DE-PASS best evidence statement (BESt): determinants of adolescents' device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis.

BACKGROUND: Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents' device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings. METHODS: A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents' device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874. RESULTS: Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual-psychological, four individual-behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. CONCLUSIONS: Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents' device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents' PA/SB, including policy and environmental variables.

Fluid and electrolyte balance following consumption of skimmed milk and a plant-based soya beverage at rest in euhydrated males.

PURPOSE: Cow's milk is one of the most hydrating beverages, but many individuals choose not to consume dairy in their diet due to intolerance, allergy, or dietary preference. Milk is commonly replaced with plant-based beverages, including soya which has the most comparable protein content, but little is known about their hydration potential. This study compared fluid and electrolyte balance responses between a soya beverage and skimmed cow's milk. METHODS: Ten healthy males [age 27 (6) y; body mass index 24.6 (2.3) kg/m2] completed two randomised counterbalanced trials, involving consuming 1000 mL water from approximately isocaloric amounts of skimmed cow's milk (MILK) or a sweetened soya beverage (SOYA), in four aliquots over 30 min in a euhydrated fasted state. Volume, specific gravity, and electrolyte (sodium, potassium, chloride) concentrations were determined in total-void urine samples collected pre-/post-beverage ingestion, and hourly for 180 min thereafter. Hunger, thirst, nausea and stomach fullness were rated proximal to urine samples. RESULTS: Total urine mass (MILK, 986 ± 254 g; SOYA, 950 ± 248 g; P = 0.435) and urine specific gravity (P = 0.156) did not differ between trials. Potassium balance was greater in SOYA 0-180 min post-beverage (P ≤ 0.013), whilst chloride balance was greater in MILK 0-120 min post-beverage (P ≤ 0.036). Sodium balance (P = 0.258), total electrolyte balance (P = 0.258), and subjective measures (P ≥ 0.139) were not different between trials. CONCLUSION: Replacing cow's milk with a soya beverage did not negatively impact fluid balance in healthy young males, making it a viable option for those who choose not to consume dairy in their diet.

Investigation into the transition to online learning due to the COVID-19 pandemic, between new and continuing undergraduate students.

Higher Education Institutions (HEIs) were required to rapidly respond to the COVID-19 pandemic, integrating online and blended learning approaches to sustain teaching and learning provision. However, limited evidence exists to understand the student experience and perception of the various methods of online learning, in particular across different levels of study (new and continuing students). Therefore, the aim of this study was to compare the experiences of online learning transition, between new first year undergraduate students and continuing second and third year students, enrolled on various undergraduate sport programmes. A total of 182 students responded to an online survey, which investigated the students' perceptions of online learning approaches. Participants were split according to level of study; [Level 3 (Foundation Year) and 4 (First Year Undergraduate) combined N = 62, Level 5 (Second Year Undergraduate), N = 51 and Level 6 (Third Year Undergraduate), N = 69]. Key findings highlight that both new and continuing students had an overall negative perception of online learning but did acknowledge that online learning provided a more flexible approach to their overall learning experience compared to face-to-face. Face-to-face teaching was deemed more engaging and sociable, in particular for the practical aspects of the programmes. Overall, there were no significant differences between the different levels of study for any of the questions asked. Although continuing students raised the difficulties of conducting practical sessions online, whereas this was not mentioned by new students. To conclude, this study provides novel insights into the experience of new and continuing students, and we advise that future blended learning strategies should consider the programme as a whole, rather than tailoring pedagogic strategies based on the level of study.

The potential nutrition-, physical- and health-related benefits of cow's milk for primary-school-aged children.

