• Users Online: 137
  • Print this page
  • Email this page


 
 
Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 4  |  Page : 115-121

Effect of aerobic exercise on some parameters of cardiovascular health among male problem gamblers


Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Roma Tor Vergata, Roma, Italy

Date of Submission26-Aug-2019
Date of Decision14-Sep-2019
Date of Acceptance25-Sep-2019
Date of Web Publication08-Nov-2019

Correspondence Address:
Dr. Chidiebere Emmanuel Okechukwu
Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Roma Tor Vergata, Via Montpellier, 1, 00133 Roma
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/iahs.iahs_55_19

Get Permissions

  Abstract 


Aims: The aim of this study was to assess some parameters of cardiovascular health among male problem gamblers and the possible effect of long-term participation in aerobic exercise training on the parameters. Materials and Methods: Three hundred and sixty-eight male volunteers aged between 35 and 55years, were enrolled in this randomized controlled trial, they were confirmed as problem gamblers from the results obtained from the analysis of the South Oaks Gambling Screen. After the exclusion of 168 participants, 200 participants were randomly assigned to the control group(n=100) and treatment group(n=100), respectively. Body mass index(BMI), waist circumference(WC), heart rate(HR), systolic blood pressure(SBP), and diastolic blood pressure(DBP) were measured. Participants in the treatment group participated in a supervised vigorous-intensity aerobic exercise training program; jogging for 30min/day at an estimated intensity of 6.32 metabolic equivalents, three times/week, consistently for 1year. Data were analyzed using the SPSS(version20 Armonk, NY, USA), and significant difference was determined at the level of P <0.05. Results: The findings from this study shows statistically significant improvements in BMI(control: 27.18±0.52, treatment: 21.73±0.30, P <0.000), SBP(control: 134.35±1.63, treatment: 110.69±1.11, P <0.000), DBP(control: 89.18±1.16, treatment: 77.14±0.52, P <0.000), HR(control: 76.85±0.70, treatment: 72.06±0.25, P <0.000), and WC(control: 91.14±0.78, treatment: 86.26±0.41, P <0.000) among participants in the treatment group compared to the control group. Conclusion: Vigorous-intensity aerobic exercise training led to a statistically significant decrease in BMI, SBP, DBP, HR, and WC among male problem gamblers.

Keywords: Aerobic exercise, behavioral addiction, cardiovascular risk, gambling disorder, problem gambling


How to cite this article:
Okechukwu CE. Effect of aerobic exercise on some parameters of cardiovascular health among male problem gamblers. Int Arch Health Sci 2019;6:115-21

How to cite this URL:
Okechukwu CE. Effect of aerobic exercise on some parameters of cardiovascular health among male problem gamblers. Int Arch Health Sci [serial online] 2019 [cited 2019 Nov 20];6:115-21. Available from: http://www.iahs.kaums.ac.ir/text.asp?2019/6/4/115/270603




  Introduction Top


Problem gambling is associated with a growing tension in individuals when they are not gambling online or offline, this tensed feeling which includes anxiety and impulsivity is usually calmed by gambling/betting offline or online, this is one of the major symptoms of gambling addiction.[1] Addiction is a disorder of the brain's reward system which develops over time due to consistent exposure to an addictive stimulus.[2] Uncontrolled gambling behavior results to distortions in mental well-being, economic, social, and occupational activities.[3] Problem gambling is an urge to gamble continuously despite the harmful consequences and a personal decision to quit.[4],[5]

Sports betting are the activities of predicting the outcome of sports events and placing a wager on them.[6],[7],[8] Sleep deprivation is one of the consequences of uncontrolled sports betting activities, this can result to motor and cognitive dysfunction, mood problems, and immunological dysregulation.[9] Problem gamblers often suffer from cardiovascular disease, mental health, and substance use disorders, and they usually have stress-related physical and psychological ill-health because of their frequent gambling activities.[10] Problem gamblers are predisposed to mood disorders and cardiovascular disease because they tend to increase their dependence on alcohol, hard drugs, and cigarette smoking.[11],[12],[13]

