STRENGTH TRAINING FOLLOWING GASTRIC BYPASS FOR OBESITY

肥胖胃绕道术后的力量训练

基本信息

批准号：
6838343
负责人：
ALLAN GELIEBTER
金额：
$ 6.29万
依托单位：
ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-03-01 至 2006-12-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): As the incidence of obesity rises dramatically in the United States, more and more severely obese individuals are undergoing surgical treatment to reduce body weight and associated risk factors. Roux-en-Y gastric bypass (RYGB) is now the most common operation to treat morbid obesity in the US. However, little is known about the effects of RYGB on body composition and resting energy expenditure (REE). The main objectives of this study are to determine: 1) the composition of weight loss following surgery, 2) whether protein supplementation and strength training can limit the expected reduction of lean mass and REE. The study candidates will be morbidly obese women with a body mass index (BMI) of 40-56 kg/m2, be 18 - 49 y.o. and premenopausal. Except for severe obesity, they will be relatively healthy with a history of diet failure. They will be sedentary except for walking. There will be 36 study participants who, after stratifying by race, will be randomly assigned to three treatment groups (n = 12): 1) standard postoperative nutritional counseling only, 2) protein supplementation and standard postoperative nutritional counseling, or 3) protein supplementation plus strength training and standard postoperative nutritional counseling. The protein supplementation will begin shortly after surgery and increase from 40 g/day to 80 g/d at 4 weeks. Strength training will begin 8 weeks postoperation, to allow for adequate wound healing, and will consist of twice weekly progressive resistance training for upper and lower body for a period of 12 weeks. A battery of test measurements following a 12 h overnight fast will be conducted prior to surgery and repeated postoperatively at 8 and 20 weeks. These tests will include measurement of REE and body composition using underwater weighing, air displacement (BODPOD), dual xray absorptiometry (DEXA), magnetic resonance imaging (MRI), isotope dilution (D20), sodium bromide, and regional anthropometrics. There also will be assessments of arm and leg strength. Additionally, there will be measures of fasting glucose and body weight related hormones insulin, leptin, cortisol, and the recently discovered ghrelin. The predictions are that during the dramatic weight loss after surgery, the loss of some lean tissue, which could adversely impact skeletal muscle and vital organs, will be reduced by enhanced protein intake and weight training. There also may be greater conservation of REE and bone density. Plasma glucose and hormones should all decrease, especially with exercise, except for ghrelin, which should increase. The findings should improve understanding of surgical weight loss in morbidly obese patients and have clinical applications in the postoperative care of such patients.

描述（由申请人提供）：随着肥胖的发生率在美国急剧上升，越来越严重的肥胖者正在接受手术治疗，以减轻体重和相关的危险因素。现在，Roux-en-Y胃旁路（RYGB）是治疗美国病态肥胖症的最常见手术。但是，关于RYGB对人体成分和静息能量消耗（REE）的影响知之甚少。这项研究的主要目标是确定：1）手术后体重减轻的组成，2）蛋白质补充和力量训练是否可以限制瘦质量和REE的预期减少。该研究候选人将是病态的肥胖女性，其体重指数（BMI）为40-56 kg/m2，为18-49 Y.O.和绝经前。除了严重的肥胖症外，它们的饮食衰竭病史将相对健康。除步行外，他们将久坐不动。将有36名研究参与者按种族分层后，将随机分配给三个治疗组（n = 12）：1）仅术后营养咨询，2）补充蛋白质和标准的术后营养咨询，或3）蛋白质补充剂以及蛋白质补充剂以及力量培训和标准的术后营养咨询。补充蛋白质将在手术后不久开始，并在4周时从40 g/天增加到80 g/d。力量训练将在8周后开始，以允许足够的伤口愈合，并包括每周两次的上半身和下半身的渐进性训练，为期12周。在手术前将进行12小时过夜后的一系列测试测量，并在8和20周进行术后重复。这些测试将包括使用水下称重，空气位移（BODPOD），双X射线吸收仪（DEXA），磁共振成像（MRI），同位素稀释（D20），溴化物溴化物和区域人类人类拟人化。还将对手臂和腿部力量进行评估。此外，还将有针对禁食葡萄糖和体重相关的激素胰岛素，瘦素，皮质醇和最近发现的生长素蛋白的措施。预测是，在手术后的急剧体重减轻期间，某些瘦肉组织的损失可能会对骨骼肌和重要器官产生不利影响，从而通过增强的蛋白质摄入和重量训练来减少。 REE和骨密度也可能有更大的保护。血浆葡萄糖和激素都应降低，尤其是在运动中，除生长素外，应增加。这些发现应提高对病态肥胖患者手术体重减轻的了解，并在此类患者的术后护理中应用临床应用。