Exercise-induced suppression of acylated ghrelin in humans

Exercise-trained men and women: role of exercise and diet on appetite and energy intake

The regulation of appetite and energy intake is influenced by numerous hormonal and neural signals, including feedback from changes in diet and exercise. Exercise can suppress subjective appetite ratings, subsequent energy intake, and alter appetite-regulating hormones, including ghrelin, peptide YY, and glucagon-like peptide 1(GLP-1) for a period of time post-exercise. Discrepancies in the degree of appetite suppression with exercise may be dependent on subject characteristics (e.g., body fatness, fitness level, age or sex) and exercise duration, intensity, type and mode. Following an acute bout of exercise, exercise-trained males experience appetite suppression, while data in exercise-trained women are limited and equivocal. Diet can also impact appetite, with low-energy dense diets eliciting a greater sense of fullness at a lower energy intake. To date, little research has examined the combined interaction of exercise and diet on appetite and energy intake. This review focuses on exercise-trained men and women and examines the impact of exercise on hormonal regulation of appetite, post-exercise energy intake, and subjective and objective measurements of appetite. The impact that low-energy dense diets have on appetite and energy intake are also addressed. Finally, the combined effects of high-intensity exercise and low-energy dense diets are examined. This research is in exercise-trained women who are often concerned with weight and body image issues and consume low-energy dense foods to keep energy intakes low. Unfortunately, these low-energy intakes can have negative health consequences when combined with high-levels of exercise. More research is needed examining the combined effect of diet and exercise on appetite regulation in fit, exercise-trained individuals.

Acute changes in substrate oxidation do not affect short-term food intake in healthy boys and men

The acute relationship between substrate oxidation as measured by respiratory exchange ratio (RER) and food intake (FI) has not been defined. The purpose of the study was to determine acute relationships between RER, modified by exercise and a glucose load, and FI and net energy balance (NEB) in physically active normal-weight boys and men. In a crossover design, 15 boys (aged 9-12 years) and 15 men (aged 20-30 years) were randomly assigned to 4 conditions: (i) water and rest, (ii) glucose-drink and rest, (iii) water and exercise, and (iv) glucose-drink and exercise. Indirect calorimetry was used to determine RER, energy expenditure, and carbohydrate and fat oxidation. Subjective appetite and blood glucose were also measured. RER was higher after glucose (0.91 ± 0.01) compared with water (0.87 ± 0.01) (p < 0.0001), and after exercise (0.91 ± 0.01) compared with rest (0.88 ± 0.01) (p = 0.0043) in men (0.91 ± 0.01) compared with boys (0.88 ± 0.01) (p = 0.0002). FI (kcal·m(-2)) did not differ between boys and men. Glucose (582 ± 24 kcal·m(-2)) reduced FI compared with water (689 ± 25 kcal·m(-2)) (p < 0.0001), and further decreased FI when combined with exercise (554 ± 34 kcal·m(-2)) (p = 0.0303). NEB was reduced with exercise (573 ± 25 kcal·m(-2)) compared with the sedentary condition (686 ± 24 kcal·m(-2)) (p < 0.0001), but was higher after the glucose drink (654 ± 27 kcal·m(-2)) compared with water (605 ± 25 kcal·m(-2)) (p = 0.0267). No correlations were found between RER and FI or NEB in boys and men, except in the control condition of resting with water. In conclusion, the short-term modification of substrate oxidation by glucose and/or exercise in normal weight and active boys and men did not affect FI and NEB.

Caffeine consumption around an exercise bout: effects on energy expenditure, energy intake, and exercise enjoyment

Combining an exercise and nutritional intervention is arguably the optimal method of creating energy imbalance for weight loss. This study sought to determine whether combining exercise and caffeine supplementation was more effective for promoting acute energy deficits and manipulations to substrate metabolism than exercise alone. Fourteen recreationally active participants (mean ± SD body mass index: 22.7 ± 2.6 kg/m2) completed a resting control trial (CON), a placebo exercise trial (EX), and a caffeine exercise trial (EX+CAF, 2 × 3 mg/kg of caffeine 90 min before and 30 min after exercise) in a randomized, double-blinded design. Trials were 4 h in duration with 1 h of rest, 1 h of cycling at ∼65% power at maximum O2 consumption or rest, and a 2-h recovery. Gas exchange, appetite perceptions, and blood samples were obtained periodically. Two hours after exercise, participants were offered an ad libitum test meal where energy and macronutrient intake were recorded. EX+CAF resulted in significantly greater energy expenditure and fat oxidation compared with EX (+250 kJ; +10.4 g) and CON (+3,126 kJ; +29.7 g) (P < 0.05). A trend for reduced energy and fat intake compared with CON (-718 kJ; -8 g) (P = 0.055) was observed. Consequently, EX+CAF created a greater energy deficit (P < 0.05). Caffeine also led to exercise being perceived as less difficult and more enjoyable (P < 0.05). Combining caffeine with exercise creates a greater acute energy deficit, and the implications of this protocol for weight loss or maintenance over longer periods of time in overweight/obese populations should be further investigated.

A randomized trial to manipulate the quality instead of quantity of dietary proteins to influence the markers of satiety

AIMS

To test whether a breakfast including eggs (EB) containing high-quality protein decreases subsequent food intake and increases satiety-related hormones in overweight or obese adults more than a breakfast including cereal (CB) of lower protein quality, but matched for energy density and macronutrient composition.

METHODS

Twenty healthy overweight or obese subjects were randomized to eat an EB or a CB daily under supervision for one week, followed by a crossover to the opposite breakfast week after a two-week washout period. On days 1 and 7 of each test week, a structured lunch was provided ad libitum. Food intake, hunger and satiety scores, and blood parameters were measured before and after breakfast. Outcomes were analyzed using mixed effects statistical models for repeated measures analysis of variance.

RESULTS

Compared to the CB week, during the EB week, a) feeling of fullness was greater (P<0.05) on day 1 but not on day 7; b) energy intake was not significantly lower on either day; c) right before lunch, acylated ghrelin was lower and PYY3-36 was higher on day 1 (P<0.01 and <0.002, respectively) but not on day 7; d) PYY3-36, but not ghrelin, showed greater rise between breakfast and lunch on days 1(P<0.001) and 7(P<0.01).

CONCLUSION

Despite a highly similar energy density and macronutrient composition, the higher protein quality breakfast significantly influenced fullness, ghrelin and PYY3-36. Only the effect on PYY3-36 lasted throughout the week. A next step would be to test if the benefits are pronounced and lasting, if protein quality of all meals is increased.

Effect of acute and regular exercise on growth hormone secretagogue receptor-1a expression in human lymphocytes, T cell subpopulation and monocytes

The orexigenic peptide hormone ghrelin exerts potent inhibitory effects on pro-inflammatory cytokine release via the growth hormone secretagogue receptor-1a (GHS-R1a) on T cells and monocytes. As such, ghrelin is a promising therapeutic agent for the treatment of inflammatory conditions, but these effects depend on the availability of GHS-R1a. The aim of this study was to determine the effect of acute exercise on GHS-R1a expression on circulating CD14+ monocytes, total lymphocytes and CD3+ T cells. Nine male club-standard cyclists cycled for 1h at 75% V̇O2peak (EX) or rested (REST) in a randomised cross-over design. Compared with the equivalent times in REST, the concentration of circulating GHS-R1a+ lymphocytes and monocytes was higher in EX at immediately and 1 and 2h post-exercise (all p<.05). The concentration of CD3+GHS-R1a+ cells was higher in EX than in REST immediately post-exercise only (258 (203)cellsμl(-1) vs. 62 (42)cellsμl(-1), p<.05). Density of GHS-R1a receptor expression was unaffected by trial or time. Comparison of active participants at rest with 7 age-, sex- and BMI-matched sedentary controls revealed a higher concentration of GHS-R1a+ lymphocytes in active males (p<.05). These findings suggest a preferential recruitment of specific cell subpopulations expressing GHS-R1a into the peripheral circulation with acute and regular exercise. Given that the anti-inflammatory effects of ghrelin depend on the availability of GHS-R1a, the preferential recruitment of subpopulations with high anti-inflammatory potential found here add a novel aspect to the potential mechanisms by which exercise acts to reduce pro-inflammatory cytokine levels.

