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Carneiro-Barrera A, Amaro-Gahete FJ, Lucas JF, Sáez-Roca G, Martín-Carrasco C, Lavie CJ, Ruiz JR. Weight loss and lifestyle intervention for cardiorespiratory fitness in obstructive sleep apnea: The INTERAPNEA trial. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 72:102614. [PMID: 38369267 DOI: 10.1016/j.psychsport.2024.102614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/04/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Although recent trials have shown benefits of weight loss and lifestyle interventions on obstructive sleep apnea (OSA) severity and comorbidities, the effect of these interventions on cardiorespiratory fitness (CRF) remains unknown. This study aimed to investigate the effects of an interdisciplinary weight loss and lifestyle intervention on CRF and self-reported physical fitness in adults with OSA. METHODS Eighty-nine men aged 18-65 years with moderate-to-severe OSA and a body mass index ≥25 kg/m2 were randomly assigned to a usual-care group or an 8-week interdisciplinary weight loss and lifestyle intervention. CRF was assessed through the 2-km walking test, and the International Fitness Scale (IFIS) was used to assess self-reported physical fitness. RESULTS As compared with usual-care, the intervention group had greater improvements at intervention endpoint in objective CRF (6% reduction in 2-km walking test total time, mean between-group difference, -1.7 min; 95% confidence interval, -2.3 to -1.1), and self-reported overall physical fitness (18% increase in IFIS total score, mean between-group difference, 2.3; 95% CI 1.2 to 3.3). At 6 months after intervention, the intervention group also had greater improvements in both 2-km walking test total time (10% reduction) and IFIS total score (22% increase), with mean between-group differences of -2.5 (CI 95%, -3.1 to -1.8) and 3.0 (CI 95%, 1.8 to 4.1), respectively. CONCLUSIONS An 8-week interdisciplinary weight loss and lifestyle intervention resulted in significant and sustainable improvements in CRF and self-reported physical fitness in men with overweight/obesity and moderate-to-severe OSA. STUDY REGISTRATION ClinicalTrials.gov registration (NCT03851653).
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Affiliation(s)
| | - Francisco J Amaro-Gahete
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain; Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria, ibs.Granada, Granada 18012, Spain
| | - Jurado-Fasoli Lucas
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18010, Spain; EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, Granada, 18010, Spain
| | - Germán Sáez-Roca
- Unidad de Trastornos Respiratorios del Sueño, Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, 18014, Spain
| | - Carlos Martín-Carrasco
- Unidad de Trastornos Respiratorios del Sueño, Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, 18014, Spain
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans 70121, LA, United States
| | - Jonatan R Ruiz
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain; Instituto de Investigación Biosanitaria, ibs.Granada, Granada 18012, Spain; Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18010, Spain
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Nunes CL, Jesus F, Oliveira MV, Thomas DM, Sardinha LB, Martins P, Minderico CS, Silva AM. The impact of body composition on the degree of misreporting of food diaries. Eur J Clin Nutr 2024; 78:209-216. [PMID: 38087045 DOI: 10.1038/s41430-023-01382-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 03/13/2024]
Abstract
BACKGROUND/OBJECTIVES Accurate assessments of energy intake (EI) are needed in lifestyle interventions to guarantee a negative energy balance (EB), thereby losing weight. This study aimed (1) to compare objectively measured and self-reported EI and (2) to determine the predictors of underreporting divided by sex, adiposity and BMI category. METHODS Seventy-three participants [mean (SD): 43.7 (9.2) years, BMI = 31.5 (4.5) kg/m2, 37% females] of the Champ4Life intervention were included in this study. EI was measured using the "intake-balance method" and self-reported through 3-day food records. Fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry. Bland-Altman analysis was performed to compare both EI assessments. RESULTS Self-reported EI was lower than measured EI during both neutral (-355 kcal/d) and negative EB (-570 kal/day). While no significant trends were observed for EI evaluation in either neutral (p = 0.315) or negative EB (p = 0.611), limits of agreement were wide (-1720 to 1010 and -1920 to 779 kcal/day, respectively). In females, the degree of misreporting (kcal/day and %) was predicted by weight (p = 0.032 and p = 0.039, respectively) and FM (p = 0.029 and p = 0.037, respectively). In males, only BMI (p = 0.036) was a predictor of misreporting (kcal/day). CONCLUSION Self-reported EI did not agree with measured EI. Our results show that larger body size was associated with higher levels of underestimation for EI (females only). Nevertheless, misreporting EI is a complex issue involving more associations than merely body composition. A deeper understanding could inform counseling for participants filling out food records in other to reduce misreporting and improve validity.
