Psycho-markers of weight loss. The roles of TFEQ Disinhibition and Restraint in exercise-induced weight management

Efficacy of Meal Replacement Products on Weight and Glycolipid Metabolism Management: A 90-Day Randomized Controlled Trial in Adults with Obesity

Background: The global obesity issue is growing increasingly serious, impacting personal health, economic development, and the sustainability of medical systems. There is an urgent need for effective weight loss strategies that can be widely implemented. This study conducted a 90-day randomized controlled trial to assess the impact of meal replacement products on weight management and glycolipid metabolism in adults with obesity. Methods: Adults with obesity meeting the inclusion and exclusion criteria were divided into three groups: the meal replacement group (n = 19), the diet control group (n = 19), and the normal diet group (n = 22). The meal replacement group used specially formulated meal replacement products for dinner, and the diet control group reduced the intake of staple food at lunch, both controlling daily energy intake between 1200 kcal and 1300 kcal, while the normal diet group maintained their regular dietary habits. Relevant indicators were measured at baseline and after 45 and 90 days of intervention. Results: The results showed that both the meal replacement group and the diet control group experienced significant decreases in weight, BMI, and body fat percentage, with the meal replacement group showing a more pronounced weight loss effect. The weight loss of the meal replacement group at 45 and 90 days was 4.44 ± 1.84 kg and 7.38 ± 3.24 kg, the diet control group was 2.62 ± 2.28 kg and 4.08 ± 2.94 kg, and the normal diet group was 0.66 ± 1.73 kg and 0.97 ± 2.02 kg. The decrease in BMI at 45 and 90 days for the meal replacement group was 1.08 ± 0.78 kg/m2 and 2.17 ± 1.57 kg/m2, for the diet control group was 0.82 ± 0.80 kg/m2 and 1.39 ± 1.16 kg/m2, and for the normal diet group was 0.19 ± 0.71 kg/m2 and 0.21 ± 0.96 kg/m2. The decrease in body fat percentage at 45 and 90 days for the meal replacement group was 1.76 ± 0.68% and 3.67 ± 2.62%, for the diet control group was 1.02 ± 1.11% and 1.52 ± 1.79%, and for the normal diet group was 0.81 ± 1.09% and 0.53 ± 0.93%. In addition, the decrease in BMI and body fat percentage in the meal replacement group was also significantly higher than in the other two groups. In terms of metabolic indicators, there were no significant differences in the changes of blood pressure, blood lipids, blood sugar, and ALT levels among the three groups during the intervention period. Conclusions: In summary, the results indicate that meal replacement products can significantly reduce weight and body fat percentage without affecting metabolic health.

Effects of Physical Activity on Disordered Eating Behaviours in Individuals With a Psychotic Disorder

AIM

This study aims to determine the effect of physical activity on cognitive restraint, uncontrolled eating and emotional eating in individuals with a psychotic disorder.

METHODS

Twenty-seven participants with a psychotic disorder (55% male; mean age: 30 ± 7.5 years; Caucasian: 66.7%; schizophrenia spectrum disorders: 44.4%; bipolar disorder with psychotic features: 29.6%) took part in a 6-month bi-weekly physical activity program (walking, running, yoga, cycling and dancing). The Three-Factor Eating Questionnaire was used to assess participant's eating behaviours, and the frequency of completed physical activity sessions was compiled.

RESULTS

The mixed models analysis approach revealed that the level of cognitive restraint remained unchanged (pre: 39.2 ± 18.7 vs. post: 44.1 ± 18.3; p = 0.24), while the levels of uncontrolled eating (pre: 39.7 ± 19 vs. post: 31.6 ± 19.7; p = 0.02) and emotional eating (pre: 45.5 ± 22.3 vs. post: 32.2 ± 22.2; p < 0.001) decreased at the end of the 6-month physical activity program.

DISCUSSION

This study showed that physical activity has positive effects on disordered eating behaviours in individuals with a psychotic disorder, similarly to previous studies on other populations (e.g., overweight and obese participants, postmenopausal women).

CONCLUSION

Further studies are warranted to better understand the role of physical activity in moderating eating behaviours.

Weight regain, body composition, and metabolic responses to weight loss in weight cycling athletes: A systematic review and meta-analyses

Depending on the nature of their sports, athletes may be engaged in successive weight loss (WL) and regain, conducing to "weight cycling." The aims of this paper were to systematically (and meta-analytically when possible) analyze the post-WL recovery of (i) body weight and (ii) fat mass; fat-free mass; and performance and metabolic responses in weight cycling athletes (18-55 years old, body mass index < 30 kg.m-2 ). MEDLINE, Embase, and SPORTDiscus databases were explored. The quality and risk of bias of the 74 included studies were assessed using the quality assessment tool for quantitative studies. Thirty-two studies were eligible for meta-analyses. Whatever the type of sports or methods used to lose weight, post-WL body weight does not seem affected compared with pre-WL. While similar results are observed for fat-free mass, strength sports athletes (also having longer WL and regain periods) do not seem to fully recover their initial fat mass (ES: -0.39, 95% CI: [-0.77; -0.00], p = 0.048, I2  = 0.0%). Although the methods used by athletes to achieve WL might prevent them from a potential post-WL fat overshooting, further studies are needed to better understand WL episodes consequences on athletes' performance as well as short- and long-term physical, metabolic, and mental health.

Exploratory analysis of reflective, reactive, and homeostatic eating behaviour traits on weight change during the 18-month NoHoW weight maintenance trial

Behaviour change interventions for weight management have found varied effect sizes and frequent weight re-gain after weight loss. There is interest in exploring whether differences in eating behaviour can be used to develop tailored weight management programs. This secondary analysis of an 18-month weight maintenance randomised controlled trial (RCT) aimed to investigate the association between individual variability in weight maintenance success and change in eating behaviour traits (EBT). Data was analysed from the NoHoW trial (Scott et al., 2019), which was designed to measure processes of change after weight loss of ≥5% body weight in the previous year. The sample included 1627 participants (mean age = 44.0 years, SD = 11.9, mean body mass index (BMI) = 29.7 kg/m2, SD = 5.4, gender = 68.7% women/31.3% men). Measurements of weight (kg) and 7 EBTs belonging to domains of reflective, reactive, or homeostatic eating were taken at 4 time points up to 18-months. Increases in measures of 'reactive eating' (binge eating, p < .001), decreases in 'reflective eating' (restraint, p < .001) and changes in 'homeostatic eating' (unlimited permission to eat, p < .001 and reliance on hunger and satiety cues, p < .05) were significantly and independently associated with concomitant weight change. Differences in EBT change were observed between participants who lost, maintained, or re-gained weight for all EBTs (p < .001) except for one subscale of intuitive eating (eating for physical reasons, p = .715). Participants who lost weight (n = 322) exhibited lower levels of reactive eating and higher levels of reflective eating than participants who re-gained weight (n = 668). EBT domains can identify individuals who need greater support to progress in weight management interventions. Increasing reflective eating and reducing reactive eating may enhance weight management success.

Prevalence of dietary supplement consumption among CrossFit practitioners

Purpose

We aimed to verify the prevalence of dietary supplements among CrossFit practitioners (CFPs), considering gender and training status. Still, we aimed to determine the type, reasons, and associated factors of dietary supplement utilization among CFPs.

Methods

This is a cross-sectional, exploratory, and descriptive study with the snowball sampling method. Data were collected through online questionnaires using the Google Forms® tool. We included CFPs aged 18-64 years, from Aug 1, 2020, to Sept 31, 2020. The questionnaire contained questions to assess the prevalence, type, and reasons for supplement use; also, we assessed information about sociodemographic variables and the prevalence of the main chronic morbidities. To analyze aspects of eating behavior and sleep-related parameters, we applied the three-factor eating questionnaire (TFEQ)-R21 and the Pittsburgh Sleep Quality Index questionnaire (PSQI), respectively.

