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.

背景
• 在加勒比黑人、西班牙裔和非洲女性生殖年龄群体中，男性和女性普遍存在体重过重或肥胖的偏见。在这些文化中，苗条女性被认为不适合怀孕，而拥有苗条配偶的男性则受到不尊重。因此，黑人及西班牙裔女性往往被劝阻减重。
• 根据治疗或预防2型糖尿病及/或体重过重/肥胖（代谢综合征，糖尿病肥胖症）的指南，普遍推荐的饮食和运动生活方式干预很少能实现超过一年的减重效果。无论是单独还是结合使用，饮食和运动都可能触发自主神经应激反应，产生持续原有自主神经失调的意外后果。
• 推荐用于减重的运动剂量基于改善心肺功能。在未减重的情况下，进行中到高强度的运动可以提高心脏代谢风险因素，如葡萄糖处置、血脂异常和高血压，并预防乳腺癌，这些在肥胖黑人女性中都很常见，但最佳的运动剂量和卡路里摄入量难以确定。
• 由于疼痛和不舒适，肥胖人群往往不参与快走、骑自行车或其他下肢运动，导致他们改善代谢健康的选择极为有限。
• 我们使用一种结合能量学和血压生理学的设备，通过使用下肢正压抗重力跑步机，使难以行走的人能够进行低强度的有氧运动，减轻体重。
假设
我们提出，在行走时进行少量的用力，即日常生活中的低强度运动，在“久坐范围”内，即低于触发补偿性交感肾上腺机制的阈值以下，可能足以减少心脏代谢风险，从而改善或预防糖尿病肥胖症，而不需要减重。
• 我们的结局指标包括血液分子在葡萄糖调节（口服葡萄糖耐量测试中的葡萄糖耐受性）和炎症到神经内分泌（食欲、情绪、神经发生）等功能范围内的前后变化。
• 我们在内城非糖尿病肥胖的加勒比黑人女性生殖年龄群体中证实，无痛的承重跑步机行走，其强度远低于指南水平，可以提高心脏代谢健康和胰岛素抵抗，而不需要减重。我们描述了脂肪因子与葡萄糖和神经调节肽之间新颖的关系。
这些新颖的发现挑战了当前的国家和国际运动指南，并建议重新评估减重以实现代谢健康的需求，在特定人群（否则不太可能进行锻炼）中证明了这一原理。