The ability of habitual exercise to influence appetite and food intake in response to high- and low-energy preloads in man

Independent effects of volume and energy density manipulation on energy intake and appetite in healthy adults: A randomized, controlled, crossover study

Consuming enough energy to meet high energy demands can be challenging for military personnel wherein logistical constraints limit food availability. Increasing dietary energy density (ED) and/or volume density (VD) of rations may be countermeasures, but whether positive linear associations between ED and energy intake (EI) hold at moderate-to-high ED and VD is unclear. This study examined the effects of covertly increasing the ED and VD of moderate ED (≥1.6 kcal/g) foods on appetite and energy intake. Twenty healthy men completed four 2-day treatments in random order by consuming a standardized diet containing three experimental food items (EXP) engineered using leavening, physical compression and fat manipulation to be isovolumetric but lower (L) or higher (H) in ED and VD creating four treatments: LED/LVD, LED/HVD, HED/LVD, HED/HVD. Consumption of EXP was compulsory during two meals and a snack, but remaining intake was self-selected (SSF). Results failed to show any ED-by-VD interactions. During LVD, EI was lower for EXP (-417 kcal [95%CI: 432, -402], p < 0.01) and TOTAL (SSF + EXP) (-276 kcal [95%CI: 470, -83], p = 0.01) compared to HVD, while SSF EI did not differ (140 kcal [-51, 332], p = 0.15). During LED, EI for EXP (-291 kcal [95%CI: 306, -276], p < 0.01) was lower than HED, while SSF EI was higher than HED (203 kcal 95%CI: [12, 394], p = 0.04) and TOTAL EI did not differ (-88 kcal [-282, 105], p = 0.36). Thus, when a small isovolumetric portion of the diet was manipulated, increasing the VD of moderate ED foods failed to elicit compensatory reductions in ad libitum EI while increasing the ED of moderate ED foods did. Findings may support VD manipulation of moderate ED foods as a strategy to promote increased short-term EI in environments wherein logistical burden may limit food volume.

Understanding age-related changes: exploring the interplay of protein intake, physical activity and appetite in the ageing population

Globally, we are currently facing a rapid demographic shift leading to an increase in the proportion of older adults within the population. This raises concerns about the potential increase in age-related diseases and their impact on our ability to provide adequate health and end-of-life care. To apply appropriate interventions, understanding the changes that happen with ageing becomes essential. Ageing is often accompanied by a decrease in appetite and physical activity, which may lead to malnutrition, resulting in decreased muscle mass, physical capabilities and independence. To preserve muscle mass, older adults are advised to increase protein intake and physical activity. However, protein's high satiating effect may cause reduced energy intake. Physical activity is also advised to maintain or enhance older adult's appetite. This review paper aims to discuss appetite-related changes that occur with ageing and their consequences. In particular, it will focus on investigating the relationship between protein intake and physical activity and their impact on appetite and energy intake in the ageing population. Recent studies suggest that physical activity might contribute to maintaining or enhancing appetite in older adults. Nevertheless, establishing a definitive consensus on the satiating effect of protein in ageing remains a work in progress, despite some promising results in the existing literature.

The complex pattern of the effects of prolonged frequent exercise on appetite control, and implications for obesity

From a public health perspective, much of the interest in the relationship between exercise and appetite rests on the implications for energy balance and obesity. Energy balance reflects a dynamic 2-way interaction between energy expenditure (EE) and energy intake (EI). Physical activity and exercise, and appetite are the behavioural components of EE and EI, respectively. Beyond EE, exercise is a powerful and complex physiological stimulus acting on several bodily systems. There are multiple effects of frequent and prolonged exercise on appetite which include inter alia an increase in fasting hunger, an enhancement of post-prandial satiety, a modulation of the hedonic responses to food and improvements in eating behaviour traits. These lead to variable adjustments in EI and in a reduction in the susceptibility to overconsumption. Frequent and prolonged physical activity and exercise behaviour can strengthen and sensitise the appetite control system, whilst physical inactivity and sedentariness (low level of EE) fails to downregulate EI and can permit overconsumption. Not all of the effects of exercise operate uniformly to drive appetite in the same direction. The complexity of the interaction between EE and EI means that the effects of prolonged exercise are characterised by substantial individual heterogeneity. This leads to variable effects on energy balance and body mass.

Long-term aerobic and combined exercises enhance the satiety response and modulate the energy intake in patients with type 2 diabetes mellitus (T2DM): A randomized controlled trial

BACKGROUND

Energy homeostasis plays a vital role in achieving glycemic control in people with type 2 diabetes mellitus (T2DM). Exercise is known to increase energy expenditure. However, its role in energy intake has not been explored in people with T2DM. Thus, this study aimed at determining the impact of long-term aerobic and combined exercises in modulating hunger, satiety and energy intake in T2DM.

METHODS

A randomized controlled trial, with 108 people with T2DM, aged 35-60 years were assigned into an aerobic, combined (aerobic and resistance) and a control group. Primary outcomes were subjective levels of hunger and satiety measured by a 100 mm visual analogue scale in relation to a standard breakfast meal (453 kcal) and energy and macronutrient intake determined by a 3-day diet diary at 0, 3 and 6 months.

RESULTS

Aerobic and combined groups exhibited reduced hunger and increased satiety at 3 and 6 months (p < 0.05). The combined group demonstrated a profound increase in satiety at 3 and 6 months compared to aerobics (3 months; p = 0.008, 6 months; p = 0.002) and controls (3 months; p = 0.006, 6 months, p = 0.014). Mean daily energy intake was reduced only at 6 months in the aerobic group (p = 0.012), whereas it was reduced in the combined group at 3 and at 6 months compared to controls (3 months: p = 0.026, 6 months: p = 0.022).

CONCLUSIONS

Long-term aerobic and combined exercises produced a reduction in hunger, energy intake and increase satiety in people with T2DM. Despite energy expenditure, exercise seems to play a significant role in reducing energy intake as well. Combined exercises show more advantages over aerobic exercise since combined exercises have a greater impact on satiety and energy intake in people with T2DM.

TRIAL REGISTRATION NUMBER

SLCTR/2015/029, https://slctr.lk/trials/slctr-2015-029 .

Physical Activity, Obesity and Weight Loss Maintenance

Regular physical activity has an impact on all human organ systems and mediates multiple beneficial effects on overall health. Physical activity alone is a poor strategy for weight loss; however, physical activity is of crucial importance for weight loss maintenance. The role of exercise in maintaining a stable body weight is not clear but might be related to better appetite regulation and food preference. In relation to exercise, muscle secretes myokines and other factors that can influence the metabolism in other organs, not least fat and brain tissues. Thereby, physical activity reduces the risk of obesity-associated diseases, such as type 2 diabetes and cardiovascular diseases, independently of weight loss and BMI. Therefore, physical activity should always be included in weight loss strategies and as a tool to maintain a healthy weight, despite its modest effect on energy expenditure and overall body weight.

