Exercise as it relates to Disease/Effect of different physical exercise on sedentary behavior in inactive obese males

This wiki book aims to critique the research study 'Effects of High-Intensity Interval and Moderate-Intensity Continuous Exercise on Physical Activity and Sedentary Behavior Levels in Inactive Obese Males: A Crossover Trial' by Matos et al.

What is the background to this research?
The research that is being critiqued aims to promote physical activity activity in men who are deemed obese and decrease time spent in sedentary behaviour. The presence of obesity has been increasing worldwide for many decades it has gotten so large that data in 2016 showed 13.1% of the global population was obese while 38.9% was overweight. The research wanted to demonstrate of using low volume Moderate-Intensity Continuous Exercise (MICE) and High-Intensity Interval Exercise (HIIE) on inactive males to decrease their sedentary behavior and increase habitual physical activity levels. The use on of MICE and HIIE has shown many study that can be linked to many beneficials areas of the body not just losing weight. Some examples are working memory and cognitive flexibility these shows significant effects using MICE and HIIE for increasing psychological and physical traits.

The increase sedentary behaviour started a multitude of problems. factors such as environment, traffic congestion, shortage of parks and pedestrian pathways, laziness, use of phones or other devices and many. Sedentary lifestyle can detrimentally effect health and also brings more risk to non communicable diseases. Approaches of using MICE and HIIE for obese men also shows issues where using one physical exercise training session as a mean to lose weight can lead towards increase sedentary behaviour due to a increase in fatigue.

The purpose of the study is to determined if using MICE and HIIE is beneficial for inactive obese men as a means to promote exercise.

Where is the research from?
The study was conducted at the Federal University of Rio Grande do Norte. The article was publish on september 18, 2019 in the journal of Sports Science and Medicine. The Journal of Sport Science and Medicine is a monthly peer-reviewed covering information about sport and medicine.

Majority of the Authors attend the university of Rio Grande do Norte which is a university that is funded by the Brazilian federal government. The university has a reputation of being one of the most top prestigious university in the state of Rio Grande do Norte. The Author that was affiliated in this research called Eduardo Caldas Costa has done many closely related researches. One related research that Eduardo Caldas Costa was in 'Effects of music on psychophysiological responses during high intensity interval training using body weight exercises'. Researched showed an increase of stimulus using preferred music which gave a positive effect of responses such as HR, blood lactate and Fatigue when comparing to non-preferred music

What kind of research was this?
The research was a randomized crossover trial, the study analysed the effects of a single session of HIIE and MICE. It was conducted with a total of 17 participants and the data consisted over 7 days. Randomized crossover trials are efficient as getting rid of patient variation is more efficient than parallels group trials. Trials are usually restricted to short term as the aim towards chronic diseases or processes the diseases over short time. Other study showed a more lengthen time which was over a 12 week period. The aim of the study was to see if replacing butter with margarine is beneficial on lipoprotein in subjects that have hypercholesterolemia.

What did the research involve?
The study was conducted to analyze the effects of a single low-volume HIIE and MICE session. Once the participants made the criteria for the study then completed the International Physical Activity Questionnaire the participants were then conducted on a maximal graded exercise test on a treadmill. The participants then were randomized to complete a session in a one-week interval. The participants then performed two exercise sessions and one controlled session Figure 1: Tests and session the participants accomplished in the randomized crossover trial 

After all the sessions the participants were then monitored over seven days by an accelerometer.

The methodology of the data was shown to have effect in losing weight in other study. Due to the nature of methods that participants went through it would not determined anything from a limited time of one week. The limitations from the methods above is firstly the lack of participants, the study only had 17 participants who were suitable for the study. With the lack of sample sized came lack of time of experiment. The goal was to use one session to monitor sedentary behavior but as results show increase sedentary was achieved.

What were the basic results?
figure 2: variables of the data during the study 

The main findings of the data showed no differences in physical activity and sedentary behaviour levels in the 7 day period. The study claimed that there hypothesis was correct that doing the sessions of HIIE and MICE would elicit a negative effect in reducing physical activity and therefore increasing sedentary behavior. The study claimed that the exercise session and intervention length were significantly associated with change in physical activity level during exercise. therefore declaring that longer the session was the more it decreased physical activity level. The use of short sessions was to imply for less DOMS delayed onset muscle soreness, which would help more in daily living. The other studies that compared sedentary behavior and MICE/HIIE shows a correlation of sedentary behaviour increasing and habitual physical activity decrease. The researchers imply that the study did not have an influence on decreasing sedentary behaviour on obese males. They came to conclusion that HIIE and MICE should be considered for inactive obese males but, given it does not reduce physical activity and increases sedentary behaviour.

What conclusions can we take from this research?
The researchers provided a very basic conclusion which was that a single session of MICE and HIIE will increase sedentary behaviour and decrease physicals activity. As the data implies the outcome could not change behaviour of the participants. Though the problems of this study comes from the lack of time and also the sample size of the participants. A study by ' International Journal of Behavioral Nutrition and Physical Activity' showed results of a systematic search that interventions such as workplace or screen time for young children has decreased sedentary behavior. The study also claims that sedentary behaviour combined with physical activity interventions shows a larger decrease in reduce sitting time. Also the benefit of both MICE and HIIE can be differed into one being more difficult than the other. A study by Int J Environ Res Public Health exclaimed that MICE was a more beneficial and positive session comparing to HIIE. So, for introducing more obese/inactive people to exercise a good start would be to use MICE as enjoyment levels would be higher and increase chance of coming back for another session.

Practical advice

 * HIIE and MICE are both practical use of increasing physical activity and losing weight
 * Considered training with someone as it helps engage more and shows more benefit overall
 * Always consider who the patient is and how they would react to a exercise session that you provide the intensity of.

Further information/resources

 * Interventions designed to reduce sedentary behaviours in young people: A review of reviews - https://vuir.vu.edu.au/29911/1/Interventions%20designed%20to%20reduce%20seds%20review%20%28VU%20IR%2025-1-16%29.pdf
 * World Health Organization on diabetes - https://www.who.int/health-topics/diabetes#tab=tab_3
 * World Health Organization on guidelines of physical and Sedentary behaviour - https://www.who.int/publications/i/item/9789240015128