Results

We assessed one hundred twelve (n = 112; 57 men; 55 women) CFPs (28.9 ± 7.64 years old; body mass index (BMI), 25.5 ± 4.83 kg/m2). Eighty-seven (50 men; 37 women; 28.2 ± 6.66 years old; BMI, 25.4 ± 4.55 kg/m2) reported using dietary supplements. Whey protein was the most used supplement (n = 70), followed by creatine (n = 54). Cognitive restraint (a dimension of eating behavior) score was higher in supplement users than in non-users (51.7 ± 18.6 vs. 42.6 ± 20.5; p = 0.040). Sleep-related parameters did not differ between supplement users and non-users. The most associated factors to supplement use were sex (being man; OR, 7.99; p = 0.007), sleep quality (poor; OR, 5.27; p = 0.045), CrossFit level (as prescribed (RX); OR, 4.51; p = 0.031), and cognitive restraint (OR, 1.03; p = 0.029).

Conclusion

The CFPs, especially RX and Elite ones, showed a higher prevalence of supplement utilization. Anabolic-related supplements (i.e., whey protein and creatine) were the most used; moreover, several CFPs used supplements not supported by scientific evidence. Cognitive restraint score was higher in supplement users than in non-users. RX level, being men, and poor sleep quality were associated with supplement utilization. These data draw attention to the necessity of nutritional education for CrossFit coaches and athletes. Broader studies are necessary to confirm our findings.

Do eating behavior traits predict energy intake and body mass index? A systematic review and meta-analysis

At present, it is unclear whether eating behavior traits (EBT) predict objectively measured short-term energy intake (EI) and longer-term energy balance as estimated by body mass index (BMI). This systematic review examined the impact of EBT on BMI and laboratory-based measures of EI in adults ( ≥ 18 years) in any BMI category, excluding self-report measures of EI. Articles were searched up until 28th October 2021 using MEDLINE, PsycINFO, EMBASE and Web of Science. Sixteen EBT were identified and the association between 10 EBT, EI and BMI were assessed using a random-effects meta-analysis. Other EBT outcomes were synthesized qualitatively. Risk of bias was assessed with the mixed methods appraisal tool. A total of 83 studies were included (mean BMI = 25.20 kg/m² , mean age = 27 years and mean sample size = 70). Study quality was rated moderately high overall, with some concerns in sampling strategy and statistical analyses. Susceptibility to hunger (n = 6) and binge eating (n = 7) were the strongest predictors of EI. Disinhibition (n = 8) was the strongest predictor of BMI. Overall, EBT may be useful as phenotypic markers of susceptibility to overconsume or develop obesity (PROSPERO: CRD42021288694).

The impact of exercise and cumulative physical activity on energy intake and diet quality in adults enrolled in the Midwest Exercise Trial for the Prevention of Weight Regain

The purpose of this study was to assess impact of different volumes of exercise as well as cumulative moderate to vigorous physical activity (MVPA) on energy intake (EI) and diet quality, as assessed by the Healthy Eating Index-2010(HEI-2010), across a 12-month weight maintenance intervention. Participants were asked to attend group behavioural sessions, eat a diet designed for weight maintenance and exercise either 150, 225 or 300 min/week. Dietary intake was assessed by 3-d food records, and MVPA was assessed by accelerometry. Two hundred and twenty-four participants (42·5 years of age, 82 % female) provided valid dietary data for at least one time point. There was no evidence of group differences in EI, total HEI-2010 score or any of the HEI-2010 component scores (all P > 0·05). After adjusting for age, sex, time, group and group-by-time interactions, there was an effect of cumulative MVPA on EI (1·08, P = 0·04), total HEI-2010 scores (-0·02, P = 0·003), Na (-0·006, P = 0·002) and empty energy scores (-0·007, P = 0·004. There was evidence of a small relationship between cumulative daily EI and weight (β: 0·00187, 95 % CI 0·001, P = 0·003). However, there was no evidence for a relationship between HEI total score (β: -0·006, 95 % CI 0·07, 0·06) or component scores (all P > 0·05) and change in weight across time. The results of this study suggest that increased cumulative MVPA is associated with clinically insignificant increases in EI and decreases in HEI.

Free-Living Energy Balance Behaviors Are Associated With Greater Weight Loss During a Weight Loss Program

Introduction: Free-living movement (physical activity [PA] and sedentary behavior [SB]) and eating behaviors (energy intake [EI] and food choice) affect energy balance and therefore have the potential to influence weight loss (WL). This study explored whether free-living movement and/or eating behaviors measured early (week 3) in a 14-week WL programme or their change during the intervention are associated with WL in women. Methods: In the study, 80 women (M ± SD age: 42.0 ± 12.4 years) with overweight or obesity [body mass index (BMI): 34.08 ± 3.62 kg/m²] completed a 14 week WL program focused primarily on diet (commercial or self-led). Body mass (BM) was measured at baseline, and again during week 2 and 14 along with body composition. Free-living movement (SenseWear Armband) and eating behavior (weighed food diaries) were measured for 1 week during week 3 and 12. Hierarchical multiple regression analyses examined whether early and early-late change in free-living movement and eating behavior were associated with WL. The differences in behavior between clinically significant weight losers (CWL; ≥5% WL) and non-clinically significant weight losers (NWL; ≤ 3% WL) were compared. Results: The energy density of food consumed [β = 0.45, p < 0.001] and vigorous PA [β = -0.30, p < 0.001] early in the intervention (regression model 1) and early-late change in light PA [β = -0.81 p < 0.001], moderate PA [β = -1.17 p < 0.001], vigorous PA [β = -0.49, p < 0.001], total energy expenditure (EE) [β = 1.84, p < 0.001], and energy density of food consumed [β = 0.27, p = 0.01] (regression model 2) significantly predicted percentage change in BM. Early in the intervention, CWL consumed less energy dense foods than NWL [p = 0.03]. CWL showed a small but significant increase in vigorous PA, whereas NWL showed a slight decrease in PA [p = 0.04]. Conclusion: Both early and early-late change in free-living movement and eating behaviors during a 14 week WL program are predictors of WL. These findings demonstrate that specific behaviors that contribute to greater EE (e.g., vigorous PA) and lower EI (e.g., less energy-dense foods) are related to greater WL outcomes. Interventions targeting these behaviors can be expected to increase the effectiveness of WL programs.

Effects of diurnal exercise timing on appetite, energy intake and body composition: A parallel randomized trial

OBJECTIVE

To determine the effect of diurnal exercise timing on appetite, energy intake and body composition in individuals with overweight or obesity.

METHODS

Forty sedentary, individuals with overweight or obesity (17 males, 23 females; age: 51 ± 13 years; BMI: 30.9 ± 4.2 kg/m²) were randomly allocated to complete a 12-week supervised multi-modal exercise training program performed either in the morning (amEX) or evening (pmEX). Outcome measures included appetite in response to a standardised test meal, daily energy intake (EI), body weight and body composition. Measures of dietary behaviour were assessed at baseline and post-intervention, along with habitual physical activity, sleep quality and sleep quantity. Significance was set at p ≤ .05 and Hedge's g effect sizes were calculated.

RESULTS

Regardless of timing, exercise training increased perceived fullness (AUC; g = 0.82-1.67; both p < .01), decreased daily EI (g = 0.73-0.93; both p < .01) and body-fat (g = 0.29-0.32; both p <. 01). The timing of exercise did not change the daily EI or body-fat response to training (all p ≥ .27), however, perceived fullness increased in the amEX group (p ≤ .01). DISINHIBITION: (g = 0.35-1.95; p ≤ .01) and Hunger (g = 0.05-0.4; p = .02) behaviours decreased following exercise training, with Disinhibition demonstrating greater improvements in the pmEX group (p = .01). Objective and subjective sleep quantity increased with training (all p ≤ .01), but sleep quality was not reported to change.

CONCLUSIONS

Multi-modal exercise training improved body composition and some appetite outcomes, although changes were inconsistent and largely independent of exercise-timing. In the absence of dietary manipulation, the effect of diurnal exercise timing on appetite and body composition appear trivial compared to the overall benefits of exercise participation.

