Search Results (86)

Background: Physical activity, sedentary behaviour, and sleep are interdependent components of the 24 h movement profile that may influence appetite control. While acute exercise can alter appetite perceptions and food reward, less is known about how reallocating time between daily behaviours affects appetite outcomes under free-living conditions. Methods: We applied isotemporal-substitution modelling in a cross-sectional study of 130 young, healthy, active adults. Accelerometer-derived estimates of sedentary time, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sleep were analysed in relation to energy intake (food diaries, laboratory meals), subjective appetite perceptions, appetite-related hormones (acylated ghrelin, PYY, leptin), and psychological traits, including food reward (Leeds Food Preference Questionnaire, LFPQ), food cravings (Control of Eating Questionnaire, CoEQ), and eating behaviour traits (Three-Factor Eating Questionnaire, TFEQ). Results: Reallocating 30 min/day of sedentary time to MVPA was associated with higher energy intake in free-living (+113 kcal/day, 95% CI: 34–192) and laboratory settings (+120 kcal/day, 95% CI: 55–185), along with greater postprandial hunger and prospective food consumption, reduced fullness, elevated fasting acylated ghrelin, and lower postprandial PYY. No associations were observed for reallocations to LPA or sleep. Furthermore, sedentary time reallocations were unrelated to leptin or psychological eating traits assessed by the LFPQ, CoEQ, or TFEQ. Conclusions: In this population, reallocating sedentary time to MVPA was linked to physiological and behavioural compensation consistent with elevated energy demands, whereas reallocating to LPA or sleep showed no associations. Trait-level eating behaviours were unaffected, suggesting MVPA influences appetite primarily through acute physiological rather than enduring cognitive or hedonic pathways. Full article

Objective: Recent work has challenged the notion that preferred substrate oxidation is a key determinant of exercise performance. This investigation tested middle-distance running performance, in the fed state, to control for glycogen and exercise-induced hypoglycemia (EIH) confounders. Methods: In a randomized crossover fashion, all while controlling dietary intake, activity, and body weight, recreational distance runners completed either a 5K (n = 15; VO_2max: 58.3 ± 6.2 mL/kg/min) or a 10K (n = 15; VO_2max: 54.51 ± 5.9 mL/kg/min) middle-distance run after consuming isocaloric low-carbohydrate high-fat (LCHF) and high-carbohydrate low-fat (HCLF) pre-exercise meals. Time trial (TT) performance (sec), carbohydrate/fat substrate oxidation, blood metabolites, heart rate (HR), ratings of perceived exertion (RPE), and subjective fullness and thirst were measured throughout. Results: LCHF pre-exercise nutrition reliably altered substrate oxidation and metabolite profiles compared to HCLF, evidenced by significant increases in fat oxidation (77% higher) and reductions in RER (5% lower), with corresponding shifts in carbohydrate oxidation. Despite distinct preferred substrate oxidation profiles during exercise, the 5 and 10 km TT performances were similar between conditions (p = 0.646/p = 0.118). RER was significantly lower (p = 0.002) after the LCHF condition compared to HCLF. Capillary R-βHB increased modestly after LCHF, while blood glucose increased after HCLF only. The LCHF meal was 35% more filling than the HCLF meal. Preferred substrate oxidation did not significantly modulate middle-distance running performance. Conclusion: This work supports recent findings that substrate oxidation is not a primary determinant of aerobic performance, as previously conceived. Full article

