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MacKenzie-Shalders KL, Byrne NM, Slater GJ, King NA. The effect of a whey protein supplement dose on satiety and food intake in resistance training athletes. Appetite 2015; 92:178-84. [PMID: 25979566 DOI: 10.1016/j.appet.2015.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 04/16/2015] [Accepted: 05/08/2015] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Many athletes perform resistance training and consume dietary protein as a strategy to promote anabolic adaptation. Due to its high satiety value, the regular addition of supplemented dietary protein could plausibly displace other key macronutrients such as carbohydrate in an athlete's diet. This effect will be influenced by the form and dose of protein. Therefore, this study assessed the impact of liquid whey protein dose manipulation on subjective sensations of appetite and food intake in a cohort of athletes. DESIGN Ten male athletes who performed both resistance and aerobic (endurance) training (21.2 ± 2.3 years; 181.7 ± 5.7 cm and 80.8 ± 6.1 kg) were recruited. In four counter-balanced testing sessions they consumed a manipulated whey protein supplement (20, 40, 60 or 80 g protein) 1 hour after a standardised breakfast. Subsequent energy intake was measured 3 hours after the protein supplement using an ad libitum test meal. Subjective appetite sensations were measured periodically during the test day using visual analogue scales. RESULTS All conditions resulted in a significant decrease in ratings of hunger (50-65%; P < 0.05) at the time of supplement consumption. However, there were no significant differences between the conditions at any time point for subjective appetite sensations or for energy consumed in the ad libitum meal: 4382 ± 1004, 4643 ± 982, 4514 ± 1112, 4177 ± 1494 kJ respectively. CONCLUSION Increasing whey protein supplement dose above 20 g did not result in a measurable increase in satiety or decrease in food intake. However, the inclusion of additional whey protein supplementation where not otherwise consumed could plausibly reduce dietary intake.
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Affiliation(s)
- Kristen L MacKenzie-Shalders
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia.
| | - Nuala M Byrne
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Gary J Slater
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Neil A King
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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Dahiya R, Shultz SP, Dahiya A, Fu J, Flatley C, Duncan D, Cardinal J, Kostner KM, Byrne NM, Hills AP, Harris M, Conwell LS, Leong GM. Relation of reduced preclinical left ventricular diastolic function and cardiac remodeling in overweight youth to insulin resistance and inflammation. Am J Cardiol 2015; 115:1222-8. [PMID: 25765589 DOI: 10.1016/j.amjcard.2015.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 11/30/2022]
Abstract
Insulin resistance (IR) and inflammation are associated with an increased risk of cardiovascular disease and may contribute to obesity cardiomyopathy. The earliest sign of obesity cardiomyopathy is impaired left ventricular (LV) diastolic function, which may be evident in obese children and adolescents. However, the precise metabolic basis of the impaired LV diastolic function remains unknown. The aims of this study were to evaluate cardiac structure and LV diastolic function by tissue Doppler imaging in overweight and obese (OW) youth and to assess the relative individual contributions of adiposity, IR, and inflammation to alterations in cardiac structure and function. We studied 35 OW (body mass index standard deviation score 2.0±0.8; non-IR n=19, IR n=16) and 34 non-OW youth (body mass index standard deviation score 0.1±0.7). LV diastolic function was reduced in OW youth compared with non-OW controls, as indicated by lower peak myocardial relaxation velocities (p<0.001) and greater filling pressures (p<0.001). OW youth also had greater LV mass index (p<0.001), left atrial volume index, and LV interventricular septal thickness (LV-IVS; both p=0.02). IR-OW youth had the highest LV filling pressures, LV-IVS, and relative wall thickness (all p<0.05). Homeostasis model of assessment-insulin resistance and C-reactive protein were negative determinants of peak myocardial relaxation velocity and positive predictors of filling pressure. Adiponectin was a negative determinant of LV-IVS, independent of obesity. In conclusion, OW youth with IR and inflammation are more likely to have adverse changes to cardiovascular structure and function which may predispose to premature cardiovascular disease in adulthood.
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Affiliation(s)
- Rachana Dahiya
- School of Medicine, The University of Queensland, Herston, Queensland; Mater Research Institute, The University of Queensland, South Brisbane, Queensland.
| | - Sarah P Shultz
- School of Sport and Exercise, College of Health, Massey University, Wellington, New Zealand
| | - Arun Dahiya
- School of Medicine, The University of Queensland, Herston, Queensland; Griffith Health Institute, Griffith University, Gold Coast, Queensland
| | - Jinlin Fu
- Mater Research Institute, The University of Queensland, South Brisbane, Queensland
| | - Christopher Flatley
- School of Medicine, The University of Queensland, Herston, Queensland; Mater Research Institute, The University of Queensland, South Brisbane, Queensland
| | - Danusia Duncan
- Department of Cardiology, Mater Adult Hospital, South Brisbane, Queensland
| | - John Cardinal
- Pathology Queensland, Royal Brisbane Hospital, Herston, Queensland
| | - Karam M Kostner
- School of Medicine, The University of Queensland, Herston, Queensland; Department of Cardiology, Mater Adult Hospital, South Brisbane, Queensland
| | - Nuala M Byrne
- The Collaborative Research Network for Advancing Exercise and Sports Science, Bond University, Robina, Queensland
| | - Andrew P Hills
- Mater Research Institute, The University of Queensland, South Brisbane, Queensland; Griffith Health Institute, Griffith University, Gold Coast, Queensland
| | - Mark Harris
- School of Medicine, The University of Queensland, Herston, Queensland; Department of Paediatric Endocrinology, Lady Cilento Children's Hospital, South Brisbane, Queensland
| | - Louise S Conwell
- School of Medicine, The University of Queensland, Herston, Queensland; Department of Paediatric Endocrinology, Lady Cilento Children's Hospital, South Brisbane, Queensland; Queensland Children's Medical Research Institute, The University of Queensland, Herston, Queensland
| | - Gary M Leong
- School of Medicine, The University of Queensland, Herston, Queensland; Department of Paediatric Endocrinology, Lady Cilento Children's Hospital, South Brisbane, Queensland; Institute for Molecular Biosciences, The University of Queensland, St Lucia, Queensland
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Shultz SP, Dahiya R, Leong GM, Rowlands DS, Hills AP, Byrne NM. Muscular strength, aerobic capacity, and adipocytokines in obese youth after resistance training: A pilot study. Australas Med J 2015; 8:113-20. [PMID: 26045721 DOI: 10.4066/amj.2015.2293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Exercise has shown positive training effects on obesity-related inflammation, however, resistance training has shown mixed results concerning adipocytokine levels. AIMS The purpose of this pilot study was to explore the effects of resistance training on blood adipocytokine concentrations in obese youth, with specific examination of the relationship between these biomarkers and improved fitness (i.e., aerobic capacity, muscular strength). METHODS Fourteen obese adolescents (16.1 ±1.6 y; BMI: 32.3 ±3.9 kg/m(2)) participated in a 16-week resistance training intervention. Body composition, fasting blood concentrations of interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-ɑ), adiponectin, and leptin were measured pre- and post-training. Aerobic capacity was assessed via a maximal discontinuous exercise test. The rate of gain in muscular strength was calculated as the slope of progression in 1-repetition maximum throughout the intervention. RESULTS Resistance training increased lean mass (total, trunk) and decreased per cent body fat (total, trunk). The training also caused moderate clear decreases in IL-6 and TNF-ɑ concentrations. A small increase in adiponectin was also observed before and after intervention. When the group was stratified by changes in aerobic capacity, there were substantially larger decreases in leptin levels for those with improved capacity. Correlation analyses also revealed a negative relationship between log-transformed leptin and aerobic capacity at rest. Improvement in quadriceps strength was positively correlated with IL-6 and TNF-ɑ, while improvement in shoulder adductor strength was positively correlated with IL-6 only. CONCLUSION Resistance training improved adipocytokine markers, which were partially associated with improved physical fitness. Specifically, the relationship between strength improvements and IL-6 and TNF-ɑ suggests an exercise-induced signalling pathway that results in overall adaptive decreases in systemic inflammation in obese youth.
