Does Caffeine Increase Fat Metabolism? A Systematic Review and Meta-Analysis.

Whether caffeine (CAF) increases fat metabolism remains debatable. Using systematic review coupled with meta-analysis, our aim was to determine effects of CAF on fat metabolism and the relevant factors moderating this effect. Electronic databases PubMed, SPORTDiscus, and Web of Science were searched using the following string: CAF AND (fat OR lipid) AND (metabolism OR oxidation). A meta-analytic approach aggregated data from 94 studies examining CAF's effect on fat metabolism assessed by different biomarkers. The overall effect size (ES) was 0.39 (95% confidence interval [CI] [0.30, 0.47], p < .001), indicating a small effect of CAF to increase fat metabolism; however, ES was significantly higher (p < .001) based on blood biomarkers (e.g., free fatty acids, glycerol) (ES = 0.55, 95% CI [0.43, 0.67]) versus expired gas analysis (respiratory exchange ratio, calculated fat oxidation) (ES = 0.26, 95% CI [0.16, 0.37]), although both were greater than zero. Fat metabolism increased to a greater extent (p = .02) during rest (ES = 0.51, 95% CI [0.41, 0.62]) versus exercise (ES = 0.35, 95% CI [0.26, 0.44]) across all studies, although ES was not different for studies reporting both conditions (ES = 0.49 and 0.44, respectively). There were no subgroup differences based on participants' fitness level, sex, or CAF dosage. CAF ingestion increases fat metabolism but is more consistent with blood biomarkers versus whole-body gas exchange measures. CAF has a small effect during rest across all studies, although similar to exercise when compared within the same study. CAF dosage did not moderate this effect.

Improved Detection of Child Maltreatment with Routine Screening in a Tertiary Care Pediatric Hospital.

OBJECTIVES: To evaluate the impact of layering routine child abuse screening on top of a preexisting electronic health record-embedded Child Abuse Clinical Decision Support System (CA-CDSS) in a pediatric emergency department. STUDY DESIGN: The Pittsburgh Child Abuse Screening Tool (P-CAST) was performed in all children aged <13 years and in nonverbal children aged ≥13 years who presented to a pediatric tertiary care center over a 6-month period. The P-CAST was layered on top of a preexisting CA-CDSS that included passive triggers, alerts, and abuse-specific order sets. RESULTS: Of the 28 797 screens performed, 1.8% were positive in children aged <13 years and 1.6% were positive in nonverbal children aged ≥13 years. One-half of the children with a positive P-CAST also triggered the CA-CDSS; the other one-half triggered only because of the P-CAST. Nineteen percent of the patients with a positive P-CAST were reported to Child Protective Services (CPS). There was no relationship between race and the odds of a positive P-CAST or between race and the likelihood of a report being made to CPS. CONCLUSIONS: Active routine child abuse screening improves identification of suspected child maltreatment in a children's hospital above and beyond what is identified with a CA-CDSS, which depends on passive triggers. The lack of a relationship between race and a positive P-CAST or a report to CPS suggest that systematic child abuse screening may mitigate well-recognized racial disparities in identifying and reporting suspected child maltreatment.

Examining the Accuracy of the Polar A360 Monitor.