Aim: To investigate the synergistic effects of exercise training and Brassica oleracea var. italica (broccoli sprout) supplementation on Apolipoprotein A-I, B-100, and J levels in men with Type 2 diabetes mellitus (T2DM). Methods: Forty-four males with T2DM were randomly assigned to four groups: Control (CG), Supplement (SG), Training (TG), and Training + Supplement (TSG) groups. Participants in the supplement groups (SG and TSG) received 10 g of broccoli supplement after meals for 12 weeks, while those in the training groups (TG and TSG) participated in a structured exercise program (resistance and aerobic), performed three times per week for 12 weeks, at intensities of 60–70% one-repetition maximum (1RM) for resistance training and 60–70% peak oxygen uptake (VO_2peak) for aerobic training. Results: Circulating levels of apolipoproteins improved after 12 weeks in the TSG, TG, and SG groups. However, the TSG group exhibited the most pronounced improvements across metabolic and lipoprotein markers, reflecting an additive effect of both interventions. Specifically, the TSG group demonstrated absolute reductions in ApoB-100 (−48.30 ± 7.20 mg/dL) and ApoJ (−44.05 ± 5.76 mg/dL), along with an increase in ApoA-I (+44.92 ± 6.05 mg/dL). Main effect analysis revealed that exercise training elicited the most substantial improvements across metabolic and lipoprotein markers, with large effect sizes for glucose (η²p = 0.787), insulin (η²p = 0.640), HOMA-IR (η²p = 0.856), ApoA-I (η²p = 0.685), ApoB-100 (η²p = 0.774), ApoJ (η²p = 0.848), and HDL-C (η²p = 0.535). Supplementation showed moderate effects, particularly on HOMA-IR (η²p = 0.370), ApoA-I (η²p = 0.383), and ApoB-100 (η²p = 0.334), supporting an additive but exercise-dominant benefit. The combined intervention group (TSG) showed the most pronounced improvements across all measured outcomes, with large effect sizes for ApoA-I (η²p = 0.883), glucose (η²p = 0.946), insulin (η²p = 0.881), HOMA-IR (η²p = 0.904), and ApoJ (η²p = 0.852). Conclusions: The effects of combining training and broccoli sprout supplementation on apolipoprotein levels are likely to result from the activation of two separate pathways, one from training and the other from supplementation. This dual-modality intervention could serve as an effective complementary strategy in managing metabolic and cardiovascular risk factors for individuals with T2DM. However, the magnitude of change induced by the combination of exercise training and broccoli supplementation was largely driven by the training component, with supplementation providing complementary but less consistent benefits. Full article

Time-restricted eating (TRE) has gained attention as an effective approach for weight management and overall well-being by focusing on limiting the eating window, rather than reducing calories. This study explores the biopsychosocial impacts of TRE in free-living individuals using a qualitative design. Twenty-one adults (aged 27–60 years) from Western Australia who had practised TRE for at least three months were purposively recruited, and semi-structured interviews were conducted. The data were analysed using a thematic analysis to identify key themes. The participants reported a range of benefits, including weight loss, reduced joint pain, better digestion, improved mental clarity, increased energy, and a more positive body image. Socially, TRE facilitated simplified daily routines but also introduced challenges, such as disruptions to social interactions and family meal dynamics. Some mixed and negative impacts were reported, including changes in sleep and exercise patterns. These findings highlight TRE’s potential as a holistic dietary intervention. Further research, particularly well-controlled, randomised controlled trials and longitudinal studies, is needed to confirm these insights and guide their appropriate application in clinical and public health settings. Full article

Obesity has emerged as a global epidemic, creating an increased burden of weight-related diseases and straining healthcare systems worldwide. While the fundamental principle of energy balance—caloric intake versus expenditure—remains central to weight regulation, real-world outcomes often deviate from simplistic predictions due to a multitude of physiological and environmental factors. Genetic predispositions, variations in basal metabolic rates, adaptive thermogenesis, physical activity, and nutrient losses via fecal and urinary excretion contribute to interindividual differences in energy homeostasis. Additionally, factors such as meal timing, macronutrient composition, gut microbiota dynamics, and diet-induced thermogenesis (DIT) further modulate energy utilization and metabolic efficiency. This Perspective explores key physiological determinants of the energy balance, while also highlighting the clinical significance of thrifty versus spendthrifty metabolic phenotypes. Key strategies for individualized weight management include precision calorimetry, circadian-aligned meal timing, the use of protein- and whole food diets to enhance DIT, and increases in non-exercise activity, as well as mild cold exposure and the use of thermogenic agents (e.g., capsaicin-like compounds) to stimulate brown adipose tissue activity. A comprehensive, personalized approach to obesity management that moves beyond restrictive caloric models is essential to achieving sustainable weight control and improving long-term metabolic health. Integrating these multifactorial insights into clinical practice will enhance obesity treatment strategies, fostering more effective and enduring interventions. Full article

