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Hughes R, Ahuja KDK, Patterson KAE, Holloway TP, Soward R, Jayasinghe S, Byrne NM, Hills AP. An exploration of the determinants of overweight and obesity and the capacity to intervene in North-West Tasmania: A stakeholder consultation. Health Promot J Austr 2024; 35:385-392. [PMID: 37331377 DOI: 10.1002/hpja.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023] Open
Abstract
ISSUE ADDRESSED The capacity of communities to develop effective obesity prevention initiatives varies and should be a focus for obesity prevention intervention planning and investment. This research aimed at engaging and consulting local community stakeholders to identify determinants, needs, strategic priorities and capacity to act on overweight and obesity prevention in North-West (NW) Tasmania. METHODS A series of semi-structured interviews and thematic analyses was implemented to explore the knowledge, insights, experiences and attitudes of stakeholders. RESULTS Mental health and obesity were identified as major concerns and were often reported to share similar determinants. This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information). CONCLUSIONS This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information). SO WHAT?: Broad upstream socio-economic, cultural and environmental determinants underpin the conditions by which the local community develops overweight/obesity and/or health and wellbeing outcomes. Including stakeholder consultations as a significant technique within a comprehensive plan of action aimed at achieving a sustainable, long-term strategy for obesity prevention and/or health promotion, should be considered in future programs.
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Affiliation(s)
- Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Kira A E Patterson
- Faculty of Education, University of Tasmania, Launceston, Tasmania, Australia
| | - Timothy P Holloway
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Robert Soward
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Hills AP, Jayasinghe S, Arena R, Byrne NM. Global status of cardiorespiratory fitness and physical activity - Are we improving or getting worse? Prog Cardiovasc Dis 2024:S0033-0620(24)00029-X. [PMID: 38417767 DOI: 10.1016/j.pcad.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 02/25/2024] [Indexed: 03/01/2024]
Abstract
Despite heightened recognition of the importance of cardiorespiratory fitness (CRF) to cardiovascular (CV) health, along with updated international consensus guidelines for physical activity (PA) and sedentary behavior (SB), significant proportions of the global adult population are physically inactive, and do not meet the threshold for CRF. Physical inactivity is considered a surrogate for low CRF given that the former is defined as not reaching the recommended minimum level of PA per week to derive a health benefit. Physical inactivity remains a major global public health problem despite decades of work by various United Nations agencies, and members of the international community to improve PA levels. Given the common coupling between physical inactivity and poor health status, it is reasonable to suggest that for a significant proportion of the global population, CRF is compromised by physical inactivity. This poses a longer-term risk to morbidity and mortality. Here we provide an indicative summary of the global status of CRF and PA and reference the implications for global health. We briefly reference opportunities moving forward, including reinforcement of the importance of engaging in movement from an early age, discouraging SB, and taking a life course approach to optimise healthy living for all.
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Affiliation(s)
- Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America.
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Herath MP, Beckett JM, Jayasinghe S, Byrne NM, Ahuja KDK, Hills AP. Body composition assessment in 6-month-old infants: A comparison of two- and three-compartment models using data from the Baby-bod study. Eur J Clin Nutr 2024:10.1038/s41430-023-01394-5. [PMID: 38233534 DOI: 10.1038/s41430-023-01394-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND/OBJECTIVES An appreciation of infant body composition is helpful to understand the 'quality' of growth in early life. Air displacement plethysmography (ADP) using PEA POD and the deuterium dilution (DD) technique are commonly used body composition approaches in infants. We evaluated the comparability of body composition assessed using both techniques with two-compartment (2C) and three-compartment (3C) models in 6-month-old infants. SUBJECTS/METHODS Infant fat mass (FM) and percent fat mass (%FM) obtained from a 2C model using PEA POD (2C-PP) and a 2C model using the deuterium dilution technique (2C-DD) were compared to those derived from a 3C model, and to each other, using Bland-Altman analysis and Deming regression. RESULTS Measurements were available from 68 infants (93% Caucasian, 53% male). The mean biases were not significant between any of the method comparisons. However, significant constant and proportional biases were identified in 2C-DD vs 3C and 2C-PP vs 2C-DD, but not in the 2C-PP vs 3C comparison. Furthermore, we observed significant associations between the mean differences and infants' percent total body water (%TBW). CONCLUSIONS While no significant between-method mean differences were found in body composition estimates, some comparisons revealed significant constant and proportional biases and notable associations between the mean differences and %TBW were observed. Our results emphasise the importance of method choice, ensuring methodological uniformity in long-term studies, and carefully considering and regulating multiple pre-analytical variables, such as the hydration status of the participants.
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Affiliation(s)
- Manoja P Herath
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, 7248, Australia
| | - Jeffrey M Beckett
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, 7248, Australia
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, 7248, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, 7248, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, 7248, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, 7248, Australia.
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Kuriyan R, Hills AP, Murphy-Alford A, Padmanabha R, Nyati LH, Byrne NM, Kurpad AV, Norris S. Body composition of infants at 6 months of age using a 3-compartment model. Eur J Clin Nutr 2023:10.1038/s41430-023-01351-2. [PMID: 37833566 DOI: 10.1038/s41430-023-01351-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 09/16/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND/OBJECTIVES Two compartment (2 C) models of body composition, including Air Displacement Plethysmography (ADP) and Deuterium Dilution (DD), assume constant composition of fat-free mass (FFM), while 3-compartment (3 C) model overcomes some of these assumptions; studies are limited in infants. The objective of the present study is to compare 3 C estimates of body composition in 6-mo. old infants from Australia, India, and South Africa, including FFM density and hydration, compare with published literature and to evaluate agreement of body composition estimates from ADP and DD. METHODS Body volume and water were measured in 176 healthy infants using ADP and DD. 3C-model estimates of fat mass (FM), FFM and its composition were calculated, compared between countries (age and sex adjusted) and with published literature. Agreement between estimates from ADP and DD were compared by Bland-Altman and correlation analyses. RESULTS South African infants had significantly higher % FM (11.5%) and density of FFM compared to Australian infants. Australian infants had significantly higher % FFM (74.7 ± 4.4%) compared to South African infants (71.4 ± 5.0) and higher FFMI (12.7 ± 0.8 kg/m2) compared to South African (12.3 ± 1.2 kg/m2) and Indian infants (11.9 ± 1.0 kg/m2). FFM composition of present study differed significantly from literature. Pooled three country estimates of FM and FFM were comparable between ADP and DD; mean difference of -0.05 (95% CI: -0.64, +0.55) kg and +0.05 (95% CI: -0.55, +0.64) kg. CONCLUSIONS 3C-model estimates of body composition in infants differed between countries; future studies are needed to confirm these findings and investigate causes for the differences.
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Affiliation(s)
| | | | | | | | | | | | | | - Shane Norris
- University of Witwatersrand, Johannesburg, South Africa
- University of Southampton, Southampton, UK
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Holloway TP, Jayasinghe S, Dalton L, Kilpatrick ML, Hughes R, Patterson KAE, Soward R, Burgess K, Byrne NM, Hills AP, Ahuja KDK. Enhancing Food Literacy and Food Security through School Gardening in Rural and Regional Communities. Int J Environ Res Public Health 2023; 20:6794. [PMID: 37754653 PMCID: PMC10530311 DOI: 10.3390/ijerph20186794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/24/2023] [Accepted: 09/19/2023] [Indexed: 09/28/2023]
Abstract
A qualitative case study approach with in-depth, semi-structured interviews of key school staff, and student feedback was used to assess a school kitchen and garden program in the regional area of North-West Tasmania, Australia. A detailed program description was produced to conduct a realist evaluation with a Context-Mechanism-Outcome configuration, followed by a program theory evaluation through the construction of a retrospective program logic model. Dedicated kitchen and garden spaces, knowledgeable teachers committed to the program, provision of sufficient materials and consumables, and support from the school and community were found to be the basic requirements to establish a program. Additionally, it is essential to integrate both the kitchen and garden teaching components into the school curriculum. The positive outcomes (e.g., engagement, participation, knowledge, skills, behavioral change) of the program were dependent on the underlying factors, including dedicated support of school leadership, teaching staff, and the parent body for effective student engagement in the teaching spaces and for wider engagement from families and the community. The students' feedback provided supporting evidence of increased food literacy with improvements in their understanding, abilities, and attitudes towards gardening, producing healthy food, and preparing food. This may further lead to enhanced food security for students' families and the broader community.
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Affiliation(s)
- Timothy P. Holloway
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (T.P.H.); (S.J.); (L.D.); (R.S.); (N.M.B.); (A.P.H.)
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (T.P.H.); (S.J.); (L.D.); (R.S.); (N.M.B.); (A.P.H.)
| | - Lisa Dalton
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (T.P.H.); (S.J.); (L.D.); (R.S.); (N.M.B.); (A.P.H.)
| | - Michelle L. Kilpatrick
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia;
| | - Roger Hughes
- School of Heath Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
| | - Kira A. E. Patterson
- School of Education, College of Arts, Law and Education, University of Tasmania, Launceston, TAS 7248, Australia;
| | - Robert Soward
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (T.P.H.); (S.J.); (L.D.); (R.S.); (N.M.B.); (A.P.H.)
| | | | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (T.P.H.); (S.J.); (L.D.); (R.S.); (N.M.B.); (A.P.H.)
| | - Andrew P. Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (T.P.H.); (S.J.); (L.D.); (R.S.); (N.M.B.); (A.P.H.)
| | - Kiran D. K. Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (T.P.H.); (S.J.); (L.D.); (R.S.); (N.M.B.); (A.P.H.)
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Herath MP, Murray S, Lewis M, Holloway TP, Hughes R, Jayasinghe S, Soward R, Patterson KAE, Byrne NM, Lee AJ, Hills AP, Ahuja KDK. Habitual Diets Are More Expensive than Recommended Healthy Diets. Nutrients 2023; 15:3908. [PMID: 37764692 PMCID: PMC10538131 DOI: 10.3390/nu15183908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Understanding food prices and affordability is crucial for promoting healthy dietary habits and informing policy actions. We assessed changes in the cost and affordability of habitual and recommended healthy diets in Northwest Tasmania from 2021 to 2023. The recommended diet was 16-22% less expensive than the habitual diet during the period. Notably, 60% of the total cost of the habitual diet was spent on discretionary items. The cost of the habitual diet increased by 9% in this period, whereas the cost of the recommended diet increased by only 2%. The habitual diet was unaffordable for households with median gross, minimum wage disposable or welfare-dependent incomes. The recommended diet, however, was affordable for some groups but posed a risk of food stress for those with median gross and minimum wage disposable income and remained unaffordable for those who were welfare dependent. Our findings reveal that adhering to a healthy Australian Dietary Guidelines-recommended diet can be more cost-effective than following a habitual unhealthy diet. However, adopting a healthy diet can be challenging for low-income families. Interventions such as financial support, nutrition education, community gardens and food hubs, as well as price regulation and subsidies for farmers, can help address food insecurity in Northwest Tasmania.
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Affiliation(s)
- Manoja P. Herath
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Sandra Murray
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Meron Lewis
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia; (M.L.); (A.J.L.)
| | - Timothy P. Holloway
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Robert Soward
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Kira A. E. Patterson
- School of Education, College of Arts, Law and Education, University of Tasmania, Launceston, TAS 7250, Australia;
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Amanda J. Lee
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia; (M.L.); (A.J.L.)
| | - Andrew P. Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Kiran D. K. Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
- Nutrition Society of Australia, Crows Nest, NSW 1585, Australia
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Hills AP, Norris SA, Byrne NM, Jayasinghe S, Murphy-Alford AJ, Loechl CU, Ismail LIC, Kurpad AV, Kuriyan R, Nyati LH, Santos IS, Costa CS, Wickramasinghe VP, Lucas MN, Slater C, Yameen A, Ariff S. Body composition from birth to 2 years. Eur J Clin Nutr 2023:10.1038/s41430-023-01322-7. [PMID: 37563231 DOI: 10.1038/s41430-023-01322-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/08/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
Providing all infants with the best start to life is a universal but challenging goal for the global community. Historically, the size and shape of infants, quantified by anthropometry and commencing with birthweight, has been the common yardstick for physical growth and development. Anthropometry has long been considered a proxy for nutritional status during infancy when, under ideal circumstances, changes in size and shape are most rapid. Developed from data collected in the Multicentre Growth Reference Study (MGRS), WHO Child Growth Standards for healthy infants and children have been widely accepted and progressively adopted. In contrast, and somewhat surprisingly, much less is understood about the 'quality' of growth as reflected by body composition during infancy. Recent advances in body composition assessment, including the more widespread use of air displacement plethysmography (ADP) across the first months of life, have contributed to a progressive increase in our knowledge and understanding of growth and development. Along with stable isotope approaches, most commonly the deuterium dilution (DD) technique, the criterion measure of total body water (TBW), our ability to quantify lean and fat tissue using a two-compartment model, has been greatly enhanced. However, until now, global reference charts for the body composition of healthy infants have been lacking. This paper details some of the historical challenges associated with the assessment of body composition across the first two years of life, and references the logical next steps in growth assessments, including reference charts.
