Are Post-Exercise Appetite Sensations and Energy Intake Coupled in Children and Adolescents?

Effect of health promotion interventions on small portion size consumption behavior among college students

Background

Large food portion size is contributing toward overweight and obesity rates and has been found directly proportional to increase in portion size.

Objectives

The study was done to see the effect of health promotion intervention on small portion size consumption behavior using multitheory model (MTM).

Materials and Methods

A quasi-experimental study was conducted among students of age groups 18 - 21 years in two different colleges from North India between 2019 to 2020. About 150 participants in the intervention group as well as control group were selected and health promotion intervention in the form of motivational group counseling, one-to-one counseling, Power Point presentations, lectures, and messages were given to participants in intervention group. Difference in difference of proportions for meal consumption behavior and the difference in the difference of means for body mass index, waist-hip ratio and for constructs of MTM for portion size consumption behavior were calculated. Paired t-test was used to test the significance between the continuous variables.

Results

There was a significant reduction (46% vs. 11%, P < 0.001) in proportion of participants consuming large portion-sized meals in the intervention group as compared to the control group. The mean change in constructs (participatory dialogues,behavioral confidence, change in physical environment, emotional transformation and practice for change) for portion size consumption behavior of participants in the intervention and control groups at base line and end line was found statistically significant.

Conclusion

MTM is a useful tool for health promotion and health education to predict the initiation and sustenance of health behavior change.

Effect of acute dietary- versus combined dietary and exercise-induced energy deficits on subsequent energy intake, appetite and food reward in adolescents with obesity

BACKGROUND

Acute dietary-induced energy deficits have been shown to favor compensatory appetitive responses. The aim of this study was to compare energy intake (EI), appetite sensations and the hedonic responses to equivalent energy deficits induced by dietary restriction alone and combined with exercise in adolescents with obesity.

METHODS

In a within-subjects design, seventeen adolescents with obesity (12-16 years, Tanner stage 3-5, 6 males) randomly completed three 14 h conditions: (i) control (CON); (ii) deficit induced by diet only (Def-EI) and; (iii) deficit induced by combined diet and physical exercise (Def-mixed). Breakfast and lunch were calibrated to generate a 500 kcal deficit in Def-EI and 250 kcal deficit in Def-mixed. A 250 kcal deficit was created through a cycling exercise set at 65% VO_2peak in Def-mixed. Ad libitum EI, macronutrients and relative EI (REI) were assessed at dinner, subjective appetite sensations taken at regular intervals, and food reward measured before dinner.

RESULTS

EI at dinner was significantly lower in Def-EI compared to CON (p = 0.014; Effect size (ES): -0.59 [-1.07; -0.12]), with no difference between Def-mixed and both CON and Def-EI. Total REI was lower in both deficit conditions compared with CON (Def-mixed: p < 0.001; ES: -3.80 [-4.27; -3.32], Def-EI: p < 0.001; ES: -4.90 [-5.37; -4.42] respectively), indicating incomplete compensation for the energy deficits. Absolute protein ingestion at dinner was lower in Def-EI than Def-mixed (p = 0.037; ES: -0.50 [-0.98; -0.03]) and absolute lipid ingestion was lower in Def-EI than in CON (p = 0.033; ES: -0.51 [-0.99; -0.04]). A higher proportion of protein and a lower proportion of carbohydrates was observed in Def-mixed than in Def-EI (p = 0.078; ES: -0.42 [-0.90; 0.04] and p = 0.067; ES: 0.44 [-0.03; 0.92] respectively). Total area under the curve for appetite sensations were similar between conditions. Explicit liking for sweet relative to savoury food was lower in Def-mixed compared to CON (p = 0.027; ES: -0.53 [-1.01; -0.06]) with no difference in food reward between Def-EI and CON.

CONCLUSION

Neither of the two acute isoenergetic deficits led to subsequent appetitive compensation, with the dietary deficit even inducing a lower ad libitum EI at the subsequent dinner. Further studies are needed to better understand the appetitive response to dietary and exercise energy balance manipulations in this population.

Breakfast Consumption Suppresses Appetite but Does Not Increase Daily Energy Intake or Physical Activity Energy Expenditure When Compared with Breakfast Omission in Adolescent Girls Who Habitually Skip Breakfast: A 7-Day Randomised Crossover Trial

With concerns that adolescent girls often skip breakfast, this study compared the effects of breakfast consumption versus breakfast omission on free-living physical activity (PA) energy expenditure (PAEE) and dietary intakes among adolescent girls classified as habitual breakfast skippers. The participants went through two 7-day conditions in a trial with a crossover design: daily standardised breakfast consumption (energy content: 25% of resting metabolic rate) before 09:00 (BC) and daily breakfast omission (no energy-providing nutrients consumed) until 10:30 (BO). Free-living PAEE, dietary intakes, and perceived appetite, tiredness, and energy levels were assessed. Analyses were linear mixed models. Breakfast manipulation did not affect PAEE or PA duration. Daily fibre intake was higher (p = 0.005; d = 1.31), daily protein intake tended to be higher (p = 0.092; d = 0.54), post-10:30 carbohydrate intake tended to be lower (p = 0.096; d = 0.41), and pre-10:30 hunger and fullness were lower and higher, respectively (p ≤ 0.065; d = 0.33-1.01), in BC versus BO. No other between-condition differences were found. Breakfast-skipping adolescent girls do not compensate for an imbalance in energy intake caused by breakfast consumption versus omission through subsequent changes in PAEE but may increase their carbohydrate intakes later in the day to partially compensate for breakfast omission. Furthermore, breakfast can make substantial contributions to daily fibre intake among adolescent girls.