Cow's milk is a naturally nutrient-dense foodstuff. A significant source of many essential nutrients, its inclusion as a component of a healthy balanced diet has been long recommended. Beyond milk's nutritional value, an increasing body of evidence illustrates cow's milk may confer numerous benefits related to health. Evidence from adult populations suggests that cow's milk may have a role in overall dietary quality, appetite control, hydration and cognitive function. Although evidence is limited compared with the adult literature, these benefits may be echoed in recent paediatric studies. This article, therefore, reviews the scientific literature to provide an evidence-based evaluation of the associated health benefits of cow's milk consumption in primary-school-aged children (4-11 years). We focus on seven key areas related to nutrition and health comprising nutritional status, hydration, dental and bone health, physical stature, cognitive function, and appetite control. The evidence consistently demonstrates cow's milk (plain and flavoured) improves nutritional status in primary-school-aged children. With some confidence, cow's milk also appears beneficial for hydration, dental and bone health and beneficial to neutral concerning physical stature and appetite. Due to conflicting studies, reaching a conclusion has proven difficult concerning cow's milk and cognitive function; therefore, a level of caution should be exercised when interpreting these results. All areas, however, would benefit from further robust investigation, especially in free-living school settings, to verify conclusions. Nonetheless, when the nutritional-, physical- and health-related impact of cow's milk avoidance is considered, the evidence highlights the importance of increasing cow's milk consumption.

Cow's milk as a post-exercise recovery drink: implications for performance and health.

Post-exercise recovery is a multi-facetted process that will vary depending on the nature of the exercise, the time between exercise sessions and the goals of the exerciser. From a nutritional perspective, the main considerations are: (1) optimisation of muscle protein turnover; (2) glycogen resynthesis; (3) rehydration; (4) management of muscle soreness; (5) appropriate management of energy balance. Milk is approximately isotonic (osmolality of 280-290 mosmol/kg), and the mixture of high quality protein, carbohydrate, water and micronutrients (particularly sodium) make it uniquely suitable as a post-exercise recovery drink in many exercise scenarios. Research has shown that ingestion of milk post-exercise has the potential to beneficially impact both acute recovery and chronic training adaptation. Milk augments post-exercise muscle protein synthesis and rehydration, can contribute to post-exercise glycogen resynthesis, and attenuates post-exercise muscle soreness/function losses. For these aspects of recovery, milk is at least comparable and often out performs most commercially available recovery drinks, but is available at a fraction of the cost, making it a cheap and easy option to facilitate post-exercise recovery. Milk ingestion post-exercise has also been shown to attenuate subsequent energy intake and may lead to more favourable body composition changes with exercise training. This means that those exercising for weight management purposes might be able to beneficially influence post-exercise recovery, whilst maintaining the energy deficit created by exercise.

Effect of supplemental whey protein timing on postprandial glycaemia in centrally obese males.

Consuming whey protein before a meal may reduce postprandial glucose excursions, however, optimising timing of supplementation is important to improve its clinical utility. A total of thirteen centrally obese, insulin-resistant males (waist circumference: 121 (sem 3) cm; homeostasis model assessment for insulin resistance (HOMA-IR): 6·4 (sem 1·2)) completed four experimental conditions in a single-blind, crossover design. Participants consumed mixed-macronutrient breakfast and lunch meals on all occasions, with 20 g whey protein consumed 15 min before (PRE), alongside (DUR) or 15 min post-breakfast (POST) or omitted (CON). Capillary glucose and plasma concentrations of insulin, TAG and NEFA, in addition to subjective appetite ratings, were collected for 180 min after each meal. PRE and DUR reduced post-breakfast glucose peak by 17·0 (sem 1·9) % (P<0·001) and 9·2 (sem 2·9) % (P=0·046), respectively, compared with CON. Post-breakfast glucose AUC was lower following PRE compared with POST and CON (PRE: 982 (sem 30) v. POST: 1031 (sem 36) and CON: 1065 (sem 37) mmol/l×180 min; P≤0·042) but similar to DUR (1013 (sem 32) mmol/l×180 min; P=0·77). Insulin was lower during PRE, when compared with POST and DUR (both P≤0·042) but similar to CON. There were no between-condition differences in measures of postprandial lipaemia or appetite, and no effect of condition post-lunch. Consumption of whey protein as a preload or alongside a mixed-macronutrient breakfast reduces postprandial glucose excursions in centrally obese, insulin-resistant males. Whey consumed as a preload has superior glycaemic-lowering effects. Supplementation at breakfast does not alter glycaemic responses to subsequent meals.

