Understanding age-related changes: exploring the interplay of protein intake, physical activity and appetite in the ageing population.

Globally, we are currently facing a rapid demographic shift leading to an increase in the proportion of older adults within the population. This raises concerns about the potential increase in age-related diseases and their impact on our ability to provide adequate health and end-of-life care. To apply appropriate interventions, understanding the changes that happen with ageing becomes essential. Ageing is often accompanied by a decrease in appetite and physical activity, which may lead to malnutrition, resulting in decreased muscle mass, physical capabilities and independence. To preserve muscle mass, older adults are advised to increase protein intake and physical activity. However, protein's high satiating effect may cause reduced energy intake. Physical activity is also advised to maintain or enhance older adult's appetite. This review paper aims to discuss appetite-related changes that occur with ageing and their consequences. In particular, it will focus on investigating the relationship between protein intake and physical activity and their impact on appetite and energy intake in the ageing population. Recent studies suggest that physical activity might contribute to maintaining or enhancing appetite in older adults. Nevertheless, establishing a definitive consensus on the satiating effect of protein in ageing remains a work in progress, despite some promising results in the existing literature.

The role of food during oncology treatment: perspectives of cancer patients, caregivers and healthcare professionals.

PURPOSE: Many cancer patients have problems eating which are usually connected to taste and smell alterations due to side effects of cancer treatment. These problems have consequences both in terms of malnutrition and reduced quality of life. In order to explore social and psychological consequences of eating problems in cancer patients, qualitative interviews were conducted with cancer patients, their caregivers and healthcare professionals. METHODS: The study was conducted in three European countries (Poland, Spain and the UK) that differed in culture, oncology care approaches and availability of nutritional products targeted to cancer patients in the market. RESULTS: Differences in the social role of eating between the three European countries were observed which subsequently influenced the impact of eating problems for cancer patients in these countries. Furthermore, the study found that problems with food affect not only the quality of life of cancer patients, but can also distress their caregivers, who are often unable to cope with such food-related problems. In addition, the study showed that commercially available nutritional products for cancer patients focus on nutritional value but tend to neglect an important aspect of eating, which is the enjoyment of food, both individually and socially.

Older adults' acceptability of and preferences for food-based protein fortification in the UK, France and Norway.

Research suggests that as we age, protein intake, recognised as vital for combating negative health outcomes, consistently falls below recommendations in older adults. Decreased food intake, combined with age-related eating complications is a major determinant of this protein undernutrition. If nutritional interventions are to be effective and sustainable, they must enable eating pleasure, cater for personal preferences and be adaptable to different eating patterns. As such, we aimed to identify successful strategies for at-home protein-fortification to empower older adults to take a personalised approach to their nutrition, without requiring a large behavioural change. To explore healthy older adults' (age 70+) acceptability and preferences for at-home protein fortification, European project Fortiphy led discussions with older adults (n = 37) and caregivers of older adults (n = 15) to develop high-protein recipes, which were then utilised in a home-use trial with healthy older adults (n = 158). Each fortified recipe was paired with a questionnaire to rate the ease of preparation and liking, and an end-of-study questionnaire was provided to capture overall opinions and preferences. The uniqueness of this study is that the protein fortified recipes were prepared and tested by older adults themselves, in their own homes. Findings showed that older adults were unaware of the importance of protein in ageing and did not have a desire to fortify their foods at present. Yet, they were positive regarding the concept and highlighted the importance of taste, familiar ingredients, and preferred preparation methods. Cultural preferences across countries were identified as having the most influence on the liking of fortified meals. This study also indicated a need for increased awareness of protein requirements to influence the motivation to use fortification.

Macronutrients effects on satiety and food intake in older and younger adults: A randomised controlled trial.

