Using the TIDieR checklist to describe development and integration of a web-based intervention promoting healthy eating and regular exercise among older cancer survivors

Objective

To facilitate replication and future intervention design of web-based multibehavior lifestyle interventions, we describe the rationale, development, and content of the AiM, Plan, and act on LIFestYles (AMPLIFY) Survivor Health intervention which provides healthy eating and exercise behavior change support for older cancer survivors. The intervention promotes weight loss, improvements in diet quality, and meeting exercise recommendations.

Methods

The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a comprehensive description of the AMPLIFY intervention, consistent with CONSORT recommendations.

Results

A social cognitive theory web-based intervention founded on the core components of efficacious print and in-person interventions was conceptualized and developed through an iterative collaboration involving cancer survivors, web design experts, and a multidisciplinary investigative team. The intervention includes the AMPLIFY website, text and/or email messaging, and a private Facebook group. The website consists of: (1) Sessions (weekly interactive e-learning tutorials); (2) My Progress (logging current behavior, receiving feedback, setting goals); (3) Tools (additional information and resources); (4) Support (social support resources, frequently asked questions); and (5) Home page. Algorithms were used to generate fresh content daily and weekly, tailor information, and personalize goal recommendations. An a priori rubric was used to facilitate intervention delivery as healthy eating only (24 weeks), exercise only (24 weeks), or both behaviors concurrently over 48 weeks.

Conclusions

Our TIDieR-guided AMPLIFY description provides pragmatic information helpful for researchers designing multibehavior web-based interventions and enhances potential opportunities to improve such interventions.

Social Environments and Physical Activity Among Active Black Women

PURPOSE

To explore the social context of physical activity (PA) among active Black women, we examine the patterns of PA engagement and the benefits of social support in PA maintenance.

DESIGN

A cross-sectional study design and descriptive phenomenological approach were used to examine social support and lived experiences of active Black women.

SETTING

The study setting was an online survey of active Black women, ages 21 to 71 years who were recruited from across the United States.

PARTICIPANTS

This secondary data analysis was conducted among a sample of 187 active Black women who maintained PA for ≥6 months. The mean age was 41 ± 12.3 years, 83.4% completed some college, 37.7% were married, and 30.0% had children.

MEASURES

Participants self-reported 'with whom' they engaged in PA and provided qualitative responses about their strategies for PA maintenance. Descriptive statistics were used to examine between-group differences among demographic characteristics and PA variables by category of PA engagement using SAS 9.4. Descriptive phenomenology was used to explore social support themes across and within categories of PA engagement.

RESULTS

On average, the active Black women in this study reported engaging in 57.0 ± 18.9 minutes of moderate intensity leisure-time PA per session. Most engaged in PA alone (n = 87), with a group (n = 72), or with another individual (n = 28). Social context themes within categories included: alone - self-management, groups - motivation and accountability, family - values health, and friends - shared interests in PA. Subthemes across social context categories included: who? - people, what and how? - types of social support, and where? - place of social support.

CONCLUSIONS

Our findings suggest that some Black women may need added social support from others beyond family and friends, while other Black women may prefer additional self-management skills. Nonetheless, this study provides data for developing hypotheses about the mechanisms by which social context may facilitate PA maintenance among Black women. Therefore, intervention studies targeting PA maintenance among Black women should include an in-depth query of social support needs.

Pretreatment and During-Treatment Weight Trajectories in Black and White Women

INTRODUCTION

Black participants often lose less weight than White participants in response to behavioral weight-loss interventions. Many participants experience significant pretreatment weight fluctuations (between baseline measurement and treatment initiation), which have been associated with treatment outcomes. Pretreatment weight gain has been shown to be more prevalent among Black participants and may contribute to racial differences in treatment responses. The purpose of this study was to (1) examine the associations between pretreatment weight change and treatment outcomes and (2) examine racial differences in pretreatment weight change and weight loss among Black and White participants.

METHODS

Participants were Black and White women (n=153, 60% Black) enrolled in a 4-month weight loss program. Weight changes occurring during the pretreatment period (41 ± 14 days) were categorized as weight stable (±1.15% of baseline weight), weight gain (≥+1.15%), or weight loss (≤-1.15%). Recruitment and data collection occurred from 2011 to 2015; statistical analyses were performed in 2021.

