饮食限制结合不同形式运动对肥胖儿童炎症因子及肠道菌群的影响

王鹏; 刘宝亮; 胡振禹; 刘岩; 蒋狄; 张平

doi:10.16835/j.cnki.1000-9817.2024179

饮食限制结合不同形式运动对肥胖儿童炎症因子及肠道菌群的影响

doi: 10.16835/j.cnki.1000-9817.2024179

王鹏¹,
刘宝亮^1, ,,
胡振禹²,
刘岩³,
蒋狄⁴,
张平⁵

1.
山东轻工职业学院体育教研室，淄博 255300
2.
福建船政交通职业学院体育教研部
3.
北京大学人民医院运营管理处
4.
河北医科大学中西医结合学院
5.
闽江师范高等专科学校附属实验小学体育教研室

基金项目:

福建省教育教学改革研究课题重点项目 GA2021019

详细信息

作者简介:
王鹏(1985-)，女，山东青岛人，硕士，副教授，主要研究方向为运动与健康

通讯作者:
刘宝亮，E-mail: 158586903@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R723.14 R155.1 G806
计量
- 文章访问数: 228
- HTML全文浏览量: 101
- PDF下载量: 31
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-21
- 修回日期: 2024-01-06
- 网络出版日期: 2024-06-27
- 刊出日期: 2024-06-25

Effects of dietary restriction combined with different exercises on inflammatory factors and gut microbiota in obese children

1.
Department of Physical Education, Shandong Vocational College of Light Industry, Zibo (255300), Shandong Province, China

摘要

摘要: 目的比较有氧运动、抗阻训练及有氧运动结合抗阻训练(联合运动)和饮食限制对肥胖儿童炎症因子及肠道菌群的影响，为改善肥胖儿童的健康水平提供参考。方法于2022年8—9月，通过网上发布通知及家长群发放微信的形式招募闽江师范高等专科学校附属实验小学10~12岁的肥胖儿童70名，采用随机数字表法分为饮食限制组(DR组，18名)、有氧运动结合饮食限制组(AE+DR组，18名)、抗阻训练结合饮食限制组(RT+DR组，17名)及联合运动结合饮食限制组(ART+DR组，17名)。2022年9—11月各组进行不同方式干预，DR组每日饮食摄入的能量依据静息能耗确定；AE+DR组运动干预主要包括跳绳、有氧操、慢跑及体育游戏，每次50 min；RT+DR组抗阻训练强度为(65%~85%)1个重复一次的最大力量，共10个动作；ART+DR组运动训练包括抗阻训练(20 min)、有氧运动(20 min)，准备及放松阶段各5 min。DR及运动干预时间为8周(每周4次，周一、二、四、五)。不同方式干预前后，采用酶联免疫吸附试验检测血清炎症因子水平，经平板菌落计数法计算粪便菌群含量。结果与干预前比较，干预后AE+DR组、RT+DR组及ART+DR组血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及C-反应蛋白(CRP)水平和粪肠球菌、大肠杆菌含量均下降，乳酸杆菌及双歧杆菌含量均增加(t值分别为7.19，7.15，4.57，5.42，5.15，-3.51，-7.30；5.14，3.64，3.02，3.27，5.00，-3.09，-3.75；7.10，10.86，7.74，10.92，9.26，-6.63，-6.33)；DR组仅血清TNF-α、CRP水平和粪肠球菌含量下降，乳酸杆菌及双歧杆菌含量均增加(t值分别为2.74，2.22，2.14，-2.21，-2.81)(P值均 < 0.05)。不同方式干预8周后，4组肥胖儿童粪肠球菌群、大肠杆菌、乳酸杆菌、双歧杆菌和血清TNF-α、IL-6、CRP水平变化量差异均有统计学意义(H值分别为22.22，23.75，13.44，28.33，18.02，33.64，25.14，P值均 < 0.01)；且ART+DR组肥胖儿童粪肠球菌群和血清TNF-α、IL-6、CRP水平下降量，以及乳酸杆菌增加量均高于其他3组。结论饮食限制及饮食限制结合不同形式运动均可使肥胖儿童炎症因子及肠道菌群发生有益的变化，联合运动及有氧运动结合饮食限制在肥胖儿童中更加有效。
- 饮食习惯 /
- 运动活动 /
- 干预性研究 /
- 肥胖症 /
- 细菌 /
- 儿童
Abstract: Objective To compare the effects of aerobic exercise, resistance training, and a combination of aerobic exercise and resistance training (combined exercise) with dietary restrictions on inflammatory factors and gut microbiota in obese children, so as to provide the reference for improving the health level of obese children. Methods From August to September 2022, a total of 70 obese children aged 10-12 from the Affiliated Experimental Primary School of Minjiang Normal University were recruited through online notifications and WeChat distribution through parent groups. Participants were divided into dietary restriction (DR, n=18) group, aerobic exercise combined with dietary restriction (AE+DR, n=18) group, resistance training combined with dietary restriction (RT+DR, n=17) group and combined exercise combined with dietary restriction (ART+DR, n=17) group, through random number table method. From September to November 2022, each group received different interventions.The daily dietary intake of calories in the DR group was determined according to resting energy consumption. The AE+DR group intervention mainly included skipping rope, aerobics exercises, jogging and sports games, and were maintained for each session lasting 50 minutes. For RT+DR group, the exercise intensity of resistance training was (65%-85%) maximum strength, with a total of 10 actions. The ART+DR group included resistance training (20 minutes), aerobic exercise (20 minutes), preparation and relaxation phases for 5 minutes each. The DR and exercise intervention was administered for 8 weeks (4 times a week for Monday, Tuesday, Thursday and Friday). Before and after different intervention methods, serum inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA) and intestinal flora was calculated by plate colony counting method. Results Compared to those before intervention, the levels of serum TNF-α, IL-6 and CRP, and the contents of enterococcus and escherichia coli in the faeces significantly decreased, while the contents of lactobacillus and bifidobacterium in the faeces significantly increased after intervention (t=7.19, 7.15, 4.57, 5.42, 5.15, -3.51, -7.30;5.14, 3.64, 3.02, 3.27, 5.00, -3.09, -3.75;7.10, 10.86, 7.74, 10.92, 9.26, -6.63, -6.33, P < 0.05) in AE+DR, RT+DR and ART+DR groups. The levels of serum TNF-α and CRP and enterococcus decreased significantly, and the contents of lactobacillus and bifidobacterium in the faeces increased significantly after intervention (t=2.74, 2.22, 2.14, -2.21, -2.81, P < 0.05) in the DR Group. After 8 weeks of intervention with different methods, the change differences of enterococcus, escherichia coli, lactobacillus, bifidobacterium in the faeces, and serum TNF-α, IL-6 and CRP levels were statistically significantin the four groups of obese children (H=22.22, 23.75, 13.44, 28.33, 18.02, 33.64, 25.14, P < 0.01). In addition, the decreases of enterococcus in the faeces and serum TNF-α, IL-6, CRP levels, and the increases of lactobacillus in the faeces were significantly higher than those in the other three groups. Conclusions Dietary restriction alone or combined with different exercises bring beneficial changes in the inflammatory factors and gut microbiota indicators in obese children. Combined exercise, as well as aerobic exercise combined with dietary restrictions are more reasonable and effective in obese children.
- Food habits /
- Motor activity /
- Intervention studies /
- Obesity /
- Bacteria /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同形式运动结合饮食限制干预前后肥胖儿童炎症因子水平比较(x±s，pg/mL)

