Effects of local vibration on waist circumference and central obesity in overweight women with sedentary lifestyle

doi:10.21203/rs.3.rs-3505895/v1

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Effects of local vibration on waist circumference and central obesity in overweight women with sedentary lifestyle

https://doi.org/10.21203/rs.3.rs-3505895/v1

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Background: Vibration is a therapeutic modality that improves muscle function, increases energy expenditure, and consequently reduces body fat. Local Vibration on abdominal region may reduce waist circumference through increasing local blood flow and sustaining contractions of the abdominal muscles. This study aimed to investigate the effects of using vibrating belt on body composition parameters among overweight women with sedentary lifestyle.

Methods: This experimental clinical study was on 35 overweight women with sedentary lifestyle. During an eight-week intervention, the effects of using vibrating belt (three sessions a week for half an hour) were investigated. Body composition was assessed via measuring waist circumference, abdominal circumference, abdominal and supra-iliac skin folds alongside the variables of an electrical bio-impedance device.

Results: The mean age of participants was 37±6 years. The percentage of body fat, waist circumference, abdominal and supra-iliac skin folds were significantly decreased at the end of the study (P<0.05). Waist circumference also showed a significant decrease in the mid-point of the study, compared to the beginning (P<0.05). Abdominal skin fold also showed a significant decrease at the end of the study, compared with the mid-point (P<0.05). However, weight, BMI, Lean Body Mass, Soft Lean Mass and abdominal circumference did not change significantly (P>0.05).

Conclusion: The use of vibrating belt by sedentary overweight women may reduce the percent body fat, waist circumference, abdominal and supra-iliac skin folds without any side effect. This might implicate the effect of using vibrating belts in the management of central obesity by reducing abdominal subcutaneous fat.

Vibrating belt

waist circumference

abdominal circumference

abdominal skin fold

supra-iliac skin fold

local vibration

Obesity and overweight have been recognized as one of the major health problems at both developed and developing countries [1, 2]. A global epidemic problem in the past is a pandemic now [3]. Obesity related problems such as cardiovascular diseases, high blood pressure, atherosclerosis, diabetes and some types of cancer [2, 4] directly and indirectly increase health care costs [5]. Body mass index is widely used as a measure of obesity, however it provides no information about the distribution of fat in the body [6]. High visceral fat or central body fat is strongly associated with an increased risk of non-communicable chronic diseases and mortality in the communities [7].

Recently, studies have been focused on abdominal fat and waist circumference is an important parameter for estimating it [6, 7]. One centimeter increase in waist circumference is associated with 2% increase in the risk of cardiovascular events in the future [8]. Compared with body mass index (BMI), anthropometric measures of abdominal obesity (waist circumference, waist to hip ratio and abdominal circumference), which play a major role in the metabolic syndrome [9], seem to have a stronger association with metabolic risk factors, diabetes, cardiovascular events and mortality [8, 10].

Treatment of obesity and overweight involve a combination of methods, including dietary modifications, physical activity and behavior therapy [11]. Aerobic exercise stimulates fat oxidation during and after exercise [12] and has a moderate effect on weight loss [9]. On the other hand, resistance exercise which maintains lean body mass [9], increases oxygen consumption and lipid metabolism after exercise [12].

Vibration therapy is currently used as a rehabilitation method to deal with muscle atrophy and bone loss during periods of forced immobilization [13]. There are several reports in scientific and empiric resources that vibration is an efficient and effective method for reducing the duration of exercise training which improves muscle function in order to enhance energy consumption and decrease body fat [12, 14]. It is claimed that ten minutes of vibration therapy is equal to one hour of conventional exercises [12].

Experts have shown more interest to vibration therapy in recent years and several reports have been stated that this mode of exercise increases blood flow in the tissues and muscles [15]. Vibration can be considered a kind of light resistance exercise [16] which increases oxygen consumption, metabolic rate and the amount of work done by the muscles via recurrent and quick concentric-eccentric muscular contractions [12, 16].