Simple Energy Balance or Microbiome for Childhood Obesity Prevention?

Obesity prevention interventions generally have either not worked or had effects inadequate to mitigate the problem. They have been predicated on the simple energy balance model, which has been severely questioned by biological scientists. Numerous other etiological mechanisms have been proposed, including the intestinal microbiome, which has been related to childhood obesity in numerous ways. Public health research is needed in regard to diet and the microbiome, which hopefully will lead to effective child obesity prevention.

New Insights Into Causal Pathways Between the Pediatric Age-Related Physical Activity Decline and Loss of Control Eating: A Narrative Review and Proposed Conceptual Model

Research consistently suggests that loss of control (LOC) eating in children and adolescents is a key factor contributing to pediatric obesity and eating disorders. However, causes of pediatric LOC eating are yet unclear, and there is a lack of longitudinal research investigating the developmental processes contributing to LOC eating and related outcomes in youth. Physical activity is an understudied behavior that declines during middle childhood to adolescence and may exert an influence in the development of LOC eating via its impact on executive functioning. While physical activity levels and executive functioning have been linked to regulation of eating, no research has examined the mechanistic processes by which these domains may together impact LOC eating during childhood and adolescence. In the current narrative review, a model is proposed that suggests how physical activity and executive functioning influence LOC eating and related outcomes during childhood and adolescence. This model has the potential to influence future theoretical models of pediatric LOC eating and guide future prevention and intervention efforts.

Developmental Trajectories of Body Mass Index, Waist Circumference, and Aerobic Fitness in Youth: Implications for Physical Activity Guideline Recommendations (CHAMPS Study-DK)

OBJECTIVES

Describe the trajectories of body mass index (BMI), waist circumference, and aerobic fitness in children and identify different outcomes of guideline-recommended physical activity (PA) in a subset of active children.

METHODS

We recruited students from 10 public primary schools and obtained repeated measures of BMI, waist circumference, and aerobic fitness over 30 months. Aerobic fitness was measured with the Andersen test. We objectively measured physical activity behaviour with accelerometers and classified children as 'physically active' when they achieved ≥ 60 min of moderate-to-vigorous PA per day (guideline concordance). Univariate trajectories of BMI, waist circumference, and aerobic fitness were calculated for all children, and we constructed a multi-trajectory model comprising all outcomes in the subgroup of physically active children. The construct validity of all models was investigated by examining for between-group differences in cardiovascular disease risk factors obtained from fasting blood samples.

RESULTS

Data from 1208 children (53% female) with a mean (SD) age of 8.4 (1.4) years were included. The univariate trajectory models identified three distinct trajectories for BMI, waist circumference, and aerobic fitness. The multi-trajectory model classified 9.1% of physically active children as following an 'overweight/obese/low fitness' trajectory. There were moderate-to-large differences in cardiovascular risk factors between all trajectory groups (p < 0.001; d = 0.4-1.20).

CONCLUSION

We identified distinct developmental trajectories of BMI, waist circumference, and aerobic fitness in children. Nearly one in 10 children who met PA guideline recommendations followed an unfavourable health trajectory. Health-related PA recommendations may be insufficient for some children.

Delayed meal timing after exercise is associated with reduced appetite and energy intake in adolescents with obesity

BACKGROUND

While the beneficial effects of exercise on appetite might depend on its timing during the day or relative to a meal, this remains poorly explored in youth.

OBJECTIVES

To examine the importance of meal timing (+30 vs +90 minutes) after performing exercise on energy intake, appetite and food reward in adolescents with obesity.

METHODS

Eighteen adolescents with obesity randomly completed three conditions: (a) lunch (12:00 pm) set 30 minutes after a rest session (11:00 am); (b) lunch (12:00 pm) set 30 minutes after an exercise session (11:00 am)(MEAL-30); (c) lunch (01:00 pm) set 90 minutes after an exercise session (11:00 am)(MEAL-90). Lunch and dinner ad libitum energy intake was assessed, food reward (LFPQ) assessed before and after lunch, and before dinner, appetite sensations were assessed at regular intervals.

RESULTS

Energy intake was lower at MEAL-90 than MEAL-30 and CON at lunch (P < .05 and P < .01, respectively) and lunch + dinner combined (P < .001). A decrease in intake (g) of protein, fat and carbohydrate was observed. Post-exercise hunger was lower on MEAL-90 compared with CON. No condition effects were found at lunch for food reward.

CONCLUSIONS

Delaying the timing of the meal after exercise might help affect energy balance by decreasing ad libitum energy intake without increasing hunger and by improving satiety in adolescents with obesity.

A review of the short- and long-term impact of weight loss on appetite in youth: what do we know and where to from here?

