Impact Of Exercise-diet Intervention And Local Pressing-Kneading On Lipid Metabolism And Improvements Of Weight Loss Effects

Objective: This study observed obese subjects’ blood fatty acid composition, lipids,insulin, leptin, adiponectin and lipoprteinlipase during the long term exercise-dietintervention and discussed the effects of aerobic exercise and diet control on lipidmetabolism. Meanwhile, local pressing-kneading was applied on subjects’ hips andthighs in the exercise-diet intervention to explore possible mechanisms ofimprovements on exercise weight loss effects by pressing-kneading, which wasultimately proved by experiments on animals. The study would provide experimentalbasis and guidance for weight loss exercise theory and practice, and was expected togenerate significant social and economic benefits.Methods:Research1:12severe obese subjects aged of22.17±4.78were selected from the fully closedweight loss camp as the subjects of the research. Before intervention, the subjectswere provided the exercise prescriptions based on their health and exercise capacity,and their recipes were arranged by dietitians according to their own basal metabolism.The subjects were taken fasting blood tests and measured body morphology indexbefore intervention and the last morning of4th,8th,12th,16thweeks intervention inorder to observe the changes of body morphology, lipids, insulin, insulin, leptin,adiponectin, lipoprteinlipase and blood fatty acid composition.Research2:12severe obese subjects were divided into2groups according to stratified body fatratio and personal wishes, and were proceeded with exercise-diet intervention(E) orlocal pressing-kneading respectively combined with exercise-diet intervention for afour-week exercise to lose weight. The local pressing-kneading (PK) group wasarranged with pressing-kneading on hips and thighs by masseur at13:30-14:30, andthen they took a2-hour moderate-low intensity aerobic exercise every day. Theexercise program and duration are the same as the other group. The body morphologyand body composition (dual-energy x-ray Absorptiometry) were tested before and after4weeks of intervention. The local pressing-kneading group was proceeded withblood tests3times and measured triglyceride, hematocrit, free fatty acid and adiposetriglyceride lipase before pressing-kneading, after pressing-kneading and afterexercise.Research3:60male Kunming mice aged6weeks were randomly assigned to2groups: ND-10mice consuming a normal diet and HFD-50mice consuming a high fat diet. WhenHFD mice got the obese weight,16obese mice were selected and randomly assignedto2new groups: pressing-kneading group (PK) and control group (CON). The PKgroup mice were simulated human local pressing-kneading trials, and didpressing-kneading on fat pad in hind limb groin area,20minutes each side.20minutes later, retro-orbital bleeding method was used for collecting blood sample andthen the mice were sacrificed. Comparing with the CON group mice, serumtriglyceride, HDL-C, LDL-C and adipose triglyceride lipase were detected and themorphology on subcutaneous adipose tissue was observed.Results:1. Effects of exercise-diet intervention for lipid composition and metabolism onsevere obese subjects.1.1After16weeks’ moderate-low intensity exercise-diet control, the subjects’ bodyweight, body fat percent, waistline, hip circumference, waist hip ratio all droppedsignificantly(P<0.01).1.2At the8th and16th week after the intervention, the subjects’ serum TFA, UFA,MUFA, PUFA, n-6PUFA, n-3PUFA declined significantly(P<0.05); Serum palmitic,γ-linolenic, palitoleic, oleic, linoleic, α-linolenic dropped after theintervention(P<0.05). At the8th week, stearic did not change significantly, but had adeclined significantly at the16th week(P<0.01); DHA dropped significantly at theend of the8th week; Oleic/TFA dropped at the8th week(P<0.05), palmitic/TFA roseat the end of16th week but at that time α-linolenic/TFA, γ-linolenic/TFA droppedsignificantly.1.3After16weeks’ exercise-diet intervention, subjects’ Serum triglyceride, totalcholesterol, LDL-C and fasting plasma glucose dropped (P<0.05). Compared withlevels before intervention, HDL-C/LDL-C rose at the end of the8th,12th and16thweeks. Insulin and HOMA-IR dropped at the end of the8th,12th and16th weeks, andhad significant statistical significances. 1.4After16weeks’ exercise-diet intervention, subjects’ serum leptin declinedgradually, and had significant statistical significance at the end of the8th and12thweeks. The insulin level in the16th week dropped very significantly compared with16weeks before. The average level of adiponectin increased but did not havestatistical significance. Lipoprteinlipase rose gradually after intervention, and had asignificant incline at the end of12th week compared with that before intervention.2. Local pressing-kneading for exercise-induce weight loss effects on severe obesesubjects.2.1After4weeks’ exercise-diet intervention, the PK group and E group subjects’body weight, BMI, body fat percent, circumferences all dropped significantly. Thedecrease ratio of waistline showed that