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Panayotov VS. Studying a Possible Placebo Effect of an Imaginary Low-Calorie Diet. Front Psychiatry 2019; 10:550. [PMID: 31417439 PMCID: PMC6682610 DOI: 10.3389/fpsyt.2019.00550] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 07/15/2019] [Indexed: 12/31/2022] Open
Abstract
In recent years the prevalence of obesity in developed countries has increased to the point that some authorities have coined the term "obesity epidemics." Combining energy intake control measures (via diet) with protocols for increasing energy expenditure (predominantly via low to medium intensity aerobic exercise) proved to be the most effective approach in addressing this problem. In this experiment, we studied for a possible placebo effect of a weight loss program on changes in body mass and fat tissue in overweight or obese people. Fourteen healthy adults of both sexes aged between 19 and 45 with body mass index (BMI) > 27 participated in the study. They were randomly assigned to two groups-one experimental and one control. The subjects in the experimental group followed an isocaloric diet but were told they were put on a calorie-deficient regimen. The subjects in the control group were aware they followed an energy-balanced diet. All participants were engaged in regular sessions of resistance exercise three times a week with total energy cost of approximately 750-900 kcal/week. We studied within-group differences of body mass, percentage of fat tissue, and BMI. All three variables reduced in value in the experimental group: body mass-9.25 ± 5.26 kg, percentage of fat tissue-3.4 ± 0.97%, and BMI-2.88 ± 1.50. No statistically significant within-group differences were measured in the control group. Despite some methodological biases of the study construct, in our opinion, a placebo effect could partially explain the changes in the experimental group.
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Rufa'i AA, Muda WAMW, Yen SH, Abd Shatar AK, Murali BVK, Tan SW. Design of a randomised intervention study: the effect of dumbbell exercise therapy on physical activity and quality of life among breast cancer survivors in Malaysia. BMJ Glob Health 2016; 1:e000015. [PMID: 28588911 PMCID: PMC5321396 DOI: 10.1136/bmjgh-2015-000015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 06/24/2016] [Accepted: 07/01/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Participation in physical activity has a positive impact on the overall health and quality of life, whereas physical inactivity is associated with a poor prognosis among breast cancer survivors. Despite the health-enhancing benefits of physical activity, the majority of Malaysian breast cancer survivors are not physically active. This paper presents the design of a randomised study to evaluate the feasibility and effect of exercise therapy intervention using light resistance dumbbell exercise to promote active lifestyle and improve the quality of life of breast cancer survivors in Malaysia. METHODS/DESIGN This is an intervention study of a 12-week exercise therapy that will explore and compare the effects of light resistance and aerobic exercise on physical activity level and quality of life components in 102 female breast cancer survivors. Major eligibility criteria include histologically confirmed diagnosis of breast cancer stages I-III, 3-12 months post-diagnosis, and absence of any disorder contraindicating exercise. Participants will be stratified based on menopausal status (pre-menopause vs post-menopause) and then assigned randomly to one of three groups. Participants in group A will participate in a three-times weekly supervised resistance exercise using light resistance dumbbells; participants in group B will participate in a three-times weekly supervised aerobic exercise; while participants in group C (control group) will be given aerobic exercise after completion of the intervention. The primary end points include physical activity level and quality of life components. The secondary end points are body mass index, body composition, total caloric intake, and waist-to-hip ratio. DISCUSSION Although there have been many studies of resistance exercise in breast cancer survivors, this is the first study using this specific mode of resistance. Findings will contribute data on the feasibility and effects of light resistance dumbbell exercises, and provide knowledge on the physical activity intervention programme that will maximally promote better overall health and well-being of survivors.