ABSTRACT: Rider, BC, Conger, SA, Ditzenberger, GL, Besteman, SS, Bouret, CM, and Coughlin, AM. Examining the accuracy of the Polar A360 monitor. J Strength Cond Res 35(8): 2165-2169, 2021-The purpose of this study was to determine the accuracy of the Polar A360 heart rate (HR) monitor during periods of rest, walking/running, and active/passive recovery from exercise. Thirty collegiate athletes (women n = 15 and men n = 15) wore an A360 monitor and a previously validated chest HR monitor (Polar RS400) that served as the criterion measurement across a range of resting and walking/running intensities. First, subjects rested in a supine, seated, and standing position. Next, each subject walked on a treadmill at 1.6 kilometers per hour (kph). Speed was increased by 1.6 kph every 2 minutes until volitional fatigue. Then, subjects walked at 4.8 kph followed by a seated recovery stage. Heart rate was recorded in 30-second increments. Total mean difference in HR readings, percent accuracy, and intraclass correlation coefficient (ICC) analysis established the level of agreement between devices. Bland-Altman plots and a regression were used to examine the agreement between devices. The A360 demonstrated a strong correlation with the RS400 (r2 = 0.98) across time points. The analysis of variance with repeated measures indicated an overall significant difference (p < 0.001) between devices. The A360 significantly underestimated HR during the 6.4-kph speed only (p < 0.05) (effect size 0.26). The greatest percent accuracy occurred during rest (91%) and recovery (90%). An ICC of 0.98 (SEM: 0.35) demonstrates a strong level of agreement between devices. The A360 is accurate at rest and during various walking and running speeds and thus is a device that can be used with confidence by athletes for specific training purposes. Future research should examine accuracy during weight training and other sport-specific activities.

Improving Power Output in Older Adults Using Plyometrics in a Body Mass-Supported Treadmill.

Dobbs, TJ, Simonson, SR, and Conger, SA. Improving power output in older adults using plyometrics in a body mass-supported treadmill. J Strength Cond Res 32(9): 2458-2465, 2018-The purpose of this study was to determine if performing plyometrics in a body mass-supported treadmill would lead to greater increases in power output and functional strength in older adults compared with traditional strength training. Twenty-three participants were randomized to strength (SG, n = 8), plyometric (PG, n = 8), or control (CG, n = 7) groups. The SG and PG exercised 3 times per week for 8 weeks, whereas the CG performed no exercise. Timed sit-to-stand and stair climb, estimated maximal muscular isotonic strength, and isokinetic strength were assessed pre- and posttraining. Significant improvements occurred in the PG vs. CG in the timed chair sit-to-stand (22.11 ± 8.48%; p = 0.013), timed stair climb (14.68 ± 6.28%; p = 0.002), and stair climb power (16.59 ± 9.07%; p < 0.001). PG and SG significantly increased their estimated 1 repetition maximum in the leg extension and single leg lunge (p < 0.05), and PG was significantly more powerful at all 3 velocities in both flexion and extension compared with SG and CG ranging from 24.54 to 61.85% (p < 0.001) except for 60°·s extension during isokinetic testing. Eight weeks of plyometrics in a body mass-supported treadmill can significantly improve functional strength and power in older adults. In this study, the PG increased muscular strength at the same rate or better than the SG without performing any resistance training. The PG also outperformed SG during the functional tests. These results suggest that plyometrics, if modified and performed in a safe environment, can increase muscular strength and power and improve functional abilities in older adults.

Predicting energy expenditure through hand rim propulsion power output in individuals who use wheelchairs.

AIM: To examine the relationship between hand rim propulsion power and energy expenditure (EE) during wheelchair wheeling and to investigate whether adding other variables to the model could improve on the prediction of EE. METHODS: Individuals who use manual wheelchairs (n=14) performed five different wheeling activities in a wheelchair with a PowerTap power meter hub built into the right rear wheel. Activities included wheeling on a smooth, level surface at three different speeds (4.5, 5.5 and 6.5 km/h), wheeling on a rubberised track at one speed (5.5 km/h) and wheeling on a sidewalk course that included uphill and downhill segments at a self-selected speed. EE was measured using a portable indirect calorimetry system. Stepwise linear regression was performed to predict EE from power output variables. A repeated-measures analysis of variance was used to compare the measured EE to the estimates from the power models. Bland-Altman plots were used to assess the agreement between the criterion values and the predicted values. RESULTS: EE and power were significantly correlated (r=0.694, p<0.001). Regression analysis yielded three significant prediction models utilising measured power; measured power and speed; and measured power, speed and heart rate. No significant differences were found between measured EE and any of the prediction models. CONCLUSION: EE can be accurately and precisely estimated based on hand rim propulsion power. These results indicate that power could be used as a method to assess EE in individuals who use wheelchairs.