Older adults are advised to increase their protein intake to maintain their muscle mass. However, protein is considered the most satiating macronutrient and this recommendation may cause a decrease in total energy intake. To date, satiety studies comparing all three macronutrients have been undertaken in young adults, and it is unclear if the same response is seen in older adults. The objective of this study was to compare the effect of preloads high in protein, fat, and carbohydrate but equal in energy (∼300 kcal) and volume (250 ml) on energy intake, perceived appetite, and gastric emptying in younger and older adults. Twenty older and 20 younger adults completed a single-blinded randomised crossover trial involving three study visits. Participants consumed a standard breakfast, followed by a preload milkshake high in either carbohydrate, fat, or protein. Three hours after the preload, participants were offered an ad libitum meal to assess food intake. Visual analogue scales were used to measure perceived appetite and gastric emptying was measured via the 13C-octanoic acid breath test. There was no significant effect of preload type or age on energy intake either at the ad libitum meal, self-recorded food intake for the rest of the test day or subjective appetite ratings. There was a significant effect of preload type on gastric emptying latency phase and ascension time, and an effect of age on gastric emptying latency and lag phase such that older adults had faster emptying. In conclusion, energy intake, and perceived appetite were not affected by macronutrient content of the preloads in both younger and older adults, but gastric emptying times differed.

Habitual consumption of high-fibre bread fortified with bean hulls increased plasma indole-3-propionic concentration and decreased putrescine and deoxycholic acid faecal concentrations in healthy volunteers.

Only 6 to 8 % of the UK adults meet the daily recommendation for dietary fibre. Fava bean processing lead to vast amounts of high-fibre by-products such as hulls. Bean hull fortified bread was formulated to increase and diversify dietary fibre while reducing waste. This study assessed the bean hull: suitability as a source of dietary fibre; the systemic and microbial metabolism of its components and postprandial events following bean hull bread rolls. Nine healthy participants (53·9 ± 16·7 years) were recruited for a randomised controlled crossover study attending two 3 days intervention sessions, involving the consumption of two bread rolls per day (control or bean hull rolls). Blood and faecal samples were collected before and after each session and analysed for systemic and microbial metabolites of bread roll components using targeted LC-MS/MS and GC analysis. Satiety, gut hormones, glucose, insulin and gastric emptying biomarkers were also measured. Two bean hull rolls provided over 85 % of the daily recommendation for dietary fibre; but despite being a rich source of plant metabolites (P = 0·04 v. control bread), these had poor systemic bioavailability. Consumption of bean hull rolls for 3 days significantly increased plasma concentration of indole-3-propionic acid (P = 0·009) and decreased faecal concentration of putrescine (P = 0·035) and deoxycholic acid (P = 0·046). However, it had no effect on postprandial plasma gut hormones, bacterial composition and faecal short chain fatty acids amount. Therefore, bean hulls require further processing to improve their bioactives systemic availability and fibre fermentation.

'Raising the Pulse': The environmental, nutritional and health benefits of pulse-enhanced foods.

Diet is a key modulator of non-communicable diseases, and food production represents a major cause of environmental degradation and greenhouse gas emissions. Yet, 'nudging' people to make better food choices is challenging, as factors including affordability, convenience and taste often take priority over the achievement of health and environmental benefits. The overall 'Raising the Pulse' project aim is to bring about a step change in the nutritional value of the UK consumers' diet, and to do so in a way that leads to improved health and greater sustainability within the UK food system. To achieve our objectives, UK-specific faba bean production systems that optimise both end users' diets and environmental and economic sustainability of production will be implemented in collaboration with key stakeholders (including industry, the retail sector and government). Palatable faba bean flours will be produced and used to develop 'Raising the Pulse' food products with improved nutritional profile and environmental value. Consumer focus groups and workshops will establish attitudes, preferences, drivers of and barriers to increased consumption of such products. They will inform the co-creation of sensory testing and University-wide intervention studies to evaluate the effects of pulses and 'Raising the Pulse' foods on diet quality, self-reported satiety, nutritional knowledge, consumer acceptance and market potential. Nutrient bioavailability and satiety will be evaluated in a randomised-controlled postprandial human study. Finally, a system model will be developed that predicts changes to land use, environment, business viability, nutrition and human health after substitution of existing less nutritionally beneficial and environmentally sustainable ingredients with pulses. Government health and sustainability priorities will be addressed, helping to define policy-relevant solutions with significant beneficial supply chain economic impacts and transformed sustainable food systems to improve consumer diet quality, health and the environment.