Appetite and gut peptide responses to exercise and calorie restriction. The effect of modest energy deficits

Weight loss is the result of a sustained negative energy balance, which is typically achieved by decreasing food intake and/or increasing physical activity. Current evidence suggests that acute energy deficits of ~4820 kJ elicit contrasting homeostatic responses when induced by exercise and food restriction but the response to government-recommended energy deficits is unknown. Twelve healthy men (mean(SD): age 24(5) years, body mass index 23.8(2.7) kg⋅m(-2), maximum oxygen uptake 55.4(9.1) mL⋅kg(-1)⋅min(-1)) completed three 8 h trials (control (Con), exercise-induced energy deficit (Ex-Def) and food restriction (Food-Def)) separated by 1 week. Thirty minutes of cycling at 64.5(3.2)% of maximum oxygen uptake was performed in Ex-Def from 0 to 0.5 h, which induced an energy deficit of 1469(256) kJ. An equivalent energy deficit was induced in Food-Def (1478(275) kJ) by reducing the energy content of standardised test meals at 1 h and 4 h. Appetite ratings, acylated ghrelin and peptide YY3-36 concentrations were measured throughout each trial. An ad libitum meal was provided at 7 h. Appetite was higher in Food-Def than Ex-Def from 4 to 8 h (P = 0.033) and tended to be higher across the entire 8 h trial (P = 0.059). However, energy intake at the ad libitum meal did not differ between trials (P = 0.634; Con 4376 (1634); Food-Def 4481 (1846); Ex-Def 4217 (1850) kJ). Acylated ghrelin was not related to changes in appetite but plasma PYY3-36 concentrations were higher in Ex-Def than Food-Def (P < 0.05) and negatively correlated with changes in appetite across the entire 8 h trial (P = 0.037). An energy deficit of ~1475 kJ stimulated compensatory increases in appetite when induced via calorie restriction but not when achieved by an acute bout of exercise. Appetite responses were associated with changes in plasma PYY3-36 but not acylated ghrelin concentrations and did not influence subsequent energy intake.

Creating an acute energy deficit without stimulating compensatory increases in appetite: is there an optimal exercise protocol?

Recent years have witnessed significant interest from both the scientific community and the media regarding the influence of exercise on subsequent appetite and energy intake responses. This review demonstrates a consensus among the majority of scientific investigations that an acute bout of land-based endurance exercise does not stimulate any compensatory increases in appetite and energy intake on the day of exercise. Alternatively, preliminary evidence suggests that low volume, supramaximal exercise may stimulate an increase in appetite perceptions during the subsequent hours. In accordance with the apparent insensitivity of energy intake to exercise in the short term, the daily energy balance response to exercise appears to be primarily determined by the energy cost of exercise. This finding supports the conclusions of recent training studies that the energy expenditure of exercise is the strongest predictor of fat loss during an exercise programme.

The effects of high-intensity exercise on neural responses to images of food

BACKGROUND

Acute bouts of high-intensity exercise modulate peripheral appetite regulating hormones to transiently suppress hunger. However, the effects of physical activity on central appetite regulation have yet to be fully investigated.

OBJECTIVE

We used functional magnetic resonance imaging (fMRI) to compare neural responses to visual food stimuli after intense exercise and rest.

DESIGN

Fifteen lean healthy men [mean ± SD age: 22.5 ± 3.1 y; mean ± SD body mass index (in kg/m(2)): 24.2 ± 2.4] completed two 60-min trials-exercise (EX; running at ∼70% maximum aerobic capacity) and a resting control trial (REST)-in a counterbalanced order. After each trial, an fMRI assessment was completed in which images of high- and low-calorie foods were viewed.

RESULTS

EX significantly suppressed subjective appetite responses while increasing thirst and core-body temperature. Furthermore, EX significantly suppressed ghrelin concentrations and significantly enhanced peptide YY release. Neural responses to images of high-calorie foods significantly increased dorsolateral prefrontal cortex activation and suppressed orbitofrontal cortex (OFC) and hippocampus activation after EX compared with REST. After EX, low-calorie food images increased insula and putamen activation and reduced OFC activation compared with REST. Furthermore, left pallidum activity was significantly elevated after EX when low-calorie images were viewed and was suppressed when high-calorie images were viewed, and these responses correlated significantly with thirst.

CONCLUSIONS

Exercise increases neural responses in reward-related regions of the brain in response to images of low-calorie foods and suppresses activation during the viewing of high-calorie foods. These central responses are associated with exercise-induced changes in peripheral signals related to appetite-regulation and hydration status. This trial was registered at www.clinicaltrials.gov as NCT01926431.

Appetite after rope skipping may differ between males and females

SUMMARY

BACKGROUND

When previously sedentary males and females follow the same exercise training programs with ad libitum feeding, males reduced body mass, but females do not, which suggests that females may increase appetite in response to exercise training compared with males. Rope skipping is traditional exercise modality that everyone had experienced during elementary school years in Japan. The purpose of this study was to determine whether there is a sex difference on appetite after acute rope skipping exercise.

METHODS AND RESULTS

Thirteen healthy young males (22.5 ± 0.8 years, 172.2 ± 1.7 cm, 68.8 ± 2.3 kg, 18.4 ± 0.9%) and 13 females (22.9 ± 0.8 years, 160.6 ± 1.5 cm, 52.9 ± 1.6 kg, 25.0 ± 1.0%) participated in this study. Subjects consumed their lunch by 13:00, and performed a total of 20 min rope skipping exercise (2 sets × 10 min with 5 min interval) from 16:00. In females, appetite significantly increased from immediately after the exercise to 30 min after the exercise (from 13 mm to 30 mm), but remained unchanged in males. Although heart rate, ratings of perceived exertion, and lactate concentrations increased from baseline to immediately after exercise, there were no differences in the increase between males and females. Blood glucose concentrations at baseline and 30 min after exercise were higher in females than in males.

CONCLUSION

These results indicated that rope skipping exercise induces an increase in appetite in females, but not in males. This increased appetite in females after the rope skipping exercise was induced without change in blood glucose concentrations.

Appetite sensations and substrate metabolism at rest, during exercise, and recovery: impact of a high-calcium meal

The aim of this study was to investigate the effects of the calcium content of a high-carbohydrate, pre-exercise meal on substrate metabolism and appetite sensations before, during, and after exercise. Nine active males participated in 2 trials in a double-blind, randomised, crossover design. After consuming a high carbohydrate (1.5 g·kg−1 of body mass) breakfast with a calcium content of either 3 (control trial) or 9 mg·kg−1 of body mass (high milk-calcium (CAL)), participants ran at 60% peak oxygen uptake for 60 min. Following exercise, a recovery drink was consumed and responses were investigated for a further 90 min. Blood and expired gas were sampled throughout to determine circulating substrate and hormone concentrations and rates of substrate oxidation. Visual analogue scales were also administered to determine subjective appetite sensations. Neither whole-body lipid oxidation nor non-esterified fatty acid availability differed between trials. The area under the curve for the first hour following breakfast consumption was 16% (95% confidence interval: 0%–35%) greater for fullness and 10% (95% confidence interval: 2%–19%) greater for insulin in the CAL trial but these differences were transient and not apparent later in the trial. This study demonstrates that increasing the calcium content of a high carbohydrate meal transiently increases insulinemia and fullness but substrate metabolism is unaffected.

