Raw metabolomics dataset for lower-body pressure ambulation pilot

BACKGROUND • Current biases shared by both men and women favor overweight-obesity in Caribbean-Black, Hispanic and African women of reproductive age. In these cultures lean women are considered unfit for pregnancy and men with lean spouses are disrespected. Thus Black and Hispanic women are discouraged from losing weight. • Life-style interventions, diet and exercise, universally recommended in guidelines for treating or preventing type 2 diabetes and/or overweight-obesity (the dysmetabolic syndrome, diabesity) rarely achieve weight loss for periods exceeding one year. Both diet and exercise, individually or combined, trigger autonomic stress responses with the unintended consequences of perpetuating the underlying dysautonomia. • Prescribed doses of physical activity for weight loss are premised on improving cardio-pulmonary performance. Moderate-high intensity exercise without weight loss improves cardio-metabolic risk factors such as glucose disposal, dyslipidemia and hypertension, and prevents breast cancer, each prevalent in obese Black women, but optimal doses of physical activity and caloric intake are elusive. • Because of pain and discomfort, people with obesity do not engage in brisk walking, cycling or other lower-body exercises leaving them few accessible options to improve metabolic fitness. • We use a device that combines the fields of Energetics and Baro-physiology to enable low-intensity aerobic physical activity using a lower-body positive pressure anti gravity treadmill off-loading weight in subjects with difficulties walking. HYPOTHESIS We posit that a small amount of exertion while walking, a low-intensity physical activity of daily living within the “sedentary range”, i.e. below an upper threshold that triggers compensatory sympatho-adrenal mechanisms, might reduce cardio-metabolic risk enough to ameliorate or prevent diabesity without weight loss. • Our outcome measures are before-after changes in blood molecules with functions ranging from gluco-regulation (glucose tolerance using oral glucose tests) and inflammation to neuroendocrine (appetite, mood, neurogenesis). • We demonstrate in inner-city, non-diabetic obese, Caribbean Black women of reproductive age that painless weight-supported treadmill ambulation, well below guideline levels, improves cardio-metabolic fitness and insulin resistance without weight loss. We describe novel relationships between adipokines, and gluco-and neuro-regulatory peptides. These novel findings challenge current national and international exercise guidelines and suggest re-evaluating the necessity for weight loss to achieve metabolic fitness, demonstrating proof of principle in a specific subject group otherwise not inclined to exercise.研究背景 当前男女共有的普遍偏见，对育龄期加勒比裔黑人（Caribbean-Black）、西班牙裔及非洲女性的超重-肥胖状态存在正向偏向。在这些文化语境中，体瘦女性被认为不适宜妊娠，而配偶体瘦的男性则会遭人非议。因此，加勒比裔黑人和西班牙裔女性往往被劝阻减重。 指南普遍推荐以生活方式干预（饮食与运动）治疗或预防2型糖尿病和/或超重-肥胖（代谢紊乱综合征（dysmetabolic syndrome）、糖胖病（diabesity）），但此类干预极少能实现超过一年的持续减重效果。饮食与运动无论单独实施还是联合应用，均会触发自主神经应激反应，进而加重潜在的自主神经功能紊乱（dysautonomia），带来意料之外的不良后果。 目前用于减重的推荐运动剂量，均以改善心肺功能（cardio-pulmonary performance）为前提。即便未实现减重，中高强度运动也可改善心血管代谢风险因素（cardio-metabolic risk factors），如葡萄糖处置能力异常、血脂异常（dyslipidemia）及高血压（hypertension），并可降低肥胖黑人女性高发的乳腺癌风险，但运动的最优剂量与热量摄入水平仍难以确定。 由于疼痛与不适，肥胖人群无法进行快走、骑行或其他下肢运动（lower-body exercises），因此几乎没有可行的方式来改善代谢健康水平。 本研究采用融合能量代谢学（Energetics）与压力生理学（Baro-physiology）的设备，借助下肢正压抗重力跑台（lower-body positive pressure anti gravity treadmill）为步行困难受试者提供体重卸载支持，以开展低强度有氧体力活动。 研究假说 我们提出如下假说：在"久坐区间"（即低于触发代偿性交感-肾上腺髓质机制（compensatory sympatho-adrenal mechanisms）的上限阈值）内进行轻度日常体力活动，即步行时施加少量运动负荷，可在无需减重的情况下，通过降低心血管代谢风险来改善或预防糖胖病。 结局指标 本研究的结局指标为干预前后血液分子的变化，涵盖糖代谢调控（gluco-regulation，如口服葡萄糖耐量试验（oral glucose tests）检测的葡萄糖耐量）、炎症反应，以及神经内分泌相关指标（食欲、情绪、神经发生（neurogenesis））。 研究结果 我们在中心城区的非糖尿病肥胖育龄期加勒比裔黑人女性中证实，低于指南推荐强度的无痛减重支撑跑台步行，可在未实现减重的情况下改善心血管代谢健康水平与胰岛素抵抗（insulin resistance）。本研究还阐明了脂肪细胞因子（adipokines）、糖代谢及神经调节肽之间的新型关联。这些创新性发现对当前国内外现行运动指南提出了挑战，并提示需重新评估"通过减重实现代谢健康"的必要性，同时在原本不愿运动的特定受试人群中完成了原理验证。