Top 10 research questions related to energy balance

Physical activity, exercise habits, and body mass index of adults

Introduction: The risk of degenerative diseases begins to appear in adulthood. Physical activity and exercise habits prevent the incidence of obesity which is a risk factor for degenerative diseases' emergence. Therefore, this study aims toexamine the relationship between physical activity, exercise habits, body mass index, and fat mass percentage. Design and  Methods: This study used an analytic observational cross-sectional design and 32 office workers in Surabaya aged 28-56 years were selected by simple random sampling technique. The data collected included measurements of physical activity, exercise habits, anthropometry, and body composition, which were analyzed using Spearman’s rank correlation test. Results: The results showed that 46.9% of participants had moderate activity, 43.8% exercised 1-2x a week, 56.3% exercised for 20-60 minutes, 56.30% had a low exercise intensity, 62.50% had an overweight body mass index, and 71.9% had overfat mass percentage. Spearman's rank test showed a significant relationship between energy intake, physical activity, exercise frequency, duration and intensity, and body mass index as well as between energy intake, physical activity, exercise intensity, and body fat percentage. Conclusions: Increased physical activity and exercise habits were associated with decreased BMI and body fat percentage.  

Acute effects of dry extract of ginger on energy expenditure in eutrophic women: A randomized clinical trial

BACKGROUND & AIMS

The thermic effect of food (TEF) is one of the components of total energy expenditure (TEE). Some bioactive compounds present in food could be useful to increase TEE. In this context, ginger has been extensively used as a thermogenic food despite no clear effect has been demonstrated yet. Herein, we evaluated the acute thermogenic effect of gingerol, a bioactive compound present in ginger, in healthy women.

METHODS

We carried out a randomized double-masked, cross-over and placebo-controlled clinical trial with 20 healthy eutrophic women. Anthropometric, body composition, indirect calorimetry and clinical variables were collected at baseline and throughout the intervention phase. A standardized breakfast was offered together with two dry extract of ginger capsules (5% gingerol) or a placebo (cellulose). Indirect calorimetry, blood pressure, heart rate, axillary temperature and blood collection were assessed at baseline and thereafter, at 30, 60, 120, 180 and 240 min postprandial. The analyses were repeated with a minimum of seven days' washout period.

RESULTS

Ginger intake did not increase the TEF of a standardized breakfast compared to the placebo. Oxygen consumption, respiratory quotient, blood pressure, heart rate, axillary temperature and metabolic profile were not different as well.

CONCLUSIONS

Our data show that gingerol did not modify the acute TEF in healthy women. More studies in human subjects, using different concentrations of gingerol, administration methods and intervention type (chronic effect) are necessary to clarify the putative thermogenic effect of ginger. Registered at ClinicalTrials.gov (Thermogenic Effect of Ginger - NCT03089593).

Adults Who Are Overweight or Obese and Consuming an Energy-Restricted Healthy US-Style Eating Pattern at Either the Recommended or a Higher Protein Quantity Perceive a Shift from "Poor" to "Good" Sleep: A Randomized Controlled Trial

BACKGROUND

Limited evidence suggests that consuming a higher-protein diet during weight loss improves subjective indices of sleep in overweight and obese adults.

OBJECTIVE

We sought to a priori assess the effects of consuming the recommended versus a higher protein Healthy US-Style Eating Pattern during energy-restriction on sleep quality indices.

DESIGN

Using a randomized, parallel study design, 51 adults (mean ± SEM age: 47 ± 1 y; BMI: 32.6 ± 0.5 kg/m2) consumed a controlled USDA Healthy US-Style Eating Pattern containing 750 kcal/d less than their estimated energy requirement for 12 wk. Participants were randomly assigned to consume either 5 or 12.5 oz-equivalent (eq)/d of protein foods. The additional 7.5 oz-eq/d came from animal-based protein sources and displaced primarily grains. Objective (wrist-worn actigraphy) and subjective (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale) sleep quality indices were measured at baseline, week 6, and week 12.

