Population aging has been accompanied by a rise in obesity and other chronic diseases, increasing cardiovascular risk particularly among women, who exhibit a higher prevalence in older age groups compared to men. Aging and obesity share pathophysiological mechanisms, such as chronic inflammation and oxidative stress. However, distinct obesity phenotypes exist, such as metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). Consequently, therapeutic interventions involving nutritional strategies and physical training are highly relevant, especially for older women. Taurine, a sulfur-containing amino acid, plays a role in modulating oxidative stress, inflammation, osmoregulation, and mitochondrial function. Rationale: Plasma taurine concentrations are lower in women with obesity compared to healthy individuals. However, studies investigating these concentrations across different phenotypes-particularly in older women, a group susceptible to functional and metabolic changes-remain limited. Understanding these variations could clarify taurine's role in the pathophysiology of obesity and aging and inform personalized therapeutic strategies. Combined physical training stands out as an effective strategy for modulating inflammatory, oxidative, and metabolic pathways, in addition to improving psychosocial aspects. Given that taurine levels can be influenced by these pathways, investigating the taurine response to physical training across different metabolic phenotypes may contribute to developing low-cost interventions aimed at improving the quality of life for older women with obesity.
This study aims to investigate differences in plasma taurine concentrations between older women with MHO and MUO, and to evaluate the response of taurine-as well as metabolic, inflammatory, oxidative, and cellular markers-to a 16-week combined physical training intervention. The study will involve 36 older women with obesity, classified as having either MHO or MUO. In Stage 1, nutritional and anthropometric assessments will be conducted, along with the collection of biological samples for biochemical and molecular analyses. In Stage 2, participants will undergo a combined physical exercise intervention for 16 weeks; nutritional, anthropometric, physical performance, and functional assessments will be performed, as well as the collection of biological samples for pre- and post-intervention biochemical and molecular analyses. Stage 3 will consist of integrated data analysis to identify variables predicting plasma taurine concentrations at baseline and post-intervention. Data analysis method: Data will be analyzed using Student's t-tests or Mann-Whitney tests (Stage 1), ANOVA or Kruskal-Wallis tests (Stage 2), Pearson or Spearman correlations (Stages 1 and 2), and linear regression models (Stage 3), using SPSS software (α=5%). Expected results: It is expected that older women with OMS will exhibit higher baseline taurine concentrations and that combined physical training will increase these concentrations in both groups-with a more pronounced effect in the OMS phenotype-in addition to promoting cardiometabolic, functional, inflammatory, oxidative, and psychosocial benefits.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
36
Combined physical Training during 16 weeks
Plasma taurine concentrations (µmol/L).
It will be analyzed by high-performance liquid chromatography.
Time frame: 16 weeks
Systolic and diastolic blood pressure (mmHg)
Using sphygmomanometer
Time frame: 16 weeks
Waist and hip circumferences (cm)
non-stretch anthropometric tape
Time frame: 16 weeks
Appendicular lean soft tissue (kg).
Using Dual-energy X-ray Absorptiometry (DXA), often referred to as iDXA, is a low-dose X-ray technology that measures bone mineral density (BMD) and body composition
Time frame: 16 Weeks
Total and regional body fat percentage (%)
Dual-energy X-ray Absorptiometry
Time frame: 16 weeks
Visceral fat (kg)
Dual-energy X-ray Absorptiometry
Time frame: 16 weeks
Body mass (kg)
Dual-energy X-ray Absorptiometry
Time frame: 16 weeks
Body mass index, BMI (kg/m²).
Using body mass and height measurements
Time frame: 16 weeks
Inflammatory and antiinflamatory profile
Changes in serum levels of cytokines will be evaluated with MILLIPLEX® Kit. Pro- inflammatory citokines: IL-1β, MCP-1,TNF-α, IL-6, IL-13 (pg/mL), leptina e PCR-us (mg/dL), IL-10 (pg/mL) e adiponectina (mg/dL).
Time frame: 16 weeks
Food Intake
A food record of three non-consecutive days: two days of the week and one day in the weekend. This evaluation will last 16 weeks. Will be evaluated with Dietwin® software (São Paulo, Brazil): The macronutrients, micronutrients and fiber in quilocalories and percentage (%)
Time frame: 16 weeks
Aerobic performance - VO2
Physical tests performed pre and post- intervention to assess aerobic physical fitness by incremental test in cycle ergometer. The test aim to evaluate VO2peak in ml.kg-1.min-1.
Time frame: 16 weeks
Aerobic performance - LacAnTh
Physical tests performed pre and post- intervention to assess aerobic physical fitness by incremental test in cycle ergometer. The test aim to evaluate: Anaerobic threshold (AT) using lactate concentration \[lac-\].