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Affiliation(s)
- Sarah P Shultz
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Rachana Dahiya
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Gary M Leong
- Department of Paediatric Endocrinology and Diabetes, Mater Children's Hospital, Brisbane, QLD, Australia ; Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - David S Rowlands
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Andrew P Hills
- Mater Mothers' Hospital & Mater Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Nuala M Byrne
- Faculty of Health Sciences and Medicine, Bond University, Gold Goast, QLD, Australia
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Sainsbury A, Evans IR, Wood RE, Seimon RV, King NA, Hills AP, Byrne NM. Effect of a 4-week weight maintenance diet on circulating hormone levels: implications for clinical weight loss trials. Clin Obes 2015; 5:79-86. [PMID: 25645138 DOI: 10.1111/cob.12086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 11/11/2014] [Accepted: 12/10/2014] [Indexed: 11/28/2022]
Abstract
The majority of weight loss studies fail to standardize conditions such as diet and exercise via a weight maintenance period prior to commencement of the trial. This study aimed to determine whether a weight stabilization period is necessary to establish stable baseline hormone concentrations. Fifty-one obese male participants with a body mass index of 30-40 kg m(-2) and aged 25-54 years underwent 4 weeks on an energy balance diet that was designed to achieve weight stability. Blood samples were collected in the fasting state at commencement and completion of the 4-week period, and circulating concentrations of 18 commonly measured hormones were determined. During the 4-week weight maintenance period, participants achieved weight stability within -1.5 ± 0.2 kg (-1.4 ± 0.2%) of their initial body weight. Significant reductions in serum insulin (by 18 ± 6.5%) and leptin (by 21 ± 6.0%) levels occurred, but no significant changes were observed for gut-derived appetite-regulating hormones (ghrelin and peptide YY), nor thyroid, adrenal, gonadal or somatotropic hormones. There were no significant correlations between the change in body weight and the change in circulating concentrations of insulin or leptin over the 4-week period, indicating that the observed changes were not due to weight loss, albeit significant negative correlations were observed between the changes in body weight and plasma ghrelin and peptide YY levels. This study demonstrates the need for baseline weight maintenance periods to stabilize serum levels of insulin and leptin in studies specifically investigating effects on these parameters in the obese. However, this does not apply to circulating levels of gut-derived appetite-regulating hormones (ghrelin and peptide YY), nor thyroid, adrenal, gonadal or somatotropic hormones.
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Affiliation(s)
- A Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown, Australia; Neuroscience Research Program, Garvan Institute of Medical Research, Darlinghurst, Australia
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Todd AS, Street SJ, Ziviani J, Byrne NM, Hills AP. Overweight and obese adolescent girls: the importance of promoting sensible eating and activity behaviors from the start of the adolescent period. Int J Environ Res Public Health 2015; 12:2306-29. [PMID: 25690003 PMCID: PMC4344727 DOI: 10.3390/ijerph120202306] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/04/2014] [Accepted: 02/09/2015] [Indexed: 12/30/2022]
Abstract
The adolescent period is associated with changes in eating and activity behaviors in girls. Less reliance on parental provision and choice of food, coupled with a decrease in participation in physical activity and sport, can create an energy imbalance, predisposing to weight gain. Physiological alterations to body composition, reduction in insulin sensitivity, and psychological adjustments may further amplify the risk of becoming overweight and maintaining an unhealthy level of body fat into childbearing years. During pregnancy excess body fat is a risk factor for poor pregnancy outcomes and may predispose an infant to a lifelong heightened risk of being overweight and developing chronic disease. Interventions aimed at preventing the accumulation of body fat in adolescent girls and young women may have far reaching impact and be critically important in reducing intergenerational weight gain. Lifestyle interventions in adolescence have the potential to modify adult obesity risk by switching at-risk individuals from a high to lower obesity risk trajectory. This paper discusses multiple approaches to assist at-risk individuals reduce obesity risk. A key focus is placed on engagement in food preparation and choice, and opportunities for physical activity and sport. Support, education, and opportunity at home and at school, are often associated with the success of lifestyle interventions, and may enable adolescents to make positive choices, and engage in health promoting behaviors during adolescence and childbearing years.
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Affiliation(s)
- Alwyn S Todd
- Centre for Nutrition and Exercise, Mater Research Institute, The University of Queensland, Brisbane 4101, Australia.
- Department of Nutrition and Dietetics, Mater Health Services, Brisbane 4101, Australia.
- School of Allied Health Sciences, Griffith University, Gold Coast 4215, Australia.
| | - Steven J Street
- Centre for Nutrition and Exercise, Mater Research Institute, The University of Queensland, Brisbane 4101, Australia.
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast 4226, Australia.
| | - Jenny Ziviani
- Children's Health Queensland, Queensland Health, Brisbane 4000, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4067, Australia.
| | - Nuala M Byrne
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast 4226, Australia.
- Bond Institute of Health and Sport, Bond University, Gold Coast 4226, Australia.
| | - Andrew P Hills
- Centre for Nutrition and Exercise, Mater Research Institute, The University of Queensland, Brisbane 4101, Australia.
- School of Allied Health Sciences, Griffith University, Gold Coast 4215, Australia.
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56
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Kulkarni B, Hills AP, Byrne NM. Nutritional influences over the life course on lean body mass of individuals in developing countries. Nutr Rev 2014; 72:190-204. [PMID: 24697348 DOI: 10.1111/nure.12097] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The double burden of childhood undernutrition and adult-onset adiposity in transitioning societies poses a significant public health challenge. The development of suboptimal lean body mass (LBM) could partly explain the link between these two forms of malnutrition. This review examines the evidence on both the role of nutrition in “developmental programming” of LBM and the nutritional influences that affect LBM throughout the life course. Studies from developing countries assessing the relationship of early nutrition with later LBM provide important insights. Overall, the evidence is consistent in suggesting a positive association of early nutritional status (indicated by birth weight and growth during first 2 years) with LBM in later life. Evidence on the impact of maternal nutritional supplementation during pregnancy on later LBM is inconsistent. In addition, the role of nutrients (protein, zinc, calcium, vitamin D) that can affect LBM throughout the life course is described. Promoting optimal intakes of these important nutrients throughout the life course is important for reducing childhood undernutrition as well as for improving the LBM of adults.
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Hills AP, Mokhtar N, Brownie S, Byrne NM. Childhood obesity in Asia: the value of accurate body composition methodology. Asia Pac J Clin Nutr 2014; 23:339-43. [PMID: 25164442 DOI: 10.6133/apjcn.2014.23.3.07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Childhood obesity, a significant global public health problem, affects an increasing number of low- and middle-income countries, including in Asia. The obesity epidemic has been fuelled by the rapid nutrition and physical activity transition with the availability of more energy-dense nutrient-poor foods and lifestyles of many children dominated by physical inactivity. During the growing years the pace and quality of grow this best quantified by a combination of anthropometric and body composition measures. However, where normative data are available, this has typically been collected on Caucasian children. To better define and characterise overweight and obesity in Asian children, and to monitor nutrition and physical activity interventions, there is a need to increase the use of standardized anthropometric and body composition methodologies. The current paper reports on initiatives facilitated by the International Atomic Energy Agency (IAEA) and outlines future research needs for the prevention and management of childhood obesity in Asia.
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Affiliation(s)
- Andrew P Hills
- Mater Mothers' Hospital, Mater Research Institute-UQ & Griffith Health Institute, Griffith University, Raymond Terrace, South Brisbane, QLD, Australia.
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58
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Horner KM, Byrne NM, King NA. Reproducibility of subjective appetite ratings and ad libitum test meal energy intake in overweight and obese males. Appetite 2014; 81:116-22. [DOI: 10.1016/j.appet.2014.06.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/13/2014] [Accepted: 06/18/2014] [Indexed: 11/16/2022]
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Abstract
However quantified, obesity is a global health problem of significant magnitude. The condition is no longer limited to the developed world, with an increasing proportion of low-to-middle income countries burdened by obesity and its comorbidities. Specifically, obesity is a risk factor for a raft of psychosocial, physiological, cardiovascular, and metabolic problems. The carriage of excess body weight, including an unhealthy proportion of body fat, also has important implications for musculoskeletal health. To date, this important relationship has not received as much attention by the research community. Coincidentally, there has been a heightened interest in the role of physical activity and exercise across the lifespan in the prevention, treatment and management of obesity. This paper considers some of the more common musculoskeletal problems in children, adolescents and adults with implications for the overweight and obese and their meaningful engagement in physical activity.
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Affiliation(s)
- Sarah P Shultz
- School of Sport and Exercise, Massey University, 63 Wallace Street, Mt Cook, Wellington, 6140, New Zealand.
| | - Nuala M Byrne
- Institute of Sport and Exercise, Bond University, Robina, Australia.
| | - Andrew P Hills
- Centre for Nutrition and Exercise, Mater Research Institute - The University of Queensland and Griffith Health Institute, Griffith University, Nathan, Australia.
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Croci I, Hickman IJ, Wood RE, Borrani F, Macdonald GA, Byrne NM. Fat oxidation over a range of exercise intensities: fitness versus fatness. Appl Physiol Nutr Metab 2014; 39:1352-9. [PMID: 25356842 DOI: 10.1139/apnm-2014-0144] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Maximal fat oxidation (MFO), as well as the exercise intensity at which it occurs (Fatmax), have been reported as lower in sedentary overweight individuals but have not been studied in trained overweight individuals. The aim of this study was to compare Fatmax and MFO in lean and overweight recreationally trained males matched for cardiorespiratory fitness (CRF) and to study the relationships between these variables, anthropometric characteristics, and CRF. Twelve recreationally trained overweight (high fatness (HiFat) group, 30.0% ± 5.3% body fat) and 12 lean males (low fatness (LoFat), 17.2% ± 5.7% body fat) matched for CRF (maximal oxygen consumption (V̇O2max) 39.0 ± 5.5 vs. 41.4 ± 7.6 mL·kg(-1)·min(-1), p = 0.31) and age (p = 0.93) performed a graded exercise test on a cycle ergometer. V̇O2max and fat and carbohydrate oxidation rates were determined using indirect calorimetry; Fatmax and MFO were determined with a mathematical model (SIN); and % body fat was assessed by air displacement plethysmography. MFO (0.38 ± 0.19 vs. 0.42 ± 0.16 g·min(-1), p = 0.58), Fatmax (46.7% ± 8.6% vs. 45.4% ± 7.2% V̇O2max, p = 0.71), and fat oxidation rates over a wide range of exercise intensities were not significantly different (p > 0.05) between HiFat and LoFat groups. In the overall cohort (n = 24), MFO and Fatmax were correlated with V̇O2max (r = 0.46, p = 0.02; r = 0.61, p = 0.002) but not with % body fat or body mass index (p > 0.05). Fat oxidation during exercise was similar in recreationally trained overweight and lean males matched for CRF. Consistently, substrate oxidation rates during exercise were not related to adiposity (% body fat) but were related to CRF. The benefits of high CRF independent of body weight and % body fat should be further highlighted in the management of obesity.
