Association between overweight/obesity and eating habits while watching television among primary-school children in the city of Shiraz, Iran.

OBJECTIVE: It has been reported that television (TV) viewing is associated with childhood obesity in Western countries. The present study aimed to investigate the relationship between obesity and eating habits while watching TV among primary-school children in the Middle East. DESIGN: Cross-sectional. SETTING: Children were recruited from primary schools of four educational districts in Shiraz, Iran. Anthropometric indices of mass (kg) and height (m) were measured, and BMI (percentile) was calculated. Demographic characteristics, TV viewing behaviours and physical activity data were collected from parents during face-to-face interviews and a 3d dietary record was completed. Subject Children (n 607) aged 6-10 years. RESULTS: Mean (sd) age of children was 8·16 (1·37) years, of whom 9·1 and 8·4 % were overweight and obese, respectively. Children who spent ≥2 h watching TV on weekdays (OR=1·99; 95 % CI 1·09, 3·60) and weekend days (OR=1·86; 95 % CI 1·01, 3·43) had higher odds of being obese, even after adjusting for physical activity. Children who ate breakfast while watching TV had higher odds of being overweight v. those who did not watch TV while eating breakfast (OR=2·70; 95 % CI 1·02, 7·60). There were no associations between TV viewing during other meals (lunch and dinner) and overweight/obesity. CONCLUSIONS: TV viewing for ≥2 h daily increases the risk of being obese in Iranian children aged 6-10 years, independent of physical activity. Further, breakfast consumption while watching TV may increase the risk of overweight/obesity, independent of total TV viewing time.

Association of vegetarian diet with inflammatory biomarkers: a systematic review and meta-analysis of observational studies.

OBJECTIVE: Vegetarian diets contain various anti-inflammatory components. We aimed to investigate the effects of vegetarianism on inflammatory biomarkers when compared with omnivores. DESIGN: Systematic review and meta-analysis. SETTING: Literature search was conducted in Science Direct, Proquest, MEDLINE and Google Scholar up to June 2016. Summary estimates and corresponding 95 % CI were derived via the DerSimonian and Laird method using random effects, subgroup analyses were run to find the source of heterogeneity and a fixed-effect model examined between-subgroup heterogeneity. SUBJECTS: Studies were included if they evaluated effects of any type of vegetarianism compared with omnivores on circulating levels of inflammatory biomarkers. No restriction was made in terms of language or the date of study publications. RESULTS: Eighteen articles were included. Pooled effect size showed no difference in high-sensitivity C-reactive protein (hs-CRP) levels in vegetarians v. omnivores (Hedges' g=-0·15; 95 % CI -0·35, 0·05), with high heterogeneity (I 2=75·6 %, P<0·01). A subgroup analysis by minimum duration of vegetarianism showed that a minimum duration of 2 years vegetarianism was associated with lower hs-CRP levels v. omnivores (Hedges' g=-0·29; 95 % CI -0·59, 0·01), with moderate heterogeneity (I 2=68·9 %, P<0·01). No significant effect was found in studies using a minimum duration of 6 months of vegetarianism, with low heterogeneity. Vegetarianism was associated with increased IL-6 concentrations (0·21 pg/ml; 95 % CI 0·18, 0·25), with no heterogeneity (I 2=0·0 %, P=0·60). CONCLUSIONS: The meta-analysis provides evidence that vegetarianism is associated with lower serum concentrations of hs-CRP when individuals follow a vegetarian diet for at least 2 years. Further research is necessary to draw appropriate conclusions regarding potential associations between vegetarianism and IL-6 levels. A vegetarian diet might be a useful approach to manage inflammaging in the long term.

Pre-meal screen-time activities increase subjective emotions, but not food intake in young girls.