Background: Breakfast is often termed the most important meal of the day. However, its importance to acute and chronic adaptations to exercise is currently not well summarized throughout the literature. Methods: A narrative review of the experimental literature regarding breakfast consumption’s impact on acute and chronic exercise performance and alterations in body composition prior to November 2024 was conducted. To be included in this review, the selected investigations needed to include some aspect of either endurance or resistance training performance and be conducted in humans. Results: These findings suggest that breakfast consumption may benefit acute long-duration (>60 min) but not short-duration (<60 min) morning endurance exercise. Evening time trial performance was consistently inhibited following breakfast omission despite the resumption of eating midday. No or minimal impact of breakfast consumption was found when examining acute morning or afternoon resistance training or the longitudinal adaptations to either resistance or endurance training. Favorable changes in body composition were often noted following the omission of breakfast. However, this was primarily driven by the concomitant reduced kilocalorie intake. Conclusions: Consuming breakfast may aid endurance athletes regularly performing exercise lasting >60 min in length. However, the morning meal’s impact on resistance training and changes in body composition appears to be minimal. Although, as the body of literature is limited, future investigations are needed to truly ascertain the dietary practice’s impact. Full article

Background and Objectives: In Italy, as in the rest of the world, government restrictions aimed at containing the spread of COVID-19 primarily imposed limitations on social relationships and personal behavior. This situation significantly affected the management of chronic illnesses, including type 2 diabetes (T2D). The objective was to evaluate the perceptions of patients with T2D regarding the quality of care received during the COVID-19 pandemic and the impact on dietary and physical activity behaviors. Materials and Methods: We conducted a retrospective cross-sectional survey. Data were collected from June to July 2023 using the convenience sampling of patients with T2D, and the Patient Assessment of Chronic Illness Care (PACIC) and Medi-Lite questionnaires were administered. Results: During the research period, out of the 130 subjects who met all enrollment criteria, 103 patients were included in this study (79.23%). The results of the administered questionnaires were heterogeneous. The average scores from the PACIC Questionnaire for each question displayed significant variability, indicating a range of experiences in the quality of care. In the Medi-Lite survey, fruit, cereals, and olive oil showed the highest adherence levels, with mean scores ranging from 2.58 (SD ± 1.18) for fruit to 1.89 (SD ± 0.34) for olive oil and 1.97 (SD ± 0.17) for cereals. Patients who reported increased food intake during the lockdown attributed it to having more time to prepare meals. Physical activity levels remained unchanged for 48 patients, decreased for 45 patients, and only 9 patients managed to exercise more during the COVID-19 restrictions. Conclusions: Healthcare systems must prioritize comprehensive care plans for T2D that address not only physical health, but also emotional and social well-being. Post-pandemic, promoting healthier lifestyles and empowering patients to manage their condition is crucial. A multidisciplinary and multidimensional approach could support the care of vulnerable individuals, such as patients with T2D, especially during crises like pandemics or other dramatic events. Full article

The detrimental impacts of postprandial hyperglycemia on health are a critical concern, and exercise is recognized a pivotal tool in enhancing glycemic control after a meal. However, current exercise recommendations for managing postprandial glucose levels remain fairly broad and require deeper clarification. This review examines the existing literature aiming to offer a comprehensive guide for exercise prescription to optimize postprandial glycemic management. Specifically, it considers various exercise parameters (i.e., exercise timing, type, intensity, volume, pattern) for crafting exercise prescriptions. Findings predominantly indicate that moderate-intensity exercise initiated shortly after meals may substantially improve glucose response to a meal in healthy individuals and those with type 2 diabetes. Moreover, incorporating short activity breaks throughout the exercise session may provide additional benefits for reducing glucose response. Full article