Whey protein consumption after resistance exercise reduces energy intake at a post-exercise meal.

PURPOSE: Protein consumption after resistance exercise potentiates muscle protein synthesis, but its effects on subsequent appetite in this context are unknown. This study examined appetite and energy intake following consumption of protein- and carbohydrate-containing drinks after resistance exercise. METHODS: After familiarisation, 15 resistance training males (age 21 ± 1 years, body mass 78.0 ± 11.9 kg, stature 1.78 ± 0.07 m) completed two randomised, double-blind trials, consisting of lower-body resistance exercise, followed by consumption of a whey protein (PRO 23.9 ± 3.6 g protein) or dextrose (CHO 26.5 ± 3.8 g carbohydrate) drink in the 5 min post-exercise. An ad libitum meal was served 60 min later, with subjective appetite measured throughout. Drinks were flavoured and matched for energy content and volume. The PRO drink provided 0.3 g/kg body mass protein. RESULTS: Ad libitum energy intake (PRO 3742 ± 994 kJ; CHO 4172 ± 1132 kJ; P = 0.007) and mean eating rate (PRO 339 ± 102 kJ/min; CHO 405 ± 154 kJ/min; P = 0.009) were lower during PRO. The change in eating rate was associated with the change in energy intake (R = 0.661, P = 0.007). No interaction effects were observed for subjective measures of appetite. The PRO drink was perceived as creamier and thicker, and less pleasant, sweet and refreshing (P < 0.05). CONCLUSION: These results suggest whey protein consumption after resistance exercise reduces subsequent energy intake, and this might be partially mediated by a reduced eating rate. Whilst this reduced energy intake is unlikely to impair hypertrophy, it may be of value in supporting an energy deficit for weight loss.

The effects of an increased calorie breakfast consumed prior to simulated match-play in Academy soccer players.

Dietary analysis of Academy soccer players highlights that total energy and carbohydrate intakes are less than optimal, especially, on match-days. As UK Academy matches predominantly kick-off at ∼11:00 h, breakfast is likely the last pre-exercise meal and thus may provide an intervention opportunity on match-day. Accordingly, the physiological and performance effects of an increased calorie breakfast consumed ∼135-min before soccer-specific exercise was investigated. English Premier League Academy soccer players (n = 7) repeated a 90-min soccer match simulation on two occasions after consumption of habitual (Bhab; ∼1100 kJ) or increased (Binc; ∼2100 kJ) energy breakfasts standardised for macronutrient contributions (∼60% carbohydrates, ∼15% proteins and ∼25% fats). Countermovement jump height, sprint velocities (15-m and 30-m), 30-m repeated sprint maintenance, gut fullness, abdominal discomfort and soccer dribbling performances were measured. Blood samples were taken at rest, pre-exercise, half-time and every 15-min during exercise. Although dribbling precision (P = .522; 29.9 ± 5.5 cm) and success (P = .505; 94 ± 8%) were unchanged throughout all time-points, mean dribbling speed was faster (4.3 ± 5.7%) in Binc relative to Bhab (P = .023; 2.84 vs 2.75 m s-1). Greater feelings of gut fullness (67 ± 17%, P = .001) were observed in Binc without changes in abdominal discomfort (P = .595). All other physical performance measures and blood lactate and glucose concentrations were comparable between trials (all P > .05). Findings demonstrate that Academy soccer players were able to increase pre-match energy intake without experiencing abdominal discomfort; thus, likely contributing to the amelioration of energy deficits on match-days. Furthermore, whilst Binc produced limited benefits to physical performance, increased dribbling speed was identified, which may be of benefit to match-play.

Metabolic, endocrine and appetite-related responses to acute and daily milk snack consumption in healthy, adolescent males.