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
- Atlântica, Instituto Universitário, Fábrica da Pólvora de Barcarena, 2730-036, Barcarena, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Mariana V Oliveira
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, New York, NY, USA
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana da Universidade de Lisboa, 1499-002, Cruz-Quebrada, Portugal
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.
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Nunes CL, Jesus F, Rosa GB, Marianito M, Francisco R, Bosy-Westphal A, Minderico CS, Martins P, Sardinha LB, Silva AM. Interindividual variability in energy intake and expenditure during a weight loss intervention. Appetite 2024; 193:107162. [PMID: 38101517 DOI: 10.1016/j.appet.2023.107162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Behavioral compensations may occur as a response to a negative energy balance. The aim of this study was to explore the associations between changes in energy intake (EI) and changes in physical activity (PA, min/day; kcal/d) as a response to a weight loss (WL) intervention and to understand if interindividual differences occur in EI and energy expenditure (EE). METHODS Eighty-one participants [mean (SD): age = 42.8 (9.4)y, BMI = 31.2 (4.4)kg/m2, 37% females] divided in intervention (IG, n = 43) and control group (CG, n = 38) were included. The IG underwent a moderate energy restriction (300-500 kcal/d). EI was measured through the intake-balance method. Non-exercise PA (NEPA) and exercise (through logbook) were assessed by accelerometery. The EE in NEPA (NEAT) and in exercise (EiEE) was calculated by applying the Freedson Combination'98 algorithm over the time spent in these activities. Pearson correlations were performed in IG to examine associations between EE components, EI and body composition. To understand if interindividual differences were observed, the SD of individual response (SDIR) and the smallest worthwhile change (SWC, SDbaselineCG×0.2) were calculated. RESULTS Changes in EI [Δ EI, (kcal/d)] was negatively associated with Δ exercise (min/d:r = -0.413, p = 0.045; %:r = -0.846, p = 0.008) and with Δ EiEE (kcal/d:r = -0.488, p = 0.016; %:r = -0.859, p = 0.006). A negative correlation was found between Δ sedentary time and Δ NEPA (min/d:r = -0.622, p = 0.002; %:r = -0.487, p = 0.018). An interindividual variability was found for EI(SDIR = 151.6, SWC = 72.3) and EE (SDIR = 165, SWC = 134). CONCLUSIONS Decreases in EI were not associated to compensatory responses such as decreases in PA and/or increases in sedentary time. Interindividual variability was found for EI and EE. Nevertheless, behavioral compensations and the interindividual variability should be considered when implementing WL interventions, to increase the likelihood of achieving sustainable results. (clinicaltrials.gov ID: NCT03031951).
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal; Atlântica, Instituto Universitário, Fábrica da Pólvora de Barcarena, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Gil B Rosa
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Mariana Marianito
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz MB, 1649-028 Lisboa, Portugal
| | - Ruben Francisco
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana da Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal.
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Chrétien A, D’arripe-Longueville F, Haffner K, Hayotte M, Bernier M, Vuillemin A. Using a socioecological approach to explore healthy lifestyle in elite sport: a qualitative study of French athletes', coaches', and managers' perspectives. Int J Qual Stud Health Well-being 2023; 18:2251235. [PMID: 37674351 PMCID: PMC10599688 DOI: 10.1080/17482631.2023.2251235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023] Open
Abstract
Elite athletes are continually subjected to a range of constraints specific to high performance, and these can have a negative impact on their health. Although many studies have explored the individual factors related to risky behaviours and disorders in elite sport contexts, few have focused on health promotion. Consequently, the interpersonal, institutional, and policy factors of the health-related behaviours of elite athletes are still poorly explored. Based on the socioecological model, this study aimed to identify the factors involved in the health-related lifestyle of elite athletes. Semi-structured interviews were conducted with 45 participants: athletes (N = 32), their coaches (N = 6) and the managers of elite sport centres (N = 7). Both deductive and inductive thematic analyses were performed. Our results highlight the views of the actors. Regarding intrapersonal factors, resilience qualities and health literacy appeared as key factors in influencing the health-related lifestyle of elite athletes. At the interpersonal level, parents and coaches emerged as the main sources of educational support. Regarding institutional factors, the health policies of the elite sport centres were key factors in supporting the athletes' healthy lifestyle. These results encourage the development of health promotion programs at different levels of intervention.