PURPOSE: To determine the effect of pre-meal screen-time activities on subjective emotions, subjective appetite, and food intake (FI) in 9-14 year-old girls. METHODS: In this clinical study, 31 girls completed four 45-min treatment conditions of television viewing (TVV), video game playing (VGP), a challenging computer task (CT), and sitting without screen exposure (control) in a randomized order. Each treatment condition was followed immediately by an ad libitum pizza lunch, and FI was calculated from the weight of the consumed pizza. Subjective appetite was assessed at baseline, 15, 30, and 45 min during the treatment condition, and upon trial completion at 75 min. Subjective emotions were assessed at baseline and at 45 min. RESULTS: FI was not affected by screen type, but was positively correlated with body composition (fat mass [FM, kg], fat free mass [FFM, kg]) in all treatment conditions. Subjective appetite was not affected by screen type, but increased with time in all treatment conditions (p < 0.0001). Subjective emotions were affected by VGP only. Anger, excitement, frustration, and upset feelings were increased at 45 min following VGP. VGP led to increased frustration compared to control (p = 0.0003), CT (p = 0.007) and TVV (p = 0.0002). CONCLUSION: Exposure to TVV or CT before eating did not affect subjective emotions, subjective appetite, or FI, and no difference was found between screen activities and the control condition for average appetite or FI. Despite a change in subjective emotions during the VGP condition, there was no increase in subjective appetite or subsequent FI. These findings suggest that physiologic signals of satiation and satiety are not overridden by environmental stimuli of pre-meal screen-time exposure among young girls. (Clinical trial number NCT01750177).

Following the Physical Activity Guidelines for Adults With Spinal Cord Injury for 16 Weeks Does Not Improve Vascular Health: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the effects of following the physical activity guidelines (PAG) for adults with spinal cord injury (SCI) for 16 weeks. DESIGN: Randomized controlled trial. SETTING: Community exercise program. PARTICIPANTS: Individuals with SCI (N=23; neurological level of injury, C3-T11; American Spinal Injury Association Impairment Scale A-C; time postinjury, 12.0±9.9 y; age, 41.4±11.6 y). INTERVENTIONS: Participants were randomly assigned to PAG training (n=12) or active control (n=11) groups. PAG training involved ≥20 minutes of moderate-vigorous aerobic exercise (rating of perceived exertion 3-6 on 10-point scale) and 3×10 repetitions of upper-body strengthening exercises (50%-70% 1 repetition maximum) 2 times per week. The control group maintained existing physical activity levels with no guidance on training intensity. MAIN OUTCOME MEASURES: Outcome measures were obtained pre- and postintervention. Vascular health indicators included arterial stiffness via carotid distensibility and pulse wave velocity, and endothelial function via flow-mediated-dilation. Fasted blood samples were analyzed for markers of cardiovascular disease (CVD) risk. Body composition was assessed via anthropometrics and with dual-energy x-ray absorptiometry. RESULTS: Twenty-one individuals completed the intervention (PAG=12, control=9). Group-by-time interactions were observed for whole-body mass (P=.03), whole-body fat (P=.04), visceral adipose tissue (P=.04), and carotid artery distensibility (P=.05), suggesting maintained body composition and carotid stiffness in the PAG group concurrent with declines in the control group. No changes were found in any other outcome measure. CONCLUSIONS: While 16 weeks of adherence to the PAG in adults with SCI is insufficient to improve many markers of CVD risk, it may prevent declines in others. The PAG should continue to be promoted as a means to increase physical fitness and maintain body composition in individuals with SCI, but changes may be needed to achieve other health outcomes.

The effect of physical activity on fertility: a mini-review.

Although lifestyle factors such as diet, cigarette smoking, and alcohol consumption are increasingly recognized as important contributors to the risk of subfertility, the role of exercise in fertility remains less clear. As such, it is challenging for healthcare providers to deliver clear, evidence-based recommendations to patients regarding the optimal frequency and intensity with which they should exercise to maximize their chances of conception. Therefore, this review provides a critical overview of the available research for various patient populations.

Predictive Validity of Image-Based Motivation-to-Eat Visual Analogue Scales in Normal Weight Children and Adolescents Aged 9-14 Years.

