摘要
肥胖已成为一种流行性疾病严重危害人类的健康,防肥减肥势在必行。能量输入和输出的不平衡是导致肥胖的重要原因,运动是增加能量消耗的一种重要方式,因此,运动减肥以其安全、可行、有效的优点越来越受到人们的青睐。大量研究表明,运动不仅可以增加运动时能量消耗,运动结束后机体仍然可以维持较高的静息代谢率,增加安静时的能量消耗。运动后过量氧耗(EPOC),指体力运动后恢复期超过安静状态耗氧量水平的额外耗氧量。越来越多的研究表明对于运动总能量消耗来说,EPOC占有较大的比例,其主要部分用来脂肪氧化,所以对EPOC在控制体重方面的研究是非常有意义的。运动训练不仅可以增强心肺适能,改善循环、呼吸和消化系统的机能状况,还可以提高抗病能力,增强有机体的适应能力,是增强体质的最积极、有效的手段之一。同时可以使脂肪的利用比率增加,有效的控制体重和体脂百分比(Fat%),特别是中低强度、长时间系统的有氧运动。那么运动训练对肥胖者EPOC有何影响?目前未见相关报道。
研究目的:本研究旨在通过对有无运动训练的肥胖者和正常体成分者三组受试者进行60%VO2max运动强度,持续运动40分钟的有氧功率车运动,观察其在运动过程中,以及运动结束后恢复期相关生理代谢指标的变化,分析运动训练对肥胖青年男性EPOC的影响,初步探讨其可能机制。其研究成果将为从运动后能量消耗的角度分析运动训练对肥胖青年男性的运动减肥效果开拓新的思路,为指导减肥运动处方的制订及实施提供理论依据。
研究方法:本研究对象为无运动训练史肥胖青年男性(F组)、一年以上运动训练史肥胖青年男性(YF组)及正常体成分青年男性(C组)各10名,运动方式为40分钟60%VO2max运动强度功率车运动。主要监测指标有EPOC总量及持续时间、心率(HR)、血压(BP)、主观体力感觉(RPE)、呼吸商(RQ)、血脂三项、血清游离脂肪酸(FFA)、血清皮质醇(C)等。
研究结果:①F组甘油三酯(TG)、高密度脂蛋白(HDL)、极低密度脂蛋白(VLDL)值超出正常范围,而YF组TG、VLDL值超出正常范围,F组TG、VLDL略高于YF组,但无统计学意义。安静状态下,F组的HR(P<0.05)、收缩压(P<0.05)和舒张压(P<0.05)都显著高于YF组,且F组动脉血压已达到准高血压范围;F组肺活量指数、VO2max相对值显著低于YF组(P<0.001)。提示,肥胖者由于脂肪积累过多而使血脂出现一定程度的异常,心血管功能、心肺功能及有氧工作能力有一定程度降低;而运动训练在一定程度上改善了肥胖者血脂异常现象,降低心血管疾病的发病风险,使心肺功能及有氧工作能力都有一定程度的提高。
②在控制饮食情况下F组与YF组安静RQ值显著高于C组(P<0.05),F组与YF组没有显著差异,提示,肥胖受试者安静状态下脂肪代谢供能所占比例降低。YF组基础代谢率(BMR)相对值显著高于F组(P<0.05),提示,脂肪积累过多可导致机体基础能耗量下降,通过运动训练可提高基础能耗量。
③运动过程中,三组受试者HR变化趋势保持一致,YF组从运动20至40分钟显著低于C组(P<0.05)。整个运动后恢复过程HR恢复时间YF组显著短于F组(P<0.001)。提示,F组由于脂肪积累过多,使心血管系统运动后恢复能力下降;运动训练可提高肥胖者心血管系统运动后恢复能力。运动过程中F组RPE显著高于YF组,提示,脂肪堆积过多使肥胖者体能下降,在运动中更容易感到疲劳,运动训练能够改善体能,使机体较快地适应运动刺激,感到轻松。
④EPOC持续时间、总量、EPOC总量相对值、运动后过量能耗,F组显著低于C组及YF组(P<0.001),YF组显著低于C组(P<0.001)。EPOC总量占总运动净耗氧量百分比C组显著高于其它两组(P<0.001),YF组略高于F组,但无统计学意义。运动净能耗量YF组显著高于C组和F组(P<0.05)。提示,肥胖者运动后机体代谢水平较低,通过运动训练能够增强肥胖者运动后机体代谢水平,使运动后耗能增加。主要结论:1.运动训练的益处不仅表现在改善肥胖青年男性的心肺功能,提高有氧运动能力,使其在以60%VO2max运动强度(相同生理负荷强度)功率车运动时,完成更多的外功,运动实际总耗氧量增多;而且还使EPOC总量增多,持续时间延长,促进了运动后恢复期脂肪的代谢,有利于每次运动后恢复期的脂肪消耗。2.建议肥胖青年男性在可承受的运动强度范围内健身运动时,做功量越大、耗氧量越多,越有利于运动后安静时脂肪的消耗。因此,在运动减肥实践中,应将EPOC因素考虑在内,通过坚持不懈的健身运动,提高EPOC达到更好的运动减肥效果。
Obesity has become an epidemic disease, which seriously endanger the human health, and it is imperative to prevent it. The imbalance of energy input and output is an important factor, while exercise is an effective way to increase the energy consumption, therefore, with its security, feasibility and effectiveness, losing weight by taking exercise is favored by people of all ages. A great number of studies show that exercise can not only increase energy consumption, but also maintain higher body RMR and increase resting energy consumption. EPOC, that is the extra oxygen consumption, which refers to physical recovery after exercise, more than resting period. More and more studies show that EPOC accounts for a large proportion of the total exercise energy consumption and mainly used to fat oxidation, so it is significant to study EPOC role in weight control. Sport training is one of the most effective methods which can not only have a positive effect on the cardiopulmonary, circulatory respiratory and digestive system, but also can increase the ratio of fat using and control the weight and fat percentage (Fat%)effectively, especially in the low-intensity, long-time aerobic exercise. What impact does sport training have on the obesity? So far there has no relevant report.
