Volume 30, Issue 1 (June 2023)
J Birjand Univ Med Sci. 2023, 30(1): 44-55 |
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Research code: IR.BIRJAND.REC.1400.014
Ethics code: IR.BIRJAND.REC.1400.014
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Hajizade F, Mogharnasi M, Ghahremani R, Kazemi T. Effect of four weeks of pomegranate supplementation and exercise at home on cardiac electrical activity and lipid profile in overweight and obese postmenopausal women. Journals of Birjand University of Medical Sciences 2023; 30 (1) :44-55
URL: http://journal.bums.ac.ir/article-1-3248-en.html
URL: http://journal.bums.ac.ir/article-1-3248-en.html
1- Department of Exercise Physiology, Faculty of Sports Sciences, University of Birjand, Birjand, Iran
2- Department of Exercise Physiology, Faculty of Sports Sciences, University of Birjand, Birjand, Iran ,mogharnasi@birjand.ac.ir
3- Department of Cardiology, Cardiovascular Diseases Research Center, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
2- Department of Exercise Physiology, Faculty of Sports Sciences, University of Birjand, Birjand, Iran ,
3- Department of Cardiology, Cardiovascular Diseases Research Center, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Keywords: Cardiac electrical activity, Home exercise, Lipid profile, Overweight and obesity, Pomegranate supplement
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Background and Aims: Athletic activities, along with the consumption of herbal supplements, can control excess weight and associated diseases. The present study aimed to investigate the effect of pomegranate supplementation and exercise at home on lipid profile and cardiac electrical activity in overweight and obese postmenopausal women.
Materials and Methods: This applied research was conducted based on a single-blind quasi-experimental design. A total of 60 overweight and obese postmenopausal women with a body mass index greater than 25 (kilograms per square meter) and an age range of 65-45 years were selected and randomly assigned to four groups: supplement + exercise (n=15), exercise(n=13 ), supplement (n=14), and placebo (n=14 ). Participants took one 225 mg pomegranate capsule and a placebo daily for 28 days. Due to the Covid-19 pandemic, resistance exercises were performed at home. Shapiro-Wilk, ANOVA, Kruskal-Wallis, and Lune tests were used in this research. Statistical calculations were performed in SPSS software (version).
Results: Based on the results, there was no significant difference in fasting blood sugar, weight, triglycerides, low-density lipoprotein (LDL-C), systolic and diastolic blood pressure, heart rate, fat percentage, cholesterol, high-density lipoprotein (HDL-C), PR interval, QRS wave amplitude, and QT interval (P>0.05).
Conclusion: It seems that a short period of four weeks of exercise at home with the consumption of pomegranate supplements did not significantly change the lipid profile and electrical activity of the heart. It is suggested that the same study with long-term training periods and different doses of pomegranate supplements should be repeated.
Materials and Methods: This applied research was conducted based on a single-blind quasi-experimental design. A total of 60 overweight and obese postmenopausal women with a body mass index greater than 25 (kilograms per square meter) and an age range of 65-45 years were selected and randomly assigned to four groups: supplement + exercise (n=15), exercise(n=13 ), supplement (n=14), and placebo (n=14 ). Participants took one 225 mg pomegranate capsule and a placebo daily for 28 days. Due to the Covid-19 pandemic, resistance exercises were performed at home. Shapiro-Wilk, ANOVA, Kruskal-Wallis, and Lune tests were used in this research. Statistical calculations were performed in SPSS software (version).
Results: Based on the results, there was no significant difference in fasting blood sugar, weight, triglycerides, low-density lipoprotein (LDL-C), systolic and diastolic blood pressure, heart rate, fat percentage, cholesterol, high-density lipoprotein (HDL-C), PR interval, QRS wave amplitude, and QT interval (P>0.05).
Conclusion: It seems that a short period of four weeks of exercise at home with the consumption of pomegranate supplements did not significantly change the lipid profile and electrical activity of the heart. It is suggested that the same study with long-term training periods and different doses of pomegranate supplements should be repeated.