Exercise is an effective tool for improving cardiovascular health and minimizing cardiovascular mortality, long-term involvement in exercise might lead to improvements in cardiometabolic parameters and net reduction in blood pressure at rest.[14],[15] Both short-and long-term involvement in aerobic and resistance exercises improves mood, quality of life, functional capacity, and minimizes the risk of high blood pressure among healthy individuals.[16] The American College of sports medicine recommends that every adult should accumulate at least 30–60min/day(≥150min/week) of moderate-intensity aerobic exercise, or 20–60min/day(≥75min/week) of vigorous-intensity aerobic exercise or a combination of moderate and vigorous-intensity aerobic exercises per day.[17]

The aim of this study was to assess some parameters of cardiovascular health among male problem gamblers addicted to sports betting and the possible effect of long-term participation in aerobic exercise training on the parameters.


  Materials and Methods Top


Research design

An exercise intervention study was conducted in Lagos State, Nigeria, from July 2016 to August 2017.

Participants

Three hundred and sixty-eight male volunteers aged between 35 and 55years were enrolled in this randomized controlled trial, they were confirmed as problem gamblers from the results obtained after the analysis of South Oaks Gambling Screen(SOGS) questionnaire, which they filled.[18] The enrolled participants scored a total average of 2.9, and according to the SOGS, an average score between 1 and 4 signifies some problem with gambling. Participants were recruited from different sports betting centers in Eti-Osa Local Government Area, Lagos State, Nigeria. After the exclusion of 168 participants, 200 participants were randomly assigned to the control group(n=100) and treatment group(n=100), respectively. Data were presented using consortium flow diagram for reporting randomized controlled trials[Figure1]. [Table1] shows the cardiovascular health parameters of subjects in the control group. [Table2] shows the cardiovascular health parameters of subjects in the treatment group.
Figure 1: Consort flow diagram

Click here to view
Table 1: Cardiovascular health parameters of subjects in the control group


Click here to view
Table 2: Cardiovascular health parameters of subjects in the treatment group


Click here to view


Anthropometrics

Weight and height were measured using an electronic weighing scale(Accuweight ® Hebei, China) and stadiometer, respectively, to obtain the body mass index(BMI) of the participants. Waist circumference(WC) was measured using a standard metric tape.

Measurement of cardiovascular health parameters

Arterial blood pressure was measured using an aneroid sphygmomanometer(Accoson ® Ayrshire, UK) and was determined after 3weeks of constant measurements and readings, before and after 1-year exercise intervention. Blood pressure readings were taken, after a 5-min sitting rest with the arm positioned at the level of the left ventricle. The I and V Korotkoff phases were used to determine the systolic and diastolic blood pressure(DBP), respectively. The sphygmomanometer calibration was constantly assessed. To avoid error in measurements due to physical activity, the participants were told not to exercise before data collection. Heart rate(HR) was measured manually by placing the index and middle finger close to the windpipe of the participants and then counted using a stopwatch(Thomas ®, New Jersey, USA).

Exercise intervention

Participants in the treatment group participated, in a supervised vigorous-intensity aerobic exercise training program, which was achieved by jogging for 30min/day, at an estimated intensity of 6.32 metabolic equivalents(METs), 3times/week, consistently for 1year. This was estimated as follows; the mean age of participants in the treatment group was=42.05years. By applying Jones equation, estimated maximal oxygen uptake(VO2max) in METs =(60–0.55×42.05)/3.5=10.54 METs. Vigorous-intensity activity criterion=VO2max in METs =(0.60×10.54 METs) = 6.32 METs. METs per week =(6.32 METs×3) = 18.96 METs·per week.[19]

Sample size

The sample size for this study was calculated using this mathematical formulae



where N=Sample size, Z=Coefficient of standard normal deviate(usually express at 1.96 for 95% confidence interval), P=Sample proportion, q=1 −p. β = sampling error(it was considered for this to be within 5% of its actual parameter with 95% confidence), the proportion(p) of individuals that were addicted to sports betting in Lagos State, Nigeria was estimated at 0.6.