Effect of exercise training interventions on energy intake and appetite control in adults with overweight or obesity: A systematic review and meta-analysis

This systematic review examined the impact of exercise training interventions on energy intake (EI) and appetite control in adults with overweight/obesity (≥18 years including older adults). Articles were searched up to October 2019. Changes in EI, fasting appetite sensations, and eating behavior traits were examined with random effects meta-analysis, and other outcomes were synthesized qualitatively. Forty-eight articles were included (median [range] BMI = 30.6 [27.0-38.4] kg/m² ). Study quality was rated as poor, fair, and good in 39, seven, and two studies, respectively. Daily EI was assessed objectively (N = 4), by self-report (N = 22), with a combination of the two (N = 4) or calculated from doubly labeled water (N = 1). In studies rated fair/good, no significant changes in pre-post daily EI were found and a small but negligible (SMD < 0.20) postintervention difference when compared with no-exercise control groups was observed (five study arms; MD = 102 [1, 203] kcal). There were negligible-to-small pre-post increases in fasting hunger and dietary restraint, decrease in disinhibition, and some positive changes in satiety and food reward/preferences. Within the limitations imposed by the quality of the included studies, exercise training (median duration of 12 weeks) leads to a small increase in fasting hunger and a small change in average EI only in studies rated fair/good. Exercise training may also reduce the susceptibility to overconsumption (PROSPERO: CRD42019157823).

Actigraphy-Derived Sleep Is Associated with Eating Behavior Characteristics

Poor sleep is a determinant of obesity, with overconsumption of energy contributing to this relationship. Eating behavior characteristics are predictive of energy intake and weight change and may underlie observed associations of sleep with weight status and obesity risk factors. However, relationships between sleep and dimensions of eating behavior, as well as possible individual differences in these relations, are not well characterized. Therefore, the aim of this study was to evaluate whether sleep behaviors, including duration, timing, quality, and regularity relate to dietary restraint, disinhibition, and tendency towards hunger and to explore whether these associations differ by sex. This cross-sectional study included 179 adults aged 20–73 years (68.7% women, 64.8% with BMI ≥ 25 kg/m²). Sleep was evaluated by accelerometry over 2 weeks. Eating behavior dimensions were measured with the Three-Factor Eating Questionnaire. Prolonged wake after sleep onset (WASO) (0.029 ± 0.011, p = 0.007), greater sleep fragmentation index (0.074 ± 0.036, p = 0.041), and lower sleep efficiency (−0.133 ± 0.051, p = 0.010) were associated with higher dietary restraint. However, higher restraint attenuated associations of higher WASO and sleep fragmentation with higher BMI (p-interactions < 0.10). In terms of individual differences, sex influenced associations of sleep quality measures with tendency towards hunger (p-interactions < 0.10). Stratified analyses showed that, in men only, higher sleep fragmentation index, longer sleep onset latency, and lower sleep efficiency were associated with greater tendency towards hunger (β = 0.115 ± 0.037, p = 0.003, β = 0.169 ± 0.072, p = 0.023, β = −0.150 ± 0.055, p = 0.009, respectively). Results of this analysis suggest that the association of poor sleep on food intake could be exacerbated in those with eating behavior traits that predispose to overeating, and this sleep-eating behavior relation may be sex-dependent. Strategies to counter overconsumption in the context of poor quality sleep should be evaluated in light of eating behavior traits.

An Increase in Fat-Free Mass is Associated with Higher Appetite and Energy Intake in Older Adults: A Randomised Control Trial

Cross-sectional studies in younger adults have demonstrated a positive association between energy intake (EI) and fat-free mass (FFM), with this relationship seemingly mediated by resting metabolic rate (RMR). Establishing a causal effect longitudinally would be prudent in older adults suffering from loss of appetite. We investigated the effects of FFM on RMR, appetite and EI in 39 healthy older adults (age: 66 ± 4 years, BMI: 25.1 ± 3.5 kg∙m²) assigned to either 12-week resistance training + protein supplementation group (RT + PRO) or control group (CON). Body composition, subjective appetite, leptin, insulin, RMR and laboratory-measured ad libitum EI were measured at baseline, weeks 6 and 12 of the intervention, while daily EI at baseline and week 12. FFM (+1.2 kg; p = 0.002), postprandial subjective appetite (+8 mm; p = 0.027), ad libitum EI (+119 kcal; p = 0.012) and daily EI (+133 kcal; p = 0.010) increased from baseline to week 12 in the RT + PRO. RMR, fasted subjective appetite, leptin and insulin concentrations remained unchanged (all p > 0.05). The increases ad libitum EI correlated with increases in FFM (r = 0.527, p = 0.001), with 54% of the change in EI attributed to FFM changes. In conclusion, FFM increases were associated with an increased ad libitum EI and postprandial appetite in older adults.

Early changes in appetite and energy expenditure are not associated to body weight and fat losses in pre-menopausal women living with overweight/obesity

BACKGROUND

The aim of the study was to investigate whether early changes (1-week) in energy balance-related measures would predict changes in body weight (BW) and fat losses in women living with overweight/obesity.

METHODS

BW, body composition (DXA), resting energy expenditure (REE)(indirect calorimetry), olfactory performance (Sniffin' Sticks), appetite and palatability (visual analogue scale) were measured at baseline, after a 1-week of caloric restriction as well as post-intervention (at 10 and 20 weeks) in a group of 30 women living with overweight/obesity.

RESULTS

A significant decrease in REE (p = 0.033) was noted after 1 week. Fasting desire to eat (p = 0.004), hunger (p = 0.001) and prospective food consumption (p = 0.001) all increased after 1 week. Similarly, significant increases in AUC SQ for desire to eat (p = 0.01), hunger (p = 0.005) and prospective food consumption (p = 0.001) were noted after 1 week. However, these early changes were not associated to final BW or FM losses at the end of the weight loss intervention.

CONCLUSION

Despite significant changes in REE and appetite soon after the onset of a BW loss intervention, these early changes do not seem to predict final BW or FM losses at the end of the program in women living with overweight/obesity.

Exercise Training Reduces Reward for High-Fat Food in Adults with Overweight/Obesity

PURPOSE

There is increasing evidence that exercise training may facilitate weight management via improvements in homeostatic appetite control, but little is known about how exercise training affects food reward and susceptibility to overeating.

METHODS

This study examined changes in food reward and eating behavior traits after a supervised 12-wk exercise intervention (10.5 MJ·wk) in inactive individuals with overweight/obesity (exercisers; n = 46, 16 men/30 women; mean (SD) body mass index, 30.6 (3.8) kg·m; and mean (SD) age, 43.2 (7.5) yr) compared with nonexercising controls (n = 15; 6 men/9 women; mean (SD) body mass index, 31.4 (3.7) kg·m; and mean (SD) age, 41.4 (10.7) yr). Liking and wanting scores for high-fat relative to low-fat foods were assessed with the Leeds Food Preference Questionnaire before and after consumption of an isoenergetic high-fat or high-carbohydrate lunch. Eating behavior traits were assessed using the Three-Factor Eating Questionnaire and Binge Eating Scale.

RESULTS

A week-group interaction indicated that wanting scores decreased from baseline to postintervention in exercisers only (M[INCREMENT]Pre-Post = -4.1, P = 0.03, ηp = 0.09, 95% confidence interval [CI], -7.8 to -0.4), but there was no exercise effect on liking. There was also a week-group interaction for binge eating, which decreased in exercisers only (M[INCREMENT]Pre-Post = -1.5, P = 0.01, ηp = 0.11; 95% CI, -2.7 to -0.4). A small reduction in disinhibition was also apparent in exercisers (M[INCREMENT]Pre-Post = -0.7, P = 0.02, ηp = 0.10; 95% CI, -1.3 to -0.1).

CONCLUSIONS

This study showed that 12 wk of exercise training reduced wanting scores for high-fat foods and trait markers of overeating in individuals with overweight/obesity compared with nonexercising controls. Further research is needed to elucidate the mechanisms behind these exercise-induced changes in food reward.

Psychological and weight history variables as predictors of short-term weight and body fat mass loss

OBJECTIVE

Identifying predictors of early weight loss may have value in predicting longer-term success in weight loss programmes. This study examined if weight history variables (ie, weight cycling history [WCH], age of onset of obesity [AOO]), and preintervention Three-Factor Eating Questionnaire (TFEQ) and Power of Food Scale (PFS) scores predicted weight loss (WL) and fat mass loss (FML) following a 3-week calorie restriction intervention.