Vibrating belt is a local vibration tool which is placed on the abdominal area. With regard to the mechanisms discussed above, the vibrating belt may reduce waist circumference and central body fat. According to the results of our literature review, the majority of published studies have investigated the effects of whole body vibration [17, 18] and there is no scientific paper on the effects of vibrating belts. In addition, because of the widespread advertisement on such products by manufacturer companies and a great public interest in the use of these tools, it is necessary to conduct a scientific study on its efficacy. Hence, this study was aimed to investigate the effects of using vibrating belts on the reduction of waist circumference and central obesity among overweight women with a sedentary lifestyle.

Study design

This quasi experimental study was conducted on 35 overweight women with a sedentary lifestyle. People who visited the clinic for dietary advice were invited to participate in the study. Inclusion criteria were overweight women (BMI = 25-29.9) aged 20–55 years old, and a sedentary lifestyle according to the American College of Sports Medicine (ACSM) criteria [19]. Individuals were excluded if they had any limitation in using a vibrating belt. The study complied with the Declaration of Helsinki and the research protocol received the local ethics committee approval. The study process was explained to all of the participants and they signed an informed consent before the procedures.

Primary and secondary outcome measures

Main outcome measures were general and central obesity parameters including weight, BMI and abdominal wall anthropometry. Abdominal wall anthropometry was performed according to ACSM guideline by measuring waist circumference, abdominal circumference and abdominal subcutaneous fat through gauging abdominal and supra-iliac skin folds [19]. To measure the waist circumference, the participants in standing position were asked to put their hands at the sides of the body, their feet close to each other and relax their abdominal muscles. The horizontal perimeter was measured at the narrowest part of the Torso (above the navel and below the xiphoid). In the same position, abdominal circumference was measured above the iliac crest at the level of the umbilicus by a tape measure. Abdominal skin fold was measured vertically 2 cm to the right side of the umbilicus and supra-iliac skin fold was measured diagonally along the lines of the natural angle of the iliac crest at the anterior axillary line immediately above the right side of the iliac crest using a caliper.

Secondary outcome measures including the percentage of body fat, soft lean mass and lean body mass were measured by means of bioelectrical impedance device (Avis 333, Jawon Medical Co. Ltd, South Korea). All measurements were performed twice in each session by an experienced physician in anthropometry and the average value was recorded.

All subjects were instructed to follow healthy eating patterns, but they did not receive any individualized diet. To ensure constant calorie intake, all subjects completed a 24-hour food recall at the beginning and end of the study.

Intervention

A vibrating belt was firmly fastened to the abdomen (around the navel) for half an hour three days a week for eight weeks. All 24 sessions were performed in the clinic under the supervision of researchers. Participants were dropped from the study, if they missed two consecutive or a total of four sessions. All outcome measures were recorded at baseline, mid-point (end of week 4), and at the end of the intervention (week 8). The physician who performed the measurements was not aware of the intervention steps.

Statistical analyses

Statistical analysis was performed using SPSS 13 software for Windows. Qualitative variables are presented as frequencies and percentages and quantitative variables are presented as mean and standard deviation (SD). Repeated Measure ANOVA and Bonferroni Post hoc test were used to investigate the effects of vibrating belt on anthropometric measurements and body mass index. In this study, P value < 0.05 was considered as a significant level. To investigate intra-rater reliability, differences between the two measurements of each anthropometric variable at the beginning, mid-point, and end of the study were assessed by Repeated Measure ANOVA test.

A total of 35 subjects were enrolled in the study. Three participants left the study within the first four weeks and one participant dropped out after the fourth week. All of them did not continue the intervention due to their personal and occupational time constraints. Furthermore, one participant did not return for the final measurements. Finally, a total of 30 subjects were analyzed. The mean (SD) age of the participants was 37 (± 6) years with a range of 21–47 years. Table 1 shows the mean (SD) anthropometric measures and body mass index at the beginning, mid-point and end of the study.