RESULTS

Among all participants, body mass decreased (-6.2 ± 0.4 kg). Dietary protein intake did not affect any objective or subjective sleep quality outcomes measured (repeated measures ANOVA). Over time, objective measures of time spent in bed, time spent sleeping, sleep onset latency, and time awake after sleep onset did not change; however, sleep efficiency improved (1 ± 1%; P = 0.027). Subjectively, global sleep scores [GSS: -2.7 ± 0.4 arbitrary units (au)] and daytime sleepiness scores (-3.8 ± 0.4 au; both P < 0.001) improved over time. The GSS improvement transitioned the participants from being categorized with "poor" to "good" sleep (GSS: >5 compared with ≤5 au of a 0-21 au scale; baseline 7.6 ± 0.4 au, week 12: 4.8 ± 0.4 au).

CONCLUSIONS

Although objective sleep quality may not improve, adults who are overweight or obese and poor sleepers may become good sleepers while consuming either the recommended or a higher-protein energy-restricted Healthy US-Style Eating Pattern. This trial was registered at clinicaltrials.gov as NCT03174769.

Caulis Spatholobi Ameliorates Obesity through Activating Brown Adipose Tissue and Modulating the Composition of Gut Microbiota

Obesity is associated with disrupted energy homeostasis and intestinal dysbiosis. Caulis Spatholobi, traditional Chinese medicine for herbal therapy, contains a wide range of bioactive compounds and has a specific pharmacological function. However, its effects on obesity and related metabolic disorder have remained largely unexplored. In this study, we showed that the water extract of Caulis Spatholobi (WECS) has a significant effect in inhibiting body weight gain, decreasing adiposity, maintaining glucose homeostasis, reducing insulin resistance and improving hepatic steatosis in diet-introduced obesity (DIO) mice. Besides, the administration of WECS significantly increased the expression levels of genes involved in the brown adipose tissue (BAT) activation and thermogenesis in DIO mice. Also, the activation of BAT treated with WECS was also confirmed in BAT primary cells. Mechanisms, the improvement of glucose homeostasis and insulin resistance may be related to the upregulated MAPK and AMPK pathways in white adipose tissue (WAT) and BAT. Notably, WECS also improved the obesity-induced gut microbiota dysbiosis, which induced an increase of anti-obesity and anti-diabetes related bacteria genus. In conclusion, Caulis Spatholobi can ameliorate obesity through activating brown adipose tissue and modulating the composition of gut microbiota. Our findings provide a novel perspective on Chinese medicine applications and provide a promising therapeutic approach for the treatment of obesity and metabolic disorders.

A Systematic Review of Technology-Driven Methodologies for Estimation of Energy Intake

Accurate measurement of energy intake (EI) is important for estimation of energy balance, and, correspondingly, body weight dynamics. Traditional measurements of EI rely on self-report, which may be inaccurate and underestimate EI. The imperfections in traditional methodologies such as 24-hour dietary recall, dietary record, and food frequency questionnaire stipulate development of technology-driven methods that rely on wearable sensors and imaging devices to achieve an objective and accurate assessment of EI. The aim of this research was to systematically review and examine peer-reviewed papers that cover the estimation of EI in humans, with the focus on emerging technology-driven methodologies. Five major electronic databases were searched for articles published from January 2005 to August 2017: Pubmed, Science Direct, IEEE Xplore, ACM library, and Google Scholar. Twenty-six eligible studies were retrieved that met the inclusion criteria. The review identified that while the current methods of estimating EI show promise, accurate estimation of EI in free-living individuals presents many challenges and opportunities. The most accurate result identified for EI (kcal) estimation had an average accuracy of 94%. However, collectively, the results were obtained from a limited number of food items (i.e., 19), small sample sizes (i.e., 45 meal images), and primarily controlled conditions. Therefore, new methods that accurately estimate EI over long time periods in free-living conditions are needed.

Tendência do nível de atividade física ocupacional e estado nutricional de adultos ao longo de quatro décadas no Brasil

Resumo Objetivo: avaliar a tendência do nível de atividade física ocupacional (Nafo) e o estado nutricional (EN) de adultos (≥ 20 anos) em pesquisas nacionais brasileiras realizadas ao longo de quatro décadas. Métodos: os dados declarados da ocupação principal foram estratificados em três Nafo (leve, moderado e pesado) segundo as classificações vigentes à época das pesquisas. O EN foi determinado segundo a classificação da OMS baseada no índice de massa corporal (IMC, kg.m-2) como baixo peso (IMC < 18,5), adequado (18,5 ≤ IMC < 25) e sobrepeso (IMC ≥ 25). Todas as estimativas foram calculadas usando os pesos amostrais das pesquisas. Resultados: a população com ocupação declarada aumentou no período, com mais Nafo moderado nos anos 1970 e migrando para Nafo leve ao final dos anos 2000. A prevalência de baixo peso diminuiu e a de sobrepeso aumentou substancialmente para todas as categorias de Nafo. O sobrepeso variou de 27,6 a 49,7% no Nafo leve e de 12,7 a 43,3% no Nafo pesado. Conclusões: apesar da limitação do estudo (atividade física estimada pela ocupação declarada sem considerar a evolução/modificação dos processos de trabalho), conclui-se que os trabalhadores no Brasil apresentam balanço energético positivo independente do Nafo.