METHODS

Thirty-two participants (19-60 y; body mass index [BMI] 30-39.9 kg/m2) participated in a 3-week calorie restriction intervention (1120 kcal/d) as part of a larger clinical trial with 28 completers included in the current analyses. Preintervention WCH, AOO, TFEQ, and PFS subscale scores were collected, and WL and FML were measured. Multiple linear regression analyses were performed to predict WL and FML for relevant covariates in this study.

RESULTS

WCH, AOO, preintervention TFEQ subscale scores, and PFS subscale scores did not predict WL (all Ps > .08) or FML (Ps > .06) except, PFS-food tasted scores significantly predicted WL (r = -0.40, P = .03).

CONCLUSION

Although these variables were not robust predictors, results for at least the PFS suggest there may be value in further exploring this measure using larger sample sizes.

Psychosocial Variables Related to Weight-Related Self-Stigma in Physical Activity among Young Adults across Weight Status

A healthy lifestyle with sufficient physical activity (PA) can contribute to weight management. Yet, many people do not maintain a healthy lifestyle. To explain PA, we propose a model that incorporates the Theory of Planned Behavior (TPB) with weight-related self-stigma. We recruited 325 young adults to complete questionnaires regarding their physical activities, weight-related self-stigma, and TPB factors. We used structural equation modeling to examine the model fit and the path invariance across weight groups. The model showed excellent model fit, but path invariance was not supported. Weight-related self-stigma significantly explained the perceived behavioral control, behavioral intention, and engagement of PA. People without overweight and people with overweight have different considerations for PA. Weight-related self-stigma is important for PA as well. To promote a healthy lifestyle, healthcare providers should provide different suggestions or interventions that suit their patients' weight-related concerns.

Effect of HIIT versus MICT on body composition and energy intake in dietary restrained and unrestrained adolescents with obesity

High-intensity interval training (HIIT) has been suggested as an effective alternative to traditional moderate-intensity continuous training (MICT) that can yield improvements in a variety of health outcomes. Yet, despite the urgent need to find effective strategies for the treatment of pediatric obesity, only a few studies have addressed the impact of HIIT on eating behaviors and body composition in this population. This study aimed to compare the effect of HIIT versus MICT on eating behaviors in adolescents with obesity and to assess if the participants' baseline dietary status is associated with the success of the intervention. Forty-three adolescents with obesity were randomly assigned to a 16-week MICT or HIIT intervention. Body composition and 24-h ad libitum energy intake were assessed at baseline and at the end of the program. Restrained eating, emotional eating, and external eating were assessed using the Dutch Eating Behavior Questionnaire at baseline. Both interventions led to significant weight, body mass index (BMI), and fat mass percentage (FM%) reductions, with better improvements in FM% in the HIIT group; whereas 24-h ad libitum energy intake increased to a similar extent in both groups. HIIT provides better body composition improvements over MICT, despite a similar increase in energy intake. Restrained eaters experienced less weight loss and smaller BMI reduction compared with unrestrained eaters; higher baseline cognitively restrained adolescents showed a greater increase of their ad libitum energy intake. Novelty HIIT favors better body composition improvements compared with MICT. Both MICT and HIIT increased ad libitum energy intake in adolescents with obesity. Weight loss achievement is better among unrestrained eaters.

The feasibility and acceptability of morning versus evening exercise for overweight and obese adults: A randomized controlled trial

BACKGROUND

The time of day that people exercise could have an influence on the efficacy of exercise for weight loss, via differences in adherence and/or physiological adaptations. However, there is currently no evidence to support an optimal time of day for exercise to maximise efficacy.

PURPOSE

To examine the feasibility and acceptability of prescribed morning and evening exercise.

METHODS

Twenty inactive, overweight adults aged 18-60 years were recruited for a 12-week intervention and randomized to one of three groups using a 2:2:1 random allocation ratio: i) morning exercise (AM; n = 9); ii) evening exercise (PM; n = 7); or iii) waitlist control (CON; n = 4). Exercise groups were prescribed self-paced walking or running on a treadmill to achieve a weekly total of 250 min. Feasibility and acceptability data were collected, and physiological and behavioural outcomes associated with energy balance were measured at baseline, mid- and post-intervention.

RESULTS

Attrition was low (n = 2 dropped out), with high measurement completion rates (>80%). The intervention groups had high adherence rates to exercise sessions (94% and 87% for the AM and PM groups, respectively). No adverse events resulting from the intervention were reported. Both intervention groups displayed improvements to their cardiometabolic risk profile; cardiorespiratory fitness improved by 5.2 ± 4.7, and 4.6 ± 4.5 mL kg-1.min-1 and body fat percentage reduced by 1.2 ± 1.4, and -0.6 ± 1.2% for AM and PM groups, respectively.

CONCLUSION

This feasibility study provides evidence that morning and evening exercise interventions are feasible, and also provides justification for a large-scale randomized controlled trial.

TRIAL REGISTRATION

This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000457448p, 7/4/2016).

Effects of a 3-month vigorous physical activity intervention on eating behaviors and body composition in overweight and obese boys and girls

PURPOSE

This study aims to analyze the effects of a 3-month vigorous physical activity (VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents.

METHODS

Forty-seven participants (7-16 years) took part in the study: 28 were assigned to the intervention group (IG) (10 boys and 18 girls) and 19 in a control group (CG) (8 boys and 11 girls). Body composition (dual-energy X-ray absorptiometry), anthropometrics (body mass, height, and body mass index (BMI)), and eating behavior traits (Three-Factor Eating Questionnaire-R21C) were determined before and after the VPA intervention.

RESULTS

A decrease in the percentage of body fat and BMI (-2.8% and -1.8%, respectively), and an increase in most lean mass variables were found in the IG (all p ≤ 0.05). In relation to the eating behavior traits, IG subjects showed a 14% reduction in the Emotional Eating score (p = 0.04), while Cognitive Restraint score did not change after the VPA intervention. The baseline factors of the questionnaire predicted changes in body mass and fat mass variables only in the CG.

CONCLUSION

A 3-month VPA intervention influenced eating behaviors of overweight or obese young, especially the Emotional Eating factor, in the presence of favorable body composition changes.

Validation of a child version of the Three-Factor Eating Questionnaire in a Canadian sample: a psychometric tool for the evaluation of eating behaviour

OBJECTIVE

To examine score validity and reliability of a child version of the twenty-one-item Three-Factor Eating Questionnaire (CTFEQ-R21) in a sample of Canadian children and adolescents and its relationship with BMI Z-score and food/taste preferences.

DESIGN

Cross-sectional study.

SETTING

School-based.

PARTICIPANTS

Children (n 158), sixty-three boys (mean age 11·5 (sd 1·6) years) and ninety-five girls (11·9 (sd 1·9) years).

RESULTS

Exploratory factor analysis revealed that the CTFEQ-R21 was best represented by four factors with item 17 removed (CFFEQ-R20), representing Cognitive Restraint (CR), Cognitive Uncontrolled Eating (UE 1), External Uncontrolled Eating (UE 2) and Emotional Eating (EE), accounting for 41·2 % of the total common variance with good scale reliability. ANOVA revealed that younger children reported higher UE 1 and CR scores than older children, and boys who reported high UE 1 scores had significantly higher BMI Z-scores. Children with high UE 1 scores reported a greater preference for high-protein and -fat foods, and high-fat savoury (HFSA) and high-fat sweet (HFSW) foods. Higher preference for high-protein, -fat and -carbohydrate foods, and HFSA, HFSW and low-fat savoury foods was found in children with high UE 2 scores.

CONCLUSIONS

The study suggests that the CFFEQ-R20 can be used to measure eating behaviour traits and associations with BMI Z-score and food/taste preferences in Canadian children and adolescents. Future research is needed to examine the validity of the questionnaire in larger samples and other geographical locations, as well as the inclusion of extraneous variables such as parental eating or socio-economic status.