Purpose: By analyzing the related physiological and metabolic indicators of non-exercise experience obesity groups and the normal ones, whose exercise mode is 60%VO2max intensity, 40 minutes aerobic power exercise, the purpose of this study is to discuss the sport training's impact on the EPOC of young obesity men and explore its possible mechanism. And the result, from the point of energy consumption after exercise, may provide a pioneer way in slimming effect on young obesity men and also provide its theoretical basis for the exercise prescription.
Methods: The study object divides into three groups, that is no-training experience obese young men(Group F), more than one year training obese young men (Group YF), and normal body composition young men (Group C). Each group has 10 numbers, and the exercise mode is 60%VO2max intensity, 40 minutes of aerobic power movement. The main monitoring indicators include the total EPOC and its duration time, heart rate (HR), blood pressure (BP), rating of perceived exertion (RPE), respiratory quotient (RQ), three blood lipids, serum free fatty acid (FFA), serum cortisol (C )and so on.
Results:①For the Group F, the values of trigalloyl glycerol (TG),high density lipoprotein(HDL), very low density lipoprotein (VLDL) exceed the normal scope, while for the Group YF, the values of TG, VLDL are also exceed the normal range. Compared the two groups, the values of Group F are higher, however, there is no statistical significance. During the resting state, for the values of HR(P<0.05)、systolic blood pressure (P<0.05) and diastolic blood pressure (P<0.05), Group F are obviously higher than the Group YF. At the same time, Group F has reached quasi-arterial blood pressure hypertension; and for the FVC index, VO2max relative value, Group F are significantly lower than Group YF (P<0.001). The above discussed indicates that due to fat accumulation, the obesity are easy to the lipid abnormalities, also a certain reduce of cardiovascular, heart and lung function and aerobic capacity, while taking sport training can improve lipid abnormalities, reduce the risk of cardiovascular disease and have an active role on the heart and lung function and aerobic capacity to some extent.
②During the diet control circumstances, the values of resting RQ of Group F and Group YF are obviously higher than Group C (P<0.05), while there is no obvious difference in the two former groups. The above information indicates that in the resting state, the proportion of obese subjects' energy supply of fat metabolism is lower. Furthermore,for the relative values of basic metabolic rate (BMR) , Group YF is significantly higher than that in Group F (P<0.05), which indicates excessive fat accumulation may lead to a decline of body basic power consumption, however, taking sport training can prevent it.