Type of Study: Original Article |
Subject:
Exercise Physiology
Received: 2023/02/20 | Accepted: 2023/06/14 | ePublished ahead of print: 2023/06/14 | ePublished: 2023/06/5
Received: 2023/02/20 | Accepted: 2023/06/14 | ePublished ahead of print: 2023/06/14 | ePublished: 2023/06/5
References
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2. YazdanShanas H, Fakhrpour R, Ghorbin B. The effect of eight weeks of 30-20-10 interval training on serum spexin levels and lipid profile in obese middle-aged men. Journal of Sport and Exercise Physiology. 2023; 16(2): 14-23. [Persian] DOI: 10.52547/joeppa.16.2.14
3. Arab S, Barjali A, Maschi F, Kakawanda, Zakari Hamidi M. The effect of self-compassion training on the attitude towards menopause of women with vasomotor symptoms. Journal of Positive Psychology 2018, 5(4), 65-76. [Persian] DOI: 10.22108/ppls.2020.119217.1810
4. Farhadi M, Matin Homaee H, Farzanegi P. The effect of six months'resistance training and ginger extract on lipid profiles, body composition and selected liver enzymes in obese menopausal women. J Neyshabur Univ Med Sci 2020; 8(2): 59-71. [Persian] URL: https://journal.nums.ac.ir/browse.php?a_id=817&sid=1&slc_lang=en [DOI:10.18502/ijdo.v12i3.4458]
5. Aviram M, Dornfeld L, Rosenblat M, Volkova N, Kaplan M, Coleman R. Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E-deficient mice. Am. J. Clin. Nutr. 2000; 71(5): 1062- 76. [DOI:10.1093/ajcn/71.5.1062] [PMID]
6. Vlachojannis C, Erne P, Schoenenberger AW, Chrubasik‐Hausmann S. A critical evaluation of the clinical evidence for pomegranate preparations in the prevention and treatment of cardiovascular diseases. Phytother Res. 2015; 29(4): 501-8. [DOI:10.1002/ptr.5280] [PMID]
7. García-Alonso J, Ros G, Vidal-Guevara ML, Periago MJ. Acute intake of phenolic-rich juice improves antioxidant status in healthy subjects. Nutr Res. 2006; 26(7): 330-9. [DOI:10.1016/j.nutres.2006.06.004]
8. Minaiyan M, Zolfaghari B, Taheri D, Gomarian M. Preventive effect of three pomegranate (Punica granatum L.) seeds fractions on cerulein-induced acute pancreatitis in mice. Int J Prev Med. 2014; 5(4): 394-404. [Persian] URL https://www.researchgate.net/publication/262342710
9. Abdi A, Mehrabani J, Haeri T, Shykholeslami Z, Mostafavian M. Protective Effect of Aerobic Training along with Punica granatum L on Cardiac Injury Biomarkers in Women with Type 2 Diabetes Iranian J Nutr Sci Food Technol. 2019; 13 (4): 1-10. [Persian] URL: http://nsft.sbmu.ac.ir/article-1-2620-en.html
10. Upaganlawar A, Balaraman R. Cardioprotective effects of co-administration of Pomegranate extract and vitamin E on electrocardiographic, biochemical and apoptotic changes in isoproterenol induced myocardial infarction in rats. Glob health, Sci. 2015; 6(5): 178-85. URL: http://pharmacologia.com/abstract.php. [DOI:10.5567/pharmacologia.2015.178.185]
11. Shishehbor F, Mohammad Shahi M, Zarei M, Saki A, Zakerkish M, Shirani F,et al. Effects of Concentrated Pomegranate Juice on Subclinical Inflammation and Cardiometabolic Risk Factors for Type 2 Diabetes. Int J Endocrinol Metab. 2016; 14(1): e33835. [Persian] DOI: 10.5812/ijem.33835 [DOI:10.5812/ijem.33835] []
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13. Arverdizadeh B, Bedrous Oghoubian Salmasi M. The Effect of Interval Training on HSP70 and Some Inflammatory, Growth and Functional Markers among Women with Breast Cancer. Iran J Obstet Gynecol Infertil 2016; 19(37): 16-24. [Persian] URL: http://ijogi.mums.ac.ir/article_8184.html
