Influence of water-based exercise on energy intake, appetite, and appetite-related hormones in adults: A systematic review and meta-analysis.

Single bouts of land-based exercise suppress appetite and do not typically alter energy intake in the short-term, whereas it has been suggested that water-based exercise may evoke orexigenic effects. The primary aim was to systematically review the available literature investigating the influence of water-based exercise on energy intake in adults (PROSPERO ID number CRD42022314349). PubMed, Medline, Sport-Discus, Academic Search Complete, CINAHL and Public Health Database were searched for peer-reviewed articles published in English from 1900 to May 2022. Included studies implemented a water-based exercise intervention versus a control or comparator. Risk of bias was assessed using the revised Cochrane 'Risk of bias tool for randomised trials' (RoB 2.0). We identified eight acute (same day) exercise studies which met the inclusion criteria. Meta-analysis was performed using a fixed effects generic inverse variance method on energy intake (8 studies (water versus control), 5 studies (water versus land) and 2 studies (water at two different temperatures)). Appetite and appetite-related hormones are also examined but high heterogeneity did not allow a meta-analysis of these outcome measures. We identified one chronic exercise training study which met the inclusion criteria with findings discussed narratively. Meta-analysis revealed that a single bout of exercise in water increased ad-libitum energy intake compared to a non-exercise control (mean difference [95% CI]: 330 [118, 542] kJ, P = 0.002). No difference in ad libitum energy intake was identified between water and land-based exercise (78 [-176, 334] kJ, P = 0.55). Exercising in cold water (18-20 °C) increased energy intake to a greater extent than neutral water (27-33 °C) temperature (719 [222, 1215] kJ; P < 0.005). The one eligible 12-week study did not assess whether water-based exercise influenced energy intake but did find that cycling and swimming did not alter fasting plasma concentrations of total ghrelin, insulin, leptin or total PYY but contributed to body mass loss 87.3 (5.2) to 85.9 (5.0) kg and 88.9 (4.9) to 86.4 (4.5) kg (P < 0.05) respectively. To conclude, if body mass management is a person's primary focus, they should be mindful of the tendency to eat more in the hours after a water-based exercise session, particularly when the water temperature is cold (18-20 °C).

Effects of moderate to vigorous intensity cycling on appetite, ad libitum energy intake and appetite-related hormones in healthy South Asian and white European men.

Compensatory changes in appetite and energy intake do not appear to occur in the short-term after acute exercise; however, responses have not been compared in South Asians, a group at high risk of central obesity and type 2 diabetes, with white Europeans. This study examined appetite perceptions, energy intake and appetite-related hormones after moderate-to-vigorous intensity cycling in South Asian versus white European men. Fifteen South Asians (mean(SD) 29(8) years; 25.4(4.5) kg m-2) and fifteen white Europeans (33(10) years; 26.1(3.8) kg m-2) matched for age and body mass index completed two 7 h trials (control and exercise). Participants rested throughout both trials apart from completing 60 min cycling at 2-3 h in the exercise trial. A standardised breakfast was consumed at 0 h and an ad libitum buffet meal at 4 h. Appetite perceptions and appetite-related hormones were measured at predetermined intervals. Exercise suppressed acylated ghrelin (d = 0.19, P < 0.001) and increased total peptide YY (PYY) (d = 0.14, P = 0.004), insulin (d = 0.09, P = 0.046) and glucose concentrations (d = 0.31, P < 0.001) (main effect of trial), without stimulating compensatory increases in energy intakes in either group (group-by-trial interactions). South Asians exhibited lower absolute energy intake and higher insulin concentrations than white Europeans (main effect group d ≥ 0.63, P ≤ 0.003), whereas group-by-time interactions revealed lower acylated ghrelin concentrations at 3 and 4 h (d ≥ 0.75, P ≤ 0.038) and higher glucose concentrations at 0.75 and 2 h (d ≥ 0.67, P ≤ 0.008) in South Asian than white European men. These findings demonstrate that acute exercise induces a short-term energy deficit and similar appetite responses in South Asian and white European men.

The influence of different concentrations of flavanol chocolate bars under acute supplement conditions on exercise and performance.