The Food4Years Ageing Network: Improving foods and diets as a strategy for supporting quality of life, independence and healthspan in older adults.

By 2050, it is predicted that one in four people in the United Kingdom will be aged 65 years and over. Increases in lifespan are not always translated into years spent in good health. Incidence rates for chronic diseases are increasing, with treatments allowing people to live longer with their disease. There is good evidence to support changes to lifestyle to maintain or improve body composition, cognitive health, musculoskeletal health, immune function and vascular health in older adults. Much research has been done in this area, which has produced significant support for foods and nutrients that contribute to improved healthspan. Yet two major barriers remain: firstly, older adult consumers are not meeting current UK recommendations for macro- and micronutrients that could benefit health and quality of life and secondly, the UK-specific recommendations may not be sufficient to support the ageing population, particularly for nutrients with key physiological roles. More work is needed to improve intakes of specific foods, diets and nutrients by older adults, through a variety of mechanisms including (i) development of specific food products; (ii) improved clarity of information and (iii) appropriate marketing, and policy changes to enable incentives. The Food4Years Ageing Network aims to build a wide-reaching and multidisciplinary community that is committed to the development, integration and communication of healthy, affordable foods and specific diets for all older adults across the UK food landscape. The Network will identify evidence-based strategies for improving food intake and nutrition in older adults, paving the way to "living well while living longer."

Review of protein intake and suitability of foods for protein-fortification in older adults in the UK.

Protein is a vital dietary component for combating negative health outcomes associated with malnutrition in older adults, including sarcopenia, functional decline and reduced quality of life. Yet, recommended daily protein intake is consistently unmet, as evidenced in the literature and reaffirmed in this review. Poor appetite is recognized as a major determinant of protein-energy undernutrition and thus fortification of regular food or drinks provides a flexible and relevant approach for older adults with reduced appetite. To increase the likelihood of fortified products being successfully incorporated into the diets of older adults, they must be adaptable to older adults eating patterns, cater for their preferences and take the specific age-related problems that complicate food intake into account. This paper aims to highlight older adults' current sources of protein, shopping habits, typical eating patterns and commonly consumed foods, and hence consider appropriate carriers for protein enrichment. Data were reanalyzed from a combination of freely available UK datasets, including the National Dietary and Nutrition Survey and the Food and You Survey, alongside data purchased from market research consultancy, Kantar. These insights draw attention to the potential suitability of foods for fortification purposes, with the ultimate objective to promote eating pleasure and prevent malnutrition.

Educating health care professionals on the importance of proper diets. An online course on nutrition, health, and sustainability.

The majority of university curricula for health professionals does not incorporate courses on human nutrition and its links with human and planetary health. This primarily applies to medical and pharmacy students, who have important counselling roles and are at the forefront of public health. To address this important issue, EIT Food recently launched an online course on nutrition, health, and sustainability. Learners were able to provide feedback on the course through an end-of-course survey and social interaction on the FutureLearn platform. The course was very well attended worldwide and received positive feedback from learners. A total of 3,858 students enrolled in the program, from >20 countries. Learners reported inadequate training on nutrition in their own curriculum and indicated they would use key insights from the course to inform their own practice. This report provides insights from the course, which could be used as guidance for future initiatives.

Finger millet-based muffin decreases insulin response in individuals with prediabetes in a randomised controlled trial.