14. Paton CM, Brandauer J, Weiss EP, Brown MD, Ivey F, Roth SM, et al. Hemostatic response to postprandial lipemia before and after exercise training. J. Appl. Physiol. 2006; 101(1): 316-21. [DOI:10.1152/japplphysiol.01363.2005] [PMID]
15. Zarezadeh M, Saedisomeolia A, Hosseini B, Emami M. The Effect of Punica granatum (Pomegranate) Extract on Inflammatory Biomarkers, Lipid Profile, and Glycemic Indices in Patients with Overweight and Obesity. Qom Univ Med Sci J. 2019, 13(8): 14-25. [Persian] URL: http://journal.muq.ac.ir/article-1-2543-en.html [DOI:10.29252/qums.13.8.14]
16. Lira FS, Yamashita, AS, Uchida MC, Zanchi NE, Gualano B, Martins E, et al. Low and moderate, rather than high intensity strength exercise induces benefit regarding plasma lipid profile. Diabetol Metab Syndr. 2010; 2(1): 1-6.. [DOI:10.1186/1758-5996-2-31] [PMID] []
17. Akbarpour M, Fathollahi Shoorabeh F, Faraji F. Effect of eight weeks of resistance training with supplementation of pomegranate juice on oxidative/ antioxidant factors and lipid profiles in women with type 2 diabetes. Journal of Knowledge & Health 2019; 14(3): 52-8. [Persian]
18. Esmailzadeh Toloee M, Afshar Nezhad, Yazdani F, Ahmadi B. The effect of 8 weeks of resistance training on evary morphology, glycemic control and body composition on woman with polycystic ovary syndrome. Med J mashhad univ Med Sci 2015; 58(7): 381-9. [Persian] DOI: 10.22038/mjms.2015.5609
19. Cegielski J, Brook MS, Quinlan JI, Wilkinson DJ, Smith K, Atherton PJ, et al. A 4-week, lifestyle-integrated, home-based exercise training programme elicits improvements in physical function and lean mass in older men and women: a pilot study. F1000Research. 2017; 6: 1235. DOI: 10.12688/f1000research.11894.2 [DOI:10.12688/f1000research.11894.2] [PMID] []
20. Kazemi T, Hajihosseini M, Mashreghimoghadam H, Azdaki N, Ziaee M. Prevalence and Determinants of Hypertension among Iranian Adults, Birjand, Iran. Int. J. Prev. Med. 2017; 8(1): 36 [Persian] DOI: 10.4103/ijpvm.IJPVM_103_16 [DOI:10.4103/ijpvm.IJPVM_103_16] [PMID] []
21. Hulke SM, Phatak MS. Cardiac adaptation to endurance training in young adult. Chron. Young Sci. 2011; 2(2): 103-8. DOI: 10.4103/2229-5186.82973 [DOI:10.4103/2229-5186.82973]
22. Mogharnasi M, Bagheri M. The effect of twelve weeks of circuit resistance training on C-reactive protein and lipid profiles of inactive women. Journal of Sport Biosciences. 2014; 6(2): 233-44.
23. Khosravi N, Sori R, Rezayan N. The effect of resistance training on serum IcAM-1 (intercellular adhesion molecule-1) level in sedentary obese postmenopausal women. Applied exercise physiology research paper. 2019; 7(14): 29-44. [Persian] URL:https://asp.journals.umz.ac.ir/article_365_30510c55e9324fe9c73c7052713d224a.pdf
24. Nayebifar SH, Afzalpour M, Saghebjoo M, Hedayati M, Shirzaee P. The effect of aerobic and resistance trainings on serum C- Reactive Protein, lipid profile and body composition in overweight women. Scientific Quarterly of Birjand Nursing and Midwifery Faculty. 2012; 8 (4): 186-96. [Persian] URL: http://sid.bums.ac.ir/dspace/handle/bums/4996
25. Amouzad Mahdirejei H, Aghababaeian A, Mirsaiedii M, Fadaei Reyhan Abadei S, Abbaspour Seyedii A. Effect of 8 weeks of resistance training on hemostasis indeces and lipid profile in adult men. J Gorgan Uni Med Sci. 2014; 16(2): 21-28. [Persian] URL: http://goums.ac.ir/journal/article-1-2044-en.html