Accentuated early postprandial satiety in people with SCI versus able-bodied controls

In persons with spinal cord injury (SCI), reduced fat-free mass and movement-related energy expenditure increase obesity risk. Although plausible mechanisms exist, it remains unknown whether impaired appetite regulation potentiates obesity risk in SCI. This study compared postprandial responses of appetite-related hormones, appetite perceptions and the sensitivity of appetite to covert preload energy manipulation in persons with SCI and able-bodied (AB) controls. In a counterbalanced order, 12 men with high-level SCI (≥T6 vertebrae) and 12 AB controls completed two trials, consuming covert high-energy (HE; 2513 kJ) and low-energy (LE; 1008 kJ) preloads on separate occasions. Subjective appetite perceptions were assessed at 30 min intervals following preload consumption (up to 150 min) and energy intake was determined from ad libitum test meals. Appetite-related hormone (total PYY, GLP-1 and acylated ghrelin) responses were measured in the HE trial only. Within the early postprandial phase (0-60 min), subjective ratings of fullness (d = 0.83) and satisfaction (d = 0.87) were higher (P ≤ 0.028) in the group with SCI. No group differences in PYY, GLP-1 or acylated ghrelin were detected in a fasted state or postprandially (d ≤ 0.64; p ≥ 0.053). Ad libitum energy intake was lower in the SCI group (1086 vs. 1713 kJ, respectively, d = 1.00; P = 0.020) but no effect of trial (preload) was found. These findings suggest that, following isocaloric preloads, postprandial satiety may be augmented, rather than attenuated, in people with SCI.

Association of Day-to-Day Variations in Physical Activity with Postprandial Appetite Regulation in Lean Young Males

Previous studies have shown that habitual physical activity improves postprandial appetite regulation. We evaluated the direct association between physical activity level (PAL) and postprandial appetite regulation, and the effect of day-to-day variations in PAL on improving postprandial appetite regulation in lean young males. Fourteen young male adults wore a triaxial accelerometer for at least 6 consecutive days to evaluate their PAL. Two random liquid preload tests were performed on separate days to evaluate the competence of postprandial appetite regulation. In the preload test, participants ate sandwiches ad libitum 75 min after drinking one of two liquids containing different energy densities. When a participant had an adequate regulation of their postprandial appetite, the difference in energy intake from sandwiches was expected to be close to the energy gap between both liquids. Average daily PAL (r = −0.558, p < 0.05), but not the SD of PAL, which is indicative of the day-to-day variations in PAL (r = −0.437, p > 0.1), correlated with the difference in energy intake from the sandwiches. In addition, higher average PAL was closer to the energy gap between the two liquids. These results suggest that average daily PAL, rather than day-to-day variations in PAL, predicts inter-individual variation in postprandial appetite regulation, at least for lean young males.

Issues in Measuring and Interpreting Human Appetite (Satiety/Satiation) and Its Contribution to Obesity

PURPOSE OF REVIEW

The goals of this paper are to report current research practices in investigations of human appetite control and to assess their relationships with emerging theoretical principles. Appetite is often distinguished by the separation of homeostatic and hedonic processes.

RECENT FINDINGS

This report assesses the validity of a homeostatic toolkit to measure subjectively perceived hunger and its relationship to the developing processes of satiation (control of meal size) and satiety (control of the post-eating period). The capacity of a procedure to measure the influence of hedonic processes on food intake is also evaluated. A major issue is the relationship between the pattern of eating behaviour (influenced by the underlying drive to eat and the inhibition induced by the act of eating itself) and the parallel underlying profile of hormonal and other metabolic biomarkers. Increasing recognition is being given to individual variability in the expression of appetite, and the fact that the use of the average (mean) response conceals important information about the nature of appetite control. There is a growing interest in the identification of satiety phenotypes that operate in parallel to metabolic phenotypes. Interestingly, energy expenditure (metabolic and behavioural) contributes to an energy balance framework for understanding energy intake (appetite).

Sweet and Umami Taste Perception Differs with Habitual Exercise in Males

Taste is influenced by several factors. However, whether habitual exercise level is associated with differences in taste perception has received little investigation. The aim of this study was to determine if habitual exercise is associated with differences in taste perception in men. Active (n = 16) and inactive (n = 14) males, between ages 18⁻55, underwent two days of sensory testing, using prototypical taste stimuli of high and low concentrations for sweet, salt, bitter, sour, umami, and carbohydrate (maltodextrin). Mean perceived intensity and hedonic ratings were recorded. Eating behaviour was assessed by the three factor eating questionnaire and food intake by EPIC food frequency questionnaire (FFQ). There were moderate to large differences between the two groups in perceived intensity for sweet taste at the high concentration and umami taste at both high and low concentrations, with active males recording a higher perceived intensity (p < 0.05 for all). The active group also recorded a greater dislike for umami low and carbohydrate low concentration (p < 0.01). Salt, bitter and sour perception did not significantly differ between the two groups. FFQ analysis showed no difference in % energy from macronutrients between the groups. Eating behaviour traits correlated with sweet taste intensity and umami taste liking, independent of activity status. Results indicated that sweet and umami taste perception differ in active compared to inactive males. Habitual exercise level should be considered in taste perception research and in product development. Whether differences in taste perception could be one factor influencing food intake and thus energy balance with habitual exercise warrants further investigation.

The influence of a fruit smoothie or cereal and milk breakfast on subsequent dietary intake: a pilot study

Smoothies are popular breakfast foods. This study examined the effect of consuming Cereal & Milk (CM) or a nutritionally-comparable Fruit Smoothie (FS) for breakfast on daily energy intake (EI) in free-living adults and the extent to which individuals compensated for calories ingested in a High Energy Fruit Smoothie (HE). Ten participants (28.4 ± 2.2y; 23.3 ± 1.0 kg·m ^-2, Mean ± SEM) attended the laboratory on 3 consecutive days per week for 3 weeks. Each week, they received a CM, FS or HE breakfast, then recorded all food/beverages consumed across the remainder of the day. The CM and FS were energy-matched to participants' usual breakfast (1675 ± 283 kJ), while the HE contained an additional 100 kJ·kg^-1 of maltodextrin (3019 ± 335 kJ). Mean 3-day EI was similar on CM and FS (7894 ± 547 vs. 7570 ± 463 kJ, p > .05), but elevated on HE (8861 ± 726 kJ, p =  .012). Thus, individuals who substitute CM for a FS breakfast should be mindful that energy-dense beverages may result in increased daily EI.

Differences in the Postprandial Release of Appetite-Related Hormones Between Active and Inactive Men

Active, as opposed to inactive, individuals are able to adjust their energy intake after preloads of different energy contents. The mechanisms responsible for this remain unknown. This study examined differences in plasma concentration of appetite-related hormones in response to breakfasts of different energy contents, between active and inactive men. Sixteen healthy nonobese (body mass index = 18.5-27 kg/m²) adult males (nine active and seven inactive) participated in this study. Participants were given a high-energy (570 kcal) or a low-energy (205 kcal) breakfast in a random order. Subjective feelings of appetite and plasma concentrations of active ghrelin, active glucagon-like peptide-1, total peptide YY (PYY), cholecystokinin, and insulin were measured in fasting and every 30 min up to 2.5 hr, in response to both breakfasts. Mixed analysis of variance (fat mass [in percentage] as a covariate) revealed a higher concentration of active ghrelin and lower concentration of glucagon-like peptide-1, and cholecystokinin after the low-energy breakfast (p < .001 for all). Postprandial concentration of PYY was greater after the high energy compared with the low energy, but for inactive participants only (p = .014). Active participants had lower postprandial concentrations of insulin than inactive participants (p < .001). Differences in postprandial insulin between breakfasts were significantly lower in active compared with inactive participants (p < .001). Physical activity seems to modulate the postprandial plasma concentration of insulin and PYY after the intake of breakfasts of different energy contents, and that may contribute, at least partially, to the differences in short-term appetite control between active and inactive individuals.