Millet is a grain high in polyphenols and antioxidants, which are bioactive compounds known to influence blood glucose response. The aim of this study was to compare the effect of finger millet muffin and wheat muffin on glycaemic response (GR), insulin response (IR), gastric emptying (GE) and satiety in healthy individuals and people with prediabetes. In a single-blind randomised controlled crossover trial at Oxford Brookes Centre for Nutrition and Health, fifteen healthy individuals and fourteen individuals with prediabetes were recruited between May and December 2017. The participants' GR (3 h), IR (3 h), GE (4 h) and satiety (4 h) were measured before and after the consumption of muffins. A mixed method ANOVA was used to compare GE and the incremental AUC (iAUC) for GR and IR between the participant groups and muffins. There was a significant interaction between participants and muffins on IR iAUC at 180 min (P = 0·042). A significant effect of muffins was found on the GR peak (P = 0·013). The millet muffin decreased the GR peak and IR iAUC compared with the wheat muffin in participants with prediabetes. A significant interaction between participants and muffins for GE ascension time Tasc (P = 0·017) was observed, with no effect of muffins on satiety AUC in the participant groups. This study suggested that polyphenol and fibre-rich finger millet may have the potential to influence the management of prediabetes.

Gluten-free diet intervention reduces thiamine intake in two weeks, increases glycaemic response and decreases body weight in four weeks, with no long term nutritional deficiencies.

This research investigated the effects of gluten free diet (GFD) on nutritional intake, glycaemic and insulin response. In a cross-sectional study, participants who consumed gluten-containing diet (GCD; n = 11) and GFD (n = 11) completed a food diary, blood glucose and insulin measurements. In a pre-post intervention study (n = 11), glycaemic and insulin responses were tested before and after four weeks of a GFD. Food intake was recorded before and after two weeks. No significant differences in nutrient intake, glycaemic or insulin responses were found in the cross-sectional study. In the intervention study, there was a significant reduction in body weight (p = .007) and body mass index (BMI) (p = .004) after four weeks and lower thiamine intake (p = .021) after two weeks of GFD. Glycaemic response was significantly higher (p < .05) following GFD with no differences in insulin response. These differences were not evident if GFD was followed for a longer period, possibly due to improved food choices.

Lower Energy-Dense Ready Meal Consumption Affects Self-Reported Appetite Ratings with No Effect on Subsequent Food Intake in Women.

Slimming World (SW), a commercial weight management organisation, has designed a range of low energy-dense ready meals (LEDRMs) in line with their programme. This randomised crossover study compared commercially available equicaloric ready meals differing in energy density on satiety and food intake. It was hypothesised that the LEDRM would reduce energy intake (EI) whilst increasing fullness and reducing hunger compared to higher energy-dense ready meal (HEDRM, control). A total of 26 female participants (aged 18-65 years; body mass index of 28.8 ± 3.0 kg·m-2) attended two test days. The participants ate a standard breakfast, and four hours later, ate either a LEDRM or HEDRM at lunch. EI was measured four hours later at an ad libitum tea. Satiety measurements were recorded throughout the day using visual analogue scales and a weighed food diary was completed for the remainder of the day. The results revealed that the LEDRM reduced hunger and increased fullness (both p < 0.001). There was no difference in EI at the evening meal between the ready meals (p > 0.05), however, during the whole LEDRM testing day, the participants consumed significantly less fat (7.1%) and saturated fat (3.6%) (both p < 0.01), but significantly more carbohydrates, sugars, fibre, protein, and salt (all p < 0.01). The results indicate that the participants felt more satiated after consuming ready meals of the same energy content but larger portion size. Despite no significant difference in short-term EI between the ready meals, the results indicated that the LEDRM produced beneficial subjective satiety responses and, therefore, can help to improve the nutritional content of meals i.e., reduce saturated fat consumption.

A comparative assessment of the nutritional composition of dairy and plant-based dairy alternatives available for sale in the UK and the implications for consumers' dietary intakes.

