INTRODUCTION

Overweight and obesity are common problems in the elderly. According to the results of a global meta-analysis in 2025, the prevalence of overweight and obesity in people aged 60 and older was reported to be about 73% and 35%, respectively (2). Most people experience adipose tissue accumulation in old age, which leads to an increase in some pro-inflammatory and anti-inflammatory biomarkers in the body. Adipose tissue also influences metabolic disorders and lifespan through a complex mechanism (7). Common signs of aging include a 2- to 4-fold increase in pro-inflammatory cytokines such as interleukin-18 (IL-18) (8). The function of IL-18 in the autoimmune destruction of pancreatic beta cells contributes to the development of type 1 diabetes (13). According to studies, with increasing age, molecules such as IL-18 increase, which leads to increased chronic inflammation and a decrease in the antioxidant defense system (14). With the increase in body fat mass and the high prevalence of cardiovascular diseases in older age, it is particularly important to investigate relevant biomarkers. One of these markers is galectin-3, which, as an adipokine, plays an important role in the prognosis and prediction of the course of heart disease. Galectin-3 is a protein secreted by tissues such as the heart, kidneys, blood vessels, and macrophages and is involved in the inflammatory and fibrotic processes associated with heart disease (23). Lifestyle modification is one of the most effective methods for preventing obesity, diabetes, cardiovascular diseases, and metabolic syndrome in older adults. It appears that the occurrence of diseases can be prevented by adopting proper nutrition, taking into account the significant role of its antioxidant indicators, and engaging in sports activities (19). Medicinal plants have experienced significant growth over the last two decades due to their minimal side effects, ease of access, and improvement in immune system function (37). The use of antioxidant compounds to reduce insulin resistance and chronic inflammation, thereby improving the management of diabetes, has been explored in recent research (38). Although it has been shown that inflammatory biomarker levels can be useful for understanding the effects of exercise, there is no information on the changes caused by high-intensity circuit training (HICT) combined with olive leaf extract supplementation on IL-18, galectin 3, and metabolic factors related to diabetes in obese older women, and no such study has been conducted so far. Therefore, this study aimed to investigate the effect of 8 weeks of HICT training combined with olive leaf extract on serum levels of galectin 3, IL-18, and fasting glucose in obese older women.
METHODS
In this quasi-experimental study, 40 obese elderly women were selected as a sample using a purposeful and accessible approach, with written informed consent, and were randomly assigned to four groups: placebo, supplement, exercise, and supplement + exercise (10 participants in each group). Among the 75 people who responded to the call, 40 met the inclusion criteria and participated in the study. Those who were rejected due to non-compliance with specific criteria, such as age, chronic diseases, or the use of certain medications, were excluded from the study. The supplement + exercise and exercise groups performed HICT training for eight weeks, three sessions per week for 45 to 60 minutes. The modified Borg Stress Perception Scale was used to control the intensity of the training program. The supplement + exercise, supplement, and placebo groups consumed one 125 mg capsule of olive leaf extract and a placebo after lunch for eight weeks. The subjects' diets were monitored by a nutritionist through a food recall form, from one week before the start of the exercise program until the end of the study. Blood samples were taken from all four groups before and after the test. Data analysis was performed using a one-way ANOVA test and Tukey's post hoc test, as well as a paired t-test, at a significance level of P<0.05.
RESULTS
The results of the one-way ANOVA indicated that the exercise, exercise + supplement, supplement, and control groups were similar in terms of anthropometric, demographic, and physiological characteristics at baseline, with no significant differences between them (P>0.05, Table 2). The results of one-way ANOVA between groups demonstrated a significant difference in the levels of galectin-3 (P=0.001, F=14.57), IL-18 (P=0.001, F=23.84), and fasting glucose (P=0.001, F=12.60) between the groups. The results of Tukey's post hoc test are reported as the mean difference between the groups in all indices in a pairwise manner (Tables 3 and 4). The within-group paired t-test showed that the levels of galectin-3, IL-18, and glucose in the exercise and exercise + supplement groups indicated a significant decrease after the intervention (P<0.05, Table 3). In terms of percentage change, the exercise + supplement group showed a greater decrease in the values of IL-18 (2.61%), galectin-3 (1.22%), and glucose (15.74%) compared to the other groups (Table 3 and Figures 1, 2, and 3).
CONCLUSION
Although HICT alone can be effective in reducing galectin-3, IL-18, and fasting glucose, prescribing HICT training in conjunction with olive leaf extract has a synergistic effect in improving proinflammatory markers and fasting glucose levels.
Ethical Considerations
Compliance with ethical guidelines
This work is the result of the first author's master's thesis in exercise physiology and health, approved by the Vice Chancellor for Research of Kashan University and registered with the code IR.QUMS.REC.1403.130.
Funding
No financial support was provided for this research.
Authors’ Contribution
All authors participated in the design, implementation, data analysis, and writing of all parts of the study.
Conflict of Interest
The authors declare that there are no conflicts of interest.
Acknowledgments
The authors express their gratitude and appreciation to all those who contributed to this research.