Current Research

Immune response to exercise in obese individuals with or without T2DM

Referred to as the silent pandemic and effecting ~ 2 billion adults globally, obesity status was identified as the independent variable to predict disease severity following the emergence of COVID-19 as a global concern. Often the precursor to development of many non-communicable diseases (such as cardiovascular disease, hypertension, stroke, cancers, and Type 2 Diabetes (T2DM)). Like T2DM, obesity is a health condition which is reversible through changes to lifestyle factors such as diet and exercise for most affected.  

As shown in various studies, along with improving vascular plasticity, cognitive function, mood disorders, and reducing adiposity, hypertension and stroke risk as identified from studies investigating athletic demographics, exercise also improves immune response to fungal, bacterial, and viral infection. The immune response to exercise in sedentary obese individuals with or without T2DM are yet less known, and in COVID-19 unknown though available data has shown that those who exceed the recommended weekly guidelines for physical activity suffer less severe symptoms following infection. Measurement of psychological aspects related to exercise in the target demographic shall be investigated to consider the wider context of potential changes found.

This randomised control trial investigates the effects of a 12-week home based lifestyle intervention to understand changes to immune profile in the target demographic (age 18 – 55 years old, BMI > 30 kg•m2, moderate intensity exercise < 150 min•week), regarding common biomarkers associated with obesity and T2DM status, exercise, and viral infection to identify possible cell signalling cascades of interest for future investigation.

Participants will be randomly assigned to either the Education and Exercise Group or the Education only group, with an age matched physically active normative population providing baseline measurements for comparison. Following acute exercise, primary variables to be investigated are changes in serum cytokine profile, and plasma IgG, IgA, and IgM to identify the effects of exercise on known biomarkers specific to disease status. Also of primary interest are mass, waist to hip ratio, body composition, flexibility, basal metabolic rate, resting heart rate, resting blood pressure, VO2max, VO2peak, Power max, max heart rate, HbA1c, HDL:LDL ratio, and triglycerides to identify key physiological changes.  Secondary psychological variables of interest include sleep quality (SQS), mental well-being (WEMWBS), and exercise enjoyment (AFFEXX) to be contextualised using interpretative phenomenological analysis (IPA) derived from semi-structured interviews to understand the effect on psychological changes following engagement with the intervention and contextualise the quantitative data.

Using IBM SPSS version 26.0, physiological and biological data shall be analysis for normality using the Shapiro-Wilks test. Following this, data will be processed accordingly using 2 way repeated-measures ANOVA for parametric data, and Kruskal-Wallis test for non-parametric data. Z-scores shall be generated for Likert scale data from the SQS, WEBWMS, and AFFEXX questionnaires. Pearson’s correlation will be generated for parametric data and Spearman’s rank for non-parametric. Multi-variate linear regression will be performed to investigate relationships between variables. Significance will be accepted at p < 0.05 for all tests. Semi-structured interviews will be coded to generate themes and build a general narrative using reflexive thematic analysis to contextualise the quantitative data.