The popularity of plant-based dairy alternatives (PBDAs) products has grown exponentially in recent years creating a new market of PBDA. The aim of this study was to compare the nutritional content of plant-based alternatives of milk, yogurt and cheese with dairy equivalents and the impact on nutritional intake across the lifespan when they are substituted into UK diets. Nutritional information from cow's milk, yogurt, cheese and PBDAs available on the UK market was collected via manufacturers information. The products were categorised according to primary plant-based ingredient/s and compared with the equivalent dairy product. The National Diet and Nutrition Survey data was used to calculate the intake of milk, yogurt and cheese across all age groups and the energy and nutrient intake was calculated. Plant-based milk, cheese and yogurt alternative categories were then substituted for dairy intakes, and energy and nutrient intakes were calculated and compared to UK Dietary Reference Values. A total of 299 PBDA products were identified consisting of 136 milk alternatives, 55 yogurt alternatives and 109 cheese alternatives. All PBDAs were more expensive than dairy products. Milk contained more energy, saturated fat, carbohydrates, protein, vitamin B2, vitamin B12 and iodine, and less fibre and free sugars, than plant-based milk alternatives (P < 0.05). There were significant differences between yogurt and cheese and their corresponding PBDAs for energy, fat, saturated fat, carbohydrate, sugars, fibre protein, salt, and calcium (P < 0.05). These differences were reflected in the nutrient intakes of different age groups and the results demonstrated that PBDA may be useful as practical replacements of dairy products but cannot be considered nutritional replacements.

A systematic review and meta-analysis of medium-chain triglycerides effects on acute satiety and food intake.

Research has indicated that consuming medium-chain triglycerides (MCT) may be more satiating than consuming long-chain triglycerides (LCT) potentially causing a reduction in energy intake. However not all studies have demonstrated this acute reduction in energy intake and it has yet to be systematically reviewed. Our main objective was to examine how ingestion of MCT influences energy intake, subjective appetite ratings and appetite-related hormones compared to LCT. Web of Science, MEDLINE, CINHAL, and Embase were searched for publications comparing the effect of MCT on appetite (commonly hunger, fullness, desire to eat, and prospective food consumption), appetite-related hormones (pancreatic polypeptide (PP), gastric inhibitory polypeptide (GIP), peptide YY (PYY), glucagon-like peptide-1 (GLP-1), neurotensin, leptin, total ghrelin and active ghrelin) and energy intake to LCT. A random-effects meta-analysis was conducted on studies which examined energy intake. Seventeen studies (291 participants) were included in the systematic review, of which 11 were included in the energy intake meta-analysis. Synthesis of combined data showed evidence of a statistically significant moderate decrease in ad libitum energy intake after both acute and chronic ingestion of MCT compared to LCT when assessed under laboratory conditions (mean effect size: -0.444, 95% CI -0.808, -0.080, p < 0.017), despite little evidence of any effect of MCT on subjective appetite ratings or circulating hormones. The current evidence supports the notion that MCT decreases subsequent energy intake, but does not appear to affect appetite. Further research is warranted to elucidate the mechanisms by which MCT reduce energy intake.

The effect of a split portion of flaxseed on 24-h blood glucose response.

PURPOSE: Flaxseed can be effective at lowering and stabilising blood glucose responses. The aim of this study was to determine whether flaxseed could lower blood glucose response more effectively when consumed as a single portion of 30 g, or a split portion consumed three times per day (10 g flaxseed per portion). METHODS: The study was a randomised, repeated measures, cross-over design. Fifteen healthy participants consumed either (1) three flaxseed muffins containing a total of 30 g of flaxseed once in the morning, (2) three flaxseed muffins consumed at three different timepoints across the day (10 g flaxseed per muffin) or (3) three control muffins consumed at three different timepoints across the day (0 g flaxseed). The 24-h blood glucose response was measured using a continuous glucose monitor. RESULTS: The results of this study demonstrated that flaxseed muffins given three times a day were effective at lowering and maintaining blood glucose levels over 24 h, compared to the control muffins and that both flaxseed treatments resulting in a lower blood glucose iAUC during the night. CONCLUSION: The results of this study indicated that adding flaxseed to a daily diet produced a lower glucose profile over 24 h in a free-living context compared to the control muffins.