26. Ghorbanian B, Saberi Y. The Effects of Eight Weeks of Progressive Resistance Training on Eotaxin Serum Levels in Overweight and Obese Men. Armaghane-danesh 2016; 21 (4): 321-34. [Persian] URL: http://armaghanj.yums.ac.ir/article-1-1419-en.html
27. Niazi S, Rajabi H, Amani S. The Effect of 12 Weeks of Circuit Resistance Training with Three Different Intensities of Equal Volume on Some Hemodynamic Factors of Obese Men. J. Anim. Sci. 2021; 14(1): 25-35. [Persian] DOI: 10.22034/ascij.2021.684769
28. Bhavna M, Sandhu JS. Effects of concentric vs eccentric loading on cardiovascular variables and ECG. Afr J Health Sci. 2010; 17(3-4): 47-51. URL: https://www.ajol.info/index.php/ajhs/article/view/99565/88850
29. Hassanpour Fard M, Arvindkumar E. Ghule, Subhash L, Bodhankar, Madhurima Dikshit. Cardioprotective effect of whole fruit extract of pomegranate on doxorubicin-induced toxicity in rat. Pharm. Biol. 2011; 49(4): 377-82. URL: [DOI:10.3109/13880209.2010.517758] [PMID]
30. Oshvandi KH,Maghsoudi Z, Kamyari N, Jahani Sayad Noveiry M. Attitude of Nurses Towards Obesity and Caring to Obese Patients and Its Predictors in Northern Iran. Iran Journal of Nursing. 2022; 35(2): 190-201. [Persian] DOI: 10.32598/ijn.35.2.2942 [DOI:10.32598/ijn.35.2.2942]
31. YazdanShanas H, Fakhrpour R, Ghorbin B. The effect of eight weeks of 30-20-10 interval training on serum spexin levels and lipid profile in obese middle-aged men. Journal of Sport and Exercise Physiology. 2023; 16(2): 14-23. [Persian] DOI: 10.52547/joeppa.16.2.14
32. Arab S, Barjali A, Maschi F, Kakawanda, Zakari Hamidi M. The effect of self-compassion training on the attitude towards menopause of women with vasomotor symptoms. Journal of Positive Psychology 2018, 5(4), 65-76. [Persian] DOI: 10.22108/ppls.2020.119217.1810
33. Farhadi M, Matin Homaee H, Farzanegi P. The effect of six months'resistance training and ginger extract on lipid profiles, body composition and selected liver enzymes in obese menopausal women. J Neyshabur Univ Med Sci 2020; 8(2): 59-71. [Persian] URL: https://journal.nums.ac.ir/browse.php?a_id=817&sid=1&slc_lang=en [DOI:10.18502/ijdo.v12i3.4458]
34. Aviram M, Dornfeld L, Rosenblat M, Volkova N, Kaplan M, Coleman R. Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E-deficient mice. Am. J. Clin. Nutr. 2000; 71(5): 1062- 76. DOI: 10.1093/ajcn/71.5.1062 [DOI:10.1093/ajcn/71.5.1062] [PMID]
35. Vlachojannis C, Erne P, Schoenenberger AW, Chrubasik‐Hausmann S. A critical evaluation of the clinical evidence for pomegranate preparations in the prevention and treatment of cardiovascular diseases. Phytother Res. 2015; 29(4): 501-8. DOI: 10.1002/ptr.5280 [DOI:10.1002/ptr.5280] [PMID]
36. García-Alonso J, Ros G, Vidal-Guevara ML, Periago MJ. Acute intake of phenolic-rich juice improves antioxidant status in healthy subjects. Nutr Res. 2006; 26(7): 330-9. [DOI:10.1016/j.nutres.2006.06.004]
37. Minaiyan M, Zolfaghari B, Taheri D, Gomarian M. Preventive effect of three pomegranate (Punica granatum L.) seeds fractions on cerulein-induced acute pancreatitis in mice. Int J Prev Med. 2014; 5(4): 394-404. [Persian] URL https://www.researchgate.net/publication/262342710
38. Abdi A, Mehrabani J, Haeri T, Shykholeslami Z, Mostafavian M. Protective Effect of Aerobic Training along with Punica granatum L on Cardiac Injury Biomarkers in Women with Type 2 Diabetes Iranian J Nutr Sci Food Technol. 2019; 13 (4): 1-10. [Persian] URL: http://nsft.sbmu.ac.ir/article-1-2620-en.html
