The Korean Journal of Physiology and Pharmacology

The Korean Society of Pharmacology (대한약리학회)
권호 표지
DOI QR코드

DOI QR Code

Yoga Training Improves Metabolic Parameters in Obese Boys

  • Seo, Dae-Yun (National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University) ;
  • Lee, Sung-Ryul (National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University) ;
  • Figueroa, Arturo (Department of Nutrition, Food and Exercise Sciences, College of Human Sciences, Florida State University) ;
  • Kim, Hyoung-Kyu (National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University) ;
  • Baek, Yeong-Ho (Department of Physical Education, Pusan National University) ;
  • Kwak, Yi-Sub (Department of Physical Education, Dong-Eui University) ;
  • Kim, Na-Ri (National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University) ;
  • Choi, Tae-Hoon (Department of Sport and Leisure Studies, Andong Science College) ;
  • Rhee, Byoung-Doo (National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University) ;
  • Ko, Kyung-Soo (National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University) ;
  • Park, Byung-Joo (Division of Leisure & Sports Science, Dong Seo University) ;
  • Park, Song-Young (Department of Nutrition, Food and Exercise Sciences, College of Human Sciences, Florida State University) ;
  • Han, Jin (National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University)
  • Received : 2012.02.21
  • Accepted : 2012.05.12
  • Published : 2012.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Yoga has been known to have stimulatory or inhibitory effects on the metabolic parameters and to be uncomplicated therapy for obesity. The purpose of the present study was to test the effect of an 8-week of yoga-asana training on body composition, lipid profile, and insulin resistance (IR) in obese adolescent boys. Twenty volunteers with body mass index (BMI) greater than the 95th percentile were randomly assigned to yoga (age $14.7{\pm}0.5$ years, n=10) and control groups (age $14.6{\pm}1.0$ years, n=10). The yoga group performed exercises three times per week at 40~60% of heart-rate reserve (HRR) for 8 weeks. IR was determined with the homeostasis model assessment of insulin resistance (HOMA-IR). After yoga training, body weight, BMI, fat mass (FM), and body fat % (BF %) were significantly decreased, and fat-free mass and basal metabolic rate were significantly increased than baseline values. FM and BF % were significantly improved in the yoga group compared with the control group (p<0.05). Total cholesterol (TC) was significantly decreased in the yoga group (p<0.01). HDL-cholesterol was decreased in both groups (p<0.05). No significant changes were observed between or within groups for triglycerides, LDL-cholesterol, glucose, insulin, and HOMA-IR. Our findings show that an 8-week of yoga training improves body composition and TC levels in obese adolescent boys, suggesting that yoga training may be effective in controlling some metabolic syndrome factors in obese adolescent boys.

Keywords

References

  1. Goran MI, Treuth MS. Energy expenditure, physical activity, and obesity in children. Pediatr Clin North Am. 2001;48:931-953. https://doi.org/10.1016/S0031-3955(05)70349-7
  2. Kennedy RL, Chokkalingham K, Srinivasan R. Obesity in the elderly: who should we be treating, and why, and how? Curr Opin Clin Nutr Metab Care. 2004;7:3-9. https://doi.org/10.1097/00075197-200401000-00002
  3. Quak SH, Furnes R, Lavine J, Baur LA. Obesity Working Group. Obesity in children and adolescents. J Pediatr Gastroenterol Nutr. 2008;47:254-259. https://doi.org/10.1097/MPG.0b013e318181b2cd