Comprising of two experiments, this study assessed the metabolic, endocrine and appetite-related responses to acute and chronic milk consumption in adolescent males (15-18 y). Eleven adolescents [mean ± SD age: 16.5 ± 0.9 y; BMI: 23.3 ± 3.3 kg/m2] participated in the acute experiment and completed two laboratory visits (milk vs. fruit-juice) in a randomized crossover design, separated by 7-d. Seventeen adolescents [age: 16.1 ± 0.9 y; BMI: 21.8 ± 3.7 kg/m2] completed the chronic experiment. For the chronic experiment, a parallel design with two groups was used. Participants were randomly allocated and consumed milk (n = 9) or fruit-juice (n = 8) for 28-d, completing laboratory visits on the first (baseline, day-0) and last day (follow-up, day-28) of the intervention phase. On laboratory visits (for both experiments), measures of appetite, metabolism and endocrine responses were assessed at regular intervals. In addition, eating behavior was quantified by ad libitum assessment under laboratory conditions and in the free-living environment by weighed food record. Acute milk intake stimulated glucagon (P = 0.027 [16.8 pg mL; 95% CI: 2.4, 31.3]) and reduced ad libitum energy intake relative to fruit-juice (P = 0.048 [-651.3 kJ; 95% CI: -1294.1, -8.6]), but was comparable in the free-living environment. Chronic milk intake reduced free-living energy intake at the follow-up visit compared to baseline (P = 0.013 [-1910.9 kJ; 95% CI: -554.6, -3267.2]), whereas the opposite was apparent for fruit-juice. Relative to baseline, chronic milk intake increased the insulin response to both breakfast (P = 0.031) and mid-morning milk consumption (P = 0.050) whilst attenuating blood glucose (P = 0.025). Together, these findings suggest milk consumption impacts favorably on eating behavior in adolescent males, potentially through integrated endocrine responses.

The between-day reproducibility of fasting, satiety-related analytes, in 8 to 11year-old boys.

The aim of the present study was to establish the between-day reproducibility of fasting plasma GLP-17-36, glucagon, leptin, insulin and glucose, in lean and overweight/obese 8-11year-old boys. A within-group study design was utilised wherein the boys attended two study days, separated by 1week, where a fasting fingertip capillary blood sample was obtained. Deming regression, mean difference, Bland-Altman limits of agreement (LOA) and typical imprecision as a percentage coefficient of variation (CV %), were utilised to assess reproducibility between-days. On a group level, Deming regression detected no evidence of systematic or proportional bias between-days for all of the satiety-related analytes however, only glucose and plasma GLP-17-36 displayed low typical and random imprecision. When analysed according to body composition, good reproducibility was maintained for glucose in the overweight/obese boys and for plasma GLP-17-36, in those with lean body mass. The present findings demonstrate that the measurement of glucose and plasma GLP-17-36 by fingertip capillary sampling on a group level, is reproducible between-days, in 8-11year-old boys. Comparison of blood glucose obtained by fingertip capillary sampling can be made between lean and overweight/obese 8-11year-old boys. Presently, the comparison of fasting plasma GLP-17-36 according to body weight is inappropriate due to high imprecision observed in lean boys between-days. The use of fingertip capillary sampling in the measurement of satiety-related analytes has the potential to provide a better understanding of mechanisms that affect appetite and feeding behaviour in children.

The Effect of a Dairy-Based Recovery Beverage on Post-Exercise Appetite and Energy Intake in Active Females.

