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    Combined Aerobic and Resistance Training Improves Body Composition, Alters Cardiometabolic Risk, and Ameliorates Cancer-Related Indicators in Breast Cancer Patients and Survivors with Overweight/Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    (Journal Sports Science & Medicine, 2024) Al-Mhanna, Sameer Badri; Batrakoulis, Alexios; Noor, Norhayati Mohd; Mohamed, Mahaneem; Drenowatz, Clemens; Irekeola, Ahmad Adebayo; Afolabi, Hafeez Abiola
    Breast cancer survivors with obesity are at a high risk of cancer recurrence, comorbidity, and mortality. This review aims to systematically evaluate the effects of combined aerobic and resistance training (CART) on body composition, lipid homeostasis, inflammation, adipokines, cancer-related fatigue, sleep, and quality of life in breast cancer patients and survivors with overweight/obesity. An electronic search was conducted in PubMed, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases from inception up to January 8, 2024. Randomized controlled trials (RCTs) meeting the inclusion criteria were selected for the analysis. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the quality of evidence. A random-effects model was used, and data were analyzed using mean (MD) and standardized mean differences (SMD) for continuous variables with 95% confidence intervals (CI). We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. A total of 17 randomized controlled trials were included in the systematic review involving 1,148 female patients and survivors (mean age: 54.0 +/- 3.4 years). The primary outcomes showed significant improvements in body mass index (SMD -0.57 kg/m(2), p = 0.04), body fat (SMD -0.50%, p = 0.02), fat mass (SMD -0.63 kg, p = 0.04), hip circumference (MD -3.14 cm, p = 0.02), and fat-free mass (SMD 1.03 kg, p < 0.001). The secondary outcomes indicated significant increases in high-density lipoprotein cholesterol (MD -0.05 mmol/L, p = 0.008), natural killer cells (SMD 0.42%, p = 0.04), reductions in triglycerides (MD -81.90 mg/dL, p < 0.01), total cholesterol (SMD -0.95 mmol/L, p < 0.01), tumor necrosis factor alpha (SMD -0.89 pg/mL, p = 0.03), and leptin (SMD -0.63 ng/mL, p = 0.03). Also, beneficial alterations were found in cancer-related fatigue (SMD -0.98, p = 0.03), sleep (SMD -1.17, p < 0.001), and quality of life (SMD 2.94, p = 0.02) scores. There was very low to low confidence in the estimated effect of most of the outcomes. The present findings reveal that CART could be considered an adjunct therapy in supporting the conventional clinical approach observed following exercise. However, further high-quality research is needed to evaluate whether CART would be a valuable intervention to lower aggressive pharmacologic use in breast cancer patients with overweight/obesity.
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    Effects of combined aerobic and resistance training on glycemic control, blood pressure, in fl ammation, cardiorespiratory fi tness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis
    (Peerj Inc, 2024) AL-Mhanna, Sameer Badri; Batrakoulis, Alexios; Ghazali, Wan Syaheedah Wan; Mohamed, Mahaneem; Aldayel, Abdulaziz; Alhussain, Maha H.; Afolabi, Hafeez Abiola
    Background: Structured aerobic or resistance training alone seems to be a bene fi cial tool for improving glucose homeostasis, chronic systemic in fl ammation, resting cardiovascular function, and mental health in people with obesity and type 2 diabetes mellitus (T2DM). The aim of the present study was to synthesize the available data on the effectiveness of combined aerobic and resistance training (CART) on glycemic control, blood pressure, in fl ammation, cardiorespiratory fi tness (CRF), and quality of life (QoL) in overweight and obese individuals with T2DM. Methods: A database search was carried out in PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar from inception up to May 2023. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the reliability of evidence. A random-effects model was used, and data were analyzed using standardized mean differences and 95% con fi dence intervals. The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42022355612). Results: A total of 21,612 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants (mean age: 57 +/- 7 years) who met the eligibility criteria. CART demonstrated signi fi cant improvements in body mass index, glycated hemoglobin, systolic and diastolic blood pressure, C -reactive protein, tumor necrosis factor -alpha, interleukin-6, CRF, and QoL compared to ST. These fi ndings highlight the signi fi cance of exercise interventions such as CART as essential elements within comprehensive diabetes management strategies, ultimately enhancing overall health outcomes in individuals with T2DM and overweight/ obesity.No differences were found in resting heart rate between CART and ST. An uncertain risk of bias and poor quality of evidence were found among the eligible studies. Conclusion: These outcomes show clear evidence considering the positive role of CART in inducing bene fi cial changes in various cardiometabolic and mental health -related indicators in patients with T2DM and concurrent overweight/obesity. More studies with robust methodological design are warranted to examine the dose -response relationship, training parameters con fi guration, and mechanisms behind these positive adaptations.