Acute and Chronic Effects of Exercise on Appetite, Energy Intake, and Appetite-Related Hormones: The Modulating Effect of Adiposity, Sex, and Habitual Physical Activity

Exercise facilitates weight control, partly through effects on appetite regulation. Single bouts of exercise induce a short-term energy deficit without stimulating compensatory effects on appetite, whilst limited evidence suggests that exercise training may modify subjective and homeostatic mediators of appetite in directions associated with enhanced meal-induced satiety. However, a large variability in responses exists between individuals. This article reviews the evidence relating to how adiposity, sex, and habitual physical activity modulate exercise-induced appetite, energy intake, and appetite-related hormone responses. The balance of evidence suggests that adiposity and sex do not modify appetite or energy intake responses to acute or chronic exercise interventions, but individuals with higher habitual physical activity levels may better adjust energy intake in response to energy balance perturbations. The effect of these individual characteristics and behaviours on appetite-related hormone responses to exercise remains equivocal. These findings support the continued promotion of exercise as a strategy for inducing short-term energy deficits irrespective of adiposity and sex, as well as the ability of exercise to positively influence energy balance over the longer term. Future well-controlled studies are required to further ascertain the potential mediators of appetite responses to exercise.

Acute modulation in dietary behavior following glycogen depletion and postexercise supplementation in trained cyclists

We investigated the influence of immediate postexercise dietary supplementation on the subsequent food consumption pattern and endurance exercise performance in physically trained individuals. On 2 occasions, trained male cyclists performed a glycogen-depleting exercise bout followed by a 2-h nutritional supplementation period, 28 h of free-living recovery, and a subsequent 40-km cycling time trial. During the 2-h postexercise supplementation, the subjects consumed equal volumes of reduced-fat chocolate milk (CM) or a sports beverage (SB) in a single-blind, randomized design. Thereafter, the cyclists maintained a food log during the free-living recovery period. Dietary and exercise performance parameters were compared between the treatment beverage visits. No differences in total caloric and macronutrient intakes were detected between the CM and SB trials over the course of the free-living recovery. However, a significant interaction (treatment × time) was detected for caloric and macronutrient intakes during the early phase of free-living recovery, such that significantly larger proportions were consumed shortly after SB as compared with CM. No difference was observed in completion time of the 40-km cycling time trial (CM: 66.9 ± 4.1 vs SB: 66.9 ± 3.7 min). Hence, the cyclists achieved similar levels of recovery during the prolonged, free-living period despite the different acute, postexercise nutrient intake rates. We suggest that given adequate time, athletes appear to subconsciously modify their food consumption in response to varied postexercise supplementation such that subsequent-day exercise performance is equivalent.

An acute bout of cycling does not induce compensatory responses in pre-menopausal women not using hormonal contraceptives

There is a clear need to improve understanding of the effects of physical activity and exercise on appetite control. Therefore, the acute and short-term effects (three days) of a single bout of cycling on energy intake and energy expenditure were examined in women not using hormonal contraceptives. Sixteen active (n = 8) and inactive (n = 8) healthy pre-menopausal women completed a randomised crossover design study with two conditions (exercise and control). The exercise day involved cycling for 1 h (50% of maximum oxygen uptake) and resting for 2 h, whilst the control day comprised 3 h of rest. On each experimental day participants arrived at the laboratory fasted, consumed a standardised breakfast and an ad libitum pasta lunch. Food diaries and combined heart rate-accelerometer monitors were used to assess free-living food intake and energy expenditure, respectively, over the subsequent three days. There were no main effects or condition (exercise vs control) by group (active vs inactive) interaction for absolute energy intake (P > 0.05) at the ad libitum laboratory lunch meal, but there was a condition effect for relative energy intake (P = 0.004, η_p² = 0.46) that was lower in the exercise condition (1417 ± 926 kJ vs. 2120 ± 923 kJ). Furthermore, post-breakfast satiety was higher in the active than in the inactive group (P = 0.005, η_p² = 0.44). There were no main effects or interactions (P > 0.05) for mean daily energy intake, but both active and inactive groups consumed less energy from protein (14 ± 3% vs. 16 ± 4%, P = 0.016, η_p² = 0.37) and more from carbohydrate (53 ± 5% vs. 49 ± 7%, P = 0.031, η_p² = 0.31) following the exercise condition. This study suggests that an acute bout of cycling does not induce compensatory responses in active and inactive women not using hormonal contraceptives, while the stronger satiety response to the standardised breakfast meal in active individuals adds to the growing literature that physical activity helps improve the sensitivity of short-term appetite control.

Does Habitual Physical Activity Increase the Sensitivity of the Appetite Control System? A Systematic Review

Background

It has been proposed that habitual physical activity improves appetite control; however, the evidence has never been systematically reviewed.

Objective

To examine whether appetite control (e.g. subjective appetite, appetite-related peptides, food intake) differs according to levels of physical activity.

Data Sources

Medline, Embase and SPORTDiscus were searched for articles published between 1996 and 2015, using keywords pertaining to physical activity, appetite, food intake and appetite-related peptides.

Study Selection

Articles were included if they involved healthy non-smoking adults (aged 18–64 years) participating in cross-sectional studies examining appetite control in active and inactive individuals; or before and after exercise training in previously inactive individuals.

Study Appraisal and Synthesis

Of 77 full-text articles assessed, 28 studies (14 cross-sectional; 14 exercise training) met the inclusion criteria.

Results

Appetite sensations and absolute energy intake did not differ consistently across studies. Active individuals had a greater ability to compensate for high-energy preloads through reductions in energy intake, in comparison with inactive controls. When physical activity level was graded across cross-sectional studies (low, medium, high, very high), a significant curvilinear effect on energy intake (z-scores) was observed.

Limitations

Methodological issues existed concerning the small number of studies, lack of objective quantification of food intake, and various definitions used to define active and inactive individuals.

Conclusion

Habitually active individuals showed improved compensation for the energy density of foods, but no consistent differences in appetite or absolute energy intake, in comparison with inactive individuals. This review supports a J-shaped relationship between physical activity level and energy intake. Further studies are required to confirm these findings.

PROSPERO Registration Number

CRD42015019696

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-016-0518-9) contains supplementary material, which is available to authorized users.

Effects of Physical Activity and Sedentary Behavior on Brain Response to High-Calorie Food Cues in Young Adults

OBJECTIVE

Physical activity (PA) promotes weight maintenance, potentially because of its beneficial effects on feeding behavior regulation via diminished food cue reactivity within brain reward regions. This study examined how levels of PA and sedentary behavior (SB) relate to brain responses to food cues.

METHODS

Participants (22 lean, 18 with obesity) completed three to five PA recalls over 2 months. Average minutes per day of moderate to vigorous PA (MVPA) and SB were calculated. Participants completed a functional magnetic resonance imaging session, viewing food and nonfood images following glucose ingestion. Region of interest (ROI) analysis examined associations between MVPA and brain percent signal change in response to food versus nonfood images, controlling for obesity and sex. Secondary analysis examined associations between SB and brain responses to food cues.