39. Upaganlawar A, Balaraman R. Cardioprotective effects of co-administration of Pomegranate extract and vitamin E on electrocardiographic, biochemical and apoptotic changes in isoproterenol induced myocardial infarction in rats. Glob health, Sci. 2015; 6(5): 178-85. URL: http://pharmacologia.com/abstract.php. [DOI:10.5567/pharmacologia.2015.178.185]
40. Shishehbor F, Mohammad Shahi M, Zarei M, Saki A, Zakerkish M, Shirani F,et al. Effects of Concentrated Pomegranate Juice on Subclinical Inflammation and Cardiometabolic Risk Factors for Type 2 Diabetes. Int J Endocrinol Metab. 2016; 14(1): e33835. [Persian] DOI: 10.5812/ijem.33835 [DOI:10.5812/ijem.33835] [PMID] []
41. Sajjan M. Learn ECG in a day: A systematic approach: Jaypee Brothers Medical Pub; 1st edition; 2012. https://www.amazon.com/Learn-ECG-Day-Systematic-Approach/dp/9350900866
42. Arverdizadeh B, Bedrous Oghoubian Salmasi M. The Effect of Interval Training on HSP70 and Some Inflammatory, Growth and Functional Markers among Women with Breast Cancer. Iran J Obstet Gynecol Infertil 2016; 19(37): 16-24. [Persian] URL: http://ijogi.mums.ac.ir/article_8184.html
43. Paton CM, Brandauer J, Weiss EP, Brown MD, Ivey F, Roth SM, et al. Hemostatic response to postprandial lipemia before and after exercise training. J. Appl. Physiol. 2006; 101(1): 316-21. [DOI:10.1152/japplphysiol.01363.2005] [PMID]
44. Zarezadeh M, Saedisomeolia A, Hosseini B, Emami M. The Effect of Punica granatum (Pomegranate) Extract on Inflammatory Biomarkers, Lipid Profile, and Glycemic Indices in Patients with Overweight and Obesity. Qom Univ Med Sci J. 2019, 13(8): 14-25. [Persian] URL: http://journal.muq.ac.ir/article-1-2543-en.html [DOI:10.29252/qums.13.8.14]
45. Lira FS, Yamashita, AS, Uchida MC, Zanchi NE, Gualano B, Martins E, et al. Low and moderate, rather than high intensity strength exercise induces benefit regarding plasma lipid profile. Diabetol Metab Syndr. 2010; 2(1): 1-6.. [DOI:10.1186/1758-5996-2-31] [PMID] []
46. Akbarpour M, Fathollahi Shoorabeh F, Faraji F. Effect of eight weeks of resistance training with supplementation of pomegranate juice on oxidative/ antioxidant factors and lipid profiles in women with type 2 diabetes. Journal of Knowledge & Health 2019; 14(3): 52-8. [Persian]
47. Esmailzadeh Toloee M, Afshar Nezhad, Yazdani F, Ahmadi B. The effect of 8 weeks of resistance training on evary morphology, glycemic control and body composition on woman with polycystic ovary syndrome. Med J mashhad univ Med Sci 2015; 58(7): 381-9. [Persian] DOI: 10.22038/mjms.2015.5609
48. Cegielski J, Brook MS, Quinlan JI, Wilkinson DJ, Smith K, Atherton PJ, et al. A 4-week, lifestyle-integrated, home-based exercise training programme elicits improvements in physical function and lean mass in older men and women: a pilot study. F1000Research. 2017; 6: 1235. DOI: 10.12688/f1000research.11894.2 [DOI:10.12688/f1000research.11894.2] [PMID] []
49. Kazemi T, Hajihosseini M, Mashreghimoghadam H, Azdaki N, Ziaee M. Prevalence and Determinants of Hypertension among Iranian Adults, Birjand, Iran. Int. J. Prev. Med. 2017; 8(1): 36 [Persian] DOI: 10.4103/ijpvm.IJPVM_103_16 [DOI:10.4103/ijpvm.IJPVM_103_16] [PMID] []
50. Hulke SM, Phatak MS. Cardiac adaptation to endurance training in young adult. Chron. Young Sci. 2011; 2(2): 103-8. DOI: 10.4103/2229-5186.82973 [DOI:10.4103/2229-5186.82973]
51. Mogharnasi M, Bagheri M. The effect of twelve weeks of circuit resistance training on C-reactive protein and lipid profiles of inactive women. Journal of Sport Biosciences. 2014; 6(2): 233-44.
