Adipo-Myokine Modulation in Obesity: Integrative Effects of Spinach Thylakoids and Functional Training in Men with Obesity: A Randomized Controlled Clinical Trial.

Both HIFT training groups demonstrated improvements in body composition and insulin sensitivity compared to the placebo group.

• Sixty men with obesity were randomly assigned to four groups (n = 15 per group): Placebo (PG), Supplement (SG), HIFT + placebo (TPG), and HIFT + supplement (TSG).
• Participants had a mean age of 27.6 ± 8.4 years and mean BMI of 32.6 ± 2.6 kg/m².
• Improvements in body composition and insulin sensitivity were statistically significant at p < 0.05 compared to PG.
• HIFT was performed for 3 sessions per week at Borg scale 15–17 over 12 weeks.

Repeated-measures ANOVA showed significant Time × Group interactions for most adipo-myokines and metabolic markers following Bonferroni correction.

• Adipo-myokines assessed included Decorin, Myostatin, Follistatin, Activin A, and TGF-β1.
• Secondary outcomes included anthropometric indices, lipid profiles, and insulin resistance markers.
• Bonferroni correction was applied to account for multiple endpoints.
• Both per-protocol and intention-to-treat (ITT) models were used to ensure robustness against a 27% attrition rate.

No significant differences were observed between the HIFT-only group and the HIFT plus thylakoid supplementation group for systemic metabolic markers.

• TPG (HIFT + placebo) and TSG (HIFT + supplement) showed comparable outcomes across the broader metabolic profile.
• Thylakoid supplementation did not reach clinical superiority over exercise alone in systemic metabolic markers.
• Preliminary data suggested thylakoid supplementation might provide modest complementary modulations specifically in decorin and follistatin.
• These observed trends were characterized as exploratory given the small sample size of 15 per group.

Thylakoid supplementation showed potential for selective complementary effects on certain myokines, specifically decorin and follistatin, but these findings are exploratory.

• The supplement group receiving thylakoids alongside HIFT (TSG) showed preliminary data suggesting modest complementary modulations in decorin and follistatin.
• These trends did not reach clinical superiority over exercise alone in the broader metabolic profile.
• The authors noted findings are exploratory given the small sample size.
• The clinical significance and long-term complementary value of thylakoid-exercise interactions require further validation in larger, more diverse cohorts.

The study experienced a 27% attrition rate, which necessitated the use of both per-protocol and intention-to-treat statistical models.

• Initial enrollment was 60 men with obesity across four groups of 15 each.
• The 27% attrition rate was considered in the robustness of statistical analyses.
• Both per-protocol and ITT models were employed to address missing data concerns.
• The attrition rate is noted as a limitation affecting the exploratory nature of some findings.