③In this study, during the Sport training, the three groups' are consistent in the movement trend of HR value, however, during 20 to 40 minutes, for the value of HR, Group YF is significantly lower than that in Group C (P<0.05). Therefore, for the HR recovery time, Group YF is significantly shorter in Group F (P<0.001) During the whole recovery process after exercise. The above indicates that due to the excessive fat accumulation, recovery of cardiovascular system decreases in Group F, while by taking sport training, the obesity can increase their cardiovascular function. What's more, during the sport training, for the values of RPE, Group F is obviously higher than that in Group YF, which indicates that excessive fat accumulation may lead to physical decline and fatigue, while through sport training, the obesity can improve physical fitness, quickly adapt to exercise stimulation and feel comfortable.
④For the values of EPOC duration, volume, the relative value of total EPOC, and excessive energy consumption after exercise, Group F is significantly lower than Group C and YF (P<0.001), and compared with the latter groups, Group YF is lower (P<0.001).
What's more, for the percentage of EPOC’s amount in net oxygen consumption, Group C is significantly higher than that of Group F and YF (P<0.001), and of the latter, Group YF is slightly higher, but there is no statistic significance. And for the value of net energy consumption, Group YF is obviously higher than that of Group F and C (P<0.05),which indicates that, after sport training, their metabolism maintain at a low level. Therefore, by taking sport training, the obesity can enhance their metabolism and energy consumption. Conclusion: 1.The benefits of sport training not only improve cardio-pulmonary function of obese young men but also increase their aerobic capacity, which resuit in increasing their amount of workand the oxygen consumption by doing aerobic power exercise at 60%VO2max intensity(the same physilogical load). Further, it can raise the total amount of EPOC and its time duration which may promote fat metabolism and consumption after exercise. 2. It is advisable for the obese young men, within the acceptable scope of exercise intensity, to do sport training. The more oxygen consume, the greater work does, which will accelerate fat consumption during the resting state. To reach to the desired results, the obese young men should take the factor of EPOC into consideration, which may lead to enhancement of EPOC, and make unremitting efforts to participate in physical exersice.
引文
[1]杨景勋.减肥药的安全性与合理使用[J].药物不良反应杂志,2003,5(2):91.
[2]Eker M C,Onat O,Pirildar S,et al.Casereport:amixtepisode induced by sibutramine[J].Bull Clncl Psychphrm ,2003,13(3):129.
[3]Chanoine JP,Hamp lS,Jensen C,et al.Effect of or list at on weight and bodycomposition in obesea do lescents:arandomized controlled trial[J].JA MA,2005,293(23):2873.
[4]Derosa G,Cicero AFG,Murdolo G,et al.Efficacy and safety comparative valuation of or list at and sibutramine treatment in hyperten sive obese patients[J].Diabetes,2005,7(1):47.
[5]Martin LF.Obesity surgery The McGraw[M].New York:Hill Companies ,2004 .65.
[6]寇玉彬,郑成竹,印慨,等.腹腔镜可调控性胃捆扎带减肥术术后并发症的诊治[J].中华外科杂志,2006,44(11):1473-1476.
[7]Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopics leevegastrect omyasaninitial weight-loss procedure for high-riskpatient swith morbid obesity[J].Surg Endosc,2006,20(6):859-863.
[8]Himpens J,Dapri G,Cadiere GB.Aprospectiver and omized study between laparoscopicg as tricbanding and laparoscopiciso-lateds leeveg as trectomy :results after 1and 3 years[J].Obes Surg,2006,16(11):1450-1456.
[9]蔡晓波,李克.减肥手术对肝病的影响[J].肝脏,2005,10(2):120-121.
[10][58]Maehlum S,Grandmontagne M,Newshlme EA,et al.Magnitude and duration of excess postexercise oxygen consumption in healthy young subjects[J].Etab- olism,1986 May,35(5):425-9.
[11][44][45][99]谢永涛.肥胖对青年男性有氧运动后 EPOC 的影响[D].河北师范大学,2005.