Appetite regulation in overweight, sedentary men after different amounts of endurance exercise: a randomized controlled trial

Weight loss induced by endurance exercise is often disappointing, possibly due to an increase in energy intake mediated through greater appetite. The aim of this study was to evaluate fasting, postprandial, and postexercise appetite regulation after an intervention prescribing two amounts of endurance exercise. Sixty-four sedentary, overweight, healthy young men were randomized to control (CON), moderate-dose (MOD: ∼30 min/day), or high-dose (HIGH: ∼60 min/day) endurance exercise for 12 wk. Along with subjective appetite ratings, plasma ghrelin, glucagon, insulin, peptide YY3–36, glucose, free fatty acids, and glycerol were measured during fasting and in relation to a breakfast meal and an acute bout of exercise, both at baseline and at follow-up. Ad libitum lunch energy intake was evaluated 3 h after the breakfast meal. Despite different amounts of endurance exercise, the subjects lost similar amounts of fat mass (MOD: 4.2 ± 0.5 kg; HIGH: 3.7 ± 0.5 kg). Fasting and postprandial insulin decreased ∼20% in both exercise groups ( P < 0.03 vs. CON). Appetite measurements were not upregulated in the fasting and postprandial states. On the contrary, fasting and postprandial ratings of fullness and postprandial PYY3–36 increased in HIGH ( P < 0.001 vs. CON). Ad libitum lunch energy intake remained unchanged over the course of the intervention. In both exercise groups, plasma ghrelin increased in relation to acute exercise after training. Thus neither moderate nor high doses of daily endurance exercise increased fasting and postprandial measures of appetite, but a high dose of exercise was associated with an increase in fasting and meal-related ratings of fullness and satiety.

Seven transmembrane G protein-coupled receptor repertoire of gastric ghrelin cells

The molecular mechanisms regulating secretion of the orexigenic-glucoregulatory hormone ghrelin remain unclear. Based on qPCR analysis of FACS-purified gastric ghrelin cells, highly expressed and enriched 7TM receptors were comprehensively identified and functionally characterized using in vitro, ex vivo and in vivo methods. Five Gαs-coupled receptors efficiently stimulated ghrelin secretion: as expected the β1-adrenergic, the GIP and the secretin receptors but surprisingly also the composite receptor for the sensory neuropeptide CGRP and the melanocortin 4 receptor. A number of Gαi/o-coupled receptors inhibited ghrelin secretion including somatostatin receptors SSTR1, SSTR2 and SSTR3 and unexpectedly the highly enriched lactate receptor, GPR81. Three other metabolite receptors known to be both Gαi/o- and Gαq/11-coupled all inhibited ghrelin secretion through a pertussis toxin-sensitive Gαi/o pathway: FFAR2 (short chain fatty acid receptor; GPR43), FFAR4 (long chain fatty acid receptor; GPR120) and CasR (calcium sensing receptor). In addition to the common Gα subunits three non-common Gαi/o subunits were highly enriched in ghrelin cells: GαoA, GαoB and Gαz. Inhibition of Gαi/o signaling via ghrelin cell-selective pertussis toxin expression markedly enhanced circulating ghrelin. These 7TM receptors and associated Gα subunits constitute a major part of the molecular machinery directly mediating neuronal and endocrine stimulation versus metabolite and somatostatin inhibition of ghrelin secretion including a series of novel receptor targets not previously identified on the ghrelin cell.

Acute aerobic exercise differentially alters acylated ghrelin and perceived fullness in normal-weight and obese individuals

Adiposity alters acylated ghrelin concentrations, but it is unknown whether adiposity alters the effect of exercise and feeding on acylated ghrelin responses. Therefore, the purpose of this study was to determine whether adiposity [normal-weight (NW) vs. obese (Ob)] influences the effect of exercise and feeding on acylated ghrelin, hunger, and fullness. Fourteen NW and 14 Ob individuals completed two trials in a randomized counterbalanced fashion, including a prior exercise trial (EX) and a no exercise trial (NoEX). During the EX trial, the participants performed 1 h of treadmill walking (55–60% peak O2 uptake) during the evening, 12 h before a 4-h standardized mixed meal test. Frequent blood samples were taken and analyzed for acylated ghrelin, and a visual analog scale was used to assess perceived hunger and fullness. In NW individuals, EX, compared with NoEX, reduced fasting acylated ghrelin concentrations by 18% ( P = 0.03), and, in response to feeding, the change in acylated ghrelin ( P = 0.02) was attenuated by 39%, but perceived hunger and fullness were unaltered. In Ob individuals, despite no changes in fasting or postprandial acylated ghrelin concentrations with EX, postprandial fullness was attenuated by 46% compared with NoEX ( P = 0.05). In summary, exercise performed the night before a meal suppresses acylated ghrelin concentrations in NW individuals without altering perceived hunger or fullness. In Ob individuals, despite no changes in acylated ghrelin concentrations, EX reduced the fullness response to the test meal. Acylated ghrelin and perceived fullness responses are differently altered by acute aerobic exercise in NW and Ob individuals.

Impaired postprandial fullness in Type 2 diabetic subjects is rescued by acute exercise independently of total and acylated ghrelin

Ghrelin levels are suppressed in obese subjects and subjects with Type 2 diabetes mellitus (T2DM). Exercise-stimulated decreases in plasma ghrelin are a proposed mediator of exercise-induced satiety in healthy subjects. However, exercise-induced satiety and the impact of impaired ghrelin levels in obesity-related disease are poorly understood. Therefore our objective was to investigate exercise-induced postprandial satiety and ghrelin responses in overweight subjects with T2DM ( N = 8) and healthy controls ( N = 7). Visual analog scale satiety questionnaires (assessing hunger, thirst, food that could be eaten, nausea, and fullness) and circulating levels of glucose, insulin, and total and acylated ghrelin were measured at baseline and in response to a 75 g oral glucose load, provided immediately after an aerobic exercise bout (1 h at 50% Wmax) or no exercise (rest trial), on two separate occasions. Baseline levels of total (284.4 ± 15.9 and 397.6 ± 35.2 pmol/l) and acylated ghrelin (7.9 ± 1.0 and 13.7 ± 1.2 pmol/l) were lower in subjects with T2DM compared with healthy subjects ( P < 0.05). In the rest trial, post- vs. preprandial feeling of fullness increased in healthy subjects but decreased in subjects with T2DM (healthy vs. T2DM; P < 0.05). Exercise increased postprandial fullness in the T2DM group ( P < 0.05), while plasma ghrelin levels were unaffected. Our data suggest that the presence of T2DM likely drives suppressed ghrelin levels and poor appetite regulation, but a single exercise bout is sufficient to restore oral glucose-induced fullness independently of ghrelin.

Meal induced gut hormone secretion is altered in aerobically trained compared to sedentary young healthy males

Postprandial insulin release is lower in healthy aerobically trained (T) compared to untrained (UT) individuals. This may be mediated by a lower release of the two incretin hormones [glucagon like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)] in T. The aim of this study was to assess and compare gut hormone response and satiety changes after a liquid meal intake in young, healthy T and UT males. Postprandial gut hormone release and subjective feelings of hunger, satiety, fullness and prospective food consumption were assessed before and frequently for the following 3 h after a 200 ml liquid meal (1,260 kJ and 27, 41 and 32 energy % as protein, carbohydrates and fat, respectively) in ten T and ten UT young, healthy male subjects. The insulin and GIP responses were markedly lower in T than UT and correlated during the first 30 min after the liquid meal. Baseline GLP-1 concentration was higher in T versus UT, but the response in the following 3 h after a liquid meal was similar in T and UT. Satiety measures did not differ between groups throughout the test. It is possible that in aerobically T subjects, a lower GIP release is partly responsible for a lower postprandial incretin stimulated insulin secretion.