This study was designed to assess the effect of a dairy-based recovery beverage on post-exercise appetite and energy intake in active females. Thirteen active females completed three trials in a crossover design. Participants completed 60 min of cycling at 65% V̇O2peak, before a 120 min recovery period. On completion of cycling, participants consumed a commercially available dairy-based beverage (DBB), a commercially available carbohydrate beverage (CHO), or a water control (H2O). Non-esterified fatty acids, glucose, and appetite-related peptides alongside measures of subjective appetite were sampled at baseline and at 30 min intervals during recovery. At 120 min, energy intake was assessed in the laboratory by ad libitum assessment, and in the free-living environment by weighed food record for the remainder of the study day. Energy intake at the ad libitum lunch was lower after DBB compared to H2O (4.43 ± 0.20, 5.58 ± 0.41 MJ, respectively; p = 0.046; (95% CI: -2.28, -0.20 MJ)), but was not different to CHO (5.21 ± 0.46 MJ), with no difference between trials thereafter. Insulin and GLP-17-36 were higher following DBB compared to H2O (p = 0.015 and p = 0.001, respectively) but not to CHO (p = 1.00 and p = 0.146, respectively). In addition, glucagon was higher following DBB compared to CHO (p = 0.008) but not to H2O (p = 0.074). The results demonstrate that where DBB consumption may manifest in accelerated recovery, this may be possible without significantly affecting total energy intake and subsequent appetite-related responses relative to a CHO beverage.

Co-Ingestion of Whey Protein with a Carbohydrate-Rich Breakfast Does Not Affect Glycemia, Insulinemia or Subjective Appetite Following a Subsequent Meal in Healthy Males.

We aimed to assess postprandial metabolic and appetite responses to a mixed-macronutrient lunch following prior addition of whey protein to a carbohydrate-rich breakfast. Ten healthy males (age: 24 ± 1 years; body mass index (BMI): 24.5 ± 0.7 kg/m²) completed three trials in a non-isocaloric, crossover design. A carbohydrate-rich breakfast (93 g carbohydrate; 1799 kJ) was consumed with (CHO + WP) or without (CHO) 20 g whey protein isolate (373 kJ), or breakfast was omitted (NB). At 180 min, participants consumed a mixed-macronutrient lunch meal. Venous blood was sampled at 15 min intervals following each meal and every 30 min thereafter, while subjective appetite sensations were collected every 30 min throughout. Post-breakfast insulinemia was greater after CHO + WP (time-averaged area under the curve (AUC0--180 min): 193.1 ± 26.3 pmol/L), compared to CHO (154.7 ± 18.5 pmol/L) and NB (46.1 ± 8.0 pmol/L; p < 0.05), with no difference in post-breakfast (0-180 min) glycemia (CHO + WP, 3.8 ± 0.2 mmol/L; CHO, 4.2 ± 0.2 mmol/L; NB, 4.2 ± 0.1 mmol/L; p = 0.247). There were no post-lunch (0-180 min) effects of condition on glycemia (p = 0.492), insulinemia (p = 0.338) or subjective appetite (p > 0.05). Adding whey protein to a carbohydrate-rich breakfast enhanced the acute postprandial insulin response, without influencing metabolic or appetite responses following a subsequent mixed-macronutrient meal.

Comparison of short-term energy intake and appetite responses to active and seated video gaming, in 8-11-year-old boys.

The acute effects of active and seated video gaming on energy intake (EI), blood glucose, plasma glucagon-like peptide-1 (GLP-17-36) and subjective appetite (hunger, prospective food consumption and fullness) were examined in 8-11-year-old boys. In a randomised, crossover manner, twenty-two boys completed one 90-min active and one 90-min seated video gaming trial during which food and drinks were provided ad libitum. EI, plasma GLP-17-36, blood glucose and subjective appetite were measured during and following both trials. Time-averaged AUC blood glucose was increased (P=0·037); however, EI was lower during active video gaming (1·63 (sem 0·26) MJ) compared with seated video gaming (2·65 (sem 0·32) MJ) (P=0·000). In a post-gaming test meal 1 h later, there were no significant differences in EI between the active and seated gaming trials. Although estimated energy expenditure was significantly higher during active video gaming, there was still no compensation for the lower EI. At cessation of the trials, relative EI (REI) was significantly lower following active video gaming (2·06 (sem 0·30) MJ) v. seated video gaming (3·34 (sem 0·35) MJ) (P=0·000). No significant differences were detected in time-averaged AUC GLP-17-36 or subjective appetite. At cessation of the active video gaming trial, EI and REI were significantly less than for seated video gaming. In spite of this, the REI established for active video gaming was a considerable amount when considering the total daily estimated average requirement for 8-11-year-old boys in the UK (7·70 MJ).

