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Cent Eur J Public Health. 2013 Mar;21(1):8-16.

Effects of supervised vs non-supervised combined aerobic and resistance exercise programme on cardiometabolic risk factors.

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Medicobiological Unit, International Scientific Institute, National Sports Academy, Sofia, Bulgaria.



We examined the effect of a 6-month combined aerobic and resistance training programme on cardiometabolic risk factors in nondiabetic subjects and compared its effectiveness when executed under strict professional supervision or without direct supervision.


Eighty-five sedentary, non-diabetic subjects (27 men and 58 women), mean age 47.5 +/- 0.6 years, mean body mass index (BMI, 33.8 +/- 0.6 kg/m2) participated in a combined exercise programme assigned to supervised (S, n = 31), non-supervised (NS, n = 24) or control group (C, n = 30). Cardiometabolic risk parameters were assessed at baseline and after the 6-month training.


In both the S and NS group there was a significant decrease in BMI (-1.6 +/- 0.3, p < 0.001 and -1.0 +/- 0.3 kg/m2, p = 0.004), waist circumference (-10.1 +/- 1.1 cm, p < 0.001 and -7.8 +/- 0.8 cm, p < 0.001), fat mass (-1.8 +/- 0.4%, p < 0.001 and -2.1 +/- 0.6%, p = 0.003), and a significant increase in fat-free mass (+1.7 +/- 0.4%, p < 0.001 and +2.0 +/- 0.7%, p = 0.008), and aerobic capacity (+6.9 +/- 1.1, p < 0.001 and +6.9 +/- 0.8 ml/kg per min, p = 0.008). Fasting glucose did not change in S and NS, but increased in C (p = 0.048). In the S group a significant decrease in fasting insulin (p < 0.001), homeostasis model assessment of insulin resistance (p < 0.001), highly sensitive C-reactive protein (p = 0.004), leucocytes count (p = 0.04), systolic high (p < 0.001) and diastolic (p = 0.009) blood pressure was found. Comparable significant decreases in total and low-density lipoprotein cholesterol were observed in all study groups.


A 6-month combined exercise programme led to substantial improvement of various cardiometabolic risk factors. This programme was effective even when executed without direct supervision, although the effects were more pronounced in the supervised group. Our findings suggest that non-supervised exercise programmes may be a valuable, cost-effective tool to translate the current physical activity guidelines in a real-life setting.

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