Table 1

Anthropometric measurements during the course of the study
	Base Mean (SD)	Mid Mean (SD)	End Mean (SD)	P value^*
Weight (Kg)	71.74 ± 7.79	71.51 ± 7.62	71.39 ± 7.67	0.236
BMI	27.52 ± 1.56	27.44 ± 1.63	27.42 ± 1.7	0.456
Body Fat %	35.42 ± 1.84	34.89 ± 2.09	34.89 ± 1.9	0.025¹
Lean Body Mass (Kg)	46.31 ± 4.92	46.54 ± 4.91	46.5 ± 5.27	0.404
Soft Lean Mass (Kg)	42.26 ± 4.49	42.5 ± 4.51	42.46 ± 4.84	0.341
Waist Circumference (cm)	82.41 ± 6.87	81.02 ± 5.57	80.29 ± 5.68	0.001^1,2
Abdominal Circumference (cm)	98.88 ± 7.05	99.23 ± 6.21	98.13 ± 5.95	0.193
Abdominal Skin Fold (mm)	30.93 ± 7.85	28.5 ± 4.67	26.67 ± 4.07	0.004^1,3
Supra-Iliac Skin Fold (mm)	27.86 ± 6.53	25.83 ± 5.76	25.18 ± 6.29	0.003¹
*Repeated Measure ANOVA ¹ Difference between baseline and end of the study, Bonferroni Post hoc test ² Difference between baseline and mid-point of the study Bonferroni Post hoc test ³ Difference between mid-point and end of the study, Bonferroni Post hoc test

Body fat percentage, waist circumference, abdominal and supra-iliac skin folds were significantly reduced at the end of the study compared to the beginning (P < 0.05). Waist circumference also showed a significant decrease in the mid-point compared to the beginning of the study (P < 0.05). Abdominal skin fold showed a significant decrease at the end of the study, compared to the mid-point (P < 0.05). However, weight, BMI, Lean Body Mass, Soft Lean Mass and abdominal circumference did not change significantly throughout the study (P > 0.05). The changes in waist and abdominal circumferences, abdominal and supra-iliac skin folds at the beginning, mid-point and end of the study are shown in Figs. 1–3.

Considering the intra-rater reliability, no significant difference was found between the two measurements of each anthropometric variable at the beginning, mid-point, and end of the study (P > 0.05). According to the 24-hour food recall analysis, there was no significant difference in the calorie intake of the participants at the beginning and end of the study. No side effects or adverse events were observed with the use of the vibrating belt during the study.

The findings of the present study showed that using vibrating belt by overweight women with a sedentary lifestyle can reduce waist circumference, abdominal and supra-iliac skin folds. These findings alongside a significant decrease in the percentage of body fat imply the positive effects of vibrating belt on reducing abdominal subcutaneous fat in this population. This is an impressive result and a practical step in the treatment of central obesity without any side effects.

Effective therapeutic methods to reduce abdominal obesity can greatly help to minimize the risk of secondary health problems associated with central obesity. According to our extensive literature review, this is the first study that scientifically evaluates the effects of local vibrating belt on central obesity parameters in overweight women with sedentary lifestyle. Most studies have investigated the effects of whole body vibration (WBV) training on body composition and anthropometric variables [20]. In a study by Milanese et al. which was conducted on 50 obese females, 10 weeks of whole body vibration training, two times a week, resulted in a significant decrease in abdominal and supra-iliac skin folds. The authors reported a statistically significant decrease in the subjects’ waist circumference for about 1.6 ± 0.3 cm [16]. In another study by Song GE et al. the effects of whole body vibration therapy for 8 weeks in 50 overweight women resulted in a reduction of 2.34 ± 2.48 cm in the participants’ waist circumference [21]. Our findings were similar to these studies and we found significant reductions in abdominal and supra-iliac skin folds, and reported a significant decrease of 2.12 ± 0.6 cm in waist circumference of the participants. Decreased waist circumference and segmental fat mass (i.e. trunk) following WBV are also reported in clinical trials and one systematic review on individuals with metabolic syndrome [22, 23].

