Appetite control and exercise: Does the timing of exercise play a role?

The Role of Meal Timing in Appetitive Responses to Acute Exercise in Adolescents with and without Obesity: A Systematic Review and Meta-Analysis

Physical activity has been shown to improve various aspects of metabolic health and is frequently applied as an intervention in the management and prevention of overweight/obesity. Chrono-exercise can be studied in relation to time of day and timing in relation to a meal, which encompasses chronology and duration of the temporal interval, but the latter has received limited attention to date. This brief review and meta-analysis investigates whether the timing of a meal subsequent to acute exercise in children and adolescents with and without overweight/obesity moderates eating behavior and appetite. A quantitative synthesis of 28 controlled trials with 51 distinct conditions (N = 575; median sample size = 15, median age = 13 y, n = 297 overweight/obesity) was performed using multilevel random-effects meta-regressions and restricted splines to test the linear and nonlinear relationships between mean differences in energy intake between exercise and control conditions and the duration of the exercise-test meal interval, and if this moderated by participant weight status or exercise characteristics (i.e., intensity, duration, and method). Commencement of meals occurred from immediately to 3 h after cessation of exercise (median = 30 min, interquartile range = 8 min). The meal interval was not associated with effect sizes overall in the linear and spline analysis (ps = 0.576 and 0.971, respectively). Although there was only an interaction with weight status present in the linear analysis (P < 0.001), the meal interval significantly moderated effect sizes within-study arms with lean participants (ps = 0.006 and 0.019, respectively), but not in those with overweight/obesity (ps = 0.070 and 0.620, respectively) in both analyses. Exercise characteristics did not have an impact on this relationship. Taken together, prescriptions for meal timing may depend on the individual phenotype when seeking to optimize potential anorexigenic effects of acute exercise. This trial was registered at PROSPERO as CRD42021287838. (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=287838).

The impact of exercise timing on energy intake: A systematic review and meta-analysis of diurnal and meal timing effects

This systematic review and meta-analysis examine the literature (up to August 2nd, 2024) on the influence of exercise timing on energy intake in both children and adults. A comprehensive search was conducted using MEDLINE, EMBASE, Cochrane Library, SPORTDiscus, and Web of Science Core Collection, following PRISMA guidelines. The review was registered in Prospero (CRD42024553381) and evaluated using QUADAS-2. From an initial 3276 articles, a meta-analysis (six studies) revealed that daily energy intake was not significantly lower when exercise was performed in the morning versus the afternoon/evening: mean difference of 64 ± 77 kcal (95% CI: 86 to 215 kcal; p = 0.403). A meta-analysis (three studies, all with children) comparing lunch energy intake before versus after exercise showed a significant difference in energy intake when exercise was performed post-meal: (-39 ± 13 kcal, 95% CI: 63 to -14 kcal; p = 0.002). For the meta-analysis of delayed lunch (five studies), where exercise ended 15 min to 4 h before the meal, and the delay between the start of each exercise condition within the same study was typically around 2 h, no significant difference in energy intake was found (-2±67 kcal; 95% CI: 134 to 130 kcal; p = 0.977). Regarding chronic exercise, a decrease in energy intake was observed with evening exercise (one study), morning exercise (two studies) or independently of exercise timing (two studies). In conclusion, findings suggest acute exercise may reduce intake in children and adolescents, but this effect is dependent on the timing of exercise.

Effects of exercise timing on metabolic health

The increasing prevalence of metabolic syndrome is associated with major health and socioeconomic consequences. Currently, physical exercise, together with dietary interventions, is the mainstay of the treatment of obesity and related metabolic complications. Although exercise training includes different modalities, with variable intensity, duration, volume, or frequency, which may have a distinct impact on several characteristics related to metabolic syndrome, the potential effects of exercise timing on metabolic health are yet to be fully elucidated. Remarkably, promising results with regard to this topic have been reported in the last few years. Similar to other time-based interventions, including nutritional therapy or drug administration, time-of-day-based exercise may become a useful approach for the management of metabolic disorders. In this article, we review the role of exercise timing in metabolic health and discuss the potential mechanisms that could drive the metabolic-related benefits of physical exercise performed in a time-dependent manner.

The Role of Physical Activity in Long-term Weight Loss: 36-month Results From a Randomized Controlled Trial

BACKGROUND

Physical activity (PA) may promote long-term weight loss, but facilitating high levels of PA in behavioral weight loss programs is challenging.