2024 Wheelchair Compendium of Physical Activities: An update of activity codes and energy expenditure values.

PURPOSE: This paper presents an update of the 2011 Wheelchair Compendium of Physical Activities designed for wheelchair users and is referred to as the 2024 Wheelchair Compendium. The Wheelchair Compendium aims to curate existing knowledge of the energy expenditure for wheelchair physical activities (PAs). METHODS: A systematic review of the published energy expenditure of PA for wheelchair users was completed between 2011 and May 2023. We added these data to the 2011 Wheelchair Compendium data that was compiled previously in a systematic review through 2011. RESULTS: A total of 47 studies were included, and 124 different wheelchair PA reported energy expenditure values ranging from 0.8 metabolic equivalents for wheelchair users (filing papers, light effort) to 11.8 metabolic equivalents for wheelchair users (Nordic sit skiing). CONCLUSION: In introducing the updated 2024 Wheelchair Compendium, we hope to bridge the resource gap and challenge the prevailing narratives that inadvertently exclude wheelchair users from physical fitness and health PAs.

Older Adult Compendium of Physical Activities: Energy costs of human activities in adults aged 60 and older.

PURPOSE: To describe the development of a Compendium for estimating the energy costs of activities in adults ≥60 years (OA Compendium). METHODS: Physical activities (PAs) and their metabolic equivalent of task (MET) values were obtained from a systematic search of studies published in 4 sport and exercise databases (PubMed, Embase, SPORTDiscus (EBSCOhost), and Scopus) and a review of articles included in the 2011 Adult Compendium that measured PA in older adults. MET values were computed as the oxygen cost (VO2, mL/kg/min) during PA divided by 2.7 mL/kg/min (MET60+) to account for the lower resting metabolic rate in older adults. RESULTS: We identified 68 articles and extracted energy expenditure data on 427 PAs. From these, we derived 99 unique Specific Activity codes with corresponding MET60+ values for older adults. We developed a website to present the OA Compendium MET60+ values: https://pacompendium.com. CONCLUSION: The OA Compendium uses data collected from adults ≥60 years for more accurate estimation of the energy cost of PAs in older adults. It is an accessible resource that will allow researchers, educators, and practitioners to find MET60+ values for older adults for use in PA research and practice.

Time Trends in Physical Activity Using Wearable Devices: A Systematic Review and Meta-analysis of Studies from 1995 to 2017.

INTRODUCTION: Conflicting evidence exists on whether physical activity (PA) levels of humans have changed over the last quarter-century. The main objective of this study was to determine if there is evidence of time trends in PA, from cross-sectional studies that assessed PA at different time points using wearable devices (e.g., pedometers and accelerometers). A secondary objective was to quantify the rate of change in PA. METHODS: A systematic literature review was conducted of English-language studies indexed in PubMed, SPORTDiscus, and Web of Science (1960-2020) using search terms (time OR temporal OR secular) AND trends AND (steps per day OR pedometer OR accelerometer OR MVPA). Subsequently, a meta-analytic approach was used to aggregate data from multiple studies and to examine specific factors (i.e., sex, age-group, sex and age-group, and PA metric). RESULTS: Based on 16 peer-reviewed scientific studies conducted between 1995 and 2017, levels of ambulatory PA are trending downward in developed countries. Significant declines were seen in both males and females (P < 0.001) as well as in children (P = 0.020), adolescents (P < 0.001), and adults (P = 0.004). The average study duration was 9.4 yr (accelerometer studies, 5.3 yr; pedometer studies, 10.8 yr). For studies that assessed steps, the average change in PA was -1118 steps per day over the course of the study (P < 0.001), and adolescents had the greatest change in PA at -2278 steps per day (P < 0.001). Adolescents also had the steepest rate of change over time, expressed in steps per day per decade. CONCLUSIONS: Evidence from studies conducted in eight developed nations over a 22-yr period indicates that PA levels have declined overall, especially in adolescents. This study emphasizes the need for continued research tracking time trends in PA using wearable devices.

