The interactive effects of aquatic aerobic training and royal jelly on body composition and Interleukin-6 in obese adolescent girls

Ghalavand, Soghra; Momeni, Leila; Bagheri, Aboutaleb

doi:10.22034/27.2.53

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Volume 27, Issue 2 (7-2025)

EBNESINA 2025, 27(2): 53-63

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The interactive effects of aquatic aerobic training and royal jelly on body composition and Interleukin-6 in obese adolescent girls

Soghra Ghalavand

, Leila Momeni ^*

, Aboutaleb Bagheri

Department of Physical Education and Sport Sciences, Dez.C., Islamic Azad University, Dezful, Iran , leilam16@iau.ir

Keywords: obesity, inflammation, physical activity, royal jelly, interleukin-6

Full-Text [PDF 1888 kb] (64 Downloads) | Abstract (HTML) (212 Views)

Type of Study: Original | Subject: Military Medicine
Received: 2024/11/19 | Revised: 2025/09/29 | Accepted: 2025/06/28 | Published: 2025/06/28

Extended Abstract: (34 Views)

Introduction

Childhood obesity is a pressing global public health issue, marked by increasing prevalence and serious associated health risks that persist into adulthood [1]. This epidemic affects both developed and developing nations [2], with a notable rise observed among Iranian children and adolescents, as evidenced by a 21-year longitudinal study from the Tehran Lipid and Glucose Study [3]. The surge in overweight and obesity is particularly pronounced in low- and middle-income countries, especially in urban areas. The underlying causes of childhood obesity mirror those in adults, and obese children often exhibit similar comorbidities [4].
The immune system undergoes critical development during childhood, and obesity can disrupt this process. The low-grade inflammation associated with childhood obesity warrants careful investigation to uncover early mechanisms and inform effective interventions [5]. Regular exercise is a cornerstone of a healthy lifestyle, and physical activity initiated in childhood can mitigate the adverse effects of obesity [5]. Aquatic exercise, in particular, reduces gravitational stress, making it an accessible option for individuals with low fitness levels [7].
Royal jelly, rich in bioactive compounds and antioxidants, has been shown to reduce oxidative stress and inflammation while improving lipid profiles and insulin sensitivity [11–13]. Combining aquatic aerobic exercise with royal jelly supplementation may offer synergistic benefits for physical health and immune-related markers in obese children. This study aimed to investigate the effects of an eight-week intervention involving aquatic aerobic exercise and royal jelly consumption on body composition and immune-related variables in obese adolescent girls.

Methods

In this semi-experimental study, 60 students aged 15–17 years with a body mass index (BMI) above the 95th percentile in Andimeshk County were selected via purposive sampling and randomly assigned to one of four groups: the aquatic aerobic exercise group, the royal jelly supplementation group, the combined group (aquatic aerobic exercise plus royal jelly), and the control group (no intervention).
The exercise protocol spanned eight weeks, with three weekly sessions on alternate days. Each session included 10 minutes of general warm-up, 5 minutes of specific warm-up, 30 minutes of main exercise at 50–70% of heart rate reserve (calculated using the Karvonen method), and 10 minutes of cool-down [16]. All sessions were supervised by a coach and the researcher. The royal jelly supplement (Eurovital 1000 mg capsules) was administered once daily, manufactured and packaged in Iran under German license [17].
Data collection included BMI measurements and fasting blood samples taken 24 hours before and 72 hours after the intervention. Interleukin-6 (IL-6) levels were quantified using the ELISA method with a human kit from Randox, UK. Statistical analyses employed paired t-tests and analysis of covariance (ANCOVA).

Results

Within-group analyses revealed significant reductions in BMI for the exercise (p < 0.001) and combined (p < 0.001) groups, while no significant changes were observed in the supplement (p = 0.933) or control (p = 0.276) groups. Additionally, IL-6 levels decreased significantly in the exercise (p < 0.001), supplement (p < 0.001), and combined (p < 0.001) groups, with no change in the control group (p = 0.843).
Between-group comparisons (ANCOVA) demonstrated significant differences in BMI and IL-6 changes (p < 0.001). Post-hoc Bonferroni tests indicated that BMI reductions in the exercise and combined groups were significantly greater than in the supplement (p < 0.001) and control groups (exercise: p < 0.001; combined: p = 0.002). Similarly, IL-6 reductions were significantly greater in the exercise (p = 0.001), supplement (p = 0.003), and combined (p < 0.001) groups compared to the control group. Notably, the combined group showed a greater IL-6 reduction than the supplement group (p = 0.015), while no significant difference was observed between the exercise and combined groups (p = 0.060).

Discussion and Conclusion

This study highlights the efficacy of aquatic aerobic exercise in significantly reducing BMI among obese adolescent girls, aligning with prior research on weight management in obese children [7, 16]. The buoyancy of water minimizes joint stress, making aquatic exercise a viable and well-tolerated option for obese individuals [19, 20]. The physical properties of water, such as its density and resistance, enhance energy expenditure, further supporting its role in weight loss and body composition improvement [19].
Aquatic exercise also significantly lowered IL6 levels, underscoring its anti-inflammatory effects—a finding consistent with other studies [6, 21–23]. Royal jelly supplementation alone reduced IL-6 without affecting BMI, corroborating earlier research in children and adults [15, 27, 28]. The anti-inflammatory properties of royal jelly may stem from its inhibition of the NF-κB, MAPK, and STAT3 pathways, along with reduced IκBα phosphorylation [29].
The combined intervention yielded significant reductions in both BMI and IL-6, suggesting that exercise plays a primary role in obesity control, while royal jelly provides complementary anti-inflammatory benefits [1, 15, 21, 29]. Aquatic exercise targets fat reduction and enhances anti-inflammatory responses, whereas royal jelly directly modulates inflammatory pathways.
In conclusion, aquatic aerobic exercise—either alone or combined with royal jelly—effectively reduces BMI and IL-6 levels in obese adolescents. This combined approach represents a safe and practical strategy for managing obesity and inflammation in this population. Future studies should explore longer intervention periods and a broader array of inflammatory markers to deepen our understanding of these effects.

Ethical Considerations

This study was conducted in accordance with ethical principles and the Declaration of Helsinki. All research procedures were approved by the Research Ethics Committee of Islamic Azad University, Dezful Branch (Ethics Code: IR.IAU.D.REC.1403.074). Parents of the children provided written informed consent after receiving full explanations of the study objectives and procedures. Age-appropriate explanations were also provided to the children, who retained the right to withdraw from the study at any time. Participants’ information was kept confidential and used solely for the purposes of this research.

Funding

There is no funding support.

Authors’ Contribution

Authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work.

Conflict of Interest

Authors declared no conflict of interest.

Acknowledgments

The authors would like to express their sincere thanks and appreciation to all individuals who contributed to this research, as well as to all the study participants.

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Ghalavand S, Momeni L, Bagheri A. The interactive effects of aquatic aerobic training and royal jelly on body composition and Interleukin-6 in obese adolescent girls. EBNESINA 2025; 27 (2) :53-63
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