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Affiliation(s)
- Ilaria Croci
- a The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, St Lucia QLD 4072, Australia
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61
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Alkahtani SA, Byrne NM, Hills AP, King NA. Acute interval exercise intensity does not affect appetite and nutrient preferences in overweight and obese males. Asia Pac J Clin Nutr 2014; 23:232-8. [PMID: 24901092 DOI: 10.6133/apjcn.2014.23.2.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigated the influence of two different intensities of acute interval exercise on food preferences and appetite sensations in overweight and obese men. Twelve overweight/obese males (age=29.0±4.1 years; BMI =29.1±2.4 kg/m2) completed three exercise sessions: an initial graded exercise test, and two interval cycling sessions: moderate-(MIIT) and high-intensity (HIIT) interval exercise sessions on separate days in a counterbalanced order. The MIIT session involved cycling for 5-minute repetitions of alternate workloads 20% below and 20% above maximal fat oxidation. The HIIT session consisted of cycling for alternate bouts of 15 seconds at 85% VO2max and 15 seconds unloaded recovery. Appetite sensations and food preferences were measured immediately before and after the exercise sessions using the Visual Analogue Scale and the Liking & Wanting experimental procedure. Results indicated that liking significantly increased and wanting significantly decreased in all food categories after both MIIT and HIIT. There were no differences between MIIT and HIIT on the effect on appetite sensations and Liking & Wanting. In conclusion, manipulating the intensity of acute interval exercise did not affect appetite and nutrient preferences.
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Affiliation(s)
- Shaea A Alkahtani
- Department of Physical Education, University of Dammam, P.O. Box 2375 Dammam, 31451, Saudi Arabia.
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Hills AP, Mokhtar N, Byrne NM. Assessment of physical activity and energy expenditure: an overview of objective measures. Front Nutr 2014; 1:5. [PMID: 25988109 PMCID: PMC4428382 DOI: 10.3389/fnut.2014.00005] [Citation(s) in RCA: 271] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 05/27/2014] [Indexed: 12/15/2022] Open
Abstract
The ability to assess energy expenditure (EE) and estimate physical activity (PA) in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity), and diabetes. It is also important to appreciate that PA and EE are different constructs with PA defined as any bodily movement that results in EE and accordingly, energy is expended as a result of PA. However, total energy expenditure, best assessed using the criterion doubly labeled water (DLW) technique, includes components in addition to physical activity energy expenditure, namely resting energy expenditure and the thermic effect of food. Given the large number of assessment techniques currently used to estimate PA in humans, it is imperative to understand the relative merits of each. The goal of this review is to provide information on the utility and limitations of a range of objective measures of PA and their relationship with EE. The measures discussed include those based on EE or oxygen uptake including DLW, activity energy expenditure, physical activity level, and metabolic equivalent; those based on heart rate monitoring and motion sensors; and because of their widespread use, selected subjective measures.
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Affiliation(s)
- Andrew P Hills
- Centre for Nutrition and Exercise, Mater Research Institute, University of Queensland , South Brisbane, QLD , Australia ; Griffith Health Institute, Griffith University , Gold Coast, QLD , Australia
| | - Najat Mokhtar
- Nutritional and Health-Related Environmental Studies Section, International Atomic Energy Agency , Vienna , Austria
| | - Nuala M Byrne
- Faculty of Health Sciences and Medicine, Bond University , Gold Coast, QLD , Australia
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Kulkarni B, Kuper H, Radhakrishna KV, Hills AP, Byrne NM, Taylor A, Sullivan R, Bowen L, Wells JC, Ben-Shlomo Y, Davey Smith G, Ebrahim S, Kinra S. The association of early life supplemental nutrition with lean body mass and grip strength in adulthood: evidence from APCAPS. Am J Epidemiol 2014; 179:700-9. [PMID: 24553777 PMCID: PMC3939852 DOI: 10.1093/aje/kwt332] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In the present study, we examined the associations of early nutrition with adult lean body mass (LBM) and muscle strength in a birth cohort that was established to assess the long-term impact of a nutrition program. Participants (n = 1,446, 32% female) were born near Hyderabad, India, in 29 villages from 1987 to 1990, during which time only intervention villages (n = 15) had a government program that offered balanced protein-calorie supplementation to pregnant women and children. Participants’ LBM and appendicular skeletal muscle mass were measured using dual energy x-ray absorptiometry; grip strength and information on lifestyle indicators, including diet and physical activity level, were also obtained. Ages (mean = 20.3 years) and body mass indexes (weight (kg)/height (m)2; mean = 19.5) of participants in 2 groups were similar. Current dietary energy intake was higher in the intervention group. Unadjusted LBM and grip strength were similar in 2 groups. After adjustment for potential confounders, the intervention group had lower LBM (β = −0.75; P = 0.03), appendicular skeletal muscle mass, and grip strength than did controls, but these differences were small in magnitude (<0.1 standard deviation). Multivariable regression analyses showed that current socioeconomic position, energy intake, and physical activity level had a positive association with adult LBM and muscle strength. This study could not detect a “programming” effect of early nutrition supplementation on adult LBM and muscle strength.
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Affiliation(s)
- Bharati Kulkarni
- Correspondence to Dr. Bharati Kulkarni, Clinical Division, National Institute of Nutrition, Jamai Osmania P.O., Hyderabad 500007 India (e-mail: )
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Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Hills AP. Body weight perception and weight loss practices among Sri Lankan adults. Obes Res Clin Pract 2014; 8:e192-200. [DOI: 10.1016/j.orcp.2013.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 05/17/2013] [Accepted: 05/19/2013] [Indexed: 01/02/2023]
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Schutz Y, Byrne NM, Dulloo A, Hills AP. Energy gap in the aetiology of body weight gain and obesity: a challenging concept with a complex evaluation and pitfalls. Obes Facts 2014; 7:15-25. [PMID: 24457473 PMCID: PMC5644816 DOI: 10.1159/000357846] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 11/27/2013] [Indexed: 11/30/2022] Open
Abstract
The concept of energy gap(s) is useful for understanding the consequence of a small daily, weekly, or monthly positive energy balance and the inconspicuous shift in weight gain ultimately leading to overweight and obesity. Energy gap is a dynamic concept: an initial positive energy gap incurred via an increase in energy intake (or a decrease in physical activity) is not constant, may fade out with time if the initial conditions are maintained, and depends on the 'efficiency' with which the readjustment of the energy imbalance gap occurs with time. The metabolic response to an energy imbalance gap and the magnitude of the energy gap(s) can be estimated by at least two methods, i.e. i) assessment by longitudinal overfeeding studies, imposing (by design) an initial positive energy imbalance gap; ii) retrospective assessment based on epidemiological surveys, whereby the accumulated endogenous energy storage per unit of time is calculated from the change in body weight and body composition. In order to illustrate the difficulty of accurately assessing an energy gap we have used, as an illustrative example, a recent epidemiological study which tracked changes in total energy intake (estimated by gross food availability) and body weight over 3 decades in the US, combined with total energy expenditure prediction from body weight using doubly labelled water data. At the population level, the study attempted to assess the cause of the energy gap purported to be entirely due to increased food intake. Based on an estimate of change in energy intake judged to be more reliable (i.e. in the same study population) and together with calculations of simple energetic indices, our analysis suggests that conclusions about the fundamental causes of obesity development in a population (excess intake vs. low physical activity or both) is clouded by a high level of uncertainty.