A compendium of energy costs of physical activities for individuals who use manual wheelchairs.

The purpose of this study was to develop a compendium of wheelchair-related physical activities. To accomplish this, we conducted a systematic review of the published energy costs of activities performed by individuals who use wheelchairs. A total of 266 studies were identified by a literature search using relevant keywords. Inclusion criteria were studies utilizing individuals who routinely use a manual wheelchair, indirect calorimetry as the criterion measurement, energy expenditure expressed as METs or VO2, and physical activities typical of wheelchair users. Eleven studies met the inclusion criteria. A total of 63 different wheelchair activities were identified with energy expenditure values ranging from 0.8 to 12.5 kcal·kg-1·hr-1. The energy requirements for some activities differed between individuals who use wheelchairs and those who do not. The compendium of wheelchair-related activities can be used to enhance scoring of physical activity surveys and to promote the benefits of activity in this population.

Acute Beet Juice Supplementation Does Not Improve 30- or 60-second Maximal Intensity Performance in Anaerobically Trained Athletes.

Research suggests that beet juice is beneficial during aerobic exercise. However, the impact of beet juice during primarily anaerobic exercise is equivocal. The purpose of this study was to determine the effects of acute beet juice supplementation on maximal intensity performance during 30-s and 60-s maximal-intensity cycling sprints. Using a double-blind, crossover-study design, 14 anaerobically trained male hockey players completed six Wingate cycling tests: familiarization trials of a 30-s and 60-s Wingate test, followed by 30-s Wingate placebo/beet juice trials, and 60-s Wingate placebo/beet juice trials. Repeated measures ANOVAs were used to compare the change in power between conditions over the duration of each trial. Paired t-tests were run to compare performance between conditions of various work and power variables. One-way ANOVAs were utilized to compare the change between conditions of the 30-s test to the change between conditions of the 60-s test. Beet juice supplementation yielded no statistical differences from placebo in any of the measured variables during the 30-s or 60-s tests (p > 0.05). The percent change for fatigue index was significantly different between the 30-s and 60-s tests (p = 0.032) suggesting less fatigue with beet juice supplementation. Overall, beet juice did not improve maximal intensity performance during 30-s or 60-s cycling sprint tests. Performance during the 60-s bout was not impacted to a greater extent than the 30-s bout after beet juice supplementation. These results suggest that beet juice supplementation does not improve short-duration exercise performance in anaerobically trained athletes.

Physical activity patterns and multimorbidity burden of older adults with different levels of functional status: NHANES 2003-2006.

BACKGROUND: Physical function and physical activity decrease with age, but differences in physical activity patterns within different physical functioning groups are unknown. OBJECTIVES: To describe physical activity patterns and multimorbidity burden by physical function group and age. METHODS: Actigraph accelerometer-derived physical activity patterns were compared by physical function (high functioning, activity limitations, activity of daily living disabled) determined by questionnaire and age among 2174 older adults (mean age = 70.9, sd = 0.2 years) from the cross-sectional 2003-2006 National Health and Nutrition Examination Survey. Associations between physical function, physical activity, and multimorbidity were examined. RESULTS: Reduced physical function and increased age were associated with lower physical activity, increased sedentary time and a compressed activity profile. During the most active hour of the day (11:00 a.m.), the oldest, lowest physical functioning group was 82% less active than the youngest, highest physical functioning group. High functioning had over 30% more total activity counts, over 56% more time in moderate-to-vigorous activity, about 8% less time sedentary and took approximately one more sedentary break/hour than lower physical functioning groups. Gender differences in physical activity variables were prevalent for high functioning, but limited within reduced physical functioning groups. Physical function, age, total activity counts/day, and breaks in sedentary time/day were independently associated with multimorbidity (p < 0.005). CONCLUSIONS: Reduced physical function and increased age are associated with physical activity levels, and all three are associated with multimorbidity. Understanding physical activity differences by physical function is important for designing interventions for older individuals at increased risk for mobility disability.