Paper-based motivation-to-eat visual analogue scales (VASs) developed for adults are widely used in the pediatric age range. The VAS is comprised of four domains: hunger, fullness, desire to eat, and prospective food consumption. The purpose of the present study was to determine agreement between the traditional paper-based VAS and a novel digital VAS (with and without images), as well as the novel digital VAS's predictive validity for subsequent food intake (FI) in 9-14-year-old children and adolescents. Following an overnight fast and 3 h after consuming a standardized breakfast at home, children and adolescents (n = 17) completed three different VAS instruments (VASpaper, VASimages, VASno-images) in a randomized order at five time-points: 0 min (baseline), 5 min (immediately after consuming a 147 kcal yogurt treatment), 20 min, 35 min (immediately before an ad libitum lunch), and 65 min (immediately post ad libitum lunch). All three instruments were comparable, as shown by low bias and limits of agreement on Bland-Altman plots, moderate to excellent intraclass correlation coefficients for all domains at all time-points (ICC = 0.72-0.98), and no differences between the incremental area under the curve for any of the domains. All three instruments also showed good predictive validity for subsequent FI, with the strongest relationship observed immediately before the ad libitum lunch (p = 0.56-0.63). There was no significant association between subjective thirst and water intake, except with VASno-images at baseline (r = 0.49, p = 0.046). In conclusion, the present study suggests that a novel image-based digital VAS evaluating motivation-to-eat is interchangeable with the traditional paper-based VAS, and provides good predictive validity for next-meal FI in 9-14-year-old normal weight children and adolescents.

Food Insecurity, Dietary Intakes, and Eating Behaviors in a Convenience Sample of Toronto Youth.

BACKGROUND: Food insecurity has been shown to be associated with poor dietary quality and eating behaviors, which can have both short- and long-term adverse health outcomes in children. The objective was to investigate the food security status, dietary intakes, and eating behaviors in a convenience sample of youth participating in the Maple Leaf Sports Entertainment LaunchPad programming in downtown Toronto, Ontario. METHODS: Youth aged 9-18 years were recruited to participate in the study. Food security status, dietary intakes, and eating behaviors were collected using parent- or self-reported questionnaires online. RESULTS: Sixty-six youth (mean ± SD: 11.7 ± 1.9 years) participated in the study. The prevalence of household food insecurity was higher than the national average with at least one child under 18 years of age (27.7% vs. 16.2%). Dietary intake patterns were similar to the national trends with low intakes of fiber, inadequate intakes of calcium and vitamin D; and excess intakes of sodium, added sugar, and saturated fat. Despite a low prevalence of poor eating habits, distracted eating was the most frequently reported poor eating habit. CONCLUSIONS: Although youth were at high risk for experiencing household food insecurity, inadequate dietary intake patterns were similar to the national trends. Our findings can be used to develop future programming to facilitate healthy dietary behaviors appropriate for the target community.

Effects of a high-intensity interval training session and chocolate milk on appetite and cognitive performance in youth aged 9-13 years.

BACKGROUND/OBJECTIVES: To investigate the separate and combined effects of a single session of high intensity interval training (HIIT) and chocolate milk on appetite and cognitive performance in youth aged 9-13 years. Blood glucose, salivary cortisol, and subjective emotions were measured to evaluate potential underlying mechanisms contributing to changes in appetite and cognitive performance. SUBJECTS/METHODS: Using a 2 × 2 repeated measures design, 20 youth (n = 12 girls and n = 8 boys; age = 11.4 ± 0.3 years) performed HIIT on a cycle ergometer (7 × 60 s bouts, interspersed by 60 s active recovery) or sitting, followed by consumption of 163 kcal chocolate milk or water. Capillary blood glucose, salivary cortisol, cognitive performance, and subjective appetite and emotions were assessed at baseline and at several time points post-treatment. RESULTS: Subjective appetite decreased from baseline following chocolate milk consumption compared water (p = 0.04), and increased from baseline after HIIT compared to sitting (p = 0.01). Participants recalled more words during a short-term memory task and had faster reaction times during an attention task following HIIT compared to sitting (Δ = 1.1 ± 0.02 words, p = 0.03; and Δ = 117.9 ± 23.1 ms, p = 0.01, respectively). Blood glucose increased from baseline following chocolate milk consumption compared to water (at 10 min: Δ = 1.0 ± 0.33 vs. Δ = 0.29 ± 0.060 mmol/L; p < 0.0001). CONCLUSIONS: Our findings that HIIT may have a positive effect on aspects of cognitive performance suggest that youth should engage in HIIT-like exercise during recesses and lunch at school to attenuate declines in cognitive performance throughout the day. Registered at https://clinicaltrials.gov (NCT03305107).