This review seeks to synthesise our knowledge about changes in hunger and satiety that occur during diet-induced weight loss and during weight loss maintenance, with a particular focus on youth with obesity. Mechanisms of appetite responses to weight loss rely heavily on the adult literature. Physiological mechanisms that control appetite and satiety via the gut-brain axis have been elucidated but we have an incomplete picture of changes in gut hormones and peptides in youth with obesity. In adolescents, the role of the brain in long-term sensing of body composition and modifying appetite and satiety changes is easily over-ridden by hedonic influences for the reward of highly palatable sweet foods and encourages over-consumption. Accordingly, reward cues and hyper-responsiveness to palatable foods lead to a pattern of food choices. Different reward systems are necessary that are substantial enough to reward the continued individual effort required to sustain new behaviours, that need to be adopted to support a reduced body weight. Periods of growth and development during childhood provide windows of opportunity for interventions to influence body weight trajectory but long-term studies are lacking. More emphasis needs to be placed on anticipatory guidance on how to manage powerful hedonic influences of food choice, essential to cope with living in our obesogenic environment and managing hunger which comes with the stronger desire to eat after weight has been lost.

Post-moderate-intensity exercise energy replacement does not reduce subsequent appetite and energy intake in adolescents with obesity

Exercise modifies energy intake (EI) in adolescents with obesity, but whether this is mediated by the exercise-induced energy deficit remains unknown. The present study examined the effect of exercise with and without dietary replacement of the exercise energy expenditure on appetite, EI and food reward in adolescents with obesity. Fourteen 12–15-year-old adolescents with obesity (eight girls; Tanner 3–4; BMI 34·8 (sd 5·7) kg/m2; BMI z score 2·3 (sd 0·4)) randomly completed three experimental conditions: (i) rest control (CON); (ii) 30-min cycling (EX) and (iii) 30-min cycling with dietary energy replacement (EX + R). Ad libitum EI was assessed at lunch and dinner, and food reward (Leeds Food Preference Questionnaire) before and after lunch. Appetite was assessed at regular intervals. Lunch, evening and total EI (excluding the post-exercise snack in EX − R) were similar across conditions. Lunch and total EI including the post-exercise snack in EX + R were higher in EX − R than CON and EX; EX and CON were similar. Total relative EI was lower in EX (6284 (sd 2042) kJ) compared with CON (7167 (sd 2218) kJ; P < 0·05) and higher in EX + R (7736 (sd 2033) kJ) compared with CON (P < 0·001). Appetite and satiety quotients did not differ across conditions (P ≥ 0·10). Pre-meal explicit liking for fat was lower in EX compared with CON and EX + R (P = 0·05). There was time by condition interaction between EX and CON for explicit wanting and liking for fat (P = 0·01). Despite similar appetite and EI, adolescents with obesity do not adapt their post-exercise food intake to account for immediate dietary replacement of the exercise-induced energy deficit, favouring a short-term positive energy balance.

Introducing eccentric cycling during a multidisciplinary weight loss intervention might prevent adolescents with obesity from increasing their food intake: The TEXTOO study

PURPOSE

The present study compared the appetite responses to an inpatient eccentric vs. concentric cycling training programs in adolescents with obesity.

METHODS

24 adolescents with obesity (12-16yrs; Tanner 3-4) followed a 12-week multidisciplinary intervention (Phase1), after which they were randomized to concentric (CON) or eccentric (ECC) training for 12 weeks (Phase2). Assessment of anthropometrics, body composition (DXA), aerobic power (VO_2max), energy (EI) and macronutrient intake, food reward, and subjective appetite were performed at baseline, and after Phase1 (T1) and Phase2 (T2).

RESULTS

Body mass, BMI, and fat mass (FM%) decreased in both groups (p < 0.001). FM% reduction was greater in ECC at T2 (-9.9%). EI did not change in either group at T1, but was greater at T2 relative to T1 in CON only (p < 0.001,+22%). There was no correlation between the change in body mass, FM%, fat-free mass and EI. Hunger (p = 0.002) and desire to eat (p = 0.001) were higher in CON vs. ECC with no time effects nor interactions. Prospective food consumption increased in both groups with no group effect nor interaction. Satiety was not different between groups or over time. In ECC, preference for high-fat foods increased (p = 0.03), and preference (p = 0.004) and implicit wanting (p = 0.016) for sweet foods decreased.

CONCLUSION

Eccentric cycling as part of an inpatient multidisciplinary weight-loss intervention might help prevent increased ad libitum energy intake compared to concentric exercise training in adolescents with obesity, potentially through distinct effects of the food reward system.

Associations between Physical Activity and Food Intake among Children and Adolescents: Results of KiGGS Wave 2

A balanced diet and sufficient physical activity are essential for the healthy growth of children and adolescents and for obesity prevention. Data from the second wave of the population-based German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2; 2014-2017) were used to analyse the association between food intake and physical activity among 6- to 17-year-old children and adolescents (n = 9842). Physical exercise (PE) and recommended daily physical activity (RDPA) were assessed with self-administered questionnaires and food intake by a semi-quantitative food frequency questionnaire. Multivariable logistic regression was used to analyse the association between food group intake (dependent variable) and level of PE or RDPA. High levels of physical activity (PE or RDPA) were associated with higher consumption of juice, water, milk, dairy products, fruits, and vegetables among both boys and girls, and among boys with a higher intake of bread, potatoes/pasta/rice, meat, and cereals. Higher PE levels were also less likely to be associated with a high soft drink intake. High levels of RDPA were associated with high intake of energy-dense foods among boys, which was not observed for PE. This study indicates that school-aged children and adolescents with higher levels of physical activity consume more beneficial foods and beverages compared to those with lower physical activity levels.