Walking for health during pregnancy: A literature review and considerations for future research.

Walking is the most commonly chosen type of physical activity (PA) during pregnancy and provides several health benefits to both mother and child. National initiatives have promoted the importance of walking in general, but little emphasis is directed toward pregnant women, the majority of whom are insufficiently active. Pregnant women face a variety of dynamic barriers to a physically active lifestyle, some of which are more commonly experienced during specific times throughout the pregnancy experience. Walking is unique in that it appears resistant to a number of these barriers that limit other types of PA participation, and it can be meaningfully integrated into some transportation and occupational activities when leisure-time options are unavailable. Preliminary intervention work suggests that walking programs can be effectively adopted into a typical pregnancy lifestyle. However, a great deal of work remains to administer successful pregnancy walking interventions, including developing and using validated methods of PA and walking assessment. This narrative review discusses the unique advantages of walking during pregnancy, provides recommendations for future intervention work, and outlines the need for pregnancy-focused community walking initiatives. Standard search procedures were followed to determine sources from the literature specific to walking during pregnancy for use in each section of this review.

Functional impact of 10 days of bed rest in healthy older adults.

BACKGROUND: Many older individuals decline functionally during hospitalization, and the deleterious consequences of bed rest may be one cause. This study reports on the effect of 10 days of bed rest on multiple functional parameters in healthy older adults. METHODS: Healthy older men and women (n = 11, 67 +/- 5 years old) remained on bed rest for 10 days continuously, and consumed a eucaloric diet providing the Recommended Dietary Allowance for protein. Measures of lower extremity strength and power, aerobic capacity and physical performance, as well as physical activity were performed before and after bed rest. RESULTS: All measures of lower extremity strength were significantly lower after bed rest including isotonic knee extensor strength (-13.2 +/- 4.1%, p =.004) and stair-climbing power (-14 +/- 4.1%, p =.01). Maximal aerobic capacity was 12% lower after bed rest (p =.04), whereas measures of physical performance (Short Physical Performance Battery, and a five-item physical performance test) were not significantly different. Voluntary physical activity decreased after bed rest, and the percentage of time spent inactive increased (7.6 +/- 1.8%, p =.004). There were no medical complications. CONCLUSIONS: In healthy older adults, 10 days of bed rest results in a substantial loss of lower extremity strength, power, and aerobic capacity, and a reduction in physical activity, but has no effect on physical performance. Identification of interventions to maintain muscle function during hospitalization or periods of bed rest in older adults should be a high priority.

Recovery nutrition: timing and composition after endurance exercise.

Consumption of macronutrients, particularly carbohydrate (CHO) and possibly a small amount of protein, in the early recovery phase after endurance exercise can enhance muscle glycogen resynthesis rates. A target of at least 1.2 g x kg body weight(-1) x h(-1) CHO (over several hours) is suggested. This rate of CHO intake could be sustained with liquid, gel, or solid food rich in CHO for maximizing muscle glycogen. Whether the coingestion of protein with CHO compared with isocaloric CHO results in meaningful differences in glycogen replenishment that translate into subsequent performance enhancement is equivocal. Advantages of added protein with CHO in reducing true muscle damage from endurance exercise remain to be verified. There are, however, no apparent contraindications for using milk or specialty CHO/protein/amino acid products either. Future investigations that examine signaling mechanisms within muscle should be conducted in parallel with translational evidence in humans.

Postprandial walking reduces glucose levels in women with gestational diabetes mellitus.

