title: The potential of phototherapy to reduce body fat, insulin resistance and "metabolic inflexibility" related to obesity in women undergoing weight loss treatment.
abstract: OBJECTIVE
  The metabolic flexibility is often impaired in diseases associated with obesity, and many studies are based on the hypothesis that dysfunction in peripheral tissues such as skeletal muscle, liver and adipose tissue represent the etiology of development of metabolic inflexibility. Experimental evidence shows that the use of phototherapy combined with exercise was effective in controlling the lipid profile, reducing the mass of adipose tissue, suggesting increased metabolic activity and changes in lipid metabolism. However, we found few data in the literature involving the use of phototherapy in association to physical training in the obese population. Thus, our objective was to evaluate the effects of exercise training (aerobic plus resistance exercises) plus phototherapy (laser, 808 nm) on metabolic profile and adiponectinemia in obese women.
  
  
  METHODS
  Sixty-four obese women (BMI 30-40 kg/m2 , age between 20 and 40 years old) were randomly assigned in two groups: Exercise Training plus SHAM group (ET-SHAM, n = 32) and Exercise Training plus Phototherapy group (ET-PHOTO, n = 32). The treatment consisted in physical exercise intervention and the individual application of phototherapy immediately after the end of the training session. However, in the ET-SHAM group the device was turned off simulating the phototherapy application (placebo effect). The study protocol lasted for 20 weeks and comprised of three weekly sessions of aerobic plus resistance training and application of phototherapy (when applicable). The body composition and metabolic parameters were assessed (HOMA, adiponectin, insulin, glucose).
  
  
  RESULTS
  Comparing the magnitude of effects between groups (ET-PHOTO vs. ET-SHAM), we observed that physical training plus phototherapy was more effective than physical training in reducing the delta of percentage of fat mass (%; -5.60 ± 1.59 vs. -4.33 ± 1.5; P < 0.04); fat mass (kg; -11.26 ± 2.82 vs. -5.80 ± 2.82; P < 0.0002); HOMA-IR index (-38.08 ± 9.23 vs. -20.91 ± 14.42; P < 0.0001). In addition, we observed an increase in delta (%) of total skeletal muscle mass (kg; 0.60 ± 1.09 vs. -1.38 ± 1.70; P < 0.003), adiponectin concentration (ng/ml; 1.08 (0.04-3.62) vs. -0.42 (-3.15 to 2.26); P < 0.03) in the same comparison.
  
  
  CONCLUSIONS
  Our results demonstrated for the first time that phototherapy enhances the physical exercise effects in obese women undergoing weight loss treatment promoting significant changes in inflexibility metabolic profile.
authors.affiliation: São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil.
authors.forename: Marcela
authors.initials: M
authors.lastname: Sene-Fiorese
authors.affiliation: Department of Physiotherapy, Therapeutic Resources Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil.
authors.forename: Fernanda Oliveira
authors.initials: FO
authors.lastname: Duarte
authors.affiliation: São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil.|Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil.
authors.forename: Antonio Eduardo
authors.initials: AE
authors.lastname: de Aquino Junior
authors.affiliation: Post-Graduated Program of Nutrition, Federal University of São Paulo (UNIFESP), 04021-001 São Paulo, São Paulo, Brazil.
authors.forename: Raquel Munhoz da Silveira
authors.initials: RM
authors.lastname: Campos
authors.affiliation: Post-Graduated Program of Nutrition, Federal University of São Paulo (UNIFESP), 04021-001 São Paulo, São Paulo, Brazil.
authors.forename: Deborah Cristina Landi
authors.initials: DC
authors.lastname: Masquio
authors.affiliation: Weight Science, São Paulo, São Paulo, Brazil.
authors.forename: Lian
authors.initials: L
authors.lastname: Tock
authors.affiliation: Department of Physical Education, Nutrition and Metabolism Applied to Exercise Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil.
authors.forename: Ana Claudia Garcia
authors.initials: AC
authors.lastname: de Oliveira Duarte
authors.affiliation: Post-Graduated Program of Nutrition, Federal University of São Paulo (UNIFESP), 04021-001 São Paulo, São Paulo, Brazil.
authors.forename: Ana Raimunda
authors.initials: AR
authors.lastname: Dâmaso
authors.affiliation: Department of Physiotherapy, Therapeutic Resources Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil.|Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil.
authors.forename: Nivaldo Antonio
authors.initials: NA
authors.lastname: Parizotto
authors.affiliation: São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil.|Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil.
authors.forename: Vanderlei Salvador
authors.initials: VS
authors.lastname: Bagnato
mesh_terms: D052242:Adiponectin / Q000097:blood; D050154:Adiposity; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D009765:Obesity / Q000097:blood / Q000628:therapy*; D010789:Phototherapy / Q000379:methods*; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D001786:Blood Glucose
keywords: adiponectin; insulin resistance; low-level light therapy; metabolic flexibility; obesity; physical exercise