  4. Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics. 1999;103:1175-1182. https://doi.org/10.1542/peds.103.6.1175
  5. Kavey RE, Daniels SR, Lauer RM, Atkins DL, Hayman LL, Taubert K. American Heart Association. American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. J Pediatr. 2003;142:368-372. https://doi.org/10.1067/mpd.2003.205
  6. Caceres M, Teran CG, Rodriguez S, Medina M. Prevalence of insulin resistance and its association with metabolic syndrome criteria among Bolivian children and adolescents with obesity. BMC Pediatr. 2008;8:31. https://doi.org/10.1186/1471-2431-8-31
  7. Fagot-Campagna A, Pettitt DJ, Engelgau MM, Burrows NR, Geiss LS, Valdez R, Beckles GL, Saaddine J, Gregg EW, Williamson DF, Narayan KM. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr. 2000;136:664-672. https://doi.org/10.1067/mpd.2000.105141
  8. Steinberger J, Daniels SR; American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young); American Heart Association Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation. 2003;107:1448-1453. https://doi.org/10.1161/01.CIR.0000060923.07573.F2
  9. Seo E, Park EJ, Park MK, Kim DK, Lee HJ, Hong SH. Differential expression of metabolism-related genes in liver of diabetic obese rats. Korean J Physiol Pharmacol. 2010;14:99-103. https://doi.org/10.4196/kjpp.2010.14.2.99
  10. Tzotzas T, Evangelou P, Kiortsis DN. Obesity, weight loss and conditional cardiovascular risk factors. Obes Rev. 2011;12:e282-289. https://doi.org/10.1111/j.1467-789X.2010.00807.x
  11. Jayasinghe SR. Yoga in cardiac health (a review). Eur J Cardiovasc Prev Rehabil. 2004;11:369-375. https://doi.org/10.1097/00149831-200410000-00002
  12. Vaze N, Joshi S. Yoga and menopausal transition. J Midlife Health. 2010;1:56-58.
  13. Collins C. Yoga: intuition, preventive medicine, and treatment. J Obstet Gynecol Neonatal Nurs. 1998;27:563-568. https://doi.org/10.1111/j.1552-6909.1998.tb02623.x
  14. Birdee GS, Legedza AT, Saper RB, Bertisch SM, Eisenberg DM, Phillips RS. Characteristics of yoga users: results of a national survey. J Gen Intern Med. 2008;23:1653-1658. https://doi.org/10.1007/s11606-008-0735-5
  15. Innes KE, Selfe TK, Taylor AG. Menopause, the metabolic syndrome, and mind-body therapies. Menopause. 2008;15:1005-1013. https://doi.org/10.1097/01.gme.0b013e318166904e
  16. Pullen PR, Nagamia SH, Mehta PK, Thompson WR, Benardot D, Hammoud R, Parrott JM, Sola S, Khan BV. Effects of yoga on inflammation and exercise capacity in patients with chronic heart failure. J Card Fail. 2008;14:407-413. https://doi.org/10.1016/j.cardfail.2007.12.007
  17. Vempati RP, Telles S. Yoga-based guided relaxation reduces sympathetic activity judged from baseline levels. Psychol Rep. 2002;90:487-494. https://doi.org/10.2466/pr0.2002.90.2.487
  18. Menshikova EV, Ritov VB, Toledo FG, Ferrell RE, Goodpaster BH, Kelley DE. Effects of weight loss and physical activity on skeletal muscle mitochondrial function in obesity. Am J Physiol Endocrinol Metab. 2005;288:E818-825. https://doi.org/10.1152/ajpendo.00322.2004
  19. Weyer C, Linkeschowa R, Heise T, Giesen HT, Spraul M. Implications of the traditional and the new ACSM physical activity recommendations on weight reduction in dietary treated obese subjects. Int J Obes Relat Metab Disord. 1998;22:1071-1078. https://doi.org/10.1038/sj.ijo.0800728
  20. Church T. Exercise in obesity, metabolic syndrome, and diabetes. Prog Cardiovasc Dis. 2011;53:412-418. https://doi.org/10.1016/j.pcad.2011.03.013
  21. Ross R, Despres JP. Abdominal obesity, insulin resistance, and the metabolic syndrome: contribution of physical activity/exercise. Obesity (Silver Spring). 2009;17 Suppl 3:S1-2.