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Affiliation(s)
- Yves Schutz
- Department of Physiology, Faculty of Medicine, University of Lausanne and University of Fribourg, Lausanne, Switzerland
- *Prof. Yves Schutz, Department of Physiology, Faculty of Medicine, University of Lausanne and University of Fribourg, Rue du Bugnon 7, 1005 Lausanne (Switzerland),
| | - Nuala M. Byrne
- Institute of Health and Biomedical Innovation, School of Human Movement Studies, Queensland University of Technology, Brisbane, Australia
| | - Abdul Dulloo
- Department of Medicine/Physiology, University of Fribourg, Switzerland
| | - Andrew P. Hills
- Centre for Nutrition and Exercise, Mater Research and Centre for Musculoskeletal Research, Mater Mothers Hospital, Griffith Health, Griffith University, Brisbane, Australia
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Schutz Y, Nguyen DMT, Byrne NM, Hills AP. Effectiveness of three different walking prescription durations on total physical activity in normal- and overweight women. Obes Facts 2014; 7:264-73. [PMID: 25137221 PMCID: PMC5644830 DOI: 10.1159/000365833] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 03/04/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE While there is a dose-response relationship between physical activity (PA) and health benefit, little is known about the effectiveness of different PA prescriptions on total daily PA. AIM To test, under real-life conditions and using an objective, non-invasive measurement technique (accelerometry), the effect of prescribing additional physical activity (walking only) of different durations (30, 60 and 90 min/day) on compliance (to the activity prescribed) and compensation (to total daily PA). Participants in each group were prescribed 5 sessions of walking per week over 4 weeks. METHODS 55 normal-weight and overweight women (mean BMI 25 ± 5 kg/m(2), height 165 ± 1 cm, weight 68 ± 2 kg and mean age 27 ± 1 years) were randomly assigned to 3 prescription groups: 30, 60 or 90 min/day PA. RESULTS Walking duration resulted in an almost linear increase in the number of steps per day during the prescription period from an average of about 10,000 steps per day for the 30-min prescription to about 14,000 for the 90-min prescription. Compliance was excellent for the 30-min prescription but decreased significantly with 60-min and 90-min prescriptions. In parallel, degree of compensation subsequent to exercise increased progressively as length of prescription increased. CONCLUSION A 30-min prescription of extra walking 5 times per week was well tolerated. However, in order to increase total PA further, much more than 60 min of walking may need to be prescribed in the majority of individuals. While total exercise 'volume' increased with prescriptions longer than 30 min, compliance to the prescription decreased and greater compensation was evident.
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Affiliation(s)
- Yves Schutz
- Department of Integrative Physiology, Medical School, University of Fribourg, Fribourg, Switzerland
- *Prof. Dr. Yves Schutz, Department of Physiology, University of Lausanne, 1005 Lausanne (Switzerland),
| | - Dac Min Tuan Nguyen
- Department of Integrative Physiology, Medical School, University of Fribourg, Fribourg, Switzerland
| | - Nuala M. Byrne
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia, Gold Coast, Australia
| | - Andrew P. Hills
- Mater Mothers’ Hospital, Mater Research Institute, University of Queensland, Brisbane, Australia, Gold Coast, Australia
- Centre for Musculoskeletal Research, Griffith Health, Griffith University, Gold Coast, Australia
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Gibson AA, Seimon RV, Byrne NM, Markovic T, Franklin J, Manson E, Denyer GS, King N, Caterson I, Sainsbury A. Comparing the compensatory responses to moderate and severe energy restrictions during the first 6 months of weight loss: The TEMPO Diet Trial. Obes Res Clin Pract 2013. [DOI: 10.1016/j.orcp.2013.12.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hastuti J, Kagawa M, Byrne NM, Hills AP. Development and validation of anthropometric prediction equations for estimation of body fat in Indonesian men. Asia Pac J Clin Nutr 2013; 22:522-9. [PMID: 24231011 DOI: 10.6133/apjcn.2013.22.4.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Body composition of 292 males aged between 18 and 65 years was measured using the deuterium oxide dilution technique. Participants were divided into development (n=146) and cross-validation (n=146) groups. Stature, body weight, skinfold thickness at eight sites, girth at five sites, and bone breadth at four sites were measured and body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) calculated. Equations were developed using multiple regression analyses with skinfolds, breadth and girth measures, BMI, and other indices as independent variables and percentage body fat (%BF) determined from deuterium dilution technique as the reference. All equations were then tested in the cross-validation group. Results from the reference method were also compared with existing prediction equations by Durnin and Womersley (1974), Davidson et al (2011), and Gurrici et al (1998). The proposed prediction equations were valid in our cross-validation samples with r=0.77- 0.86, bias 0.2-0.5%, and pure error 2.8-3.6%. The strongest was generated from skinfolds with r=0.83, SEE 3.7%, and AIC 377.2. The Durnin and Womersley (1974) and Davidson et al (2011) equations significantly (p<0.001) underestimated %BF by 1.0 and 6.9% respectively, whereas the Gurrici et al (1998) equation significantly (p<0.001) overestimated %BF by 3.3% in our cross-validation samples compared to the reference. Results suggest that the proposed prediction equations are useful in the estimation of %BF in Indonesian men.
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Affiliation(s)
- Janatin Hastuti
- Faculty of Medicine, Gadjah Mada University, Medika Street, Sleman, Yogyakarta 55281, Indonesia. ;
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Croci I, Byrne NM, Choquette S, Hills AP, Chachay VS, Clouston AD, O'Moore-Sullivan TM, Macdonald GA, Prins JB, Hickman IJ. Whole-body substrate metabolism is associated with disease severity in patients with non-alcoholic fatty liver disease. Gut 2013; 62:1625-33. [PMID: 23077135 DOI: 10.1136/gutjnl-2012-302789] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES In non-alcoholic fatty liver disease (NAFLD), hepatic steatosis is intricately linked with a number of metabolic alterations. We studied substrate utilisation in NAFLD during basal, insulin-stimulated and exercise conditions, and correlated these outcomes with disease severity. METHODS 20 patients with NAFLD (mean ± SD body mass index (BMI) 34.1 ± 6.7 kg/m(2)) and 15 healthy controls (BMI 23.4 ± 2.7 kg/m(2)) were assessed. Respiratory quotient (RQ), whole-body fat (Fat ox) and carbohydrate (CHO ox) oxidation rates were determined by indirect calorimetry in three conditions: basal (resting and fasted), insulin-stimulated (hyperinsulinaemic-euglycaemic clamp) and exercise (cycling at an intensity to elicit maximal Fat ox). Severity of disease and steatosis were determined by liver histology, hepatic Fat ox from plasma β-hydroxybutyrate concentrations, aerobic fitness expressed as VO2 peak, and visceral adipose tissue (VAT) measured by computed tomography. RESULTS Within the overweight/obese NAFLD cohort, basal RQ correlated positively with steatosis (r=0.57, p=0.01) and was higher (indicating smaller contribution of Fat ox to energy expenditure) in patients with NAFLD activity score (NAS) ≥ 5 vs <5 (p=0.008). Both results were independent of VAT, % body fat and BMI. Compared with the lean control group, patients with NAFLD had lower basal whole-body Fat ox (1.2 ± 0.3 vs 1.5 ± 0.4 mg/kg FFM/min, p=0.024) and lower basal hepatic Fat ox (ie, β-hydroxybutyrate, p=0.004). During exercise, they achieved lower maximal Fat ox (2.5 ± 1.4 vs. 5.8 ± 3.7 mg/kg FFM/min, p=0.002) and lower VO2 peak (p<0.001) than controls. Fat ox during exercise was not associated with disease severity (p=0.79). CONCLUSIONS Overweight/obese patients with NAFLD had reduced hepatic Fat ox and reduced whole-body Fat ox under basal and exercise conditions. There was an inverse relationship between ability to oxidise fat in basal conditions and histological features of NAFLD including severity of steatosis and NAS.
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Affiliation(s)
- Ilaria Croci
- The University of Queensland Diamantina Institute, University of Queensland, Brisbane, Australia
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Alkahtani SA, King NA, Hills AP, Byrne NM. Effect of interval training intensity on fat oxidation, blood lactate and the rate of perceived exertion in obese men. Springerplus 2013; 2:532. [PMID: 24255835 PMCID: PMC3824717 DOI: 10.1186/2193-1801-2-532] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/07/2013] [Indexed: 11/10/2022]
Abstract
PURPOSE The objectives of this study were to examine the effect of 4-week moderate- and high-intensity interval training (MIIT and HIIT) on fat oxidation and the responses of blood lactate (BLa) and rating of perceived exertion (RPE). METHODS Ten overweight/obese men (age = 29 ±3.7 years, BMI = 30.7 ±3.4 kg/m(2)) participated in a cross-over study of 4-week MIIT and HIIT training. The MIIT training sessions consisted of 5-min cycling stages at mechanical workloads 20% above and 20% below 45%VO2peak. The HIIT sessions consisted of intervals of 30-s work at 90%VO2peak and 30-s rest. Pre- and post-training assessments included VO2max using a graded exercise test (GXT) and fat oxidation using a 45-min constant-load test at 45%VO2max. BLa and RPE were also measured during the constant-load exercise test. RESULTS There were no significant changes in body composition with either intervention. There were significant increases in fat oxidation after MIIT and HIIT (p ≤ 0.01), with no effect of intensity. BLa during the constant-load exercise test significantly decreased after MIIT and HIIT (p ≤ 0.01), and the difference between MIIT and HIIT was not significant (p = 0.09). RPE significantly decreased after HIIT greater than MIIT (p ≤ 0.05). CONCLUSION Interval training can increase fat oxidation with no effect of exercise intensity, but BLa and RPE decreased after HIIT to greater extent than MIIT.