Acute and Chronic Effects of Exercise on Appetite, Energy Intake, and Appetite-Related Hormones: The Modulating Effect of Adiposity, Sex, and Habitual Physical Activity

Exercise facilitates weight control, partly through effects on appetite regulation. Single bouts of exercise induce a short-term energy deficit without stimulating compensatory effects on appetite, whilst limited evidence suggests that exercise training may modify subjective and homeostatic mediators of appetite in directions associated with enhanced meal-induced satiety. However, a large variability in responses exists between individuals. This article reviews the evidence relating to how adiposity, sex, and habitual physical activity modulate exercise-induced appetite, energy intake, and appetite-related hormone responses. The balance of evidence suggests that adiposity and sex do not modify appetite or energy intake responses to acute or chronic exercise interventions, but individuals with higher habitual physical activity levels may better adjust energy intake in response to energy balance perturbations. The effect of these individual characteristics and behaviours on appetite-related hormone responses to exercise remains equivocal. These findings support the continued promotion of exercise as a strategy for inducing short-term energy deficits irrespective of adiposity and sex, as well as the ability of exercise to positively influence energy balance over the longer term. Future well-controlled studies are required to further ascertain the potential mediators of appetite responses to exercise.

Energy depletion by 24-h fast leads to compensatory appetite responses compared with matched energy depletion by exercise in healthy young males

Although there is a growing interest for the effects of intermittent fasting on energy balance, this study aimed to compare appetite, energy intake and food reward responses with an energy depletion induced either by 24-h food restriction or an equivalent deficit with exercise in healthy males. In all, twelve healthy lean males (21·5 (sd 0·5) years old; BMI: 22·5 (sd 1·7) kg/m2) participated in this study. Body composition, aerobic capacity, food preferences and energy intake were assessed. They randomly completed three conditions: (i) no depletion (CON); (ii) full 24-h energy restrictions (Def-EI); and (iii) exercise condition (Def-EX). Ad libitum energy intake and food reward were assessed at the end of each session. Appetite feelings were assessed regularly. Ad libitum energy intake was higher on Def-EI (7330 (sd 2975) kJ (1752 (sd 711) kcal) compared with that on CON (5301 (sd 1205) kJ (1267 (sd 288) kcal)) (P<0·05), with no difference between CON and Def-EX (6238 (sd 1741) kJ (1491 (sd 416) kcal) (P=0·38) and between Def-EX and Def-EI (P=0·22). There was no difference in the percent energy ingested from macronutrients. Hunger was lower on CON and Def-EX compared with Def-EI (P<0·001). Satiety was higher on CON and Def-EI compared with that on Def-EX (P<0·001). There was a significant interaction condition × time for food choice fat bias (P=0·04), showing a greater preference for high-fat v. low-fat food during Def-EI and Def-EX. Although 24-h fasting leads to increased energy intake at the following test meal (without total daily energy intake difference), increased hunger profile and decreased post-meal food choice fat bias, such nutritional responses are not observed after a similar deficit induced by exercise.

Does Habitual Physical Activity Increase the Sensitivity of the Appetite Control System? A Systematic Review

Background

It has been proposed that habitual physical activity improves appetite control; however, the evidence has never been systematically reviewed.

Objective

To examine whether appetite control (e.g. subjective appetite, appetite-related peptides, food intake) differs according to levels of physical activity.

Data Sources

Medline, Embase and SPORTDiscus were searched for articles published between 1996 and 2015, using keywords pertaining to physical activity, appetite, food intake and appetite-related peptides.

Study Selection

Articles were included if they involved healthy non-smoking adults (aged 18–64 years) participating in cross-sectional studies examining appetite control in active and inactive individuals; or before and after exercise training in previously inactive individuals.

Study Appraisal and Synthesis

Of 77 full-text articles assessed, 28 studies (14 cross-sectional; 14 exercise training) met the inclusion criteria.

Results

Appetite sensations and absolute energy intake did not differ consistently across studies. Active individuals had a greater ability to compensate for high-energy preloads through reductions in energy intake, in comparison with inactive controls. When physical activity level was graded across cross-sectional studies (low, medium, high, very high), a significant curvilinear effect on energy intake (z-scores) was observed.

Limitations

Methodological issues existed concerning the small number of studies, lack of objective quantification of food intake, and various definitions used to define active and inactive individuals.

Conclusion

Habitually active individuals showed improved compensation for the energy density of foods, but no consistent differences in appetite or absolute energy intake, in comparison with inactive individuals. This review supports a J-shaped relationship between physical activity level and energy intake. Further studies are required to confirm these findings.

PROSPERO Registration Number

CRD42015019696

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-016-0518-9) contains supplementary material, which is available to authorized users.

Perceived Exertion during Exercise Is Associated with Children's Energy Intake

PURPOSE

To examine the individual-level factors that predict energy intake (EI) after imposed exercise (EX) and sedentary time (SED) in children.

METHODS

Healthy-weight children ages 9-12 yr (n = 20) reported to the laboratory for one baseline and two experimental visits (EX and SED) each separated by 1 wk in a randomized crossover design. Percent body fat, weight (kg), and height (m) were used to calculate fat-mass index (FM index) and fat-free mass index (FFM index; kg·m). On the EX day, children exercised at 70% estimated V˙O2peak for 30 min on a cycle ergometer, whereas cardiovascular responses and RPE were measured. Objective EI (kcal) was measured at identical meals (breakfast, lunch, snack, and dinner) on the EX and SED days.

RESULTS

Total EI was not statistically different between the EX and SED days (t = 1.8, P = 0.09). FFM index was positively associated with EI on the EX day (r = 0.54, P < 0.05). RPE was also positively associated with EI on the EX day (r = 0.82, P < 0.001). Together, FFM index and RPE explained 77% of the variability in EX day EI (F(2,17) = 26.4, P < 0.001). For each unit increase in RPE, children consumed approximately 270 more calories on the EX day. A similar pattern of associations was observed on the SED day.

CONCLUSIONS

FFM index was positively associated with EI on the EX day. Despite experiencing the same 70% relative exercise intensity, increased perceived difficulty predicted greater EI on both the EX and SED day. These findings demonstrate a role for both FFM and RPE in explaining EI variability in children.

Weight Loss and Appetite Control in Women

PURPOSE OF REVIEW

The aim of this review is to describe and discuss weight loss-induced variations in appetite in women and factors responsible for these changes.

RECENT FINDINGS

Studies have shown postweight loss increases in fasting and postprandial appetite in individuals engaged in weight loss trials, especially in women. Similarly, appetite-related peptides associated to the homeostatic control of feeding, such as leptin, ghrelin and peptide YY, were also found to be altered in way that promotes increased appetite after weight loss interventions. Sustained caloric deficits also drive increases in the frequency and strength of food cravings, food reward and seem to enhance oro-sensory sensations in women who lost weight. The menstrual cycle has also been to shown to influence caloric intake in women, more specifically food cravings. On the other hand, caloric restriction seems to increase cognitive restraint, decrease habitual disinhibition and susceptibility to hunger among women engaged in weight loss trials. Neural analysis corroborates these results, showing increased activation in brain areas involved in food reward and self-control processing. In conclusion, evidence supports that weight loss increases appetite sensations, and promotes changes in homeostatic and non-homeostatic control of feeding, which collectively seem to upregulate appetite in women.

The Weight-Related Eating Questionnaire offers a concise alternative to the Three-Factor Eating Questionnaire for measuring eating behaviors related to weight loss

OBJECTIVE

During a one-year weight loss trial, we compared the Three-Factor Eating Questionnaire (TFEQ), a valid 51-item measure of restraint, disinhibition, and hunger subscales, with the newer 16-item Weight-Related Eating Questionnaire (WREQ) measuring routine and compensatory restraint and external and emotional eating.

METHODS

Both questionnaires were administered to women with overweight or obesity (n = 186, mean ± SD, age 50 ± 10.6 y, BMI 34 ± 4.2 kg/m²) at five time points. Completion rates were 100% at baseline and Month 1, 94% at Month 3, 83% at Month 6, and 76% at Month 12. Confirmatory factor analysis was conducted on baseline WREQ data and correlations were calculated between TFEQ and WREQ subscales. Multilevel models evaluated the relationship between each subscale and weight change over time.

RESULTS

Factor analysis revealed a WREQ structure consistent with previous research, and corresponding subscales on the TFEQ and WREQ were correlated. Lower baseline TFEQ restraint predicted greater weight loss. Across five administrations, TFEQ and WREQ restraint scores were positively related to weight loss (p < 0.01) and TFEQ disinhibition and WREQ external and emotional eating scores were negatively related (p < 0.001). Thus, with one baseline administration, only TFEQ restraint was significantly related to weight change, but multiple administrations showed relationships between all TFEQ and WREQ subscales and weight change.