A sample size of 368 was used for this study.

Inclusion criteria

Individuals residing in Lagos State, Nigeria, aged between 35 and 55years and were active bettors(both offline and online sports bettors), BMI≥23 kg/m2, WC>94 cm, and weight stable(<5% weight loss or gain) for 3 months before the beginning of the study, were enrolled for this study.

Exclusion criteria

Individual who reported any severe cardiovascular disease, psychiatric disorder, renal disease, and respiratory disease were excluded from the study.

Ethical considerations

The study was conducted in accordance with the Declaration of Helsinki 1964 as revised in 2000. This was a community health development project(CD) conducted for 1year under the National Youth Service Corps scheme in Lagos State, Nigeria, from 2016 to 2017(LA/NUA/2016/026620). Ethical approval was obtained from the national committee. Informed written consent was filled and signed by all the participants, to ensure the protection of participants' privacy and data.

Statistical analysis

Data regarding BMI, systolic blood pressure(SBP), DBP, HR, and WC were collected and analyzed before and after the intervention. The data collected before and after the trial was analyzed using one-way analysis of variance(ANOVA) test, a significant difference was determined at the level of P <0.05 using the SPSS software package version20(IBM Corp. Version20.0, Armonk, NY, USA). Dependent paired t-test was used to compare the results within the groups.


  Results Top


The mean age of all the participants was 42.43±0.65years. The mean age of participants assigned to the control group was 42.80±0.64years, while that of participants assigned to the treatment group was 42.05±0.65years. There was no significant difference between the mean age of participants in the control group and treatment group. When the cardiovascular health parameters of participants in the control group and treatment group were compared before 1year regular exercise intervention, the results from the analysis revealed no significant difference in their mean ages(control: 42.80±0.64, treatment: 42.05±0.65, P >0.414), BMI(control: 27.18±0.52, treatment: 25.85±0.50, P >0.072), SBP(control: 134.35±1.63, treatment: 133.37±1.49, P >0.659), DBP(control: 89.18±1.16, treatment: 88.15±1.08, P >0.519), and HR(control: 76.85±0.70, treatment: 75.67±0.51, P >0.179). However, there was a significant difference when their WC(control: 91.14±0.78, treatment: 88.79±0.63, P >0.020) was compared[Table3].
Table 3: Comparison of the cardiovascular health parameters of subjects in the control group and treatment group before 1 year regular exercise intervention


Click here to view


The results from the ANOVA comparison of the cardiovascular health parameters of participants in the control group and treatment group after 1-year regular exercise intervention was statistically significant, when the mean BMI(control: 27.18±0.52, treatment: 21.73±0.30, P >0.000), SBP(control: 134.35±1.63, treatment: 110.69±1.11, P >0.000), DBP(control: 89.18±1.16, treatment: 77.14±0.52, P >0.000), HR(control: 76.85±0.70, treatment: 72.06±0.25, P >0.000), and WC(control: 91.14±0.78, treatment: 86.26±0.41, P >0.000) of participants in the treatment group were compared with the control group, there was a significant improvement. However, there was no significant difference in the mean age(control: 42.80±0.64, treatment: 42.05±0.65, P >0.641) between the control group and treatment group[Table4]. From the results of ANOVA, comparison of some cardiovascular health parameters of participants in the control group and treatment group before and after 1-year regular exercise intervention, the composite chart[Figure2], shows a statistical significant difference in the cardiovascular health parameters(BMI, SBP, DBP, HR, and WC) between the control group and treatment group after 1-year exercise intervention, indicating improvements in the parameters of cardiovascular health among participants in the treatment group.
Table 4: Analysis of variance comparison of the cardiovascular health parameters of subjects in the control group and treatment group after 1 year of exercise