A comparison of the satiating properties of medium-chain triglycerides and conjugated linoleic acid in participants with healthy weight and overweight or obesity.

PURPOSE: Inconsistent evidence exists for greater satiety after medium-chain triglycerides (MCT) or conjugated linoleic acid (CLA) compared to long-chain triglycerides (LCT). Furthermore, the mechanisms are poorly understood and effects in people with a healthy weight and those with overweight/obesity have not been compared. This study aimed to compare appetite responses in these groups and examine the mechanisms behind any differences. METHODS: Fifteen participants with healthy weight (BMI: 22.7 ± 1.9 kg·m-2) and fourteen participants with overweight/obesity (BMI: 30.9 ± 3.9 kg·m-2) consumed a breakfast containing either 23.06 g vegetable oil (CON), 25.00 g MCT oil (MCT), or 6.25 g CLA and 16.80 g vegetable oil (CLA). Appetite, peptide YY (PYY), total ghrelin (TG), ß-hydroxybutyrate, and gastric emptying (GE) were measured throughout. Energy intake was assessed at an ad libitum lunch and throughout the following ~ 36 h. RESULTS: Neither MCT nor CLA decreased ad libitum intake; however MCT decreased day 1 energy intake (P = 0.031) and the 48-h period (P = 0.005) compared to CON. MCT delayed GE (P ≤ 0.01) compared to CON, whereas CLA did not. PYY and TG concentrations were not different (P = 0.743 and P = 0.188, respectively), but MCT increased ß-hydroxybutyrate concentrations compared to CON (P = 0.005) and CLA (P < 0.001). ß-hydroxybutyrate concentrations were higher in participants with overweight/obesity (P = 0.009). CONCLUSION: Consumption of MCT reduces energy intake in the subsequent 48 h, whereas CLA does not. Delayed gastric emptying or increased ß-hydroxybutyrate concentrations may mediate this.

The Effects of a Functional Food Breakfast on Gluco-Regulation, Cognitive Performance, Mood, and Satiety in Adults.

A whole diet which combines multiple functional foods benefits metabolic risk factors and cognition, but evidence supporting meal to meal benefits, which individuals may find easier to implement, is limited. This study developed a functional food breakfast (FB), using polyphenol-rich ingredients selected for their gluco-regulating and cognitive-enhancing properties, and compared it to a control breakfast (CB). For study 1, total polyphenols were determined using the Folin-Ciocalteu method, and sugar release by in vitro digestion, in frozen and fresh samples. In study 2, healthy adults (n = 16) consumed an FB, CB and ready-to-eat breakfast cereal (RTEC) in a randomised crossover design. Glucose (GR) and insulin response (IR), satiety, mood and memory were measured over 180 min. The FB was a rich source of polyphenols (230 mg) compared to the CB (147 mg) (p < 0.05), and using frozen muffins did not compromise the polyphenol content or sugar release. Peak GR was highest after the RTEC (p < 0.05), and the insulin area under the curve (AUC) was lowest in the FB at 60, 120, 180 min and peak (p < 0.05). There were no effects on GR AUC, mood, satiety or memory. Reductions in GR peak and IR following consumption of the FB support the inclusion of functional ingredients at breakfast.

The Influence of Social Relationships on Men's Weight.