CONCLUSIONS

The WREQ offers a shorter alternative to the TFEQ when repeatedly assessing eating behaviors related to weight change.

Executive function in weight loss and weight loss maintenance: a conceptual review and novel neuropsychological model of weight control

Weight loss maintenance is a complex, multifaceted process that presents a significant challenge for most individuals who lose weight. A growing body of literature indicates a strong relationship between cognitive dysfunction and excessive body weight, and suggests that a subset of high-order cognitive processes known as executive functions (EF) likely play an important role in weight management. Recent reviews cover neuropsychological correlates of weight status yet fail to address the role of executive function in the central dilemma of successful weight loss maintenance. In this paper, we provide an overview of the existing literature examining executive functions as they relate to weight status and initial weight loss. Further, we propose a novel conceptual model of the relationships between EF, initial weight loss, and weight loss maintenance, mapping specific executive functions onto strategies known to be associated with both phases of the weight control process. Implications for the development of more efficacious weight loss maintenance interventions are discussed.

Exercise, Appetite and Weight Control: Are There Differences between Men and Women?

Recent years have witnessed significant research interest surrounding the interaction among exercise, appetite and energy balance, which has important implications for health. The majority of exercise and appetite regulation studies have been conducted in males. Consequently, opportunities to examine sex-based differences have been limited, but represent an interesting avenue of inquiry considering postulations that men experience greater weight loss after exercise interventions than women. This article reviews the scientific literature relating to the acute and chronic effects of exercise on appetite control in men and women. The consensus of evidence demonstrates that appetite, appetite-regulatory hormone and energy intake responses to acute exercise do not differ between the sexes, and there is little evidence indicating compensatory changes occur after acute exercise in either sex. Limited evidence suggests women respond to the initiation of exercise training with more robust compensatory alterations in appetite-regulatory hormones than men, but whether this translates to long-term differences is unknown. Current exercise training investigations do not support sex-based differences in appetite or objectively assessed energy intake, and increasing exercise energy expenditure elicits at most a partial energy intake compensation in both sexes. Future well-controlled acute and chronic exercise studies directly comparing men and women are required to expand this evidence base.

A Serious Game to Increase Healthy Food Consumption in Overweight or Obese Adults: Randomized Controlled Trial

BACKGROUND

Obesity is a growing global issue that is linked to cognitive and psychological deficits.

OBJECTIVE

This preliminary study investigated the efficacy of training to improve inhibitory control (IC), a process linked to overeating, on consumption and cognitive control factors.

METHODS

This study utilized a multisession mobile phone-based intervention to train IC in an overweight and obese population using a randomized waitlist-control design. A combination of self-assessment questionnaires and psychophysiological measures was used to assess the efficacy of the intervention in terms of improved general IC and modified food consumption after training. Attitudes toward food were also assessed to determine their mediating role in food choices. A total of 58 participants (47 female) completed 2 assessment sessions 3 weeks apart, with 2 weeks of intervention training for the training group during this time. The groups did not differ in baseline demographics including age, body mass index, and inhibitory control.

RESULTS

Inhibitory control ability improved across the training sessions, with increases in P3 amplitude implying increased cognitive control over responses. Inhibitory control training was associated with increased healthy and reduced unhealthy food consumption in a taste test and in the week following training, as measured by the Healthy Eating Quiz and the food consumption test. Cognitive restraint was enhanced after training for the training but not the waitlist condition in the Three-Factor Eating Questionnaire, implying that attempts to avoid unhealthy foods in the future will be easier for the training group participants.

CONCLUSIONS

Inhibitory control training delivered via a purpose-designed mobile phone app is easy to complete, is convenient, and can increase cognitive restraint and reduce unhealthy food consumption.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12616000263493; http://www.ANZCTR.org.au/ACTRN12616000263493.aspx (Archived by WebCite at http://www.webcitation.org/6ioHjGING).

Energy and Macronutrient Intake in the Midwest Exercise Trial 2 (MET-2)

PURPOSE

This study aimed to examine the effect of exercise training over 10 months at two levels of energy expenditure on energy and macronutrient intake in a sample of previously sedentary, overweight/obese young adults.

METHODS

We conducted a 10-month trial in 141 young adults who were randomized to either supervised exercise 5 d·wk(-1) at 400 and 600 kcal per session or nonexercise control. Participants were instructed to maintain their usual ad libitum diet. Energy/macronutrient intake was assessed at baseline and 3.5, 7, and 10 months over 7-d periods of ad libitum eating in a university cafeteria using digital photography. Foods consumed outside the cafeteria were assessed using multiple-pass recalls.

RESULTS

There were no significant between-group differences in absolute energy intake at baseline or at any other time point in the total sample or in men. In women, absolute energy intake was significantly greater in the 600-kcal-per-session group versus controls at both 3.5 and 7 months. There were no significant between-group differences in relative energy intake (kcal·kg·d(-1)) at any time point in the total sample, in men or women. There were no significant within- or between-group differences of change in absolute or relative energy intake in any of the three study groups in the total sample or in men or women. No clinically relevant changes in macronutrient intake were observed.

CONCLUSIONS

Aerobic exercise training does not significantly alter energy or macronutrient intake in overweight and obese young adults. The possibility of a threshold level beyond which increased exercise energy expenditure fails to produce a more negative energy balance and potential sex differences in the energy intake response to increased levels of exercise are potentially important.

Low levels of physical activity are associated with dysregulation of energy intake and fat mass gain over 1 year

BACKGROUND

Previous studies suggest that appetite may be dysregulated at low levels of activity, creating an energy imbalance that results in weight gain.

OBJECTIVE

The aim was to examine the relation between energy intake, physical activity, appetite, and weight gain during a 1-y follow-up period in a large sample of adults.

DESIGN

Participants included 421 individuals (mean ± SD age: 27.6 ± 3.8 y). Measurements included the following: energy intake with the use of interviewer-administered dietary recalls and calculated by using changes in body composition and energy expenditure, moderate-to-vigorous physical activity (MVPA) with the use of an arm-based monitor, body composition with the use of dual-energy X-ray absorptiometry, and questionnaire-derived perceptions of dietary restraint, disinhibition, hunger, and control of eating. Participants were grouped at baseline into quintiles of MVPA (min/d) by sex. Measurements were repeated every 3 mo for 1 y.

RESULTS

At baseline, an inverse relation existed between body weight and activity groups, with the least-active group (15.7 ± 9.9 min MVPA/d, 6062 ± 1778 steps/d) having the highest body weight (86.3 ± 13.2 kg) and the most-active group (174.5 ± 60.5 min MVPA/d, 10260 ± 3087 steps/d) having the lowest body weight (67.5 ± 11.0 kg). A positive relation was observed between calculated energy intake and activity group, except in the lowest quintile of activity. The lowest physical activity group reported higher levels of disinhibition (P = 0.07) and cravings for savory foods (P = 0.03) compared with the group with the highest level of physical activity. Over 1 y of follow-up, the lowest activity group gained the largest amount of fat mass (1.7 ± 0.3 kg) after adjustment for change in MVPA and baseline fat mass. The odds of gaining >3% of fat mass were between 1.8 and 3.8 times as high for individuals in the least-active group as for those in the middle activity group.

CONCLUSIONS

These results suggest that low levels of physical activity are a risk factor for fat mass gain. In the current sample, a threshold for achieving energy balance occurred at an activity level corresponding to 7116 steps/d, an amount achievable by most adults. This trial was registered at clinicaltrials.gov as NCT01746186.

Eating behavior associated with gray matter volume alternations: A voxel based morphometry study

Little is known about whether eating behavior is associated with alterations of brain structure or whether the possible alterations are related to body weight status. The current study employed structural imaging from an open MRI data set (http://fcon_1000.