RESULTS

During the pretreatment period, most participants (56%) remained weight stable. Pretreatment weight trajectories did not differ by race (p=0.481). At 4-months, those who lost weight before treatment experienced 2.63% greater weight loss than those who were weight stable (p<0.005), whereas those who gained weight before treatment experienced 1.91% less weight loss (p<0.01).

CONCLUSIONS

Pretreatment weight changes can impact weight outcomes after initial treatment, although no differences between Black and White participants were observed. Future studies should consider the influence of pretreatment weight change on long-term outcomes (e.g., weight loss maintenance) along with potential racial differences in these associations. This study is registered (retrospectively registered) at ClinicalTrials.gov (NCT02487121) on June 26, 2015.

The daily Self-Weighing for Obesity Management in Primary Care Study: Rationale, design and methodology

Background Daily self-weighing (DSW) may be an effective harm-reduction intervention to disrupt continued weight gain. Self-Weighing for Obesity Management in Primary Care (SWOP) is a 24-month randomized controlled trial in 400 adults with obesity (BMI: kg/m² ≥ 30) receiving primary care through a clinical network affiliated with an academic medical center. Objective To test DSW as a potentially scalable way to deter age-related weight gain among primary care patients with obesity. Methods Randomized-controlled trial with two conditions: DSW (instruction to weigh daily and provision of a web-enabled digital scale with graphical weight feedback) or Standard Care (receive a monetary gift card equivalent to value of the scale). Both groups receive standardized weight management educational material. SWOP will test the causal effect of assignment to DSW (Aim 1) and adherence to DSW (Aim 2) on weight (primary outcome) and adoption of weight management practices (secondary outcomes), as well as evaluate the cost-effectiveness of DSW compared to standard care (Aim 3). Findings may inform clinical guidelines for weight management by providing evidence that DSW attenuates continued age-related weight gain among adults with obesity. This trial is registered with ClinicalTrials.gov (NCT04044794).

Similar weight loss and maintenance in African American and White women in the Improving Weight Loss (ImWeL) trial

Objective: African Americans (AA) are often underrepresented and tend to lose less weight than White participants during the intensive phase of behavioral obesity treatment. Some evidence suggests that AA women experience better maintenance of lost weight than White women, however, additional research on the efficacy of extended care programs (i.e. continued contacts to support the maintenance of lost weight) is necessary to better understand these differences.Methods: The influence of race on initial weight loss, the likelihood of achieving ≥5% weight reduction (i.e. extended care eligibility), the maintenance of lost weight and extended care program efficacy was examined in 269 AA and White women (62.1% AA) participating in a 16-month group-based weight management program. Participants achieving ≥5% weight reduction during the intensive phase (16 weekly sessions) were randomized to a clustered campaign extended care program (12 sessions delivered in three, 4-week clusters) or self-directed control.Results: In adjusted models, race was not associated with initial weight loss (p = 0.22) or the likelihood of achieving extended care eligibility (odds ratio 0.64, 95% CI [0.29, 1.38]). AA and White women lost -7.13 ± 0.39 kg and -7.62 ± 0.43 kg, respectively, during initial treatment. There were no significant differences in weight regain between AA and White women (p = 0.64) after adjusting for covariates. Clustered campaign program participants (AA: -6.74 ± 0.99 kg, White: -6.89 ± 1.10 kg) regained less weight than control (AA: -5.15 ± 0.99 kg, White: -4.37 ± 1.04 kg), equating to a 2.12 kg (p = 0.03) between-group difference after covariate adjustments.Conclusions: Weight changes and extended care eligibility were comparable among all participants. The clustered campaign program was efficacious for AA and White women. The high representation and retention of AA participants may have contributed to these findings.