Time frame: 16 weeks
Aerobic performance - IAnTh
Physical tests performed pre and post- intervention to assess aerobic physical fitness by incremental test in cycle ergometer. The test aim to evaluate: Anaerobic threshold (AT) using intensity in Watts (W).
Time frame: 16 weeks
Aerobic performance - HRAnTh
Physical tests performed pre and post- intervention to assess aerobic physical fitness by incremental test in cycle ergometer. The test aim to evaluate: Anaerobic threshold (AT) using heart rate (HR).
Time frame: 16 weeks
Food intake - frequency
Application of Food Frequency Questionnaire, QFA-NOVA for each food group (g/group).
Time frame: 16 weeks
Strength test - leg press
Strength test - leg press - maximum repetitions pre and post intervention
Time frame: 16 weeks
Strength test - bench press
Strength test using bench press, pre and post intervention
Time frame: 16 weeks
Funtional capacity: chair sit-to-stand
Funtional capacity evaluation pre and post intervention
Time frame: 16 weeks
handgrip strength
handgrip strength using manual dinamometer
Time frame: 16 weeks
funtional capacity: elbow flexion and extension
funtional capacity: elbow flexion and extension using a dumpbell
Time frame: 16 weeks
Funtional capacity: 6-minute walk test
6-minute walk test using an 30-meter course with markings every 3 meters.
Time frame: 16 weeks
Glycemic profile
Quantified by Total Liquiform Cholesterol Kit, HDL Cholesterol Kit and Liquiform Triglycerides Kit, from Labtest diagnóstica®, using an enzymatic system and absorbance spectrophotometer: Changes in blood glucose (mg/dL).
Time frame: 16 weeks
Lipid profile - Total cholesterol
Quantified by Total Liquiform Cholesterol Kit, HDL Cholesterol Kit and Liquiform Triglycerides Kit, from Labtest diagnóstica®, using an enzymatic system and absorbance spectrophotometer: Changes in total cholesterol (mg/dL).
Time frame: 16 weeks
Lipid profile: HDL-cholesterol and LDL-cholesterol (mg/dL).
Quantified by Total Liquiform Cholesterol Kit, HDL Cholesterol Kit and Liquiform Triglycerides Kit, from Labtest diagnóstica®, using an enzymatic system and absorbance spectrophotometer: Changes in HDL-cholesterol and LDL-cholesterol (mg/dL).
Time frame: 16 weeks
Lipid profile: triglycerides (mg/dL).
Quantified by Total Liquiform Cholesterol Kit, HDL Cholesterol Kit and Liquiform Triglycerides Kit, from Labtest diagnóstica®, using an enzymatic system and absorbance spectrophotometer: Changes in triglycerides (mg/dL).
Time frame: 16 weeks
Glycemic profile - C-peptide
C-peptide pre and post intervention using Chemiluminescence (CLIA - Chemiluminescent Immunoassay)
Time frame: 16 weeks
Expression of inflammatory and anti-inflammatory genes in peripheral blood mononuclear cells (PBMCs)
Using RT-qPCR pre and post-intervention.
Time frame: 16 weeks
Expression of genes related to telomere length: TRF1, TRF2, RAP1, TPP1, POT1, TIN2, and hTERT.
Using RT-qPCR pre and post intervention
Time frame: 16 weeks
Micronutrients (mg/dL)
Blood Zinc, selenium, and magnesium (mg/dL) using spectrophotometry pre and post intervention
Time frame: 16 weeks
Antioxidant enzymes - Superoxide dismutase
Superoxide Dismutase (SOD) Assay Kit Pre and post intervention (U/mg)
Time frame: 16 weeks
Antioxidants enzymes - Catalase (CAT)
Catalase Assay Kit Pre and post intervention (U/mg)
Time frame: 16 weeks
Antioxidants enzymes: Glutationa-peroxidase GPx (U/mg)
Glutathione Peroxidase Assay Kit Pre and post intervention
Time frame: 16 weeks
Oxidative stress markers - Malondialdehyde (nmol/mL).
TBARS (Thiobarbituric Acid Reactive Substances) assay pre and post intervention
Time frame: 16 weeks
Relative telomere length
The assay will be based on quantifying the ratio between the amplification of telomeric sequences (T) and a single-copy gene (S), enabling the estimation of relative telomere length in the biological samples.
Time frame: 16 weeks
Nitrogen balance
Urinary nitrogen excretion (g) will be determined using the Labtest Diagnóstica kit (UREA CE), estimating urinary nitrogen excretion based on urea levels. Daily protein intake will also be used, pre and post intervention
Time frame: 16 weeks
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