OBJECTIVE: The purpose of this study was to assess the effects and acute dosage of different flavanol concentrations in a dark chocolate bar on physiological parameters during steady state (SS) and incremental exercise. METHODS: In a double-blind, randomised, crossover study, 15 healthy participants with a mean ± SD age of 30 ± 7 years; stature 176.8 ± 8.6 cm and body mass 80.3 ± 8.4 kg supplemented with high flavanol (HF) (1060 mg), moderate flavanol (MF) (746 mg), low flavanol (LF) (406 mg), or a control (CON) (88 mg) chocolate bar (~ 34 g), 2 h prior to 40 min of SS cycling (80% gas-exchange threshold) followed by an incremental test to volitional fatigue. During the SS cycle oxygen consumption ([Formula: see text]), respiratory exchange ratio (RER) and heart rate (HR) were continuously monitored. Plasma samples were collected prior to commencing exercise to determine nitrate (NO3-) and nitrite (NO2-) levels under each condition. RESULTS: There was no observed effect between flavanol concentrations on [Formula: see text], RER, and HR during SS cycling (P > 0.05). [Formula: see text], peak power, HR peak, and RER peak also did not significantly differ between conditions (P > 0.05). There was a small trend for higher plasma NO2- levels following higher flavanol concentration; however, this did not reach statistical significance (P > 0.05). CONCLUSION: Acute supplementation with cocoa of differing flavanol concentrations does not appear to have any effect on exercise and performance. It is plausible that longer flavanol supplementation periods might have greater accumulative effects and thus may potentially elicit a larger effect.

Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Blood Glucose, Insulin and Triacylglycerol Measures: A Systematic Review and Meta-analysis.

BACKGROUND: Physical activity (PA) breaks in sitting time might attenuate metabolic markers relevant to the prevention of type 2 diabetes. OBJECTIVES: The primary aim of this paper was to systematically review and meta-analyse trials that compared the effects of breaking up prolonged sitting with bouts of PA throughout the day (INT) versus continuous sitting (SIT) on glucose, insulin and triacylglycerol (TAG) measures. A second aim was to compare the effects of INT versus continuous exercise (EX) on glucose, insulin and TAG measures. METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations. Eligibility criteria consisted of trials comparing INT vs. SIT or INT vs. one bout of EX before or after sitting, in participants aged 18 or above, who were classified as either metabolically healthy or impaired, but not with other major health conditions such as chronic obstructive pulmonary disease or peripheral arterial disease. RESULTS: A total of 42 studies were included in the overall review, whereas a total of 37 studies were included in the meta-analysis. There was a standardised mean difference (SMD) of - 0.54 (95% CI - 0.70, - 0.37, p = 0.00001) in favour of INT compared to SIT for glucose. With respect to insulin, there was an SMD of - 0.56 (95% CI - 0.74, - 0.38, p = 0.00001) in favour of INT. For TAG, there was an SMD of - 0.26 (95% CI - 0.44, - 0.09, p = 0.002) in favour of INT. Body mass index (BMI) was associated with glucose responses (ß = - 0.05, 95% CI - 0.09, - 0.01, p = 0.01), and insulin (ß = - 0.05, 95% CI - 0.10, - 0.006, p = 0.03), but not TAG (ß = 0.02, 95% CI - 0.02, 0.06, p = 0.37). When energy expenditure was matched, there was an SMD of - 0.26 (95% CI - 0.50, - 0.02, p = 0.03) in favour of INT for glucose, but no statistically significant SMDs for insulin, i.e. 0.35 (95% CI - 0.37, 1.07, p = 0.35), or TAG i.e. 0.08 (95% CI - 0.22, 0.37, p = 0.62). It is worth noting that there was possible publication bias for TAG outcomes when PA breaks were compared with sitting. CONCLUSION: The use of PA breaks during sitting moderately attenuated post-prandial glucose, insulin, and TAG, with greater glycaemic attenuation in people with higher BMI. There was a statistically significant small advantage for PA breaks over continuous exercise for attenuating glucose measures when exercise protocols were energy matched, but no statistically significant differences for insulin and TAG. PROSPERO Registration: CRD42017080982. PROSPERO REGISTRATION: CRD42017080982.

Immunoendocrine responses of male spinal cord injured athletes to 1-hour self-paced exercise: pilot study.