Positive Outliers Among African American Women and the Factors Associated with Long-Term Physical Activity Maintenance

Studying positive outliers, individuals who have achieved success with long-term (> 6-month) physical activity (PA) engagement, may be an important approach for understanding strategies for improving leisure-time PA maintenance among African American (AA) women. This cross-sectional, mixed-methods study (1) examined the personal characteristics, PA patterns, and behavioral practices of positive outliers among AA women and (2) compared characteristics of those who maintain PA at recommended levels (HIGH, ≥ 150 min/week > 6 months) with those who maintain low PA volumes (LOW, < 150 min/week > 6 months). A large sample of positive outliers completed this study (n = 290), and most became physically active on their own (76.2%). These AA women were committed to maintaining an active lifestyle, accumulated 249.7 ± 105.8 min of PA/week, and engaged in a variety of activities. Their behavioral practices included scheduling PA during the week (85.9%), goal-setting (82.4%), engaging in PA with others (55.9%), self-monitoring (78.3%), and having a backup plan for missed sessions (54.8%). HIGH maintainers (84.9%) made up most of the sample, and these women were characteristically similar to LOW maintainers with few differences. HIGH maintainers have been active longer, achieved higher commitment scores, and engaged in PA at a higher frequency, duration, and intensity, resulting in higher weekly PA volume compared to LOW maintainers (273.8 ± 96.1 vs. 114.4 ± 24.3 min per week, p ≤ 0.001). Our findings identify factors that may be important for successful PA maintenance among AA women and may help to inform the development of effective behavioral interventions to promote sustained, long-term PA engagement in this population.

Formative Assessment: Design of a Web-Connected Sedentary Behavior Intervention for Females

Background

Sedentary behavior (SB) is a significant risk factor for heart disease, diabetes, obesity, and early mortality, particularly among women, and the health consequences associated with SB are independent of physical activity status. Interventions utilizing wearable technologies can improve SB, but their effectiveness is influenced by individual preferences, device engagement strategies, and technological features, which may affect user compliance. Gathering a priori insight from target populations on their preferences for program tools and strategies may assist researchers in identifying effective methods to improve the efficacy of SB interventions.

Objective

The objective of this study was to (1) explore the likeability (likes and dislikes) and usability (engagement intentions and navigation) of a wearable device (Movband) and its accompanying website (dashboard), (2) examine social incentive preferences (teammates), and (3) assess the feasibility (participants’ experiences during an activity-monitoring period) of these tools for use in an intervention to reduce SB in girls and women.

Methods

A total of 9 girls (mean age: 8.9 years, standard deviation [SD] 1.1 years) and 11 college-aged women (mean age: 22.6 years, SD 3.2 years) participated in this study. Separate focus groups were held for girls and women, and all participants attended one before and the other following a 7-day activity-monitoring period. During the focus groups, participants were prompted with questions to address the study aims, and the nominal group technique was used to compile lists of group-specific preferences for the activity-monitoring system. The top three ranking likes and dislikes were reverse coded to determine likeability.

Results

The top-ranking responses for the girls and women were the following: visual display of movements and ease of navigation (dashboard like), boring to look at and no calorie-tracking function (dashboard dislike), backlight and long battery life (Movband like), and color and not waterproof (tied for girls) and vertical time display (Movband dislike). Additionally, participants identified several aesthetic preferences and functional limitations. At the second focus group visit, the majority of the participants self-reported less SB during the previous week. Objective data from the activity-monitoring period revealed that the average steps per day for girls and women were 12,373.4 (SD 2617.6) and 8515.8 (SD 3076.7), respectively.

Conclusions

These results suggest that the girls and women liked many features of the Movband and dashboard. However, several dislikes were mentioned, which may negatively influence compliance and the effectiveness of the activity-monitoring system and require improvements before using in an SB intervention.

Visual Representation of Body Shape in African-American and European American Women: Clinical Considerations

BACKGROUND

Body mass index (BMI) has been used widely among clinicians to assess obesity in their patients due to its ease and availability. However, BMI has some diagnostic limitations and other measures related to health risks; in particular, body shape may be of greater relevance to health outcomes.

OBJECTIVE

The objective of this study was to illustrate the importance of body shape assessments above and beyond BMI and its relationship to health risk among a sample of African-American and European American women.

METHODS

African-American and European American women aged 19–78 years (n = 552) in Birmingham, Alabama, were recruited and stratified by menopausal status (ie, pre- or postmenopausal). Pictorial body shapes were derived from digital photographs, while body fat distribution defined by android–gynoid ratio (AGR) and body composition were obtained from dual-energy X-ray absorptiometry.

RESULTS

Images of BMI and age-matched women illustrate variability in fat distribution. Among both menopausal status groups, more than 50% of women had a pear body shape (AGR < 1). An apple body shape was associated with higher odds of having diabetes (unadjusted odds ratio [OR]: 4.1, 95% confidence interval [CI]: 1.9–9.3), hypertension (unadjusted OR: 3.1, 95% CI: 2.0–4.7), and high cholesterol (unadjusted OR: 3.0, 95% CI: 1.8–5.1).

