Search Results (55)

Background: The introduction of cystic fibrosis transmembrane conductance regulator modulators, especially the triple therapy elexacaftor, tezacaftor, ivacaftor (ETI), has improved outcomes in people with cystic fibrosis (pwCF), reducing underweight but increasing overweight rates. Objectives: This study investigates the effect of ETI on appetite control, body composition, and energy balance during a 3-week inpatient rehabilitation programme with regular exercise. Methods: In 54 pwCF (38 on ETI, 16 without ETI), changes in body composition (fat mass index, FMI; fat-free mass index, FFMI) and energy balance (calculated from body composition changes) were assessed. Appetite control was evaluated via plasma peptide YY (PYY) levels and post-exercise meal energy intake. Results: The programme significantly increased BMI (+0.3 ± 0.1 kg/m²; CI 0.1–0.4) and energy balance (+4317 ± 1976 kcal/3 weeks), primarily through FFMI gains (+0.3 ± 0.1 kg/m²; CI 0.1–0.4). Despite higher post-exercise meal energy intake and a tendency towards lower PYY levels in the ETI group, changes in body composition and energy balance did not differ between groups. This is explained by a higher prevalence of exocrine pancreatic insufficiency in the ETI group (92% vs. 50%, p < 0.001). Small sample sizes limit the interpretation of data on appetite control and energy intake. Conclusions: A 3-week inpatient rehabilitation programme improved body composition in pwCF, without resulting in a more positive energy balance with ETI therapy. This is due to a higher prevalence of pancreatic insufficiency in this group. Full article

Background/Objectives: The STRIVE study was a multicentre, open-label, real-world clinical trial evaluating the effectiveness of a targeted prescribing pathway for liraglutide 3.0 mg as an adjunct to standard care versus standard care alone in people with obesity attending Specialist Weight Management Services (SWMS) in the UK and Ireland. This post hoc analysis focuses on the standard care arm to explore differences in outcomes between sites, particularly the potential impact of offering meal replacements as part of usual care. Methods: Participants included individuals with a BMI ≥ 35 kg/m² and at least one obesity-related complication who received standard care at five SWMS sites. All sites provided specialist nutrition and exercise counselling; however, only the Dublin site (n = 40) included meal replacements as part of routine care. Baseline characteristics and weight change data were compared between the Dublin and UK cohorts (n = 92) at 52 and 104 weeks. Statistical comparisons were made using appropriate parametric and non-parametric tests. Results: At baseline, the Dublin cohort was significantly older (p < 0.01), had a higher prevalence of hypertension (p < 0.05), and a lower reported incidence of depression/anxiety (p < 0.05) than the UK cohort. At week 52, the Dublin group achieved greater mean weight loss (−6.1%, SD ± 5.7%) compared to the UK cohort (−1.3%, SD ± 6.7%, n = 27, p < 0.01). By week 104, Dublin participants maintained a mean weight loss of −4.4% (SD ± 5.7%) while UK participants had a mean weight gain of 0.37% (SD ± 7.6%) (p < 0.05). Conclusions: The integration of meal replacements as part of usual care may have contributed to the greater and sustained weight loss observed in the Dublin cohort compared to other SWMS in the UK. Full article

Background: This study assessed the feasibility, acceptability, and preliminary effectiveness of a teaching kitchen intervention that synergistically provided nutrition education, culinary skills/techniques, mindfulness, physical activity, and behavior change strategies. Methods: Non-randomized pilot study of 16 weekly 2 h hands-on virtual culinary sessions. Curbside grocery pickup assured food access/consistency. Qualitative interviews and pre/post-anthropometrics (BMI, waist circumference), labs (fasting glucose, insulin, lipids, HbA1c, ALT), and health habits surveys assessed program impact. Results: The program was successfully implemented from January to May of 2022. Of 56 participants screened, 13 (23%) enrolled, and 12 (92%) completed the program (mean age 51 years; 92% female; 92% white) with an average of 15.4 of 16 (96%) sessions attended and 100% completing assessments. Satisfaction with the program and with virtual cooking was high (100% and 92% satisfied-very satisfied). Days/week main meal was prepared from scratch increased from 3.8 to 5.9 (p < 0.05). Sense of well-being and three core mindfulness items (satiety, snacking, and food appreciation) improved (p ≤ 0.05). Confidence in 13 culinary skills/techniques improved (p < 0.05), as did diet recall and daily exercise, with variable significance. Labs improved LDL significantly (p < 0.05); anthropometrics did not. Conclusions: This teaching kitchen program was feasible, very well accepted, and suggested potential efficacy in improving health habits and metrics. Larger studies with randomization are needed. Full article