This study examined the effect of a 1 h, self-paced handcycling time trial on blood leukocytes, mucosal immunity, and markers of stress in paraplegic athletes. Nine male paraplegic athletes (spinal injury level thoracic 4-lumbar 2) performed 1 h of handcycling exercise on a standard 400 m athletics track. Heart rate (HR) was measured continuously during exercise, and a retrospective rating of perceived exertion (RPE) was obtained immediately after. Venous blood and saliva samples were collected immediately before exercise (Pre-Ex), after exercise (End-Ex), and 1 h postexercise (1-h Post). The athletes completed mean +/- standard error of mean 22.4 +/- 1.1 km cycling at HR 165 +/- 2 beats/min, RPE 15 +/- 1, and blood lactate 7.9 +/- 2.5 mmol/L. Total leukocytes increased 72% and neutrophils increased 74% End-Ex; both remained elevated at 1-h Post (both p < 0.05). Lymphocytes increased 53% and natural killer cells increased 175% End-Ex (both p < 0.05), but returned to near baseline levels 1-h Post. Increases (p < 0.05) were observed End-Ex in alpha-amylase activity (p < 0.05), which returned to baseline at 1-h Post, but there was no significant change in saliva flow rate, salivary immunoglobulin A, or cortisol. These data confirm that 1 h of handcycling exercise elevated circulating leukocytes but had a minimal effect on mucosal immunity. These changes appear to be associated with alpha-amylase rather than cortisol.

Influence of a fed or fasted state on the s-IgA response to prolonged cycling in active men and women.

This study investigated the effect of a fed or fasted state on the salivary immunoglobulin A (s-IgA) response to prolonged cycling. Using a randomized, crossover design, 16 active adults (8 men and 8 women) performed 2 hr of cycling on a stationary ergometer at 65% of maximal oxygen uptake on 1 occasion after an overnight fast (FAST) and on another occasion 2 hr after consuming a 2.2-MJ high-carbohydrate meal (FED). Timed, unstimulated whole saliva samples were collected immediately before ingestion of the meal, immediately preexercise, 5 min before cessation of exercise, immediately postexercise, and 1 hr postexercise. The samples were analyzed for s-IgA concentration, osmolality, and cortisol, and saliva flow rates were determined to calculate s-IgA secretion rate. Saliva flow rate decreased by 50% during exercise (p < .05), and s-IgA concentration increased by 42% (p < .05), but s-IgA secretion rate remained unchanged. There was a 37% reduction in s-IgA:osmolality postexercise (p < .05), and salivary cortisol increased by 68% (p < .05). There was no effect of FED vs. FAST on these salivary responses. The s-IgA concentration, secretion rate, and osmolality were found to be significantly lower in women than in men throughout the exercise protocol (p < .05); however, there was no difference between genders in saliva flow rate, s-IgA:osmolality ratio, or cortisol. These data demonstrate that a fed or fasted state 2 hr before exercise does not influence resting s-IgA or the response to prolonged cycling. Furthermore, these results show lower levels of s-IgA and osmolality in women than in men at rest.

Effects of exercise intensity on salivary antimicrobial proteins and markers of stress in active men.

In the present study, we assessed the effects of exercise intensity on salivary immunoglobulin A (s-IgA) and salivary lysozyme (s-Lys) and examined how these responses were associated with salivary markers of adrenal activation. Using a randomized design, 10 healthy active men participated in three experimental cycling trials: 50% maximal oxygen uptake (VO2max), 75%VO2max, and an incremental test to exhaustion. The durations of the trials were the same as for a preliminary incremental test to exhaustion (22.3 min, sx = 0.8). Timed, unstimulated saliva samples were collected before exercise, immediately after exercise, and 1 h after exercise. In the incremental exhaustion trial, the secretion rates of both s-IgA and s-Lys were increased. An increase in s-Lys secretion rate was also observed at 75%VO2max. No significant changes in saliva flow rate were observed in any trial. Cycling at 75%VOmax and to exhaustion increased the secretion of alpha-amylase and chromogranin A immediately after exercise; higher cortisol values at 75%VO2max and in the incremental exhaustion trial compared with 50%VO2max were observed 1 h immediately after exercise only. These findings suggest that short-duration, high-intensity exercise increases the secretion rate of s-IgA and s-Lys despite no change in the saliva flow rate. These effects appear to be associated with changes in sympathetic activity and not the hypothalamic - pituitary - adrenal axis.