EFFECTS OF STRUCTURED AND UNSTRUCTURED PHYSICAL ACTIVITIES ON BIOCHEMICAL INDICES, DISEASES RISK SCORES AND COST OF CARE OF OVERWEIGHT AND OBESE ADULTS

Abstract

Overweight and obesity are global problems associated with a myriad of non-communicable diseases. Physical Activity (PA) is known to have positive effects on some Biochemical Indices (BI) of overweight and obese adults. However, studies comparing the effects of structured and unstructured PAs on BI, Disease Risk Scores (DRS) and Cost of Care (CoC) of overweight and obese adults in Nigeria are sparse. This study was conducted to compare the effects of structured and unstructured PA on BI, DRS and CoC of overweight and obese adults. Forty-nine overweight and obese adults participated in a12-week randomised clinical trial. They were recruited from Gwagwalada Area Council of the Federal Capital Territory, Abuja; and randomly assigned into Structured PA Group [SPAG] (n=25) and Unstructured PA Group [UPAG] (n=24). Intervention consisted of thrice a week flexibility, resistance and aerobic exercises using the Healthy Active Living and Obesity Research Group’s protocol for SPAG. Participants in UPAG underwent daily self-paced walking activity monitored with a pedometer. High-Density Lipoprotein (HDL, mmol/L), Low-Density Lipoprotein (LDL, mmol/L), Total Cholesterol (TC, mmol/L), Triglycerides (mmol/L), Fasting Blood Glucose (FBG, mmol/L), Glycated Haemoglobin (HbA1c, %), Aspartate Amino Transferase (AST, IU/L) and Alanine Amino Transferase (ALT, IU/L); DRS [Framingham Risk Scores (FRS) for cardiovascular disease, Finnish Diabetes Risk Scores (FINDRISC) for diabetes, Hypertension Risk Score (HRS) for hypertension] and cost of obesity for CoC (₦) were measured at baseline, 6th (except HbA1c) and 12th week using standard procedures, instruments and outcome measures. Data were analysed using Repeated Measure ANOVA, paired sample t-test and independent t-test at α0.05. Participants in SPAG (43.48±6.85 years) and UPAG (44.88±7.54 years) were comparable in age. Baseline variables of SPAG and UPAG for BI [HDL=1.13;1.23, LDL=4.28;3.74, TC=5.11;5.05, Triglyceride=1.54;1.54, FBG=6.80;6.60, HbA1c=4.7;4.9, AST=11.04;11.46, ALT=8.00;7.75], DRS [FRS=8.12;8.04, FINDRISC=13.16;14.00, HRS=12.20;12.08] and CoC=135,200.00;179,266.67, respectively, were also comparable. At the 12th week, all the BI were not significantly different from the baseline in the two groups except HDL (1.13±0.31,1.24±0.29; 1.23±0.35,1.41±0.28), which increased significantly in both groups and AST (11.04±1.34,9.84±0.94;11.46±1.62,10.67±1.05), which decreased significantly in both groups. All the DRS were not significantly different between SPAG and UPAG at the 12th week. There was a significant reduction in CoC at the 12th week in SPAG (66,822.00±38,822.65) than UPAG (135,712.50 ±75,752.39). Within group comparison for SPAG showed that cardiovascular disease (8.12±3.95; 5.48±3.63), diabetes (13.16±2.34; 7.88±2.73) and hypertension (12.20±3.30; 7.16±2.36) risk scores were significantly reduced at the 12th week. Similarly, within-group comparison for UPAG showed that cardiovascular disease (8.04±3.91; 5.54±3.27), diabetes (14.00±2.21; 9.00±2.86) and hypertension (12.08±3.09; 7.33±2.01) risk scores were significantly reduced across the study periods. The CoC within SPAG at baseline (135,200.00±50,372.48) was significantly reduced (66,822.00±38,822.65) across the study periods, but the reduction in CoC within UPAG was not significant. Structured and unstructured physical activity reduced the risk of developing cardiovascular diseases, diabetes and hypertension and impacted positively on selected biochemical indices of overweight and obese adults. However, structured physical activity was superior to unstructured physical activity in reducing the cost of care in overweight and obese adults.