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Affiliation(s)
- Shaea A Alkahtani
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Australia & University of Dammam, P.O. Box 2375, Dammam, 31451 Saudi Arabia
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Abstract
BACKGROUND Identification of bacterial pathogens is paramount for prompt and effective treatment of respiratory exacerbations in children with cystic fibrosis (CF). This can be a challenge in non-expectorating patients as reliability of cough swabs (CS) is poor. More recently, cough plates (CP) have been reported to give high yields in some series. The aim of the study was to ascertain their effectiveness compared to CS and to assess the impact of cough strength on efficacy of CP. METHOD Non-expectorating children with CF aged 3-16 years were recruited. Baseline data was recorded and peak cough flow measured. Specimens were obtained with CP and a cough swab in a randomised order and repeated at up to four clinic visits to obtain multiple measurements. Subjects completed a short questionnaire. RESULTS Number of subjects was 95, mean age 8.8±4.1 years, 45 males. Mean baseline % predicted FEV1 was 90.8±18. In total, 324 sets of specimens were collected. Pathogens were isolated in 18.2% of CS and 8% of CP. Agreement between the two specimens occurred in only 5.5% of cases. CP isolated pathogens on six occasions when the CS was negative while 40 CS were positive with a corresponding negative CP. Cough strength increased with age, and there was a trend towards older children isolating more pathogens on CP. However, this was not statistically significant. The majority of subjects preferred the CP. CONCLUSIONS CP are less effective than CS in identifying respiratory pathogens in children with CF.
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Affiliation(s)
- N M Byrne
- Paediatric Respiratory Unit, Great North Children's Hospital, , Newcastle upon Tyne, UK
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Horner KM, Byrne NM, Cleghorn GJ, King NA. Reproducibility of gastric emptying in overweight and obese males. Clin Nutr 2013; 33:684-8. [PMID: 24074547 DOI: 10.1016/j.clnu.2013.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Revised: 07/19/2013] [Accepted: 09/05/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIM To understand whether any change in gastric emptying (GE) is physiologically relevant, it is important to identify its variability. Information regarding the variability of GE in overweight and obese individuals is lacking. The aim of this study was to determine the reproducibility of GE in overweight and obese males. METHODS Fifteen overweight and obese males [body mass index 30.3 (4.9) kg/m(2)] completed two identical GE tests 7 days apart. GE of a standard pancake breakfast was assessed by (13)C-octanoic acid breath test. Data are presented as mean (±SD). RESULTS There were no significant differences in GE between test days (half time (t1/2): 179 (15) and 176 (19 min), p = 0.56; lag time (tlag): 108 (14) and 104 (8) min, p = 0.26). Mean intra-individual coefficient of variation for t1/2 was 7.9% and tlag 7.5%. Based on these findings, to detect a treatment effect in a paired design with a power of 80% and α = 0.05, minimum mean effect sizes for t1/2 would need to be ≥14.4 min and tlag ≥ 8.1 min. CONCLUSIONS These data show that GE is reproducible in overweight and obese males and provide minimum mean effect sizes required to detect a hypothetical treatment effect in this population.
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Affiliation(s)
- Katy M Horner
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| | - Nuala M Byrne
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| | | | - Neil A King
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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Kulkarni B, Kuper H, Taylor A, Wells JC, Radhakrishna KV, Kinra S, Ben-Shlomo Y, Smith GD, Ebrahim S, Byrne NM, Hills AP. Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women. J Appl Physiol (1985) 2013; 115:1156-62. [PMID: 23950165 PMCID: PMC3798815 DOI: 10.1152/japplphysiol.00777.2013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Lean body mass (LBM) and muscle mass remain difficult to quantify in large epidemiological studies due to the unavailability of inexpensive methods. We therefore developed anthropometric prediction equations to estimate the LBM and appendicular lean soft tissue (ALST) using dual-energy X-ray absorptiometry (DXA) as a reference method. Healthy volunteers (n = 2,220; 36% women; age 18-79 yr), representing a wide range of body mass index (14–44 kg/m2), participated in this study. Their LBM, including ALST, was assessed by DXA along with anthropometric measurements. The sample was divided into prediction (60%) and validation (40%) sets. In the prediction set, a number of prediction models were constructed using DXA-measured LBM and ALST estimates as dependent variables and a combination of anthropometric indices as independent variables. These equations were cross-validated in the validation set. Simple equations using age, height, and weight explained >90% variation in the LBM and ALST in both men and women. Additional variables (hip and limb circumferences and sum of skinfold thicknesses) increased the explained variation by 5–8% in the fully adjusted models predicting LBM and ALST. More complex equations using all of the above anthropometric variables could predict the DXA-measured LBM and ALST accurately, as indicated by low standard error of the estimate (LBM: 1.47 kg and 1.63 kg for men and women, respectively), as well as good agreement by Bland-Altman analyses (Bland JM, Altman D.Lancet 1: 307–310, 1986). These equations could be a valuable tool in large epidemiological studies assessing these body compartments in Indians and other population groups with similar body composition.
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Affiliation(s)
- Bharati Kulkarni
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Abstract
Obesity is associated with numerous short- and long-term health consequences. Low levels of physical activity and poor dietary habits are consistent with an increased risk of obesity in an obesogenic environment. Relatively little research has investigated associations between eating and activity behaviors by using a systems biology approach and by considering the dynamics of the energy balance concept. A significant body of research indicates that a small positive energy balance over time is sufficient to cause weight gain in many individuals. In contrast, small changes in nutrition and physical activity behaviors can prevent weight gain. In the context of weight management, it may be more feasible for most people to make small compared to large short-term changes in diet and activity. This paper presents a case for the use of small and incremental changes in diet and physical activity for improved weight management in the context of a toxic obesogenic environment.
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Affiliation(s)
- Andrew P Hills
- Mater Mothers' Hospital, Mater Research and Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, South Brisbane, Brisbane, Australia.
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Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Yadav B, Hills AP. High dietary diversity is associated with obesity in Sri Lankan adults: an evaluation of three dietary scores. BMC Public Health 2013; 13:314. [PMID: 23566236 PMCID: PMC3626879 DOI: 10.1186/1471-2458-13-314] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 04/03/2013] [Indexed: 12/04/2022] Open
Abstract
Background Dietary diversity is recognized as a key element of a high quality diet. However, diets that offer a greater variety of energy-dense foods could increase food intake and body weight. The aim of this study was to explore association of diet diversity with obesity in Sri Lankan adults. Methods Six hundred adults aged > 18 years were randomly selected by using multi-stage stratified sample. Dietary intake assessment was undertaken by a 24 hour dietary recall. Three dietary scores, Dietary Diversity Score (DDS), Dietary Diversity Score with Portions (DDSP) and Food Variety Score (FVS) were calculated. Body mass index (BMI) ≥ 25 kg.m-2 is defined as obese and Asian waist circumference cut-offs were used diagnosed abdominal obesity. Results Mean of DDS for men and women were 6.23 and 6.50 (p=0.06), while DDSP was 3.26 and 3.17 respectively (p=0.24). FVS values were significantly different between men and women 9.55 and 10.24 (p=0.002). Dietary diversity among Sri Lankan adults was significantly associated with gender, residency, ethnicity, education level but not with diabetes status. As dietary scores increased, the percentage consumption was increased in most of food groups except starches. Obese and abdominal obese adults had the highest DDS compared to non obese groups (p<0.05). With increased dietary diversity the level of BMI, waist circumference and energy consumption was significantly increased in this population. Conclusion Our data suggests that dietary diversity is positively associated with several socio-demographic characteristics and obesity among Sri Lankan adults. Although high dietary diversity is widely recommended, public health messages should emphasize to improve dietary diversity in selective food items.
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Affiliation(s)
- Ranil Jayawardena
- Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
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Foxcroft KF, Callaway LK, Byrne NM, Webster J. Development and validation of a pregnancy symptoms inventory. BMC Pregnancy Childbirth 2013; 13:3. [PMID: 23324494 PMCID: PMC3599678 DOI: 10.1186/1471-2393-13-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 12/27/2012] [Indexed: 11/17/2022] Open
Abstract
Background Physical symptoms are common in pregnancy and are predominantly associated with normal physiological changes. These symptoms have a social and economic cost, leading to absenteeism from work and additional medical interventions. There is currently no simple method for identifying common pregnancy related problems in the antenatal period. A validated tool, for use by pregnancy care providers would be useful. The aim of this study was to develop and validate a Pregnancy Symptoms Inventory for use by health professionals. Methods A list of symptoms was generated via expert consultation with health professionals. Focus groups were conducted with pregnant women. The inventory was tested for face validity and piloted for readability and comprehension. For test-re-test reliability, the tool was administered to the same women 2 to 3 days apart. Finally, midwives trialled the inventory for 1 month and rated its usefulness on a 10cm visual analogue scale (VAS). Results A 41-item Likert inventory assessing how often symptoms occurred and what effect they had, was developed. Individual item test re-test reliability was between .51 to 1, the majority (34 items) scoring ≥0.70. The top four “often” reported symptoms were urinary frequency (52.2%), tiredness (45.5%), poor sleep (27.5%) and back pain (19.5%). Among the women surveyed, 16.2% claimed to sometimes or often be incontinent. Referrals to the incontinence nurse increased > 8 fold during the study period. Conclusions The PSI provides a comprehensive inventory of pregnancy related symptoms, with a mechanism for assessing their effect on function. It was robustly developed, with good test re-test reliability, face validity, comprehension and readability. This provides a validated tool for assessing the impact of interventions in pregnancy.