Table 1. Comparison of inflammatory factor levels in obese children before and after different exercises combined with dietary restrictions interventions (x±s, pg/mL)

组别	干预前后及差值	人数	统计值	TNF-α	IL-6	CRP
DR组	干预前	20		5.54±1.09	2.16±1.14	2.83±0.98
	干预后	18		5.27±1.04	2.09±1.06	2.68±1.02
	差值	18		-0.24(-0.66，0.05)	-0.15(-0.24，-0.07)	-0.09(-0.31，0.04)
			t值	2.74	1.84	2.22
			P值	0.01	0.08	0.04
AE+DR组	干预前	20		5.10±1.85	2.05±1.13	3.02±1.23
	干预后	18		4.35±1.61	1.45±0.88	2.70±1.04
	差值	18		-0.80(-1.07，-0.35)	-0.61(-0.92，-0.31)	-0.25(-0.47，-0.09)
			t值	7.19	7.15	4.57
			P值	< 0.01	< 0.01	< 0.01
RT+DR组	干预前	20		4.93±1.34	1.99±0.80	2.93±1.33
	干预后	17		4.35±1.29	1.76±0.75	2.70±1.15
	差值	17		-0.47(-0.91，-0.22)	-0.25(-0.35，-0.08)	-0.27(-0.44，0.07)
			t值	5.14	3.64	3.02
			P值	< 0.01	< 0.01	0.01
ART+DR组	干预前	20		5.00±1.41	1.92±0.67	2.87±1.27
	干预后	17		3.92±0.91	1.17±0.53	1.97±1.01
	差值	17		-1.10(-1.41，-0.67)	-0.83(-0.91，-0.53)	-1.03(-1.18，-0.47)
			t值	7.10	10.86	7.74
			P值	< 0.01	< 0.01	< 0.01
注：差值=干预后-干预前，不符合正态分布，用M(P₂₅，P₇₅)表示。