The 4Rs of sports nutrition were proposed in recent years as an evidence-based framework to optimize post-exercise recovery within the context of allostasis. Under this paradigm, it is important to consider that each R represents a factor with a tremendous influence on the allostatic response and improves individual components of the allostatic load (AL), which will positively impact the exercise-induced adaptations and the athlete’s recovery. The 4Rs correspond to the following. (i) Rehydration—This is necessary to guarantee the post-exercise consumption of at least 150% of the body mass lost during the exercise accompanied by sodium (if faster replacement is required). (ii) Refuel—Carbohydrate intake (~1.2 g/kg body mass per hour for up to 4 h post-exercise) is essential not only in restoring glycogen reserves but also in supporting the energy needs of the immune system and facilitating tissue repair. Despite changes in substrate utilization, a ketogenic diet generally has neutral or negative effects on athletic performance compared to carbohydrate-rich diets. (iii) Repair—The ingestion of high-quality protein stimulates post-exercise net muscle protein anabolism and might contribute to faster tissue growth and repair. The use of certain supplements, such as creatine monohydrate, might help to enhance recovery, while tart cherry, omega-3 fatty acids, and dietary nitrate (e.g., Beta vulgaris, Amaranthus L.), as well as other herbal extracts containing flavonoid-rich polyphenols, deserve further clinical research. (iv) Recuperate—Pre-sleep nutrition (casein- or protein-rich meal with slow digestion rate) has a restorative effect, facilitating the recovery of the musculoskeletal, endocrine, immune, and nervous systems. In this article, we update the 4Rs framework, delve deeper into the allostasis paradigm, and offer theoretical foundations and practical recommendations (the 4Rs app) for the assessment of AL in athletes. We cautiously propose an AL index (AL_index) for physique competitors and elite athletes to evaluate the cumulative physiological stress induced by exercise and, thereby, to adjust exercise and nutrition interventions. Full article

Background/Objectives: Exercise and nutrition may be useful strategies in dynapenic and sarcopenic obesity management, but the identification of treatment modalities aimed at improving this condition is still lacking. We compared the effect of a five-month hypocaloric diet plus resistance training (RT) with and without essential amino acids (EAAs) on body composition, physical performance, and muscle strength among older adults with dynapenic obesity (DO). Methods: Older individuals (n = 48) with DO [(BMI ≥ 30 kg/m² and/or high waist circumference and low handgrip strength (HGS)] were randomized into two double-blind groups (RT without EAAs vs. RT+EAAs). All participants followed a hypocaloric diet (1 g of proteins/kg spread over three meals) and RT for five months. Pre- and post-intervention assessments included the body composition (DXA), Short Physical Performance Battery (SPPB), HGS, one-repetition maximum (1-RM), and maximal isometric torque with an isokinetic dynamometer. Results: Both groups reduced body mass (RT: −4.66 kg; RT+EAAs: −4.02 kg), waist circumference (RT: −4.66 cm; RT+EAAs: −2.2 cm), total fat mass (RT: −3.81 kg; RT+EAAs: −3.72 kg), and compartmental fat mass with no between-group differences. Both groups improved 1-RM strength (33–47%), isometric torque for body mass (RT: 14.5%; RT+EAAs: 10.6%), and functional performance (chair stand (RT: −3.24 s; RT+EAAs: −1.5 s) and HGS (RT: −2.7 kg; RT+EAAs: 2.9 kg)) with no between-group differences. Conclusions: A moderate hypocaloric diet combined with RT improves body composition and physical function in DO participants, but EAA supplementation did not provide additional benefits. Full article