The purpose of this study was to investigate blood glucose changes, as measured by a continuous glucose monitoring system, that occur in women with gestational diabetes mellitus (GDM) following an acute bout of moderate-intensity walking after consuming a high-carbohydrate/low-fat meal. This study found that moderate-intensity walking induced greater postprandial glucose control compared with sedentary activity and it appears that moderate-intensity activity may be used to reduce postprandial glucose levels in women with GDM.

Objective Assessment of Strength Training Exercises using a Wrist-Worn Accelerometer.

UNLABELLED: The 2008 Physical Activity Guidelines for Americans recommend that all adults perform muscle-strengthening exercises to work all of the major muscle groups of the body on at least 2 d·wk, in addition to aerobic activity. Studies using objective methods of monitoring physical activity have focused primarily on the assessment of aerobic activity. To date, a method for assessing resistance training (RT) exercises has not been developed using a wrist-worn activity monitor. PURPOSE: The purpose of this study was to examine the use of a wrist-worn triaxial accelerometer-based activity monitor for classifying upper- and lower-body dumbbell RT exercises. METHODS: Sixty participants performed 10 repetitions each of 12 different upper- and lower-body dynamic dumbbell exercises. Algorithms for classifying the exercises were developed using two different methods: support vector machine and cosine similarity. Confusion matrices were developed for each method, and intermethod reliabilities were assessed using Cohen's kappa. A repeated-measures ANOVA was used to compare the predicted repetitions, identified from the largest acceleration peaks, with the actual repetitions. RESULTS: The results indicated that support vector machine and cosine similarity accurately classified the 12 different RT exercises 78% and 85% of the time, respectively. Both methods struggled to correctly differentiate bench press versus shoulder press and squat versus walking lunges. Repetition estimates were not significantly different for 8 of the 12 exercises. For the four exercises that were significantly different, the differences amount to less than 10%. CONCLUSION: This study demonstrated that RT exercises can be accurately classified using a single activity monitor worn on the wrist.

Energy Expenditure for 70 Activities in Children and Adolescents.

BACKGROUND: Thirty-five percent of the activities assigned MET values in the Compendium of Energy Expenditures for Youth were obtained from direct measurement of energy expenditure (EE). The aim of this study was to provide directly measured EE for several different activities in youth. METHODS: Resting metabolic rate (RMR) of 178 youths (80 females, 98 males) was first measured. Participants then performed structured activity bouts while wearing a portable metabolic system to directly measure EE. Steady-state oxygen consumption data were used to compute activity METstandard (activity VO2/3.5) and METmeasured (activity VO2/measured RMR) for the different activities. RESULTS: Rates of EE were measured for 70 different activities and ranged from 1.9 to 12.0 METstandard and 1.5 to 10.0 METmeasured. CONCLUSION: This study provides directly measured energy cost values for 70 activities in children and adolescents. It contributes empirical data to support the expansion of the Compendium of Energy Expenditures for Youth.

Trends in Physical Activity and Sedentary Behaviors of United States Youth.

BACKGROUND: Increases in childhood and adolescent obesity are a growing concern in the United States (U.S.), and in most countries throughout the world. Declines in physical activity are often postulated to have contributed to the rise in obesity rates during the past 40 years. METHODS: We searched for studies of trends in physical activity and sedentary behaviors of U.S. youth, using nontraditional data sources. Literature searches were conducted for active commuting, physical education, high-school sports, and outdoor play. In addition, trends in sedentary behaviors were examined. RESULTS: Data from the Youth Risk Behavior Surveillance System (YRBSS) and other national surveys, as well as longitudinal studies in the transportation, education, electronic media, and recreation sectors showed evidence of changes in several indicators. Active commuting, high school physical education, and outdoor play (in 3- to 12-year-olds) declined over time, while sports participation in high school girls increased from 1971 to 2012. In addition, electronic entertainment and computer use increased during the first decade of the 21st century. CONCLUSIONS: Technological and societal changes have impacted the types of physical activities performed by U.S. youth. These data are helpful in understanding the factors associated with the rise in obesity, and in proposing potential solutions.