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Affiliation(s)
- Adamu Ahmad Rufa'i
- School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Borno, Nigeria
| | | | - Siew Hwa Yen
- School of Distance Education, Universiti Sains Malaysia, Pinang, Malaysia
| | - Aishah Knight Abd Shatar
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | | | - Shu Wen Tan
- School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
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Probst Y, Zammit G. Predictors for Reporting of Dietary Assessment Methods in Food-based Randomized Controlled Trials over a Ten-year Period. Crit Rev Food Sci Nutr 2015. [DOI: 10.1080/10408398.2013.816653] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Laddu D, Dow C, Hingle M, Thomson C, Going S. A review of evidence-based strategies to treat obesity in adults. Nutr Clin Pract 2012; 26:512-25. [PMID: 21947634 DOI: 10.1177/0884533611418335] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Obesity, with its comorbidities, is a major public health problem. Population-based surveys estimate 2 of every 3 U.S. adults are overweight or obese. Despite billions of dollars spent annually on weight loss attempts, recidivism is high and long-term results are disappointing. In simplest terms, weight loss and maintenance depend on energy balance, and a combination of increased energy expenditure by exercise and decreased energy intake through caloric restriction is the mainstay of behavioral interventions. Many individuals successfully lose 5%-10% of body weight through behavioral approaches and thereby significantly improve health. Similar success occurs with some weight loss prescriptions, although evidence for successful weight loss with over-the-counter medications and supplements is weak. Commercial weight loss programs have helped many individuals achieve their goals, although few programs have been carefully evaluated and compared, limiting recommendations of one program over another. For the very obese, bariatric surgery is an option that leads to significant weight loss and improved health, although risks must be carefully weighed. Lifestyle changes, including regular physical activity, healthy food choices, and portion control, must be adopted, regardless of the weight loss approach, which requires ongoing support. Patients can best decide the appropriate approach working with a multidisciplinary team, including their health care provider and experts in nutrition, exercise, and behavioral intervention.
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Affiliation(s)
- Deepika Laddu
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721-0093, USA
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Wycherley TP, Noakes M, Clifton PM, Cleanthous X, Keogh JB, Brinkworth GD. Timing of protein ingestion relative to resistance exercise training does not influence body composition, energy expenditure, glycaemic control or cardiometabolic risk factors in a hypocaloric, high protein diet in patients with type 2 diabetes. Diabetes Obes Metab 2010; 12:1097-105. [PMID: 20977582 DOI: 10.1111/j.1463-1326.2010.01307.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To investigate timing of protein ingestion relative to resistance exercise training (RT) on body composition, cardiometabolic risk factors, glycaemic control and resting energy expenditure (REE) during weight loss on a high-protein (HP) diet in overweight and obese patients with type 2 diabetes (T2DM). METHODS Thirty-four men/women with T2DM (age 57 ± 7 years and body mass index 34.9 ± 4.2 kg m(-2) ) were randomly assigned to the ingestion of a HP meal (860 kJ, 21 g protein, 0.7 g fat, 29.6 g carbohydrate) either immediately prior to RT or at least 2 h following RT. All participants followed a 16-week, energy-restricted (6-7 MJ day(-1) ), HP diet (carbohydrate : protein : fat 43 : 33 : 22) and participated in supervised RT (3 day week(-1) ). Outcomes were assessed pre- and postintervention at 16 weeks. RESULTS There was an overall reduction in bodyweight (-11.9 ± 6.1 kg), fat mass (-10.0 ± 4.4 kg), fat-free mass (-1.9 ± 3.1 kg), waist circumference (-12.1 ± 5.3 cm), REE (-742 ± 624 kJ day(-1) ), glucose (-1.9 ± 1.7 mmol l(-1) ), insulin (-6.1 ± 6.7 mU l(-1) ) and glycosylated haemoglobin (-1.1 ± 0.1%), p ≤ 0.01 time for all variables, with no difference between groups (p ≥ 0.41 group effect). Strength improved and cardiometabolic risk factors were reduced similarly in both groups; single repetition maximum chest press 11.0 ± 8.7 kg, single repetition maximum lat pull down 9.9 ± 6.0 kg, total cholesterol -0.6 ± 0.5 mmol l(-1) , high-density lipoprotein cholesterol -0.1 ± 0.2 mmol l(-1) , low-density lipoprotein cholesterol -0.3 ± 0.5 mmol l(-1) , triglycerides -0.6 ± 0.7 mmol l(-1) , blood pressure (systolic/diastolic) -13 ± 10/-7 ± 7 mmHg (p ≤ 0.04 time effect, p ≥ 0.24 group effect). CONCLUSION A HP, energy-restricted diet with RT was effective in improving glycaemic control, body composition, strength and cardiometabolic risk factors in overweight/obese patients with T2DM irrespective of altering the timing of protein ingestion relative to RT.
