Abstract
Background
Obesity is a major health problem and leads to metabolic diseases such as type 2 diabetes, insulin resistance and hyperlipidemia. Recently, it was reported that aloe QDM complex, composed of processed aloe vera gel, aloesin and chromiun could improve insulin sensitivity by enhancing 5' adenosine monophosphate-activated protein (AMPK) activity and has an anti-inflammatory effect by reducing the level of pro-inflammatory cytokines. It is also known that aloe QDM complex can reduce body weight, body fat mass and insulin resistance in type 2 diabetes patients. The purpose of this study was to assess for possible synergistic effects of weight-bearing circuit training and aloe QDM complex supplementation on body composition, physical fitness, blood profile and diabetes risk factors.
Methods
Study subjects included 19 participants randomly assigned to the Exercise group (Ex, n=9) and to the Exercise with aloe QDM complex group (Q-Ex, n=10). Both groups participated in weight-bearing circuit training 3 times a week for 4 weeks and took a capsule composed of either aloe (aloe QDM complex) or soy bean (placebo), 1100 mg/day for 4 weeks. Body composition was measured by dual-energy x-ray absorptiometry. Grip strength, flexibility, curl-up, balance, agility, Sargent jump and VO2max were measured, as well as fasting blood samples taken.
Results
After 4 weeks of weight-bearing circuit training and aloe QDM complex supplementation, the significant interactions (time × intervention) between the groups regarding body fat percentage (F=7.024, P=0.017) and body fat mass (F=5.243, P=0.035) were calculated. There were significant differences in body fat percentage (P=0.029) and body fat mass (P=0.039). No significant interaction was observed in physical fitness, blood profile and diabetes risk factors.
References
1. Statistics Korea. National Health and Nutrition Survey 2011. Korea Health Statistics 2011: Korea National Health and Nutrition Examination Survey(KNHANESV‐2). Reston: Ministry of Health and Welfare;2012. [Accessed January 2, 2013].https://knhanes.cdc.go.kr/knhanes/sub04/sub04_03.do?classType=7.
2. Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies: a statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Diabetes Care. 2004; 27(8):2067–73.
3. American College of Sports Medicine; Whaley MH, Brubaker PH, Otto RM, Armstrong LE. ACSM's Guidelines for Exercise Testing and Prescription. 7th ed.Philadelphia, PA: Lippincott Williams & Wilkins;2006. p. 19–54. 216–9.
4. Hunter GR, Bryan DR, Wetzstein CJ, Zuckerman PA, Bamman MM. Resistance training and intraabdominal adipose tissue in older men and women. Med Sci Sports Exerc. 2002; 34(6):1023–8.
5. Booth FW, Tseng BS. America needs to exercise for health. Med Sci Sports Exerc. 1995; 27(3):462–5.
6. Most J, Goossens GH, Jocken JW, Blaak EE. Short-term supplementation with a specific combination of dietary polyphenols increases energy expenditure and alters substrate metabolism in overweight subjects. Int J Obes (Lond). 2014; 38(5):698–706.
7. Capasso F, Borrelli F, Capasso R, Di Carlo G, Izzo AA, Pinto L, et al. Aloe and its therapeutic use. Phytother Res. 1998; 12(S1):S124–7.
8. Heggers JP, Kucukcelebi A, Stabenau CJ, Ko F, Broemeling LD, Robson MC, et al. Wound healing effects of Aloe gel and other topical antibacterial agents on rat skin. Phytother Res. 1995; 9(6):455–7.
10. Winters WD, Benavides R, Clouse WJ. Effects of aloe extracts on human normal and tumor cells in vitro. Econ Bot. 1981; 35(1):89–95.
11. Ngo MQ, Nguyen NN, Shah SA. Oral aloe vera for treatment of diabetes mellitus and dyslipidemia. Am J Health Syst Pharm. 2010; 67(21):1804–11.
12. Langmead L, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, et al. Randomized, double-blind, placebocontrolled trial of oral aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther. 2004; 19(7):739–47.
13. Yongchaiyudha S, Rungpitarangsi V, Bunyapraphatsara N, Chokechaijaroenporn O. Antidiabetic activity of Aloe vera L. juice. I. Clinical trial in new cases of diabetes mellitus. Phytomedicine. 1996; 3(3):241–3.
14. Bunyapraphatsara N, Yongchaiyudha S, Rungpitarangsi V, Chokechaijaroenporn O. Antidiabetic activity of Aloe vera L. juice II. Clinical trial in diabetes mellitus patients in combination with glibenclamide. Phytomedicine. 1996; 3(3):245–8.
15. Misawa E, Tanaka M, Nomaguchi K, Yamada M, Toida T, Takase M, et al. Administration of phytosterols isolated from Aloe vera gel reduce visceral fat mass and improve hyperglycemia in Zucker diabetic fatty (ZDF) rats. Obes Res Clin Pract. 2008; 2(4):239–45.
16. Choi HC, Kim SJ, Son KY, Oh BJ, Cho BL. Metabolic effects of aloe vera gel complex in obese prediabetes and early non-treated diabetic patients: randomized controlled trial. Nutrition. 2013; 29(9):1110–4.