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Affiliation(s)
| | - Shane A Norris
- University of the Witwatersrand, Johannesburg, South Africa
- University of Southampton, Southampton, United Kingdom
| | | | | | | | | | - Leila I Cheikh Ismail
- University of Sharjah, Sharjah, United Arab Emirates
- University of Oxford, Oxford, United Kingdom
| | | | | | | | | | | | | | | | | | - Ayesha Yameen
- Pakistan Institute of Nuclear Science and Technology (PINSTECH), Nilore, Pakistan
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Herath MP, Hills AP, Beckett JM, Jayasinghe S, Byrne NM, Ahuja KDK. Trends and associations between maternal characteristics and infant birthweight among Indigenous and non-Indigenous people in Tasmania, Australia: a population-based study. Public Health 2023; 221:10-16. [PMID: 37348425 DOI: 10.1016/j.puhe.2023.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE This study aimed to investigate the trends and associations of maternal characteristics and birthweight among Indigenous and non-Indigenous infants. STUDY DESIGN This was a retrospective population-based study. METHODS Fourteen years (2005-2018) of birthweight and perinatal health data of live-born singletons and their mothers obtained from the Tasmanian Data Linkage Unit were used to assess the trends and associations between maternal characteristics and infant birthweight using regression modelling. RESULTS Compared with non-Indigenous mothers (n = 76,750), Indigenous mothers (n = 3805) had a significantly higher prevalence of risk factors during the 14-year period. Although the prevalence of prepregnancy obesity and gestational diabetes mellitus (GDM) markedly increased in both groups, the rate of increase was higher (P < 0.001) for Indigenous than non-Indigenous mothers. Smoking, alcohol consumption and illegal drug use during pregnancy reduced over the years, and there was no significant difference in the rate of reduction between the groups. Large-for-gestational-age (LGA) births increased while small-for-gestational-age (SGA) births decreased in both groups over time. In addition, high birthweight (HBW) births decreased while low birthweight (LBW) births increased. The rates of increase in LGA and LBW births and the rates of decrease in SGA and HBW births were significantly higher in Indigenous mothers compared with non-Indigenous mothers (P < 0.001 for all). The association between Indigenous ethnicity and LBW and SGA births weakened after adjusting for other confounding maternal and perinatal variables. LBW and SGA were positively associated with Indigenous ethnicity, age <18 years, smoking, alcohol consumption and illegal drug use, pre-eclampsia, underweight prepregnancy body mass index and low socio-economic status. Women with higher parity, pre-existing diabetes and prepregnancy overweight or obesity were more likely to give birth to an infant with HBW or LGA. CONCLUSIONS The prevalence of risk factors for abnormal birthweight is higher among Tasmanian Indigenous mothers, contributing to a gap in birthweight outcomes between Indigenous and non-Indigenous infants. The dramatic increase in prepregnancy obesity and GDM in both groups highlight the importance of screening and management of GDM during pregnancy. Comprehensive programmes co-designed and co-managed in consultation with Indigenous people are needed to support healthy lifestyle choices among Indigenous women to address the barriers to individuals adopting behaviour change and to help close the health outcomes-related gap between Indigenous and non-Indigenous mothers and infants.
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Affiliation(s)
- Manoja P Herath
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia
| | - Jeffrey M Beckett
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia.
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9
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Murphy-Alford AJ, Johnson W, Nyati LH, Santos IS, Hills AP, Ariff S, Wickramasinghe VP, Kuriyan R, Lucas MN, Costa CS, Slater C, Ahmad T, Byrne NM, Divya PJ, Kurpad AV, Cheikh Ismail LI, Loechl CU, Norris SA. Body composition reference charts for infants from birth to 24 months: Multicenter Infant Body Composition Reference Study. Am J Clin Nutr 2023; 117:1262-1269. [PMID: 37270290 DOI: 10.1016/j.ajcnut.2023.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Body composition assessment in the first 2 y of life provides important insights into child nutrition and health. The application and interpretation of body composition data in infants and young children have been challenged by a lack of global reference data. OBJECTIVES We aimed to develop body composition reference charts of infants aged 0-6 mo based on air displacement plethysmography (ADP) and those aged 3-24 mo based on total body water (TBW) by deuterium dilution (DD). METHODS Body composition was assessed by ADP in infants aged 0-6 mo from Australia, India, and South Africa. TBW using DD was assessed for infants aged 3-24 mo from Brazil, Pakistan, South Africa, and Sri Lanka. Reference charts and centiles were constructed for body composition using the lambda-mu-sigma method. RESULTS Sex-specific reference charts were produced for FM index (FMI), FFM index (FFMI), and percent FM (%FM) for infants aged 0-6 mo (n = 470 infants; 1899 observations) and 3-24 mo (n = 1026 infants; 3690 observations). When compared with other available references, there were observable differences but similar patterns in the trajectories of FMI, FFMI, and %FM. CONCLUSIONS These reference charts will strengthen the interpretation and understanding of body composition in infants across the first 24 mo of life.
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Affiliation(s)
- Alexia J Murphy-Alford
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria.
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Lukhanyo H Nyati
- SAMRC Developmental Pathways for Health Research Unit, Department of Pediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Ina S Santos
- Post-graduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Tasmania, Australia
| | - Shabina Ariff
- Department of Pediatric and Child Health, Medical College, The Aga Khan University, Sindh, Pakistan
| | | | | | - M Nishani Lucas
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Caroline S Costa
- Post-graduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Christine Slater
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Tanvir Ahmad
- Life Science Group, Isotope Application Division, Pakistan; Institute of Nuclear Science and Technology (PINSTECH), Nilore, Islamabad, Pakistan
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Tasmania, Australia
| | | | | | - Leila I Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Nuffield Department of Women's & Reproductive Health, University of Oxford, United Kingdom
| | - Cornelia U Loechl
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, Department of Pediatrics, University of the Witwatersrand, Johannesburg, South Africa; School of Human Development and Health, University of Southampton, Southampton, United Kingdom
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10
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Holloway TP, Dalton L, Hughes R, Jayasinghe S, Patterson KAE, Murray S, Soward R, Byrne NM, Hills AP, Ahuja KDK. School Gardening and Health and Well-Being of School-Aged Children: A Realist Synthesis. Nutrients 2023; 15:nu15051190. [PMID: 36904189 PMCID: PMC10005652 DOI: 10.3390/nu15051190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
School environments can create healthy settings to foster children's health and well-being. School gardening is gaining popularity as an intervention for healthier eating and increased physical activity. We used a systematic realist approach to investigate how school gardens improve health and well-being outcomes for school-aged children, why, and in what circumstances. The context and mechanisms of the specific school gardening interventions (n = 24) leading to positive health and well-being outcomes for school-aged children were assessed. The impetus of many interventions was to increase fruit and vegetable intake and address the prevention of childhood obesity. Most interventions were conducted at primary schools with participating children in Grades 2 through 6. Types of positive outcomes included increased fruit and vegetable consumption, dietary fiber and vitamins A and C, improved body mass index, and improved well-being of children. Key mechanisms included embedding nutrition-based and garden-based education in the curriculum; experiential learning opportunities; family engagement and participation; authority figure engagement; cultural context; use of multi-prong approaches; and reinforcement of activities during implementation. This review shows that a combination of mechanisms works mutually through school gardening programs leading to improved health and well-being outcomes for school-aged children.
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Affiliation(s)
- Timothy P. Holloway
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Lisa Dalton
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Kira A. E. Patterson
- School of Education, College of Arts, Law and Education, University of Tasmania, Launceston, TAS 7250, Australia
| | - Sandra Murray
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Robert Soward
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Andrew P. Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Kiran D. K. Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
- Nutrition Society of Australia, Crows Nest, NSW 1585, Australia
- Correspondence:
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11
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Sharma C, Ahuja KDK, Kulkarni B, Byrne NM, Hills AP. Life course research in physical activity: Pathway to Global Action Plan 2030. Obes Rev 2023; 24:e13554. [PMID: 36815214 DOI: 10.1111/obr.13554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/13/2022] [Accepted: 01/13/2023] [Indexed: 02/24/2023]
Abstract
Current global trends in physical activity levels demonstrate that the world is not on track to achieve the 2030 target set by the Global Action Plan. The Action Plan posited that physical activity should be an integral component of "daily lives" of all individuals "across the life course." Potential contributions to achieve global physical activity goals include the utilization of compositional data analysis and life course epidemiology to provide a framework for the composite nature of physical activity and complex life course relationships. Combining these two traditionally disconnected fields represents a paradigm shift in physical activity research. Here, we discuss how these combined fields enable a reinterpretation of previous research findings and explore their impact on policy and potential advantages and challenges. Careful consideration needs to be given to the implications of both fields remaining disconnected and the alternate option of consolidation to realize ambitions.
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Affiliation(s)
- Chitra Sharma
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Bharati Kulkarni
- Division of Reproductive Biology Maternal and Child Health and Nutrition, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Nuala M Byrne
- Division of Reproductive Biology Maternal and Child Health and Nutrition, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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12
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Mavragani A, Holloway TP, Soward R, Patterson KAE, Ahuja KDK, Dalton L, Murray S, Hughes R, Byrne NM, Hills AP. "An Ounce of Prevention is Worth a Pound of Cure": Proposal for a Social Prescribing Strategy for Obesity Prevention and Improvement in Health and Well-being. JMIR Res Protoc 2023; 12:e41280. [PMID: 36800232 PMCID: PMC9985003 DOI: 10.2196/41280] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Social and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management, and public health. Accordingly, social prescribing (SP) has received increased attention in recent times. The rampant global prevalence of obesity indicates that the customary, reductionistic, and disease-oriented biomedical approach to health service delivery is inadequate/ineffective at arresting the spread and mitigating the damaging consequences of the condition. There is an urgent need to shift the focus from reactive downstream disease-based treatments to more proactive, upstream, preventive action. In essence, this requires more effort to affect the paradigm shift from the traditional "biomedical approach of care" to a "biopsychosocial model" required to arrest the increasing prevalence of obesity. To this end, an SP approach, anchored in systems thinking, could be an effective means of moderating prevalence and consequences of obesity at a community level. OBJECTIVE The proposed SP intervention has the following three key objectives: (1) build a sustainable program for Circular Head based on SP, peer education, and health screening to minimize the incidence of obesity and related lifestyle diseases; (2) increase service and workforce connectivity and collaboration and initiate the introduction of new services and activities for obesity prevention and community health promotion; and (3) enhance health and well-being and minimize preventable adverse health outcomes of obesity and related lifestyle diseases through enhancement of food literacy and better nutrition, enhancement of physical literacy and habitual personal activity levels, and improvement of mental health, community connectedness, and reduction of social isolation. METHODS This paper describes a prospective SP strategy aimed at obesity prevention in Circular Head, a local government area in Northwest (NW) Tasmania. SP is a prominent strategy used in the Critical Age Periods Impacting the Trajectory of Obesogenic Lifestyles Project, which is an initiative based in NW Tasmania focused on assessing obesity prevention capacity. A social prescription model that facilitates the linkage of primary health screening with essential health care, education, and community resources through a dedicated "navigator" will be implemented. Four interlinked work packages will be implemented as part of the initial plan with each either building on existing resources or developing new initiatives. RESULTS A multimethod approach to triangulate insights from quantitative and qualitative research that enables the assessment of impact on individuals, community groups, and the health care system will be implemented within the initial pilot phase of the project. CONCLUSIONS Literature is replete with rhetoric advocating complex system approaches to curtail obesity. However, real-life examples of whole-of-systems interventions operationalized in ways that generate relevant evidence or effective policies are rare. The diverse approach for primary prevention of obesity-related lifestyle diseases and strategies for improvement of health and well-being described in this instance will contribute toward closing this evidence gap. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/41280.
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Affiliation(s)
| | - Timothy P Holloway
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Robert Soward
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Kira A E Patterson
- College of Arts, Law and Education, University of Tasmania, Launceston, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Lisa Dalton
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Sandra Murray
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
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13
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Dalton LM, Hills AP, Jayasinghe S, Strong K, Hyland P, Byrne NM. The Allied Health Expansion Program: Rethinking how to prepare a workforce to enable improved public health outcomes. Front Public Health 2023; 11:1119726. [PMID: 36875373 PMCID: PMC9982750 DOI: 10.3389/fpubh.2023.1119726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/30/2023] [Indexed: 02/19/2023] Open
Abstract
Improvements in global public health require universal health care supported by a health workforce with competencies appropriate for local population needs-the right capabilities, in the right place, and at the right time. Health inequities persist in Tasmania, and Australia more broadly, most notably for those people living in rural and remote areas. The article describes the curriculum design thinking approach being used to codesign and develop a connected system of education and training to target intergenerational change in the allied health (AH) workforce capacity in Tasmania, and beyond. A curriculum design thinking process is engaging AH participant groups (faculty, AH professionals, and leaders across health, education, aged and disability sectors) in a series of focus groups and workshops. The design process deals with four questions: What is? What if? What wows? and What works? It also involves Discover, Define, Develop and Deliver phases that continue to inform the development of the new suite of AH education programs. The British Design Council's Double Diamond model is used to organize and interpret stakeholder input. During the initial design thinking discover phase, stakeholders identified four overarching problems: rurality, workforce challenges, graduate skill set shortfalls, and clinical placements and supervision. These problems are described in terms of relevance to the contextual learning environment in which AH education innovation is occurring. The develop phase of design thinking continues to involve working collaboratively with stakeholders to codesign potential solutions. Solutions to date include AH advocacy, a transformative visionary curriculum, and an interprofessional community-based education model. In Tasmania, innovative educational innovations are catalyzing attention and investment in the effective preparation of AH professionals for practice to deliver improved public health outcomes. A suite of AH education that is deeply networked and engaged with Tasmanian communities is being developed to drive transformational public health outcomes. These programs are playing an important role in strengthening the supply of allied health professionals with the right capabilities for metropolitan, regional, rural, and remote Tasmania. They are situated in a broader AH education and training strategy that supports the ongoing development of the AH workforce to better meet the therapy needs of people in Tasmanian communities.