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    Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis
    (Bmc, 2023) Al-Mhanna, Sameer Badri; Rocha-Rodriguesc, Silvia; Mohamed, Mahaneem; Batrakoulis, Alexios; Aldhahi, Monira I.; Afolabi, Hafeez Abiola; Yagin, Fatma Hilal
    Background Lifestyle modifications involving diet and exercise are recommended for patients diagnosed with obesity and type 2 diabetes mellitus (T2DM). The purpose of this review was to systematically evaluate the effects of combined aerobic exercise and diet (AEDT) on various cardiometabolic health-related indicators among individuals with obesity and T2DM.Methodology A comprehensive search of the PubMed/Medline, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases was conducted for this meta-analysis. The Cochrane risk of bias tool was used to evaluate eligible studies, and the GRADE tool was used to rate the certainty of evidence. A random-effects model for continuous variables was used, and the results were presented as mean differences or standardised mean differences with 95% confidence intervals.Results A total of 16,129 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants. The findings revealed significant improvements in body mass index, body weight, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, fasting blood glucose, fasting plasma insulin, glycated hemoglobin, leptin, interleukin-6, C-reactive protein, and adiponectin (p < 0.05) compared to the standard treatment (ST) group. No significant differences were observed between the AEDT and ST groups in fat mass, hip circumference, waist-to-hip ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and tumor necrosis factor-alpha. The present findings are based on low- to moderate-quality evidence.Conclusions AEDT may be a critical behavior for holistic cardiometabolic health-related benefits as a contemporary anti-obesity medication due to its significant positive impact on patients with obesity and T2DM. Nevertheless, further robust evidence is necessary to determine whether AEDT is an effective intervention for lowering cardiovascular and metabolic risk factors among individuals with obesity and T2DM.
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    Impact of COVID-19 lockdown on physical activity behavior among students in Somalia
    (Amer Inst Mathematical Sciences-Aims, 2024) Al-Mhanna, Sameer Badri; Batrakoulis, Alexios; Sheikh, Abdulrahman M.; Aldayel, Abdulaziz A.; Sabo, Aabdulwali; Mohamed, Mahaneem; Afolabi, Hafeez Abiola
    Background: Due to the worldwide reach of the COVID-19 pandemic, authorities across the globe deemed it essential to enforce exceptional containment measures. Maintaining physical activity (PA) during this time was only feasible through engaging in activities at home. Therefore, this study focused on elucidating the levels of PA and well-being among Somali students in the aftermath of the lockdown measures implemented by governments at the onset of the COVID-19 pandemic. Methods: This study was conducted in Somalia among undergraduate students studying at Somali International University. A total of 1266 students were included in the present study. An online survey was utilized to measure participant PA behavior. The assessment of PA was conducted in the aftermath of the COVID19 pandemic, utilizing the Godin Leisure questionnaire. The study showed that 85.8% of the study participants (n = 1086) were between the ages of 17 and 22. More than half of the participants (58.7%, n = 743) were female and had no other employment (57.3%, n = 743). Results: Jogging was the most frequently reported PA (57.3%, n = 726), and PA level was on average 59.7 minutes per day (SD = 25.9). Also, most of the study participants were in their last year (82.1%). In the regression analysis, age, gender, academic year, and work status were significant predictors of being physically active after the COVID19 pandemic. Conclusion: Factors affecting PA after the COVID-19 pandemic include age, gender, academic year, and work status. Males, younger individuals, and those who engage in outdoor exercise are more likely to be physically active. Once the COVID-19 restrictions were relaxed, undergraduate students in Somalia were physically active. A high level of PA appears to be advantageous for public health. Universities in Somalia should uphold school policies that promote an active lifestyle among students, aiming to maintain or enhance the existing level of PA.