RESULTS

Greater MVPA was associated with decreased food cue reactivity after glucose across brain ROIs (β = -0.00057, P = 0.005), controlling for obesity and sex. Greater SB was associated with increased food cue reactivity after glucose across brain ROIs in unadjusted analyses (β = 0.00041, P = 0.026).

CONCLUSIONS

PA may have beneficial effects on brain regulation of feeding behavior after caloric intake in lean individuals and individuals with obesity.

High Habitual Physical Activity Improves Acute Energy Compensation in Nonobese Adults

PURPOSE

Evidence suggests that homeostatic satiety signaling is enhanced with higher levels of physical activity (PA), with active individuals demonstrating an improved ability to compensate for previous energy intake (EI). However, prior studies lacked objective assessment of both PA level and EI. This study examined the effect of objectively measured PA level on homeostatic (energy compensation) and hedonic (liking and wanting) responses to high-energy (HEP), low-energy (LEP), and control preloads.

METHODS

Thirty-four nonobese individuals were grouped by tertiles of accelerometry-measured habitual moderate-to-vigorous PA (low, LoMVPA; moderate, ModMVPA; high, HiMVPA), similar in age, sex, and body mass index. After a preliminary assessment, EI (fixed-energy breakfast and ad libitum lunch, dinner, and evening snack box meals) was determined for three probe meal days in which preloads varying in energy content (HEP, 699 kcal; LEP, 258 kcal; control, 0 kcal) were consumed before the lunch meal. Liking and wanting were assessed before and after preload consumption (Leeds Food Preference Questionnaire), and appetite ratings were taken throughout the day.

RESULTS

Relative to control, EI at lunch was reduced to a greater extent after consumption of HEP compared with LEP in ModMVPA (P < 0.01) and HiMVPA (P = 0.01) but not LoMVPA (P = 0.59), reflecting more accurate energy compensation in HiMVPA and ModMVPA. There were no effects on cumulative EI after preload consumption of (lunch, dinner, and snack box combined). HEP led to a greater suppression of hunger, liking, and wanting compared with LEP in all MVPA tertiles.

CONCLUSIONS

Nonobese individuals with lower levels of measured PA were insensitive to the nutritional manipulation of the preloads, suggesting a weaker satiety response to food. This study provides objective evidence that higher habitual PA improves acute homeostatic appetite control.

Mechanisms responsible for homeostatic appetite control: theoretical advances and practical implications

Homeostatic appetite control is part of a psychobiological system that has evolved to maintain an adequate supply of nutrients for growth and maintenance. The system links the physiological needs for energy with the behaviour that satisfies these needs (feeding), and is shaped by excitatory and inhibitory signals. Owing to rapid shifts in the food environment, homeostatic appetite control is not well adapted for modern-day human functioning. Areas covered: Homeostatic appetite control has two divisions. Tonic processes exert stable and enduring influences, with signals arising from bodily tissues and metabolism. Episodic processes fluctuate rapidly and are related to nutrient ingestion and the composition of foods consumed. Research in these areas incorporates potent endocrine signals that can influence behaviour. Expert commentary: The regulation of adipose tissue, and its impact on appetite (energy) homeostasis, has been heavily researched. More recently however, it has been demonstrated that fat-free mass has the potential to act as a tonic driver of food intake. A challenging issue is to determine how the post-prandial action of episodic satiety hormones and gastrointestinal mechanisms can effectively brake the metabolic drive to eat, in order to keep food intake under control and prevent a positive energy balance and fat accumulation.

Energy balance, body composition, sedentariness and appetite regulation: pathways to obesity

Energy balance is not a simple algebraic sum of energy expenditure and energy intake as often depicted in communications. Energy balance is a dynamic process and there exist reciprocal effects between food intake and energy expenditure. An important distinction is that of metabolic and behavioural components of energy expenditure. These components not only contribute to the energy budget directly, but also by influencing the energy intake side of the equation. It has recently been demonstrated that resting metabolic rate (RMR) is a potential driver of energy intake, and evidence is accumulating on the influence of physical activity (behavioural energy expenditure) on mechanisms of satiety and appetite control. These effects are associated with changes in leptin and insulin sensitivity, and in the plasma levels of gastrointestinal (GI) peptides such as glucagon-like peptide-1 (GLP-1), ghrelin and cholecystokinin (CCK). The influence of fat-free mass on energy expenditure and as a driver of energy intake directs attention to molecules emanating from skeletal tissue as potential appetite signals. Sedentariness (physical inactivity) is positively associated with adiposity and is proposed to be a source of overconsumption and appetite dysregulation. The molecular signals underlying these effects are not known but represent a target for research.

Impact of physical activity level and dietary fat content on passive overconsumption of energy in non-obese adults

Background

Passive overconsumption is the increase in energy intake driven by the high-fat energy-dense food environment. This can be explained in part because dietary fat has a weaker effect on satiation (i.e. process that terminates feeding). Habitually active individuals show improved satiety (i.e. process involved in post-meal suppression of hunger) but any improvement in satiation is unknown. Here we examined whether habitual physical activity mitigates passive overconsumption through enhanced satiation in response to a high-fat meal.

Methods

Twenty-one non-obese individuals with high levels of physical activity (HiPA) and 19 individuals with low levels of physical activity (LoPA) matched for body mass index (mean = 22.8 kg/m²) were recruited. Passive overconsumption was assessed by comparing ad libitum energy intake from covertly manipulated high-fat (HFAT; 50% fat) or high-carbohydrate (HCHO; 70% carbohydrate) meals in a randomized crossover design. Habitual physical activity was assessed using SenseWear accelerometers (SWA). Body composition, resting metabolic rate, eating behaviour traits, fasting appetite-related peptides and hedonic food reward were also measured.

Results

In the whole sample, passive overconsumption was observed with greater energy intake at HFAT compared to HCHO (p < 0.01), without any differences between activity groups (p > 0.05). SWA confirmed that HiPA were more active than LoPA (p < 0.01). HiPA had lower body fat and greater fat-free mass than LoPA (p < 0.05 for both) but did not differ in resting metabolic rate, eating behaviour traits, appetite-related peptides or food reward (p > 0.05 for all).

Conclusions

Non-obese individuals with high or low physical activity levels but matched for BMI showed similar susceptibility to passive overconsumption when consuming an ad libitum high-fat compared to a high-carbohydrate meal. This occurred despite increased total daily energy expenditure and improved body composition in HiPA. Greater differences in body composition and/or physical activity levels may be required to impact on satiation.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0473-3) contains supplementary material, which is available to authorized users.

Appetite and Energy Intake Responses to Acute Energy Deficits in Females versus Males

Purpose

To explore whether compensatory responses to acute energy deficits induced by exercise or diet differ by sex.

Methods

In experiment one, 12 healthy women completed three 9-h trials (control, exercise-induced (Ex-Def) and food restriction–induced energy deficit (Food-Def)) with identical energy deficits being imposed in the Ex-Def (90-min run, ∼70% of V˙O_2max) and Food-Def trials. In experiment two, 10 men and 10 women completed two 7-h trials (control and exercise). Sixty minutes of running (∼70% of V˙O_2max) was performed at the beginning of the exercise trial. The participants rested throughout the remainder of the exercise trial and during the control trial. Appetite ratings, plasma concentrations of gut hormones, and ad libitum energy intake were assessed during main trials.