下载: 导出CSV

表 2 不同形式运动结合饮食限制干预前后肥胖儿童肠道菌群含量比较(x±s，lg CFU/g)

Table 2. Comparison of the contents of gut microbiota in obese children before and after the different exercise combined with dietary restriction interventions (x±s, lg CFU/g)

组别	干预前后及差值	人数	统计值	肠球菌	大肠杆菌	乳酸杆菌	双歧杆菌
DR组	干预前	20		7.80±1.09	9.58±1.44	6.19±1.23	6.88±1.40
	干预后	18		7.52±1.15	9.49±1.08	6.39±1.27	7.07±1.20
	差值	18		-0.28(-0.67，-0.04)	-0.33(-0.68，0.07)	0.16(0.06，0.35)	0.13(0.03，0.35)
			t值	2.14	0.33	-2.21	-2.81
			P值	0.05	0.74	0.04	0.01
AE+DR组	干预前	20		8.01±1.04	9.44±1.45	6.65±0.80	6.84±1.12
	干预后	18		7.11±1.01	8.57±1.81	7.17±0.70	7.81±1.04
	差值	18		-0.91(-1.50，-0.52)	-1.17(-1.57，-0.79)	0.43(0.16，0.87)	1.08(0.56，1.30)
			t值	5.42	5.15	-3.51	-7.30
			P值	< 0.01	< 0.01	< 0.01	< 0.01
RT+DR组	干预前	20		7.96±1.37	10.06±1.91	6.72±1.34	7.01±1.08
	干预后	17		7.51±1.13	9.52±1.90	7.23±1.47	7.38±0.90
	差值	17		-0.31(-0.89，-0.03)	-0.51(-0.81，-0.07)	0.44(0.15，0.93)	0.34(0.22，0.56)
			t值	3.27	5.00	-3.09	-3.75
			P值	0.01	< 0.01	< 0.01	< 0.01
ART+DR组	干预前	20		8.02±1.40	9.12±1.61	6.33±1.24	7.09±1.22
	干预后	17		6.81±1.14	7.98±1.34	7.32±0.93	8.12±0.78
	差值	17		-1.17(-1.63，-0.96)	-1.15(-1.56，-0.94)	0.91(0.72，1.54)	0.96(0.56，1.27)
			t值	10.92	9.26	-6.63	-6.33
			P值	< 0.01	< 0.01	< 0.01	< 0.01
注：差值=干预后-干预前，不符合正态分布，用M(P₂₅，P₇₅)表示。

下载: 导出CSV

参考文献(19)