PROJECTS

nitrc.org/indi/pro/nki.html) to examine the relationship between eating behavior traits and brain structural changes. The eating behavior traits were measured by the Three Factor Eating Questionnaire Scale. The brain structural alterations were analyzed using the Voxel Based Morphometry (VBM) method, and a multiple linear regression model was constructed to identify significant brain structural changes that related to eating behavior factors. We found that cognitive restraint of eating was positively correlated with the gray matter volume (GMV) in the dorsolateral prefrontal cortex (DLPFC) and negatively correlated with the GMV in the putamen; disinhibition scores were negatively associated with the GMV in the left middle frontal gyrus; hunger scores showed a positive correlation with the GMV in the hypothalamus and the visual memory areas and a negative association with the GMV in the inferior temporal gyrus and the bilateral middle frontal gyrus. These results indicated a close connection between the eating behavior traits and structural changes in particular brain regions. Conjunction analysis was also performed to further explore the brain structural alterations that were commonly associated with eating behavior and weight status. The findings add to our understanding of the neural basis underlying eating behaviors, and the connection between these behaviors and body weight status.

Obesity and the neurocognitive basis of food reward and the control of intake

With the rising prevalence of obesity, hedonic eating has become an important theme in obesity research. Hedonic eating is thought to be that driven by the reward of food consumption and not metabolic need, and this has focused attention on the brain reward system and how its dysregulation may cause overeating and obesity. Here, we begin by examining the brain reward system and the evidence for its dysregulation in human obesity. We then consider the issue of how individuals are able to control their hedonic eating in the present obesogenic environment and compare 2 contrasting perspectives on the control of hedonic eating, specifically, enhanced control of intake via higher cognitive control and loss of control over intake as captured by the food addiction model. We conclude by considering what these perspectives offer in terms of directions for future research and for potential interventions to improve control over food intake at the population and the individual levels.

Psychometric properties of Spanish version of the Three-Factor Eating Questionnaire-R18 (Tfeq-Sp) and its relationship with some eating- and body image-related variables

The aims of this study were to analyze the psychometric properties of the Spanish version of the Three-Factor Eating Questionnaire-R18 (TFEQ-SP), as well as determine its validity by evaluating the relationship of the TFEQ-SP with different parameters related to body mass index, weight perception, perception of physical fitness, self-esteem, and food intake, as well as with weight control-related variables. A total of 281 participants (aged 18.38 ± 6.31) were studied. The factor analysis yielded three factors: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The internal consistency of the TFEQ-SP was determined by means of Cronbach’s α coefficient, with values ranging between 0.75 and 0.87. Higher scores on CR were found in women (p < 0.5), overweight/obese participants (p < 0.001), participants with lower self-esteem (p < 0.05), participants who overestimated their weight (p < 0.001), participants who weighed themselves frequently (p < 0.001) and those who were about to go on a diet (p < 0.001). Higher EE scores were found in participants with lower self-esteem scores (p < 0.05), among participants with a poorer perception of their physical fitness (p < 0.01) and when participants were about to diet (p < 0.05). Higher scores on UE were observed in case of poorer perception of physical fitness (p < 0.05). The validation study of the TFEQ-SP meets the requirements for measuring the three different facets of eating behavior: CR, UE, and EE.

[Outcome of a one-year behavior therapy weight loss program]

INTRODUCTION

Treatment of obesity has become one of the most challenging issues.

AIM

The aims of the authors were to present the results of standard behavior therapy weight loss program combined with self-help and the results of one-year follow-up.

METHOD

The 24-week program involved 41 participants of which 33 subjects participated in the follow-up. Anthropometric data were obtained and the participants were asked to fill questionnaires (the 21 items Three Factor Eating Questionnair Revised 21 items; Physical Exercise: Steps of change [Short Form].

RESULTS

87.8% of participants achieved a minimum weight loss of 5% which is the rate expected in professional therapies for obesity. Significant changes in maladaptive eating pattern and an increase in the rate of regular exercise were observed. Significant association was found between the increase of cognitive restraint and the rate of weight loss during treatment. At one-year follow-up the majority of participants (75.8%) did keep their minimum weight loss of 5% and they showed significant change in eating pattern.

CONCLUSIONS

The results suggest that standard behavior therapy extended with self-help elements may be a cost-effective treatment of obesity.

Uncontrolled eating is associated with reduced executive functioning

Accumulating evidence indicates obesity is associated with reduced cognitive functioning, particularly attention and executive function, as well as maladaptive eating behaviour such as uncontrolled eating. The current study examined relationships between eating patterns and attention/executive function test performance in lean and obese individuals. Sixty-two (32 lean, 30 obese) healthy young adults (21.13 ± 2.31 years; 56.5% female) completed the abbreviated Three-Factor Eating Questionnaire (TFEQ-R18) to assess eating patterns, including uncontrolled eating, cognitive restraint, and emotional eating. The Go/No-Go (GNG), Running Memory Continuous Performance Test (RCMPT) and Standard Continuous Performance Test from the Automated Neuropsychological Assessment Metrics-4 were administered as measures of executive functioning and attention. An independent samples t-test revealed greater report of uncontrolled eating in obese compared with lean participants (t[60] = -2.174, P < 0.05; d = -0.55) but no differences in cognitive restraint or emotional eating. Multivariate analysis of variance revealed cognitive differences between lean and obese groups (F[6, 54] = 3.86, P < 0.005; λ = 0.70; ηp(2) = 0.30), which were driven by GNG reaction time (F[1, 59] = 8.36, P < 0.01, d = 0.74). Pearson bivariate correlations revealed a positive correlation between uncontrolled eating and reaction time on GNG (r = 0.343, P < 0.05) and RMCPT (r = 0.267, P < 0.05) in all participants. Relative to lean participants, obese individuals reported higher levels of uncontrolled eating and exhibited slower performance on a task of inhibitory control. In the full sample, greater self-reported dyscontrol in eating behaviour was related to slower inhibitory control and working memory. Results support a link between executive function and control of eating behaviour. Obese individuals may be more vulnerable to difficulties in these domains relative to those who are lean.

Fasting for 24 hours heightens reward from food and food-related cues

Introduction

We examined the impact of a 24 hour complete fast (vs. fed state) on two measures of food reward: 1) ‘wanting’, as measured by response to food images and by the relative-reinforcing value of food (RRV), and 2) ‘liking’, as measured by response to food images and the hedonic evaluation of foods consumed.

Methods

Utilizing a randomized crossover design, 15 subjects (9 male; 6 female) aged 28.6±4.5 yrs with body mass index 25.3±1.4 kg/m² were randomized and counterbalanced to normal feeding (FED) and 24-hour fast (FASTED) conditions. Trait characteristics were measured with the Three Factor Eating Questionnaire. Two computer tasks measured food reward: 1) RRV progressive ratio task, 2) explicit ‘liking’ and ‘wanting’ (Leeds Food Preference Questionnaire, LFPQ). Also measured were ad libitum energy intake (EI; buffet) and food ‘liking’ (visual analogue scale) of personalized stimuli.

Results

There were no significant anthropometric changes between conditions. Appetite scores, hedonic ratings of ‘liking’, and ad libitum EI all significantly increased under the FASTED condition (p<0.05). Under the FASTED condition there were significant increases in the RRV of snack foods; similarly, explicit ‘wanting’ and ‘liking’ significantly increased for all food categories. ‘Liking’ of sweet foods remained high across-meals under FASTED, but savory foods decreased in hedonic saliency.

Conclusion

Relative to a fed state, we observed an increase in hedonic ratings of food, the rewarding value of food, and food intake after a 24 hr fast. Alliesthesia to food and food cues is suggested by heightened hedonic ratings under the FASTED condition relative to FED.

Does increased exercise or physical activity alter ad-libitum daily energy intake or macronutrient composition in healthy adults? A systematic review

BACKGROUND

The magnitude of the negative energy balance induced by exercise may be reduced due to compensatory increases in energy intake.

OBJECTIVE

TO ADDRESS THE QUESTION: Does increased exercise or physical activity alter ad-libitum daily energy intake or macronutrient composition in healthy adults?

DATA SOURCES

PubMed and Embase were searched (January 1990-January 2013) for studies that presented data on energy and/or macronutrient intake by level of exercise, physical activity or change in response to exercise. Ninety-nine articles (103 studies) were included.

STUDY ELIGIBILITY CRITERIA

Primary source articles published in English in peer-reviewed journals. Articles that presented data on energy and/or macronutrient intake by level of exercise or physical activity or changes in energy or macronutrient intake in response to acute exercise or exercise training in healthy (non-athlete) adults (mean age 18-64 years).