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Affiliation(s)
- Lisa M Dalton
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, TAS, Australia
| | - Andrew P Hills
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, TAS, Australia
| | - Sisitha Jayasinghe
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, TAS, Australia
| | - Kendra Strong
- Department of Health, Tasmanian Government, Hobart, TAS, Australia
| | - Paula Hyland
- Tasmanian Health Services, Department of Health, Hobart, TAS, Australia
| | - Nuala M Byrne
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, TAS, Australia
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14
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Jayasinghe S, Soward R, Dalton L, Holloway TP, Murray S, Patterson KAE, Ahuja KDK, Hughes R, Byrne NM, Hills AP. Domains of Capacity Building in Whole-Systems Approaches to Prevent Obesity-A "Systematized" Review. Int J Environ Res Public Health 2022; 19:10997. [PMID: 36078714 PMCID: PMC9517932 DOI: 10.3390/ijerph191710997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Despite increased awareness of its risks, for the most part, contemporary efforts for obesity prevention have been patchy at best. As such, the burgeoning interest in whole-systems approaches (WSAs) that acknowledge the complex, dynamic nature of overweight and obesity and operate across multiple levels of society is particularly timely. Many components of "community capacity building" (CB), an essential but often neglected aspect of obesity prevention, overlap with "best practice principles" in effective/optimal community-based obesity-prevention initiatives. Rhetoric urging WSAs and community CB in public health abounds although operative and efficacious contemporary examples of these approaches to reducing obesity levels are scarce. The aim of this investigation was to undertake a systematized review of the level of capacity building incorporated in published literature on WSAs targeting obesity to better understand how domains of CB have been incorporated. A PubMed search and a recently published systematic review were utilized to identify WSAs to obesity prevention between 1995-2020. A team-based approach to qualitative thematic data analysis was used to systematically assess and describe each intervention regarding explicit capacity-building practice. Despite not being specifically designed for building capacity, a significant proportion of the WSAs studied in the current report had implemented several CB domains.
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Affiliation(s)
- Sisitha Jayasinghe
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Robert Soward
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Lisa Dalton
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Timothy P. Holloway
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Sandra Murray
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Kira A. E. Patterson
- College of Arts, Law and Education, University of Tasmania, Launceston, TAS 7250, Australia
| | - Kiran D. K. Ahuja
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia
| | - Nuala M. Byrne
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Andrew P. Hills
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
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15
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Jayasinghe S, Soward R, Holloway TP, Patterson KAE, Ahuja KDK, Hughes R, Byrne NM, Hills AP. Why some do but too many don't? Barriers and enablers to physical activity in regional Tasmania - an exploratory, mixed-methods study. BMC Public Health 2022; 22:627. [PMID: 35354448 PMCID: PMC8967567 DOI: 10.1186/s12889-022-13001-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background The interconnectedness of physical inactivity and sedentarism, obesity, non-communicable disease (NCD) prevalence, and socio-economic costs, are well known. There is also strong research evidence regarding the mutuality between well-being outcomes and the neighbourhood environment. However, much of this evidence relates to urban contexts and there is a paucity of evidence in relation to regional communities. A better understanding of available physical activity (PA) infrastructure, its usage, and community perceptions regarding neighbourhood surroundings, could be very important in determining requirements for health improvement in regional communities. The aims of this research were to 1. Explore and evaluate the public’s perception of the PA environment; and 2. Evaluate the quantity, variety, and quality of existing PA infrastructure in regional Northwest (NW) Tasmania. Methods A mixed methods approach guided data collection, analysis, and presentation. Quality of PA infrastructure was assessed using the Physical Activity Resource Assessment (PARA) instrument and public perception about PA environment was evaluated using the International Physical Activity Questionnaire – Environmental (IPAQ-E) module. Quantitative data were analysed using descriptive summative methods and a team-based researcher triangulation approach was utilised for qualitative data. Results Overall, a wide array of high-quality PA infrastructure (with minimal incivilities such as auditory annoyance, litter, graffiti, dog refuse, and vandalism etc.) was available. Survey respondents rated neighbourhoods positively. The overall quality of PA infrastructure, rated on a scale from 0 to 3, was assessed as high (all rated between 2 to 3) with minimal incivilities (rated between 0 and 1.5). Of note, survey respondents confirmed the availability of numerous free-to-access recreational tracks and natural amenities across the 3 local government areas (LGAs) studied. Importantly, most respondents reported minimal disruption to their routine PA practices due to the COVID-19 pandemic. Conclusion This exploratory research confirmed the availability of a wide range of high-quality PA infrastructure across all three LGAs and there was an overwhelming public appreciation of this infrastructure. The challenge remains to implement place-based PA interventions that address extant barriers and further increase public awareness and utilisation of high-quality PA infrastructure. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13001-6.
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Affiliation(s)
- Sisitha Jayasinghe
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
| | - Robert Soward
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Timothy P Holloway
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Kira A E Patterson
- College of Arts, Law and Education, University of Tasmania, Hobart, Tasmania, Australia
| | - Kiran D K Ahuja
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Roger Hughes
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Nuala M Byrne
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Andrew P Hills
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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16
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Jin X, Gibson AA, Salis Z, Seimon RV, Harper C, Markovic TP, Byrne NM, Keating SE, Stamatakis E, Inan-Eroglu E, da Luz FQ, Ayre J, Sainsbury A. Effect of severe compared with moderate energy restriction on physical activity among postmenopausal female adults with obesity: a prespecified secondary analysis of the Type of Energy Manipulation for Promoting optimum metabolic health and body composition in Obesity (TEMPO) Diet randomized controlled Trial. Am J Clin Nutr 2022; 115:1393-1403. [PMID: 35102380 PMCID: PMC9071468 DOI: 10.1093/ajcn/nqac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/24/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND An under-explored strategy for increasing physical activity is the dietary treatment of obesity, but empirical evidence is lacking. OBJECTIVES We aimed to compare the effects of weight loss via severe as opposed to moderate energy restriction on physical activity over 36 mo. METHODS A total of 101 postmenopausal female adults (45-65 y, BMI 30-40 kg/m2, <180 min/wk of structured exercise) were randomly assigned to either 12 mo of moderate energy restriction (25%-35% of energy requirement) with a food-based diet, or a severe intervention involving 4 mo of severe energy restriction (65%-75% of energy requirement) with a total meal replacement diet, followed by 8 mo of moderate energy restriction. Physical activity was encouraged, but no tailored or supervised exercise prescription was provided. Physical activity was assessed with an accelerometer worn for 7 d before baseline (0 mo) and 0.25, 1, 4, 6, 12, 24, and 36 mo after intervention commencement. RESULTS Compared with the moderate group, the severe group exhibited greater mean: total volume of physical activity; duration of moderate-to-vigorous-intensity physical activity (MVPA); duration of light-intensity physical activity; step counts, as well as lower mean duration of sedentary time. All these differences (except step counts) were apparent at 6 mo [e.g., 1006 metabolic equivalent of task (MET)-min/wk; 95% CI: 564, 1449 MET-min/wk for total volume of physical activity], and some were also apparent at 4 and/or 12 mo. There were no differences between groups in the 2 other outcomes investigated (self-efficacy to regulate exercise; and proportion of participants meeting the WHO's 2020 Physical Activity Guidelines for MVPA). When the analyses were adjusted for weight at each time point, the differences between groups were either attenuated or abolished. CONCLUSIONS Among female adults with obesity, including a dietary component to reduce excess body weight-notably one involving severe energy restriction-could potentially enhance the effectiveness of physical activity interventions.This trial was registered at www.anzctr.org.au as ACTRN12612000651886.
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Affiliation(s)
- Xingzhong Jin
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia,The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Sydney Musculoskeletal Health, Kolling Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Alice A Gibson
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Zubeyir Salis
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Radhika V Seimon
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Claudia Harper
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tania P Markovic
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Metabolism & Obesity Service, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Nuala M Byrne
- School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Elif Inan-Eroglu
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Felipe Q da Luz
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Eating Disorders Program (AMBULIM), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Julie Ayre
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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17
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Jayasinghe S, Flies EJ, Soward R, Kendal D, Kilpatrick M, Holloway TP, Patterson KAE, Ahuja KDK, Hughes R, Byrne NM, Hills AP. A Spatial Analysis of Access to Physical Activity Infrastructure and Healthy Food in Regional Tasmania. Front Public Health 2021; 9:773609. [PMID: 34926390 PMCID: PMC8671161 DOI: 10.3389/fpubh.2021.773609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Prevalence of physical inactivity and obesity continues to increase in regional areas such as North-West (NW) Tasmania and show no signs of abating. It is possible that limited access to physical activity infrastructure (PAI) and healthier food options are exacerbating the low levels of habitual physical activity and obesity prevalence in these communities. Despite a burgeoning research base, concomitant exploration of both physical activity and food environments in rural and regional areas remain scarce. This research evaluated access (i.e., coverage, variety, density, and proximity) to physical activity resources and food outlets in relation to socioeconomic status (SES) in three NW Tasmanian communities. In all three study areas, the PAI and food outlets were largely concentrated in the main urban areas with most recreational tracks and natural amenities located along the coastline or river areas. Circular Head had the lowest total number of PAI (n = 43) but a greater proportion (30%) of free-to-access outdoor amenities. There was marked variation in accessibility to infrastructure across different areas of disadvantage within and between sites. For a considerable proportion of the population, free-to-access natural amenities/green spaces and recreational tracks (73 and 57%, respectively) were beyond 800 m from their households. In relation to food accessibility, only a small proportion of the food outlets across the region sells predominantly healthy (i.e., Tier 1) foods (~6, 13, and 10% in Burnie, Circular Head and Devonport, respectively). Similarly, only a small proportion of the residents are within a reasonable walking distance (i.e., 5–10 min walk) from outlets. In contrast, a much larger proportion of residents lived close to food outlets selling predominantly energy-dense, highly processed food (i.e., Tier 2 outlets). Circular Head had at least twice as many Tier 1 food stores per capita than Devonport and Burnie (0.23 vs. 0.10 and 0.06; respectively) despite recording the highest average distance (4.35 and 5.66 km to Tier 2/Tier 1 stores) to a food outlet. As such, it is possible that both food and physical activity environment layouts in each site are contributing to the obesogenic nature of each community.
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Affiliation(s)
- Sisitha Jayasinghe
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Emily J Flies
- School of Natural Sciences, University of Tasmania, Hobart, TAS, Australia.,Healthy Landscapes Research Group, University of Tasmania, Hobart, TAS, Australia
| | - Robert Soward
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Dave Kendal
- Healthy Landscapes Research Group, University of Tasmania, Hobart, TAS, Australia.,School of Geography, Planning and Spatial Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Michelle Kilpatrick
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Timothy P Holloway
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Kira A E Patterson
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Kiran D K Ahuja
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Roger Hughes
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Nuala M Byrne
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Andrew P Hills
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
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18
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Sharma C, Ahuja KD, Kulkarni B, Byrne NM, Hills AP. Cardiovascular diseases in rural South Asia: the story of one billion people. J Epidemiol Community Health 2021; 75:927-928. [PMID: 34503980 DOI: 10.1136/jech-2021-216837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/10/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Chitra Sharma
- School of Health Sciences, University of Tasmania College of Health and Medicine, Launceston, Tasmania, Australia
| | - Kiran Dk Ahuja
- School of Health Sciences, University of Tasmania College of Health and Medicine, Launceston, Tasmania, Australia
| | - Bharati Kulkarni
- Clinical Division, National Institute of Nutrition, Hyderabad, Telangana, India
| | - Nuala M Byrne
- School of Health Sciences, University of Tasmania College of Health and Medicine, Launceston, Tasmania, Australia
| | - Andrew P Hills
- School of Health Sciences, University of Tasmania College of Health and Medicine, Launceston, Tasmania, Australia
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19
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Horner KM, Byrne NM, King NA. Effect of Combined Interval and Continuous Exercise Training on Gastric Emptying, Appetite, and Adaptive Responses in Men With Overweight and Obesity. Front Nutr 2021; 8:654902. [PMID: 34124120 PMCID: PMC8192796 DOI: 10.3389/fnut.2021.654902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/26/2021] [Indexed: 12/30/2022] Open
Abstract
Background/Objectives: Characterizing compensatory and adaptive responses to exercise assists in understanding changes in energy balance and health outcomes with exercise interventions. This study investigated the effects of a short-term exercise intervention (combining high intensity interval (HII) and continuous exercise) on (1) gastric emptying, appetite and energy intake; and (2) other adaptive responses including cardiorespiratory fitness, in inactive men with overweight/obesity. Methods: Fifteen men (BMI: 29.7 ± 3.3 kg/m-2) completed a 4-wk supervised exercise intervention, consisting of 5 exercise sessions per week alternating between HII (30 s at 100% VO2max followed by 30 s recovery) and continuous (at 50% VO2max) training on a cycle ergometer, progressing from 30 to 45 min session duration. Gastric emptying (13C-octanoic acid breath test), appetite (visual analog scale), energy intake (ad libitum lunch meal), body composition (air displacement plethysmography), non-exercise activity (accelerometery) VO2max, blood pressure, and fasting concentrations of glucose, insulin, and ghrelin were measured before and after (≥48 h) the intervention. Results: Gastric emptying, glucose, insulin and ghrelin were unchanged, but energy intake at the ad libitum lunch test meal significantly increased at post-intervention (+171 ± 116 kcal, p < 0.01). Body weight (-0.9 ± 1.1 kg), waist circumference (-2.3 ± 3.5 cm) and percent body fat (-0.9 ± 1.1%) were modestly reduced (P < 0.05). VO2max increased (+4.4 ± 2.1 ml.kg.min-1) by 13% and systolic (-6.2 ± 8.4 mmHg) and diastolic (-5.8 ± 2.2 mmHg) blood pressure were significantly reduced (P ≤ 0.01 for all). Conclusions: Four weeks of exercise training did not alter gastric emptying, indicating gastric emptying may only adapt to a higher volume/longer duration of exercise or changes in other characteristics associated with regular exercise. The combination of HII and continuous exercise training had beneficial effects on body composition, cardiorespiratory fitness, and blood pressure and warrants further investigation in larger randomized controlled trials.