Test-retest reliability and validity of body composition methods in adults.

Cost-effective and efficient body composition measurement devices that are reliable and valid are necessary for identifying health risk as well as for understanding the effectiveness of lifestyle interventions. The objective of this study was to evaluate the test-retest reliability and validity of three body composition measurement devices. Forty-nine adults (mean age (SD) = 31.5 (10.7) y; BMI = 23.5 (3.0) kg/m2 ) completed a reference air displacement plethysmography (ADP) measure, and duplicate measures using skinfold callipers (Lange), ultrasound (BodyMetrix A-mode) and a 3-dimensional photonic scanner (3DPS; Fit3D ProScanner). Skinfold thickness was measured at seven sites using callipers and ultrasound; percent body fat (%BF) was then estimated using population-specific algorithms. The 3DPS was used to measure body circumferences, and then %BF was estimated using its beta-software. While skinfold callipers showed poor absolute reliability (mean differences (Δ) [95% CI] = 0.54% [0.22, 0.87], standard error of measurement (SEM) = 0.63%), ultrasound and the 3DPS showed excellent absolute (Δ = 0.17% [-0.25, 0.58], SEM = 0.78%; and Δ = -0.01% [-0.43, 0.40], SEM = 0.67%, respectively) and relative reliability (ICC2,1  = 0.988 [0.979, 0.993]; and ICC2,1  = 0.983 [0.968, 0.991], respectively). Compared to ADP (n = 43), skinfold callipers underestimated %BF (Δ = -4.53 [-7.72, -1.34]; p = 0.003), while ultrasound (Δ = -0.32 [-3.51, 2.87]; p = 0.99) and the 3DPS (Δ = 1.06 [-2.12. 4.26]; p = 0.77) were not significantly different. Bland-Altman plots showed a minimal bias of ultrasound [95% limit of agreement (LOA) = -7.87, 7.23] and the 3DPS [95% LOA = -6.66, 8.79]. In conclusion, estimating %BF from subcutaneous fat measurements using ultrasound and body circumferences using a 3DPS may be reliable and valid methods that require minimal technician expertise.

Assessment of body composition in spinal cord injury: A scoping review.

The objective of this scoping review was to map the evidence on measurement properties of body composition tools to assess whole-body and regional fat and fat-free mass in adults with SCI, and to identify research gaps in order to set future research priorities. Electronic databases of PubMed, EMBASE and the Cochrane library were searched up to April 2020. Included studies employed assessments related to whole-body or regional fat and/or fat-free mass and provided data to quantify measurement properties that involved adults with SCI. All searches and data extractions were conducted by two independent reviewers. The scoping review was designed and conducted together with an expert panel (n = 8) that represented research, clinical, nutritional and lived SCI experience. The panel collaboratively determined the scope and design of the review and interpreted its findings. Additionally, the expert panel reached out to their professional networks to gain further stakeholder feedback via interactive practitioner surveys and workshops with people with SCI. The research gaps identified by the review, together with discussions among the expert panel including consideration of the survey and workshop feedback, informed the formulation of future research priorities. A total of 42 eligible articles were identified (1,011 males and 143 females). The only tool supported by studies showing both acceptable test-retest reliability and convergent validity was whole-body dual-energy x-ray absorptiometry (DXA). The survey/workshop participants considered the measurement burden of DXA acceptable as long as it was reliable, valid and would do no harm (e.g. radiation, skin damage). Practitioners considered cost and accessibility of DXA major barriers in applied settings. The survey/workshop participants expressed a preference towards simple tools if they could be confident in their reliability and validity. This review suggests that future research should prioritize reliability and validity studies on: (1) DXA as a surrogate 'gold standard' tool to assess whole-body composition, regional fat and fat-free mass; and (2) skinfold thickness and waist circumference as practical low-cost tools to assess regional fat mass in persons with SCI, and (3) females to explore potential sex differences of body composition assessment tools. Registration review protocol: CRD42018090187 (PROSPERO).