The effects of vibration therapy on lean body mass and soft lean mass

After eight weeks of whole body vibration, aerobic and resistance training, body composition of overweight women with a sedentary lifestyle was analyzed using dual-energy X-ray absorptiometry (DXA) [24]. There were no significant effects on body composition variables between groups, however, moderate to large effect size was reported for the percentage of body fat and lean body mass favoring aerobic and resistance training groups. Finally, it was concluded that whole body vibration training is not an effective alternative to traditional exercises with regard to body composition. These findings are consistent with the results of our study with no significant effects on lean body mass and soft lean mass.

Studies with positive effects of whole body vibration therapy on muscle mass and muscle strength often used resistance training or aerobic exercise alongside with vibration which could lead to a bias in their reports. Fjeldstad et al. investigated the effects of eight months of resistance exercise with and without whole body vibration on body composition in postmenopausal women with a sedentary lifestyle [25]. A total of 55 women participated in their study and were divided into three groups of resistance exercise, vibration and the control group. Body composition was assessed by total body DXA scans and the results showed no significant difference between the exercise groups in terms of bone free lean tissue mass. Both exercise groups had better outcomes than the control group.

In a study on 48 young non-athlete females, the effects of 24 weeks of whole body vibration therapy on body composition and muscle strength were evaluated [26]. Body composition was determined by underwater weighing and 12 skin folds measurements. There was no significant difference between the control group and the vibration therapy group in terms of the weight, the percentage of body fat and the skin folds. Muscle strength was increased in vibration therapy group compared to the control group; however, since vibration group performed unloaded static and dynamic leg and arm exercises on a vibrating platform, this increased level of muscle strength cannot be attributed to vibration therapy per se. Such results are confirmed by a recent systematic review with meta-analysis on overweight and obese population which their findings were not consistent with significant improvements on body composition variables [18].

To justify the lack of the effects of local vibration on lean body mass and soft lean mass, it can be assumed that since vibrating belts are fastened to the abdomen, the probable effects of such intervention occur locally on the abdominal area. These probable effects and mechanism of action include: increasing in blood flow of tissues and muscles as a result of vibration [15, 27] with rapid and frequent concentric-eccentric muscle contractions which increase muscular work, oxygen consumption and metabolic rate [12, 16] on the affected areas.

One limitation of an interventional study is the participants’ compliance with the interventions. In this study, to ensure the accurate and timely completion of the intervention, participants performed all abdominal vibration treatments in the clinic and under the supervision of research team members with sufficient number of sessions. A limitation of this study was the lack of a control group. This was because of the difficulties in finding a sham vibrating device for the control group. It is therefore recommended to conduct further studies with larger sample size and a control group with sham intervention to investigate the effects of local vibration therapy on central obesity in overweight people with a sedentary lifestyle.

The findings of our study indicate that the use of vibrating belts in overweight women with a sedentary lifestyle may reduce the percent body fat, waist circumference, abdominal and supra-iliac skin folds without any side effects. So, we can conclude that the use of vibrating belts may reduce abdominal subcutaneous fat and might be helpful in the management of central obesity.

BMI body mass index; ACSM American College of Sports Medicine; SD standard deviation; WBV whole body vibration; DXA dual-energy X-ray absorptiometry

This study is supported by the Research deputy of Tehran University of Medical Sciences (TUMS) and is approved by the Ethics Committee of TUMS (code: 88-04-53-9894).

Competing Interest: The authors declare no conflict of interest.

Author contributions conception and design: RM; data collection: BH and ZA; analysis and interpretation of data: RM; Writing the original draft: RM; review and editing of the manuscript: BH and ZA; critical revision: MG; supervision: RM.

Funding This study is supported by the Research deputy of Tehran University of Medical Sciences (TUMS) and is approved by the Ethics Committee of TUMS (code: 88-04-53-9894).

Acknowledgments None.

Conflicts of Interest None declared.

Data availability The authors confirm that the data of this study are available within the article.

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No competing interests reported.

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Effects of local vibration on waist circumference and central obesity in overweight women with sedentary lifestyle

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Abstract

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Introduction

Material and Methods

Study design

Primary and secondary outcome measures

Intervention

Statistical analyses

Results

Discussion

The effects of vibration therapy on lean body mass and soft lean mass

Conclusion

Abbreviations

Declarations

References

Additional Declarations

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