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Affiliation(s)
- Aurélia Chrétien
- Graduate School of Health Science Ecosystems, Université Côté d'Azur, LAMHESS, Nice, France
| | | | - Kevin Haffner
- Faculté des Sciences du Sport et de l’éducation, Université de Bretagne Occidentale, CREAD, Brest, France
| | - Meggy Hayotte
- Graduate School of Health Science Ecosystems, Université Côté d'Azur, LAMHESS, Nice, France
| | - Marjorie Bernier
- Faculté des Sciences du Sport et de l’éducation, Université de Bretagne Occidentale, CREAD, Brest, France
| | - Anne Vuillemin
- Graduate School of Health Science Ecosystems, Université Côté d'Azur, LAMHESS, Nice, France
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Raubenheimer D, Simpson SJ. Protein appetite as an integrator in the obesity system: the protein leverage hypothesis. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220212. [PMID: 37661737 PMCID: PMC10475875 DOI: 10.1098/rstb.2022.0212] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/21/2023] [Indexed: 09/05/2023] Open
Abstract
Despite the large volume and extensive range of obesity research, there is substantial disagreement on the causes and effective preventative strategies. We suggest the field will benefit from greater emphasis on integrative approaches that examine how various potential contributors interact, rather than regarding them as competing explanations. We demonstrate the application of nutritional geometry, a multi-nutrient integrative framework developed in the ecological sciences, to obesity research. Such studies have shown that humans, like many other species, regulate protein intake more strongly than other dietary components, and consequently if dietary protein is diluted there is a compensatory increase in food intake-a process called protein leverage. The protein leverage hypothesis (PLH) proposes that the dilution of protein in modern food supplies by fat and carbohydrate-rich highly processed foods has resulted in increased energy intake through protein leverage. We present evidence for the PLH from a variety of sources (mechanistic, experimental and observational), and show that this mechanism is compatible with many other findings and theories in obesity research. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.
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Affiliation(s)
- David Raubenheimer
- Charles Perkins Centre and School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Stephen J. Simpson
- Charles Perkins Centre and School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales 2006, Australia
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Nunes CL, Rosa GB, Jesus F, Heymsfield SB, Minderico CS, Martins P, Sardinha LB, Silva AM. Interindividual variability in metabolic adaptation of non-exercise activity thermogenesis after a 1-year weight loss intervention in former elite athletes. Eur J Sport Sci 2022:1-10. [PMID: 36377398 DOI: 10.1080/17461391.2022.2147020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lack of efficacy of weight loss(WL) interventions is attributed in-part to low adherence to dietary/physical activity(PA) recommendations. However, some compensation may occur in PA as a response to energy restriction such as a decrease in non-exercise PA(NEPA) or non-exercise activity thermogenesis(NEAT). The current study aim was (1) to investigate whether adaptive thermogenesis(AT) in NEAT occurs after WL, and (2) to understand the associations of these compensations with WL. Ninety-four former athletes [mean±SD, age: 43.0±9.4y, BMI: 31.1±4.3 kg/m2, 34.0% female] were recruited and randomly assigned to intervention or control groups (IG, CG). The IG underwent a one-year lifestyle WL-intervention; no treatments were administered to the CG. PA was measured using accelerometery and NEAT was predicted with a model including sample baseline characteristics. AT was calculated as measuredNEAT4mo/12mo(kcal/d)-predictedNEAT4mo/12mo(kcal/d)-measuredNEATbaseline(kcal/d)-predictedNEATbaseline(kcal/d). Dual-energy x-ray absorptiometry was used to assess fat-free mass and fat mass. No differences were found in the IG for NEAT or NEPA after WL. Considering mean values, AT was not found for either group. The SD of individual response (SDIR) for AT was -2(4-months) and 24(12-months) (smallest worthwhile change = 87kcal/d), suggesting that the interindividual variability regarding AT in NEAT is not relevant and the variability in this outcome might reflect a large within-subject variability and/or a large degree of random measurement error. No associations were found between AT in NEAT and changes in body composition. Further studies are needed to clarify the mechanisms behind the large variability in AT observed in NEAT and related changes in NEPA to better implement lifestyle-induced WL interventions.Highlights No significant differences were found for non-exercise activity thermogenesis (NEAT) or non-exercise physical activity (NEPA) after the weight loss (WL) intervention;Although a large variability was found for NEAT and NEPA, the interindividual variability regarding these outcomes is not relevant. The variability in these outcomes might reflect a large within-subject variability and/or a large degree of random measurement error;Although no energy conservation was observed in NEAT after moderate WL (mean values), further studies are needed to clarify the mechanisms behind the large variability in adaptive thermogenesis observed in NEAT and related changes in NEPA to better implement lifestyle-induced WL interventions.Trial registration: ClinicalTrials.gov identifier: NCT03031951.