Effect of White Potatoes on Subjective Appetite, Food Intake, and Glycemic Response in Healthy Older Adults.

The objective of this study was to determine the effect of white potato cooking methods on subjective appetite, short-term food intake (FI), and glycemic response in healthy older adults. Using a within-subject, repeated-measures design, 20 participants (age: 70.4 ± 0.6 y) completed, in random order, five treatment conditions: three potato treatments (baked potatoes, mashed potatoes, and French fries), an isocaloric control treatment (white bread), or a fasting condition (meal skipping). Subjective appetite and glycemic response were measured for 120 min using visual analogue scales and capillary blood samples, respectively. Lunch FI was measured with an ad libitum pizza meal at 120 min. Change from baseline subjective appetite (p < 0.001) and lunch FI (p < 0.001) were lower after all test treatments compared with meal skipping (p < 0.001), but did not differ among test treatments. Cumulative FI (test treatment + lunch FI) did not differ among treatment conditions. Blood glucose concentrations were higher after all test treatments compared with meal skipping (p < 0.001), but were not different from each other. In healthy older adults, white potatoes suppressed subjective appetite and lunch FI compared with meal skipping, suggesting white potatoes do not bypass regulatory control mechanisms of FI.

Effect of Increasing the Dietary Protein Content of Breakfast on Subjective Appetite, Short-Term Food Intake and Diet-Induced Thermogenesis in Children.

Dietary protein affects energy balance by decreasing food intake (FI) and increasing energy expenditure through diet-induced thermogenesis (DIT) in adults. Our objective was to investigate the effects of increasing the dietary protein in an isocaloric breakfast on subjective appetite, FI, blood glucose, and DIT in 9-14 y children. Two randomized repeated measures designs were used. In experiment 1, 17 children (9 boys, 8 girls) consumed isocaloric meals (450 kcal) on four separate mornings containing: 7 g (control), 15 g (low protein, LP), 30 g (medium protein, MP) or 45 g (high protein, HP) of protein. Blood glucose and subjective appetite were measured at baseline and regular intervals for 4 h, and FI was measured at 4 h. In experiment 2, 9 children (6 boys, 3 girls) consumed the control or HP breakfast on two separate mornings, and both DIT and subjective appetite were determined over 5 h. In experiment 1, all dietary protein treatments suppressed subjective appetite compared to control (p < 0.001), and the HP breakfast suppressed FI compared with the LP breakfast and control (p < 0.05). In experiment 2, DIT was higher after HP than control (p < 0.05). In conclusion, increasing the dietary protein content of breakfast had favorable effects on satiety, FI, and DIT in children.

Effect of potatoes and other carbohydrate-containing foods on cognitive performance, glycemic response, and satiety in children.