Background and Objectives: In Italy, as in the rest of the world, government restrictions aimed at containing the spread of COVID-19 primarily imposed limitations on social relationships and personal behavior. This situation significantly affected the management of chronic illnesses, including type 2 diabetes (T2D). The objective was to evaluate the perceptions of patients with T2D regarding the quality of care received during the COVID-19 pandemic and the impact on dietary and physical activity behaviors. Materials and Methods: We conducted a retrospective cross-sectional survey. Data were collected from June to July 2023 using the convenience sampling of patients with T2D, and the Patient Assessment of Chronic Illness Care (PACIC) and Medi-Lite questionnaires were administered. Results: During the research period, out of the 130 subjects who met all enrollment criteria, 103 patients were included in this study (79.23%). The results of the administered questionnaires were heterogeneous. The average scores from the PACIC Questionnaire for each question displayed significant variability, indicating a range of experiences in the quality of care. In the Medi-Lite survey, fruit, cereals, and olive oil showed the highest adherence levels, with mean scores ranging from 2.58 (SD ± 1.18) for fruit to 1.89 (SD ± 0.34) for olive oil and 1.97 (SD ± 0.17) for cereals. Patients who reported increased food intake during the lockdown attributed it to having more time to prepare meals. Physical activity levels remained unchanged for 48 patients, decreased for 45 patients, and only 9 patients managed to exercise more during the COVID-19 restrictions. Conclusions: Healthcare systems must prioritize comprehensive care plans for T2D that address not only physical health, but also emotional and social well-being. Post-pandemic, promoting healthier lifestyles and empowering patients to manage their condition is crucial. A multidisciplinary and multidimensional approach could support the care of vulnerable individuals, such as patients with T2D, especially during crises like pandemics or other dramatic events. Full article

The detrimental impacts of postprandial hyperglycemia on health are a critical concern, and exercise is recognized a pivotal tool in enhancing glycemic control after a meal. However, current exercise recommendations for managing postprandial glucose levels remain fairly broad and require deeper clarification. This review examines the existing literature aiming to offer a comprehensive guide for exercise prescription to optimize postprandial glycemic management. Specifically, it considers various exercise parameters (i.e., exercise timing, type, intensity, volume, pattern) for crafting exercise prescriptions. Findings predominantly indicate that moderate-intensity exercise initiated shortly after meals may substantially improve glucose response to a meal in healthy individuals and those with type 2 diabetes. Moreover, incorporating short activity breaks throughout the exercise session may provide additional benefits for reducing glucose response. Full article

This study evaluates the psychophysiological response to a simulated hunter–gatherer endurance task with restricted caloric intake over four days. It assesses changes in body composition, autonomic modulation, and physical and cognitive performance. Participants underwent daily 8 h fasted walks followed by a 150 kcal meal to replicate hunter–gatherer activity and dietary patterns. Measurements of metabolic, respiratory, and subjective well-being, along with heart rate variability (HRV) monitoring, were conducted pre- and post-activity to evaluate the impact of endurance activity under caloric restriction. We found weight loss, decreased body and visceral fat, and reduced skeletal muscle mass and water percentage. High sympathetic activation and stable urinary markers, except for increased proteinuria, indicated stress responses and muscular degradation. Elevated perceived exertion post-exercise with good adaptation to prolonged effort underlines the body’s adaptability to ancestral lifestyle conditions, highlighting the connection among endurance, nutrition, and psychophysiological health. Full article