Homeostatic and neurocognitive control of energy intake in response to exercise in pediatric obesity: a psychobiological framework

While energy intake and energy expenditure have long been studied independently, the alarming progression of obesity has led to a more integrative approach to energy balance considering their potential interactions. Although the available literature concerned with the effect of chronic and acute exercise on energy intake and appetite control in adults is considerable, these questions remain less explored among children and adolescents. Based on the search of four databases (Medline, Embase, PsycINFO and Cochrane Library; articles published until May 2018), the objective of this review is to summarize and discuss the effect of acute and chronic physical exercise on energy intake and appetite control in children and adolescents with obesity, and to identify the physiological and neurocognitive signals and pathways involved. Evidence suggested that acute intensive exercise has the potential to reduce subsequent energy intake in children and adolescents with obesity but not healthy weight, through both peripheral (mainly gastro-peptides) and neurocognitive (neural responses to food cues) pathways. The nutritional responses to chronic physical activity remain less clear and require further consideration, especially from an anti-obesity perspective.

Cognitive restriction accentuates the increased energy intake response to a 10-month multidisciplinary weight loss program in adolescents with obesity

BACKGROUND

Multidisciplinary interventions have shown some merits in weight reduction strategies in youth, however, their impact on subsequent daily energy intake remains largely unknown. The aim of the present study was to evaluate the nutritional responses to a 10-month multidisciplinary intervention among adolescents with obesity, in relation to their eating behavior characteristics.

METHODS

Thirty-five adolescents (mean age: 13.4 ± 1.2 years) with obesity took part in a 10-month residential multidisciplinary weight loss program. Anthropometric measurements, body composition (dual-energy X-ray absorptiometry), 24-h ad libitum energy intake (weighted), eating behaviors (Dutch Eating Behavior Questionnaire) and appetite sensations (Visual Analogue Scales) were assessed on three occasions: at their arrival in the institution (T0), after 5 months (T1), and at the end of the 10-month program (T2).

RESULTS

The mean weight loss reached 11% of the adolescents' initial body weight, with an important inter-individual variability (-25% to +3% of their initial body weight). Results revealed sex differences change, with boys showing a higher decrease in fat mass percent and increase in fat-free mass compared with girls. Weight loss was accompanied by a significant decrease in emotional (-8.3%, p < 0.05) and external (-14.8%, p < 0.001) eating scores and a significant increase in 24-h ad libitum energy intake (+246 kcal, p < 0.001). The observed subsequent increased 24-h ad libitum energy intake at T2 compared to T0 was significantly higher in cognitively restrained eaters (+492 kcal) compared to unrestrained eaters (+115 kcal, p = 0,015). Dietary restraint score at baseline was inversely correlated with the percentage of weight loss (r = -0.44, p = 0.010).

CONCLUSION

A 10-month multidisciplinary weight loss intervention induced an increase in 24-h ad libitum energy intake compared to baseline, especially in cognitively restrained eaters. Moreover, initially cognitively restrained eaters tended to lose less body weight compared to unrestrained ones. These findings suggest that cognitive restriction may be a useful eating behavior characteristic to consider as a screening tool for identifying adverse responders to weight loss interventions in youth.

Effect of Exercise Duration on Subsequent Appetite and Energy Intake in Obese Adolescent Girls

There is a growing interest regarding the effect of exercise on appetite and energy intake in youth. While the role of exercise intensity has been a primary focus of study, the effect of exercise duration on subsequent food intake has not been fully examined in obese adolescents. On three separate mornings in a randomly assigned order, obese adolescent girls (n = 20) aged 12-15 years old were asked to perform a rest session (control, CON) or two cycling sessions for 20 (EX20) or 40 min (EX40) set at their ventilatory threshold. Absolute and relative energy intake were measured from an ad libitum lunch meal 30 min after rest or exercise and appetite feelings assessed using visual analogue scales throughout the day. Hunger, satiety, and prospective food consumption were not significantly different between conditions. Absolute energy intake (kcal) did not differ between conditions, while relative energy intake on EX40 (571 ± 381 kcal) was significantly lower than during CON (702 ± 320 kcal; p < .05) and EX20 (736 ± 457 kcal; p < .05). Fat ingestion (in grams) was significantly lower on CON (7.8 ± 3.2 g) compared with EX20 (10.3 ± 4.6 g; p < .01). Protein intake (in grams) was higher on EX20 (37.0 ± 16.6 g) compared with both CON (29.5 ± 11.7 g; p < .01) and EX40 (33.1 ± 10.9 g; p < .05). However, the percentage of total energy derived from each macronutrient was not different between conditions. Obese adolescent girls do not compensate for an acute bout of exercise set at their ventilatory threshold by increasing energy intake, regardless of the exercise duration.