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Affiliation(s)
- Katy M Horner
- School of Public Health, Physiotherapy and Sport Sciences, Institute for Sport and Health and Institute of Food and Health, University College Dublin, Dublin, Ireland.,School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Neil A King
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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20
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Jayasinghe S, Herath MP, Beckett JM, Ahuja KDK, Byrne NM, Hills AP. Exclusivity of breastfeeding and body composition: learnings from the Baby-bod study. Int Breastfeed J 2021; 16:41. [PMID: 34011366 PMCID: PMC8132405 DOI: 10.1186/s13006-021-00389-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 05/06/2021] [Indexed: 01/22/2023] Open
Abstract
Background This report evaluated the breastfeeding status in a Tasmanian cohort and its effects on infant and maternal anthropometry and body composition. Methods An observational-cohort analysis of self-reported feeding data from 175 Tasmanian mother-baby dyads (recruited via in-person contact between September 2017 and October 2019), was executed. Only mothers who were ≥ 18 years of age, who had a singleton pregnancy and were able to speak and understand English, were included in the study. Infants outside a gestational age range between 37+ 0 and 41+ 6 weeks were excluded. Infant (using Air Displacement Plethysmography) and maternal body composition was assessed at 0, 3 and 6 months. Analysis of variance with relevant statistical corrections were utilised for cross-sectional and longitudinal comparisons between non-exclusively breastfed (neBF) and exclusively breastfed (eBF) groups. Results Fat-free mass was significantly higher [t = 2.27, df = 98, P = 0.03, confidence interval (CI) 0.03, 0.48] in neBF infants at 6 months (5.59 ± 0.59 vs 5.33 ± 0.50 kg) despite a higher mean fat-free mass in eBF infants at birth (2.89 ± 0.34 vs 3.01 ± 0.35 kg). Weak evidence for different fat mass index trajectories was observed for eBF and neBF infants in the first 6 months of life (ANOVA, F = 2.42, df = 1.9, P = 0.09) with an inversion in fat mass index levels between 3 and 6 months. Body Mass Index (BMI) trajectories were significantly different in eBF and neBF mothers through pregnancy and the first 6 months postpartum (ANOVA, F = 5.56, df = 30.14, P = 0.01). Compared with eBF mothers, neBF mothers retained significantly less weight (t = − 2.754, df = 158, P = 0.02, CI -6.64, − 1.09) at 3 months (0.68 ± 11.69 vs 4.55 ± 6.08 kg) postpartum. Prevalence for neBF was incrementally higher in mothers with a normal BMI compared to mothers with obesity, and mothers who underwent surgical or medical intervention during birth were less likely to exclusively breastfeed. Conclusions Infants with different feeding patterns may display varying growth patterns in early life and sustained breastfeeding can contribute to greater postpartum maternal weight loss.
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Affiliation(s)
- Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Manoja P Herath
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Jeffrey M Beckett
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, TAS, 7250, Australia.
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21
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Herath MP, Ahuja KDK, Beckett JM, Jayasinghe S, Byrne NM, Hills AP. Determinants of Infant Adiposity across the First 6 Months of Life: Evidence from the Baby-bod study. J Clin Med 2021; 10:jcm10081770. [PMID: 33921680 PMCID: PMC8073882 DOI: 10.3390/jcm10081770] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/06/2021] [Accepted: 04/15/2021] [Indexed: 12/16/2022] Open
Abstract
Excess adiposity in infancy may predispose individuals to obesity later in life. The literature on determinants of adiposity in infants is equivocal. In this longitudinal cohort study, we investigated pre-pregnancy, prenatal and postnatal determinants of different adiposity indices in infants, i.e., fat mass (FM), percent FM (%FM), fat mass index (FMI) and log-log index (FM/FFMp), from birth to 6 months, using linear mixed-effects regression. Body composition was measured in 322, 174 and 109 infants at birth and 3 and 6 months afterwards, respectively, utilising air displacement plethysmography. Positive associations were observed between gestation length and infant FM, maternal self-reported pre-pregnancy body mass index and infant %FM, and parity and infant %FM and FMI at birth. Surprisingly, maternal intake of iron supplements during pregnancy was associated with infant FM, %FM and FMI at 3 months and FM/FFMp at 6 months. Male infant sex and formula feeding were negatively associated with all adiposity indices at 6 months. In conclusion, pre-pregnancy and pregnancy factors influence adiposity during early life, and any unfavourable impacts may be modulated postnatally via infant feeding practices. Moreover, as these associations are dependent on the adiposity indices used, it is crucial that researchers use conceptually and statistically robust approaches such as FM/FFMp.
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22
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Herath MP, Beckett JM, Hills AP, Byrne NM, Ahuja KDK. Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions. J Clin Med 2021; 10:jcm10040835. [PMID: 33670645 PMCID: PMC7922793 DOI: 10.3390/jcm10040835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.
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23
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West DWD, Doering TM, Thompson JLM, Budiono BP, Lessard SJ, Koch LG, Britton SL, Steck R, Byrne NM, Brown MA, Peake JM, Ashton KJ, Coffey VG. Low responders to endurance training exhibit impaired hypertrophy and divergent biological process responses in rat skeletal muscle. Exp Physiol 2021; 106:714-725. [PMID: 33486778 DOI: 10.1113/ep089301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/19/2021] [Indexed: 12/11/2022]
Abstract
NEW FINDINGS What is the central question of this study? The extent to which genetics determines adaptation to endurance versus resistance exercise is unclear. Previously, a divergent selective breeding rat model showed that genetic factors play a major role in the response to aerobic training. Here, we asked: do genetic factors that underpin poor adaptation to endurance training affect adaptation to functional overload? What is the main finding and its importance? Our data show that heritable factors in low responders to endurance training generated differential gene expression that was associated with impaired skeletal muscle hypertrophy. A maladaptive genotype to endurance exercise appears to dysregulate biological processes responsible for mediating exercise adaptation, irrespective of the mode of contraction stimulus. ABSTRACT Divergent skeletal muscle phenotypes result from chronic resistance-type versus endurance-type contraction, reflecting the principle of training specificity. Our aim was to determine whether there is a common set of genetic factors that influence skeletal muscle adaptation to divergent contractile stimuli. Female rats were obtained from a genetically heterogeneous rat population and were selectively bred from high responders to endurance training (HRT) or low responders to endurance training (LRT; n = 6/group; generation 19). Both groups underwent 14 days of synergist ablation to induce functional overload of the plantaris muscle before comparison to non-overloaded controls of the same phenotype. RNA sequencing was performed to identify Gene Ontology biological processes with differential (LRT vs. HRT) gene set enrichment. We found that running distance, determined in advance of synergist ablation, increased in response to aerobic training in HRT but not LRT (65 ± 26 vs. -6 ± 18%, mean ± SD, P < 0.0001). The hypertrophy response to functional overload was attenuated in LRT versus HRT (20.1 ± 5.6 vs. 41.6 ± 16.1%, P = 0.015). Between-group differences were observed in the magnitude of response of 96 upregulated and 101 downregulated pathways. A further 27 pathways showed contrasting upregulation or downregulation in LRT versus HRT in response to functional overload. In conclusion, low responders to aerobic endurance training were also low responders for compensatory hypertrophy, and attenuated hypertrophy was associated with differential gene set regulation. Our findings suggest that genetic factors that underpin aerobic training maladaptation might also dysregulate the transcriptional regulation of biological processes that contribute to adaptation to mechanical overload.
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Affiliation(s)
- Daniel W D West
- Department of Physiology and Membrane Biology, University of California Davis, Davis, California, USA.,Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Thomas M Doering
- Faculty of Health Sciences and Medicine, Bond University, Robina, Gold Coast, Queensland, Australia.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Jamie-Lee M Thompson
- Faculty of Health Sciences and Medicine, Bond University, Robina, Gold Coast, Queensland, Australia
| | - Boris P Budiono
- School of Community Health, Charles Sturt University, Port Macquarie, New South Wales, Australia
| | - Sarah J Lessard
- Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lauren G Koch
- Department of Physiology and Pharmacology, University of Toledo, Toledo, Ohio, USA
| | - Steven L Britton
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Roland Steck
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nuala M Byrne
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Matthew A Brown
- Guy's & St Thomas' NHS Foundation Trust and King's College London NIHR Biomedical Research Centre, London, UK
| | - Jonathan M Peake
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kevin J Ashton
- Faculty of Health Sciences and Medicine, Bond University, Robina, Gold Coast, Queensland, Australia
| | - Vernon G Coffey
- Faculty of Health Sciences and Medicine, Bond University, Robina, Gold Coast, Queensland, Australia
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24
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Jayasinghe S, Herath MP, Beckett JM, Ahuja KDK, Byrne NM, Hills AP. WHO Child Growth Standards in context: The Baby-bod Project - Observational study in Tasmania. BMJ Paediatr Open 2021; 5:e001123. [PMID: 34222680 PMCID: PMC8211047 DOI: 10.1136/bmjpo-2021-001123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/03/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This research evaluated (1) differences in body size and composition of Tasmanian infants at birth and 3 and 6 months postpartum compared with WHO child growth standards and (2) body composition changes in Tasmanian infants at the extremes of the weight-for-length (WFL) spectrum. DESIGN Observational study. SETTING A hospital in Northern Tasmania, Australia. PATIENTS 315 healthy infants (~90% Caucasian) born between 2017 and 2019 in Tasmania. INTERVENTIONS Body composition and anthropometric measures at 0, 3 and 6 months. MAIN OUTCOME MEASURES Growth characteristics at birth and growth trajectories from 0 to 6 months were compared against WHO child growth standards for 0-2 years. RESULTS Overall, growth of Tasmanian infants in the first 6 months of life was similar to the global prescriptive standards. Trajectories of fat mass (FM) and fat-free mass (FFM) accrual in infants from the extremes of the size spectrum appear to converge at the 6-month time point. Infants in the lower extremity demonstrated the most precipitous accrual in percentage FM (and the steepest decline in percentage FFM), compared with all other infants. CONCLUSION No significant deviations of growth were observed in Tasmanian infants from 0 to 6 months in comparison to the WHO prescriptive growth standards. Infants below the third percentile WFL showed the most precipitous increase in FM accretion. Periodic comparisons local infants with global standards will enable identification of significant deviations from optimal growth patterns.
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Affiliation(s)
- Sisitha Jayasinghe
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Manoja P Herath
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Jeffrey M Beckett
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Kiran D K Ahuja
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Nuala M Byrne
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Andrew P Hills
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
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Jayasinghe S, Byrne NM, Patterson KAE, Ahuja KDK, Hills AP. The current global state of movement and physical activity - the health and economic costs of the inactive phenotype. Prog Cardiovasc Dis 2020; 64:9-16. [PMID: 33130190 DOI: 10.1016/j.pcad.2020.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 01/23/2023]
Abstract
Physical inactivity is one of the major contributing factors to the global pandemic of non-communicable diseases. Unfortunately, low levels of habitual movement and physical activity (PA) are seen in an increasing proportion of populations across low- and middle-income countries and high-income countries alike. This new normal - the inactive phenotype - is a significant contributor to multiple health and economic costs. Here we provide a brief historical overview of societal declines in PA, roughly consistent with major transitions in PA and nutrition in recent decades. This is followed by a synthesis of research evidence linking inactivity with poor health outcomes and prevention approaches needed to impact a perpetuation of poor lifestyle behaviors. A major focus of the paper is on the economic/health costs and the reduction of the inactive phenotype. In summary, we demonstrate that the consequences of insufficient PA are manifold, and if sustained, impact short and long-term health and quality of life, along with substantial economic costs.
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Affiliation(s)
- Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Kira A E Patterson
- Faculty of Education, University of Tasmania, Launceston, TAS, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia.
