Publications by authors named "Alejandro Carretero-Ruiz"

5 Publications

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Impact of exercise training after bariatric surgery on cardiometabolic risk factors: a systematic review and meta-analysis of controlled trials.

Rev Endocr Metab Disord 2021 Apr 16. Epub 2021 Apr 16.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.

The purpose of this systematic review was to provide updated evidence synthesis of the effectiveness of exercise training in patients with obesity undergoing bariatric surgery to improve cardio-metabolic risk. We systematically searched the MEDLINE, EMBASE, Scopus, Cochrane, and Web of Science databases. The studies selected were those in which an exercise-based intervention was performed after bariatric surgery, a control group was present, and at least one of the following outcomes was investigated: VO or VO, resting heart rate (RHR), blood pressure, lipid profile, glucose, and insulin. The study quality was assessed using the PEDro scale and the data were meta-analyzed with a random effects model, comparing control groups to intervention groups using standardized measurements. Twenty articles were included in the systematic review and fourteen (70%) in the meta-analysis. Significant differences were observed between the control and intervention groups (always in favor of exercise) for absolute VO / VO (ES = 0.317; 95% CI = 0.065, 0.569; p = 0.014), VO / peak relative to body weight (ES = 0.673; 95% CI = 0.287, 1.060; p = 0.001), HDL cholesterol (ES = 0.22; 95% CI = 0.009, 0.430; p = 0.041) and RHR (ES = -0.438; 95% CI = -0.753, -0.022; p = 0.007). No effects were observed for either systolic or diastolic blood pressure. Exercise training for patients undergoing bariatric surgery appears to be effective in improving absolute and relative VO / VO, HDL cholesterol and reducing the RHR. More intervention studies using (better) exercise interventions are needed before discarding their effects on other cardiometabolic risk factors. This systematic review and meta-analysis has been registered in Prospero (CRD42020153398).
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http://dx.doi.org/10.1007/s11154-021-09651-3DOI Listing
April 2021

Physical Exercise following bariatric surgery in women with Morbid obesity: Study protocol clinical trial (SPIRIT compliant).

Medicine (Baltimore) 2020 Mar;99(12):e19427

Obstetrics and Gynecology Unit, Torrecárdenas University Hospital, Almería.

Background: Severe and morbid obesity are increasing globally, particularly in women. As BMI increases, the likelihood of anovulation is higher. The primary aim of the EMOVAR clinical trial is to examine, over the short (16 weeks) and medium (12 months) term, the effects of a supervised physical exercise program (focused primarily on aerobic and resistance training) on ovarian function in women with severe/morbid obesity who have undergone bariatric surgery. Secondary objectives are to examine the effects of the intervention on chronic inflammation, insulin resistance, arterial stiffness, physical fitness, and health-related quality of life.

Methods: This is a randomized controlled trial in which ∼40 female bariatric surgery patients, aged between 18 and 45 years old, will be included. Participants assigned to the experimental group will perform a total of 48 sessions of supervised concurrent (strength and aerobic) training (3 sessions/week, 60 min/session) spread over 16 weeks. Patients assigned to the control group will receive lifestyle recommendations. Outcomes will be assessed at baseline, week 16 (i.e., after the exercise intervention) and 12 months after surgery. The primary outcome is ovarian function using the Sex-Hormone Binding Globuline, measured in serum. Secondary outcomes are serum levels of anti-mullerian hormone, TSH, T4, FSH, LH, estradiol, prolactine, and free androgen index, as well as oocyte count, the diameters of both ovaries, endometrial thickness, and uterine arterial pulsatility index (obtained from a transvaginal ultrasound), the duration of menstrual bleeding and menstrual cycle duration (obtained by personal interview) and hirsutism (Ferriman Gallwey Scale). Other secondary outcomes include serum markers of chronic inflammation and insulin resistance (i.e., C-reactive protein, interleukin 6, tumor necrosis factor-alpha, leptin, glomerular sedimentation rate, glucose, insulin and the HOMA-IR), arterial stiffness, systolic, diastolic and mean blood pressure, body composition, and total weight loss. Physical fitness (including cardiorespiratory fitness, muscular strength, and flexibility), health-related quality of life (SF-36 v2) and sexual function (Female Sexual Function Index) will also be measured.