Background. Bone Health and Osteoporosis Foundation (BHOF) reports that as of 2023, approximately 10 million of older Americans have osteoporosis and another 44 million have low bone density. Osteoporosis is a serious handicap for the elderly and, in particular, for estrogen-deficient postmenopausal women, as it increases the risk of debilitating bone weakness and fractures. The BHOF recommendations for prevention of osteopenia, osteoporosis and bone fractures are to perform weight-bearing and muscle-strengthening exercises and to take recommended amounts of daily calcium and vitamin D. Methods. The purpose of this review is to describe and discuss recent evidence-based research on how to effectively utilize timing of exercise and calorie intake for stimulation of postmenopausal bone anabolism, and to provide this new information in the form of specific and actionable recommendations. Results. The five evidence-based recommendations are as follows: 1. Select an appropriate circadian time of day for exercise; 2. Increase walking speed to raise the movement momentum; 3. Eat a weight-maintenance meal one or two hours before the exercise bout; 4. Sustain the duration of walking activity (impulse) for 40 to 45 min; and 5. Repeat effective exercise stimulus 7 to 8 h after the first one to double the anabolic effect. Osteogenesis can also be increased with subthreshold mechanical loading, where needed, under several special circumstances. Conclusions. This review should provide pragmatic actionable pointers on how to utilize the idiosyncratic bone responsiveness to timing of movement and meals to prevent osteoporosis and encourage research toward a better understanding of how bone detects adequacy of a mechanical stimulus and determines duration of necessary rest to recover its sensitivity to mechanical stimulation and nutrients. Full article

Older adults are vulnerable to undernutrition, resulting in weight loss and adverse health outcomes, including a loss of independence and a lower quality of life. Adequate protein intake is particularly important for the maintenance of muscle health during ageing. The UK population reference intake for protein (0.75 g/kg/day) may not be sufficient to counteract the reduced responsiveness of older skeletal muscle to anabolic stimulus. Research suggests that 1.2 g/kg/day of protein may be optimal, considering distribution (25–30 g/meal) and leucine-rich sources typically found in animal protein, especially for those at high nutritional risk. PROMED-EX is a randomised controlled trial testing a PROtein-enriched MEDiterranean Diet, with or without Exercise on nutritional status and memory, in older adults (60+) at risk of undernutrition, with subjective memory decline. The current aim is to determine the baseline nutritional adequacy of adults enrolled in PROMED-EX. Participants completed 4-day food diaries at baseline. Diaries were analysed for energy and nutrients using Nutritics. Nutritional adequacy was determined by comparing sex- and age-specific UK dietary reference values (DRVs). Protein intake was also compared to higher recommended DRVs for older adults. Fifty participants (60% female; age 67 ± 6.0 years; BMI: 23.5 ± 2.8 kg/m²) were included. Insufficient energy intake in men (1803.4 ± 510.7 kcal/d) and women (1776.2 ± 508.7 kcal/d)) in the sample, with 22.0% meeting the energy DRVs. The risk of nutrient inadequacy was highest for fibre and vitamin D, with almost all failing to meet the DRVs. Less than 50% met nutritional adequacy for vitamin A, iodine, iron, magnesium, potassium, and selenium. Over 35% had suboptimal intakes for selected B vitamins (niacin, folate) and calcium. Most (82%) of the sample achieved the UK protein target of 0.75 g/kg/day, with only 34% meeting the higher 1.2 g/kg/day target. The mean protein intake was less than optimal for breakfast (12.3 ± 7.0 g) and lunch (17.1 ± 8.8 g), accounting for 17.3% and 24.1% total daily protein intake, and highest at dinner time (48.2%) at 34.3 ± 18.3 g. The primary protein contributors were ‘cereals’ (15.7%), followed by ‘dairy’ (14.9%), ‘processed meat’ (10.9%), ‘poultry’ (10.8%), and ‘red meat’ (10.5%). Increasing protein intakes at breakfast and lunch alongside leucine-rich sources could help achieve the optimal protein intake. The nutrient-dense PROMED-EX intervention may be beneficial for this at- risk population with suboptimal nutrient intakes. Full article