Click here to view
Figure 2: Comparison of the cardiovascular health parameters of subjects in the control group and treatment group before and after 1-year exercise intervention. +Represent the significant difference when the treatment group is compared with the control group at the level of P < 0.05. AGE: Participants ages, BMI: Body mass index, SBP: Systolic blood pressure, DBP: Diastolic blood pressure, HR: Heart rate, WC: Waist Circumference

Click here to view



  Discussion Top


There is a rise in sports gambling activities in Lagos State, Nigeria, especially among the uneducated and unemployed youths in the state.[20] Problem gambling was associated with anxiety, depression, substance abuse, suicide ideation, and financial difficulties in the UnitedKingdom.[21]

Mohammadkhani et al. found that the consumption of 50 mg of caraway per kilogram of body weight daily combined with aerobic exercise(3 sessions per week at an intensity of 65%–70% maximum HR) among obese women for 8weeks, caused significant improvements in waist-hip ratio, percentage of body fat, and there was a statistical significant decrease in the level of C-reactive protein(CRP) and improvement in sleep quality among subjects in the combined supplement and exercise group when compared to the control group.[22] This result described the beneficial role of aerobic exercise training in lifestyle intervention and in the decrease of cardiovascular risk, which could be more effective if combined with supplements or diets.

Irandoust and Taheri conducted an experimental study on the effects of water-based exercises on inflammatory markers with regard to cardiovascular health, they analyzed the activities of homocysteine, CRP, and fibrinogen in 28 obese women, they carried out a combined resistance, stretching, and balance exercise program, 3 sessions/week in the surface end of the pool for 10weeks; however at the end of the experiment, they discovered significant improvements in CRP, fibrinogen, and homocysteine indices among obese women that participated in the 10weeks combined water-based exercise training; moreover, there were significant reductions in body fat percentage, cholesterol, and SBP.[23] These results further support the argument that regular physical activity is effective in minimizing cardiovascular risk factors, thus causing significant improvements in cardiometabolic health.

Exercise was effective as an adjunct therapy for individuals suffering from alcohol use disorder.[24] However, there are few scientific information on the effects of exercise on cardiovascular health among problem gamblers. Exercise program resulted in a significant decrease in psychiatric comorbidities associated with problem gambling.[25] Apart from the role of exercise in improving cardiovascular health among problem gamblers as proven by this study, mind-body exercises can be an effective therapy for the treatment of substance use disorders among problem gamblers.[26] There was a decrease in gambling craving among pathological gamblers, after participating in an exercise program.[27] Problem gamblers are predisposed to high blood pressure, angina, and tachycardia.[28] Exercise might be an effective therapy in addition to psychotherapeutic treatment of gambling disorder, because exercise improves cardiovascular health, reduces the craving to gamble and minimizes the symptoms of anxiety and depression.[29]

The result of the ANOVA comparison of the cardiovascular health parameters between the control group and treatment group after 1year exercise intervention[Table4], shows statistically significant improvements in BMI(control: 27.18±0.52, treatment: 21.73±0.30, P >0.000), SBP(control: 134.35±1.63, treatment: 110.69±1.11, P >0.000), DBP(control: 89.18±1.16, treatment: 77.14±0.52, P >0.000), HR(control: 76.85±0.70, treatment: 72.06±0.25, P >0.000), and WC(control: 91.14±0.78, treatment: 86.26±0.41, P >0.000) among participants in the treatment group, this was in line with the findings of Mohammadkhani et al.,[22] Irandoust and Taheri,[23] and Salas et al.,[30] They discovered that being physically active modifies the detrimental effects of sedentary behaviors on cardio-metabolic and obesity-related traits.

Exercise improves the level of dopamine in adults, which could go also long way to minimize gambling cravings, impulsivity, and other addictive behaviors.[31] There is a need to incorporate an exercise-training program as part of the pharmacological and psychotherapeutic treatment of gambling disorder and associated psychiatric comorbidities because of the beneficial effects of regular physical exercise on the cardiovascular and mental health in healthy individuals and psychiatric patients.[31]

Limitations

The limitations of this study were the inability to carry out a blinded randomized controlled trial due to the nature of the exercise intervention program, and cardio-metabolic tests such as the analysis of the level of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides were not utilized.