High-intensity intermittent exercise attenuates ad-libitum energy intake

OBJECTIVE

To examine the acute effects of high-intensity intermittent exercise (HIIE) on energy intake, perceptions of appetite and appetite-related hormones in sedentary, overweight men.

DESIGN

Seventeen overweight men (body mass index: 27.7±1.6 kg m(-2); body mass: 89.8±10.1 kg; body fat: 30.0±4.3%; VO(2peak): 39.2±4.8 ml kg(-1) min(-1)) completed four 30-min experimental conditions using a randomised counterbalanced design. CON: resting control, MC: continuous moderate-intensity exercise (60% VO(2peak)), HI: high-intensity intermittent exercise (alternating 60 s at 100% VO(2peak) and 240 s at 50% VO(2peak)), VHI: very-high-intensity intermittent exercise (alternating 15 s at 170% VO(2peak) and 60 s at 32% VO(2peak)). Participants consumed a standard caloric meal following exercise/CON and an ad-libitum meal 70 min later. Capillary blood was sampled and perceived appetite assessed at regular time intervals throughout the session. Free-living energy intake and physical activity levels for the experimental day and the day after were also assessed.

RESULTS

Ad-libitum energy intake was lower after HI and VHI compared with CON (P=0.038 and P=0.004, respectively), and VHI was also lower than MC (P=0.028). Free-living energy intake in the subsequent 38 h remained less after VHI compared with CON and MC (P≤0.050). These observations were associated with lower active ghrelin (P≤0.050), higher blood lactate (P≤0.014) and higher blood glucose (P≤0.020) after VHI compared with all other trials. Despite higher heart rate and ratings of perceived exertion (RPE) during HI and VHI compared with MC (P≤0.004), ratings of physical activity enjoyment were similar between all the exercise trials (P=0.593). No differences were found in perceived appetite between trials.

CONCLUSIONS

High-intensity intermittent exercise suppresses subsequent ad-libitum energy intake in overweight inactive men. This format of exercise was found to be well tolerated in an overweight population.

Exercise and ghrelin. A narrative overview of research

Since its discovery in 1999, ghrelin has been implicated in a multiplicity of physiological activities. Most notably, ghrelin has an important influence on energy metabolism and after the identification of its potent appetite stimulating effects ghrelin has been termed the 'hunger hormone'. Exercise is a stimulus which has a significant impact on energy homeostasis and consequently a substantial body of research has investigated the interaction between exercise and ghrelin. This narrative review provides an overview of research relating to the acute and chronic effects of exercise on circulating ghrelin (acylated, unacylated and total). To enhance study comparability, the scope of this review is limited to research undertaken in adult humans and consequently studies involving children and animals are not discussed. Although there is significant ambiguity within much of the early research, our review suggests that acute exercise transiently interferes with the production of acylated ghrelin. Furthermore, the consensus of evidence indicates that exercise training does not influence circulating ghrelin independent of weight loss. Additional research is needed to verify and extend the available literature, particularly by uncovering the mechanisms governing acute exercise-related changes and characterising responses in other populations such as females, older adults, and the obese.

Influence of netball-based exercise on energy intake, subjective appetite and plasma acylated ghrelin in adolescent girls

This study explored 5-day regulation of exercise-induced energy expenditure, energy intake, and hormonal appetite, via acylated ghrelin, after acute exercise. Using a randomized crossover design, 10 female adolescents (13-15 years old) completed two 7-day treatment weeks (2 days of maintenance, 1 day of treatment, and a 4-day follow-up), interspersed with a 1-week period. On day 3, 47 min of netball-based exercise or sedentary activity was imposed with a test meal 1 h later. Measures of energy expenditure, subjective appetite, test meal energy intake, plasma acylated ghrelin, insulin, and glucose were taken during this period. Energy intake compensation for the exercise period was calculated. Four-day follow-up measures were daily subjective appetite, energy intake, energy expenditure, and energy balance. Girls felt more full 20 min during the netball-based exercise bout compared with sedentary activity (87 ± 15 mm vs. 75 ± 24 mm). An energy intake compensation of 27% was identified for the netball-based exercise. Compared with immediately before exercise or sedentary activity, plasma acylated ghrelin was elevated 45 min after netball (103.8 ± 56.9 pg·mL(-1) vs. 85.7 ± 26.9 pg·mL(-1); n = 7) and sedentary activity (98.2 ± 27.1 pg·mL(-1) vs. 60.8 ± 33.5 pg·mL(-1); n = 7) but not different between treatments. Adolescent girls (13-15 years old) only partially compensated for the netball-based exercise-induced energy expenditure. The effect of exercise on appetite needs to be further explored in adolescents, whereby nutritional behaviour is tracked for more than 1 week to investigate full compensation for acute exercise.

Energy compensation after an aerobic exercise session in high-fat/low-fit and low-fat/high-fit young male subjects

There is general agreement that exercise-induced energy expenditure is not entirely compensated for at the next meal or over the following 24 h, but inter-individual variability is high. The role of ‘fatness and fitness’ in this variability has never been assessed. Therefore, eighteen non-obese male subjects aged 22·2 (sd2·0) years were selected and separated into a ‘high-fatness and low-fitness’ (Hfat/Lfit,n9) and a ‘low-fatness and high-fitness’ (Lfat/Hfit,n9) group, according to three criteria: maximal oxygen uptake; weekly hours of physical activity; fat mass index. At 1 h before lunch, they were subjected to 60 min of exercise on a cycle ergometer (70 % VO2max), or stayed at rest. Then, they self-reported food intake in diaries until the next breakfast. Intake at lunch was not different between conditions, but was higher after exercise than after rest over the 24 h, leading to a significant but partial mean level of compensation of 49·8 (sem16·5) and 37·8 (sem24·6) % for the Hfat/Lfit and Lfat/Hfit groups, respectively. Energy compensation at lunch and over the 24 h were strongly correlated (r0·76,P< 0·001). Both groups consumed more fat and protein after exercise than after rest over the 24 h, but the percentage of energy derived from fat increased only in the Hfat/Lfit group (2·1 (sem0·6) %,P= 0·026). Thus, the energy cost of an aerobic exercise session was partially compensated over the next 24 h independently of the ‘fatness and fitness’ status, but ‘high-fat and low-fit’ individuals compensated more specifically on fats.

The Interaction Between Exercise, Appetite, and Food Intake

Exercise could indirectly affect body weight by exerting changes on various components of appetite control, including nutrient and taste preferences, meal size and frequency, and the drive to eat. This review summarizes the evidence on how exercise affects appetite and eating behavior and in particular answers the question, “Does exercise induce an increase in food intake to compensate for the increase in energy expenditure?” Evidence will be presented to demonstrate that there is no automatic increase in food intake in response to acute exercise and that the response to repeated exercise is variable. The review will also identify areas of further study required to explain the variability. One limitation with studies that assess the efficacy of exercise as a method of weight control is that only mean data are presented—the individual variability tends to be overlooked. Recent evidence highlights the importance of characterizing the individual variability by demonstrating exercise-induced changes in appetite. Individuals who experience lower than theoretically predicted reductions in body weight can be characterized by hedonic (eg, pleasure) and homeostatic (eg, hunger) features.

Role of resting metabolic rate and energy expenditure in hunger and appetite control: a new formulation

A long-running issue in appetite research concerns the influence of energy expenditure on energy intake. More than 50 years ago, Otto G. Edholm proposed that “the differences between the intakes of food [of individuals] must originate in differences in the expenditure of energy”. However, a relationship between energy expenditure and energy intake within any one day could not be found, although there was a correlation over 2 weeks. This issue was never resolved before interest in integrative biology was replaced by molecular biochemistry. Using a psychobiological approach, we have studied appetite control in an energy balance framework using a multi-level experimental system on a single cohort of overweight and obese human subjects. This has disclosed relationships between variables in the domains of body composition [fat-free mass (FFM), fat mass (FM)], metabolism, gastrointestinal hormones, hunger and energy intake. In this Commentary, we review our own and other data, and discuss a new formulation whereby appetite control and energy intake are regulated by energy expenditure. Specifically, we propose that FFM (the largest contributor to resting metabolic rate), but not body mass index or FM, is closely associated with self-determined meal size and daily energy intake. This formulation has implications for understanding weight regulation and the management of obesity.