52. Khosravi N, Sori R, Rezayan N. The effect of resistance training on serum IcAM-1 (intercellular adhesion molecule-1) level in sedentary obese postmenopausal women. Applied exercise physiology research paper. 2019; 7(14): 29-44. [Persian] URL:https://asp.journals.umz.ac.ir/article_365_30510c55e9324fe9c73c7052713d224a.pdf
53. Nayebifar SH, Afzalpour M, Saghebjoo M, Hedayati M, Shirzaee P. The effect of aerobic and resistance trainings on serum C- Reactive Protein, lipid profile and body composition in overweight women. Scientific Quarterly of Birjand Nursing and Midwifery Faculty. 2012; 8 (4): 186-96. [Persian] URL: http://sid.bums.ac.ir/dspace/handle/bums/4996
54. Amouzad Mahdirejei H, Aghababaeian A, Mirsaiedii M, Fadaei Reyhan Abadei S, Abbaspour Seyedii A. Effect of 8 weeks of resistance training on hemostasis indeces and lipid profile in adult men. J Gorgan Uni Med Sci. 2014; 16(2): 21-28. [Persian] URL: http://goums.ac.ir/journal/article-1-2044-en.html
55. Ghorbanian B, Saberi Y. The Effects of Eight Weeks of Progressive Resistance Training on Eotaxin Serum Levels in Overweight and Obese Men. Armaghane-danesh 2016; 21 (4): 321-34. [Persian] URL: http://armaghanj.yums.ac.ir/article-1-1419-en.html
56. Niazi S, Rajabi H, Amani S. The Effect of 12 Weeks of Circuit Resistance Training with Three Different Intensities of Equal Volume on Some Hemodynamic Factors of Obese Men. J. Anim. Sci. 2021; 14(1): 25-35. [Persian] DOI: 10.22034/ascij.2021.684769
57. Bhavna M, Sandhu JS. Effects of concentric vs eccentric loading on cardiovascular variables and ECG. Afr J Health Sci. 2010; 17(3-4): 47-51. URL: https://www.ajol.info/index.php/ajhs/article/view/99565/88850
58. Hassanpour Fard M, Arvindkumar E. Ghule, Subhash L, Bodhankar, Madhurima Dikshit. Cardioprotective effect of whole fruit extract of pomegranate on doxorubicin-induced toxicity in rat. Pharm. Biol. 2011; 49(4): 377-82. URL: [DOI:10.3109/13880209.2010.517758] [PMID]
59. Oshvandi KH,Maghsoudi Z, Kamyari N, Jahani Sayad Noveiry M. Attitude of Nurses Towards Obesity and Caring to Obese Patients and Its Predictors in Northern Iran. Iran Journal of Nursing. 2022; 35(2): 190-201. [Persian] [DOI:10.32598/ijn.35.2.2942]
60. YazdanShanas H, Fakhrpour R, Ghorbin B. The effect of eight weeks of 30-20-10 interval training on serum spexin levels and lipid profile in obese middle-aged men. Journal of Sport and Exercise Physiology. 2023; 16(2): 14-23. [Persian] DOI: 10.52547/joeppa.16.2.14
61. Arab S, Barjali A, Maschi F, Kakawanda, Zakari Hamidi M. The effect of self-compassion training on the attitude towards menopause of women with vasomotor symptoms. Journal of Positive Psychology 2018, 5(4), 65-76. [Persian] DOI: 10.22108/ppls.2020.119217.1810
62. Farhadi M, Matin Homaee H, Farzanegi P. The effect of six months'resistance training and ginger extract on lipid profiles, body composition and selected liver enzymes in obese menopausal women. J Neyshabur Univ Med Sci 2020; 8(2): 59-71. [Persian] URL: https://journal.nums.ac.ir/browse.php?a_id=817&sid=1&slc_lang=en [DOI:10.18502/ijdo.v12i3.4458]
63. Aviram M, Dornfeld L, Rosenblat M, Volkova N, Kaplan M, Coleman R. Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E-deficient mice. Am. J. Clin. Nutr. 2000; 71(5): 1062- 76. [DOI:10.1093/ajcn/71.5.1062] [PMID]