Acute effects of active gaming on ad libitum energy intake and appetite sensations of 8-11-year-old boys.

The present study examined the acute effects of active gaming on energy intake (EI) and appetite responses in 8-11-year-old boys in a school-based setting. Using a randomised cross-over design, twenty-one boys completed four individual 90-min gaming bouts, each separated by 1 week. The gaming bouts were (1) seated gaming, no food or drink; (2) active gaming, no food or drink; (3) seated gaming with food and drink offered ad libitum; and (4) active gaming with food and drink offered ad libitum. In the two gaming bouts during which foods and drinks were offered, EI was measured. Appetite sensations - hunger, prospective food consumption and fullness - were recorded using visual analogue scales during all gaming bouts at 30-min intervals and at two 15-min intervals post gaming. In the two bouts with food and drink, no significant differences were found in acute EI (MJ) (P=0·238). Significant differences were detected in appetite sensations for hunger, prospective food consumption and fullness between the four gaming bouts at various time points. The relative EI calculated for the two gaming bouts with food and drink (active gaming 1·42 (sem 0·28) MJ; seated gaming 2·12 (sem 0·25) MJ) was not statistically different. Acute EI in response to active gaming was no different from seated gaming, and appetite sensations were influenced by whether food was made available during the 90-min gaming bouts.

Assessment of Energy Intake and Energy Expenditure of Male Adolescent Academy-Level Soccer Players during a Competitive Week.

This study investigated the energy intake and expenditure of professional adolescent academy-level soccer players during a competitive week. Over a seven day period that included four training days, two rest days and a match day, energy intake (self-reported weighed food diary and 24-h recall) and expenditure (tri-axial accelerometry) were recorded in 10 male players from a professional English Premier League club. The mean macronutrient composition of the dietary intake was 318 ± 24 g·day(-1) (5.6 ± 0.4 g·kg(-1) BM) carbohydrate, 86 ± 10 g·day(-1) (1.5 ± 0.2 g·kg(-1) BM) protein and 70 ± 7 g·day(-1) (1.2 ± 0.1 g·kg(-1) BM) fats, representing 55% ± 3%, 16% ± 1%, and 29% ± 2% of mean daily energy intake respectively. A mean daily energy deficit of -1302 ± 1662 kJ (p = 0.035) was observed between energy intake (9395 ± 1344 kJ) and energy expenditure (10679 ± 1026 kJ). Match days (-2278 ± 2307 kJ, p = 0.012) and heavy training days (-2114 ± 2257 kJ, p = 0.016) elicited the greatest deficits between intake and expenditure. In conclusion, the mean daily energy intake of professional adolescent academy-level soccer players was lower than the energy expended during a competitive week. The magnitudes of these deficits were greatest on match and heavy training days. These findings may have both short and long term implications on the performance and physical development of adolescent soccer players.

Agreement between Two Methods of Dietary Data Collection in Male Adolescent Academy-Level Soccer Players.

Collecting accurate and reliable nutritional data from adolescent populations is challenging, with current methods providing significant under-reporting. Therefore, the aim of the study was to determine the accuracy of a combined dietary data collection method (self-reported weighed food diary, supplemented with a 24-h recall) when compared to researcher observed energy intake in male adolescent soccer players. Twelve Academy players from an English Football League club participated in the study. Players attended a 12 h period in the laboratory (08:00 h-20:00 h), during which food and drink items were available and were consumed ad libitum. Food was also provided to consume at home between 20:00 h and 08:00 h the following morning under free-living conditions. To calculate the participant reported energy intake, food and drink items were weighed and recorded in a food diary by each participant, which was supplemented with information provided through a 24-h recall interview the following morning. Linear regression, limits of agreement (LOA) and typical error (coefficient of variation; CV) were used to quantify agreement between observer and participant reported 24-h energy intake. Difference between methods was assessed using a paired samples t-test. Participants systematically under-reported energy intake in comparison to that observed (p < 0.01) but the magnitude of this bias was small and consistent (mean bias = -88 kcal·day(-1), 95% CI for bias = -146 to -29 kcal·day(-1)). For random error, the 95% LOA between methods ranged between -1.11 to 0.37 MJ·day(-1) (-256 to 88 kcal·day(-1)). The standard error of the estimate was low, with a typical error between measurements of 3.1%. These data suggest that the combined dietary data collection method could be used interchangeably with the gold standard observed food intake technique in the population studied providing that appropriate adjustment is made for the systematic under-reporting common to such methods.