The effects of diet- and diet plus exercise-induced weight loss on basal metabolic rate and acylated ghrelin in grade 1 obese subjects

BACKGROUND

Diet and exercise are often prescribed as primary intervention regarding obesity-related disorders. Additionally, recent studies have shown beneficial effects of weight loss through diet and exercise in ghrelin concentrations in obese subjects. The aim of this study was to evaluate the effects of a 5% weight loss on lipid profile, resting metabolic rate (RMR), and acylated ghrelin (AG) using two different methods of intervention (diet or diet plus exercise).

MATERIALS AND METHODS

Eighteen subjects (twelve women and six men) aged 20-40 years with a body mass index of 30-34.9 kg/m(2) (grade 1 obesity) were randomized into two intervention groups: diet (n=9) or diet plus exercise (n=9). Both groups underwent treatment until 5% of the initial body weight was lost. At baseline and upon completion, RMR and AG were analyzed.

RESULTS

Both groups showed a significant decrease in body fat percentage and fat mass. The diet-plus-exercise group showed a decrease in AG (pre: 54.4±25.3 pg/mL and post: 33.2±19.1 pg/mL) and an increase in RMR (pre: 1,363±379 kcal/day, post: 1,633±223 kcal/day).

CONCLUSION

These data suggest that diet plus exercise induced weight loss and had beneficial effects on AG concentration and RMR, essential factors to ensure the benefits of a weight-loss program.

Effects of acute exercise on appetite hormones and ad libitum energy intake in men and women

Acute exercise suppresses relative energy intake; however, it remains unclear whether this occurs in both men and women exposed to the same relative exercise treatment. Eleven healthy men (22 ± 2 years; 16% ± 6% body fat (BF); 26 ± 4 body mass index (BMI); 42.9 ± 6.5 mL·kg–1·min–1 peak oxygen consumption ([Formula: see text]O2peak)) and 10 healthy women (21 ± 2 years; 24 ± 2 BMI; 23% ± 3% BF; 39.9 ± 5.5 mL·kg–1·min–1 [Formula: see text]O2peak) rested for 60 min or exercised on a cycle ergometer at 70% [Formula: see text]O2peak until 30% of total daily energy expenditure was expended (men, expenditure = 975 ± 195 kcal in 82 ± 13 min; women, expenditure = 713 ± 86 kcal in 84 ± 17 min) in a counterbalanced, crossover fashion. Appetite hormones and appetite ratings were assessed in response to each condition. Forty minutes after both conditions, ad libitum total and relative energy intake (energy intake minus energy cost of exercise) were assessed at a buffet meal. There was no significant sex or condition effect in appetite hormones (PYY3-36, acylated ghrelin, insulin) and appetite ratings (hunger, satisfaction, fullness). Total energy intake in men was significantly higher (P < 0.05) in exercise and rest conditions (1648 ± 950, 1216 ± 633 kcal, respectively) compared with women (591 ± 183, 590 ± 231 kcal, respectively). Relative energy intake was significantly lower (P < 0.05) after exercise compared with rest in men (672 ± 827, 1133 ± 619 kcal, respectively) and women (−121 ± 243, 530 ± 233 kcal, respectively). These data highlight the effectiveness of acute exercise to suppress relative energy intake regardless of sex.

The influence of vigorous running and cycling exercise on hunger perceptions and plasma acylated ghrelin concentrations in lean young men

Vigorous running suppresses plasma acylated ghrelin concentrations but the limited literature on cycling suggests that acylated ghrelin is unchanged, perhaps because body mass is supported during cycling. It is important from a research and applied perspective to determine whether acylated ghrelin and hunger responses are exercise-mode specific. This study sought to examine this. Eleven recreationally active males fasted overnight and completed three 4-h trials: control, running, and cycling, in a random order. Participants rested throughout the control trial and ran or cycled at 70% of mode-specific maximal oxygen uptake for the first hour during exercise trials, resting thereafter. Hunger was measured every 0.5 h using visual analogue scales. Eight venous blood samples were collected to determine acylated ghrelin concentrations and a standardised meal was consumed at 3 h. Compared with the control trial, acylated ghrelin concentrations were suppressed to a similar extent at 0.5 and 1 h during the running (p < 0.005) and cycling (p < 0.001) trials. Area under the curve values for ghrelin concentration over time were lower during exercise trials versus control (Control: 606 ± 379; Running: 455 ± 356; Cycling: 448 ± 315 pg·mL(-1)·4 h(-1); mean ± SD, p < 0.05). Hunger values did not differ significantly between trials but an interaction effect (p < 0.05) indicated a tendency for hunger to be suppressed during exercise. Thus, at similar relative exercise intensities, plasma acylated ghrelin concentrations are suppressed to a similar extent during running and cycling.

Daily energy balance in children and adolescents. Does energy expenditure predict subsequent energy intake?

Both physical and sedentary activities primarily impact energy balance through energy expenditure, but they also have important implications in term of ingestive behavior. The literature provides scarce evidence on the relationship between daily activities and subsequent nutritional adaptations in children and adolescents. Sedentary activities and physical exercise are generally considered distinctly despite the fact that they represent the whole continuum of daily activity-induced energy expenditure. This brief review paper examines the impact of daily activities (from vigorous physical activity to imposed sedentary behaviors) on acute energy intake control of lean and obese children and adolescents, and whether energy expenditure is the main predictor of subsequent energy intake in this population. After an overview of the available literature, we conclude that both acute physical activity and sedentary behaviors induce food consumption modifications in children and adolescents but also that the important discrepancy between the methodologies used does not allow any clear conclusion so far. When considering energy intake responses according to the level of energy expenditure generated by those activities, it is clear that energy expenditure is not the main predictor of food consumption in both lean and obese children and adolescents. This suggests that other characteristics of those activities may have a greater impact on calorie intake (such as intensity, duration or induced mental stress) and that energy intake may be mainly determined by non-homeostatic pathways that could override the energetic and hormonal signals.

Appetite regulation in response to sitting and energy imbalance

The impact of sitting and energy imbalance on appetite and appetite-regulating hormones (acylated ghrelin and leptin) was assessed in response to 1 day of sitting, with and without changes in energy intake. Fourteen men and women completed each of three 24-h conditions: high energy expenditure (standing) with energy balance (STAND), low energy expenditure (sitting) with energy surplus (SIT), and sitting with energy balance (SIT-BAL). Ghrelin, leptin, and appetite were measured in the fasted state and following a standardized meal. In the fasted state, there were no differences among conditions. Following the meal, ghrelin was lower in SIT than in STAND, with no change in appetite. When intake was reduced (SIT-BAL), the decrease in ghrelin when sitting was attenuated, hunger increased, and fullness decreased. SIT led to lower ghrelin concentrations in the men, whereas in the women, leptin increased. SIT-BAL led to an increase in ghrelin in the men but attenuated the leptin response, reduced ghrelin, increased hunger, and decreased fullness in the women. Because a dramatic reduction in energy expenditure was not accompanied by reduced appetite, prolonged sitting may promote excess energy intake, leading to weight gain in both men and women.