Dietary carbohydrates have been shown to influence cognitive performance and satiety in children. However, it remains unclear whether the carbohydrate source is a primary determinant of cognitive performance and satiety. The objective was to compare the effects of white potatoes and other carbohydrate-containing foods on cognitive performance, glycemic response, and satiety in children. On 6 separate mornings, in random order, children (n = 22) consumed 50 g of available carbohydrates from microwaved mashed potatoes (prepared from fresh potatoes then frozen), deep-fried potato strips (French fries), hash browns, white rice, white beans, or skipped a meal. Cognitive performance, glycemic response, and satiety were measured over 180 min. Cognitive performance was measured using a battery of tests assessing verbal declarative memory, spatial memory, short-term memory, working memory, and information processing speed. Although cognitive performance after the treatment meals did not differ from meal skipping, children recalled more words after French fries (9.1 ± 0.4 words) compared with mashed potatoes (8.2 ± 0.3 words; p = 0.001) and white rice (8.4 ± 0.3 words; p = 0.04) on the verbal declarative memory test. Blood glucose concentrations were higher after white rice compared with white beans, mashed potatoes, and hash browns (p < 0.05). Change from baseline subjective average appetite (mm/kcal) was lower after mashed potatoes compared with all other treatment meals (p < 0.05). In conclusion, verbal declarative memory was higher after French fries and subjective average appetite was lower after mashed potatoes. Future longitudinal studies are needed to confirm these short-term findings and to elucidate the mechanism of action.

Effect of video game playing and a glucose preload on subjective appetite, subjective emotions, and food intake in overweight and obese boys.

Video game playing (VGP) is associated with overweight/obesity (OW/OB). VGP and caloric preloads in the pre-meal environment influence short-term food intake (FI) in healthy-weight children. Therefore, the purpose of the present study was to examine the effect of pre-meal VGP and a glucose preload on subjective emotions, subjective appetite, and FI in boys with OW/OB. On 4 separate mornings, boys with OW/OB (n = 22; mean ± SD: age = 11.9 ± 1.6 years; body mass index percentile = 94.3 ± 3.9) participated in 4 test conditions. Two hours after a standardized breakfast, boys consumed equally sweetened preloads (250 mL) of sucralose (0 kcal) or glucose (200 kcal), with or without 30 min of subsequent VGP. Immediately after each test condition, FI was evaluated during an ad libitum pizza meal. Subjective appetite was measured at 0 (baseline), 15, and 30 min. Subjective emotions (aggression, anger, excitement, disappointment, happiness, upset, and frustration) were measured at 0 and 30 min. VGP did not affect FI, but the glucose preload decreased FI compared with the sucralose control (Δ = -103 ± 48 kcal, p < 0.01). However, cumulative FI (preload kcal + meal kcal) was 9% higher after the glucose preload (p < 0.01). Subjective appetite increased with time (p < 0.05) but was not influenced by preload or VGP. Frustration was the only subjective emotion that increased following VGP (p < 0.01). A glucose preload, but not VGP, suppressed FI in boys with OW/OB, suggesting a primary role of physiological factors in short-term FI regulation.

Effect of Commercially Available Sugar-Sweetened Beverages on Subjective Appetite and Short-Term Food Intake in Boys.

It is unclear whether sugar sweetened beverages bypass regulatory controls of food intake (FI) in boys. The objective of the present study was to determine the effects of isovolumetric preloads (350 mL) of a fruit-flavoured drink (154 kcal), cola (158 kcal), 1% M.F. chocolate milk (224 kcal), and water (0 kcal) on subjective appetite and FI in boys aged 9⁻14 years. On four separate mornings, boys consumed one of the preloads in a random order; subjective appetite was measured at 15 min intervals, and FI was measured via an ad libitum pizza lunch at 60 min post-beverage consumption. In the 32 boys (age: 11.8 ± 0.3 years), FI was reduced (p < 0.001) after cola (940 ± 46 kcal) and chocolate milk (878 ± 41 kcal) compared with the water control (1048 ± 35 kcal) and after chocolate milk compared to the fruit drink (1005 ± 44 kcal). Cumulative FI after the fruit drink was greater than the water control (1159 ± 44 vs. 1048 ± 35 kcal; p = 0.03). Average appetite was not affected by the treatment, but the cola treatment resulted in greater fullness (p = 0.04) and lower prospective food consumption (p = 0.004) compared with the fruit drink. In conclusion, chocolate milk and cola suppressed next-meal FI at 60 min, while fruit drink increased cumulative FI (beverage + next meal) over 60 min in boys. Results from this study suggest that beverage composition is an important determinant of FI suppression in boys.