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Affiliation(s)
- Katie F Foxcroft
- Department of Internal Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Australia
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Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Hills AP. Prevalence, trends and associated socio-economic factors of obesity in South Asia. Obes Facts 2013; 6:405-14. [PMID: 24107686 PMCID: PMC5644757 DOI: 10.1159/000355598] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 12/31/2012] [Indexed: 01/13/2023] Open
Abstract
AIM Worldwide obesity levels have increased unprecedentedly over the past couple of decades. Although the prevalence, trends and associated socio-economic factors of the condition have been extensively reported in Western populations, less is known regarding South Asian populations. METHODS A review of articles using Medline with combinations of the MeSH terms: 'Obesity', 'Overweight' and 'Abdominal Obesity' limiting to epidemiology and South Asian countries. RESULTS Despite methodological heterogeneity and variation according to country, area of residence and gender , the most recent nationally representative and large regional data demonstrates that without any doubt there is a epidemic of obesity, overweight and abdominal obesity in South Asian countries. Prevalence estimates of overweight and obesity (based on Asian cut-offs: overweight ≥ 23 kg/m², obesity ≥ 25 kg/m²) ranged from 3.5% in rural Bangladesh to over 65% in the Maldives. Abdominal obesity was more prevalent than general obesity in both sexes in this ethnic group. Countries with the lowest prevalence had the highest upward trend of obesity. Socio-economic factors associated with greater obesity in the region included female gender, middle age, urban residence, higher educational and economic status. CONCLUSION South Asia is significantly affected by the obesity epidemic. Collaborative public health interventions to reverse these trends need to be mindful of many socio-economic constraints in order to provide long-term solutions.
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Affiliation(s)
- Ranil Jayawardena
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- Diabetes Research Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- *Dr. Ranil Jayawardena, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland 4059 (Australia),
| | - Nuala M. Byrne
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Mario J. Soares
- Curtin Health Innovation Research Institute, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Prasad Katulanda
- Diabetes Research Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Andrew P. Hills
- Mater Mother's Hospital, Mater Medical Research Institute and Griffith Health Institute, Griffith University, Brisbane, Queensland, Australia
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Affiliation(s)
- Ranil Jayawardena
- Queensland University of Technology, Brisbane, Queensland, Australia University of Colombo, Colombo, Sri Lanka
| | - Nuala M Byrne
- Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Andrew P Hills
- Mater Mother's Hospital and Medical Research Institute, Griffith Health Institute, Griffith University
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Jayawardena R, Swaminathan S, Byrne NM, Soares MJ, Katulanda P, Hills AP. Development of a food frequency questionnaire for Sri Lankan adults. Nutr J 2012; 11:63. [PMID: 22937734 PMCID: PMC3496639 DOI: 10.1186/1475-2891-11-63] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 08/27/2012] [Indexed: 12/29/2022] Open
Abstract
Background Food Frequency Questionnaires (FFQs) are commonly used in epidemiologic studies to assess long-term nutritional exposure. Because of wide variations in dietary habits in different countries, a FFQ must be developed to suit the specific population. Sri Lanka is undergoing nutritional transition and diet-related chronic diseases are emerging as an important health problem. Currently, no FFQ has been developed for Sri Lankan adults. In this study, we developed a FFQ to assess the regular dietary intake of Sri Lankan adults. Methods A nationally representative sample of 600 adults was selected by a multi-stage random cluster sampling technique and dietary intake was assessed by random 24-h dietary recall. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. We constructed a comprehensive food list with the units of measurement. A stepwise regression method was used to identify foods contributing to a cumulative 90% of variance to total energy and macronutrients. In addition, a series of photographs were included. Results We obtained dietary data from 482 participants and 312 different food items were recorded. Nutritionists grouped similar food items which resulted in a total of 178 items. After performing step-wise multiple regression, 93 foods explained 90% of the variance for total energy intake, carbohydrates, protein, total fat and dietary fibre. Finally, 90 food items and 12 photographs were selected. Conclusion We developed a FFQ and the related nutrient composition database for Sri Lankan adults. Culturally specific dietary tools are central to capturing the role of diet in risk for chronic disease in Sri Lanka. The next step will involve the verification of FFQ reproducibility and validity.
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Affiliation(s)
- Ranil Jayawardena
- Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
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80
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Jayawardena R, Ranasinghe P, Byrne NM, Soares MJ, Katulanda P, Hills AP. Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis. BMC Public Health 2012; 12:380. [PMID: 22630043 PMCID: PMC3447674 DOI: 10.1186/1471-2458-12-380] [Citation(s) in RCA: 170] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 05/07/2012] [Indexed: 01/28/2023] Open
Abstract
Background Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic) and ‘Epidemology/EP’ (MeSH subheading). Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years). The conjunction of the above results was narrowed down with country names. Results The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural), India–4.6%:12.5% (2007;Rural); Maldives–3.0%:3.7% (2004;National), Nepal–19.5%:9.5% (2007;Urban), Pakistan–3.0%:7.2% (2002;Rural), Sri Lanka–11.5%:10.3% (2005–2006;National). Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%), while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%). Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .
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Affiliation(s)
- Ranil Jayawardena
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
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81
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Byrne NM, Groves AM, McIntyre HD, Callaway LK. Reply to M-A Gaud et al. Am J Clin Nutr 2012. [DOI: 10.3945/ajcn.111.028290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Nuala M Byrne
- School of Human Movement Studies, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove Q4059, Brisbane, Australia
| | - Ainsley M Groves
- School of Human Movement Studies, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove Q4059, Brisbane, Australia
| | - H David McIntyre
- School of Medicine, University of Queensland, Brisbane, Australia
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Abstract
The gastrointestinal tract plays an important role in the improved appetite control and weight loss in response to bariatric surgery. Other strategies which similarly alter gastrointestinal responses to food intake could contribute to successful weight management. The aim of this review is to discuss the effects of surgical, pharmacological and behavioural weight loss interventions on gastrointestinal targets of appetite control, including gastric emptying. Gastrointestinal peptides are also discussed because of their integrative relationship in appetite control. This review shows that different strategies exert diverse effects and there is no consensus on the optimal strategy for manipulating gastric emptying to improve appetite control. Emerging evidence from surgical procedures (e.g. sleeve gastrectomy and Roux-en-Y gastric bypass) suggests a faster emptying rate and earlier delivery of nutrients to the distal small intestine may improve appetite control. Energy restriction slows gastric emptying, while the effect of exercise-induced weight loss on gastric emptying remains to be established. The limited evidence suggests that chronic exercise is associated with faster gastric emptying, which we hypothesize will impact on appetite control and energy balance. Understanding how behavioural weight loss interventions (e.g. diet and exercise) alter gastrointestinal targets of appetite control may be important to improve their success in weight management.
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Affiliation(s)
- K M Horner
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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83
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Zulu RM, Byrne NM, Munthali GK, Chipeta J, Handema R, Musonda M, Hills AP. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs. BMC Public Health 2011; 11:714. [PMID: 21936938 PMCID: PMC3188494 DOI: 10.1186/1471-2458-11-714] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 09/21/2011] [Indexed: 11/24/2022] Open
Abstract
Background Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). Methods/Design This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. Discussion This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Trial Registration Pan African Clinical Trial Registry PACTR201108000303396.
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Affiliation(s)
- Rodah M Zulu
- Mater Mother's Hospital, Mater Medical Research Institute, Raymond Terrace, South Brisbane, QLD, Australia
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84
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Byrne NM, Groves AM, McIntyre HD, Callaway LK. Changes in resting and walking energy expenditure and walking speed during pregnancy in obese women. Am J Clin Nutr 2011; 94:819-30. [PMID: 21795438 DOI: 10.3945/ajcn.110.009399] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Energy-conserving processes reported in undernourished women during pregnancy are a recognized strategy for providing the energy required to support fetal development. Women who are obese before conceiving arguably have sufficient fat stores to support the energy demands of pregnancy without the need to provoke energy-conserving mechanisms. OBJECTIVE We tested the hypothesis that obese women would show behavioral adaptation [ie, a decrease in self-selected walking (SSW) speed] but not metabolic compensation [ie, a decrease in resting metabolic rate (RMR) or the metabolic cost of walking] during gestation. DESIGN RMR, SSW speed, metabolic cost of walking, and anthropometric variables were measured in 23 women aged 31 ± 4 y with a BMI (in kg/m(2)) of 33.6 ± 2.5 (mean ± SD) at ≈15 and 30 wk of gestation. RMR was also measured in 2 cohorts of nonpregnant control subjects matched for the age, weight, and height of the pregnant cohort at 15 (n = 23) and 30 (n = 23) wk. RESULTS Gestational weight gain varied widely (11.3 ± 5.4 kg), and 52% of the women gained more weight than is recommended. RMR increased significantly by an average of 177 ± 176 kcal/d (11 ± 12%; P < 0.0001); however, the within-group variability was large. Both the metabolic cost of walking and SSW speed decreased significantly (P < 0.01). Whereas RMR increased in >80% of the cohort, the net oxygen cost of walking decreased in the same proportion of women. CONCLUSION Although the increase in RMR was greater than that explained by weight gain, evidence of both behavioral and biological compensation in the metabolic cost of walking was observed in obese women during gestation. The trial is registered with the Australian Clinical Trials Registry as ACTRN012606000271505.