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Affiliation(s)
- T P Wycherley
- Preventative Health Flagship, Commonwealth Scientific and Industrial Research Organisation-Food and Nutritional Sciences, Adelaide, South Australia, Australia
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Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009; 41:459-71. [PMID: 19127177 DOI: 10.1249/mss.0b013e3181949333] [Citation(s) in RCA: 1419] [Impact Index Per Article: 94.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Overweight and obesity affects more than 66% of the adult population and is associated with a variety of chronic diseases. Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies. Guidelines of the National Heart, Lung, and Blood Institute (NHLBI) encourage a 10% reduction in weight, although considerable literature indicates reduction in health risk with 3% to 5% reduction in weight. Physical activity (PA) is recommended as a component of weight management for prevention of weight gain, for weight loss, and for prevention of weight regain after weight loss. In 2001, the American College of Sports Medicine (ACSM) published a Position Stand that recommended a minimum of 150 min wk(-1) of moderate-intensity PA for overweight and obese adults to improve health; however, 200-300 min wk(-1) was recommended for long-term weight loss. More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss. To this end, we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain, for weight loss, and prevention of weight regain. Evidence supports moderate-intensity PA between 150 and 250 min wk(-1) to be effective to prevent weight gain. Moderate-intensity PA between 150 and 250 min wk(-1) will provide only modest weight loss. Greater amounts of PA (>250 min wk(-1)) have been associated with clinically significant weight loss. Moderate-intensity PA between 150 and 250 min wk(-1) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction. Cross-sectional and prospective studies indicate that after weight loss, weight maintenance is improved with PA >250 min wk(-1). However, no evidence from well-designed randomized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss. Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk. Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk. There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain.
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Hackney KJ, Engels HJ, Gretebeck RJ. Resting Energy Expenditure and Delayed-Onset Muscle Soreness After Full-Body Resistance Training With an Eccentric Concentration. J Strength Cond Res 2008; 22:1602-9. [DOI: 10.1519/jsc.0b013e31818222c5] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Froehle AW. Climate variables as predictors of basal metabolic rate: New equations. Am J Hum Biol 2008; 20:510-29. [DOI: 10.1002/ajhb.20769] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Ramirez-Zea M. Validation of three predictive equations for basal metabolic rate in adults. Public Health Nutr 2007; 8:1213-28. [PMID: 16277831 DOI: 10.1079/phn2005807] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjectiveTo cross-validate three predictive set of equations for basal metabolic rate (BMR) developed by Schofield (Schofield database), Henry (Oxford database) and Cole (Oxford database) using mean values for age, weight, height and BMR of published studies.DesignLiterature review of studies published from 1985 to March 2002.SettingAll studies selected used appropriate methods and followed conditions that met the criteria established for basal metabolism, were performed in healthy adults, and were not part of the Schofield or Oxford database.SubjectsA total of 261 groups of men and women from 175 studies were selected and categorised in three age groups (18.5–29.9, 30.0–59.9, ≥60 years old) and three body mass index (BMI) groups (normal weight, overweight and obese).ResultsLinear regression and concordance correlation analysis showed that the three sets of equations had the same association and agreement with measured BMR, across gender, age, and BMI groups. The agreement of all equations was moderate for men and poor for women. The lowest mean squared prediction errors (MSPRs) were given by Henry equations in men and Cole equations in women. Henry and Cole equations gave lower values than Schofield equations, except for men over 60 years of age. Henry equations were the most accurate in men. None of the three equations performed consistently better in women.ConclusionThese results support the use of Henry equations in men with a wide range of age and BMI. None of the proposed predictive equations seem to be appropriate to estimate BMR in women.
