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Effects of non-periodized and linear periodized combined exercise training on insulin resistance indicators in adults with obesity: a randomized controlled trial [with consumer summary]
Streb AR, dos Santos Leonel L, Delevatti RS, Cavaglieri CR, del Duca GF
Sports Medicine Open 2021 Sep 26;7(69):Epub
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: The aim was to verify the effect of non-periodized and linear periodized combined (aerobic plus resistance) exercise training on insulin resistance markers in adults with obesity. METHODS: A blinded randomized control trial was conducted with three groups of individuals with obesity (BMI 30 to 39.9 kg/m2): control group (CG, n = 23), non-periodized group (NG, n = 23), and linear periodized group (PG, n = 23). The NG and PG performed aerobic and resistance exercises in the same session in aerobic-resistance order for 16 weeks. Both intervention groups trained three sessions weekly, with a total duration of 60 min each. The aerobic training of the NG had a duration of 30 min always between 50% and 59% of the reserve heart rate (HRres), while resistance exercise was comprised of 6 exercises, performed always in 2x 0 to 12 maximum repetitions (MRs). The PG progressed the aerobic and resistance training from 40% to 49% to 60% to 69% (HRres) and from 2x12 to 14 to 2x8 to 10 RM, respectively, along the intervention period. The evaluated indicators of insulin resistance included fasting glucose, fasting insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) collected pre- and post-intervention. The analyses to verify the exercise training effect were performed using generalized estimating equations. RESULTS: After 16 weeks of training, per protocol analysis (n = 39) showed significant reductions in HOMA-IR only in the training groups (NG delta -1.6, PG delta -0.6; p = 0.094). Intention-to-treat analysis demonstrated significant reductions in fasting insulin levels (NG delta -1.4, PG delta -1.0; p = 0.004) and HOMA-IR (NG delta -5.5, PG delta -3.8; p = 0.002). CONCLUSION: Periodized and non-periodized combined exercise training similarly reduces insulin resistance markers in adults with obesity. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-3c7rt3. Registered 07 February 2019 -- https://ensaiosclinicos.gov.br/trial/5970/1.

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