Dynamic Energy Balance: An Integrated Framework for Discussing Diet and Physical Activity in Obesity Prevention-Is it More than Eating Less and Exercising More?

Understanding the dynamic nature of energy balance, and the interrelated and synergistic roles of diet and physical activity (PA) on body weight, will enable nutrition educators to be more effective in implementing obesity prevention education. Although most educators recognize that diet and PA are important for weight management, they may not fully understand their impact on energy flux and how diet alters energy expenditure and energy expenditure alters diet. Many nutrition educators have little training in exercise science; thus, they may not have the knowledge essential to understanding the benefits of PA for health or weight management beyond burning calories. This paper highlights the importance of advancing nutrition educators’ understanding about PA, and its synergistic role with diet, and the value of incorporating a dynamic energy balance approach into obesity-prevention programs. Five key points are highlighted: (1) the concept of dynamic vs. static energy balance; (2) the role of PA in weight management; (3) the role of PA in appetite regulation; (4) the concept of energy flux; and (5) the integration of dynamic energy balance into obesity prevention programs. The rationale for the importance of understanding the physiological relationship between PA and diet for effective obesity prevention programming is also reviewed.

[Prevention of overweight and obesity in children and adolescents : Critical appraisal of the evidence base]

BACKGROUND

Despite careful planning and implementation, overweight/obesity prevention interventions in children and adolescents typically show no, inconsistent or merely weak effects. Such programs usually aim at behavior changes, rarely also at environmental changes, that draw upon conventional wisdom regarding the commonly accepted determinants of childhood overweight/obesity.

OBJECTIVE

This paper evaluates the evidence base of the apparently overweight-/obesity-related determinants diet, physical activity and stress. The results of international intervention studies are discussed against this background.

METHODS AND MATERIALS

Based on the mediating-moderating variable model, we investigate the effect of theory specified mediating variables and how potential moderating variables may impact these relationships.

RESULTS

Contrary to common beliefs, recent research has revealed inconsistent evidence regarding associations between potentially obesogenic behaviors and overweight/obesity in youth. Moreover, the evidence for strong and causal relationships between mediating variables and targeted behaviors seems to be inconsistent. In addition, inadequate attention is paid to moderating effects.

DISCUSSION

The etiology of overweight/obesity in youth is likely the result of a complex interplay of multi-causal influences. Future prevention interventions would benefit from a more thorough understanding of the complex relationships that have been hypothesized and of the mechanisms of suspected behaviors for affecting overweight/obesity. Only if substantial change can be demonstrated in mediators with reasonable effort under real world circumstances, it will make sense to progress to community behavior change trials.

Development and validation of an energy-balance knowledge test for fourth- and fifth-grade students

A valid test measuring children's energy-balance (EB) knowledge is lacking in research. This study developed and validated the energy-balance knowledge test (EBKT) for fourth and fifth grade students. The original EBKT contained 25 items but was reduced to 23 items based on pilot result and intensive expert panel discussion. De-identified data were collected from 468 fourth and fifth grade students enrolled in four schools to examine the psychometric properties of the EBKT items. The Rasch model analysis was conducted using the Winstep 3.65.0 software. Differential item functioning (DIF) analysis flagged 1 item (item #4) functioning differently between boys and girls, which was deleted. The final 22-item EBKT showed desirable model-data fit indices. The items had large variability ranging from -3.58 logit (item #10, the easiest) to 1.70 logit (item #3, the hardest). The average person ability on the test was 0.28 logit (SD = .78). Additional analyses supported known-group difference validity of the EBKT scores in capturing gender- and grade-based ability differences. The test was overall valid but could be further improved by expanding test items to discern various ability levels. For lack of a better test, researchers and practitioners may use the EBKT to assess fourth- and fifth-grade students' EB knowledge.