[12][40][101]Short KR,Sedlock DA. Excess postexercise oxygen consumption and recovery rate in trained and untrained subjects[J].J Appl Physiol,1997 Jul, 83(1):153-159.
[13]Luc Tappy,Jean P,Fellber,et al.Energy and substrate metabolism in obesity and post obese state[J].Diabetes Care,1991,14(12):1180-1188.
[14]Brehm B A.Recovery energy expenditure for steady state exercise in runners and nonexercisers[J].Med Sci Sports Exerc,1986,18(2):205-210.
[15][94]Bahr R.Triglyceride/fatty acid cycling is increased after exercise [J].Metabolism,1990 Sep,9(9):993-999.
[16][95]Trost S.The effect of substrate utilization ,manipulated by nicotinic acid,on excess postexercise oxygen consumption[J].Int J Sport Med,1997 Feb, 18(2):83-88.
[17][96]Lacour JR.Lipid metabolism and exercise[J].Rev Prat,2001 Jun,30: 51(12 suppl):s36-4.
[18][98]Binzen CA. Postexercise oxygen consumption and substrate use after resistence exercise in women[J].Med Sci Sport Exerc,2001 Jun,33(6):932-938.
[19][97]Lee YS.The effect of various intensities and durations of exercise with and without glucose in milk ingestion on postexercise oxygen consumption [J].J Sports Med Phys Fitness,1999 Dec,39(4):341-347.
[20][28]Thornton MK,Potteiger JA.Effects of resistance exercise bouts of different interesitties but equal work on EPOC[J].Med Sci Sports Exerc,2002 Apr,34(4):715-22.
[21][30]Phelain JF. Postexercise energy expenditure and substrate oxidation in young women r esulting from exercise bouts of different intensity[J].Am Coll Nutr,1997 Apr,16(2):140-6.
[22][34]Bahr R. Effect of split exercise on excess postexercise 02 consumption [J].J Appl Physiol,1987 Fed,62(2):485-90.
[23][36]Almuzaini KS.Effects of split exercise session on excess postexercise oxygen consumption and resting metabolic rate[J].Can J Appl Physiol,1998 Oct,23(5):433-43.
[24][37]Kaminsky LA.Effect of split exercise sessions on decess post-exerxise oxygen consumption[J].Br J Sport Med,1990 Jun,24(2):95-8.
[25]MJ Drummond,PR Vehrs.Aerobic and resistance exercise sequence affectsexcess postexercise oxygen consumption[J].J Strength Cond Res,2005 May, 19(2):332-7.
[26]S Lyons, M Richardson.Excess postexercise oxygen consumption in untrained men following exercise of equal expenditure:comparisons of upper and lower body exercise[J].Diabetes Obes Metab,2007 Nov,9(6):889-94.
[27]TV Hancock,TT Gleeson.Contributions to Elevated Metabolism during Recovery: Dissecting the Excess postexercise oxygen consumption(EPOC) in the Desert Iguana[J].Physiol Biochem Zool,2008 Jan,81(1):1-13.
[29]Short KR.The effect of upper body exercise intensity and duration on post-exercise oxygen consumption[J].Int Sports Med,1996 Nov,17(8):559-63.
[31]Knuttgen H.G, Saltin B. Muscle metabolites and oxygen uptake in short-term submaximal exercise in man[J].J Appl Physiol,1972,32:690-694.
[32]Hagberg J M, Mullin J P, Nagle F J.Effect of work intensity and duration on recover O2[J].J Appl Physiol,1980,48:540-544.
[33]Laforgia J, Withers R T,Shipp M J,et al. Comparison of energy expenditure elevations after submaximal and supramaximal running[J].J Appl Physiol, 1997,82:661-666.
[35]Haltom RW. Circuit weight training and its effects on excess postexercise oxygen consumption[J].Med Sci Sport Exerc,1999 Dec,24(12):689-693.
[38]Lyons S,Richardson M.Excess postexercise oxygen consumption in untrained males: effects of intermittent durations of arm ergometry[J].Appl Physiol Nutr Metab,2006 Jun,31(3):196-201.
[39][100]Sedlock DA. Fitness level and postexercise energy expenditure[J]. J Sports Med Phys Fitness,1994 Dec,21(6):662-6.