CONCLUSION

Use of visual cues alongside traditional methods of weight status assessment may help to facilitate weight management conversations between physicians and female patients. However, next steps should include the validation of visual assessments of body shape in women for use by physicians.

The influence of nighttime feeding of carbohydrate or protein combined with exercise training on appetite and cardiometabolic risk in young obese women

Single macronutrient intake prior to sleep reduces appetite but may negatively impact insulin sensitivity in sedentary obese women. The present study examined the additive impact of nighttime feeding of whey (WH), casein (CAS), or carbohydrate (CHO) combined with exercise training on appetite, cardiometabolic health, and strength in obese women. Thirty-seven sedentary obese women (WH, n = 13, body mass index (BMI) 34.4 ± 1.3 kg/m(2); CAS, n = 14, BMI 36.5 ± 1.8 kg/m(2); CHO, n = 10, BMI 33.1 ± 1.7 kg/m(2)) consumed WH, CAS, or CHO (140-150 kcal/serving), every night of the week, within 30 min of sleep, for 4 weeks. Supervised exercise training (2 days of resistance training and 1 day of high-intensity interval training) was completed 3 days per week. Pre- and post-testing measurements included appetite ratings, mood state, resting metabolic rate, fasting lipids, glucose, and hormonal responses (insulin, leptin, adiponectin, hs-CRP, IGF-1, and cortisol), body composition, and strength. Nighttime intake of CAS significantly (p < 0.05) increased morning satiety (pretraining, 25 ± 5; post-training 41 ± 6) more than WH (pretraining, 34 ± 5; post-training, 35 ± 6) or CHO (pre 40 ± 8, post 43 ± 7). Exercise training increased lean mass and strength, decreased body fat, and improved mood state in all groups. No other differences were noted. Nighttime feeding of CAS combined with exercise training increased morning satiety more than WH or CHO. Nighttime feeding for 4 weeks did not impact insulin sensitivity (assessed via homeostatic model assessment of insulin resistance) when combined with exercise training in obese women. ClinicalTrial.gov: NCT01830946.

Impact of Four Weeks of a Multi-Ingredient Performance Supplement on Muscular Strength, Body Composition, and Anabolic Hormones in Resistance-Trained Young Men

Although multi-ingredient performance supplements (MIPS) have increased in popularity because of their array of ergogenic ingredients, their efficacy and safety remain in question. The objective of this study was to determine the impact of supplementation with T+ (SUP; Onnit Labs, Austin, TX, USA), an MIPS containing long jack root, beta-alanine, and branched-chain amino acids, and other proprietary blends, on strength, body composition, and hormones in young resistance-trained men. Subjects were randomized to consume either T+ (SUP; n = 14; age, 21 ± 3 years; body fat, 18.3 ± 4.7%) or an isocaloric placebo (PL; n = 13; age, 21 ± 3 years; body fat, 21.5 ± 6.2%) for 4 weeks. Both groups underwent a progressive, 4-week high-intensity resistance training protocol. Before and after the training protocol, mood state, body composition, blood hormones (also collected at midpoint), and maximal strength were measured. SUP had significantly greater increases in bench press (SUP, 102 ± 16 kg to 108 ± 16 kg vs. PL, 96 ± 22 kg to 101 ± 22 kg; p < 0.001) and total weight lifted (SUP, 379 ± 59 kg to 413 ± 60 kg vs. PL, 376 ± 70 kg to 400 ± 75 kg; p < 0.001) compared with PL. Additionally, deadlift strength relative to total body mass (calculated as weight lifted/body mass; kg:kg) (2.08 ± 0.18 to 2.23 ± 0.16; p = 0.036) and lean mass (2.55 ± 0.19 to 2.72 ± 0.16; p = 0.021) increased significantly in SUP but not PL (2.02 ± 0.30 to 2.15 ± 0.36 and 2.56 ± 0.31 to 2.70 ± 0.36, respectively). No other significant differences were detected between groups for the remaining variables. Supplementing with SUP enhanced resistance training adaptations independent of hormonal status, and thus SUP use may warrant inclusion into peri-workout nutrition regimens. This study was registered with clinicaltrials.gov (identifier: NCT01971723).