Results

In experiment one, an energy deficit of approximately 3500 kJ induced via food restriction increased appetite and food intake. These changes corresponded with heightened concentrations of plasma acylated ghrelin and lower peptide YY_3–36. None of these compensatory responses were apparent when an equivalent energy deficit was induced by exercise. In experiment two, appetite ratings and plasma acylated ghrelin concentrations were lower in exercise than in control, but energy intake did not differ between trials. The appetite, acylated ghrelin, and energy intake response to exercise did not differ between men and women.

Conclusions

Women exhibit compensatory appetite, gut hormone, and food intake responses to acute energy restriction but not in response to an acute bout of exercise. Additionally, men and women seem to exhibit similar acylated ghrelin and PYY_3–36 responses to exercise-induced energy deficits. These findings advance understanding regarding the interaction between exercise and energy homeostasis in women.

The Effects of Food Labelling on Postexercise Energy Intake in Sedentary Women

Food labelling has been previously reported to influence energy intake (EI). Whether food labels influence postexercise EI remains to be determined. We assessed how food labelling and exercise (Ex) interact to influence food perception and postexercise EI. In this randomized crossover design, 14 inactive women participated in 4 experimental conditions: Ex (300 kcal at 70% of VO_2peak) and lunch labelled as low in fat (LF), Ex and lunch labelled as high in fat (HF), Rest and LF, and Rest and HF. The lunch was composed of a plate of pasta, yogurt, and oatmeal cookies, which had the same nutritional composition across the 4 experimental conditions. EI at lunch and for the 48-hour period covering the testing day and the following day was assessed. Furthermore, perceived healthiness of the meal and appetite ratings were evaluated. There were no effects of exercise and food labelling on EI. However, meals labelled as LF were perceived as heathier, and this label was associated with higher prospective food consumption. Initial beliefs about food items had a stronger effect on healthiness perception than the different food labels and explain the positive correlation with the amount of food consumed (ρ = 0.34, P < 0.001).

Test-meal palatability is associated with overconsumption but better represents preceding changes in appetite in non-obese males

Single-course, ad libitum meals are recommended for the assessment of energy intake within appetite research. This study represents the first investigation of the comparative sensitivity of two single-course, ad libitum meals designed to differ in palatability. We conducted two experiments using a preload study design. All protocols were identical except for the energy content of the preloads (Expt 1: 579 and 1776 kJ; Expt 2: 828 and 4188 kJ). During each experiment, ten healthy men completed four experimental trials constituting a low- or high-energy preload beverage, a 60-min intermeal interval and consumption of a pasta-based or a porridge-based, ad libitum meal. Appetite ratings were measured throughout each trial, and palatability was assessed after food consumption. Preload manipulation did not influence appetite (P=0·791) or energy intake (P=0·561) in Expt 1. Palatability and energy intake were higher for the pasta meal than for the porridge meal in both experiments (palatability P≤0·002; energy intake P≤0·001). In Expt 2, consumption of the high-energy preload decreased appetite (P=0·051) and energy intake (P=0·002). Energy compensation was not significantly different between pasta and porridge meals (P=0·172), but was more strongly correlated with preceding changes in appetite at the pasta meal (r -0·758; P=0·011) than the porridge meal (r -0·498; P=0·143). The provision of a highly palatable, pasta-based meal produced energy intakes that were more representative of preceding appetite ratings, but the moderately palatable, porridge-based meal produced more ecologically valid energy intakes. Ad libitum meal selection and design may require a compromise between sensitivity and ecological validity.

Food reward in active compared to inactive men: Roles for gastric emptying and body fat

Habitual exercise could contribute to weight management by altering processes of food reward via the gut-brain axis. We investigated hedonic processes of food reward in active and inactive men and characterised relationships with gastric emptying and body fat. Forty-four men (active: n=22; inactive: n=22, BMI range 21-36kg/m(2); percent fat mass range 9-42%) were studied. Participants were provided with a standardised fixed breakfast and an ad libitum lunch meal 5h later. Explicit liking, implicit wanting and preference among high-fat, low-fat, sweet and savoury food items were assessed immediately post-breakfast (fed state) and again pre-lunch (hungry state) using the Leeds Food Preference Questionnaire. Gastric emptying was assessed by (13)C-octanoic acid breath test. Active individuals exhibited a lower liking for foods overall and a greater implicit wanting for low-fat savoury foods in the fed state, compared to inactive men. Differences in the fed state remained significant after adjusting for percent fat mass. Active men also had a greater increase in liking for savoury foods in the interval between breakfast and lunch. Faster gastric emptying was associated with liking for savoury foods and with an increase in liking for savoury foods in the postprandial interval. In contrast, greater implicit wanting for high-fat foods was associated with slower gastric emptying. These associations were independent of each other, activity status and body fat. In conclusion, active and inactive men differ in processes of food reward. The rate of gastric emptying may play a role in the association between physical activity status and food reward, via the gut-brain axis.

Energy flux: staying in energy balance at a high level is necessary to prevent weight gain for most people

Energy flux, the rate of energy conversion from absorption to expenditure or storage, is a critical component of understanding weight management. Individuals who maintain body weight over time have common characteristics including a relatively high level of physical activity and minimal changes in body composition, muscle mass and metabolic rate. A higher state of energy flux resulting from high energy expenditure may provide for a greater 'sensitivity' between energy intake and expenditure. This sensitivity stabilizes body weight by enhancing reciprocal compensation among these components with changes in eating or activity. The energy balance framework suggests that a higher level of energy expenditure requires higher energy intake to maintain body mass. Maintaining energy balance at a higher caloric intake and expenditure should be a more successful long-term strategy for weight maintenance than reduced consumption or extreme caloric restriction at a low level of energy expenditure (a low energy flux) and improve intervention effectiveness for sustainable methods for body weight stability.

Weight regaining: From statistics and behaviors to physiology and metabolism

Achieving maintenance of weight loss is crucial to combat obesity. However, most individuals tend to regain weight. Data from successful maintainers show that they remain vigilant and constantly apply techniques to oppose the course of regaining. On the other hand, current advances in obesity research show that the reduced obese state is a state of altered physiology in terms of energy balance. This review describes the physiological adaptations occurring after weight loss that predispose to regaining. Specifically, changes regarding body composition, hormonal background, energy expenditure and control of food intake are discussed. Moreover, metabolites that can act as regain predictors and dietary techniques to oppose regaining are presented.