Effects of walnuts consumption on vascular endothelial function in humans: A systematic review and meta-analysis of randomized controlled trials.

BACHGROUND AND AIMS: Endothelial dysfunction can promote atherosclerosis pathogenesis. The aim of the present meta-analysis was to determine the effects of walnut consumption on peripheral endothelial function (EF) in adults. METHODS: PUBMED, MEDLINE and EMBASE were searched to identify studies up to August 2017. Eligible studies conducted randomized controlled trials (RCTs) on the effects of walnut consumption compared with a control on EF. Standard mean difference (SMD) and 95% confidence intervals (CI) were reported as summary statistics. Standard methods were used for assessment of heterogeneity, meta-regression, sensitivity analysis and publication bias. RESULTS: Five studies comprising a total of 323 subjects were included in the meta-analysis. The results showed a significant increase in EF after walnut consumption (SMD: 0.40%; 95% CI: 0.20 to 0.62; p < 0.001) with no evidence of heterogeneity across studies. Sensitivity analysis showed that the effect size was robust and not sensitive to any single study. Meta-regression did not indicate any significant association for an increase in EF after walnut consumption with dose of treatment, duration of treatment, or baseline EF. CONCLUSION: The available evidence from RCTs suggests there may be a clinically relevant effect of walnut consumption on EF.

Effect of Commercially Available Sugar-Sweetened Beverages on Subjective Appetite and Short-Term Food Intake in Girls.

BACKGROUND: The effect of sugar-sweetened beverages (SSBs) on satiety and short-term food intake (FI) regulation in girls has received little attention. The objective of the present study was to compare the effect of pre-meal consumption of commercially available SSBs on subjective appetite and short-term FI in 9-14-year-old girls. The methods we used include using a randomized crossover design in which 28 girls consumed isovolumetric amounts (350 mL) of a fruit drink (154 kcal), cola (158 kcal), 1% chocolate milk (224 kcal), or water (control; 0 kcal) on four separate mornings. Subjective appetite and thirst were measured at regular intervals via visual analogue scales (VAS) and FI was assessed at 60 min post-beverage consumption. The results show that subjective appetite and thirst decreased after all beverages, but did not differ among beverages. Short-term FI was suppressed following consumption of chocolate milk (15%; p < 0.001) and cola (11%; p = 0.02) compared to the water control. However, cumulative energy intake (beverage (kcal) + test meal (kcal)) was not affected by beverage type. In conclusion, chocolate milk and cola, but not fruit drink, suppressed FI in girls while cumulative FI did not differ among treatments.

Modeling Perceived Exertion during Graded Arm Cycling Exercise in Spinal Cord Injury.

PURPOSE: RPE may be useful for exercise testing and prescription in individuals with spinal cord injury (SCI), although the roles of differentiated central and peripheral fatigue during exercise are not clear. We aimed to model differentiated RPE responses during graded arm cycling in individuals with SCI and to describe their relationship to cardiorespiratory outcomes. METHODS: Thirty-six individuals with SCI (13 paraplegia and 23 tetraplegia) completed a maximal graded arm cycling exercise test to volitional exhaustion (5 W·min paraplegia; 10 W·min tetraplegia). Participants were asked to report central RPE (CRPE) and peripheral RPE (PRPE) every minute using the Borg category ratio (CR10) scale until termination of exercise. Heart rate and breath-by-breath respiratory outcomes were collected throughout the exercise test. Ventilatory threshold (VT) was assessed using the ventilatory equivalents method. RESULTS: Cardiorespiratory indices increased linearly during graded arm exercise. By contrast, both CRPE and PRPE responses were best fit to a quadratic model with positively accelerating growth in individuals with paraplegia (P < 0.01) and tetraplegia (P < 0.05). PRPE developed faster than CRPE in individuals with tetraplegia (P < 0.01). Individuals with paraplegia had accelerated CRPE (P < 0.05) and PRPE (P < 0.05) responses compared with tetraplegia, but not when considering only individuals who reached VT. PRPE was higher than CPRE only in the late stages (80%-100% test duration; P < 0.05) in both groups when only considering individuals who reached VT. CONCLUSIONS: PRPE develops faster than CRPE in individuals with tetraplegia in a nonlinear fashion, despite linear increases in cardiorespiratory responses during graded arm cycling. Although there is promise to use differentiated RPE for exercise testing and prescription within the SCI population, our results indicate that there are differences in how individuals with tetraplegia perceive peripheral versus central exertion.