PURPOSE

This study reports the 36-month follow-up of a behavioral weight loss trial that tested the efficacy of increasing the emphasis on PA during treatment and using traditional or acceptance-based therapy (ABT) for this purpose. We also examined the extent to which long-term weight loss differed by PA pattern and tested if individual differences in eating behavior moderated this relationship.

METHODS

Participants (N = 320) were randomized to (1) standard behavioral weight loss treatment (BT), (2) BT with a focus on PA, or (3) ABT with a focus on PA. Weight loss and PA were measured at 24- and 36-month follow-up.

RESULTS

There were no differences between conditions in weight loss or PA at 24 or 36 months. Participants consistently engaging in high PA experienced the greatest weight losses. The positive impact of PA on weight loss was more pronounced among those with low emotional eating and those who believed that exercise did not affect their appetite.

CONCLUSIONS

Findings emphasize the difficulty of improving long-term PA among adults with overweight/obesity beyond what standard behavioral weight loss treatment achieves. This study highlights the need to develop new PA treatment strategies, and suggests that ABT for weight loss may be more effective when applied to eating behavior versus PA. Results also demonstrate the importance of addressing problematic eating behavior and cognitions to fully realize the benefits of PA for weight loss.

CLINICAL TRIAL INFORMATION

ClinicalTrials.gov identifier: NCT02363010.

Effects of Movement Behaviors on Overall Health and Appetite Control: Current Evidence and Perspectives in Children and Adolescents

PURPOSE OF REVIEW

To present the definitions and recommendations for movement behaviors in children and adolescents, including physical activity (PA), sedentary behaviors (SB), and sleep, and to provide an overview regarding their impact on health and obesity outcomes from childhood to adulthood, as well as interactions with appetite control.

RECENT FINDINGS

PA represents a variable proportion of daily energy expenditure and one can be active with high SB or vice versa. Studies have described movements across the whole day on a continuum from sleep to SB to varying intensities of PA. More PA, less SB (e.g., less screen time) and longer sleep are positively associated with indicators of physical health (e.g., lower BMI, adiposity, cardiometabolic risk) and cognitive development (e.g., motor skills, academic achievement). However, less than 10% of children currently meet recommendations for all three movement behaviors. Movement behaviors, adiposity, and related cardiometabolic diseases in childhood track into adolescence and adulthood. Furthermore, low PA/high SB profiles are associated with increased energy intake. Recent studies investigating energy balance regulation showed that desirable movement behavior profiles are associated with better appetite control and improved eating habits. Early identification of behavioral phenotypes and a comprehensive approach addressing all key behaviors that directly affect energy balance will allow for individual strategies to prevent or treat obesity and its comorbidities. Investigating exercise as a potential "corrector" of impaired appetite control offers a promising weight management approach.

Physical Activity and Total Daily Energy Expenditure in Older US Adults: Constrained versus Additive Models

PURPOSE

This study aimed to examine the shape of the relationship between physical activity (PA) and total energy expenditure (TEE) and to explore the role of energy balance status (negative, stable, positive) in influencing this association.

METHODS

Cross-sectional. Participants were 584 older adults (50-74 yr) participating in the Interactive Diet and Activity Tracking in AARP study. TEE was assessed by doubly labeled water and PA by accelerometer. The relationship between PA and TEE was assessed visually and using nonlinear methods (restricted cubic splines). Percent weight change (>3%) over a 6-month period was used as a proxy measurement of energy balance status.

RESULTS

TEE generally increased with increasing deciles of PA averaging 2354 (SD, 351) kcal·d-1 in the bottom decile to 2693 (SD, 480) kcal·d-1 in the top decile. Cubic spline models showed an approximate linear association between PA and TEE (linear relation, P < 0.0001; curvature, P = 0.920). Results were similar in subgroup analyses for individuals classified as stable or positive energy balance. For those in negative energy balance, TEE was generally flat with increasing deciles of PA averaging 2428 (SD, 285) kcal·d-1 in the bottom decile to 2372 (SD, 560) kcal·d-1 in the top decile.

CONCLUSIONS

Energy balance status seems to play an important role in the relationship between PA and TEE. When in a positive energy balance, the relationship between TEE and PA was consistent with an additive model; however, when energy balance was negative, TEE seems to be consistent with a constrained model. These findings support PA for weight gain prevention by increasing TEE; however, the effect of PA on TEE during periods of weight loss may be limited. An adequately powered, prospective study is warranted to confirm these exploratory findings.