  22. Buemann B, Tremblay A. Effects of exercise training on abdominal obesity and related metabolic complications. Sports Med. 1996;21:191-212. https://doi.org/10.2165/00007256-199621030-00004
  23. Shubair MM, Kodis J, McKelvie RS, Arthur HM, Sharma AM. Metabolic profile and exercise capacity outcomes: their relationship to overweight and obesity in a Canadian cardiac rehabilitation setting. J Cardiopulm Rehabil. 2004;24:405-413. https://doi.org/10.1097/00008483-200411000-00008
  24. Page A, Cooper AR, Stamatakis E, Foster LJ, Crowne EC, Sabin M, Shield JP. Physical activity patterns in nonobese and obese children assessed using minute-by-minute accelerometry. Int J Obes (Lond). 2005;29:1070-1076. https://doi.org/10.1038/sj.ijo.0802993
  25. Hagins M, Moore W, Rundle A. Does practicing hatha yoga satisfy recommendations for intensity of physical activity which improves and maintains health and cardiovascular fitness? BMC Complement Altern Med. 2007;7:40. https://doi.org/10.1186/1472-6882-7-40
  26. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240-1243. https://doi.org/10.1136/bmj.320.7244.1240
  27. ACSM. ACSM'S Guideline for Exercise Testing and Prescription, 7's ed. ACSM. 2006:38-44.
  28. Kim KR, Bang HS. Effects of incremental asana program of Hatha Yoga on body composition, respire-circulatory response, isokinetic muscular articulation function and bone mineral density. Korean Alliance for Health, Physcial Education, Recreation and Dance. 2009;48:389-400.
  29. Karvonen MJ, Kentala E, Mustala O. The effects of training on heart rate; a longitudinal study. Ann Med Exp Biol Fenn. 1957;35:307-315.
  30. Tomoum HY, Badawy NB, Hassan NE, Alian KM. Anthropometry and body composition analysis in children with cerebral palsy. Clin Nutr. 2010;29:477-481. https://doi.org/10.1016/j.clnu.2009.10.009
  31. Cereda E, Klersy C, Rondanelli M, Caccialanza R. Energy balance in patients with pressure ulcers: a systematic review and meta-analysis of observational studies. J Am Diet Assoc. 2011;111:1868-1876. https://doi.org/10.1016/j.jada.2011.09.005
  32. Douglas CC, Lawrence JC, Bush NC, Oster RA, Gower BA, Darnell BE. Ability of the Harris Benedict formula to predict energy requirements differs with weight history and ethnicity. Nutr Res. 2007;27:194-199. https://doi.org/10.1016/j.nutres.2007.01.016
  33. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412-419. https://doi.org/10.1007/BF00280883
  34. Madanmohan, Bhavanani AB, Dayanidy G, Sanjay Z, Basavaraddi IV. Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post-menopausal diabetic patients. Int J Yoga. 2012;5:10-15. https://doi.org/10.4103/0973-6131.91696
  35. Ankad RB, Herur A, Patil S, Shashikala GV, Chinagudi S. Effect of short-term pranayama and meditation on cardiovascular functions in healthy individuals. Heart Views. 2011;12:58-62. https://doi.org/10.4103/1995-705X.86016
  36. Mody BS. Acute effects of Surya Namaskar on the cardiovascular & metabolic system. J Bodyw Mov Ther. 2011;15:343-347. https://doi.org/10.1016/j.jbmt.2010.05.001
  37. Pal A, Srivastava N, Tiwari S, Verma NS, Narain VS, Agrawal GG, Natu SM, Kumar K. Effect of yogic practices on lipid profile and body fat composition in patients of coronary artery disease. Complement Ther Med. 2011;19:122-127. https://doi.org/10.1016/j.ctim.2011.05.001
  38. Telles S, Singh N, Joshi M, Balkrishna A. Post traumatic stress symptoms and heart rate variability in Bihar flood survivors following yoga: a randomized controlled study. BMC Psychiatry. 2010;10:18. https://doi.org/10.1186/1471-244X-10-18
  39. Gopal A, Mondal S, Gandhi A, Arora S, Bhattacharjee J. Effect of integrated yoga practices on immune responses in examination stress - A preliminary study. Int J Yoga. 2011;4:26-32. https://doi.org/10.4103/0973-6131.78178
  40. Cakmakci O. The effect of 8 week pilates exercise on body composition in obese women. Coll Antropol. 2011;35:1045-1050.