[41]Borsheim E. Effect of beta-adrenoceptor blockade on post-exercise oxygen consumption[J].Metabolism,1994 May,43(5):565-571.
[42]Fukuba Y.The effect of dietary restriction and menstryal cycle on EPOC in yong women[J].Clin physiol,2000 Mar,32(3):919-923.
[43]K Donelly. The effects of two levels of caffeine ingestion on excess postexercise oxygen consumption in untrained women[J].Eur J Appl PhysiolOccup Physiol,1992 Jan,65(5):459-463.
[46]Ramhamadany E, Dasgupta P, Brigden G, et al.Cardio-vascular changes in obese subjects on very low calorie di-et[J].Int I Obes,1989,13 (Suppl 2):95.
[47] Hubert H B,Feinleib M,Mcnamara P M,et al.Obesity as an independent risk factor for cardiovascular disease:a 26-year follow-up of participants in Framingham heart study[J].Circulation,1983,67(5):968.
[48]Grossman E,Oren S,Messerli F H.Left ventricular filling in systemic hypertension of obesity[J].Am I Cardiol,1991,68(1):57.
[49]Egan B, Fitzpatrick M A, Juni ,et al. Importance of overweight in studies of left ventricular hypertrophy and diastolic function in mild systemic hypertension[J].Am J Cardiol,1989,64(12):752.
[50]Amano M, Kanda T, Ue H, et al.Exercise training and auto-nomic nerVOus system activity in obese individuals[J].Med Sci Sports Exerc,2001,33:1287 -1291.
[51]Wannamethee SG, Shaper AG, Whincup PH. Body fat distribution,body com- position,and respiratory function in elderly men[J].Am J Clin Nutr,2005, 82(5):996-1003.
[52]刘迅雷,李骁君,赵兰革,等.非饮食干预条件下耐力运动对单纯性肥胖儿童血压、血脂的影响[J].北京体育大学学报,2002,25(2):198-200.
[53]Ready A.E,Dinkwater D.T,Ducas J,et al.Walking program reduces elevated cholesterol in women postmenopause[J].Can J Cardiol,1995,11(10):905-912.
[54]Houmard J A,Bruno N J,Bruner R K,et al,Effects of exercise training on the chemical composition of plasma LDL[J].Arterioscler Thromb,1994,14:325- 330.
[55]Hill J O, Thiel J, Heller P A, et al, Differences in effect of aerobic exercise training on blood lipids in men and women[J].Am J Cardiol,1989,63: 254-256.
[56]王玢,左雪明.人体及动物生理学[M](第二版).北京:高等教育出版社,2001.316- 319.
[57]DEGEN A A.Ecophysiology of Small Desert Mammals[M].Berlin: SpringerVerlag Berlin Heidelberg,1997.163-236.
[59]季成叶.儿童少年卫生学[M].(第 5 版),北京:人民卫生出版社,2003.55.
[60]NEVILL A M.Scaling Physiological Measurements for Individuals of Different Body Size[J].Eur J Appl Physiol,1992,(65):110-117.
[61][73]郭红.长期有氧训练对老年人最大吸氧量的影响及有氧训练对策[J].中国运动医学杂志,2006,2(4):407-410.
[62][74]詹实支,刘新黎.赛艇运动对最大吸氧量的影响及其与心功能的关系[J].武汉体育学院学报,1997,4:32-33.
[63]李文宝.肥胖对中年男性心肺功能和运动能力的影响[D].东北师范大学,2007.
[64]Conway B, Rene A. Obesity as a disease: no lightweight matter[J].Obes Rev, 2004,5:145-151.
[65]McCarthy H D, Ellis S M,Cole T.Central overweight and obesity in British youth aged 11-16 years: cross sectional surveys of waist circumferences [J].BMJ,2003,326:624-627.
[66]黄馄,孙莹,叶青,等.肥胖、超重青少年通气功能与体成分关系[J]中国公共卫生,2006,22(2):152-154.
[67]王正珍,赵慧娟.超重和肥胖少年心肺功能下降及与身体成分的相关性[J]体育科学,2005,25(9):29-32.