Influence of habitual physical activity on gastric emptying in healthy males and relationships with body composition and energy expenditure

Although a number of studies have examined the role of gastric emptying (GE) in obesity, the influences of habitual physical activity level, body composition and energy expenditure (EE) on GE have received very little consideration. In the present study, we compared GE in active and inactive males, and characterised relationships with body composition (fat mass and fat-free mass) and EE. A total of forty-four males (active n 22, inactive n 22; BMI 21-36 kg/m2; percentage of fat mass 9-42%) were studied, with GE of a standardised (1676 kJ) pancake meal being assessed by the [13C]octanoic acid breath test, body composition by air displacement plethysmography, RMR by indirect calorimetry, and activity EE (AEE) by accelerometry. The results showed that GE was faster in active compared with inactive males (mean half-time (t 1/2): active 157 (sd 18) and inactive 179 (sd 21) min, P< 0.001). When data from both groups were pooled, GE t 1/2 was associated with percentage of fat mass (r 0.39, P< 0.01) and AEE (r - 0.46, P< 0.01). After controlling for habitual physical activity status, the association between AEE and GE remained, but not that for percentage of fat mass and GE. BMI and RMR were not associated with GE. In summary, faster GE is considered to be a marker of a habitually active lifestyle in males, and is associated with a higher AEE level and a lower percentage of fat mass. The possibility that GE contributes to a gross physiological regulation (or dysregulation) of food intake with physical activity level deserves further investigation.

Consistency in compensatory eating responses following acute exercise in inactive, overweight and obese women

It is often assumed that some individuals reliably increase energy intake (EI) post-exercise ('compensators') and some do not ('non-compensators'), leading researchers to examine the characteristics that distinguish these two groups. However, it is unclear whether EI post-exercise is stable over time. The present study examined whether compensatory eating responses to a single exercise bout are consistent within individuals across three pairs of trials. Physically inactive, overweight/obese women (n 28, BMI 30·3 (SD 2·9) kg/m²) participated in three pairs of testing sessions, with each pair consisting of an exercise (30 min of moderate-intensity walking) and resting testing day. EI was measured using a buffet meal 1 h post-exercise/rest. For each pair, the difference in EI (EIdiff = EIex - EIrest) was calculated, where EIex is the EI of the exercise session and EIrest is the EI of the resting session, and women were classified as a 'compensator' (EIex > EIrest) or 'non-compensator' (EIex ≤ EIrest). The average EI on exercise days (3328·0 (SD 1686·2) kJ) was similar to those on resting days (3269·4 (SD 1582·4) kJ) (P= 0·67). Although EI was reliable within individuals across the three resting days (intraclass correlation coefficient (ICC) 0·75, 95 % CI 0·60, 0·87; P< 0·001) and three exercise days (ICC 0·83, 95 % CI 0·70, 0·91; P< 0·001), the ICC for EIdiff across the three pairs of trials was low (ICC 0·20, 95 % CI -0·02, 0·45; P= 0·04), suggesting that compensatory eating post-exercise is not a stable construct. Moreover, the classification of 'compensators'/'non-compensators' was not reliable (κ = -0·048; P= 0·66). The results were unaltered when 'relative' EI was used, which considers the energy expenditure of the exercise/resting sessions. Acute compensatory EI following an exercise bout is not reliable in overweight women. Seeking to understand what distinguishes 'compensators' from 'non-compensators' based on a single eating episode post-exercise is not justified.

Consumption of a high-fat soup preload leads to differences in short-term energy and fat intake between PROP non-taster and super-taster women

Taste blindness to the bitterness of PROP (6-n-propylthiouracil) has been used as a genetic marker for food selection and adiposity. We have shown that PROP non-taster (NT) women have higher BMIs and habitually consume more fat and energy than either medium-taster (MT) or super-taster (ST) women. These data imply that differences in dietary selection underlie the body weight differences among PROP taster groups. However, no studies investigated energy compensation in women classified by PROP status. We investigated if NTs would compensate less accurately for the calories and fat in a high-fat soup preload in a subsequent test meal compared to MTs and STs. Energy intake from a buffet meal was measured in 75 healthy non-diet-restrained, lean women 30 min after the ingestion of a high-fat soup preload (0.8 kcal/g; 55% calories from fat), calculated to represent 10% of resting energy expenditure for each subject, or the same volume of water. Subjects (n = 20-28/taster group) ate a standard breakfast followed 3 hr later by an ad-libitum buffet lunch, on two occasions. There were no differences in energy intake or macronutrient selection across taster groups after water. After soup, NTs consumed more energy than STs. Fat intake (as %-energy) was higher in NTs (46.4% ± 2.4) compared to either MTs (36.1 ± 1.9%) or STs (38.1% ± 2.3; p < 0.05). NTs overate by 11% ± 5 after the soup compared to MTs and STs who underrate by 16% ± 6 and 26% ± 10, respectively (p < 0.01). These data suggest that small discrepancies in short-term energy compensation and selection of fat after a mixed-nutrient, high-fat preload may play a role in positive energy balance and increased adiposity in women with the PROP non-taster phenotype.

Does the method of weight loss effect long-term changes in weight, body composition or chronic disease risk factors in overweight or obese adults? A systematic review

BACKGROUND

Differences in biological changes from weight loss by energy restriction and/or exercise may be associated with differences in long-term weight loss/regain.

OBJECTIVE

To assess the effect of weight loss method on long-term changes in weight, body composition and chronic disease risk factors.

DATA SOURCES

PubMed and Embase were searched (January 1990-October 2013) for studies with data on the effect of energy restriction, exercise (aerobic and resistance) on long-term weight loss. Twenty articles were included in this review.

STUDY ELIGIBILITY CRITERIA

Primary source, peer reviewed randomized trials published in English with an active weight loss period of >6 months, or active weight loss with a follow-up period of any duration, conducted in overweight or obese adults were included.

STUDY APPRAISAL AND SYNTHESIS METHODS

Considerable heterogeneity across trials existed for important study parameters, therefore a meta-analysis was considered inappropriate. Results were synthesized and grouped by comparisons (e.g. diet vs. aerobic exercise, diet vs. diet + aerobic exercise etc.) and study design (long-term or weight loss/follow-up).

RESULTS

Forty percent of trials reported significantly greater long-term weight loss with diet compared with aerobic exercise, while results for differences in weight regain were inconclusive. Diet+aerobic exercise resulted in significantly greater weight loss than diet alone in 50% of trials. However, weight regain (∼ 55% of loss) was similar in diet and diet+aerobic exercise groups. Fat-free mass tended to be preserved when interventions included exercise.

Is eating behavior manipulated by the gastrointestinal microbiota? Evolutionary pressures and potential mechanisms

Microbes in the gastrointestinal tract are under selective pressure to manipulate host eating behavior to increase their fitness, sometimes at the expense of host fitness. Microbes may do this through two potential strategies: (i) generating cravings for foods that they specialize on or foods that suppress their competitors, or (ii) inducing dysphoria until we eat foods that enhance their fitness. We review several potential mechanisms for microbial control over eating behavior including microbial influence on reward and satiety pathways, production of toxins that alter mood, changes to receptors including taste receptors, and hijacking of the vagus nerve, the neural axis between the gut and the brain. We also review the evidence for alternative explanations for cravings and unhealthy eating behavior. Because microbiota are easily manipulatable by prebiotics, probiotics, antibiotics, fecal transplants, and dietary changes, altering our microbiota offers a tractable approach to otherwise intractable problems of obesity and unhealthy eating.

Effect of chronic exercise on appetite control in overweight and obese individuals

PURPOSE

The effect of exercise on body mass is likely to be partially mediated through changes in appetite control. However, no studies have examined the effect of chronic exercise on obestatin and cholecystokinin (CCK) plasma concentrations or the sensitivity to detect differences in preload energy in obese individuals. The objective of this study was to investigate the effects of chronic exercise on 1) fasting and postprandial plasma concentrations of obestatin, CCK, leptin, and glucose insulinotropic peptide (GIP) and 2) the accuracy of energy compensation in response to covert preload manipulation.