OBJECTIVE: To explore how men's social relationships influence their dietary, physical activity, and weight loss intentions and behaviors. DESIGN: Qualitative study using semistructured interviews. SETTING: One county in the southwest of England. PARTICIPANTS: Men (n = 19) aged 18-60 years with a body mass index ≥24 kg/m2 who were otherwise healthy. PHENOMENON OF INTEREST: Men's perceptions of dieting, physical activity and weight loss, and how social relationships influence these behaviors. ANALYSIS: Interviews were audiorecorded and transcribed verbatim. Transcripts were coded line by line using NVivo software. Themes and subthemes were inductively generated using thematic analysis. RESULTS: Four themes were derived: (1) how experiences shape beliefs, (2) being a proper bloke, (3) adapting to family life, and (4) support from outside the home. Men discussed how partners were a greater influence on diet than physical activity. Attitudes toward diet and physical activity were influenced by life events such as becoming a father. It was framed as acceptable for men to talk to their friends about exercise and food intake in general, but they emphasized that this was not for "support." CONCLUSIONS AND IMPLICATIONS: Family members were key influences on men's behaviors. Future qualitative research could include interviews with men's families. Findings may inform family weight loss interventions.

The sugar content of children's and lunchbox beverages sold in the UK before and after the soft drink industry levy.

BACKGROUND: Childhood obesity is associated with an increased intake of sugary soft drinks and juice drinks. The aims of this study were (1) to report the sugar and energy content in commercial fruit juice (FJ), juice drinks (JDs) and smoothies (S) specifically targeted at children in the UK, (2) to identify beverages liable for the soft drinks industry levy (SDIL) and (3) to compare the amount of sugar in these beverages before and after the levy. METHODS: The beverages were retrieved using the online shopping tool, my Supermarket, websites of nine major supermarkets in the UK and manufacturers webpages. Comparisons of sugar content were taken before and after the introduction of the SDIL. RESULTS: 131 FJJDS fulfilled the inclusion criteria. The mean sugar content of all the beverages was 6.3 g ± 4.5/100 mL. There was large variation in the sugar content from 0.1 g/100 mL to 15.2 g/100 mL, with smoothies found to contain the most sugar (11.55 ± 1.62 g/mL). The beverages were reanalysed in September 2018 to determine their eligibility for the SDIL. Of the 131 products only seven JDs were eligible for the levy. Four of these beverages had reformulated their ingredients since the initial analysis resulting in a sugar content of <5 g/100 mL. CONCLUSIONS: The majority of the beverages targeted at children and children's lunch boxes were not eligible for the SDIL. This study suggests the necessity to adapt the SDIL to include all FJJDS aimed at children as the total sugar content of these beverages are still above the recommended quantities for this age group.

Effect of medium-chain TAG and exercise on satiety, energy intake and energy balance.

The present study examined whether the combination of medium-chain TAG (MCT) along with exercise suppresses energy intake to a greater extent compared with either intervention alone. Twelve participants consumed a porridge breakfast containing 692·9 kJ of either vegetable or MCT oil on two separate occasions: one followed by rest for 240 min and another followed by rest broken up with 1 h of cycling at 65 % $\dot V$O2peak starting at 120 min. At 240 min, participants consumed a buffet lunch to satiation and recorded their food intake for the rest of the day. Expired air samples (for calculation of energy expenditure (EE)) and subjective ratings of appetite on visual analogue scales were taken every 30 min, and gastric emptying (GE) breath samples were taken every 15 min. No effect of either breakfast or exercise condition was observed on energy intake at any time point (P > 0·05) or no effect was observed on subjective appetite ratings (P > 0·05). Exercise trials resulted in significantly higher EE compared with resting trials (2960·6 kJ, 95 % CI 2528·9, 3392·2; P < 0·001), and MCT increased resting EE over 4 h compared with long-chain TAG (LCT) (124·8 kJ, 95 % CI 13·5, 236·0; P = 0·031). GE was accelerated by exercise, regardless of the breakfast consumed, but delayed by MCT in both resting and exercise trials. The results show that exercise causes energy deficits via increased EE without promoting dietary compensation. MCT has no effect on energy intake or satiety but increases EE under resting conditions. There is no additive effect of MCT and exercise on EE, intake or appetite ratings.