[68]杨午红,胡虞志,黄艳,等.我国 11 城市儿童单纯性肥胖症调查及影响因素分析[J].同济医科大学学报,1999,28(1):394-396.
[69]张凤梅.超重肥胖对大学生心肺功能的影响[J].中国学校卫生,2007,5,28(5): 420-422.
[70]曲绵域.实用运动医学[M].北京:人民体育出版社,1982.23-84.
[71]林福美.我国优秀足球运动员心脏形态和功能的医学观察[J].中国运动医学杂志,1990,9(4):232.
[72]邓树勋.少年运动员心功能对动静力负荷的适应[J].体育科学,1991,11(1):48.
[75]Benson R,Running.In:Burke ER.Precisionheart rate traing[J].Champaign, Human Kinetics,1998,17(5):69-9.
[76]James DVB,Barnes Aj,Lopep,et al.Heart rate variability :response following a single bout of interval training[J].Int Sport Med 2002,23:247-251.
[77]Portier H,Louisy F,Laude D,et al.Intense endurance training on heart rate and blood pressure variability in runner[J].Med Sci Sports Exerc,2001,33: 1120-5.
[78]周永平,沈国琴.不同高度台阶试验后心率反应、心率下降斜率与 VO2max、12 min跑、台阶指数关系的实验研究[J].体育科学,2005,25(1):38-41.
[79]陈历明,田学隆,肖守中等.运动后心力及心率同时遥测的心力恢复趋势与心率恢复趋势的对比研究[J].生物物理学报,2004,20(5):403-407.
[80]Obesity in Scotland.Intergrating Prevention with Weight Management A National Clinical Guideline Recommended for Use in Scotland[J].Edinburgh, Scottish Intercollegiate Guidelines Network,1996,23(4):67-74.
[81] FIatt JP. Use and Storage of Carbohydrate and Fat[J].American Journal of Clinical Nutrition,1995,(61):952-959.
[82]Richard D,Rivest S.The role of exereise in and energy balance[J].Can J Physiol Pharmacol,1989,67(4):402-9.
[83]高新友,强大平.女子短跑运动员递增负荷期间呼吸/代谢变化特征[J].体育与科学,2000,5,124(21):26-28.
[84]李红艳,田文华.超重及肥胖者血浆游离脂肪酸浓度与动态血压的关系[J].心血管康复医学杂志,2007,16(4):319-324.
[85]Wilde DW,Massay KD,Waller GK, et a1.High-fat diet elevates blood pressure and cerebrovascular muscle Ca2+ current[J].Hypertension,2000,35(3):832-837.
[86]许豪文.运动生物化学概论[M].高等教育出版社,2001.9.
[87]曾凡星.运动与睾酮和皮质醇[J].荆州师专学报(自然科学版),1992,15(2):69 -72.
[88]Duclos M, Corcuff J B, Rashedi M,et al.Trained versus to exercise recovery [J].European Journal Applied Physiology,1997,75:343-350.
[89]高林洲.体育锻炼对血清胰岛素和皮质醇的影响[J].蚌埠医学院学报,1999,24 (5):364-365.
[90]Kuoppasalmi K.Plasma cortisol,and rostenedion,testosterone and LH inrunning exercise of different intensity[J].Scand J Clin Lab Invest,1980,40:403-409.
[91]Davics CTM.Effect of exercise on adrencortical function[J].Appl Physio1, 1973,35(6):887-891.
[92]Daly R M,Rich P A,Klein R.Hormonal responses to physical training in high-level peripubertal male gymnasts[J].European Journal Applied Physiolo- gy,1998,79:74-81.
[93]Richard D,Rivest S.The role of exercise in thermogenesis and energy balance[J].Can J Physiol Pharmacol,1989 Apr,67(4):402-9.
[94]王健.运动强度和持续时间对运动后过量氧耗的影响[J].应用心理学,1999,5(1) :43-47.
[95]cottK.Powers,EdwardT.Howley 原著,林贵福等编译.运动生理学(第四版)[M].台湾:美商麦格罗.希尔国际股份有限公司台湾分公司,艺轩图书出版社,2002.
[96]中国高血压防治指南修定委员会.中国高血压防治指南(试用本)[J].高血压杂志,2000,8(1):94-102.