An RCT to Facilitate Implementation of School Practices Known to Increase Physical Activity

INTRODUCTION

Although comprehensive school-based physical activity interventions are efficacious when tested under research conditions, they often require adaptation in order for implementation at scale. This paper reports the effectiveness of an adapted efficacious school-based intervention in improving children's moderate to vigorous physical activity. The impact of strategies to support program implementation was also assessed.

DESIGN

A cluster RCT of low socioeconomic elementary schools in New South Wales, Australia.

SETTING/PARTICIPANTS

Consenting schools were randomized (25 intervention, 21 control) using a computerized random number function. Follow-up measures were taken at 6 months post-randomization (May-August 2015) by blinded research assistants. The multicomponent school-based intervention, based on an efficacious school-based physical activity program (Supporting Children's Outcomes using Rewards, Exercise and Skills), consisted of four physical activity strategies and seven implementation support strategies. The intervention was adapted for scalability and delivery by a local health service over 6 months. The primary outcome was accelerometer assessed, student mean daily minutes spent in moderate to vigorous physical activity. Physical education lesson quality and other school physical activity practices were also assessed.

RESULTS

Participants (n=1,139, 49% male) were third- through sixth-grade students at follow-up (May-August 2015). Valid wear time and analysis of data were provided for 989 (86%) participants (571 intervention, 568 control). At 6-month follow-up, there were no significant effects in overall daily minutes of moderate to vigorous physical activity between groups (1.96 minutes, 95% CI= -3.49, 7.41, p=0.48). However, adjusted difference in mean minutes of overall vigorous physical activity (2.19, 95% CI=0.06, 4.32, p=0.04); mean minutes of school day moderate to vigorous physical activity (2.90, 95% CI=0.06, 5.85, p=0.05); and mean minutes of school day vigorous physical activity (1.81, 95% CI=0.78, 2.83, p≤0.01) were significantly different in favor of the intervention group. Physical education lesson quality and school physical activity practices were significantly different favoring the intervention group (analyzed October 2015-January 2016).

CONCLUSIONS

The modified intervention was not effective in increasing children's overall daily minutes of moderate to vigorous physical activity, when adapted for implementation at scale. However, the intervention did improve daily minutes of vigorous physical activity and school day moderate to vigorous physical activity, lesson quality, and school physical activity practices.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry: ACTRN12615000437561.

Reduced neural responses to food cues might contribute to the anorexigenic effect of acute exercise observed in obese but not lean adolescents

Acute exercise has been found to reduce subsequent energy intake in obese adolescents. Although it has been suggested that some neural pathways are involved in this post-exercise energy intake regulation, it remains unknown whether the post-exercise attentional response to food cues differs as a function of weight status. We hypothesize that there will be a reduction in the neural response to food cues as a result of exercise in obese adolescents, but not in their lean counterparts. Fourteen obese and 14 lean adolescent boys (12-15 years) were randomized (within-subjects design) to remain seated (CON) or to exercise 45 minutes at 65% of their maximal capacities (EX). After the exercise or sitting period, the adolescents' cognitive engagement in the processing of food vs. non-food cues was assessed during an attentional computer-based task with electroencephalography (EEG) recording. An ad libitum lunch meal was offered and appetite feelings were assessed (visual analog scales). There was no main effect of condition on energy intake in lean subjects, but obese adolescents ate significantly less following EX compared with CON (P<.05). There was no effect of condition or stimulus type (food vs. non-food) on the EEG-recorded amplitude of the P3b component in lean adolescents. However, the response to food cues was significantly reduced compared with non-food stimuli after exercise in obese participants (P<.01). Following EX, but not CON, total body weight, body mass index, and fat mass were inversely correlated with the EEG response to food-non-food stimuli (all P<.05). However, this response was not associated with ad libitum EI (both P>.1). Acute exercise favors decreased neural response to food cues compared with non-food cues in obese but not lean adolescents, suggesting differential effects of exercise on the neural processing of food cues based on weight status.

A systematic review and meta-analysis of energy and macronutrient intake responses to physical activity interventions in children and adolescents with obesity

BACKGROUND

The effects of regular physical activity on energy intake in obese adolescents are unknown.

OBJECTIVE

The objective is to determine how physical activity interventions affect energy and macronutrient intake in overweight/obese youth.

DATA SOURCES

Databases were searched from December 2014 to December 2015 for studies that measured energy and/or macronutrient consumption in response to physical activity intervention in overweight/obese youth.

DATA SELECTION

The review comprises primary source articles published in English in peer-reviewed journals. Articles that presented data on energy and/or macronutrient intake before and after a physical activity intervention (without dietary restriction) in overweight or obese children and teenagers (up to 18 years old) were included. Of the initial 307 references found, nine were included.

RESULTS

The nine included studies analysed the effect of 15 different physical activity interventions. Nine showed a decrease and six unchanged energy intakes. The effect size for total energy intake ranged from -2.108 to -0.207 (n = 14). Results of the meta-analysis revealed a mean effect of physical intervention to reduce intake of -1.003 (95% confidence interval = -1.261 to -0.745, p < 0.001). Results for heterogeneity among these studies were I²  = 67.421; Q = 39.903; d_f  = 13, p < 0.001. The mean energy intake reduction was -323 ± 286 kcal. Macronutrient intake was assessed in 11 interventions. Protein intake was found decreased in five (reduction of -26.8 ± 19.2 g), seven reported fat decrease (reduction of -26.4 ± 17.8 g) and five a decrease in CHO (reduction of -72.5 ± 22.8 g). The meta-analysis revealed significant decreases of each macronutrient (p < 0.001).