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Affiliation(s)
- Nuala M Byrne
- School of Human Movement Studies, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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85
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Alahmadi MA, Hills AP, King NA, Byrne NM. Exercise intensity influences nonexercise activity thermogenesis in overweight and obese adults. Med Sci Sports Exerc 2011; 43:624-31. [PMID: 21412111 DOI: 10.1249/mss.0b013e3181f7a0cb] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to determine the effect of acute bouts of moderate- and high-intensity walking exercise on nonexercise activity thermogenesis (NEAT) in overweight and obese adults. METHODS Sixteen participants performed a single bout of either moderate-intensity walking exercise (MIE) or high-intensity walking exercise (HIE) on two separate occasions. The MIE consisted of walking for 60 min on a motorized treadmill at 6 km·h(-1). The 60-min HIE session consisted of walking in 5-min intervals at 6 km·h(-1) and 10% grade followed by 5 min at 0% grade. NEAT was assessed by accelerometer 3 d before, on the day of, and 3 d after the exercise sessions. RESULTS There was no significant difference in NEAT vector magnitude (counts per minute) between the preexercise period (days 1-3) and the exercise day (day 4) for either the MIE or the HIE protocol. In addition, there was no change in NEAT during the 3 d after the MIE session; however, NEAT increased by 16% on day 7 (postexercise) compared with the exercise day (P = 0.32). However, during the postexercise period after the HIE session, NEAT was increased by 25% on day 7 compared with the exercise day (P = 0.08) and by 30%-33% compared with the preexercise period (days 1, 2, and 3; P = 0.03, 0.03, and 0.02, respectively). CONCLUSION A single bout of either MIE or HIE did not alter NEAT on the exercise day or on the first 2 d after the exercise session. However, monitoring NEAT on a third day allowed the detection of a 48-h delay in increased NEAT after performing HIE. A longer-term intervention is needed to determine the effect of accumulated exercise sessions over a week on NEAT.
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Affiliation(s)
- Mohammad A Alahmadi
- School of Human Movement Studies, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
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86
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Liu A, Byrne NM, Ma G, Nasreddine L, Trinidad TP, Kijboonchoo K, Ismail MN, Kagawa M, Poh BK, Hills AP. Validation of bioelectrical impedance analysis for total body water assessment against the deuterium dilution technique in Asian children. Eur J Clin Nutr 2011; 65:1321-7. [DOI: 10.1038/ejcn.2011.122] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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87
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Liu A, Byrne NM, Kagawa M, Ma G, Kijboonchoo K, Nasreddine L, Koon Poh B, Ismail MN, Hills AP. Ethnic differences in body fat distribution among Asian pre-pubertal children: a cross-sectional multicenter study. BMC Public Health 2011; 11:500. [PMID: 21703012 PMCID: PMC3146863 DOI: 10.1186/1471-2458-11-500] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 06/26/2011] [Indexed: 01/06/2023] Open
Abstract
Background Ethnic differences in body fat distribution contribute to ethnic differences in cardiovascular morbidities and diabetes. However few data are available on differences in fat distribution in Asian children from various backgrounds. Therefore, the current study aimed to explore ethnic differences in body fat distribution among Asian children from four countries. Methods A total of 758 children aged 8-10 y from China, Lebanon, Malaysia and Thailand were recruited using a non-random purposive sampling approach to enrol children encompassing a wide BMI range. Height, weight, waist circumference (WC), fat mass (FM, derived from total body water [TBW] estimation using the deuterium dilution technique) and skinfold thickness (SFT) at biceps, triceps, subscapular, supraspinale and medial calf were collected. Results After controlling for height and weight, Chinese and Thai children had a significantly higher WC than their Lebanese and Malay counterparts. Chinese and Thais tended to have higher trunk fat deposits than Lebanese and Malays reflected in trunk SFT, trunk/upper extremity ratio or supraspinale/upper extremity ratio after adjustment for age and total body fat. The subscapular/supraspinale skinfold ratio was lower in Chinese and Thais compared with Lebanese and Malays after correcting for trunk SFT. Conclusions Asian pre-pubertal children from different origins vary in body fat distribution. These results indicate the importance of population-specific WC cut-off points or other fat distribution indices to identify the population at risk of obesity-related health problems.
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Affiliation(s)
- Ailing Liu
- Griffith Health Institute, Griffith University and Mater Mother's Hospital, Mater Medical Research Institute, Australia.
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88
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King NA, Horner K, Hills AP, Byrne NM, Wood RE, Bryant E, Caudwell P, Finlayson G, Gibbons C, Hopkins M, Martins C, Blundell JE. Exercise, appetite and weight management: understanding the compensatory responses in eating behaviour and how they contribute to variability in exercise-induced weight loss. Br J Sports Med 2011; 46:315-22. [DOI: 10.1136/bjsm.2010.082495] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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89
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Shultz SP, Byrne NM, Dahiya R, Leong GM, Hills AP. Resistance Weight Training Affects Body Composition in Obese Adolescents: A Pilot Study. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000402324.63726.2c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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90
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Foxcroft KF, Rowlands IJ, Byrne NM, McIntyre HD, Callaway LK. Exercise in obese pregnant women: the role of social factors, lifestyle and pregnancy symptoms. BMC Pregnancy Childbirth 2011; 11:4. [PMID: 21226958 PMCID: PMC3025919 DOI: 10.1186/1471-2393-11-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 01/12/2011] [Indexed: 12/16/2022] Open
Abstract
Background Physical activity may reduce the risk of adverse maternal outcomes, yet there are very few studies that have examined the correlates of exercise amongst obese women during pregnancy. We examined which relevant sociodemographic, obstetric, and health behaviour variables and pregnancy symptoms were associated with exercise in a small sample of obese pregnant women. Methods This was a secondary analysis using data from an exercise intervention for the prevention of gestational diabetes in obese pregnant women. Using the Pregnancy Physical Activity Questionnaire (PPAQ), 50 obese pregnant women were classified as "Exercisers" if they achieved ≥900 kcal/wk of exercise and "Non-Exercisers" if they did not meet this criterion. Analyses examined which relevant variables were associated with exercise status at 12, 20, 28 and 36 weeks gestation. Results Obese pregnant women with a history of miscarriage; who had children living at home; who had a lower pre-pregnancy weight; reported no nausea and vomiting; and who had no lower back pain, were those women who were most likely to have exercised in early pregnancy. Exercise in late pregnancy was most common among tertiary educated women. Conclusions Offering greater support to women from disadvantaged backgrounds and closely monitoring women who report persistent nausea and vomiting or lower back pain in early pregnancy may be important. The findings may be particularly useful for other interventions aimed at reducing or controlling weight gain in obese pregnant women.
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Affiliation(s)
- Katie F Foxcroft
- Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, (Butterfield St), Brisbane, (4029), Australia.
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91
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Hunter GR, Bickel CS, Del Corral P, Byrne NM, Hills AP, Larson-Meyer DE, Bamman MM, Newcomer BR. Age, muscle fatigue, and walking endurance in pre-menopausal women. Eur J Appl Physiol 2010; 111:715-23. [PMID: 20972575 DOI: 10.1007/s00421-010-1694-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2010] [Indexed: 12/01/2022]
Abstract
Aging is associated with loss of endurance; however, aging is also associated with decreased fatigue during maximal isometric contractions. The aims of this study were to examine the relationship between age and walking endurance (WE) and maximal isometric fatigue (MIF) and to determine which metabolic/fitness components explain the expected age effects on WE and MIF. Subjects were 96 pre-menopausal women. Oxygen uptake (walking economy) was assessed during a 3-mph walk; aerobic capacity and WE by progressive treadmill test; knee extension strength by isometric contractions, MIF during a 90-s isometric plantar flexion (muscle metabolism measured by (31)P MRS). Age was related to increased walking economy (low VO(2), r = -0.19, P < 0.03) and muscle metabolic economy (force/ATP, 0.34, P = 0.01), and reduced MIF (-0.26, P < 0.03). However, age was associated with reduced WE (-0.28, P < 0.01). Multiple regression showed that muscle metabolic economy explained the age-related decrease in MIF (partial r for MIF and age -0.13, P = 0.35) whereas walking economy did not explain the age-related decrease in WE (partial r for WE and age -0.25, P < 0.02). Inclusion of VO(2max) and knee endurance strength accounted for the age-related decreased WE (partial r for WE and age = 0.03, P > 0.80). In premenopausal women, age is related to WE and MIF. In addition, these results support the hypothesis that age-related increases in metabolic economy may decrease MIF. However, decreased muscle strength and oxidative capacity are related to WE.
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Affiliation(s)
- Gary R Hunter
- Department of Human Studies, University of Alabama at Birmingham, 901 South 13th Street, Birmingham, AL 35294-1250, USA.