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Cruz-Quebrada, Portugal
| | - Gil B Rosa
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Cruz-Quebrada, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Cruz-Quebrada, Portugal
| | | | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Cruz-Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana da Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Cruz-Quebrada, Portugal
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Silva TR, Nunes CL, Jesus F, Francisco R, Teixeira VH, Sardinha LB, Martins P, Minderico C, Silva AM. Between-devices agreement in obtaining raw bioelectrical parameters after a lifestyle intervention targeting weight loss in former athletes. J Sports Sci 2022; 40:1857-1864. [PMID: 36101017 DOI: 10.1080/02640414.2022.2115755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
It is unclear if different bioelectrical impedance (BI) devices provide similar results regarding raw parameters [Resistance (R), Reactance (Xc), Phase Angle (PhA), and Impedance (Z)] for the same population/individual undergoing a weight loss intervention. The aim was to evaluate the cross-sectional and longitudinal agreement of raw data obtained by two BI devices in former athletes with overweight/obesity. Fifty-nine participants [mean (SD): 43.5 (9.2) years, 30.5 (4.0) kg/m2, 42% females] were included. All the assessments were performed before and after a 4-months lifestyle intervention targeting weight loss (WL). BI parameters were assessed at 50 kHz by two devices: a BI spectroscopy (Xitron Technologies, 4200B, San Diego, USA) and a phase-sensitive single-frequency device (RJL/Akern Systems, BIA-101, Italy). Cross-sectionally, BIS provided lower mean values for all parameters (0.4% for R, 1.6% for Xc, 1.0% for PhA and 0.4% for Z, p <0.001) compared to SF-BIA. In individuals with a WL≥2.5% (n =18), no longitudinal differences were found in any of the raw parameters between devices (p≥0.128) and there was no proportional bias (p≥0.408). Despite small baseline differences in raw BI parameters, both devices agreed in tracking changes over time at the group level but interpretation should be careful at the individual level.
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Affiliation(s)
- Tiago R Silva
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Ruben Francisco
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Vitor H Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Paulo Martins
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Cláudia Minderico
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
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Nunes CL, Jesus F, Francisco R, Hopkins M, Sardinha LB, Martins P, Minderico CS, Silva AM. Effects of a 4-month active weight loss phase followed by weight loss maintenance on adaptive thermogenesis in resting energy expenditure in former elite athletes. Eur J Nutr 2022; 61:4121-4133. [PMID: 35833970 DOI: 10.1007/s00394-022-02951-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/27/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Despite adaptive thermogenesis (AT) being studied as a barrier to weight loss (WL), few studies assessed AT in the resting energy expenditure (REE) compartment after WL maintenance. The aim of this study was twofold: (1) to understand if AT occurs after a moderate WL and if AT persists after a period of WL maintenance; and (2) if AT is associated with changes in body composition, hormones and energy intake (EI). METHODS Ninety-four participants [mean (SD); BMI, 31.1(4.3)kg/m2; 43.0(9.4)y; 34% female] were randomized to intervention (IG, n = 49) or control groups (CG, n = 45). Subjects underwent a 1-year lifestyle intervention, divided in 4 months of an active WL followed by 8 months of WL maintenance. Fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry and REE by indirect calorimetry. Predicted REE (pREE) was estimated through a model using FM, FFM. EI was measured by the "intake-balance" method. RESULTS For the IG, the weight and FM losses were - 4.8 (4.9) and - 11.3 (10.8)%, respectively (p < 0.001). A time-group interaction was found between groups for AT. After WL, the IG showed an AT of -85(29) kcal.d-1 (p < 0.001), and remained significant after 1 year [AT = - 72(31)kcal.d-1, p = 0.031]. Participants with higher degrees of restriction were those with an increased energy conservation (R = - 0.325, p = 0.036 and R = - 0.308, p = 0.047, respectively). No associations were found between diet adherence and AT. Following a sub-analysis in the IG, the group with a higher energy conservation showed a lower WL and fat loss and a higher initial EI. CONCLUSION AT in REE occurred after a moderate WL and remained significant after WL maintenance. More studies are needed to better clarify the mechanisms underlying the large variability observed in AT and providing an accurate methodological approach to avoid overstatements. Future studies on AT should consider not only changes in FM and FFM but also the FFM composition.