  41. Yang G, Badeanlou L, Bielawski J, Roberts AJ, Hannun YA, Samad F. Central role of ceramide biosynthesis in body weight regulation, energy metabolism, and the metabolic syndrome. Am J Physiol Endocrinol Metab. 2009;297:E211-224. https://doi.org/10.1152/ajpendo.91014.2008
  42. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403. https://doi.org/10.1056/NEJMoa012512
  43. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M. Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343-1350. https://doi.org/10.1056/NEJM200105033441801
  44. Benson AC, Torode ME, Fiatarone Singh MA. The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial. Int J Obes (Lond). 2008;32:1016-1027. https://doi.org/10.1038/ijo.2008.5
  45. McGuigan MR, Tatasciore M, Newton RU, Pettigrew S. Eight weeks of resistance training can significantly alter body composition in children who are overweight or obese. J Strength Cond Res. 2009;23:80-85. https://doi.org/10.1519/JSC.0b013e3181876a56
  46. Benavides S, Caballero J. Ashtanga yoga for children and adolescents for weight management and psychological well being: an uncontrolled open pilot study. Complement Ther Clin Pract. 2009;15:110-114. https://doi.org/10.1016/j.ctcp.2008.12.004
  47. Vogelsang TW, Hanel B, Kristoffersen US, Petersen CL, Mehlsen J, Holmquist N, Larsson B, Kjaer A. Effect of eight weeks of endurance exercise training on right and left ventricular volume and mass in untrained obese subjects: a longitudinal MRI study. Scand J Med Sci Sports. 2008;18:354-359. https://doi.org/10.1111/j.1600-0838.2007.00706.x
  48. Wong PC, Chia MY, Tsou IY, Wansaicheong GK, Tan B, Wang JC, Tan J, Kim CG, Boh G, Lim D. Effects of a 12-week exercise training programme on aerobic fitness, body composition, blood lipids and C-reactive protein in adolescents with obesity. Ann Acad Med Singapore. 2008;37:286-293.
  49. Slentz CA, Duscha BD, Johnson JL, Ketchum K, Aiken LB, Samsa GP, Houmard JA, Bales CW, Kraus WE. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study. Arch Intern Med. 2004;164:31-39. https://doi.org/10.1001/archinte.164.1.31
  50. Levine GN, Keaney JF Jr, Vita JA. Cholesterol reduction in cardiovascular disease. Clinical benefits and possible mechanisms. N Engl J Med. 1995;332:512-521. https://doi.org/10.1056/NEJM199502233320807
  51. Mahajan AS, Reddy KS, Sachdeva U. Lipid profile of coronary risk subjects following yogic lifestyle intervention. Indian Heart J. 1999;51:37-40.
  52. Manchanda SC, Narang R, Reddy KS, Sachdeva U, Prabhakaran D, Dharmanand S, Rajani M, Bijlani R. Retardation of coronary atherosclerosis with yoga lifestyle intervention. J Assoc Physicians India. 2000;48:687-694.