Combined whole-body vibration training and l-citrulline supplementation improves pressure wave reflection in obese postmenopausal women

Postmenopausal women have increased wave reflection (augmentation pressure (AP) and index (AIx)) and reduced muscle function that predispose them to cardiac diseases and disability. Our aim was to examine the combined and independent effects of whole-body vibration training (WBVT) and l-citrulline supplementation on aortic hemodynamics and plasma nitric oxide metabolites (NOx) in postmenopausal women. Forty-one obese postmenopausal women were randomized to 3 groups: l-citrulline, WBVT+l-citrulline and WBVT+Placebo for 8 weeks. Brachial and aortic systolic blood pressure, diastolic blood pressure, AP, AIx, AIx adjusted to 75 beats/min (AIx@75), and NOx were measured before and after 8 weeks. All groups similarly decreased (P < 0.05) brachial and aortic pressures as well as AP, and similarly increased (P < 0.05) NOx levels. AIx and AIx@75 decreased (P < 0.01) in the WBVT+l-citrulline and WBVT+Placebo groups, but not in the l-citrulline group. The improvement in AIx@75 (−10.5% ± 8.8%, P < 0.05) in the WBVT+l-citrulline group was significant compared with the l-citrulline group. l-Citrulline supplementation and WBVT alone and combined decreased blood pressures. The combined intervention reduced AIx@75. This study supports the effectiveness of WBVT+l-citrulline as a potential intervention for prevention of hypertension-related cardiac diseases in obese postmenopausal women.

The effects of a multi-ingredient dietary supplement on body composition, adipokines, blood lipids, and metabolic health in overweight and obese men and women: a randomized controlled trial

Background

The present study investigated the effects of a multi-ingredient dietary supplement (MIDS) containing caffeine, conjugated linoleic acid (CLA), green tea, and branched-chain amino acids (BCAA) taken for 8 weeks on body composition, blood lipid profile, glucose, insulin, adiponectin, leptin, and high-sensitivity C-reactive protein (hs-CRP) in overweight and obese men and women.

Methods

Twenty-two participants completed the study (PL, n = 11; 7 women, 4 men; age, 34 ± 3.5 years; height, 169.2 ± 3.3 cm; body mass, 96.9 ± 6.8 kg; BMI, 34.1 ± 1.8 kg/m²; MIDS, n = 11; 9 women, 2 men; age, 36 ± 3.4 years; height, 173.2 ± 2.9 cm; body mass, 91.9 ± 5.6 kg; BMI, 30.0 ± 1.5 kg/m²). Participants were randomly assigned and stratified by body fat percentage to two groups: 1) a soybean oil placebo (PL) or 2) MIDS. Each group consumed two pills with breakfast and two pills with lunch. Body composition and android fat, waist and hip circumferences, blood pressure and heart rate were measured at baseline and after 8 weeks of supplementation.

Results

There were no significant changes for any of the variables of body composition. Feelings of hunger were significantly higher in MIDS versus PL with no changes observed in satiety or desire to eat. Heart rate and blood pressure were unaltered in MIDS after 8 weeks of supplementation. Furthermore, lipid profile, food intake, mood state variables, fasting blood glucose, and endocrine markers did not significantly change regardless of group.

Conclusion

MIDS intake does not appear to alter body composition or markers of cardiovascular health versus PL. Moreover, MIDS may actually increase feelings of hunger versus PL.

The effects of pre- and post-exercise consumption of multi-ingredient performance supplements on cardiovascular health and body fat in trained men after six weeks of resistance training: a stratified, randomized, double-blind study

Background

The cardiovascular (CV) and metabolic health benefits or risks associated with consumption of multi-ingredient performance supplements (MIPS) in conjunction with periodized resistance training (RT) in resistance-trained men are unknown. This population is a major target audience for performance supplements, and therefore, the purpose of this study was to investigate the combined effect of RT and commercially available pre- and post-exercise performance supplements on CV health and body fat in resistance-trained men.