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26
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Sabag A, Way KL, Sultana RN, Keating SE, Gerofi JA, Chuter VH, Byrne NM, Baker MK, George J, Caterson ID, Twigg SM, Johnson NA. The Effect of a Novel Low-Volume Aerobic Exercise Intervention on Liver Fat in Type 2 Diabetes: A Randomized Controlled Trial. Diabetes Care 2020; 43:2371-2378. [PMID: 32732374 DOI: 10.2337/dc19-2523] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/05/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to examine the effect of a novel low-volume high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), or placebo (PLA) intervention on liver fat, glycemia, and cardiorespiratory fitness using a randomized placebo-controlled design. RESEARCH DESIGN AND METHODS Thirty-five inactive adults (age 54.6 ± 1.4 years, 54% male; BMI 35.9 ± 0.9 kg/m2) with obesity and type 2 diabetes were randomized to 12 weeks of supervised MICT (n = 12) at 60% VO2peak for 45 min, 3 days/week; HIIT (n = 12) at 90% VO2peak for 4 min, 3 days/week; or PLA (n = 11). Liver fat percentage was quantified through proton MRS. RESULTS Liver fat reduced in MICT (-0.9 ± 0.7%) and HIIT (-1.7 ± 1.1%) but increased in PLA (1.2 ± 0.5%) (P = 0.046). HbA1c improved in MICT (-0.3 ± 0.3%) and HIIT (-0.3 ± 0.3%) but not in PLA (0.5 ± 0.2%) (P = 0.014). Cardiorespiratory fitness improved in MICT (2.3 ± 1.2 mL/kg/min) and HIIT (1.1 ± 0.5 mL/kg/min) but not in PLA (-1.5 ± 0.9 mL/kg/min) (P = 0.006). CONCLUSIONS MICT or a low-volume HIIT approach involving 12 min of weekly high-intensity aerobic exercise may improve liver fat, glycemia, and cardiorespiratory fitness in people with type 2 diabetes in the absence of weight loss. Further studies are required to elucidate the relationship between exercise-induced reductions in liver fat and improvements in glycemia.
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Affiliation(s)
- Angelo Sabag
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia .,The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
| | - Kimberley L Way
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
| | - Rachelle N Sultana
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - James A Gerofi
- The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
| | - Vivienne H Chuter
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Tasmania, Australia
| | - Michael K Baker
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, New South Wales, Australia
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research and Westmead Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | - Ian D Caterson
- The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephen M Twigg
- The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nathan A Johnson
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
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27
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Arezzolo D, Coffey VG, Byrne NM, Doering TM. Effects of Eight Interval Training Sessions in Hypoxia on Anaerobic, Aerobic, and High Intensity Work Capacity in Endurance Cyclists. High Alt Med Biol 2020; 21:370-377. [PMID: 32830992 DOI: 10.1089/ham.2020.0066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: This study aimed to determine if eight sessions of supramaximal but steady-state, set duration interval training in hypoxia enhanced measured anaerobic capacity and work performed during high intensity exercise. High Alt Med Biol. 21:370-377, 2020. Materials and Methods: Eighteen cyclists (V̇O2peak: 57 ± 7 ml·kg-1·min-1) were pair-matched for anaerobic capacity determined by maximal accumulated oxygen deficit (MAOD) and allocated to a 4-week interval training in hypoxia (IHT; FiO2 = 14.7% ± 0.5%, n = 9) or interval training in normoxia (NORM; FiO2 = 20.6% ± 0.3%, n = 9). Cyclists completed twice weekly interval training (8 × 1 minutes: ∼120% V̇O2peak, 5 minutes recovery: ∼50% V̇O2peak) in addition to their habitual training. Before and after the intervention, a constant work rate supramaximal time to fatigue and a graded exercise test were used to determine changes in anaerobic capacity/supramaximal work performed and aerobic capacity/peak aerobic power output, respectively. Results: No interaction or main effects were observed. Using indirect calorimetry, anaerobic capacity was not significantly different in either group pre- to postintervention using MAOD (IHT: 4% ± 15%; NORM: -5% ± 12%) or gross efficiency methods (IHT: 7% ± 14%; NORM: -2% ± 9%), and VO2peak was unchanged (IHT: 1% ± 6%; NORM: 1% ± 4%). However, within-group analysis shows that supramaximal work performed improved with IHT (14% ± 13%; p = 0.02; d = 0.42) but not NORM (1% ± 22%), and peak aerobic power output increased with IHT (5% ± 7%; p = 0.04; d = 0.32) but not NORM (2% ± 4%). Conclusion: Steady-state, set duration supramaximal interval training in hypoxia appears to provide a small beneficial effect on work capacity during supramaximal and high intensity exercise.
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Affiliation(s)
- Damon Arezzolo
- Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Vernon G Coffey
- Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Nuala M Byrne
- School of Health Sciences, University of Tasmania, Newnham, Australia
| | - Thomas M Doering
- Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
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28
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Seimon RV, Wild-Taylor AL, McClintock S, Harper C, Gibson AA, Johnson NA, Fernando HA, Markovic TP, Center JR, Franklin J, Liu PY, Grieve SM, Lagopoulos J, Caterson ID, Byrne NM, Sainsbury A. 3-Year effect of weight loss via severe versus moderate energy restriction on body composition among postmenopausal women with obesity - the TEMPO Diet Trial. Heliyon 2020; 6:e04007. [PMID: 32613096 PMCID: PMC7322133 DOI: 10.1016/j.heliyon.2020.e04007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/06/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022] Open
Abstract
We have previously shown that a severely energy-restricted diet leads to greater loss of weight, fat, lean mass and bone mineral density (BMD) at 12 months in postmenopausal women with obesity than a moderately energy-restricted diet. We now aim to evaluate whether these effects are sustained longer term (ie, at 36 months). 101 postmenopausal women were randomized to either 12 months of moderate (25 to 35%) energy restriction with a food-based diet (moderate intervention), or 4 months of severe (65 to 75%) energy restriction with a total meal replacement diet followed by moderate energy restriction for 8 months (severe intervention). Body weight and composition were measured at 0, 24 and 36 months. Participants in the severe intervention lost ~1.5 to 1.7 times as much weight, waist circumference, whole-body fat mass and visceral adipose tissue compared to those in the moderate intervention, and were 2.6 times more likely (42% versus 16%) to have lost 10% or more of their initial body weight at 36 months (P < 0.01 for all). However, those in the severe versus moderate intervention lost ~1.4 times as much whole-body lean mass (P < 0.01), albeit this was proportional to total weight lost and there was no greater loss of handgrip strength, and they also lost ~2 times as much total hip BMD between 0 and 36 months (P < 0.05), with this bone loss occurring in the first 12 months. Thus, severe energy restriction is more effective than moderate energy restriction for reducing weight and adiposity in postmenopausal women in the long term (3 years), but attention to BMD loss in the first year is required. Trial registration Australian New Zealand Clinical Trials Registry Reference Number: 12612000651886, anzctr.org.au.
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Affiliation(s)
- Radhika V. Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Corresponding author.
| | - Anthony L. Wild-Taylor
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sally McClintock
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Claudia Harper
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alice A. Gibson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nathan A. Johnson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Hamish A. Fernando
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Tania P. Markovic
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jacqueline R. Center
- Bone Biology Program, Garvan Institute of Medical Research, St Vincent's Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Peter Y. Liu
- Division of Endocrinology, Department of Medicine, Harbor-University of California Los Angeles Medical Center and Los Angeles BioMedical Research Institute, Los Angeles
| | - Stuart M. Grieve
- Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience–Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Ian D. Caterson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Crawley, Western Australia, Australia
- Corresponding author.
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MacKenzie-Shalders K, Kelly JT, So D, Coffey VG, Byrne NM. The effect of exercise interventions on resting metabolic rate: A systematic review and meta-analysis. J Sports Sci 2020; 38:1635-1649. [PMID: 32397898 DOI: 10.1080/02640414.2020.1754716] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The systematic review and meta-analysis evaluated the effect of aerobic, resistance and combined exercise on RMR (kCal·day-1) and performed a methodological assessment of indirect calorimetry protocols within the included studies. Subgroup analyses included energy/diet restriction and body composition changes. Randomized control trials (RCTs), quasi - RCTs and cohort trials featuring a physical activity intervention of any form and duration excluding single exercise bouts were included. Participant exclusions included medical conditions impacting upon RMR, the elderly (≥65 years of age) or pregnant, lactating or post-menopausal women. The review was registered in the International Prospective Register of Systematic Reviews (CRD 42,017,058,503). 1669 articles were identified; 22 were included in the qualitative analysis and 18 were meta-analysed. Exercise interventions (aerobic and resistance exercise combined) did not increase resting metabolic rate (mean difference (MD): 74.6 kCal·day-1[95% CI: -13.01, 161.33], P = 0.10). While there was no effect of aerobic exercise on RMR (MD: 81.65 kCal·day-1[95% CI: -57.81, 221.10], P = 0.25), resistance exercise increased RMR compared to controls (MD: 96.17 kCal·day-1[95% CI: 45.17, 147.16], P = 0.0002). This systematic review effectively synthesises the effect of exercise interventions on RMR in comparison to controls; despite heterogenous methodologies and high risk of bias within included studies.
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Affiliation(s)
- Kristen MacKenzie-Shalders
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health and Sport , Gold Coast, Australia
| | - Jaimon T Kelly
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health and Sport , Gold Coast, Australia.,Menzies Health Institute Queensland, Griffith University , Gold Coast, Queensland, Australia
| | - Daniel So
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health and Sport , Gold Coast, Australia.,Faculty of Medicine Nursing and Health Sciences, Central Clinical School, Department of Gastroenterology, Monash University , Melbourne, Australia
| | - Vernon G Coffey
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health and Sport , Gold Coast, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania , Launceston, Australia
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Seimon RV, Wild-Taylor AL, Keating SE, McClintock S, Harper C, Gibson AA, Johnson NA, Fernando HA, Markovic TP, Center JR, Franklin J, Liu PY, Grieve SM, Lagopoulos J, Caterson ID, Byrne NM, Sainsbury A. Effect of Weight Loss via Severe vs Moderate Energy Restriction on Lean Mass and Body Composition Among Postmenopausal Women With Obesity: The TEMPO Diet Randomized Clinical Trial. JAMA Netw Open 2019; 2:e1913733. [PMID: 31664441 PMCID: PMC6824325 DOI: 10.1001/jamanetworkopen.2019.13733] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Severely energy-restricted diets are the most effective dietary obesity treatment. However, there are concerns regarding potential adverse effects on body composition. OBJECTIVE To compare the long-term effects of weight loss via severe vs moderate energy restriction on lean mass and other aspects of body composition. DESIGN, SETTING, AND PARTICIPANTS The Type of Energy Manipulation for Promoting Optimum Metabolic Health and Body Composition in Obesity (TEMPO) Diet Trial was a 12-month, single-center, randomized clinical trial. A total of 101 postmenopausal women, aged 45 to 65 years with body mass index (calculated as weight in kilograms divided by height in meters squared) from 30 to 40, who were at least 5 years after menopause, had fewer than 3 hours of structured physical activity per week, and lived in the Sydney metropolitan area of New South Wales, Australia, were recruited between March 2013 and July 2016. Data analysis was conducted between October 2018 and August 2019. INTERVENTION Participants were randomized to either 12 months of moderate (25%-35%) energy restriction with a food-based diet (moderate intervention) or 4 months of severe (65%-75%) energy restriction with a total meal replacement diet followed by moderate energy restriction for an additional 8 months (severe intervention). Both interventions had a prescribed protein intake of 1.0 g/kg of actual body weight per day, and physical activity was encouraged but not supervised. MAIN OUTCOMES AND MEASURES The primary outcome was whole-body lean mass at 12 months after commencement of intervention. Secondary outcomes were body weight, thigh muscle area and muscle function (strength), bone mineral density, and fat mass and distribution, measured at 0, 4, 6, and 12 months. RESULTS A total of 101 postmenopausal women were recruited (mean [SD] age, 58.0 [4.2] years; mean [SD] weight, 90.8 [9.1] kg; mean [SD] body mass index, 34.4 [2.5]). Compared with the moderate group at 12 months, the severe group lost more weight (effect size, -6.6 kg; 95% CI, -8.2 to -5.1 kg), lost more whole-body lean mass (effect size, -1.2 kg; 95% CI, -2.0 to -0.4 kg), and lost more thigh muscle area (effect size, -4.2 cm2; 95% CI, -6.5 to -1.9 cm2). However, decreases in whole-body lean mass and thigh muscle area were proportional to total weight loss, and there was no difference in muscle (handgrip) strength between groups. Total hip bone mineral density (effect size, -0.017 g/cm2; 95% CI, -0.029 to -0.005 g/cm2), whole-body fat mass (effect size, -5.5 kg; 95% CI, -7.1 to -3.9 kg), abdominal subcutaneous adipose tissue (effect size, -1890 cm3; 95% CI, -2560 to -1219 cm3), and visceral adipose tissue (effect size, -1389 cm3; 95% CI, -1748 to -1030 cm3) loss were also greater for the severe group than for the moderate group at 12 months. CONCLUSIONS AND RELEVANCE Severe energy restriction had no greater adverse effect on relative whole-body lean mass or handgrip strength compared with moderate energy restriction and was associated with 2-fold greater weight and fat loss over 12 months. However, there was significantly greater loss of total hip bone mineral density with severe vs moderate energy restriction. Therefore, caution is necessary when implementing severe energy restriction in postmenopausal women, particularly those with osteopenia or osteoporosis. TRIAL REGISTRATION anzctr.org.au Identifier: 12612000651886.