The effects of whole body vibration on pulse wave velocity in men with chronic spinal cord injury.

OBJECTIVE: A pilot study to evaluate the therapeutic potential of 40 weeks of passive standing with whole body vibration (PS-WBV) on central and peripheral arterial stiffness among men with chronic spinal cord injury (SCI). METHODS: Consenting participants were pre-screened to ensure safe participation. Fifteen individuals with chronic SCI were enrolled to participate in PS-WBV sessions three times per week for 40 weeks on a modified WAVE platform custom-fitted with an EASYStand 5000. Knee angle was set at 160°, and vibration parameters were 45Hz frequency and 0.7mm displacement. Each 45-minute session of PS-WBV training was intermittent (60 seconds on and 120 seconds off). Aortic and leg pulse wave velocity (PWV) was measured at baseline, mid-point (20 weeks) and exit (40 weeks). RESULTS: Nine males (age 41±11 years, American Spinal Injury Association Impairment Scale A-D, neurological level of injury T4-T10, years post-injury 12±8 years) completed the intervention. Aortic PWV was collected on n=7 at exit, and leg PWV was collected on n=6 at exit. No changes over time were found for either aortic PWV (P = 0.46) or leg PWV (P = 0.54). One possible study-related serious adverse event occurred during study intervention: the development of a grade III pressure sore on the right proximal anterior shin (n=1). CONCLUSION: Forty weeks of PS-WBV in adults with SCI did not result in an observable change in arterial stiffness.

Predicting peak oxygen uptake from submaximal exercise after spinal cord injury.

The purpose of this study was to determine the validity of the 6-min arm ergometry test (6MAT) in predicting peak oxygen consumption (V̇O2peak) in individuals with chronic spinal cord injury (SCI). Fifty-two individuals with chronic SCI (age, 38 ± 10 years; American Spinal Injury Association Impairment Scale (AIS), A-D; neurological level of injury (NLI), C1-L2; years post-injury (YPI), 13 ± 10 years) completed an incremental arm ergometry V̇O2peak test and a submaximal 6MAT. Oxygen consumption (V̇O2) data from both tests were used to create a predictive equation with regression analysis. Subsequently, a cross-validation group comprising an additional 10 individuals with SCI (age, 39 ± 13 years; AIS, A-D; NLI, C3-L3; YPI, 9 ± 9 years) were used to determine the predictive power of the equation. All participants were able to complete both the V̇O2peak and 6MAT assessments. Regression analysis yielded the following equation to predict V̇O2peak from end-stage 6MAT V̇O2: V̇O2peak (mL·kg(-1)·min(-1)) = 1.501(6MAT V̇O2) - 0.940. Correlation between measured and predicted V̇O2peak was excellent (r = 0.89). No significant difference was found between measured (17.41 ± 7.44 mL·kg(-1)·min(-1)) and predicted (17.42 ± 6.61 mL·kg(-1)·min(-1)) V̇O2peak (p = 0.97). When cross-validated with a sample of 10 individuals with SCI, correlation between measured and predicted V̇O2peak remained high (r = 0.89), with no differences between measured (18.81 ± 8.35 mL·kg(-1)·min(-1)) and predicted (18.73 ± 7.27 mL·kg(-1)·min(-1)) V̇O2peak (p = 0.75). Results suggest that 6MAT V̇O2 can be used to predict V̇O2peak among individuals with chronic SCI. The 6MAT should be used as a clinical tool for assessing aerobic capacity when peak exercise testing is not feasible.