CONCLUSION

Structured physical activity interventions favour decreased daily energy intake in obese adolescents.

Decreased Appetite after High-Intensity Exercise Correlates with Increased Plasma Interleukin-6 in Normal-Weight and Overweight/Obese Boys

Background: High-intensity exercise (HIEX) suppresses appetite in adults and is thought to be mediated by appetite-regulating hormones. However, the effects of HIEX-induced inflammatory and stress biomarkers on appetite control and body weight have not been reported in children or adults. Objective: The objective of this study was to describe the effects of acute HIEX at 70% peak oxygen consumption (VO2peak) on postexercise appetite and selective biomarkers of inflammation, stress, and appetite regulatory hormones in normal-weight (NW) and in overweight/obese boys. Methods: NW (n = 11) and overweight/obese (n = 11) boys aged 10-18 y were randomly assigned in a crossover design to either rest or HIEX. Visual analog scale appetite ratings and plasma biomarkers of appetite, inflammation, stress, and glucose control were measured after HIEX or rest. Results: Appetite increased from baseline to 110 min (P < 0.001), but was lower after HIEX (P = 0.04), with no difference between body weight groups. HIEX also resulted in lower active ghrelin (P < 0.001) and increased interleukin-6 (IL-6; P < 0.001), tumor necrosis factor-α (P < 0.001), and cortisol (P < 0.001) concentrations, independent of body weight. It increased blood glucose (P = 0.002) and insulin (P = 0.028) concentrations in NW but not overweight and obese boys. Leptin, glucagon-like peptide 1, peptide tyrosine tyrosine, C-reactive protein, and cortisol were not affected by HIEX. An inverse correlation was found between IL-6 and appetite (r = -0.379; P = 0.012), but not any other biomarkers. Conclusions: HIEX resulted in reduced appetite that correlated with an increase in IL-6 in both NW and overweight/obese boys. However, although a role for IL-6 in the response can be suggested, the suppression of appetite was potentially mediated by the decrease in active ghrelin and/or increase in cortisol. This trial was registered at clinicaltrials.gov as NCT02619461.

Interactions between sleep, movement and other non-movement behaviours in the pathogenesis of childhood obesity

Research examining the health effects of physical activity, sedentary behaviour and sleep on different health outcomes has largely been conducted independently or in isolation of the other behaviours. However, the fact that time is finite (i.e. 24 h) suggests that the debate on whether or not the influence of a single behaviour is independent of another one is conceptually incorrect. Time spent in one behaviour should naturally depend on the composition of the rest of the day. Recent evidence using more appropriate analytical approaches to deal with this methodological issue shows that the combination of sleep, movement and non-movement behaviours matters and all components of the 24-h movement continuum should be targeted to enhance health and prevent childhood obesity. The objective of this review is to discuss research investigating how combinations of physical activity, sedentary behaviour and sleep are related to childhood obesity. Emerging statistical approaches (e.g. compositional data analysis) that can provide a good understanding of the best 'cocktail' of behaviours associated with lower adiposity and improved health are also discussed. Finally, future research directions are provided. Collectively, it becomes clearer that guidelines and public health interventions should target all movement behaviours synergistically to optimize health of children and youth around the world.

Effects of combined physical education and nutritional programs on schoolchildren's healthy habits

Background. A multidisciplinary approach seems to be effective in creating healthy habits in children. The aim of this study was to evaluate the efficacy of three 5-month combined physical education (PE) and nutritional interventions on body composition, physical activity (PA) level, sedentary time and eating habits of schoolchildren. Methods. Anthropometric data, weekly PA level, sedentary time and eating habits of 230 healthy students were analysed using a repeated-measures ANOVA with Group (experimental group 1 vs experimental group 2 vs control group), Adiposity Status (under fat vs normal fat vs obese), and Time (pre vs post) as factors. Results. Body fat mass percentage increased after intervention (18.92 ± 8.61% vs 19.40 ± 8.51%) in all groups. The weekly PA level significantly increased after intervention in both experimental groups. Sedentary time significantly decreased after the intervention period (565.70 ± 252.93 vs 492.10 ± 230.97 min/week, p < 0.0001). Moreover, obese children were more sedentary than under fat and normal fat children. Children significantly changed the consumption of some specific foods after intervention. Discussion. This study revealed the effectiveness of a combined PE and nutritional intervention to improve children's healthful dietary practices and to encourage an active lifestyle. However, it needs a further appropriate development to establish patterns of healthful dietary practices that encourage an active lifestyle with which to maintain healthy habits through life.