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Affiliation(s)
- Radhika V. Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Anthony L. Wild-Taylor
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Shelley E. Keating
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Sally McClintock
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Claudia Harper
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alice A. Gibson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nathan A. Johnson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Hamish A. Fernando
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Tania P. Markovic
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jacqueline R. Center
- Bone Biology Program, Garvan Institute of Medical Research, St Vincent’s Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Janet Franklin
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Peter Y. Liu
- Division of Endocrinology, Department of Medicine, Harbor-University of California Los Angeles Medical Center and Los Angeles BioMedical Research Institute, Los Angeles
| | - Stuart M. Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience–Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Ian D. Caterson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Amanda Sainsbury
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Hills AP, Farpour-Lambert NJ, Byrne NM. Precision medicine and healthy living: The importance of the built environment. Prog Cardiovasc Dis 2019; 62:34-38. [PMID: 30639136 DOI: 10.1016/j.pcad.2018.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 12/31/2018] [Indexed: 12/28/2022]
Abstract
The built environment encompasses the major physical spaces, including buildings, streets, homes, schools, parks, playgrounds and other infrastructure in which we live, work and play. In an ideal world, the built environment should support and facilitate a healthy engagement in physical activity across the lifespan. However, in the context of an environment characterized by increased mechanization and urbanization, physical inactivity and higher levels of overweight and obesity, too many settings are not conducive to physical activity and/or are not safe and walkable. In the knowledge that there are multiple challenges to redress the low levels of physical activity seen in many parts of the world, this paper provides some examples of opportunities for healthy living (HL) in a built environment characteristic of an increasingly urbanized world. Particular foci include opportunities for HL fostered in child-friendly cities, in which walkability is high, and active transport is encouraged and supported.
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Affiliation(s)
- Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, TAS, Australia.
| | - Nathalie J Farpour-Lambert
- Obesity Prevention and Care Program "Contrepoids," Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; Pediatric Sports Medicine Consultation, Service of General Pediatrics, Department of Child and Adolescent, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, TAS, Australia
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MacKenzie-Shalders KL, Byrne NM, King NA, Slater GJ. Are increases in skeletal muscle mass accompanied by changes to resting metabolic rate in rugby athletes over a pre-season training period? Eur J Sport Sci 2019; 19:885-892. [PMID: 30614386 DOI: 10.1080/17461391.2018.1561951] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Optimising dietary energy intake is essential for effective sports nutrition practice in rugby athletes. Effective dietary energy prescription requires careful consideration of athletes' daily energy expenditure with the accurate prediction of resting metabolic rate (RMR) important due to its influence on total energy expenditure and in turn, energy balance. This study aimed to (a) measure rugby athletes RMR and (b) report the change in RMR in developing elite rugby players over a rugby preseason subsequent to changes in body composition and (c) explore the accurate prediction of RMR in rugby athletes. Eighteen developing elite rugby union athletes (age 20.2 ± 1.7 years, body mass 101.2 ± 14.5 kg, stature 184.0 ± 8.4 cm) had RMR (indirect calorimetry) and body composition (dual energy x-ray absorptiometry) measured at the start and end of a rugby preseason ∼14 weeks later. There was no statistically significant difference in RMR over the preseason period (baseline 2389 ± 263 kcal·day-1 post 2373 ± 270 kcal·day-1) despite a significant increase in lean mass of +2.0 ± 1.6 kg (P < 0.01) and non-significant loss of fat mass. The change in RMR was non-significant and non-meaningful; thus, this study contradicts the commonly held anecdotal perception that an increase in skeletal muscle mass will result in a significant increase in metabolic rate and daily energy needs. Conventional prediction equations generally under-estimated rugby athletes' measured RMR, and may be problematic for identifying low energy availability, and thus updated population-specific prediction equations may be warranted to inform practice.
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Affiliation(s)
- Kristen L MacKenzie-Shalders
- a Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport , Bond University , Gold Coast , Australia
| | - Nuala M Byrne
- b School of Health Sciences, College of Health and Medicine , University of Tasmania , Launceston , Australia
| | - Neil A King
- c School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Australia
| | - G J Slater
- d School of Health and Sport Sciences , University of the Sunshine Coast , Sippy Downs , Australia
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Croci I, Byrne NM, Chachay VS, Hills AP, Clouston AD, O’Moore-Sullivan TM, Prins JB, Macdonald GA, Hickman IJ. The independent effects of dietary energy restriction and circuit exercise training on fat oxidation in patients with NAFLD. Obes Res Clin Pract 2019. [DOI: 10.1016/j.orcp.2016.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sainsbury A, Wood RE, Seimon RV, Hills AP, King NA, Gibson AA, Byrne NM. Rationale for novel intermittent dieting strategies to attenuate adaptive responses to energy restriction. Obes Rev 2018; 19 Suppl 1:47-60. [PMID: 30511512 DOI: 10.1111/obr.12787] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/11/2018] [Indexed: 12/16/2022]
Abstract
Eating patterns involving intermittent energy restriction (IER) include 'intermittent fasting' where energy intake is severely restricted for several 'fasting' days per week, with 'refeeding' days (involving greater energy intake than during fasting days) at other times. Intermittent fasting does not improve weight loss compared to continuous energy restriction (CER), where energy intake is restricted every day. We hypothesize that weight loss from IER could be improved if refeeding phases involved restoration of energy balance (i.e. not ongoing energy restriction, as during intermittent fasting). There is some evidence in adults with overweight or obesity showing that maintenance of a lower weight may attenuate (completely or partially) some of the adaptive responses to energy restriction that oppose ongoing weight loss. Other studies show some adaptive responses persist unabated for years after weight loss. Only five randomized controlled trials in adults with overweight or obesity have compared CER with IER interventions that achieved energy balance (or absence of energy restriction) during refeeding phases. Two reported greater weight loss than CER, whereas three reported similar weight loss between interventions. While inconclusive, it is possible that achieving energy balance (i.e. avoiding energy restriction or energy excess) during refeeding phases may be important in realizing the potential of IER.
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Affiliation(s)
- A Sainsbury
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, NSW, Australia
| | - R E Wood
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - R V Seimon
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, NSW, Australia
| | - A P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - N A King
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - A A Gibson
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, NSW, Australia
| | - N M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
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Byrne NM, Hills AP. How much exercise should be promoted to raise total daily energy expenditure and improve health? Obes Rev 2018; 19 Suppl 1:14-23. [PMID: 30511509 DOI: 10.1111/obr.12788] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 09/17/2018] [Indexed: 01/19/2023]
Abstract
Despite longstanding recognition of the benefits of a physically active lifestyle, there remains ambiguity regarding exactly how much exercise should be promoted to raise total energy expenditure (TEE) and improve health. This review provides a brief summary of the dose-response relationship between physical activity and relative risk of morbidity and mortality; mechanisms through which exercise drives an increase in TEE; the highest reported levels of TEE measured via doubly labelled water; and the potential impact of non-compliance and confounders in moderating the contribution of exercise to increase TEE. Cohort studies provide a compelling argument that 'more is better' regarding the exercise dose for increasing TEE, that increasing TEE is protective for health, and that this is mediated through increased cardiorespiratory fitness. However, growing evidence shows that ever increasing volumes of weekly physical activity may reverse the cost-benefit seen with more modest doses. Animal and human studies show that the elevation in TEE associated with increasing exercise volume is commonly less than expected, due to physiological confounders. Further, there is considerable evidence of behavioural non-compliance to planned exercise in all but the most highly motivated athletes. Therefore, inbuilt defence mechanisms may safeguard against TEE being elevated to maximum levels.
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Affiliation(s)
- N M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - A P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Hills AP, Misra A, Gill JMR, Byrne NM, Soares MJ, Ramachandran A, Palaniappan L, Street SJ, Jayawardena R, Khunti K, Arena R. Public health and health systems: implications for the prevention and management of type 2 diabetes in south Asia. Lancet Diabetes Endocrinol 2018; 6:992-1002. [PMID: 30287104 DOI: 10.1016/s2213-8587(18)30203-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 02/07/2023]
Abstract
Many non-communicable chronic diseases, including type 2 diabetes, are highly prevalent, costly, and largely preventable. The prevention and management of type 2 diabetes in south Asia requires a combination of lifestyle changes and long-term health-care management. However, public health and health-care systems in south Asian countries face serious challenges, including the need to provide services to many people with inadequate resources, and substantial between-population and within-population inequalities. In this Series paper, we explore the importance and particular challenges of public health and health systems in south Asian countries (Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka) with respect to the provision of culturally appropriate lifestyle modification to prevent and manage diabetes, especially in resource-poor settings. Effective primary prevention strategies are urgently needed to counter risk factors and behaviours preconception, in utero, in infancy, and during childhood and adolescence. A concerted focus on education, training, and capacity building at the community level would ensure the more widespread use of non-physician care, including community health workers. Major investment from governments and other sources will be essential to achieve substantial improvements in the prevention and management of type 2 diabetes in the region.
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Affiliation(s)
- Andrew P Hills
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia.
| | - Anoop Misra
- Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, India; National Diabetes, Obesity, and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
| | - Jason M R Gill
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Nuala M Byrne
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Mario J Soares
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Ambady Ramachandran
- India Diabetes Research Foundation & Dr A Ramachandran's Diabetes Hospitals, Guindy, Chennai, India
| | | | - Steven J Street
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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Ruddick-Collins LC, King NA, Byrne NM. Measurement duration affects the calculation of whole body protein turnover kinetics but not between-day variability. Metabolism 2018; 87:80-86. [PMID: 29932957 DOI: 10.1016/j.metabol.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 06/17/2018] [Accepted: 06/18/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Assessment of whole body protein turnover (WBPT) can provide fundamental information about protein kinetics which underpins the conservation of lean tissue. Reliability and methodology studies on the measurement of WBPT are scarce. This study aimed to assess the effects of urine collection duration (9 versus 12 h) and the reproducibility of WBPT with the end product method calculated from ammonia as the end product. METHODS WBPT was assessed in 21 healthy participants (11M, 10F) on 2 test days. WBPT was assessed using the end product method with a single dose of 15N glycine with ammonia as end product in a postprandial state with 9 and 12-h urine collections. RESULTS The CV for protein flux averaged 10% and 12% for 9 and 12-h urine collections respectively. Protein flux, synthesis and balance were significantly higher and protein breakdown significantly lower with 9-h urine collections compared to 12-h collections (P < 0.01) and there was a trend towards increasingly greater overestimation of 9-h calculated WBPT kinetics with greater overall rates of WBPT. Correlations between the 9 and 12-h values were strong (r > 0.962, P < 0.001 for all variables). CONCLUSIONS The reproducibility of WBPT with ammonia as the end product was similar to previously reported reproducibility of the gold standard precursor technique. The use of a 12-h urine collection is more effective to achieve full turnover of the ammonia free amino acid (AA) pool.
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Affiliation(s)
- Leonie C Ruddick-Collins
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia.
| | - Neil A King
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham, TAS 7248, Australia
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Hsu MSH, Harper C, Gibson AA, Sweeting AN, McBride J, Markovic TP, Caterson ID, Byrne NM, Sainsbury A, Seimon RV. Recruitment Strategies for a Randomised Controlled Trial Comparing Fast Versus Slow Weight Loss in Postmenopausal Women with Obesity-The TEMPO Diet Trial. Healthcare (Basel) 2018; 6:healthcare6030076. [PMID: 29986398 PMCID: PMC6163885 DOI: 10.3390/healthcare6030076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 12/12/2022] Open
Abstract
Current research around effective recruitment strategies for clinical trials of dietary obesity treatments have largely focused on younger adults, and thus may not be applicable to older populations. The TEMPO Diet Trial (Type of Energy Manipulation for Promoting optimal metabolic health and body composition in Obesity) is a randomised controlled trial comparing the long-term effects of fast versus slow weight loss on body composition and cardio-metabolic health in postmenopausal women with obesity. This paper addresses the recruitment strategies used to enrol participants into this trial and evaluates their relative effectiveness. 101 post-menopausal women aged 45–65 years, with a body mass index of 30–40 kg/m2 were recruited and randomised to either fast or slow weight loss. Multiple strategies were used to recruit participants. The total time cost (labour) and monetary cost per randomised participant from each recruitment strategy was estimated, with lower values indicating greater cost-effectiveness and higher values indicating poorer cost-effectiveness. The most cost-effective recruitment strategy was word of mouth, followed (at equal second place) by free publicity on TV and radio, and printed advertorials, albeit these avenues only yielded 26/101 participants. Intermediate cost-effective recruitment strategies were flyer distribution at community events, hospitals and a local tertiary education campus, internet-based strategies, and clinical trial databases and intranets, which recruited a further 40/101 participants. The least cost-effective recruitment strategy was flyer distribution to local health service centres and residential mailboxes, and referrals from healthcare professionals were not effective. Recruiting for clinical trials involving postmenopausal women could benefit from a combination of recruitment strategies, with an emphasis on word of mouth and free publicity via radio, TV, and print media, as well as strategic placement of flyers, supplemented with internet-based strategies, databases and intranets if a greater yield of participants is needed.
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Affiliation(s)
- Michelle S H Hsu
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Alice A Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Arianne N Sweeting
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - John McBride
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Tania P Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - Ian D Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia.