  Conclusion Top


The findings from this study shows that male problem gamblers that participated in a supervised vigorous-intensity aerobic exercise training program which was achieved by jogging for 30min/day, at an estimated intensity of 6.32 METs, 3times/week, consistently for 1year, had a statistically significant decrease in BMI, SBP, DBP, HR, and WC.

Acknowledgment

The author would like to acknowledge the 15 medical students that volunteered in this project. Thanks to all the participants for maintaining the exercise training routines and schedule.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Castrén S, BasnetS, PankakoskiM, RonkainenJE, HelakorpiS, UutelaA, etal. An analysis of problem gambling among the Finnish working-age population: Apopulation survey. BMC Public Health 2013;13:519.  Back to cited text no. 1
    
2.
VolkowND, BoyleM. Neuroscience of addiction: Relevance to prevention and treatment. Am J Psychiatry 2018;175:729-40.  Back to cited text no. 2
    
3.
PotenzaMN, FiellinDA, HeningerGR, RounsavilleBJ, MazureCM. Gambling: An addictive behavior with health and primary care implications. JGen Intern Med 2002;17:721-32.  Back to cited text no. 3
    
4.
HingN, RussellAM, VitartasP, LamontM. Demographic, behavioural and normative risk factors for gambling problems amongst sports bettors. JGambl Stud 2016;32:625-41.  Back to cited text no. 4
    
5.
LaBrieRA, LaPlanteDA, NelsonSE, SchumannA, ShafferHJ. Assessing the playing field: Aprospective longitudinal study of internet sports gambling behavior. JGambl Stud 2007;23:347-62.  Back to cited text no. 5
    
6.
GassmannF, EmrichE, PierdziochC. Who bets on sports? Some further empirical evidence using German data. Int Rev Socio Sport 2017;52:391-410.  Back to cited text no. 6
    
7.
Lopez-GonzalezH, Guerrero-Solé F, GriffithsMD. Acontent analysis of how “normal” sports betting behaviour is represented in gambling advertising. Addict Res Theory 2018;26:238-47.  Back to cited text no. 7
    
8.
Cunningham-WilliamsRM, CottlerLB, Compton WM 3rd, SpitznagelEL. Taking chances: Problem gamblers and mental health disorders–Results from the st. Louis epidemiologic catchment area study. Am J Public Health 1998;88:1093-6.  Back to cited text no. 8
    
9.
Lopez-GonzalezH, Estévez A, GriffithsMD. Spanish validation of the problem gambling severity index: Aconfirmatory factor analysis with sports bettors. JBehav Addict 2018;7:814-20.  Back to cited text no. 9
    
10.
PotenzaMN, SteinbergMA, WuR, RounsavilleBJ, O'malley SS. Characteristics of older adult problem gamblers calling a gambling helpline. JGambl Stud 2006;22:241-54.  Back to cited text no. 10
    
11.
LorainsFK, CowlishawS, ThomasSA. Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction 2011;106:490-8.  Back to cited text no. 11
    
12.
PetryNM, OnckenC. Cigarette smoking is associated with increased severity of gambling problems in treatment-seeking gamblers. Addiction 2002;97:745-53.  Back to cited text no. 12
    
13.
PilverCE, LibbyDJ, HoffRA, PotenzaMN. Problem gambling severity and the incidence of axis I psychopathology among older adults in the general population. JPsychiatr Res 2013;47:534-41.  Back to cited text no. 13
    
14.
HaskellWL. The influence of exercise on the concentrations of triglyceride and cholesterol in human plasma. Exerc Sport Sci Rev 1984;12:205-44.  Back to cited text no. 14
    
15.
HaskellWL, LeeIM, PateRR, PowellKE, BlairSN, FranklinBA, etal. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and The American Heart Association. Med Sci Sports Exerc 2007;39:1423-34.  Back to cited text no. 15
    