Methods

Twenty-four resistance-trained men completed six weeks (three times/week) of periodized RT while either ingesting SHOT 15-min pre-exercise and SYN immediately post-exercise (multi-ingredient performance supplement group: MIPS) or an isocaloric maltodextrin placebo 15-min pre-exercise and immediately post-exercise (Placebo group). Before and after six weeks of RT and supplementation, resting heart rate (HR), blood pressure (BP), total body fat, android fat, gynoid fat, fat-free mass (FFM) and fasting blood measures of glucose, lipids, nitrate/nitrite (NOx), cortisol and high sensitivity C-reactive protein (hs-CRP) were measured. Statistical analysis was conducted using a one-way ANOVA for baseline differences and a 2 × 2 (group × time) repeated measures ANOVA and Tukey post-hoc tests where appropriate. Significance was set at p < 0.05.

Results

There was no group × time interaction for HR, BP, blood glucose, lipids, NOx, hs-CRP, cortisol concentrations or body fat. However, there was a time effect where significant decreases in body fat (mean ± SD; MIPS: -1.2 ± 1.2%; Placebo: -0.9 ± 1.1%), android fat (MIPS: -1.8 ± 2.1%; Placebo: -1.6 ± 2.0%), and gynoid fat (MIPS: -1.3 ± 1.6%; Placebo: -1.0 ± 1.4%) for both groups were observed. FFM increased in both groups, and a group × time interaction was observed with MIPS increasing significantly more than the Placebo group (4.2% vs. 1.9%).

Conclusions

Six weeks of MIPS ingestion and periodized RT does not alter CV health parameters or blood indices of health or body fat more than a Placebo treatment in healthy, resistance-trained men. However, MIPS significantly increased FFM more than Placebo.

The effects of six weeks of supplementation with multi-ingredient performance supplements and resistance training on anabolic hormones, body composition, strength, and power in resistance-trained men

Background

Resistance training (RT) enhances muscle protein synthesis and hypertrophy while increasing strength and power. Some multi-ingredient performance supplements (MIPS) have been shown to augment the physiological improvements associated with RT. The purpose of this study was to investigate the impact of specific pre- and post-workout MIPS on anabolic hormones, body composition, muscle strength, and power in resistance-trained men participating in a periodized RT program.

Methods

Twenty-four ( mean ± SE; 24.0 ± 0.9 years; 180.5 ± 5.8 cm; 83.7 ± 0.5 kg) resistance-trained men completed 6 wks of periodized RT (3x/wk). Participants were assigned to one of two groups based upon maximal voluntary contraction of the quadriceps (Biodex) to lean mass (LM) ratio. Group 1 (n = 13; MIPS) consumed one serving of NO-Shotgun® (whey protein, casein protein, branched-chain amino acids, creatine, beta alanine, and caffeine) before each workout and one serving of NO-Synthesize® (whey protein, casein protein, branched-chain amino acids, creatine, and beta alanine; Vital Pharmaceuticals, Inc., Davie, FL) immediately after each workout and on non-RT days. Group 2 (n = 11; Placebo; PLA) consumed a flavor-matched isocaloric maltodextrin placebo. Serum insulin-like growth factor 1, human growth hormone, testosterone, body composition (DXA), circumferences, 1-repetition maximal strength (1RM) of the upper (chest press) and lower body (leg press), and anaerobic power (Wingate test) were assessed before and after the intervention. Statistical analysis included a 2 × 2 (group x time) ANOVA with repeated measures. Tukey LSD post hoc tests were used to examine pairwise differences. Significance was set at p < 0.05.

Results

There was a main time effect (p = 0.035) for testosterone to increase, but no differences between groups were observed. There were no differences in the other blood hormones. Group x time interactions were observed for LM (MIPS: PRE, 62.9 ± 2.1 to POST, 65.7 ± 2.0 vs. PLA: PRE, 63.5 ± 2.3 to POST, 64.8 ± 2.5 kg; p = 0.017). Only a main effect of time was noted for circumference measures. Both groups increased upper and lower body 1RM strength to a similar degree. MIPS significantly increased peak anaerobic power (PRE, 932.7 ± 172.5 W vs. POST, 1119.2 ± 183.8 W, p = 0.002) while PLA remained unchanged (PRE, 974.4 ± 44.1 W vs. POST, 1033.7 ± 48.6 W, p = 0.166).

Conclusion

Consumption of MIPS during the course of a periodized RT program facilitated training-induced improvement in LM in trained males, whereas the consumption of PLA did not. MIPS improved measures of anaerobic power while PLA did not.