Aerobic exercise reduces neuronal responses in food reward brain regions

Acute exercise suppresses ad libitum energy intake, but little is known about the effects of exercise on food reward brain regions. After an overnight fast, 30 (17 men, 13 women), healthy, habitually active (age = 22.2 ± 0.7 yr, body mass index = 23.6 ± 0.4 kg/m(2), Vo(2peak) = 44.2 ± 1.5 ml·kg(-1)·min(-1)) individuals completed 60 min of exercise on a cycle ergometer or 60 min of rest (no-exercise) in a counterbalanced, crossover fashion. After each condition, blood oxygen level-dependent responses to high-energy food, low-energy food, and control visual cues, were measured by functional magnetic resonance imaging. Exercise, compared with no-exercise, significantly (P < 0.005) reduced the neuronal response to food (high and low food) cues vs. control cues in the insula (-0.37 ± 0.13 vs. +0.07 ± 0.18%), putamen (-0.39 ± 0.10 vs. -0.10 ± 0.09%), and rolandic operculum (-0.37 ± 0.17 vs. 0.17 ± 0.12%). Exercise alone significantly (P < 0.005) reduced the neuronal response to high food vs. control and low food vs. control cues in the inferior orbitofrontal cortex (-0.94 ± 0.33%), insula (-0.37 ± 0.13%), and putamen (-0.41 ± 0.10%). No-exercise alone significantly (P < 0.005) reduced the neuronal response to high vs. control and low vs. control cues in the middle (-0.47 ± 0.15%) and inferior occipital gyrus (-1.00 ± 0.23%). Exercise reduced neuronal responses in brain regions consistent with reduced pleasure of food, reduced incentive motivation to eat, and reduced anticipation and consumption of food. Reduced neuronal response in these food reward brain regions after exercise is in line with the paradigm that acute exercise suppresses subsequent energy intake.

Influence of rest and exercise at a simulated altitude of 4,000 m on appetite, energy intake, and plasma concentrations of acylated ghrelin and peptide YY

The reason for high altitude anorexia is unclear but could involve alterations in the appetite hormones ghrelin and peptide YY (PYY). This study examined the effect of resting and exercising in hypoxia (12.7% O2; ∼4,000 m) on appetite, energy intake, and plasma concentrations of acylated ghrelin and PYY. Ten healthy males completed four, 7-h trials in an environmental chamber in a random order. The four trials were control-normoxia, control-hypoxia, exercise-normoxia, and exercise-hypoxia. During exercise trials, participants ran for 60 min at 70% of altitude-specific maximal oxygen consumption (V̇o2max) and then rested. Participants rested throughout control trials. A standardized meal was consumed at 2 h and an ad libitum buffet meal at 5.5 h. Area under the curve values for hunger (assessed using visual analog scales) tended to be lower during hypoxic trials than normoxic trials (repeated-measures ANOVA, P = 0.07). Ad libitum energy intake was lower ( P = 0.001) in hypoxia (5,291 ± 2,189 kJ) than normoxia (7,718 ± 2,356 kJ; means ± SD). Mean plasma acylated ghrelin concentrations were lower in hypoxia than normoxia (82 ± 66 vs. 100 ± 69 pg/ml; P = 0.005) while PYY concentrations tended to be higher in normoxia (32 ± 4 vs. 30 ± 3 pmol/l; P = 0.059). Exercise suppressed hunger and acylated ghrelin and increased PYY but did not influence ad libitum energy intake. These findings confirm that hypoxia suppresses hunger and food intake. Further research is required to determine if decreased concentrations of acylated ghrelin orchestrate this suppression.

Nutritional behavior of cyclists during a 24-hour team relay race: a field study report

Background

Information about behavior of energy intake in ultra-endurance cyclists during a 24-hour team relay race is scarce. The nutritional strategy during such an event is an important factor which athletes should plan carefully before the race. The purpose of this study was to examine and compare the nutritional intake of ultra-endurance cyclists during a 24-hour team relay race with the current nutritional guidelines for endurance events. Additionally, we analyzed the relationship among the nutritional and performance variables.

Methods

Using a observational design, nutritional intake of eight males (mean ± SD: 36.7 ± 4.7 years; 71.6 ± 4.9 kg; 174.6 ± 7.3 cm; BMI 23.5 ± 0.5 kg/m²) participating in a 24-hour team relay cycling race was assessed. All food and fluid intake by athletes were weighed and recorded. Additionally, distance and speed performed by each rider were also recorded. Furthermore, before to the race, all subjects carried out an incremental exercise test to determine two heart rate-VO₂ regression equations which were used to estimate the energy expenditure.

Results

The mean ingestion of macronutrients during the event was 943 ± 245 g (13.1 ± 4.0 g/kg) of carbohydrates, 174 ± 146 g (2.4 ± 1.9 g/kg) of proteins and 107 ± 56 g (1.5 ± 0.7 g/kg) of lipids, respectively. This amount of nutrients reported an average nutrient intake of 22.8 ± 8.9 MJ which were significantly lower compared with energy expenditure 42.9 ± 6.8 MJ (P = 0.012). Average fluid consumption corresponded to 10497 ± 2654 mL. Mean caffeine ingestion was 142 ± 76 mg. Additionally, there was no relationship between the main nutritional variables (i.e. energy intake, carbohydrates, proteins, fluids and caffeine ingestion) and the main performance variables (i.e. distance and speed).

Conclusions

A 24-hour hours cycling competition in a team relay format elicited high energy demands which were not compensated by energy intake of the athletes despite that dietary consumption of macronutrients did not differ to the nutritional guidelines for longer events.

Circadian system, sleep and endocrinology

Levels of numerous hormones vary across the day and night. Such fluctuations are not only attributable to changes in sleep/wakefulness and other behaviors but also to a circadian timing system governed by the suprachiasmatic nucleus of the hypothalamus. Sleep has a strong effect on levels of some hormones such as growth hormone but little effect on others which are more strongly regulated by the circadian timing system (e.g., melatonin). Whereas the exact mechanisms through which sleep affects circulating hormonal levels are poorly understood, more is known about how the circadian timing system influences the secretion of hormones. The suprachiasmatic nucleus exerts its influence on hormones via neuronal and humoral signals but it is now also apparent that peripheral tissues contain circadian clock proteins, similar to those in the suprachiasmatic nucleus, that are also involved in hormone regulation. Under normal circumstances, behaviors and the circadian timing system are synchronized with an optimal phase relationship and consequently hormonal systems are exquisitely regulated. However, many individuals (e.g., shift-workers) frequently and/or chronically undergo circadian misalignment by desynchronizing their sleep/wake and fasting/feeding cycle from the circadian timing system. Recent experiments indicate that circadian misalignment has an adverse effect on metabolic and hormonal factors such as circulating glucose and insulin. Further research is needed to determine the underlying mechanisms that cause the negative effects induced by circadian misalignment. Such research could aid the development of novel countermeasures for circadian misalignment.

Combined effects of aerobic exercise and high-carbohydrate meal on plasma acylated ghrelin and levels of hunger

The present study investigated the effect of an aerobic exercise bout associated with a high-carbohydrate (CHO) meal on plasma levels of acylated ghrelin and hunger sensation. Eight healthy males performed an exercise (ET) and a control (CT) trial. In ET, participants performed a 60-min cycling exercise (∼70% of maximal oxygen uptake) after consuming a high-CHO meal. In the CT, participants remained at rest throughout the whole period after consuming the high-CHO meal. Hunger sensation was assessed and blood samples were taken to determine the levels of acylated ghrelin, glucose, insulin, total cholesterol (TC), and triglycerides (TG). There was suppression of hunger after consuming the meal in ET and CT (p = 0.028 and p = 0.011, respectively). Hunger increased in CT in the period correspondent to the exercise session (p = 0.017) and remained suppressed in the ET. The area under the curve for acylated ghrelin showed that its levels were lower in the ET compared with CT in the period of the exercise plus the immediate period (1 h) postexercise (60.7 vs. 96.75 pg·mL–1·2 h–1, respectively; p = 0.04). Inverse correlations between acylated ghrelin levels and insulin, TC, and TG levels at different time points were observed. In conclusion, these findings suggest that 1 bout of aerobic exercise maintains the meal-induced suppression of hunger. The mechanism underlying this effect may involve the exercise-induced suppression of acylated ghrelin. These results implicate that the combination of a high-CHO meal and aerobic exercise may effectively improve appetite control and body weight management.