Food intake response to exercise and active video gaming in adolescents: effect of weight status

Although a few data are available regarding the impact of video games on energy intake (EI) in lean adolescents, there is no evidence on the effect of passive and active video gaming on food intake in both lean and obese youth. It is also unknown whether isoenergetic active video games and exercise differently affect food consumption in youth. In all, twelve lean and twelve obese adolescent boys (12-15 years old) had to complete four 1-h sessions in a cross-over design study: control (CON; sitting), passive video game (PVG; boxing game on Xbox 360), active video game (AVG; boxing game on Xbox Kinect 360) and exercise (EX; cycling). The exercise and active video game activities were designed to generate the same energy expenditure (EE). EE was measured using a K4b2 portable indirect calorimeter. Ad libitum food intake and appetite sensations were assessed following the sessions. AVG and EX-EE were significantly higher in obese participants and significantly higher compared with PVG and CON in both groups. Obese participants significantly ate more than lean ones in all four conditions (P<0·001). EI did not differ between conditions in obese participants (CON: 4935 (SD 1490) kJ; PVG: 4902 (SD 1307) kJ; AVG: 4728 (SD 1358) kJ; EX: 4643 (SD 1335) kJ), and was significantly lower in lean participants after EX (2847 (SD 577) kJ) compared with PVG (3580 (SD 863) kJ) and AVG (3485 (SD 643) kJ) (P<0·05). Macronutrient intake was not significantly different between the groups or conditions. Hunger was significantly higher and satiety was lower in obese participants but no condition effect was observed. Overall, moderate-intensity exercise provides better effect on energy balance than an isoenergetic hour of active video gaming in lean adolescent boys by dually affecting EE and EI.

Reduced neural response to food cues following exercise is accompanied by decreased energy intake in obese adolescents

BACKGROUND

Acute exercise has been found to favor a transient anorexigenic effect in obese adolescents. Although the role of some gastro-peptides has been suggested as an explanation for this observed reduced energy intake after exercise, it is unknown whether neural pathways involved in the regulation of food intake are modulated in youth.

METHODS

Body composition (dual-energy X-ray absorptiometry) and aerobic capacities were assessed in 19 obese adolescent boys. Participants were randomized to remain at rest in a sitting position (CON condition) or to exercise 45 min at 65% of their maximal capacities (EX condition) by the end of the morning. An attentional computer task with electroencephalography recording was completed immediately after the exercise or sitting period to measure an event-related component (P3b) reflecting the level of cognitive engagement in the processing of food cues. A lunch test-meal was offered ad libitum and appetite feelings assessed at regular intervals using visual analog scales.

RESULTS

The 45-min cycling exercise set at 65% VO2max induced a mean energy expenditure of 399±75 kcal. Both absolute (P<0.05) and relative (P<0.001) subsequent energy intake were significantly reduced after EX (1037±260 and 639±256 kcal, respectively) compared with CON (1116±243 and 1011±239 kcal, respectively). The energy ingested derived from each macronutrient and self-reported appetite remained unchanged. Although the amplitudes of the P3b component evoked by food and non-food visual stimuli were not significantly different during CON, the response to food cues was significantly reduced compared with non-food stimuli after exercise (P<0.01).

DISCUSSION

An acute exercise favors decreased neural response to food cues compared with non-food ones in obese adolescents that may contribute to their subsequently reduced energy intake.

Acute effects of active gaming on ad libitum energy intake and appetite sensations of 8–11-year-old boys

The present study examined the acute effects of active gaming on energy intake (EI) and appetite responses in 8–11-year-old boys in a school-based setting. Using a randomised cross-over design, twenty-one boys completed four individual 90-min gaming bouts, each separated by 1 week. The gaming bouts were (1) seated gaming, no food or drink; (2) active gaming, no food or drink; (3) seated gaming with food and drink offered ad libitum; and (4) active gaming with food and drink offered ad libitum. In the two gaming bouts during which foods and drinks were offered, EI was measured. Appetite sensations – hunger, prospective food consumption and fullness – were recorded using visual analogue scales during all gaming bouts at 30-min intervals and at two 15-min intervals post gaming. In the two bouts with food and drink, no significant differences were found in acute EI (MJ) (P=0·238). Significant differences were detected in appetite sensations for hunger, prospective food consumption and fullness between the four gaming bouts at various time points. The relative EI calculated for the two gaming bouts with food and drink (active gaming 1·42 (sem 0·28) MJ; seated gaming 2·12 (sem 0·25) MJ) was not statistically different. Acute EI in response to active gaming was no different from seated gaming, and appetite sensations were influenced by whether food was made available during the 90-min gaming bouts.

Nutritional Adaptations in Elite Soccer Referees: First Evidence and Perspectives

Although the physiological cost of refereeing has been already studied in the literature, especially in soccer umpires, it remains unknown whether referees spontaneously adapt their energy intake during game days. Six national soccer referees completed 24-hour dietary recalls (assisted by the SU.VI.MAX copybook) during a control day (CON) and a day with a game (GAME). The stress level and hunger feelings were assessed using visual analogue scales. Total energy intake, energy derived from macronutrients and energy intake at each meal were analyzed using the Bilnuts nutrition software. Total daily energy intake was not significantly different between conditions (CON: 2270 ± 535 vs. GAME: 2782 ± 293). Energy derived from fat and protein was not different between conditions but the participants ingested more calories derived from carbohydrates during the GAME day (45.5 ± 5.9% vs. 54.9 ± 5.5%, respectively, p<0.05). The calories ingested during snacking were significantly increased during GAME compared with CON (p<0.05). The stress level was significantly higher during GAME and especially before the breakfast, lunch and snack (p<0.05). Hunger feeling was not different between conditions. Referring leads to nutritional adaptations in elite soccer umpires, who tend to increase their energy intake mainly during snacking, by increasing their carbohydrate consumption.