64. Vlachojannis C, Erne P, Schoenenberger AW, Chrubasik‐Hausmann S. A critical evaluation of the clinical evidence for pomegranate preparations in the prevention and treatment of cardiovascular diseases. Phytother Res. 2015; 29(4): 501-8. [DOI:10.1002/ptr.5280] [PMID]
65. García-Alonso J, Ros G, Vidal-Guevara ML, Periago MJ. Acute intake of phenolic-rich juice improves antioxidant status in healthy subjects. Nutr Res. 2006; 26(7): 330-9. [DOI:10.1016/j.nutres.2006.06.004]
66. Minaiyan M, Zolfaghari B, Taheri D, Gomarian M. Preventive effect of three pomegranate (Punica granatum L.) seeds fractions on cerulein-induced acute pancreatitis in mice. Int J Prev Med. 2014; 5(4): 394-404. [Persian] URL https://www.researchgate.net/publication/262342710
67. Abdi A, Mehrabani J, Haeri T, Shykholeslami Z, Mostafavian M. Protective Effect of Aerobic Training along with Punica granatum L on Cardiac Injury Biomarkers in Women with Type 2 Diabetes Iranian J Nutr Sci Food Technol. 2019; 13 (4): 1-10. [Persian] URL: http://nsft.sbmu.ac.ir/article-1-2620-en.html
68. Upaganlawar A, Balaraman R. Cardioprotective effects of co-administration of Pomegranate extract and vitamin E on electrocardiographic, biochemical and apoptotic changes in isoproterenol induced myocardial infarction in rats. Glob health, Sci. 2015; 6(5): 178-85. URL: http://pharmacologia.com/abstract.php. [DOI:10.5567/pharmacologia.2015.178.185]
69. Shishehbor F, Mohammad Shahi M, Zarei M, Saki A, Zakerkish M, Shirani F,et al. Effects of Concentrated Pomegranate Juice on Subclinical Inflammation and Cardiometabolic Risk Factors for Type 2 Diabetes. Int J Endocrinol Metab. 2016; 14(1): e33835. [Persian] [DOI:10.5812/ijem.33835] [PMID] []
70. Sajjan M. Learn ECG in a day: A systematic approach: Jaypee Brothers Medical Pub; 1st edition; 2012. https://www.amazon.com/Learn-ECG-Day-Systematic-Approach/dp/9350900866
71. Arverdizadeh B, Bedrous Oghoubian Salmasi M. The Effect of Interval Training on HSP70 and Some Inflammatory, Growth and Functional Markers among Women with Breast Cancer. Iran J Obstet Gynecol Infertil 2016; 19(37): 16-24. [Persian] URL: http://ijogi.mums.ac.ir/article_8184.html
72. Paton CM, Brandauer J, Weiss EP, Brown MD, Ivey F, Roth SM, et al. Hemostatic response to postprandial lipemia before and after exercise training. J. Appl. Physiol. 2006; 101(1): 316-21. [DOI:10.1152/japplphysiol.01363.2005] [PMID]
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101. Paton CM, Brandauer J, Weiss EP, Brown MD, Ivey F, Roth SM, et al. Hemostatic response to postprandial lipemia before and after exercise training. J. Appl. Physiol. 2006; 101(1): 316-21. [DOI:10.1152/japplphysiol.01363.2005] [PMID]
102. Zarezadeh M, Saedisomeolia A, Hosseini B, Emami M. The Effect of Punica granatum (Pomegranate) Extract on Inflammatory Biomarkers, Lipid Profile, and Glycemic Indices in Patients with Overweight and Obesity. Qom Univ Med Sci J. 2019, 13(8): 14-25. [Persian] URL: http://journal.muq.ac.ir/article-1-2543-en.html [DOI:10.29252/qums.13.8.14]
103. Lira FS, Yamashita, AS, Uchida MC, Zanchi NE, Gualano B, Martins E, et al. Low and moderate, rather than high intensity strength exercise induces benefit regarding plasma lipid profile. Diabetol Metab Syndr. 2010; 2(1): 1-6.. [DOI:10.1186/1758-5996-2-31] [PMID] []
104. Akbarpour M, Fathollahi Shoorabeh F, Faraji F. Effect of eight weeks of resistance training with supplementation of pomegranate juice on oxidative/ antioxidant factors and lipid profiles in women with type 2 diabetes. Journal of Knowledge & Health 2019; 14(3): 52-8. [Persian]