The 24-h energy intake of obese adolescents is spontaneously reduced after intensive exercise: a randomized controlled trial in calorimetric chambers

Background

Physical exercise can modify subsequent energy intake and appetite and may thus be of particular interest in terms of obesity treatment. However, it is still unclear whether an intensive bout of exercise can affect the energy consumption of obese children and adolescents.

Objective

To compare the impact of high vs. moderate intensity exercises on subsequent 24-h energy intake, macronutrient preferences, appetite sensations, energy expenditure and balance in obese adolescent.

Design

This randomized cross-over trial involves 15 obese adolescent boys who were asked to randomly complete three 24-h sessions in a metabolic chamber, each separated by at least 7 days: (1) sedentary (SED); (2) Low-Intensity Exercise (LIE) (40% maximal oxygen uptake, VO₂max); (3) High-Intensity Exercise (HIE) (75%VO₂max).

Results

Despite unchanged appetite sensations, 24-h total energy intake following HIE was 6–11% lower compared to LIE and SED (p<0.05), whereas no differences appeared between SED and LIE. Energy intake at lunch was 9.4% and 8.4% lower after HIE compared to SED and LIE, respectively (p<0.05). At dinner time, it was 20.5% and 19.7% lower after HIE compared to SED and LIE, respectively (p<0.01). 24-h energy expenditure was not significantly altered. Thus, the 24-h energy balance was significantly reduced during HIE compared to SED and LIE (p<0.01), whereas those of SED and LIE did not differ.

Conclusions

In obese adolescent boys, HIE has a beneficial impact on 24-h energy balance, mainly due to the spontaneous decrease in energy intake during lunch and dinner following the exercise bout. Prescribing high-intensity exercises to promote weight loss may therefore provide effective results without affecting appetite sensations and, as a result, food frustrations.

Trial Registration

ClinicalTrial.gov NCT01036360

The impact of the circadian timing system on cardiovascular and metabolic function

Epidemiological studies show that adverse cardiovascular events peak in the morning (i.e., between 6 AM and noon) and that shift work is associated with cardiovascular disease, obesity, and diabetes. The endogenous circadian timing system modulates certain cardiovascular risk markers to be highest (e.g., cortisol, nonlinear dynamic heart rate control, and platelet activation) or to respond most unfavorably to stressors such as exercise (e.g., epinephrine, norepinephrine, and vagal cardiac modulation) at an internal body time corresponding to the time of day when adverse cardiovascular events most likely occur. This indicates that the circadian timing system and its interaction with external cardiovascular stressors (e.g., physical activity) could contribute to the morning peak in adverse cardiovascular events. Moreover, circadian misalignment and simulated night work have adverse effects on cardiovascular and metabolic function. This suggests that misalignment between the behavioral cycle and the circadian timing system in shift workers contributes to that population's increased risk for cardiometabolic disease.

Influence of running and walking on hormonal regulators of appetite in women

Nine female runners and ten walkers completed a 60 min moderate-intensity (70% VO(2)max) run or walk, or 60 min rest in counterbalanced order. Plasma concentrations of the orexogenic peptide ghrelin, anorexogenic peptides peptide YY (PYY), glucagon-like peptide-1 (GLP-1), and appetite ratings were measured at 30 min interval for 120 min, followed by a free-choice meal. Both orexogenic and anorexogenic peptides were elevated after running, but no changes were observed after walking. Relative energy intake (adjusted for cost of exercise/rest) was negative in the meal following running (-194 ± 206 kcal) versus walking (41 ± 196 kcal) (P = 0.015), although both were suppressed (P < 0.05) compared to rest (299 ± 308 and 284 ± 121 kcal, resp.). The average rate of change in PYY and GLP-1 over time predicted appetite in runners, but only the change in GLP-1 predicted hunger (P = 0.05) in walkers. Results provide evidence that exercise-induced alterations in appetite are likely driven by complex changes in appetite-regulating hormones rather than change in a single gut peptide.

The effects of exercise on the neuronal response to food cues

Increased physical activity is associated with successful long-term weight loss maintenance due to mechanisms likely more complex than simply increased energy expenditure. The impact of physical activity on the central regulation of food intake may be an important mechanism of this effect. The objective of this study was to examine the effects of exercise training and acute exercise on the neuronal response to food cues as well as eating behaviors. fMRI was performed in the fasted state at baseline and again after a 6 month progressive exercise intervention (supervised, 5 days/wk) both with and without an acute exercise bout in 12 overweight/obese (5 women, 7 men; BMI 33 ± 4 kg/m(2)) healthy adults. fMRI data were acquired while subjects were presented with visual stimuli of foods of high hedonic value as compared to neutral control objects. Questionnaires on eating behaviors, ratings of appeal and desire for foods, and ratings of appetite (hunger, satiety, prospective intake) using visual analog scales were also performed at baseline and again after the 6-month exercise intervention. While only a trend was observed for a reduction in body weight (102 ± 5 to 99 ± 6 kg, p=0.09), a significant reduction in fat mass was observed (36.4 ± 2.8 to 33.7 ± 3.2 kg, p=0.04), although as expected changes in fat mass were variable (-10.0 to +3.7 kg). Chronic exercise was associated with a reduction in the neuronal response to food, primarily in the posterior attention network and insula. A significant positive correlation between the change in fat/body mass and the change in insula response to food cues with chronic exercise was observed. An acute exercise bout attenuated the effects of chronic exercise. The exercise intervention, however, did not impact any of the measures of appetitive behavior. In summary, despite no effects on behavioral measures of appetite, chronic exercise training was associated with attenuation in the response to visual food cues in brain regions known to be important in food intake regulation. The insula, in particular, appears to play an important role in the potential exercise-induced weight loss and weight loss maintenance.

Brisk walking reduces ad libitum snacking in regular chocolate eaters during a workplace simulation

Workplace snacking can contribute to obesity. Exercise reduces chocolate cravings but effects on chocolate consumption are unknown. This study investigated the effect of brief exercise on ad libitum consumption during breaks in a computerised task. Seventy-eight regular chocolate eaters, age: 24.90±8.15 years, BMI: 23.56±3.78 kg/m(2) abstained for 2 days. They were randomly assigned to one of four conditions, in a 2 × 2 factorial design, involving either a 15 min brisk walk or quiet rest, and then computerised Stroop tasks with low or high demanding conditions, in three 180 s blocks with a 90 s interval. Throughout, a pre-weighed bowl of chocolates was available for ad libitum eating. A two-way ANOVA revealed no interaction effect of exercise and stress on total chocolate consumption, or main effect of stress, but a main effect of exercise [F(1, 74)=7.12, p<.01]. Mean (SD) chocolate consumption was less (t(73.5)=2.69, 95% CI for difference 3.4-22.9, ES=0.61) for the exercise (15.6 g) than control (28.8 g) group. Exercise also increased affective activation, but there was no mediating effect of change in affect on chocolate consumption. A brief walk may help to reduce ad libitum snacking in regular chocolate eaters.

Physical activity and weight control: conflicting findings

PURPOSE OF REVIEW

It is often hypothesized that increasing the volume of physical activity in the American lifestyle will slow and possibly even reverse the epidemic of obesity. Herein, we review the evidence pertaining to the role of physical activity in weight control from interventions performed in adults.

RECENT FINDINGS

Evidence exists both for and against the role of physical activity in weight control. High levels of physical activity and successful maintenance of body weight may be a result of better coupling between energy intake and energy expenditure, potentially mediated by physiological changes in appetite, albeit in the presence of large interindividual variability. Prospective studies, however, find little evidence of the more physically active members of a population gaining less excess weight than those who are the least physically active.