17. Shin E, Shin S, Kong H, Lee S, Do SG, Jo TH, et al. Dietary aloe reduces adipogenesis via the activation of AMPK and suppresses obesity-related inflammation in obese mice. Immune Netw. 2011; 11(2):107–13.
18. Mu J, Brozinick JT Jr, Valladares O, Bucan M, Birnbaum MJ. A role for AMP-activated protein kinase in contraction- and hypoxia-regulated glucose transport in skeletal muscle. Mol Cell. 2011; 7(5):1085–94.
19. Reznick RM, Shulman GI. The role of AMP-activated protein kinase in mitochondrial biogenesis. J Physiol. 2006; 574(Pt 1):33–9.
20. O'Neill HM, Holloway GP, Steinberg GR. AMPK regulation of fatty acid metabolism and mitochondrial biogenesis: implications for obesity. Mol Cell Endocrinol. 2013; 366(2):135–51.
21. American College of Sports Medicine; Pescatello LS. ACSM's Guidelines for Exercise Testing and Prescription. 9th ed.Philadelphia, PA: Lippincott Williams & Wilkins Health;2014. p.320.
22. Shin E, Shim KS, Kong H, Lee S, Shin S, Kwon J, et al. Dietary aloe improves insulin sensitivity via the suppression of obesity-induced inflammation in obese mice. Immune Netw. 2011; 11(1):59–67.
23. So WY, Choi DH. Effects of walking and resistance training on the body composition, cardiorespiratory function, physical fitness, and blood profiles of middle-aged obese women. Exerc Sci. 2007; 16(2):85–94.
24. Kwon YI, Park TG, Park GH, Park CH, Jeon JY, Choi MG, et al. Effects of combined exercise training on physical fitness and metabolic syndrome in obese middle school boys. Korean J Phys Educ-Nat Sci. 2006; 45(6):611–21.
25. Watts K, Jones TW, Davis EA, Green D. Exercise training in obese children and adolescents: current concepts. Sports Med. 2005; 35(5):375–92.
26. Swain DP. Moderate or vigorous intensity exercise: which is better for improving aerobic fitness? Prev Cardiol. 2005; 8(1):55–8.
Table 1.
Table 2.
Variables | ITT | PP | P | |||
---|---|---|---|---|---|---|
Ex (n=12) | Q‐Ex (n=16) | Ex (n=9) | Q‐Ex (n=10) | ITT | PP | |
Age, y | 51.0±2.0 | 50.0±2.3 | 50.7±2.4 | 50.7±2.4 | N.S. | N.S. |
Height, cm | 155.3±1.8 | 157.8±1.4 | 153.7±2.1 | 156.2±1.3 | N.S. | N.S. |
Weight, kg | 64.6±2.4 | 63.5±2.1 | 65.0±2.7 | 59.9±1.7 | N.S. | N.S. |
WHR | 0.92±0.008 | 0.90±0.014 | 0.93±0.009 | 0.88±0.013 | N.S. | 0.013b |
BMI, kg/m2 | 26.8±0.8 | 25.5±0.7 | 27.4±0.7 | 24.6±0.7 | N.S. | 0.010c |
Body fat, % | 37.2±0.8 | 37.6±0.9 | 38.2±0.7 | 36.5±1.0 | N.S. | N.S. |
Lean body, % | 62.8±0.8 | 62.4±0.9 | 61.8±0.7 | 63.5±1.0 | N.S. | N.S. |
VO2max, mL/kg/min | 21.9±1.5 | 22.9±0.6 | 20.0±1.3 | 22.68±0.9 | N.S. | N.S. |
FBG, mg/dL | 94.8±3.4 | 104.1±11.4 | 95.3±4.4 | 91.6±3.1 | N.S. | N.S. |
Insulin, mlU/L | 6.6±1.0 | 7.3±1.1 | 7.3±1.2 | 6.5±1.7 | N.S. | N.S. |
HbA1c, % | 6.1±0.1 | 5.9±0.2 | 6.0±0.1 | 5.6±0.1 | N.S. | 0.004d |
HOMA‐IR | 1.6±0.2 | 1.9±0.3 | 1.7±0.3 | 1.5±0.5 | N.S. | N.S. |
Total cholesterol, mg/dL | 208.0±8.6 | 192.2±5.8 | 216.9±9.6 | 197.1±8.1 | N.S. | N.S. |
HDL‐C, mg/dL | 49.8±2.3 | 55.6±3.8 | 49.0±2.7 | 57.6±5.8 | N.S. | N.S. |
Triglyceride, mg/dL | 131.0±25.6 | 112.6±23.2 | 145.6±33.0 | 124.0±36.8 | N.S. | N.S. |
Table 3.
Variables | Pre | Post | F | P | ||
---|---|---|---|---|---|---|
Ex | Q‐Ex | Ex | Q‐Ex | |||
Body fat, % | 38.2±2.1 | 36.5±3.1 | 37.7±2.3 | 34.9±2.9b,c | 7.024 | 0.017d |
Body fat mass, kg | 24.8±3.6 | 22.0±3.5 | 24.2±3.6e | 20.6±3.5f,g | 5.243 | 0.035h |
Lean body mass, kg | 40.1±4.9 | 37.9±2.8 | 39.9±5.1 | 38.3±3.3 | 1.929 | 0.183 |