Should the IDEFICS outcomes have been expected?

The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study evaluated with a large sample a comprehensive carefully planned obesity prevention intervention targeting multiple levels of influence that were culturally adapted to the situations in eight European countries. Despite the great effort and attention to detail, the IDEFICS study did not achieve its targeted adiposity or behaviour change objectives. Should we be surprised that the IDEFICS trial did not have its intended effects? We think not, and would have been surprised if it did. Recent research has revealed the lack of consistent meaningful relationships between several apparently obesogenic behaviours and adiposity, weak or no relationships among behavioural change procedures, mediating variables and targeted behaviours and inadequate attention to moderating effects. Future obesity prevention interventions would benefit from a more thorough understanding of the complex relationships that have been hypothesized and the interrelationships with biological factors. While systems modelling has been proposed as providing the solution, important less complex identification of new constructs, new relationships and community interventions are still needed, both to find innovative solutions and to provide input into the systems models. We should question results from cross-sectional studies and be satisfied only with longitudinal or experimental tests of relationships.

Prevalence of coronary heart disease risk factors in physical education students

Abstract To establish the prevalence of coronary risk in physical education students, and compare risk between the genders and the years of course. We evaluated 246 physical education students using RISKO questionnaire to determine eight risk factors: age, heredity, body weight, smoking, physical inactivity, hypercholesterolemia, hypertension and sex. Students had mean coronary risk score of 16.03 ± 3.52 points, rated "below-average risk." Men had significantly greater risk compared to women. No difference was found between the years of course. The prevalence of risk factors were heritability (58.37%), physical inactivity (32.65%), hypercholesterolemia (32.24%), overweight (27.35%), smoking (3.67%) and hypertension (2.45%). The coronary risk of physical education students was rated as below average, being higher among men than women, and no difference in risk between years of course. The most prevalent risk factors were heredity, physical inactivity, overweight and hypercholesterolemia.

The potential and reality of physical education in controlling overweight and obesity

Although preventing youth overweight and obesity is a public health priority, quality physical education (PE) is marginalized in practice. In May 2014, we estimated energy expenditure (EE; derived from PE frequency, duration, and intensity; mean student mass; and class size) from national recommendations and data from the 19 US states with PE duration guidelines, under 3 scenarios: potential (quality PE, defined as 50% moderate-to-vigorous physical activity [MVPA]), reality (MVPA = 35%), and classroom instruction only. Students in schools following nationally recommended PE standards from grades 1 through 10 could expend from 35 000 to 90 000 more kilocalories than students who received classroom instruction instead. PE's potential for increasing student EE will only be realized with stronger school policies and increased accountability.

How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative

Prevailing thinking about obesity and related diseases holds that quantifying calories should be a principal concern and target for intervention. Part of this thinking is that consumed calories – regardless of their sources – are equivalent; i.e. ‘a calorie is a calorie’. The present commentary discusses various problems with the idea that ‘a calorie is a calorie’ and with a primarily quantitative focus on food calories. Instead, the authors argue for a greater qualitative focus on the sources of calories consumed (i.e. a greater focus on types of foods) and on the metabolic changes that result from consuming foods of different types. In particular, the authors consider how calorie-focused thinking is inherently biased against high-fat foods, many of which may be protective against obesity and related diseases, and supportive of starchy and sugary replacements, which are likely detrimental. Shifting the focus to qualitative food distinctions, a central argument of the paper is that obesity and related diseases are problems due largely to food-induced physiology (e.g. neurohormonal pathways) not addressable through arithmetic dieting (i.e. calorie counting). The paper considers potential harms of public health initiatives framed around calorie balance sheets – targeting ‘calories in’ and/or ‘calories out’ – that reinforce messages of overeating and inactivity as underlying causes, rather than intermediate effects, of obesity. Finally, the paper concludes that public health should work primarily to support the consumption of whole foods that help protect against obesity-promoting energy imbalance and metabolic dysfunction and not continue to promote calorie-directed messages that may create and blame victims and possibly exacerbate epidemics of obesity and related diseases.

Obesity: global trends in the prevalence of overweight and obesity

A new report provides compelling evidence of the high prevalence of overweight and obesity throughout the world. The prevalence has increased since 1980, but at different rates across ages, times and locations. Studies exploring the causes of these differences could aid development of effective prevention strategies.