METHODS

This study used a 12-wk supervised exercise program in 22 sedentary overweight/obese individuals. Fasting/postprandial plasma concentrations of obestatin, CCK, leptin, and GIP were assessed before and after the intervention. Energy compensation at a 30-min test meal after a high-energy (607 kcal) or a low-energy (246 kcal) preload and for the rest of the day (cumulative energy intake [EI]) was also measured.

RESULTS

There was a significant reduction in the plasma concentration of fasting plasma GIP and both fasting and postprandial leptin concentrations after the exercise intervention (P < 0.05 for all). No significant changes were observed for CCK or obestatin. A significant preload-exercise interaction (P = 0.011) was observed on cumulative EI and energy compensation for the same period (-87% ± 196% vs 68% ± 165%, P = 0.011). Weight loss (3.5 ± 1.4 kg, P < 0.0001) was not correlated with changes in energy compensation.

CONCLUSIONS

This study suggests that exercise improves the accuracy of compensation for previous EI, independent of weight loss. Unexpectedly, and in contrast to GIP and leptin, exercise-induced weight loss had no effect on obestatin or CCK concentrations.

Activity related energy expenditure, appetite and energy intake: potential implications for weight management

The aim was to investigate relationships between activity related energy expenditure (AREE), appetite ratings and energy intake (EI) in a sample of 40 male (26.4years; BMI 23.5kg/m(2)) and 42 female (26.9years; BMI 22.4kg/m(2)) participants. AREE was expressed as the residual value of the regression between total daily EE (by doubly labeled water) and resting EE (by indirect calorimetry). EI was measured using an ad libitum buffet meal and visual analogue scales measured subjective appetite ratings before and after the meal. AREE was divided into low, middle and high sex-specific tertiles. General linear models were used to investigate differences in appetite ratings and EI across AREE tertiles. Before the meal, males in the high AREE tertile had significantly lower desire to eat and lower prospective food consumption and higher feelings of fullness compared to those in the low tertile. Males in the middle tertile had significantly higher satiety quotients after the meal and lower EI compared to the other tertiles. No significant differences across tertiles were found in females. Sex differences in relationships between AREE, appetite ratings and EI may lead to differing patterns of EI and subsequent weight maintenance.

Energy compensation after an aerobic exercise session in high-fat/low-fit and low-fat/high-fit young male subjects

There is general agreement that exercise-induced energy expenditure is not entirely compensated for at the next meal or over the following 24 h, but inter-individual variability is high. The role of ‘fatness and fitness’ in this variability has never been assessed. Therefore, eighteen non-obese male subjects aged 22·2 (sd2·0) years were selected and separated into a ‘high-fatness and low-fitness’ (Hfat/Lfit,n9) and a ‘low-fatness and high-fitness’ (Lfat/Hfit,n9) group, according to three criteria: maximal oxygen uptake; weekly hours of physical activity; fat mass index. At 1 h before lunch, they were subjected to 60 min of exercise on a cycle ergometer (70 % VO2max), or stayed at rest. Then, they self-reported food intake in diaries until the next breakfast. Intake at lunch was not different between conditions, but was higher after exercise than after rest over the 24 h, leading to a significant but partial mean level of compensation of 49·8 (sem16·5) and 37·8 (sem24·6) % for the Hfat/Lfit and Lfat/Hfit groups, respectively. Energy compensation at lunch and over the 24 h were strongly correlated (r0·76,P< 0·001). Both groups consumed more fat and protein after exercise than after rest over the 24 h, but the percentage of energy derived from fat increased only in the Hfat/Lfit group (2·1 (sem0·6) %,P= 0·026). Thus, the energy cost of an aerobic exercise session was partially compensated over the next 24 h independently of the ‘fatness and fitness’ status, but ‘high-fat and low-fit’ individuals compensated more specifically on fats.

The Interaction Between Exercise, Appetite, and Food Intake

Exercise could indirectly affect body weight by exerting changes on various components of appetite control, including nutrient and taste preferences, meal size and frequency, and the drive to eat. This review summarizes the evidence on how exercise affects appetite and eating behavior and in particular answers the question, “Does exercise induce an increase in food intake to compensate for the increase in energy expenditure?” Evidence will be presented to demonstrate that there is no automatic increase in food intake in response to acute exercise and that the response to repeated exercise is variable. The review will also identify areas of further study required to explain the variability. One limitation with studies that assess the efficacy of exercise as a method of weight control is that only mean data are presented—the individual variability tends to be overlooked. Recent evidence highlights the importance of characterizing the individual variability by demonstrating exercise-induced changes in appetite. Individuals who experience lower than theoretically predicted reductions in body weight can be characterized by hedonic (eg, pleasure) and homeostatic (eg, hunger) features.

Beverage consumption, appetite, and energy intake: what did you expect?

BACKGROUND

Beverage consumption is implicated in the overweight/obesity epidemic through the weaker energy compensation response it elicits compared with solid food forms. However, plausible mechanisms are not documented.

OBJECTIVE

This study assessed the cognitive and sensory contributions of differential postingestive responses to energy- and macronutrient-matched liquid (in beverage form) and solid food forms and identifies physiologic processes that may account for them.

DESIGN

Fifty-two healthy adults [mean ± SD age: 24.7 ± 5.5 y; BMI (in kg/m(2)): 26.3 ± 6.3] completed this randomized, 4-arm crossover study. Participants consumed oral liquid and solid preloads that they perceived, through cognitive manipulation, to be liquid or solid in their stomach (ie, oral liquid/perceived gastric liquid, oral liquid/perceived gastric solid, oral solid/perceived gastric liquid, or oral solid/perceived gastric solid). However, all preloads were designed to present a liquid gastric challenge. Appetite, gastric-emptying and orocecal transit times, and selected endocrine responses were monitored for the following 4 h; total energy intake was also recorded.

RESULTS

Oral-liquid and perceived gastric-liquid preloads elicited greater postprandial hunger and lower fullness sensations, more rapid gastric-emptying and orocecal transit times, attenuated insulin and glucagon-like peptide 1 release, and lower ghrelin suppression than did responses after oral-solid and perceived gastric-solid treatments (all P < 0.05). Faster gastric-emptying times were significantly associated with greater energy intake after consumption of perceived gastric-liquid preloads (P < 0.05). Energy intake was greater on days when perceived gastric-liquid preloads were consumed than when perceived gastric solids were consumed (2311 ± 95 compared with 1897 ± 72 kcal, P = 0.007).

CONCLUSIONS

These data document sensory and cognitive effects of food form on ingestive behavior and identify physical and endocrine variables that may account for the low satiety value of beverages. They are consistent with findings that clear, energy-yielding beverages pose a particular risk for positive energy balance. This study was registered at clinicaltrials.gov as NCT01070199.

Satiety-relevant sensory qualities enhance the satiating effects of mixed carbohydrate-protein preloads

BACKGROUND

Orosensory cues such as food texture and flavor have been shown to play a role in satiation, but their role in satiety remains less clear.

OBJECTIVE

The objective was to determine whether satiety-relevant orosensory cues enhance the satiating effects of energy in the context of beverage preloads.