16.
FagardRH. Exercise is good for your blood pressure: Effects of endurance training and resistance training. Clin Exp Pharmacol Physiol 2006;33:853-6.  Back to cited text no. 16
    
17.
GarberCE, BlissmerB, DeschenesMR, FranklinBA, LamonteMJ, LeeIM, etal. American college of sports medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med Sci Sports Exerc 2011;43:1334-59.  Back to cited text no. 17
    
18.
LesieurHR, BlumeSB. The South Oaks Gambling Screen(SOGS): Anew instrument for the identification of pathological gamblers. Am J Psychiatry 1987;144:1184-8.  Back to cited text no. 18
    
19.
AinsworthBE, HaskellWL, HerrmannSD, MeckesN, Bassett DR Jr., Tudor-LockeC, etal. 2011 compendium of physical activities: Asecond update of codes and MET values. Med Sci Sports Exerc 2011;43:1575-81.  Back to cited text no. 19
    
20.
SalaamAO. Gambling for sustainability: “Area boys” and gambling behaviour in Lagos, Nigeria. Int J Ment Health Addict 2014;12:80-93.  Back to cited text no. 20
    
21.
CowlishawS, KesslerD. Problem gambling in the UK: Implications for health, psychosocial adjustment and health care utilization. Eur Addict Res 2016;22:90-8.  Back to cited text no. 21
    
22.
MohammadkhaniPG, IrandoustK, TaheriM, MirmoezziM, Baić M. Effects of eight weeks of aerobic exercise and taking caraway supplement on C-reactive protein and sleep quality in obese women. Biol Rhythm Res 2019. doi: 10.1080/09291016.2019.1587837. [Epub ahead of print].  Back to cited text no. 22
    
23.
IrandoustK, TaheriM. The effect of aquatic exercises on inflammatory markers of cardiovascular disease in obese women. Int Arch Health Sci 2018;5:145-9.  Back to cited text no. 23
  [Full text]  
24.
HallgrenM, VancampfortD, GiesenES, LundinA, StubbsB. Exercise as treatment for alcohol use disorders: Systematic review and meta-analysis. Br J Sports Med 2017;51:1058-64.  Back to cited text no. 24
    
25.
AnnaCP, HyonSK, AntonioMC, HermanoT. The impact of an exercise program as a treatment for gambling disorder: Arandomized controlled trial. Ment Health Phys Act 2018;15:53-62.  Back to cited text no. 25
    
26.
WangD, WangY, WangY, LiR, ZhouC. Impact of physical exercise on substance use disorders: Ameta-analysis. PLoS One 2014;9:e110728.  Back to cited text no. 26
    
27.
AngeloDL, TavaresH, BotturaHM, ZilbermanML. Physical exercise for pathological gamblers. Braz J Psychiatry 2009;31:76.  Back to cited text no. 27
    
28.
CaladoF, GriffithsMD. Problem gambling worldwide: An update and systematic review of empirical research(2000-2015). JBehav Addict 2016;5:592-613.  Back to cited text no. 28
    
29.
AngeloDL, TavaresH, ZilbermanML. Evaluation of a physical activity program for pathological gamblers in treatment. JGambl Stud 2013;29:589-99.  Back to cited text no. 29
    
30.
SalasC, Cristi-MonteroC, FanY, Durán E, Labraña AM, Martínez MA, etal. Being physically active modifies the detrimental effect of sedentary behavior on obesity and cardiometabolic markers in adults. Rev Med Chil 2016;144:1400-9.  Back to cited text no. 30
    
31.
OkechukwuCE. Role of exercise in the treatment of gambling disorder. Niger J Exp Clin Biosci 2019;7:50-4.  Back to cited text no. 31
  [Full text]  


    Figures

  [Figure1], [Figure2]
 
 
    Tables

  [Table1], [Table2], [Table3], [Table4]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Introduction
Materials and Me...
Results
Discussion
Conclusion
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed347    
    Printed3    
    Emailed0    
    PDF Downloaded30    
    Comments [Add]    

Recommend this journal