessed in September, 2014.
American College of Sports Medicine (ACSM). Exercise prescription for Other Clinical Populations. In: ACSM’s Guidelines for Exercise Testing and Prescription. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 226–72.
Hoeger WWK, Hopkins DR, Barette SL, Hale DF. Relationship between repetitions and selected percentages of one repetition maximum: a comparison between untrained and trained males and females. J Appl Sport Sci Res. 1990;4(2):47–54.
França-Pinto A, Mendes FAR, de Carvalho-Pinto R, Agondi RC, Cukier A, Stelmack R, Saraiva-Romanholo BM, Kalil J, Martins MA, Giavina-Bianchi P, Carvalho CRF. Aerobic Training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma : a randomised controlled trial. Thorax 2015: epub ahead.
Engineering/Marketing A. Actilife users manual. Pensacola, FL: ActiGraph; 2009.
Gibson AL, Holmes JC, Desautels RL, Edmonds LB, Nuudi L. Ability of new octapolar bioimpedance spectroscopy analyzers to predict 4-component-model percentage body fat in Hispanic, black, and white adults. Am J Clin Nutr. 2008;87(2):332–8. PubMed
Brazilian Association Nutrology & Brasilian Association for parenteral and enteral nutrition, Using the bioimpedance to evaluate the body mass. “Projeto Diretrizes”, 2009.
Gordon CC, Chumlea WC, Roche AF. Stature, Recumbent Length and Weigth. In: Lohman TG, Roche AF, Martorell R, editors. Anthropometric Standardization Reference Manual. Champaign, III: Human Kinetics; 1988. p. 3–8.
Keenan NL, Strogatz DS, James SA, Ammerman AS, Rice BL. Distribution and correlates of waist-to-hip ratio in black adults: the Pitt County Study. Am J Epidemiol. 1992;135(6):678–84. PubMed
ATS/ACCP. Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167(2):211–77. CrossRef
Wasserman K, Hansen JE, Sue DY, Casaburi R, Whipp BJ. Pathophysiology of disorders limiting exercise. In: Principles of Exercise Testing and Interpretation. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 1999. p. 1142–95.
Neder JA, Andreoni S, Castelo-Filho A, Nery LE. Reference values for lung function tests. I. Static volumes. Braz J Med Biol Res. 1999;32(6):703–17. PubMed
Pereira CAC, Barreto SP, Simões JG, Pereira FWL, Gerstler JG, Nakatani J. Valores de Referência para Espirometria em uma amostra da população brasileira adulta. J Bras Pneumol. 1992;18(1):10–2.
Shaw K, Gennat H, O’Rourke P, Del Mar C. Exercise for overweight or obesity. Cochrane Database Syst Rev. 2006;4:CD003817. PubMed
Silva RA, Almeida FM, Olivo CR, Saraiva-Romanholo BM, Martins MA, Carvalho CR. Exercise reverses OVA-induced inhibition of glucocorticoid receptor and increases anti-inflammatory cytokines in asthma. Scand J Med Sci Sports. 2015. epub ahead.
- The effects of exercise training in a weight loss lifestyle intervention on asthma control, quality of life and psychosocial symptoms in adult obese asthmatics: protocol of a randomized controlled trial
Patricia D. Freitas
Palmira G. Ferreira
Analuci da Silva
João Marcos Salge
Frederico LA Fernandes
Marcio C. Mancini
Milton A. Martins
Celso RF Carvalho
- BioMed Central
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