[1]	WHO. Obesity and overweight[EB/OL]. (2022-04-06)[2024-03-08]. http://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight.
[2]	李怡璇, 刘洋, 闻德亮. 肥胖相关代谢性炎症研究进展[J]. 现代预防医学, 2022, 49(17): 3246-3251. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202217031.htm LI Y X, LIU Y, WEN D L. Advances in research on metaflammation related to obesity[J]. Mod Prev Med, 2022, 49(17): 3246-3251. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202217031.htm
[3]	王梓宇, 张智慧, 吴鹏, 等. 基于肠道菌群和短链脂肪酸代谢探讨甘草制远志降低肠道炎症的作用机制[J]. 中草药, 2023, 54(14): 4556-4563. https://www.cnki.com.cn/Article/CJFDTOTAL-ZCYO202314016.htm WANG Z Y, ZHANG Z H, WU P, et al. Mechanism of licorice-boiled Polygalae Radix on reducing intestinal inflammation based on intestinal flora and short-chain fatty acid metabolism[J]. Chin Tradit Herb Drugs, 2023, 54(14): 4556-4563. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZCYO202314016.htm
[4]	LEY R E, BÄCKHED F, TURNBAUGH P, et al. Obesity alters gut microbial ecology[J]. Proc Natl Acad Sci USA, 2005, 102(31): 11070-11075. doi: 10.1073/pnas.0504978102
[5]	AMOROSO C, PERILLO F, STRATI F, et al. The role of gut microbiota biomodulators on mucosal immunity and intestinal inflammation[J]. Cells, 2020, 9(5): 1234. doi: 10.3390/cells9051234
[6]	施曼丽. 不同运动方式对绝经后女性IL-6、TNF-α和hs-CRP的影响[J]. 西安体育学院学报, 2011, 28(4): 481-488. https://www.cnki.com.cn/Article/CJFDTOTAL-XATY201104023.htm SHI M L. Effects of different modes of exercise training on IL-6, TNF-α and hs-CRP in post-menopausal women[J]. J Xi'an Inst Phys Educ, 2011, 28(4): 481-488. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XATY201104023.htm
[7]	HO S S, DHALIWAL S S, HILLS A P, et al. The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial[J]. BMC Public Health, 2012, 12: 704. doi: 10.1186/1471-2458-12-704
[8]	中华人民共和国国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[M]. 北京: 中国标准出版社, 2018. National Health and Family Planning Commission of the PRC. Overweight and obesity screening in school-age children and adolescents: WS/T 586-2018[M]. Beijing: Standards Press of China, 2018. (in Chinese)
[9]	李娟, 唐东辉, 陈巍. 有氧运动结合抗阻训练对男性肥胖青少年心血管功能的改善及可能机制[J]. 体育科学, 2013, 33(8): 37-42. https://www.cnki.com.cn/Article/CJFDTOTAL-TYKX201308004.htm LI J, TANG D H, CHEN W. The effects of aerobic combined with resistance exercise on cardiovascular efficiency in male obese adolescents and related mechanisms[J]. China Sport Sci, 2013, 33(8): 37-42. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-TYKX201308004.htm
[10]	阿依木古丽·艾尼, 靳瑾. 饮食模式和肠道菌群与肥胖关系的研究进展[J]. 中国医药导报, 2023, 20(16): 62-65. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202316014.htm AYIMUGULI A N, JIN J. Research progress on the relationship between dietary patterns, intestinal flora and obesity[J]. China Med Her, 2023, 20(16): 62-65. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202316014.htm
[11]	孙海翔. 正常体重、超重和肥胖儿童肠道菌群差异研究[D]. 南京: 东南大学, 2019. SUN H X. Differences in gut microbiota among normal weight, overweight, and obese children[D]. Nanjing: Southeast University, 2019. (in Chinese)
[12]	FERRO D, BARATTA F, PASTORI D, et al. New insights into the pathogenesis of non-alcoholic fatty liver disease: gut-derived lipopolysaccharides and oxidative stress[J]. Nutrients, 2020, 12(9): 2762. doi: 10.3390/nu12092762
[13]	DUPUIT M, CHAVANELLE V, CHASSAING B, et al. The TOTUM-63 supplement and high-intensity interval training combination limits weight gain, improves glycemic control, and influences the composition of gut mucosa-associated bacteria in rats on a high fat diet[J]. Nutrients, 2021, 13(5): 1569. doi: 10.3390/nu13051569
[14]	BALDUCCI S, ZANUSO S, NICOLUCCI A, et al. Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss[J]. Nutr Metab Cardiovasc Dis, 2010, 20(8): 608-617. doi: 10.1016/j.numecd.2009.04.015
[15]	张秋. 不同运动方式调节肠道菌群对2型糖尿病小鼠炎症反应的作用研究[D]. 南宁: 广西医科大学, 2021. ZHANG Q. Effect of different exercise modulates microbiota on inflammatory response in type 2 diabetic mice[D]. Nanning: Guangxi Medical University, 2021. (in Chinese)
[16]	CARBAJO-PESCADOR S, PORRAS D, GARCÍA-MEDIAVILLA M V, et al. Beneficial effects of exercise on gut microbiota functionality and barrier integrity, and gut-liver crosstalk in an in vivo model of early obesity and non-alcoholic fatty liver disease[J]. Dis Model Mech, 2019, 12(5): dmm039206. doi: 10.1242/dmm.039206
[17]	BYCURA D, SANTOS A C, SHIFFER A, et al. Impact of different exercise modalities on the human gut microbiome[J]. Sports (Basel), 2021, 9(2): 14.
[18]	SOHAIL M U, YASSINE H M, SOHAIL A, et al. Impact of physical exercise on gut microbiome, inflammation, and the pathobiology of metabolic disorders[J]. Rev Diabet Stud, 2019, 15: 35-48. doi: 10.1900/RDS.2019.15.35
[19]	梁家琪, 刘恒旭, 阳金鑫, 等. 运动与肠道菌健康效益的关系[J]. 中国组织工程研究, 2023, 27(8): 1292-1299. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF202308026.htm LIANG J Q, LIU H X, YANG J X, et al. Health benefit relationship between exercise and intestinal bacteria[J]. Chin J Tissue Engineer Res, 2023, 27(8): 1292-1299. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF202308026.htm