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Ruben Francisco
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Mark Hopkins
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, UK
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana da Universidade de Lisboa, 1499-002, Cruz-Quebrada, Portugal
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.
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Nunes CL, Carraça EV, Jesus F, Finlayson G, Francisco R, Silva MN, Santos I, Bosy-Westphal A, Martins P, Minderico C, Sardinha LB, Silva AM. Changes in food reward and intuitive eating after weight loss and maintenance in former athletes with overweight or obesity. Obesity (Silver Spring) 2022; 30:1004-1014. [PMID: 35347875 DOI: 10.1002/oby.23407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to explore the following: 1) the impact of Champ4Life's intervention on intuitive eating and food reward; and 2) associations between changes in eating behavior and changes in body composition. METHODS A total of 94 former athletes (mean [SD], BMI = 31.1 [4.3] kg/m2 , age = 43.0 [9.4] years, 34% female) assigned to intervention (n = 49) and control groups (n = 45) underwent 4 months of active weight loss (WL) followed by 8 months of WL maintenance. Intuitive eating and food reward were assessed by the Intuitive Eating Scale and the Leeds Food Preference Questionnaire, respectively. RESULTS The WL was -4.8% (4.9%) and 0.3% (2.6%) for the intervention and control groups, respectively. Participants reported a decrease in fat bias for explicit/implicit wanting and explicit liking after 4 months and 1 year. For intuitive eating, the unconditional permission to eat decreased after 4 months, and the body-food choice congruence increased after 1 year. Changes in unconditional permission to eat and in body-food choice congruence were positively and negatively associated with both Δweight and with Δfat mass, respectively. Changes in explicit wanting for fat and taste bias were associated with Δweight. CONCLUSIONS Food reward decreased after a moderate WL intervention. Participants successfully maintained their reduced weight, and most of the changes in eating behavior remained significant at the end of the follow-up period. Lifestyle interventions aiming at WL should also consider intuitive eating and food reward.
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Eliana V Carraça
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES): Lusophone University, Lisbon, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Graham Finlayson
- Appetite Control Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Rúben Francisco
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Marlene N Silva
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES): Lusophone University, Lisbon, Portugal
- Programa Nacional para a Promoção da Atividade Física, Direcção-Geral da Saúde, Lisbon, Portugal
| | - Inês Santos
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES): Lusophone University, Lisbon, Portugal
- Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Cláudia Minderico
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
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Adaptive thermogenesis after moderate weight loss: magnitude and methodological issues. Eur J Nutr 2021; 61:1405-1416. [PMID: 34839398 DOI: 10.1007/s00394-021-02742-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was (1) to assess AT through 13 different mathematical approaches and to compare their results; and (2) to understand if AT occurs after moderate WL. METHODS Ninety-four participants [mean (SD); BMI, 31.1 (4.3) kg/m2; age, 43.0 (9.4) years; 34% females] underwent a 1-year lifestyle intervention (clinicaltrials.gov ID: NCT03031951) and were randomized to intervention (IG, n = 49) or control groups (CG, n = 45), and all measurements were made at baseline and after 4 months. Fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry and REE by indirect calorimetry. AT was assessed through 13 different approaches, varying in how REE was predicted and/or how AT was assessed. RESULTS IG underwent a mean negative energy balance (EB) of 270 (289) kcal/day, p < 0.001), resulting in a WL of - 4.8 (4.9)% and an FM loss of - 11.3 (10.8)%. Regardless of approach, AT occurred in the IG, ranging from ~ - 65 to ~ - 230 kcal/day and three approaches showed significant AT in the CG. CONCLUSIONS Regardless of approach, AT occurred after moderate WL in the IG. AT assessment should be standardized and comparisons among studies with different methodologies to assess AT must be avoided.
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