  53. Bijlani RL, Vempati RP, Yadav RK, Ray RB, Gupta V, Sharma R, Mehta N, Mahapatra SC. A brief but comprehensive lifestyle education program based on yoga reduces risk factors for cardiovascular disease and diabetes mellitus. J Altern Complement Med. 2005;11:267-274. https://doi.org/10.1089/acm.2005.11.267
  54. Roberts CK, Vaziri ND, Barnard RJ. Effect of diet and exercise intervention on blood pressure, insulin, oxidative stress, and nitric oxide availability. Circulation. 2002;106:2530-2532. https://doi.org/10.1161/01.CIR.0000040584.91836.0D
  55. Roberts CK, Won D, Pruthi S, Kurtovic S, Sindhu RK, Vaziri ND, Barnard RJ. Effect of a short-term diet and exercise intervention on oxidative stress, inflammation, MMP-9, and monocyte chemotactic activity in men with metabolic syndrome factors. J Appl Physiol. 2006;100:1657-1665. https://doi.org/10.1152/japplphysiol.01292.2005
  56. Sun MX, Huang XQ, Yan Y, Li BW, Zhong WJ, Chen JF, Zhang YM, Wang ZZ, Wang L, Shi XC, Li J, Xie MH. One-hour after-school exercise ameliorates central adiposity and lipids in overweight Chinese adolescents: a randomized controlled trial. Chin Med J (Engl). 2011;124:323-329.
  57. Jorge ML, de Oliveira VN, Resende NM, Paraiso LF, Calixto A, Diniz AL, Resende ES, Ropelle ER, Carvalheira JB, Espindola FS, Jorge PT, Geloneze B. The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism. 2011;60:1244-1252. https://doi.org/10.1016/j.metabol.2011.01.006
  58. Damodaran A, Malathi A, Patil N, Shah N, Suryavansihi, Marathe S. Therapeutic potential of yoga practices in modifying cardiovascular risk profile in middle aged men and women. J Assoc Physicians India. 2002;50:633-640.
  59. Elder C, Aickin M, Bauer V, Cairns J, Vuckovic N. Randomized trial of a whole-system ayurvedic protocol for type 2 diabetes. Altern Ther Health Med. 2006;12:24-30.
  60. Balagopal P, George D, Patton N, Yarandi H, Roberts WL, Bayne E, Gidding S. Lifestyle-only intervention attenuates the inflammatory state associated with obesity: a randomized controlled study in adolescents. J Pediatr. 2005;146:342-348. https://doi.org/10.1016/j.jpeds.2004.11.033
  61. Sahay BK. Role of yoga in diabetes. J Assoc Physicians India. 2007;55:121-126.

Cited by

  1. Oxygen Consumption Changes With Yoga Practices : A Systematic Review vol.18, pp.4, 2013, https://doi.org/10.1177/2156587213492770
  2. Reduction of cholesterol and other cardiovascular disease risk factors by alternative therapies vol.8, pp.3, 2012, https://doi.org/10.2217/clp.13.24
  3. Characteristics of randomized controlled trials of yoga: a bibliometric analysis vol.14, pp.None, 2012, https://doi.org/10.1186/1472-6882-14-328
  4. Yoga in the Management of Overweight and Obesity vol.8, pp.1, 2014, https://doi.org/10.1177/1559827613492097
  5. Effect of Yoga on Heart Rate Variability in Women with Metabolic Syndrome vol.14, pp.4, 2012, https://doi.org/10.15384/kjhp.2014.14.4.147
  6. Effects of 1-year yoga on cardiovascular risk factors in middle-aged and older adults with metabolic syndrome: a randomized trial vol.7, pp.None, 2012, https://doi.org/10.1186/s13098-015-0034-3
  7. Complementary, Holistic, and Integrative Medicine: Yoga vol.36, pp.10, 2015, https://doi.org/10.1542/pir.36.10.468
  8. Increased BMR in overweight and obese patients with type 2 diabetes may result from an increased fat-free mass vol.36, pp.1, 2012, https://doi.org/10.1007/s11596-016-1542-6
  9. Young Children's Physical and Psychological Well-Being Through Yoga vol.92, pp.6, 2012, https://doi.org/10.1080/00094056.2016.1251792
  10. Could hatha yoga be a health-related physical activity? vol.8, pp.1, 2016, https://doi.org/10.1515/bhk-2016-0002