Studies investigating the acute effect of postprandial exercise (PPE) on glucose responses exhibit significant heterogeneity in terms of participant demographic, exercise protocol, and exercise timing post-meal. As such, this study aimed to further analyze the existing literature on the impact of PPE on glycemic control in overweight individuals and individuals with obesity and type 2 diabetes (T2DM). A literature search was conducted through databases such as PubMed, CINAHL, and Google Scholar. Thirty-one original research studies that met the inclusion criteria were selected. A random-effect meta-analysis was performed to compare postprandial glucose area under the curve (AUC) and 24 h mean glucose levels between PPE and the time-matched no-exercise control (CON). Subgroup analyses were conducted to explore whether the glucose-lowering effect of PPE could be influenced by exercise duration, exercise timing post-meal, and the disease status of participants. This study revealed a significantly reduced glucose AUC (Hedges’ g = −0.317; SE = 0.057; p < 0.05) and 24 h mean glucose levels (Hedges’ g = −0.328; SE = 0.062; p < 0.05) following PPE compared to CON. The reduction in glucose AUC was greater (p < 0.05) following PPE lasting >30 min compared to ≤30 min. The reduction in 24 h mean glucose levels was also greater (p < 0.05) following PPE for ≥60 min compared to <60 min post-meal and in those with T2DM compared to those without T2DM. PPE offers a viable approach for glucose management and can be performed in various forms so long as exercise duration is sufficient. The glucose-lowering effect of PPE may be further enhanced by initiating it after the first hour post-meal. PPE is a promising strategy, particularly for patients with T2DM. This manuscript is registered with Research Registry (UIN: reviewregistry1693). Full article

Exercise confers a multitude of benefits with limited adverse side effects, making it a powerful “medication” for a plethora of diseases. In people living with uncontrolled glucose levels, exercise can be an effective “medication” to assist in the management of hyperglycemia. We sought to survey healthcare providers (physicians and physical therapists) to determine the current state of exercise recommendation for people with glucose control issues. Healthcare providers were surveyed from six academic medical centers in the Midwest to determine the recommended exercise parameters (type, frequency, duration, intensity, and timing) for patients with glucose control issues. Data from 209 practitioners who completed the survey were used for analysis. Chi-square tests were used to determine differences in exercise recommendations between physical therapists (PTs) and physicians (MD/DOs). PTs and MD/DOs recommended similar exercise parameters. Of all respondents, 78.9% recommended exercise to patients with glucose control issues. Respondents who considered themselves to be active exercisers were more likely to recommend exercise than those who were not exercisers. Only 6.1% of all respondents recommended post-meal exercise. Healthcare providers overwhelmingly recommended exercise for people with glucose control issues, but the “timing” is not congruent with best practice recommendations. Full article

(1) The purpose of this study was to investigate the effect of whey protein supplementation under dietary control on improvements in muscle mass and function following resistance exercise training. (2) Thirty-two men were randomly assigned to a whey protein supplementation group taking whey protein isolate (PSG, n = 17) and a placebo group (CON, n = 15). Participants were provided with three meals per day corresponding to the estimated individual daily energy intake. The supervised resistance exercise program was conducted 60 min per day, six days per week, for four weeks. (3) Post-intervention, there was a significant interaction between groups in terms of muscle mass increase (p = 0.033, η² = 0.14), with a greater increase in the PSG. There were also significant interactions between the groups and increases in peak torque of the dominant knee flexors (p = 0.048, η² = 0.12), dominant shoulder extensors, and non-dominant shoulder extensors (p = 0.028, η² = 0.15; p = 0.015, η² = 0.18), and the total work of the dominant knee and shoulder extensors (p = 0.012, η² = 0.19; p = 0.013, η² = 0.19), with greater increases in the PSG. (4) These results suggest that whey protein supplementation enhances resistance exercise-induced increase in muscle mass and overall muscular strength and endurance, independent of dietary influence. Full article

This study examined the effects of four weeks of resistance training combined with time-restricted eating (TRE) vs. habitual diet on fat and fat-free mass as well as maximum and explosive force production in healthy, trained participants (18 males, aged 23.7 ± 2.6 years). The order of dieting was randomized and counterbalanced, and the participants served as their own controls. TRE involved an 8-h eating window and non-TRE involved a habitual meal pattern. Participants completed performance strength tests and body composition scans at baseline and post-intervention. The participants followed a structured training routine during each dietary intervention (four sets of maximum repetitions at 85% 1RM in five dynamic exercises, three times/week). Both interventions elicited deceases in fat mass (p < 0.05) but not in fat-free mass. After training (controlling for baseline values as covariates), non-TRE was compatible with better lower body jump performance than TRE (p < 0.05). Conversely, training with TRE elicited higher values in terms of peak force and dynamic strength index at the level of the upper body (p < 0.05). Thus, it can be concluded that there were no differences in fat mass and fat-free mass changes between interventions in already trained young males. Additionally, while the combination of TRE and resistance training might be beneficial for individuals focusing on developing high-speed strength performance at the upper body level, this is not applicable to those focusing on training the lower body. Full article