105. Esmailzadeh Toloee M, Afshar Nezhad, Yazdani F, Ahmadi B. The effect of 8 weeks of resistance training on evary morphology, glycemic control and body composition on woman with polycystic ovary syndrome. Med J mashhad univ Med Sci 2015; 58(7): 381-9. [Persian] DOI: 10.22038/mjms.2015.5609
106. Cegielski J, Brook MS, Quinlan JI, Wilkinson DJ, Smith K, Atherton PJ, et al. A 4-week, lifestyle-integrated, home-based exercise training programme elicits improvements in physical function and lean mass in older men and women: a pilot study. F1000Research. 2017; 6: 1235. DOI: 10.12688/f1000research.11894.2 [DOI:10.12688/f1000research.11894.2] [PMID] []
107. Kazemi T, Hajihosseini M, Mashreghimoghadam H, Azdaki N, Ziaee M. Prevalence and Determinants of Hypertension among Iranian Adults, Birjand, Iran. Int. J. Prev. Med. 2017; 8(1): 36 [Persian] [DOI:10.4103/ijpvm.IJPVM_103_16] [PMID] []
108. Hulke SM, Phatak MS. Cardiac adaptation to endurance training in young adult. Chron. Young Sci. 2011; 2(2): 103-8. [DOI:10.4103/2229-5186.82973]
109. Mogharnasi M, Bagheri M. The effect of twelve weeks of circuit resistance training on C-reactive protein and lipid profiles of inactive women. Journal of Sport Biosciences. 2014; 6(2): 233-44.
110. Khosravi N, Sori R, Rezayan N. The effect of resistance training on serum IcAM-1 (intercellular adhesion molecule-1) level in sedentary obese postmenopausal women. Applied exercise physiology research paper. 2019; 7(14): 29-44. [Persian] URL:https://asp.journals.umz.ac.ir/article_365_30510c55e9324fe9c73c7052713d224a.pdf
111. Nayebifar SH, Afzalpour M, Saghebjoo M, Hedayati M, Shirzaee P. The effect of aerobic and resistance trainings on serum C- Reactive Protein, lipid profile and body composition in overweight women. Scientific Quarterly of Birjand Nursing and Midwifery Faculty. 2012; 8 (4): 186-96. [Persian] URL: http://sid.bums.ac.ir/dspace/handle/bums/4996
112. Amouzad Mahdirejei H, Aghababaeian A, Mirsaiedii M, Fadaei Reyhan Abadei S, Abbaspour Seyedii A. Effect of 8 weeks of resistance training on hemostasis indeces and lipid profile in adult men. J Gorgan Uni Med Sci. 2014; 16(2): 21-28. [Persian] URL: http://goums.ac.ir/journal/article-1-2044-en.html
113. Ghorbanian B, Saberi Y. The Effects of Eight Weeks of Progressive Resistance Training on Eotaxin Serum Levels in Overweight and Obese Men. Armaghane-danesh 2016; 21 (4): 321-34. [Persian] URL: http://armaghanj.yums.ac.ir/article-1-1419-en.html
114. Niazi S, Rajabi H, Amani S. The Effect of 12 Weeks of Circuit Resistance Training with Three Different Intensities of Equal Volume on Some Hemodynamic Factors of Obese Men. J. Anim. Sci. 2021; 14(1): 25-35. [Persian] DOI: 10.22034/ascij.2021.684769
115. Bhavna M, Sandhu JS. Effects of concentric vs eccentric loading on cardiovascular variables and ECG. Afr J Health Sci. 2010; 17(3-4): 47-51. URL: https://www.ajol.info/index.php/ajhs/article/view/99565/88850
116. Hassanpour Fard M, Arvindkumar E. Ghule, Subhash L, Bodhankar, Madhurima Dikshit. Cardioprotective effect of whole fruit extract of pomegranate on doxorubicin-induced toxicity in rat. Pharm. Biol. 2011; 49(4): 377-82. [DOI:10.3109/13880209.2010.517758] [PMID]
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