The Effect of High-Fat Diet and Exercise Intervention on the TNF-α Level in Rat Spleen

High-fat diet (HFD) consumption can trigger chronic inflammation in some tissues. However, it remains unclear if HFD induces chronic inflammation in the spleen. This investigation aims to address the effect of HFD consumption and exercise intervention on the level of tumor necrosis factor alpha (TNF-α) in the spleen. Rats were subjected to HFD feeding and/or moderate-intensity treadmill running. The TNF-α levels in plasma and spleen were detected by ELISA. The mass and total cell numbers of the spleen were measured. In addition, the expression of TNF-α and its relevant gene mRNAs in macrophages from the spleen were analyzed by qRT-PCR. We found that HFD consumption did not significantly affect the mass and total cell numbers of the spleen. However, HFD consumption significantly increased splenic TNF-α level, the expression of TNF-α, toll-like receptor 4, and nuclear factor κB p65 mRNAs. In contrast, the expression of nicotinic acetylcholine receptor alpha 7 subunit (α7nAChR) mRNA in macrophages was downregulated. Additionally, exercise abolished the increase in splenic TNF-α level as well as the abnormal expression of TNF-α and related gene mRNAs in macrophages in HFD-fed rats. In conclusion, our results reveal that HFD consumption increases TNF-α level in the spleen, which is along with upregulation of the expression of TLR4 and NF-κB mRNAs as well as downregulation of the expression of α7nAChR mRNA in splenic macrophages in rats. Exercise abolished detrimental effects of HFD on TNF-α level in the spleen and prevented abnormal expression of these genes in the macrophages from rat spleen.

Post-exercise energy intake: do the intensity and mode of exercise matter? A systematic review and meta-analysis comparing high-intensity interval with moderate-intensity continuous protocols

The present systematic review and meta-analysis aimed to compare the impact of exercise intensity and mode (high-intensity interval exercise-HIIE or sprint interval exercise-SIE versus moderate-intensity continuous exercise-MICE) on post-exercise ad libitum energy intake. The studies were required to have at least two exercise conditions (HIIE or SIE vs MICE). Overall, 642 manuscripts were initially identified and 17 met the eligibility criteria. The random effect meta-analysis did not reveal differences for absolute energy intake (28 pairwise comparisons) between HIIE (p = 0.54; 95% Confidence Interval - CI: -0.14 to 0.26; 22 pairwise comparisons) or SIE (p = 0.08; 95% CI -0.65 to 0.03; 6 pairwise comparisons) versus MICE, neither for relative energy intake (p = 0.97; 95% CI: -0.35 to 0.10 for HIIE; p = 0.28; 95% CI: -1.03 to 0.06 for SIE) with five and one pairwise comparisons, respectively. Subgroup analyses for methods to evaluate ad libitum energy intake, body mass, sex, volume, and timing of exercise were non-significant. Inspecting each study, two pairwise comparisons reported lower post-exercise absolute energy intake in HIIE compared to control (CRTL), and three pairwise comparisons reported lower absolute energy intake after SIE compared to MICE. None pairwise comparison reported differences between protocols (HIIE or SIE versus MICE) for relative energy intake. In conclusion, the meta-analysis did not show differences between protocols for absolute and relative energy intake; five pairwise comparisons from 28 demonstrated lower absolute energy intake in HIIE or SIE compared to CRTL or MICE. Further studies are needed to address the key relevant variables in which exercise intensity and mode may impact energy intake.

Evaluation of Protein Content in the Diet of Amateur Male Bodybuilder

Public gyms and fitness clubs promote active lifestyles. At the same time, numerous nutritional errors and the phenomenon of incorrect supplementation are being observed among the given study group. Behavior can lead to malaise, injury, or lack of progression. One of the most serious mistakes is the incorrect level of protein in the diet. The aim of the study is to assess the quantity and quality of protein consumed by men undertaking recreational strength training in Szczecin. The study involved 35 men aged 18-35, practicing amateur strength training, from Szczecin (Poland). The author's questionnaire collected information on supplementation, physical activity, and subjective assessment of nutritional knowledge. The obtained test results were subjected to statistical analysis performed in the Statistica12 program. On average, respondents consumed 1.8 g of protein/kg, with the highest recorded conversion rate of 3.7 g of protein/kg of body weight, and the lowest of 0.9 g/kg of body weight. Total protein consumption ranged from 70.2 to 295.7 g, and the average value was 147.8 g (22%), which differs from the study group, that is, 129-133 g, which gives 14% energy proteins. It was found that the protein supplementation, on average, provided 31% of the total protein intake of the study group. The results show inappropriate dietary behavior regarding food supplementation among the examined group. Further education on the nutritional value of the food and a healthy and balanced diet is being recommended for the individuals practicing strength sports.