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    Impact of Exercise on High-Density Lipoprotein Cholesterol in Adults with Overweight and Obesity: A Narrative Review
    (Annals Applied Sport Science, 2024) Al-mhanna, Sameer Badri; Leao, Cesar; Ghazali, Wan Syaheedah Wan; Mohamed, Mahaneem; Batrakoulis, Alexios; Afolabi, Hafeez Abiola; Abubakar, Bishir Daku
    Background. Sedentary lifestyles and insufficient physical activity contribute significantly to the rising global epidemic of obesity, fostering an environment where excess calories are stored as adipose tissue. Lack of regular physical activity and diminished cardiorespiratory fitness are key factors in the emergence of obesity-related illnesses, leading to cardiovascular and metabolic complications. However, the extent to which low levels of physical activity and obesity directly cause low HDL-C levels is uncertain, and the specific impact of obesity on reducing HDL-C as well as the associated risks are not well clarified. The influence of different types of exercise on HDL function is intricate and depends on various factors, including exercise intensity and individual characteristics. Objectives. This study aims to investigate the effect of exercise on HDL-C levels in overweight and obese adults, as well as review the mechanisms and pathways by which various exercise types influence HDL-C metabolism in this population. Methods. A literature search was conducted using the PubMed, Scopus, and Google Scholar databases. Studies were included if they were published in English. Results. A sequential moderate-tohigh-intensity exercise regimen resulted in sustained or gradual improvements in HDL-C levels. For increased HDL-C levels, frequent moderate-to-high-intensity, long-duration exercise at an aerobic threshold in conjunction with body mass reduction and dietary modification is observed from the reviewed studies. Conclusion. Regular exercise can improve HDL-C levels in overweight and obese individuals. A combination of moderate-to-high-intensity, long-duration exercise at an aerobic threshold with body mass reduction and dietary modification is most effective. Overweight and obese individuals should engage in regular exercise to improve their HDL-C levels and overall health.
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    Impact of Heat Acclimatisation in Sports: A Narrative Review
    (Annals Applied Sport Science, 2024) Al-mhanna, Sameer Badri; Gulu, Mehmet; Saffah, Faisal F.; Afolabi, Hafeez Abiola; Batrakoulis, Alexios; Abubakar, Bishir Daku; Ghazali, Wan Syaheedah Wan
    Background. The summer is a time for various sporting events, many of which occur in hot and humid environments. Heat exposure can have a significant impact on athletic performance and can even be fatal. Heat acclimatization (HA) is gradually exposing the body to hot environments to improve its ability to regulate temperature and function in the heat. Objectives. This paper reviews the physiological changes associated with heat exposure and the effects of HA on athletic performance. It also provides recommendations for minimizing heat-related illness and death in sports. Methods. A literature search was conducted to identify relevant studies on HA and heat-related illness in sports. The search terms used included heat acclimatization, heat stress, sport, and performance. Results. Heat acclimatization induces a series of beneficial physiological adaptations that contribute to enhanced athletic performance in hot conditions. These changes include increased sweating, heart rate, and blood flow to the skin. Enhances thermoregulatory mechanisms, allowing the body to better cope with heat stress and improving sweat rate and electrolyte balance, aiding in more efficient cooling. Acclimatization results in increased plasma volume, reducing the risk of dehydration. Additionally, it promotes cardiovascular adaptations, enhancing overall heat tolerance. HA can improve exercise performance in hot conditions, making it a valuable strategy for athletes and workers in warm environments. Therefore, proper HA can reduce the risk of heat exhaustion and heatstroke. Conclusion. HA is an important tool for athletes who train and compete in hot environments. It can improve performance, reduce the risk of heat-related illness, and even save lives. Sports federations and coaches should encourage athletes to participate in HA programs. HA programs should include gradual exposure to hot environments, both with and without exercise.
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    Psychophysiological Adaptations to Exercise Training in COVID-19 Patients: A Systematic Review
    (Hindawi Ltd, 2024) AL-Mhanna, Sameer Badri; Batrakoulis, Alexios; Hofmeister, Martin; Drenowatz, Clemens; Ghazali, Wan Syaheedah Wan; Badicu, Georgian; Afolabi, Hafeez Abiola
    Introduction. Many COVID-19 patients display adverse symptoms, such as reduced physical ability, poor quality of life, and impaired pulmonary function. Therefore, this systematic review is aimed at evaluating the effectiveness of physical exercise on various psychophysiological indicators among COVID-19 patients who may be at any stage of their illness (i.e., critically ill, hospitalized, postdischarge, and recovering). Methods. A systematic search was conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar from 2019 to 2021. Twenty-seven studies, which assessed a total of 1525 patients, were included and analysed. Results. Overall, data revealed significant improvements in the following parameters: physical function, dyspnoea, pulmonary function, quality of life (QOL), lower limb endurance and strength, anxiety, depression, physical activity level, muscle strength, oxygen saturation, fatigue, C-reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), lymphocyte, leukocytes, and a fibrin degradation product (D-dimer). Conclusions. Physical training turns out to be an effective therapy that minimises the severity of COVID-19 in the intervention group compared to the standard treatment. Therefore, physical training could be incorporated into conventional treatment of COVID-19 patients. More randomized controlled studies with follow-up evaluations are required to evaluate the long-term advantages of physical training. Future research is essential to establish the optimal exercise intensity level and assess the musculoskeletal fitness of recovered COVID-19 patients. This trial is registered with CRD42021283087.