DESIGN

The effects of 6 drink preloads that combined 2 amounts of energy [high energy (HE): 279 kcal; low energy (LE): 78 kcal] and 3 satiety-relevant sensory contexts [low sensory (LS), medium sensory (MS), and high sensory (HS)] on subsequent appetite and test meal intake were assessed in 36 healthy nonobese volunteers.

RESULTS

The ability of the preloads to modify appetite 30 min after consumption depended on both energy content and sensory context (P-interaction < 0.05), with hunger significantly being lower after consumption of the HE than after the LE preload in the HS context (P < 0.001), tending to be lower in the MS context (P = 0.08), but not different in the LS context. Food intake at lunch was lower after the HE than after the LE preloads (effect of energy P < 0.001), but this effect depended on sensory context (P < 0.005). The degree to which reduced test meal intake compensated for the added energy in the HE preloads was 88% in the HS context, which was significantly greater than in the MS (47%) and LS (18%) contexts.

CONCLUSION

Small changes in the sensory characteristics of drinks altered the degree to which added energy was satiating, which implies that nutrients become more satiating when they are predicted by relevant sensory cues such as thickness and creaminess. This trial was registered at http://www.controlled-trials.com as ISRCTN36258511.

The effects of weight loss strategies on gastric emptying and appetite control

The gastrointestinal tract plays an important role in the improved appetite control and weight loss in response to bariatric surgery. Other strategies which similarly alter gastrointestinal responses to food intake could contribute to successful weight management. The aim of this review is to discuss the effects of surgical, pharmacological and behavioural weight loss interventions on gastrointestinal targets of appetite control, including gastric emptying. Gastrointestinal peptides are also discussed because of their integrative relationship in appetite control. This review shows that different strategies exert diverse effects and there is no consensus on the optimal strategy for manipulating gastric emptying to improve appetite control. Emerging evidence from surgical procedures (e.g. sleeve gastrectomy and Roux-en-Y gastric bypass) suggests a faster emptying rate and earlier delivery of nutrients to the distal small intestine may improve appetite control. Energy restriction slows gastric emptying, while the effect of exercise-induced weight loss on gastric emptying remains to be established. The limited evidence suggests that chronic exercise is associated with faster gastric emptying, which we hypothesize will impact on appetite control and energy balance. Understanding how behavioural weight loss interventions (e.g. diet and exercise) alter gastrointestinal targets of appetite control may be important to improve their success in weight management.

Exercise attenuates the association of body weight with diet in 106,737 runners

PURPOSE

The high prevalence of obesity in Western societies has been attributed in part to high-fat low-CHO food consumption. However, people have also become less active, and inactivity may have increased the risk for weight gain from poor dietary choices. Analyses were performed to test whether diet-weight relationships were attenuated by vigorous exercise.

METHODS

Age- and education-adjusted cross-sectional regression analyses of 62,042 men and 44,695 women recruited for the National Runners' Health Study were conducted. Reported meat and fruit intakes were analyzed separately and as indicators of high-risk diets.

RESULTS

The runners were generally lean (mean ± SD: males = 24.15 ± 2.81 kg·m(-2), females = 21.63 ± 2.70 kg·m(-2)) as measured by body mass index (BMI), educated (males = 16.42 ± 2.47 yr, females = 16.04 ± 2.32 yr), and middle-aged (males = 44.40 ± 10.83 yr, females = 38.21 ± 10.08 yr), who ran 5.30 ± 3.23 km·d(-1) if male and 4.79 ± 3.00 km·d(-1) if female. Running significantly attenuated BMI's relationship to reported meat and fruit intakes in men (P < 10(-8) and P < 10(-12), respectively) and women (P < 10(-15) and P < 10(-6), respectively). Specifically, compared with running <2 km·d(-1), running >8 km·d(-1) reduced the apparent BMI increase per serving of meat by 43% in men (slope ± SE = from 0.74 ± 0.10 to 0.42 ± 0.06) and 55% in women (from 1.26 ± 0.13 to 0.57 ± 0.09) and reduced the apparent BMI reduction per serving of fruit by 75% in men (from -0.28 ± 0.04 to -0.07 ± 0.02) and 94% in women (from -0.16 ± 0.05 to -0.01 ± 0.02). Running also significantly attenuated the concordant relationship between reported meat intake and waist and chest circumferences in men (P < 10(-9) and P = 0.0002, respectively) and women (P = 0.0004 and P < 10(-5), respectively) and the concordant relationship between meat intake and hip circumference in women (P < 10(-6)).

CONCLUSIONS

Vigorous exercise may mitigate diet-induced weight gain, albeit not guaranteeing protection from poor dietary choices.

The relationship between substrate metabolism, exercise and appetite control: does glycogen availability influence the motivation to eat, energy intake or food choice?

The way in which metabolic fuels are utilized can alter the expression of behaviour in the interests of regulating energy balance and fuel availability. This is consistent with the notion that the regulation of appetite is a psychobiological process, in which physiological mediators act as drivers of behaviour. The glycogenostatic theory suggests that glycogen availability is central in eliciting negative feedback signals to restore energy homeostasis. Due to its limited storage capacity, carbohydrate availability is tightly regulated and its restoration is a high metabolic priority following depletion. It has been proposed that such depletion may act as a biological cue to stimulate compensatory energy intake in an effort to restore availability. Due to the increased energy demand, aerobic exercise may act as a biological cue to trigger compensatory eating as a result of perturbations to muscle and liver glycogen stores. However, studies manipulating glycogen availability over short-term periods (1-3 days) using exercise, diet or both have often produced equivocal findings. There is limited but growing evidence to suggest that carbohydrate balance is involved in the short-term regulation of food intake, with a negative carbohydrate balance having been shown to predict greater ad libitum feeding. Furthermore, a negative carbohydrate balance has been shown to be predictive of weight gain. However, further research is needed to support these findings as the current research in this area is limited. In addition, the specific neural or hormonal signal through which carbohydrate availability could regulate energy intake is at present unknown. Identification of this signal or pathway is imperative if a casual relationship is to be established. Without this, the possibility remains that the associations found between carbohydrate balance and food intake are incidental.

Physical activity and weight control: conflicting findings

PURPOSE OF REVIEW

It is often hypothesized that increasing the volume of physical activity in the American lifestyle will slow and possibly even reverse the epidemic of obesity. Herein, we review the evidence pertaining to the role of physical activity in weight control from interventions performed in adults.

RECENT FINDINGS

Evidence exists both for and against the role of physical activity in weight control. High levels of physical activity and successful maintenance of body weight may be a result of better coupling between energy intake and energy expenditure, potentially mediated by physiological changes in appetite, albeit in the presence of large interindividual variability. Prospective studies, however, find little evidence of the more physically active members of a population gaining less excess weight than those who are the least physically active.

SUMMARY

When considering the impact of physical activity on body weight regulation, it is important to keep in mind that there are multiple hormones that acutely suppress (or stimulate) food intake and that the integration of these signals influence overall energy balance in a manner that is not yet fully understood. Moreover, cognitive and social influences may override these signals. Even though the impact of physical activity for weight control is still controversial, little doubt exists that increasing regular physical activity, particularly energy expended during structured exercise, is important for improving physical fitness and cardiovascular health.