PK group＜E group. The decrease ratio of hipcircumference and thigh circumference showed that PK group＞E group.2.2After4weeks’ exercise-diet intervention, android fat mass and gynoid fat massboth dropped significantly. The decrease ratio of android area showed that PK group＞E group(P<0.05), the trend of which was the same as the decrease ration of gynoidaera.2.3After1hour’s local pressing-kneading, the subjects’ serum TFA, SFA, UFA,MUFA, PUFA, n-6PUFA, n-3PUFA all rose significantly(P<0.01) and MUFA had asignificant decrease after exercise(P<0.05). The level of TFA, SFA, UFA, PUFA,n-6PUFA, n-3PUFA dropped, and had very significant statistical significancecomparing with that before intervention (P<0.01); After1hour’s localpressing-kneading, MUFA/TFA increased significantly(P<0.01) and the ratioremained high level after2hours’ exercise; After1hour’s local pressing-kneading,subjects’ serum stearic rose significantly and meanwhile the levels of palmitic,palmitoleic, oleic, linoleic, γ-linolenic, arachidonic,α-linolenic and DNA showed avery significant rise(P<0.01) and EPA dropped very significantly(P<0.01). After2hours’ exercise, EPA rose significantly and other fatty acid levels decreasedcomparing with the levels before exercise; After local pressing-kneading,Pamitic/TFA dropped (P<0.05), palmitoleic/TFA, oleic/TFA and EPA/TFA increasedsignificantly (P<0.01). After2hours’ exercise, the EPA/TFA dropped, and had verysignificant statistical significance (P<0.01).2.4After1hour’s local pressing-kneading, subjects’ serum adipose triglyceride lipaseincreased significantly (P<0.01), and had a very significant decrease after2hours’exercise.2.5After1hour’s local pressing-kneading, subjects’ serum triglyceride increased, and had very significant statistical significance(P<0.01), and then triglyceride decreasedslightly; The FFA level did not have a significant change after local pressing-kneading,and FFA increased after exercise without a statistical significance.3. Effects of local pressing-kneading for blood lipids and adipose tissue on obese mice3.1After fed with normal diet and high fat diet for66days, the weight, abdominal fatweight, fat body ration and insulin of the PK group and CON group mice which werefed with high fat diet were higher than ND group(P<0.05). After diet intervention, theserum levels of triglyceride of PK group and CON group were higher than NDgroup(P<0.05), ND group mice’s HDL-C was higher than PK group and CONgroup(P<0.05), and obviously the level of ND group mice’s LDL-C was lower thanPK group and CON group(P<0.05).3.2Compared with CON group, the PK group mice’s serum triglyceride increasedsignificantly after40minutes’ local pressing-kneading(P<0.05). The difference ofHDL-C and LDL-C between the two groups had no statistical significance.3.3The ND group mice’s serum adipose triglyceride lipase was21.35±1.65ng/ml,which had no significant difference from the CON group(P＞0.05). The PK groupmice’s serum adipose triglyceride lipase was27.20±1.33ng/ml, which was higherthan the ND group and CON group, and had a very important statistical significance.3.4Using a200times optical microscope to observe the subcutaneous adipose tissueof the high fat diet induced obese mice, lipid are stained red with oil red O, and nucleiare stained blue with hematoxylin. The adipocyte of CON group mice of fat cells wasarranged regularly, and the structure of adipocyte membrane was integral andboundary of adipocyte was clear. The adipocyte of PK group mice was fused intopieces and arranged in disorder. Especially when the bigger adipocyte was irregular,the membrane was ruptured, the boundary was not clear. But the structures of smalleradipocyte were complete. In addition to lipids, loose connective tissue also stained redby oil red O.Conclusion:1. Exercise-diet intervention would significantly bring down obese subjects’ bodyweight, body fat percent, BMI, fat mass and improve their body shape.2. Severe obese subjects have emerged the lipid metabolism disorder and insulinresistance.16weeks’ exercise-diet intervention could improve their blood lipids andinsulin, and bring down their serum fatty acid compositon and leptin, which wouldimprove their fasting serum lipoprotein lipase activity. It played an important role in improving lipid metabolism and promoting health in obese subjects.3. The pressing-kneading on hips and thighs’ subcutaneous fat could increase theserum fatty acid and adipose triglyceride lipase. Aerobic exercise significantlyimproved fat mobilization rate on the pressing-kneading areas, which made thedecreasing degree of hip circumference and thigh circumference similar as waistline.It enhanced the effects of exercise weight loss.4. High fat diet could establish the obese mice model. After local pressing-kneading,the levels of triglyceride and adipose triglyceride lipase increased, which proved thatthe local pressing-kneading destructed adipose tissue. Local pressing-kneading brokedown adipocyte structure of obese mice’s subcutaneous adipose, especially when thebigger adipocyte was irregular and the boundary was not clear.