The Role of Exercise in a Weight-Loss Program on Clinical Control in Obese Adults with Asthma A Randomized Controlled Trial

Author(s)

Freitas, Patricia D. ; Ferreira, Palmira G. ; Silva, Aline G. ; Stelmach, Rafael ; Carvalho-Pinto, Regina M. ; Fernandes, Frederico L. A. ; Mancini, Marcia C. ; Sato, Maria N. ; Martins, Milton A. ; Carvalho, Celso R. F.

• Document type: Journal article
• Source: American Journal of Respiratory and Critical Care Medicine; v. 195, n. 1, p. 11-pg., 2017-01-01.

Abstract

Rationale: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated. Objectives: To examine the effect of exercise training in a weight loss program on asthma control, quality of life, inflammatory biomarkers, and lung function. Methods: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program plus exercise (WL + E group, n = 28) or a weight-loss program plus sham (WL + S group, n = 27), where the weight-loss program included nutrition (caloric restriction) and psychological therapies. The WL + E group incorporated aerobic and resistance muscle training, whereas the WL + S group incorporated breathing and stretching exercises. Measurements and Main Results: The primary outcome was clinical improvement in asthma control over 3 months. Secondary outcomes included quality of life, lung function, body composition, aerobic capacity, muscle strength, and inflammatory/antiinflammatory biomarkers. After 3 months, 51 patients were analyzed. Compared with the WL + S group, the WL + E group demonstrated improved clinical control scores (median [25th to 75th percentile],-0.7 [-1.3 to -0.3] vs. -0.3 [-0.9 to 0.4]; P = 0.01) and greater weight loss (mean +/- SD, -6.8% +/- 3.5 vs. -3.1% +/- 2.6; P < 0.001) and aerobic capacity (median [25th to 75th percentile], 3.0 [2.4 to 4.0] vs. 0.9 [-0.3 to 1.3] ml O-2 X kg(-1) X min(-1); P < 0.001). These improvements in the WL + E group were also accompanied by improvements in lung function, antiinflammatory biomarkers, and vitamin D levels, as well as reductions in airway and systemic inflammation. Conclusions: Adding exercise to a short-term weight-loss program should be considered as a useful strategy for achieving clinical control of asthma in obese patients. (AU)

• FAPESP's process: 12/16134-3 - Effect of a pulmonary rehabilitation in the clinical control and health related quality of life in obese asthmatics
• Grantee: Patricia Duarte Freitas
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 12/16700-9 - Limiting factors during exercise and effect of a pulmonary rehabilitation in the clinical control and Health Related Quality of Life in obese asthmatics
• Grantee: Celso Ricardo Fernandes de Carvalho
• Support Opportunities: Regular Research Grants