Delayed meal timing after exercise is associated with reduced appetite and energy intake in adolescents with obesity

BACKGROUND

While the beneficial effects of exercise on appetite might depend on its timing during the day or relative to a meal, this remains poorly explored in youth.

OBJECTIVES

To examine the importance of meal timing (+30 vs +90 minutes) after performing exercise on energy intake, appetite and food reward in adolescents with obesity.

METHODS

Eighteen adolescents with obesity randomly completed three conditions: (a) lunch (12:00 pm) set 30 minutes after a rest session (11:00 am); (b) lunch (12:00 pm) set 30 minutes after an exercise session (11:00 am)(MEAL-30); (c) lunch (01:00 pm) set 90 minutes after an exercise session (11:00 am)(MEAL-90). Lunch and dinner ad libitum energy intake was assessed, food reward (LFPQ) assessed before and after lunch, and before dinner, appetite sensations were assessed at regular intervals.

RESULTS

Energy intake was lower at MEAL-90 than MEAL-30 and CON at lunch (P < .05 and P < .01, respectively) and lunch + dinner combined (P < .001). A decrease in intake (g) of protein, fat and carbohydrate was observed. Post-exercise hunger was lower on MEAL-90 compared with CON. No condition effects were found at lunch for food reward.

CONCLUSIONS

Delaying the timing of the meal after exercise might help affect energy balance by decreasing ad libitum energy intake without increasing hunger and by improving satiety in adolescents with obesity.

Consistent Morning Exercise May Be Beneficial for Individuals With Obesity

This review explores the hypothesis that a consistent exercise time, especially consistent morning exercise, improves exercise adherence and weight management for individuals with overweight or obesity. We discuss data supporting this premise, identify limitations of current research, and outline directions for future research on exercise timing to more robustly evaluate our thesis.

Does exercising before or after a meal affect energy balance in adolescents with obesity?

BACKGROUND AND AIM

Exercise timing has been suggested to affect appetite and energy intake (EI). The aim of this study was to examine the impact of exercising immediately before or after a meal on EI, appetite sensations and food reward (FR) in adolescents with obesity.

METHODS AND RESULTS

Seventeen adolescents with obesity completed 3 experimental sessions (randomized controlled trial): rest + lunch (CON); exercise + lunch (EX-MEAL); lunch + exercise (MEAL-EX). The exercise consisted of cycling 30 min at 65%V̇O_2peak. Outcomes included ad libitum EI (weighed lunch and dinner), FR (Leeds Food Preference Questionnaire at pre- and post-combination of exercise/rest and lunch, and pre-dinner) and appetite sensations (visual analogue scales). EI was not different between conditions. Compared with CON, relative EI at lunch was lower in EX-MEAL and MEAL-EX (p ≤ 0.05) and daily only in MEAL-EX (p < 0.01). Postprandial fullness was higher in EX-MEAL compared to CON. Compared with CON, both EX-MEAL and MEAL-EX attenuated the increase in wanting for sweet food and reduced explicit liking for fat.

CONCLUSIONS

These preliminary results suggest that exercising immediately before or after a meal produce few differences in appetite and have small beneficial effects on overall energy balance in adolescents with obesity, as well as on FR.

CLINICAL TRIALS

NCT03967782.

Physical Activity in the Prevention of Childhood Obesity: The Position of the European Childhood Obesity Group and the European Academy of Pediatrics

Obesity affects an increasing number of children and adolescents. Physical activity (PA) is a significant factor in the prevention of excessive body mass in the pediatric population. A significant percentage of pediatric population do not attain the public health recommendation for PA, and typically, those with higher levels of PA have lower content of body fat than less active peers. Although the development of childhood obesity is multifactorial, the decline in energy expenditure is considered as one of the most important determinants of excessive body weight. The lack of intervention causes that excess body weight to remain stable from birth through childhood and adolescence to adulthood. Accordingly, public health interventions are needed to increase the level of PA in the pediatric population. The task force from the European Childhood Obesity Group and the European Academy of Pediatrics reviewed English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases, from 2018 to August 2020, and developed a consensus statement. This statement presents the role of PA in the prevention of excessive body weight and gives age-appropriate recommendations for PA and recommendations for school-based interventions, parents, and guardians.