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Radhika V Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
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Abstract
BACKGROUND AND OBJECTIVES Anthropometric equations are widely used to estimate body composition however, are only appropriate for use in populations in which they have been developed and validated. The present study developed anthropometric prediction equations for Indonesian adults and cross-validated them with selected equations used in this population. METHODS AND STUDY DESIGN Six hundred Indonesian adults aged between 18- 65 years (292 males and 308 females) were divided equally into development and validation groups. Stature, body weight, skinfold thickness at eight sites, girth at five sites, and bone breadth at four sites were measured. Stepwise multiple regression analysis was used to propose percentage body fat (%BF) prediction equations using measured variables and %BF from the deuterium oxide dilution technique as the reference. The proposed prediction equations were then cross-validated using the validation group and %BF estimated from several existing equations. RESULTS Proposed prediction equations showed r ranged from 0.82 to 0.86 and Standard Error of the Estimate (SEE) from 4.7 to 5.4%. Cross-validation analysis showed bias with the reference %BF between 0.2 and 3.3% and Pure Error (PE) between 2.8 and 4.0%. Among the existing equations, the Durnin and Womersley equation was applicable in females whilst the equation by Davidson et al. underestimated %BF by 6.3-6.6% and the equation by Gurrici et al overestimated by 2.0-3.4% in both genders (p<0.01). CONCLUSION The proposed prediction equations provide better options for accurate prediction of %BF in Indonesian adults.
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Affiliation(s)
- Janatin Hastuti
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Masaharu Kagawa
- Institute of Nutrition Sciences, Kagawa Nutrition University, Japan
| | - Nuala M Byrne
- School of Health Sciences, University of Tasmania, Australia
| | - Andrew P Hills
- School of Health Sciences, University of Tasmania, Australia
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Seimon RV, Wild-Taylor AL, Gibson AA, Harper C, McClintock S, Fernando HA, Hsu MSH, da Luz FQ, Keating SE, Johnson NA, Grieve SM, Markovic TP, Caterson ID, Byrne NM, Sainsbury A. Less Waste on Waist Measurements: Determination of Optimal Waist Circumference Measurement Site to Predict Visceral Adipose Tissue in Postmenopausal Women with Obesity. Nutrients 2018; 10:nu10020239. [PMID: 29461494 PMCID: PMC5852815 DOI: 10.3390/nu10020239] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/01/2018] [Accepted: 02/14/2018] [Indexed: 11/16/2022] Open
Abstract
With obesity being a leading cause of preventable death, it is vital to understand how best to identify individuals with greater risk of metabolic disease, especially those with high visceral adipose tissue (VAT). This study aimed to determine whether three commonly used waist circumference (WC) measurement sites could provide accurate estimations of VAT, as determined by magnetic resonance imaging (MRI), which is a gold standard for measuring VAT, in postmenopausal women with obesity. VAT volume was measured by MRI of the total abdomen in 97 women aged 57.7 ± 0.4 years (mean ± SEM), mean body mass index 34.5 ± 0.2 kg/m2. WC was measured at the midpoint between the lowest rib and the iliac crest (WCmid), the narrowest point of the torso (WCnarrow), and at the level of the umbilicus (WCumbilicus). WC differed significantly according to measurement site, with WCnarrow (102.1 ± 0.7 cm) < WCmid (108.3 ± 0.7 cm) < WCumbilicus (115.7 ± 0.8 cm) (p < 0.001). WCmid, WCnarrow and WCumbilicus were all significantly correlated with VAT, as measured by MRI (r = 0.581, 0.563 and 0.390, respectively; p < 0.001 for all), but the relationships between WCmid or WCnarrow and VAT determined by MRI were stronger than for WCumbilicus. Measurement of either WCmid or WCnarrow provides valid estimates of VAT in postmenopausal women with obesity, with WCnarrow being favoured in light of its greater ease and speed of measurement in this population.
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Affiliation(s)
- Radhika V. Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Correspondence: ; Tel.: +61-2-8627-1918; Fax: +61-2-8627-0141
| | - Anthony L. Wild-Taylor
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Alice A. Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Sally McClintock
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Hamish A. Fernando
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Michelle S. H. Hsu
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Felipe Q. da Luz
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Shelley E. Keating
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Nathan A. Johnson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2050, Australia
| | - Stuart M. Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia;
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Tania P. Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Ian D. Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia;
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia
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Hastuti J, Kagawa M, Byrne NM, Hills AP. Determination of new anthropometric cut-off values for obesity screening in Indonesian adults. Asia Pac J Clin Nutr 2017; 26:650-656. [PMID: 28582815 DOI: 10.6133/apjcn.072016.09] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) have increasingly been used as screening tools for obesity. However, optimal cut-off values may be different between populations. The current study determined the optimum cut-off values for BMI, WC, WHR, and WSR for obesity screening in Indonesian adults using receiver-operating characteristic (ROC) analysis. METHODS AND STUDY DESIGN Stature, body weight, waist and hip circumferences were measured on 600 Indonesians aged 18-65 years (males, n=292; females, n=308) and BMI, WHR, and WSR calculated. Percentage of body fat (%BF) was determined using the deuterium isotope (D2O) dilution technique. Some existing cut-off points for obesity determination were evaluated for sensitivity and specificity. RESULTS The existing cutoff values showed low sensitivity in our sample (between 18.4 and 71.1%) and new proposed cut-offs increased the sensitivity to reach 66.7 to 88.5%. The new cut-offs for BMI, WC, WHR, and WSR for determination of obesity were 21.9 (kg/m2), 76.8 (cm), 0.86, and 0.48, respectively, for males and 23.6 (kg/m2), 71.7 (cm), 0.77, and 0.47, respectively, for females. CONCLUSIONS WC and WSR are the most predictive both for males and females, and therefore are considered as better screening tools for obesity in this population.
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Affiliation(s)
- Janatin Hastuti
- Lab. of Bioanthropology and Paleoanthropology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Masaharu Kagawa
- Institute of Nutrition Sciences, Kagawa Nutrition University, Japan
| | - Nuala M Byrne
- School of Health Sciences, University of Tasmania, Australia
| | - Andrew P Hills
- School of Health Sciences, University of Tasmania, Australia
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Byrne NM, Sainsbury A, King NA, Hills AP, Wood RE. Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study. Int J Obes (Lond) 2017; 42:129-138. [PMID: 28925405 PMCID: PMC5803575 DOI: 10.1038/ijo.2017.206] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/02/2017] [Accepted: 08/06/2017] [Indexed: 11/09/2022]
Abstract
Background/Objectives: The MATADOR (Minimising Adaptive Thermogenesis And Deactivating Obesity Rebound) study examined whether intermittent energy restriction (ER) improved weight loss efficiency compared with continuous ER and, if so, whether intermittent ER attenuated compensatory responses associated with ER. Subjects/Methods: Fifty-one men with obesity were randomised to 16 weeks of either: (1) continuous (CON), or (2) intermittent (INT) ER completed as 8 × 2-week blocks of ER alternating with 7 × 2-week blocks of energy balance (30 weeks total). Forty-seven participants completed a 4-week baseline phase and commenced the intervention (CON: N=23, 39.4±6.8 years, 111.1±9.1 kg, 34.3±3.0 kg m−2; INT: N=24, 39.8±9.5 years, 110.2±13.8 kg, 34.1±4.0 kg m−2). During ER, energy intake was equivalent to 67% of weight maintenance requirements in both groups. Body weight, fat mass (FM), fat-free mass (FFM) and resting energy expenditure (REE) were measured throughout the study. Results: For the N=19 CON and N=17 INT who completed the intervention per protocol, weight loss was greater for INT (14.1±5.6 vs 9.1±2.9 kg; P<0.001). INT had greater FM loss (12.3±4.8 vs 8.0±4.2 kg; P<0.01), but FFM loss was similar (INT: 1.8±1.6 vs CON: 1.2±2.5 kg; P=0.4). Mean weight change during the 7 × 2-week INT energy balance blocks was minimal (0.0±0.3 kg). While reduction in absolute REE did not differ between groups (INT: -502±481 vs CON: −624±557 kJ d−1; P=0.5), after adjusting for changes in body composition, it was significantly lower in INT (INT: −360±502 vs CON: −749±498 kJ d−1; P<0.05). Conclusions: Greater weight and fat loss was achieved with intermittent ER. Interrupting ER with energy balance ‘rest periods’ may reduce compensatory metabolic responses and, in turn, improve weight loss efficiency.
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Affiliation(s)
- N M Byrne
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - A Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown New South Wales, Australia
| | - N A King
- Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - A P Hills
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - R E Wood
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
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Croci I, Byrne NM, Chachay VS, Hills AP, Clouston AD, O’Moore-Sullivan TM, Prins JB, Macdonald GA, Hickman IJ. Independent effects of diet and exercise training on fat oxidation in non-alcoholic fatty liver disease. World J Hepatol 2016; 8:1137-1148. [PMID: 27721919 PMCID: PMC5037327 DOI: 10.4254/wjh.v8.i27.1137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 07/13/2016] [Accepted: 08/18/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the independent effects of 6-mo of dietary energy restriction or exercise training on whole-body and hepatic fat oxidation of patients with non-alcoholic fatty liver disease (NAFLD).
METHODS Participants were randomised into either circuit exercise training (EX; n = 13; 3 h/wk without changes in dietary habits), or dietary energy restriction (ER) without changes in structured physical activity (ER; n = 8). Respiratory quotient (RQ) and whole-body fat oxidation rates (Fatox) were determined by indirect calorimetry under basal, insulin-stimulated and exercise conditions. Severity of disease and steatosis was determined by liver histology; hepatic Fatox was estimated from plasma β-hydroxybutyrate concentrations; cardiorespiratory fitness was expressed as VO2peak. Complete-case analysis was performed (EX: n = 10; ER: n = 6).
RESULTS Hepatic steatosis and NAFLD activity score decreased with ER but not with EX. β-hydroxybutyrate concentrations increased significantly in response to ER (0.08 ± 0.02 mmol/L vs 0.12 ± 0.04 mmol/L, P = 0.03) but remained unchanged in response to EX (0.10 ± 0.03 mmol/L vs 0.11 ± 0.07 mmol/L, P = 0.39). Basal RQ decreased (P = 0.05) in response to EX, while this change was not significant after ER (P = 0.38). VO2peak (P < 0.001) and maximal Fatox during aerobic exercise (P = 0.03) improved with EX but not with ER (P > 0.05). The increase in β-hydroxybutyrate concentrations was correlated with the reduction in hepatic steatosis (r = -0.56, P = 0.04).
CONCLUSION ER and EX lead to specific benefits on fat metabolism of patients with NAFLD. Increased hepatic Fatox in response to ER could be one mechanism through which the ER group achieved reduction in steatosis.
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Gibson AA, Seimon RV, Franklin J, Markovic TP, Byrne NM, Manson E, Caterson ID, Sainsbury A. Fast versus slow weight loss: development process and rationale behind the dietary interventions for the TEMPO Diet Trial. Obes Sci Pract 2016; 2:162-173. [PMID: 27840689 PMCID: PMC5089659 DOI: 10.1002/osp4.48] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/19/2016] [Accepted: 05/02/2016] [Indexed: 11/24/2022] Open
Abstract
Objective and methods Finding effective solutions to curb the obesity epidemic is a great global public health challenge. The need for long‐term follow‐up necessitates weight loss trials conducted in real‐world settings, outside the confines of tightly controlled laboratory or clinic conditions. Given the complexity of eating behaviour and the food supply, this makes the process of designing a practical dietary intervention that stands up to scientific rigor difficult. Detailed information about the dietary intervention itself, as well as the process of developing the final intervention and its underlying rationale, is rarely reported in scientific weight management publications but is valuable and essential for translating research into practice. Thus, this paper describes the design process and underlying rationale behind the dietary interventions in an exemplar weight loss trial – the TEMPO Diet Trial (Type of Energy Manipulation for Promoting optimal metabolic health and body composition in Obesity). This trial assesses the long‐term effects of fast versus slow weight loss on adiposity, fat free mass, muscle strength and bone density in women with obesity (body mass index 30–40 kg m−2) that are 45–65 years of age, postmenopausal and sedentary. Results and conclusions This paper is intended as a resource for researchers and/or clinicians to illustrate how theoretical values based on a hypothesis can be translated into a dietary weight loss intervention to be used in free‐living women of varying sizes.