Introduction: Dietary and physical activity interventions have beneficials health effects for people with type 2 diabetes (T2D). Although the effects of such interventions on long-term changes in glucose levels are well studied in a controlled setting, little is known about the acute effects of lifestyle interventions in a real-life setting and on an individual level. Quantifying the effects of lifestyle on metrics of continuously measured glucose and how these differ between individuals may allow for personalized lifestyle advice for people with T2D. Methods: Forty people with T2D were included in this study. Participants wore a continuous glucose monitor (CGM) for 11 periods of 4 days, of which 3 were control periods (habitual everyday life) and 8 were intervention periods (2× low carbohydrate diet, 2× Mediterranean diet, 2× walking after each meal, and 2× hourly exercise bouts of 5 minutes (‘active day’)). The CGM metrics used in the ambulatory glucose profile, an internationally recognized standard for interpreting glucose control, were calculated. We used a random effects model to quantify the effect of the four lifestyle interventions on CGM metrics with the participants as a random effect. Results: On overage, a low carbohydrate diet, walking after a meal, and an active day resulted in improved CGM metrics, including a lower mean glucose (−0.70, −0.34, and −0.25 mmol/L, respectively) and SD (−0.22, −0.05, and −0.02) and higher time in range (6.9, 3.5, and 3.2%, respectively), the latter being the average percentage of time per day spend in the target glucose range (3.9–10.0 mmol/L). Only the low carbohydrate diet had a positive effect on the coefficient of variation (−1.48), a measure of glucose variability. Also, the magnitude of the effects varied between the interventions. Surprisingly, the Mediterranean diet had adverse effects on all the calculated CGM metrics. Our next step is to investigate inter-individual variation in these intervention effects. Discussion: The low carbohydrate diet, walking after a meal, and active day intervention showed positive, but differential, effects on CGM metrics within 4 days, while the Mediterranean diet showed negative effects. Further analysis on inter-individual variation can be used for personalized lifestyle recommendations, for instance targeted at avoiding high glucose peaks, or reducing variability in glucose levels. Full article

The use of continuous glucose monitors (CGMs) in individuals living without diabetes is increasing. The purpose of this study was to profile various CGM metrics around nutritional intake, sleep and exercise in a large cohort of physically active men and women living without any known metabolic disease diagnosis to better understand the normative glycemic response to these common stimuli. A total of 12,504 physically active adults (age 40 ± 11 years, BMI 23.8 ± 3.6 kg/m²; 23% self-identified as women) wore a real-time CGM (Abbott Libre Sense Sport Glucose Biosensor, Abbott, USA) and used a smartphone application (Supersapiens Inc., Atlanta, GA, USA) to log meals, sleep and exercise activities. A total of >1 M exercise events and 274,344 meal events were analyzed. A majority of participants (85%) presented an overall (24 h) average glucose profile between 90 and 110 mg/dL, with the highest glucose levels associated with meals and exercise and the lowest glucose levels associated with sleep. Men had higher mean 24 h glucose levels than women (24 h—men: 100 ± 11 mg/dL, women: 96 ± 10 mg/dL). During exercise, the % time above >140 mg/dL was 10.3 ± 16.7%, while the % time <70 mg/dL was 11.9 ± 11.6%, with the remaining % within the so-called glycemic tight target range (70–140 mg/dL). Average glycemia was also lower for females during exercise and sleep events (p < 0.001). Overall, we see small differences in glucose trends during activity and sleep in females as compared to males and higher levels of both TAR and TBR when these active individuals are undertaking or competing in endurance exercise training and/or competitive events. Full article