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92
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Abstract
In both developed and developing countries, increased prevalence of obesity has been strongly associated with increased incidence of type 2 diabetes mellitus (T2DM) in the adult population. Previous research has emphasized the importance of physical activity in the prevention and management of obesity and T2DM, and generic exercise guidelines originally developed for the wider population have been adapted for these specific populations. However, the guidelines traditionally focus on aerobic training without due consideration to other exercise modalities. Recent reviews on resistance training in the T2DM population have not compared this modality with others including aerobic training, or considered the implications of resistance training for individuals suffering from both obesity and T2DM. In short, the optimal mix of exercise modalities in the prescription of exercise has not been identified for it benefits to the metabolic, body composition and muscular health markers common in obesity and T2DM. Similarly, the underlying physical, social and psychological barriers to adopting and maintaining exercise, with the potential to undermine the efficacy of exercise interventions, have not been addressed in earlier reviews. Because it is well established that aerobic exercise has profound effects on obesity and T2DM risk, the purpose of this review was to address the importance of resistance training to obese adults with T2DM.
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Affiliation(s)
- A P Hills
- School of Human Movement Studies, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Astralia
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93
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Alahmadi MA, Hills AP, King NA, Byrne NM. The effect of exercise training intensity on fat oxidation in overweight/obese men. Obes Res Clin Pract 2010. [DOI: 10.1016/j.orcp.2010.09.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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94
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Abstract
The purpose of this study was to compare the amount of exercise prescribed with the amount completed between two different modes of training intervention and between the sexes. Thirty-two men (mean age = 39.1 years, body mass index = 32.9 kg x m(-2)) and women (mean age = 39.6 years, body mass index = 32.1 kg x m(-2)) were prescribed traditional resistance training or light-resistance circuit training for 16 weeks. Lean mass and fat mass were determined by dual-energy X-ray absorptiometry at weeks 1 and 16. A completion index was calculated to provide a measure of the extent to which participants completed exercise training relative to the amount of exercise prescribed. The absolute amount of exercise completed by the circuit training group was significantly greater than the amount prescribed (P < 0.0001). The resistance training group consistently under-completed relative to the amount prescribed, but the difference was not significant. The completion index for the circuit training group (26 +/- 21.7%) was significantly different from that of the resistance training group (-7.4 +/- 3.0%). The completion index was not significantly different between men and women in either group. These data suggest that overweight and obese individuals participating in light-resistance circuit training complete more exercise than is prescribed. Men and women do not differ in the extent to which they over- or under-complete prescribed exercise.
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Affiliation(s)
- Neil King
- Institute of Health and Biomedical Innovation, School of Human Movement Studies, Queensland University of Technology, Brisbane, QLD, Australia.
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95
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Callaway LK, Colditz PB, Byrne NM, Lingwood BE, Rowlands IJ, Foxcroft K, McIntyre HD. Prevention of gestational diabetes: feasibility issues for an exercise intervention in obese pregnant women. Diabetes Care 2010; 33:1457-9. [PMID: 20357374 PMCID: PMC2890340 DOI: 10.2337/dc09-2336] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the feasibility of an individualized exercise program to prevent gestational diabetes mellitus (GDM) in obese pregnant women. RESEARCH DESIGN AND METHODS The study was a pilot randomized controlled trial with obese pregnant women (intervention group, individualized exercise program [n = 25]; control group, usual care [n = 25]). Average weekly energy expenditure (MET hours per week and kilocalories per week) of exercise-specific activity was assessed during pregnancy using the Pregnancy Physical Activity Questionnaire. Fasting glucose and insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed at baseline and 20, 28, and 36 weeks' gestation. RESULTS Of the women in the intervention group, 16 of 22 (73%) achieved more than 900 kcal/week of exercise-based activity at 28 weeks compared with 8 of 19 women in the control group (42%), P = 0.047. However, insulin resistance (HOMA-IR) did not differ between the groups. CONCLUSION This intervention was feasible and prompted a modest increase in physical activity. However, we are not confident that this intervention would be sufficient to prevent GDM.
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Affiliation(s)
- Leonie K Callaway
- Royal Brisbane Clinical School, Royal Brisbane and Women's Hospital, Brisbane, Australia.
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96
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Colley RC, Hills AP, King NA, Byrne NM. Exercise-induced energy expenditure: implications for exercise prescription and obesity. Patient Educ Couns 2010; 79:327-332. [PMID: 20392589 DOI: 10.1016/j.pec.2010.03.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 03/03/2010] [Accepted: 03/04/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Walking is commonly recommended to help with weight management. We measured total energy expenditure (TEE) and its components to quantify the impact of increasing exercise-induced energy expenditure (ExEE) on other components of TEE. METHODS Thirteen obese women underwent an 8-week walking group intervention. TEE was quantified using doubly labeled water, ExEE was quantified using heart rate monitors, daily movement was assessed by accelerometry and resting metabolic rate was measured using indirect calorimetry. RESULTS Four of the 13 participants achieved the target of 1500kcalwk(-1) of ExEE and all achieved 1000kcalwk(-1). The average ExEE achieved by the group across the 8 weeks was 1434+/-237kcalwk(-1). Vigorous physical activity, as assessed by accelerometry, increased during the intervention by an average of 30min per day. Non-exercise activity thermogenesis (NEAT) decreased, on average, by 175kcald(-1) (-22%) from baseline to the intervention and baseline fitness was correlated with change in NEAT. CONCLUSIONS Potential alterations in non-exercise activity should be considered when exercise is prescribed. The provision of appropriate education on how to self-monitor daily activity levels may improve intervention outcomes in groups who are new to exercise. PRACTICE IMPLICATIONS Strategies to sustain incidental and light physical activity should be offered to help empower individuals as they develop and maintain healthy and long-lasting lifestyle habits.
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Affiliation(s)
- Rachel C Colley
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
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97
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Abstract
PURPOSE The purpose of this study was to determine whether adiposity affects the attainment of (.)VO2max. METHODS Sixty-seven male and 68 female overweight (body mass index (BMI) = 25-29.9 kg.m) and obese (BMI > or = 30 kg x m) participants undertook a graded treadmill test to volitional exhaustion (phase 1) followed by a verification test (phase 2) to determine the proportion who could achieve a plateau in (.)VO2 and other "maximal" markers (RER, lactate, HR, RPE). RESULTS At the end of phase 1, 46% of the participants reached a plateau in (.)VO2, 83% increased HR to within 11 beats of age-predicted maximum, 89% reached an RER of > or = 1.15, 70% reached a blood lactate concentration of > or = 8 mmol x L, and 74% reached an RPE of > or = 18. No significant differences between genders and between BMI groups were found with the exception of blood lactate concentration (males = 84% vs females = 56%, P < 0.05). Neither gender nor fatness predicted the number of other markers attained, and attainment of other markers did not differentiate whether a (.)VO2 plateau was achieved. The verification test (phase 2) revealed that an additional 52 individuals (39%) who did not exhibit a plateau in (.)VO2 in phase 1 had no further increase in (.)VO2 in phase 2 despite an increase in workload. CONCLUSIONS These findings indicate that the absence of a plateau in (.)VO2 alone is not indicative of a failure to reach a true maximal (.)VO2 and that individuals with excessive body fat are no less likely than "normal-weight" individuals to exhibit a plateau in (.)VO2 provided that the protocol is appropriate and encouragement to exercise to maximal exertion is provided.
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Affiliation(s)
- Rachel E Wood
- School of Human Movement Studies and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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98
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Amorim PR, Byrne NM, Hills AP. Indirect Techniques To Measure Energy Expenditure In Children: Validation By Doubly Labelled Water. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000386504.21975.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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99
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Alahmadi MA, Hills AP, King NA, Byrne NM. The Reliability of a Discontinuous FATmax Protocol to Determine Maximal Fat Oxidation in Overweight/Obese Adults. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000385400.61269.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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100
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Abstract
The purpose of this study was to determine what effect aerobic and resistance exercise training has on gain of visceral fat during the year following weight loss. After being randomly assigned to aerobic training, resistance training, or no exercise training, 45 European-American (EA) and 52 African-American (AA) women lost 12.3 +/- 2.5 kg on a 800 kcal/day diet. Computed tomography was used to measure abdominal subcutaneous and visceral adipose tissue, whereas total fat and regional fat (leg, arm, and trunk) were measured by dual energy X-ray absorptiometry after weight loss and 1 year following the weight loss. Because not all the subjects adhered to the 2 time/week 40 min/day exercise training during the 1-year follow-up, subjects were divided into five groups for analysis: aerobic adherers, aerobic nonadherers, resistance adherers, resistance nonadherers, and no exercise. No significant differences were observed between the aerobic training and resistance training adherers for any variable. However, the aerobic (3.1 kg) and resistance (3.9 kg) exercise adherers gained less weight than any of the other three groups (all >6.2 kg). In addition, the two exercise adherence groups did not significantly increase visceral fat (<0.8%) as compared with the 38% increase for the two nonadhering exercise groups and the 25% for the nonexercise group. In conclusion, as little as 80 min/week aerobic or resistance training had modest positive effects on preventing weight regain following a diet-induced weight loss. More importantly, both aerobic and resistance training prevented regain of potentially harmful visceral fat.
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Affiliation(s)
- Gary R Hunter
- Department of Human Studies, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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