Discussion: This study will provide, for the first time, relevant information on the effects of exercise training on ovarian function and underlying mechanisms in severe/morbid obese women following bariatric surgery.

Trial Registration Number: ISRCTN registry (ISRCTN27697878).
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http://dx.doi.org/10.1097/MD.0000000000019427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220774PMC
March 2020

Supervised exercise following bariatric surgery in morbid obese adults: CERT-based exercise study protocol of the EFIBAR randomised controlled trial.

BMC Surg 2019 Sep 5;19(1):127. Epub 2019 Sep 5.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.

Background: There is increasing evidence of weight regain in patients after bariatric surgery (BS), generally occurring from 12 to 24 months postoperatively. Postoperative exercise has been suggested to ad long-term weight maintenance and to improve physical function in BS patients. However, there are a limited number of intervention studies investigating the possible benefits of exercise in this population. The aim of the current report is to provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the rationale and details of the exercise programme implemented in the EFIBAR Study (Ejercicio FÍsico tras cirugía BARiátrica), a randomised controlled trial investigating the effects of a 16-week supervised concurrent (aerobic and strength) exercise intervention program on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, physical activity and quality of life (secondary outcomes) in patients with severe/morbid obesity following bariatric surgery.

Methods: A total of 80 BS patients [60-80% expected women, aged 18 to 60 years, body mass index (BMI) ≥ 40 kg/m or ≥ 35 kg/m with comorbid conditions)] will be enrolled in the EFIBAR Randomized Control Trial (RCT). Participants allocated in the exercise group (n = 40) will undertake a 16-week supervised concurrent (strength and aerobic) exercise programme (three sessions/week, 60 min/session), starting 7 to 14 days after surgery. The rationale of the exercise programme will be described following the CERT criteria detailing the 16 key items. The study has been reviewed and approved by the Ethics Committee of the Torrecárdenas University Hospital (Almería, Spain) (ref. N° 76/2016).

Discussion: The present study details the exercise programme of the EFIBAR RCT, which may serve: 1) exercise professionals who would like to implement an evidence-based exercise programme for BS patients, and 2) as an example of the application of the CERT criteria.

Trial Registration: The trial was prospectively registered at Clinicaltrials.gov NCT03497546 on April 13, 2018.
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http://dx.doi.org/10.1186/s12893-019-0566-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6729089PMC
September 2019

Correction to: Effects of Exercise Training on Weight Loss in Patients Who Have Undergone Bariatric Surgery: a Systematic Review and Meta-Analysis of Controlled Trials.

Obes Surg 2019 Nov;29(11):3778

Department of Education, Faculty of Education Sciences, University of Almería, Ctra. Sacramento s/n, La Cañada de San Urbano, 04120, Almería, Spain.

In the original article the name of author Enrique G. Artero was misspelled.
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http://dx.doi.org/10.1007/s11695-019-04130-wDOI Listing
November 2019

Effects of Exercise Training on Weight Loss in Patients Who Have Undergone Bariatric Surgery: a Systematic Review and Meta-Analysis of Controlled Trials.

Obes Surg 2019 10;29(10):3371-3384

Department of Education, Faculty of Education Sciences, University of Almería, Ctra. Sacramento s/n, La Cañada de San Urbano, 04120, Almería, Spain.

The combination of bariatric surgery and physical exercise has been suggested as a promising strategy to positively influence obesity, not only body weight but also all associated comorbidities. An electronic search of intervention studies was carried out in which an exercise training program was implemented after bariatric surgery. The quality of each study was assessed and the data were meta-analyzed using a random effect model. Twenty-six articles were included in the systematic review and 16 in the meta-analysis. As the main conclusion, exercise in patients who have undergone bariatric surgery does not seem to be effective in enhancing weight loss (SMD = 0.15; 95% CI = - 0.02, 0.32; p = 0.094). However, the variability in the protocols used makes it too early to reach a definite conclusion.
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http://dx.doi.org/10.1007/s11695-019-04096-9DOI Listing
October 2019