Prof. Antonio La Torre – Dott. Jacopo Vitale antonio.lattore@unimi.it Jacopo.vitale@grupposandonato.it

ObLoMoV: Obesity and Low Motility Victims Obesity and High Intensity Interval Training (HIIT)

Obesity crisis: a «BIG» problem

The first «Short shock»

Overweight and obesity are linked to more deaths

worldwide than underweight.

In 2014, more than 1.9 billion adults were overweight.

Of these, over 900 million were obese.

35% of adults were overweight in 2014, and 18% were obese.

Most of the world's population live in countries where overweight and obesity

kills more people than underweight.

41 million children under the age of 5 were overweight or obese in 2014.

Obesity is preventable!

In 2014, 41 million of children under the age of 5 years were overweight or obese.

Overweight and obesity are now on the rise in low- and middle-income countries,

particularly in urban settings.

In Africa, the number of children who are overweight or obese has nearly doubled

from 5.4 million in 1990 to 10.6 million in 2014.

Nearly half of the children who were overweight or obese in 2014 lived in Asia.

CHILDREN AND OBESITY

Obesity is increasing both in the developed and in the

developing countries

CHILDREN AND OBESITY

If current trends continue, the number of overweight or obese infants and young children globally

will increase to…..

70 million by 2025

The second «Short shock»

Dati del ministero della Salute:

22.2% of children are overweight.

10.6% of children are obese.

Prevalence in the South (40%).

Sardegna, Valle d’Aosta e Trentino Alto

Adige are under the 25 %.

Parents’ weight and level of instruction

seem to be associated with their children

healht.

WHAT ABOUT IN ITALY?

An energy imbalance between calories consumed and calories expended.

Increased intake of foods that are high in fat.

Increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.

Causes of obesity and overweight

Cardiovascular diseases which were the leading cause of death in 2012.

Endocrine complications (diabetes, hypogonadism).

Musculoskeletal disorders (especially osteoarthritis).

Cancer (including , breast, ovarian, prostate, liver, kidney, and colon).

Obesity: consequences

and finally….

Physical activity !

2010, Lausanne (SWI)

Recommended levels of physical activity

for children aged 5 - 17 years

Play, games, sports, transportation, chores, recreation, physical education, or

planned exercise, in the context of family, school, and community activities.

Children and youth aged 5–17 should accumulate at least 60 minutes of

moderate- to vigorous-intensity physical activity daily.

Amounts of physical activity greater than 60 minutes provide additional

health benefits.

Most of the daily physical activity should be aerobic. Vigorous-intensity

activities should be incorporated, including those that strengthen muscle

and bone, at least 3 times per week.

SOMMINISTRAZIONE ATTIVITÀ FISICA

How and what kind

of physical activity ?

Pierre Louis (1787-1872): promotore nel 1830 della “Medicine d’Observation”. I medici dovrebbero agire sulla base di ampie serie sperimentali

EBC

EBM: Evidence-Based Medicine

EBC: Evidence-Based Coaching e l’uso scrupoloso, esplicito e assennato delle migliori evidenze attuali nel prendere una decisione riguardo ”l’insegnare qualcosa” SPORT

High Intensity Interval Training

High Intensity Interval Training (HIIT)

is a mode of training that requires very little time, yet in many studies shows similar improvements in reducing cardiometabolic risk factors as traditional

moderate-intensity continuous training (MIT) programs despite…

only requiring 10–20% of the time commitment.

NO waste of time !

Gibala MJ, Little JP, van Essen M, Wilkin GP, Burgomaster KA, Safdar A, et al. Short-term sprint interval versus traditional endurance training:

similar initial adaptations in human skeletal muscle and exercise performance. J Physiol. 2006

General adaptations

• > Insulin sensitivity • < Blood pressure (acute and chronic)

…effect of HIIT on

body fat mass..

Study 1: review

…in the adult population…

Study 1: review

…effect of HIIT on

body fat mass…

IN CHILDREN

Study 2: a RCT

• 28 sedentary overweight or obese men, aged 18 y.o. • Participants were randomly assigned to HIIT or MIT. • 6 weeks exercise treatment and 3 days/week.

HIIT

Participants performed a 20-minute protocol, consisting of four minutes of cycling at 15% of maximum anaerobic power followed by 30 seconds at 85%.

Study 2: a RCT

MIT

Participants performed 45–60 min of continuous cycling at 55–65% of VO2peak

on a Monark cycle ergometer.

HIIT = MID but different time needed.

Study 3: a RCT

• 48 overweight children (age: 10.4 ± 0.9 years) • Randomly assigned to intervention or control group: LOW and HIGH intensity training. • 15-second run at the required speed, followed by a 15-second passive recovery. • 6 weeks and 3 days/week.

Study 3: a RCT

High Intensity Training group had:

• significantly higher percentage reduction in skinfolds (i.e. calf).

• significantly fewer steps during the functional obstacle performance as

compared with LOW control group.

• significant improvement was found in intermittent aerobic endurance as

compared with LOW control group.

Higher intensity intermittent training is an

effective and time-efficient intervention for improving body

composition, functional walking and aerobic endurance in overweight children.

Study 4: a meta-analysis

PSYCHOLOGICAL ASPECTS

DEPRESSION

DISCRIMINATION

SELF-ESTEEM

EATING DISORDERS

FAMILY AND EDUCATION?

EMBARASSMENT

CONFIDENCE RULES

ObLoMoV: Obesity and Low Motility Victims

S hort

H igH

I ntense

E njoyable

F lexible

T ime Efficient

S hared Our flexible and enjoyable proposal is:

2 minutes of work + 2 minutes of rest x 6 games.

NB: 2 minutes of work can vary:

• 2 mins continuous > 85% of HRmax. • 2 mins with «all-out» sprints of 10-12 sec alternated with rest periods of 10-12 sec.

ObLoMoV: Obesity and Low Motility Victims

HOW TO VALIDATE OUR METHODOLOGY FROM A SCIENTIFIC POV?

1. Heart Rrate (HR) monitoring during the school labs: a non-invasive method to quantify and

observe the HR response to HIIT.

2. Anthropometric measures: easily and objectively collect data on height, weight and,

consequently, BMI (why not circumferences?) to observe the possible positive effect of our

HIIT Oblomov methodology on body composition/measures.

3. Questionnaire to assess dietary habits. We can collected these data at baseline to describe

their habits. Furthermore, it could be interesting to evaluate if both children and parents will

change their dietary habits at the end of the project.

4. Physical / functional evaluation. Despite the main outcome principally refers to awareness,

we would like to evaluate a possible improvement of the physical and functional ability of the

children. This would support the validity of our methodology too. We would like to make the

children perform the standing broad jump and the 4 x 10meters shuttle run tests.

Opioid Release after High-Intensity Interval Training in Healthy Human Subjects Tiina Saanijoki, Lauri Tuominen, Jetro J Tuulari, Lauri Nummenmaa, Eveliina Arponen, Kari Kalliokoski and Jussi Hirvonen

JOURNAL: NATURE, 2017

• Effects of acute physical exercise on the cerebral μ-opioid receptors (MOR) of 22 healthy active males.

• HIIT significantly decreased MOR binding selectively in the frontolimbic regions involved in pain, reward, and emotional processing.

• Moderate-intensity exercise did not change MOR binding.

FURTHER LITERATURE