Short communication: Patterns of dairy consumption in free-living children and adolescents.

According to national survey data, dairy food consumption has fallen in recent years and declines further with age, especially from childhood to adolescence. Dietary surveys typically rely on retrospective dietary assessment methods and use broad age groupings (4-10 yr; 11-18 yr), making it challenging to differentiate between middle-childhood and adolescence. Consequently, there is a need to assess dairy food consumption during middle-childhood and adolescence using more robust dietary assessment tools. Therefore, the present study aimed to describe and compare patterns of dairy consumption throughout middle-childhood and adolescence. Dairy food consumption was assessed during school term-time over 4 consecutive days, including 2 weekdays and 2 weekend days, in a sample of free-living children (9-11 yr, n=40) and adolescents (15-18 yr, n=35). For children, free-living dairy intake was evaluated through parental-weighed food records, and for adolescents, a combined weighed self-reported food record and 24-h dietary recall technique was utilized. Food records were explored to determine types, amounts, and frequency of dairy food consumption, and were analyzed for differences between middle-childhood and adolescence using a between group 2×2 (age×sex) ANOVA. Descriptive data suggested that milk was the most popular dairy product consumed by both children and adolescents. Statistical analysis revealed a main effect for sex on total milk consumption (mL) and number of daily milk portions consumed. No interaction or main effect was present for any other variable. The present study indicates that independent of age, boys consumed greater amounts of milk compared with girls. Contrary to existing literature, findings suggest no difference in milk-based dairy consumption between middle-childhood and adolescence.

Calcium ingestion suppresses appetite and produces acute overcompensation of energy intake independent of protein in healthy adults.

BACKGROUND: Prior evidence suggests that high-calcium intake influences postprandial appetite and insulinemia, possibly due to elevated incretins. In vitro and ex vivo models demonstrate that extracellular calcium and protein synergistically enhance secretion of incretins. This is yet to be shown in humans. OBJECTIVE: This study was designed to assess energy intake compensation in response to protein and calcium ingestion. METHODS: Twenty healthy adults (13 men; 7 women) completed 4 trials in a randomized, double-blind crossover design separated by ≥48 h. During the trials, each participant consumed a low-calcium and low-protein control preload [(CON); 4 g and 104 mg, respectively], a high-protein preload (PRO; 29 g), a high-calcium preload (CAL; 1170 mg), or a high-protein and high-calcium preload (PROCAL). Blood samples were collected at baseline and 15, 30, 45, and 60 min after preload ingestion to determine insulin and incretin hormone concentrations. Energy intake was assessed by a homogenous test meal 60 min after the preload. Visual analog scales were completed immediately before blood sampling to assess subjective appetite sensations. RESULTS: Relative to the CON, the PRO produced 100% (95% CI: 85%, 115%) energy compensation, whereas the CAL produced significant overcompensation [118% (95% CI: 104%, 133%)], which was significantly more positive than with the PRO (P < 0.05). The PROCAL resulted in energy compensation of 109% (95% CI: 95%, 123%), which tended to be greater than with the PRO (P = 0.06). The mean difference in appetite sensations relative to the CON was not significantly different between the PRO (-3 mm; 95% CI: -8, 3 mm), CAL (-5 mm; 95% CI: -9, 0 mm), and PROCAL (-5 mm; 95% CI: -10, -1 mm) (P > 0.05). CONCLUSIONS: The addition of protein to a preload results in almost perfect energy compensation, whereas the addition of calcium, with or without protein, suppresses appetite and produces overcompensation of subsequent energy intake. The role of circulating insulin and incretin concentrations in these responses, however, remains unclear. This trial was registered at clinicaltrials.gov as NCT01986036.