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Affiliation(s)
- A A Gibson
- Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre University of Sydney Sydney NSW Australia
| | - R V Seimon
- Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre University of Sydney Sydney NSW Australia
| | - J Franklin
- Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre University of Sydney Sydney NSW Australia
| | - T P Markovic
- Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre University of Sydney Sydney NSW Australia; Metabolism & Obesity Services Royal Prince Alfred Hospital Camperdown NSW Australia
| | - N M Byrne
- Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine Bond University Gold Coast Australia
| | - E Manson
- Metabolism & Obesity Services Royal Prince Alfred Hospital Camperdown NSW Australia
| | - I D Caterson
- Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre University of Sydney Sydney NSW Australia; Metabolism & Obesity Services Royal Prince Alfred Hospital Camperdown NSW Australia
| | - A Sainsbury
- Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre University of Sydney Sydney NSW Australia
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Byrne NM, Nesbitt H, Ming L, McKeown SR, Worthington J, McKenna DJ. Androgen deprivation in LNCaP prostate tumour xenografts induces vascular changes and hypoxic stress, resulting in promotion of epithelial-to-mesenchymal transition. Br J Cancer 2016; 114:659-68. [PMID: 26954717 PMCID: PMC4800298 DOI: 10.1038/bjc.2016.29] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/04/2016] [Accepted: 01/14/2016] [Indexed: 12/21/2022] Open
Abstract
Background: When single-agent androgen deprivation therapy (ADT) is administered for locally advanced prostate cancer, men usually relapse within 1–2 years with more malignant castrate-resistant disease. The reason for this is currently unknown. We now hypothesise that an initial treatment response that increases tumour hypoxia drives selection of more malignant tumours. Methods: The LNCaP prostate tumour xenografts were analysed for physiological (oxygen and vasculature) and genetic (PCR array) changes during longitudinal treatment with ADT (bicalutamide, 6 or 2 mg kg−1 daily for 28 days). Results: Bicalutamide caused an immediate (within 24 h) dose-dependent fall in oxygenation in LNCaP-luc prostate tumours with a nadir of ≤0.1% oxygen within 3–7 days; this was attributed to a significant loss of tumour microvessels (window chamber study). The hypoxic nadir persisted for 10–14 days. During the next 7 days, tumours regrew, oxygenation improved and the vasculature recovered; this was inhibited by the VEGF inhibitor B20.4.1.1. Gene expression over 28 days showed marked fluctuations consistent with the physiological changes. Accompanying the angiogenic burst (day 21) was a particularly striking increase in expression of genes associated with epithelial-to-mesenchymal transition (EMT). In particular, insulin-like growth factor 1 (IGF-1) showed increases in mRNA and protein expression. Conclusions: Hypoxic stress caused by ADT promotes EMT, providing a mechanism for the cause of malignant progression in prostate cancer.
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Affiliation(s)
- N M Byrne
- Biomedical Science Research Institute, University of Ulster, Cromore Road, Coleraine, BT52 1SA Northern Ireland, UK.,Bone Biology Division, Garvan Institute of Medical Research, Darlinghurst, Sydney, NSW 2010, Australia
| | - H Nesbitt
- Biomedical Science Research Institute, University of Ulster, Cromore Road, Coleraine, BT52 1SA Northern Ireland, UK
| | - L Ming
- Biomedical Science Research Institute, University of Ulster, Cromore Road, Coleraine, BT52 1SA Northern Ireland, UK
| | - S R McKeown
- Biomedical Science Research Institute, University of Ulster, Cromore Road, Coleraine, BT52 1SA Northern Ireland, UK
| | - J Worthington
- Axis Bioservices Ltd, Research Laboratory, Castleroe Road, Coleraine BT51 3RP, Northern Ireland, UK
| | - D J McKenna
- Biomedical Science Research Institute, University of Ulster, Cromore Road, Coleraine, BT52 1SA Northern Ireland, UK
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46
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Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Hills AP. Validity of a food frequency questionnaire to assess nutritional intake among Sri Lankan adults. Springerplus 2016; 5:162. [PMID: 27026859 PMCID: PMC4766149 DOI: 10.1186/s40064-016-1837-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 02/15/2016] [Indexed: 11/13/2022]
Abstract
Sri Lanka is undergoing nutritional transition and diet-related chronic diseases are emerging as an important health problem. Currently, no validated food frequency questionnaire (FFQ) exists to measure habitual dietary intake of Sri Lankan adults. The purpose of the study is to assess the validity of a semi-quantitative FFQ and 7-day weighed-intake dietary records (7DWR), designed to assess dietary intake among Sri Lankan adults. Dietary intake was measured using both a FFQ and 7DWR. The FFQ consisted of 8 food groups containing the main foods comprising the diet of Sri Lankan adults, a total of 85 items and 12 color photographs to identify serving size. One hundred healthy adults were randomly recruited from a community sample and administrated the FFQ followed by completion of the 7DWR. Paired sample t tests, Pearson’s correlation coefficients, kappa test and Bland–Altman analysis were conducted to determine correlation and the level of agreement for energy and micronutrients. Seventy-seven participants completed both the FFQ and 7DWR. Estimated mean energy intake (SD) from FFQ (1794 ± 398 kcal) and 7DWR (1698 ± 333 kcal, p < 0.001) were significantly different due to a significant overestimation of carbohydrate (11.5 g/day, p < 0.001) and to some extent fat (5.7 g/day, ns). Significant positive correlations (p < 0.05) were found between the FFQ and 7DWR for energy (r = 0.39), carbohydrate (r = 0.47), protein (r = 0.26), fat (r = 0.17) and dietary fiber (r = 0.32). Bland–Altman graphs indicated fairly good agreement between methods with no relationship between bias and average intake of each nutrient examined. Based on these findings, the FFQ appears to be an acceptable tool for assessing the nutrient intake of Sri Lankans and will assist proper categorization of individuals by dietary intake.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka ; Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD Australia
| | - Nuala M Byrne
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Mario J Soares
- Curtin Health Innovation Research Institute, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA Australia
| | - Prasad Katulanda
- Diabetes Research Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Andrew P Hills
- School of Health Sciences, University of Tasmania, Launceston, TAS Australia
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47
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Horner KM, Schubert MM, Desbrow B, Byrne NM, King NA. Acute exercise and gastric emptying: a meta-analysis and implications for appetite control. Sports Med 2016; 45:659-78. [PMID: 25398225 DOI: 10.1007/s40279-014-0285-4] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Gastric emptying (GE) could influence exercise-induced changes in appetite and energy intake. GE also could contribute to changes in gastric symptoms and the availability of nutrients during exercise, which will subsequently affect performance. OBJECTIVE The objective of this review was to determine the effects of acute exercise on GE using a systematic review and meta-analysis. The most common parameters to determine GE were selected, consisting of half-emptying time and volume emptied. Oral-caecal transit time (OCTT) was also examined. DATA SOURCES Research databases (PubMed, Scopus, Google Scholar, EBSCOhost, SPORTDiscus) were searched through November 2013 for original studies, abstracts, theses and dissertations that examined the influence of acute exercise on GE. STUDY SELECTION Studies were included if they evaluated GE or OCTT during and/or after exercise and involved a resting control trial. STUDY APPRAISAL AND SYNTHESIS Initially, 195 studies were identified. After evaluation of study characteristics and quality and validity, data from 20 studies (35 trials) involving 221 participants (157 men; 52 women; 12 unknown) were extracted for meta-analysis. Random-effects meta-analyses were utilised for the three main outcome variables, and effect sizes (ES) are reported as Hedge's g due to numerous small sample sizes. RESULTS Random-effects modelling revealed non-significant and small/null main effect sizes for volume emptied (ES = 0.195; 95% CI -0.25 to 0.64), half-time (ES = -0.109, 95% CI -0.66 to 0.44) and OCTT (ES = 0.089; 95% CI -0.64 to 0.82). All analyses exhibited significant heterogeneity and numerous variables moderated the results. There was a dose response of exercise intensity; at lower intensities GE was faster, and at high exercise intensities GE was slower. Walking was associated with faster GE and cycling with slower GE. Greater volume of meal/fluid ingested, higher osmolality of beverage and longer exercise duration were also associated with slower GE with exercise. LIMITATIONS The major limitation is that the majority of studies utilised a liquid bolus administered pre-exercise to determine GE; the relationship to post-exercise appetite and energy intake remains unknown. Study populations were also generally active or trained individuals. Furthermore, our review was limited to English language studies and studies that utilised resting control conditions. CONCLUSIONS These results suggest that exercise intensity, mode, duration and the nature of meal/fluid ingested all influence GE during and after acute exercise. The relationship of GE parameters with appetite regulation after exercise remains largely unexplored. Further integrative studies combining GE and alterations in gut hormones, as well as in populations such as overweight and obese individuals are needed.
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Affiliation(s)
- Katy M Horner
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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48
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Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, Wood RE, King NA, Byrne NM, Sainsbury A. Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials. Mol Cell Endocrinol 2015; 418 Pt 2:153-72. [PMID: 26384657 DOI: 10.1016/j.mce.2015.09.014] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 01/14/2023]
Abstract
Energy restriction induces physiological effects that hinder further weight loss. Thus, deliberate periods of energy balance during weight loss interventions may attenuate these adaptive responses to energy restriction and thereby increase the efficiency of weight loss (i.e. the amount of weight or fat lost per unit of energy deficit). To address this possibility, we systematically searched MEDLINE, PreMEDLINE, PubMed and Cinahl and reviewed adaptive responses to energy restriction in 40 publications involving humans of any age or body mass index that had undergone a diet involving intermittent energy restriction, 12 with direct comparison to continuous energy restriction. Included publications needed to measure one or more of body weight, body mass index, or body composition before and at the end of energy restriction. 31 of the 40 publications involved 'intermittent fasting' of 1-7-day periods of severe energy restriction. While intermittent fasting appears to produce similar effects to continuous energy restriction to reduce body weight, fat mass, fat-free mass and improve glucose homeostasis, and may reduce appetite, it does not appear to attenuate other adaptive responses to energy restriction or improve weight loss efficiency, albeit most of the reviewed publications were not powered to assess these outcomes. Intermittent fasting thus represents a valid--albeit apparently not superior--option to continuous energy restriction for weight loss.
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Affiliation(s)
- Radhika V Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown NSW 2006, Australia
| | - Jessica A Roekenes
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown NSW 2006, Australia
| | - Jessica Zibellini
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown NSW 2006, Australia
| | - Benjamin Zhu
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown NSW 2006, Australia
| | - Alice A Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown NSW 2006, Australia
| | - Andrew P Hills
- Centre for Nutrition and Exercise, Mater Research Institute, The University of Queensland, South Brisbane QLD, 4101, Australia
| | - Rachel E Wood
- Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Neil A King
- Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation and School of Exercise and Nutrition Sciences, Brisbane, QLD 4059, Australia
| | - Nuala M Byrne
- Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown NSW 2006, Australia.
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49
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Ipavec-Levasseur S, Croci I, Choquette S, Byrne NM, Cowin G, O'Moore-Sullivan TM, Prins JB, Hickman IJ. Effect of 1-h moderate-intensity aerobic exercise on intramyocellular lipids in obese men before and after a lifestyle intervention. Appl Physiol Nutr Metab 2015; 40:1262-8. [PMID: 26575100 DOI: 10.1139/apnm-2015-0258] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Intramyocellular lipids (IMCL) are depleted in response to an acute bout of exercise in lean endurance-trained individuals; however, it is unclear whether changes in IMCL content are also seen in response to acute and chronic exercise in obese individuals. We used magnetic resonance spectroscopy in 18 obese men and 5 normal-weight controls to assess IMCL content before and after an hour of cycling at the intensity corresponding with each participant's maximal whole-body rate of fat oxidation (Fatmax). Fatmax was determined via indirect calorimetry during a graded exercise test on a cycle ergometer. The same outcome measures were reassessed in the obese group after a 16-week lifestyle intervention comprising dietary calorie restriction and exercise training. At baseline, IMCL content decreased in response to 1 h of cycling at Fatmax in controls (2.8 ± 0.4 to 2.0 ± 0.3 A.U., -39%, p = 0.02), but not in obese (5.4 ± 2.1 vs. 5.2 ± 2.2 A.U., p = 0.42). The lifestyle intervention lead to weight loss (-10.0 ± 5.4 kg, p < 0.001), improvements in maximal aerobic power (+5.2 ± 3.4 mL/(kg·min)), maximal fat oxidation rate (+0.19 ± 0.22 g/min), and a 29% decrease in homeostasis model assessment score (all p < 0.05). However, when the 1 h of cycling at Fatmax was repeated after the lifestyle intervention, there remained no observable change in IMCL (4.6 ± 1.8 vs. 4.6 ± 1.9 A.U., p = 0.92). In summary, there was no IMCL depletion in response to 1 h of cycling at moderate intensity either before or after the lifestyle intervention in obese men. An effective lifestyle intervention including moderate-intensity exercise training did not impact rate of utilisation of IMCL during acute exercise in obese men.
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Affiliation(s)
| | - Ilaria Croci
- a The University of Queensland Diamantina Institute, Brisbane, Australia.,b School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,c Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Stéphane Choquette
- d Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Nuala M Byrne
- e Bond Institute of Health and Sport, Bond University, Robina, Australia.,f Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Gary Cowin
- g Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Trisha M O'Moore-Sullivan
- c Mater Research Institute, University of Queensland, Brisbane, Australia.,h Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Australia
| | - Johannes B Prins
- c Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Ingrid J Hickman
- a The University of Queensland Diamantina Institute, Brisbane, Australia.,c Mater Research Institute, University of Queensland, Brisbane, Australia
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50
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Abstract
Much recent interest has focused on the relationship between physical activity and health and supported with an abundance of scientific evidence. However, the concept of Exercise is Medicine™ copromoted by the American College of Sports Medicine and American Medical Association and similar august bodies worldwide is far from new--the importance of exercise for health has been reported for centuries. Participation in regular physical activity and exercise provides numerous benefits for health with such benefits typically varying according to the volume completed as reflected by intensity, duration, and frequency. Evidence suggests a dose-response relationship such that being active, even to a modest level, is preferable to being inactive or sedentary. Greatest benefits are commonly associated with the previously sedentary individual assuming a more active lifestyle. There is an apparent linear relationship between physical activity and health status and as a general rule, increases in physical activity and fitness result in additional improvements in health status. This narrative review provides a selective appraisal of the evidence for the importance of physical activity for health, commencing with a baseline historical perspective followed by a summary of key health benefits associated with an active lifestyle.
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Affiliation(s)
- Andrew P Hills
- Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia.
| | - Steven J Street
- Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia
| | - Nuala M Byrne
- Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
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