STUDY APPRAISAL AND SYNTHESIS METHODS

Articles were grouped by study design: cross-sectional, acute/short term, non-randomized, and randomized trials. Considerable heterogeneity existed within study groups for several important study parameters, therefore a meta-analysis was considered inappropriate. Results were synthesized and presented by study design.

RESULTS

No effect of physical activity, exercise or exercise training on energy intake was shown in 59% of cross-sectional studies (n = 17), 69% of acute (n = 40), 50% of short-term (n = 10), 92% of non-randomized (n = 12) and 75% of randomized trials (n = 24). Ninety-four percent of acute, 57% of short-term, 100% of non-randomized and 74% of randomized trials found no effect of exercise on macronutrient intake. Forty-six percent of cross-sectional trials found lower fat intake with increased physical activity.

LIMITATIONS

The literature is limited by the lack of adequately powered trials of sufficient duration, which have prescribed and measured exercise energy expenditure, or employed adequate assessment methods for energy and macronutrient intake.

CONCLUSIONS

We found no consistent evidence that increased physical activity or exercise effects energy or macronutrient intake.

Characteristics of individuals who report present and past weight loss behaviours: results from a Canadian university community

PURPOSE

To characterise individuals who reported present and past weight loss behaviours on psycho-behavioural factors known to influence body weight, e.g. overeating, dietary restriction.

METHODS

An online questionnaire was distributed to a university community. Questions pertaining to present weight loss, previous weight loss, eating behaviour tendencies, perceived stress and sleep quality were answered by 3,069 individuals. Body weight and height were self-reported.

RESULTS

Present and past weight loss behaviours were prevalent in the sample, with 33.3 % of the participants who reported trying to lose weight, 33.1 % who reported having previously lost weight (>10 lbs), and 18.8 % who reported repeated weight loss behaviour (i.e. present and past weight loss behaviours). Trying to lose weight and previous weight loss were both independently associated with increased risk for psycho-behavioural characteristics known to be associated with obesity, e.g. overeating tendencies, perceived stress, short sleep duration. This risk was particularly elevated among the underweight/normal-weight individuals who reported repeated weight loss behaviours. Indeed, adjusted odds ratios for reporting restrictive and overeating tendencies, perceived stress and short sleep for these individuals were significantly higher compared to their underweight/normal-weight peers who did not report repeated weight loss behaviours (adjusted odds ratios 4.7, 2.7, 1.8, and 1.8, respectively, p < 0.01 to <0.0001).

CONCLUSIONS

Normal-weight individuals reporting weight loss behaviours are characterised by a psycho-behaviour profile which may further increase their risk of weight gain.

Dietary disinhibition modulates neural valuation of food in the fed and fasted states

BACKGROUND

Dietary disinhibition is a behavioral trait associated with weight gain and obesity. Because food choices are made according to the relative value assigned to each option, examination of valuation signals through functional magnetic resonance imaging (fMRI) may elucidate the neural basis for the association between dietary disinhibition and weight gain.

OBJECTIVE

We examined how food valuation signals differ in the fed and fasted states between persons with high dietary disinhibition (HD) and low dietary disinhibition (LD).

DESIGN

Sixteen men with HD and 14 with LD underwent fMRI once while fasted and once after being fed in a counterbalanced order. In-scanner preference to consume a test food relative to a neutral-tasting, neutral-health reference food was examined. The slope of magnetic resonance signal change corresponding to these food preferences constituted the food valuation signal that was compared across disinhibition group and satiety state.

RESULTS

Both the HD and LD participants reported being less hungry (F(1,28) = 113.11, P < 0.001) after being fed than when fasted. However, food valuation signals in the ventromedial prefrontal cortex (vmPFC) differed between the groups (F(1,28) = 21.34, P < 0.001). Although LD participants showed attenuated vmPFC activity after being fed (t(13) = 4.11, P < 0.001), HD participants showed greater vmPFC activity in the fed than in the fasted state (t(15) = -2.56, P < 0.05).

CONCLUSIONS

Despite reporting normal decreases in hunger ratings after being fed, persons with HD have an altered neural valuation of food. This may be a mechanism underlying their propensity to overeat and gain weight. This trial was registered at clinicaltrials.gov as NCT00988819.

Activity related energy expenditure, appetite and energy intake: potential implications for weight management

The aim was to investigate relationships between activity related energy expenditure (AREE), appetite ratings and energy intake (EI) in a sample of 40 male (26.4years; BMI 23.5kg/m(2)) and 42 female (26.9years; BMI 22.4kg/m(2)) participants. AREE was expressed as the residual value of the regression between total daily EE (by doubly labeled water) and resting EE (by indirect calorimetry). EI was measured using an ad libitum buffet meal and visual analogue scales measured subjective appetite ratings before and after the meal. AREE was divided into low, middle and high sex-specific tertiles. General linear models were used to investigate differences in appetite ratings and EI across AREE tertiles. Before the meal, males in the high AREE tertile had significantly lower desire to eat and lower prospective food consumption and higher feelings of fullness compared to those in the low tertile. Males in the middle tertile had significantly higher satiety quotients after the meal and lower EI compared to the other tertiles. No significant differences across tertiles were found in females. Sex differences in relationships between AREE, appetite ratings and EI may lead to differing patterns of EI and subsequent weight maintenance.

Changes in body composition, cardiovascular disease risk factors, and eating behavior after an intensive lifestyle intervention with high volume of physical activity in severely obese subjects: a prospective clinical controlled trial

We examined the effects of a 10-14-weeks inpatient lifestyle modification program, including minimum 90 min of physical activity (PA) five days/week, on body composition, CVD risk factors, and eating behavior in 139 obese subjects (BMI 42.6 ± 5.2 kg/m²). Completion rate was 71% (n = 71) in the intensive lifestyle intervention (ILI) group and 85% (n = 33) among waiting list controls. Compared to controls body weight (-17.0 (95% CI: -18.7, -15.3) kg, P < 0.0001), fat mass (-15.2 (95% CI: -17.4, -13.1) kg, P < 0.0001), fat free mass (-1.2 (95% CI: -2.2, -0.2) kg, P = 0.016) and visceral fat (-86.6(95% CI: -97.4, -75.7) cm², P < 0.0001) were reduced in the ILI-group after 10-14 weeks. Within the ILI-group weight loss was -23.8 (95% CI: -25.9, -21.7) kg, P < 0.0001 and -20.3 (95% CI: -23.3, -17.3) kg, P < 0.0001, after six and 12 months, respectively. Systolic BP, glucose, triglycerides, and LDL-C were reduced, and HDL-C was increased (all P ≤ 0.006) after 10-14 weeks within the ILI group. The reduction in glucose and increase in HDL-C were sustained after 12 months (all P < 0.0001). After one year, weight loss was related to increased cognitive restraint and decreased uncontrolled eating (all P < 0.05). Thus, ILI including high volume of PA resulted in weight loss with almost maintenance of fat-free mass, favorable changes in CVD risk factors, and eating behavior in subjects with severe obesity.

Low fat loss response after medium-term supervised exercise in obese is associated with exercise-induced increase in food reward

Objective. To examine exercise-induced changes in the reward value of food during medium-term supervised exercise in obese individuals. Subjects/Methods. The study was a 12-week supervised exercise intervention prescribed to expend 500 kcal/day, 5 d/week. 34 sedentary obese males and females were identified as responders (R) or non-responders (NR) to the intervention according to changes in body composition relative to measured energy expended during exercise. Food reward (ratings of liking and wanting, and relative preference by forced choice pairs) for an array of food images was assessed before and after an acute exercise bout. Results. 20 responders and 14 non-responders were identified. R lost 5.2 kg ± 2.4 of total fat mass and NR lost 1.7 kg ± 1.4. After acute exercise, liking for all foods increased in NR compared to no change in R. Furthermore, NR showed an increase in wanting and relative preference for high-fat sweet foods. These differences were independent of 12-weeks regular exercise and weight loss. Conclusion. Individuals who showed an immediate post-exercise increase in liking and increased wanting and preference for high-fat sweet foods displayed a smaller reduction in fat mass with exercise. For some individuals, exercise increases the reward value of food and diminishes the impact of exercise on fat loss.