During a men’s decathlon, a combined event conducted over two consecutive days, fluctuations in blood glucose were measured using flash glucose monitoring. Because decathletes repeatedly intake and exercise, high and low blood glucose levels are observed, but the actual conditions have not yet been clarified. Low blood glucose levels (<80 mg/dL) were observed in nine athletes, while high blood glucose levels (>139 mg/dL) were observed in all athletes at least once during the competition days. Furthermore, low blood glucose levels were observed in nine athletes at least once during and after intake (“intake” refers to consuming energy-containing food and beverages). Additionally, high blood glucose levels were observed in nine athletes at least once during and after intake. Five athletes had low blood glucose during competing time. It was suggested that even if they had eaten a meal just prior to the competition, their intake was likely insufficient for their energy expenditure. A significant positive correlation was found between the mean blood glucose level and the number of intakes on competition days. It is believed that meals may have had a strong influence on blood glucose, even on competition days with a high frequency of eating and exercise for the decathlon. Full article

A high prevalence of both squamous (ESGD) and glandular (EGGD) ulcers was previously found in, mainly young, Icelandic horses coming into training for the first time. This study evaluated risk factors for gastric ulcers in Icelandic riding horses at various ages and stages of training. The horses (n = 211) were gastroscoped from 21 equine establishments across Iceland. A variety of morphometric, clinical, behavioural and management factors were evaluated as potential risk factors for gastroscopically significant (grade ≥ 2/4: found in 27% of horses) or gastroscopically severe (grade 3 or 4/4: found in ~10% of horses) ESGD or gastroscopically significant EGGD (grade ≥ 1/2: found in 46.4%). Body condition score (BCS), cresty neck score (CNS), stable/turnout behaviour, exercise intensity/frequency and age were not significantly associated with ESGD or EGGD ulcer score. However, having come off the pasture into training for 4 weeks or less was a significant risk factor for gastroscopically significant and severe ESGD compared to 5 weeks or more. For both EGGD and ESGD, “region” was important. Gastroscopically significant EGGD and gastroscopically severe ESGD were more prevalent in those showing clinical signs often associated with ulcers. Geldings were more likely to have gastroscopically significant ESGD than both mares and stallions and more EGGD than stallions. Being stabled, but spending >2 h/day out in the paddock, compared with <2 h paddock time or full-time turnout, was protective for gastroscopically significant ESGD as was being fed complementary feed (all fed <1 g non-structural carbohydrate (NSC)/kg/BW/meal). Being at a training establishment for >4 weeks was protective for gastroscopically significant and gastroscopically severe ESGD but not EGGD. This study confirms the relatively low prevalence of ESGD in Icelandic horses being kept in training establishments and fed low NSC diets but highlights the high prevalence of EGGD. Full article

Studies investigating the acute effect of postprandial exercise (PPE) on glucose responses exhibit significant heterogeneity in terms of participant demographic, exercise protocol, and exercise timing post-meal. As such, this study aimed to further analyze the existing literature on the impact of PPE on glycemic control in overweight individuals and individuals with obesity and type 2 diabetes (T2DM). A literature search was conducted through databases such as PubMed, CINAHL, and Google Scholar. Thirty-one original research studies that met the inclusion criteria were selected. A random-effect meta-analysis was performed to compare postprandial glucose area under the curve (AUC) and 24 h mean glucose levels between PPE and the time-matched no-exercise control (CON). Subgroup analyses were conducted to explore whether the glucose-lowering effect of PPE could be influenced by exercise duration, exercise timing post-meal, and the disease status of participants. This study revealed a significantly reduced glucose AUC (Hedges’ g = −0.317; SE = 0.057; p < 0.05) and 24 h mean glucose levels (Hedges’ g = −0.328; SE = 0.062; p < 0.05) following PPE compared to CON. The reduction in glucose AUC was greater (p < 0.05) following PPE lasting >30 min compared to ≤30 min. The reduction in 24 h mean glucose levels was also greater (p < 0.05) following PPE for ≥60 min compared to <60 min post-meal and in those with T2DM compared to those without T2DM. PPE offers a viable approach for glucose management and can be performed in various forms so long as exercise duration is sufficient. The glucose-lowering effect of PPE may be further enhanced by initiating it after the first hour post-meal. PPE is a promising strategy, particularly for patients with T2DM. This manuscript is registered with Research Registry (UIN: reviewregistry1693). Full article