  11. Implementing yoga within the school curriculum: a scientific rationale for improving social-emotional learning and positive student outcomes vol.11, pp.1, 2012, https://doi.org/10.1108/jcs-10-2014-0044
  12. Mind-Body Therapies in Children and Youth vol.138, pp.3, 2012, https://doi.org/10.1542/peds.2016-1896
  13. Yoga for metabolic syndrome: A systematic review and meta-analysis vol.23, pp.18, 2012, https://doi.org/10.1177/2047487316665729
  14. Access and barriers to implementing yoga-based interventions for at-risk adolescent youth vol.55, pp.1, 2012, https://doi.org/10.1080/14635240.2016.1217163
  15. Effects of a 12-Week Systematized Yoga Intervention on Health-Related Physical Fitness in Healthy Adults vol.7, pp.1, 2012, https://doi.org/10.4236/ape.2017.71003
  16. Combined exercise reduces arterial stiffness, blood pressure, and blood markers for cardiovascular risk in postmenopausal women with hypertension vol.24, pp.3, 2012, https://doi.org/10.1097/gme.0000000000000765
  17. Hatha Yoga as a Form of Physical Activity in the Context of Lifestyle Disease Prevention vol.24, pp.2, 2012, https://doi.org/10.1515/pjst-2017-0007
  18. Combined exercise training reduces blood pressure, arterial stiffness, and insulin resistance in obese prehypertensive adolescent girls vol.39, pp.6, 2017, https://doi.org/10.1080/10641963.2017.1288742
  19. Combined resistance and aerobic exercise training reduces insulin resistance and central adiposity in adolescent girls who are obese: randomized clinical trial vol.118, pp.8, 2018, https://doi.org/10.1007/s00421-018-3898-8
  20. Routine Yoga Practice Impacts Whole Body Protein Utilization in Healthy Women vol.26, pp.1, 2018, https://doi.org/10.1123/japa.2016-0085
  21. Routine Yoga Practice Impacts Whole Body Protein Utilization in Healthy Women vol.26, pp.1, 2018, https://doi.org/10.1123/japa.2016-0085
  22. Using the International Classification of Functioning, Disability, and Health Model to Gain Perspective of the Benefits of Yoga in Stroke, Multiple Sclerosis, and Children to Inform Practice for Child vol.24, pp.5, 2018, https://doi.org/10.1089/acm.2017.0030
  23. Efficacy of forced right nostril breathing and selected yogasanas on female obese college students vol.15, pp.3, 2018, https://doi.org/10.1515/jcim-2017-0070
  24. Efficacy of forced right nostril breathing and selected yogasanas on female obese college students vol.15, pp.3, 2018, https://doi.org/10.1515/jcim-2017-0070
  25. The effects of a 12-week jump rope exercise program on abdominal adiposity, vasoactive substances, inflammation, and vascular function in adolescent girls with prehypertension vol.119, pp.2, 2012, https://doi.org/10.1007/s00421-018-4051-4
  26. The effects of swimming training on arterial function, muscular strength, and cardiorespiratory capacity in postmenopausal women with stage 2 hypertension vol.26, pp.6, 2012, https://doi.org/10.1097/gme.0000000000001288
  27. The effects of a 12-week jump rope exercise program on body composition, insulin sensitivity, and academic self-efficacy in obese adolescent girls vol.33, pp.1, 2020, https://doi.org/10.1515/jpem-2019-0327
  28. Do Mindfulness Interventions Improve Obesity Rates in Children and Adolescents: A Review of the Evidence vol.14, pp.None, 2012, https://doi.org/10.2147/dmso.s220671
  29. Mind–Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis vol.18, pp.1, 2021, https://doi.org/10.3390/ijerph18010224
  30. The impacts of exercise on pediatric obesity vol.64, pp.5, 2021, https://doi.org/10.3345/cep.2020.00997
  31. The Effects of Different Exercise Modalities in the Treatment of Cardiometabolic Risk Factors in Obese Adolescents with Sedentary Behavior-A Systematic Review and Meta-Analysis of Randomized Controlle vol.8, pp.11, 2021, https://doi.org/10.3390/children8111062