SUMMARY

When considering the impact of physical activity on body weight regulation, it is important to keep in mind that there are multiple hormones that acutely suppress (or stimulate) food intake and that the integration of these signals influence overall energy balance in a manner that is not yet fully understood. Moreover, cognitive and social influences may override these signals. Even though the impact of physical activity for weight control is still controversial, little doubt exists that increasing regular physical activity, particularly energy expended during structured exercise, is important for improving physical fitness and cardiovascular health.

Short-,moderate-, and long-term treadmill training protocols reduce plasma, fundus, but not small intestine ghrelin concentrations in male rats

BACKGROUND

It has been suggested that circulating ghrelin levels are upregulated by fasting, hypoglycemic status, and a physical exercise-induced energy deficit.

AIM

The purpose of the present study was to investigate the timecourse adaptations of the plasma, fundus, and small intestine ghrelin concentrations as well as related hormones and liver ATP levels to 3, 6, and 12 weeks of treadmill endurance running.

MATERIAL/SUBJECTS AND METHODS

Thirty-nine male Wistar rats (12-14 weeks old) were randomly assigned to 3 control (C3, no.=5; C6, no.=7 and C12, no.=7) and 3 training groups (E3, no.=6; E6, no.=7 and E12, no.=7). The rats in the 3 training groups were exercised on a motor-driven treadmill at 25 m/min (0% grade) for 60 min/day, 5 days/week for 3, 6, and 12 weeks, respectively. The animals were sacrificed 48 h after the last session of each training program and tissues were analyzed.

RESULTS

Total ghrelin concentrations were significantly (p<0.05) lower in trained rat plasma and fundus tissue after all treadmill endurance running programs. Small intestine ghrelin concentrations remained unchanged. Plasma GH concentrations and liver ATP content were significantly higher in E6 and E12 groups.

CONCLUSION

Data indicate that as little as 3 weeks of moderate treadmill exercise reduces plasma and fundus total ghrelin concentrations with elevated plasma GH and liver ATP content occurring after 6 and 12 weeks of training. Exercise training-induced improvement of energy source availability and negative feedback from increased GH levels may play a role in reducing plasma and fundus ghrelin levels.

Lifestyle factors and ghrelin: critical review and implications for weight loss maintenance

Ghrelin, the only known appetite-stimulating hormone in humans, may be one factor involved in increased appetite, cravings and food intake following weight loss. Innovative strategies for suppressing ghrelin and decreasing appetite during weight loss maintenance are needed. Recent research has highlighted relationships between ghrelin, stress and lifestyle factors. The purposes of the current review are to (i) describe the current status of knowledge about ghrelin and lifestyle factors; (ii) critically examine research in this area, highlighting inconsistencies and methodological issues and (iii) discuss future directions and implications for obesity treatment. Based on Literature search using PsycINFO and Medline databases, we reviewed experimental studies on relationships between ghrelin, stress, exercise and sleep. Ghrelin levels are positively related to stress hormones, and stress management interventions including exercise and sleep may help to reduce acylated ghrelin and corresponding appetite. Behavioural interventions may offer a practical, cost-effective alternative for reducing or stabilizing ghrelin levels after initial weight loss. Adding behavioural techniques designed to reduce ghrelin to traditional weight loss maintenance protocols may help individuals to maintain weight loss. Future directions for investigating relationships between ghrelin and behavioural factors, examining the efficacy of behavioural programmes in reducing ghrelin and improving weight loss maintenance are discussed.

Differential acylated ghrelin, peptide YY3-36, appetite, and food intake responses to equivalent energy deficits created by exercise and food restriction

CONTEXT

Acute energy deficits imposed by food restriction increase appetite and energy intake; however, these outcomes remain unchanged when energy deficits are imposed by exercise.

OBJECTIVE

Our objective was to determine the potential role of acylated ghrelin and peptide YY(3-36) (PYY(3-36)) in mediating appetite and energy intake responses to identical energy deficits imposed by food restriction and exercise.

DESIGN

Twelve healthy males completed three 9-h trials (exercise deficit, food deficit, and control) in a randomized counterbalanced design. Participants ran for 90 min (70% of VO(2) max) at the beginning of the exercise deficit trial and then rested for 7.5 h. Participants remained sedentary throughout the food deficit and control trials. Test meals were consumed by participants at 2 and 4.75 h in all trials. The amount provided in the food deficit trial was restricted so that an energy deficit (equivalent to that imposed by exercise) was induced relative to control. Participants were permitted access to a buffet meal at 8 h.

RESULTS

The energy deficits imposed by food restriction (4820 ± 151 kJ) and exercise (4715 ± 113 kJ) were similar. Appetite and ad libitum energy intake responded in a compensatory fashion to food restriction yet were not influenced by exercise. Plasma acylated ghrelin concentrations increased, whereas PYY(3-36) decreased, in response to food restriction (two-way ANOVA, trial × time interaction, P < 0.001 for each). Exercise did not induce such compensatory responses.

CONCLUSIONS

These findings suggest a mediating role of acylated ghrelin and PYY(3-36) in determining divergent feeding responses to energy deficits imposed by food restriction and exercise.

Significant lowering of plasma ghrelin but not des-acyl ghrelin in response to acute exercise in men

Ghrelin, an acylated peptide produced predominantly in the stomach, stimulates feeding and growth hormone (GH) secretion via interaction with the GH secretagogue receptor. Ghrelin molecules are present in two major endogenous forms, an acylated form (ghrelin) and a des-acylated form (des-acyl ghrelin). Recent studies indicated that aerobic exercise did not change plasma total ghrelin levels, however, dynamics of circulating ghrelin and des-acyl ghrelin during aerobic exercise remains unclear. The purpose of this study is to examine the effects of moderate intensity exercise on plasma ghrelin and des-acyl ghrelin concentrations, and to investigate the relationship between ghrelin molecules and other hormonal and metabolic parameters during exercise. Nine healthy males (25.2 ± 0.5 years) exercised for 60 min at 50% of their maximal oxygen consumptions. We measured the plasma concentrations of ghrelin, des-acyl ghrelin, GH, norepinephrine (NE), epinephrine (E), dopamine (DA), insulin, and glucose. Plasma ghrelin level significantly decreased during exercise, whereas plasma des-acyl ghrelin and total ghrelin levels did not change. Plasma NE, E, DA and GH levels were significantly increased during exercise. Plasma insulin level significantly decreased during exercise, and plasma glucose levels remained steady during exercise. NE, E, DA, and GH were correlated negatively with plasma ghrelin levels. These findings suggest that acute moderate exercise may suppress ghrelin release from the stomach, decrease ghrelin O-acyltransferase activity, and/or activate ghrelin utilization in peripheral tissues and that exercise-induced ghrelin suppression may be mediated by activated adrenergic system.

The acute effects of swimming on appetite, food intake, and plasma acylated ghrelin

Swimming may stimulate appetite and food intake but empirical data are lacking. This study examined appetite, food intake, and plasma acylated ghrelin responses to swimming. Fourteen healthy males completed a swimming trial and a control trial in a random order. Sixty min after breakfast participants swam for 60 min and then rested for six hours. Participants rested throughout the control trial. During trials appetite was measured at 30 min intervals and acylated ghrelin was assessed periodically (0, 1, 2, 3, 4, 6, and 7.5 h. N = 10). Appetite was suppressed during exercise before increasing in the hours after. Acylated ghrelin was suppressed during exercise. Swimming did not alter energy or macronutrient intake assessed at buffet meals (total trial energy intake: control 9161 kJ, swimming 9749 kJ). These findings suggest that swimming stimulates appetite but indicate that acylated ghrelin and food intake are resistant to change in the hours afterwards.