Active video games and energy balance in male adolescents: a randomized crossover trial

BACKGROUND

Active video games (AVGs) have been shown to acutely increase energy expenditure when compared with seated video games; however, the influence of AVGs on compensatory adjustments in energy intake and expenditure is largely unknown.

OBJECTIVE

The aim was to examine the acute effects of AVGs on energy intake and expenditure.

DESIGN

With the use of a randomized crossover design, 26 male adolescents (mean ± SD age: 14.5 ± 1.4 y) completed three 1-h experimental conditions: resting control, seated video game play (Xbox 360; Microsoft), and AVG play (Kinect Adventures on Xbox 360) followed by an ad libitum lunch. A validated food menu was used to assess food intake immediately after the conditions and for the remainder of the day, and a dietary record was used for the subsequent 3-d period. Energy expenditure was measured by using portable indirect calorimetry throughout each experimental condition, and an accelerometer was used to assess the subsequent 3-d period. Appetite sensations were assessed by using visual analog scales at different time points during the testing day. The primary outcomes were acute (immediately after the conditions and 24-h) and short-term (3-d) energy intake and expenditure.

RESULTS

Energy expenditure was significantly higher (~145%; P < 0.001) during the AVG condition than during the resting control and seated video game conditions; however, no significant differences in energy expenditure were observed 24 h (~6%; P > 0.49) and 3 d after the experimental conditions (~3%; P > 0.82). No significant differences were observed in absolute energy intake immediately after the conditions (~2%; P > 0.94) or in absolute energy intake 24 h (~5%; P > 0.63) and 3 d (~9%; P > 0.53) after the experimental conditions. Finally, appetite sensations were similar between conditions at all time points (P > 0.05).

CONCLUSIONS

The increase in energy expenditure promoted by a single session of Kinect AVG play is not associated with increased food intake but is compensated for after the intervention, resulting in no measurable change in energy balance after 24 h. These results suggest that the potential of Kinect to reduce the energy gap underlying weight gain is offset within 24 h in male adolescents. This trial was registered at clinicaltrials.gov as NCT01655901.

Nutritional responses to acute training sessions in young elite rugby players

BACKGROUND

Acute exercise has been shown to induce nutritional adaptations in obese and lean inactive youth but it remains unclear whether youth with a high level of physical activity experience such exercise-induced energy intake and appetite modifications.

METHODS

14 (15- to 16-year-old) male elite rugby players completed sessions on three separate occasions: (1) a control session (CON); (2) an exercise session (EX) and; (3) a rugby session (RUGBY). The energy induced by the rugby and exercise sessions was matched (Polar Team2 pro technology), and participants' energy intake, food preferences (ad libitum buffet meals) and appetite feelings (Visual Analogue Scales) were assessed throughout the experimental days.

RESULTS

The energy intake during lunch and snack time was not different between conditions. Dinner time energy intake was significantly increased after RUBGY compared to CON with respectively 969 ± 145 kcal and 777 ± 183 kcal (p < 0.05). The energy intake at dinner time was significantly increased during EX (1185 ± 199 kcal) compared to both CON (p < 0.001) and RUGBY (p < 0.01). None of the appetite feelings investigated were modified between sessions.

CONCLUSION

Adolescent elite rugby players regulate their energy intake differently depending on the nature of their training; independently of the energy expended. This demonstrates the need for energetic and nutritional education to optimize their physical fitness and performance.

Is energy intake altered by a 10-week aerobic exercise intervention in obese adolescents?

AIM

To examine energy intake adaptations to a 10-week aerobic exercise program in obese adolescents.

METHODS

Twenty-six 12-17year old obese adolescents were asked to cycle twice a week for an hour in a research laboratory. Body composition, aerobic fitness (submaximal fitness test) and energy intake (3-day food record) were assessed before and immediately after the 10-week intervention.

RESULTS

The average time spent pedaling per session was 55.3±12.1min for a mean energy expenditure of 2196±561kJpersession. The intervention produced significant improvements in percentage of body fat (44.5±10.6% vs. 43.4±9.8%; p<0.05) but no significant weight and fat-free mass change. Peak workload (79.5±20.8W vs. 87.3±17.6W; p<0.05) and peak heart rate (174.6±18.7bpm vs. 166.2±21.0bpm; p<0.01) were improved. The mean total daily energy intake (in kJ/day) showed a tendency to decrease through the intervention (7440±1744 to 6740±2124kJ; p=0.07) but a high inter-individual variability observed in the energy intake response to the intervention may explain the non-significant association between the energy intake response and weight loss.

CONCLUSION

A 10-week aerobic exercise program may result in a small decrease in energy intake and an associated decrease in percentage of body fat but no weight loss in obese adolescents. This lack of weight loss could be explained by a decrease in spontaneous energy expenditure outside the intervention sessions.