We evaluated the effects of different exercise types suitable for a home/work setting on the postprandial glucose response. Twenty-three healthy, active, young individuals performed one of two studies (12 in Study 1 and 11 in Study 2), with four randomized protocols each. After a meal high in carbohydrate content (1 g of carbohydrate per kg of body weight), in Study 1, participants performed 30 min of either walking (WALK), bench stepping exercise (STEP) or isometric wall squat (SQUAT); in Study 2, participants performed 30 min of either walking (WALK), neuromuscular electrical stimulation alone (P_NMES) or superimposed on voluntary muscle contraction (VC_NMES). In both studies, participants performed a prolonged sitting condition (CON) that was compared to the exercise sessions. In Study 1, WALK and STEP significantly reduced the glucose peak compared to CON (p < 0.011). In Study 2, the peak was significantly reduced in WALK compared to CON, P_NMES and VC_NMES (p < 0.011) and in VC_NMES compared to CON and P_NMES (p < 0.011). A significant reduction of 3 h glucose iAUC was found for WALK and VC_NMES compared to CON and P_NMES (p < 0.033). In conclusion, WALK is the most effective strategy for improving the postprandial glycemic response. However, STEP and VC_NMES can also be used for reducing postprandial glycemia. Full article

COVID-19 and imposed restrictions are linked with numerous health consequences, especially among endurance athletes (EA). Unfavorable changes in physical activity and nutrition may affect later sports and competition performance. The aims of this study were: (1) to assess the impact of COVID-19 infection and pandemic restrictions on the nutrition and physical activity of EAs and (2) to compare them with the results of cardiopulmonary exercise testing (CPET). In total, 49 EAs (n_male = 43, n_female = 6, mean age = 39.9 ± 7.8 year., height = 178.4 ± 6.8 cm, weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m⁻²) underwent pre- and post-COVID-19 CPET and fulfilled the dietary and physical activity survey. COVID-19 infection significantly deteriorated CPET performance. There was a reduction in oxygen uptake and in heart rate post-COVID-19 (both p < 0.001). Consuming processed meat and replacing meat with plant-based protein affected blood lactate concentration (p = 0.035). Fat-free mass was linked with consuming unsaturated fatty acids (p = 0.031). Adding salt to meals influenced maximal speed/power (p = 0.024) and breathing frequency (p = 0.033). Dietary and Fitness Practitioners and Medical Professionals should be aware of possible COVID-19 infection and pandemic consequences among EA. The results of this study are a helpful guideline to properly adjust the treatment, nutrition, and training of EA. Full article

Research suggests exercise may reduce eosinophilic airway inflammation in adults with asthma. The Dietary Inflammatory Index (DII^®) quantifies the inflammatory potential of the diet and has been associated with asthma outcomes. This study aimed to determine whether the DII of a meal consumed either before or after exercise influences exercise-induced changes in airway inflammation. A total of 56 adults with asthma were randomised to (1) 30–45 min moderate–vigorous exercise, or (2) a control group. Participants consumed self-selected meals, two hours pre- and two hours post-intervention. Energy-adjusted DII (E-DII^TM) was determined for each meal, with meals then characterised as “anti-inflammatory” or “pro-inflammatory” according to median DII. Induced sputum cell counts were measured pre- and four hours post-intervention. Participants consuming an anti-inflammatory meal two hours post-exercise had a decrease in sputum %eosinophils (−0.5 (−2.0, 0.3)%) compared with participants who consumed a pro-inflammatory meal two hours post-exercise (0.5 (0, 3.0)%, p = 0.009). There was a positive correlation between the E-DII score of the post-exercise meal and change in sputum %eosinophils (r_s = 0.478, p = 0.008). The E-DII score of the meal consumed two hours pre-exercise had no effect on sputum %eosinophils (p = 0.523). This study suggests an anti-inflammatory meal two hours post-exercise augments exercise-induced improvements in eosinophilic airway inflammation in adults with asthma. Full article