Comparison of appetite responses to high- and low-glycemic index postexercise meals under matched insulinemia and fiber in type 1 diabetes.

BACKGROUND: Patients with type 1 diabetes face heightened risk of hypoglycemia after exercise. Subsequent overfeeding, as a preventative measure against hypoglycemia, negates the energy deficit after exercise. Patients are also required to reduce the insulin dose administered with postexercise foods to further combat hypoglycemia. However, the insulin dose is dictated solely by the carbohydrate content, even though postprandial glycemia is vastly influenced by glycemic index (GI). With a need to control the postexercise energy balance, appetite responses after meals differing in GI are of particular interest. OBJECTIVES: We assessed the appetite response to low-glycemic index (LGI) and high-glycemic index (HGI) postexercise meals in type 1 diabetes patients. This assessment also offered us the opportunity to evaluate the influence of GI on appetite responses independently of insulinemia, which confounds findings in individuals without diabetes. DESIGN: Ten physically active men with type 1 diabetes completed 2 trials in a randomized crossover design. After 45 min of treadmill exercise at 70% of the peak oxygen uptake, participants consumed an LGI (GI ∼37) or HGI (GI ∼92) meal with a matched macronutrient composition, negligible fiber content, and standardized insulin-dose administration. The postprandial appetite response was determined for 180 min postmeal. During this time, circulating glucose, insulin, glucagon, and glucagon-like peptide-1 (GLP-1) concentrations and subjective appetite ratings were determined. RESULTS: The HGI meal produced an ∼60% greater postprandial glucose area under the curve (AUC) than did the LGI meal (P = 0.008). Insulin, glucagon, and GLP-1 did not significantly differ between trials (P > 0.05). The fullness AUC was ∼25% greater after the HGI meal than after the LGI meal (P < 0.001), whereas hunger sensations were ∼9% lower after the HGI meal than after the LGI meal (P = 0.001). CONCLUSION: Under conditions of matched insulinemia and fiber, an HGI postexercise meal suppresses feelings of hunger and augments postprandial fullness sensations more so than an otherwise equivalent LGI meal in type 1 diabetes patients.

Milk consumption following exercise reduces subsequent energy intake in female recreational exercisers.

The aim of this study was to evaluate the effects of skimmed milk as a recovery drink following moderate-vigorous cycling exercise on subsequent appetite and energy intake in healthy, female recreational exercisers. Utilising a randomised cross-over design, nine female recreational exercisers (19.7 ± 1.3 years) completed a V̇O2peak test followed by two main exercise trials. The main trials were conducted following a standardised breakfast. Following 30 min of moderate-vigorous exercise (65% V̇O2peak), either 600 mL of skimmed milk or 600 mL of orange drink (475 mL orange juice from concentrate, 125 mL water), which were isoenergetic (0.88 MJ), were ingested, followed 60 min later with an ad libitum pasta meal. Absolute energy intake was reduced 25.2% ± 16.6% after consuming milk compared to the orange drink (2.39 ± 0.70 vs. 3.20 ± 0.84 MJ, respectively; p = 0.001). Relative energy intake (in relation to the energy content of the recovery drinks and energy expenditure) was significantly lower after milk consumption compared to the orange drink (1.49 ± 0.72 vs. 2.33 ± 0.90 MJ, respectively; p = 0.005). There were no differences in AUC (× 1 h) subjective appetite parameters (hunger, fullness and desire to eat) between trials. The consumption of skimmed milk following 30 min of moderate-vigorous cycling exercise reduces subsequent energy intake in female recreational exercisers.