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Affiliation(s)
- Manuel Ramirez-Zea
- Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
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Stiegler P, Cunliffe A. The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss. Sports Med 2006; 36:239-62. [PMID: 16526835 DOI: 10.2165/00007256-200636030-00005] [Citation(s) in RCA: 242] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The incidence of obesity is increasing rapidly. Research efforts for effective treatment strategies still focus on diet and exercise programmes, the individual components of which have been investigated in intervention trials in order to determine the most effective recommendations for sustained changes in bodyweight. The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss. Therefore, with respect to long-term effectiveness of weight-loss programmes, the loss of fat mass while maintaining FFM and RMR seems desirable. Diet intervention studies suggest spontaneous losses in bodyweight following low-fat diets, and current data on a reduction of the carbohydrate-to-protein ratio of the diet show promising outcomes. Exercise training is associated with an increase in energy expenditure, thus promoting changes in body composition and bodyweight while keeping dietary intake constant. The advantages of strength training may have greater implications than initially proposed with respect to decreasing percentage body fat and sustaining FFM. Research to date suggests that the addition of exercise programmes to dietary restriction can promote more favourable changes in body composition than diet or physical activity on its own. Moreover, recent research indicates that the macronutrient content of the energy-restricted diet may influence body compositional alterations following exercise regimens. Protein emerges as an important factor for the maintenance of or increase in FFM induced by exercise training. Changes in RMR can only partly be accounted for by alterations in respiring tissues, and other yet-undefined mechanisms have to be explored. These outcomes provide the scientific rationale to justify further randomised intervention trials on the synergies between diet and exercise approaches to yield favourable modifications in body composition.
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Affiliation(s)
- Petra Stiegler
- Department of Human and Health Sciences, University of Westminster, London, UK.
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Krieger JW, Sitren HS, Daniels MJ, Langkamp-Henken B. Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression 1. Am J Clin Nutr 2006; 83:260-74. [PMID: 16469983 DOI: 10.1093/ajcn/83.2.260] [Citation(s) in RCA: 294] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND It is unclear whether low-carbohydrate, high-protein, weight-loss diets benefit body mass and composition beyond energy restriction alone. OBJECTIVE The objective was to use meta-regression to determine the effects of variations in protein and carbohydrate intakes on body mass and composition during energy restriction. DESIGN English-language studies with a dietary intervention of > or =4200 kJ/d (1000 kcal/d), with a duration of > or =4 wk, and conducted in subjects aged > or =19 y were considered eligible for inclusion. A self-reported intake in conjunction with a biological marker of macronutrient intake was required as a minimum level of dietary control. A total of 87 studies comprising 165 intervention groups met the inclusion criteria. RESULTS After control for energy intake, diets consisting of < or =35-41.4% energy from carbohydrate were associated with a 1.74 kg greater loss of body mass, a 0.69 kg greater loss of fat-free mass, a 1.29% greater loss in percentage body fat, and a 2.05 kg greater loss of fat mass than were diets with a higher percentage of energy from carbohydrate. In studies that were conducted for >12 wk, these differences increased to 6.56 kg, 1.74 kg, 3.55%, and 5.57 kg, respectively. Protein intakes of >1.05 g/kg were associated with 0.60 kg additional fat-free mass retention compared with diets with protein intakes < or =1.05 g/kg. In studies conducted for >12 wk, this difference increased to 1.21 kg. No significant effects of protein intake on loss of either body mass or fat mass were observed. CONCLUSION Low-carbohydrate, high-protein diets favorably affect body mass and composition independent of energy intake, which in part supports the proposed metabolic advantage of these diets.
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Affiliation(s)
- James W Krieger
- Department of Food Science and Human Nutrition and of Statistics, University of Florida, Gainesville, FL 32611-0370, USA
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