The effects of acute exercise on food intake and appetite in adolescents with and without obesity: A systematic review and meta-analysis.

This systematic review and meta-analysis synthesized evidence pertaining to consummatory and appetitive responses to acute exercise in children and adolescents with and without obesity (5-18 years). Articles reporting on supervised, controlled trials of any modality, duration, or intensity with laboratory-measured food intake were found using MEDLINE, EMBASE, and Cochrane up to July 2023. Differences between conditions in laboratory energy and macronutrient intake, appetite sensations, and food reward were quantitatively synthesized using random-effects meta-analyses. Thirty-five studies were eligible for the systematic review of energy intake, consisting of 60 distinct intervention arms with lean (n = 374) and overweight/obesity participants (n = 325; k = 51 eligible for meta-analysis). Study quality as indicated by the Effective Public Healthy Practice Project tool was rated as low and moderate risk of bias for 80% and 20% of studies, respectively. Acute exercise had no significant effect on energy intake during an ad libitum test meal (mean difference [MD] = -4.52 [-30.58, 21.54] kcal, p = .729). Whilst absolute carbohydrate intake was lower after exercise (23 arms; MD = -6.08 [-11.26, -0.91] g, p = .023), the proportion of carbohydrate was not (30 arms; MD = -0.62 [-3.36, 2.12] %, p = .647). A small elevation in hunger (27 arms; MD = 4.56 [0.75, 8.37] mm, p = .021) and prospective food consumption (27 arms; PFC; MD = 5.71 [1.62, 9.80] mm, p = .008) was observed post-exercise, but not immediately prior to the test meal (Interval: Mdn = 30 min, Range = 0-180). Conversely, a modest decrease in explicit wanting for high-fat foods was evident after exercise (10 arms; MD = -2.22 [-3.96, -0.47] mm, p = .019). Exercise intensity (p = .033) and duration (p = .013) moderated food intake only in youth with overweight/obesity, indicating lower intake at high intensity and short duration. Overall, acute exercise does not lead to compensation of energy intake or a meaningful elevation of appetite or food reward and might have a modest benefit in youth with overweight/obesity if sufficiently intense. However, conclusions are limited by substantial methodological heterogeneity and the small number of trials employing high-intensity exercise, especially in youth with overweight/obesity.

Time-restricted eating and supervised exercise for improving hepatic steatosis and cardiometabolic health in adults with obesity: protocol for the TEMPUS randomised controlled trial.

INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease is a major public health problem considering its high prevalence and its strong association with extrahepatic diseases. Implementing strategies based on an intermittent fasting approach and supervised exercise may mitigate the risks. This study aims to investigate the effects of a 12-week time-restricted eating (TRE) intervention combined with a supervised exercise intervention, compared with TRE or supervised exercise alone and with a usual-care control group, on hepatic fat (primary outcome) and cardiometabolic health (secondary outcomes) in adults with obesity. METHODS AND ANALYSIS: An anticipated 184 adults with obesity (50% women) will be recruited from Granada (south of Spain) for this parallel-group, randomised controlled trial (TEMPUS). Participants will be randomly designated to usual care, TRE alone, supervised exercise alone or TRE combined with supervised exercise, using a parallel design with a 1:1:1:1 allocation ratio. The TRE and TRE combined with supervised exercise groups will select an 8-hour eating window before the intervention and will maintain it over the intervention. The exercise alone and TRE combined with exercise groups will perform 24 sessions (2 sessions per week+walking intervention) of supervised exercise combining resistance and aerobic high-intensity interval training. All participants will receive nutritional counselling throughout the intervention. The primary outcome is change from baseline to 12 weeks in hepatic fat; secondary outcomes include measures of cardiometabolic health. ETHICS AND DISSEMINATION: This study was approved by Granada Provincial Research Ethics Committee (CEI Granada-0365-N-23). All participants will be asked to provide written informed consent. The findings will be disseminated in scientific journals and at international scientific conferences. TRIAL REGISTRATION NUMBER: NCT05897073.

Endometrial whole metabolome profile at the receptive phase: influence of Mediterranean Diet and infertility.

Introduction: Several metabolite classes have been identified in human endometrium, including lipids, nucleotides, amino acids, organic acids, and sugars. The first studies suggest the importance of metabolites in endometrial functions, as imbalance in uterine metabolites has been associated with low implantation rate and endometriosis. Nevertheless, most of studies have put emphasis on specific metabolite classes, and we lack the knowledge of the whole metabolome composition in human uterus. Further, a healthy dietary pattern has been shown to potentially protect against different endometrial dysfunctions and is a potential modulator of metabolomic composition and, consequently, the intrauterine microenvironment. The Mediterranean Diet (MD), characterized by a high intake of fruits, vegetables, cereals, nuts, legumes, fish, and olive oil, and a low consumption of meat, dairy products, and processed foods, has been associated with a wide range of benefits for health. Indeed, the MD pattern has displayed a beneficial role in endometriosis management and fertility; however, the relationship between the MD and the endometrial metabolome is still unknown. In our study, we set out to analyze receptive-phase endometrial metabolome profiles among women with infertility and their associations with MD. Methods: The study included women with male factor infertility (n=8), unexplained infertility (n=10), recurrent implantation failure (n=14), and endometriosis (n=13). The endometrial metabolome was analyzed with ultrahigh-performance liquid chromatography-tandem mass spectroscopy (UPLC-MS/MS). The MD adherence of the participants was assessed using the 14-point MEDAS questionnaire of adherence to the MD. Results: We provide the whole metabolome profile of the endometrium, where 925 different metabolites were identified. Among these metabolites, lipids comprised the largest part, where polyunsaturated fatty acids (PUFAs) prevailed. Women with endometriosis and recurrent implantation failure were found to have lower levels of PUFAs compared to women with male factor and unexplained infertility (i.e., no clear endometrial alterations), identifying a metabolome profile associated with infertility diagnoses where altered endometrial functions are suspected. Moreover, MD adherence seemed to be associated with the endometrial metabolomic profile in a manner dependent on the health status of the uterus. Conclusion: The study findings provide insight into the molecular background of female infertility and lead to identification of potential molecular biomarkers and possibilities for modulating the endometrial microenvironment and, thereby, endometrial functions involved in embryo implantation and infertility.