The magnitude of the negative energy balance induced by exercise may be reduced due to compensatory increases in energy intake.
TO ADDRESS THE QUESTION: Does increased exercise or physical activity ...alter ad-libitum daily energy intake or macronutrient composition in healthy adults?
PubMed and Embase were searched (January 1990-January 2013) for studies that presented data on energy and/or macronutrient intake by level of exercise, physical activity or change in response to exercise. Ninety-nine articles (103 studies) were included.
Primary source articles published in English in peer-reviewed journals. Articles that presented data on energy and/or macronutrient intake by level of exercise or physical activity or changes in energy or macronutrient intake in response to acute exercise or exercise training in healthy (non-athlete) adults (mean age 18-64 years).
Articles were grouped by study design: cross-sectional, acute/short term, non-randomized, and randomized trials. Considerable heterogeneity existed within study groups for several important study parameters, therefore a meta-analysis was considered inappropriate. Results were synthesized and presented by study design.
No effect of physical activity, exercise or exercise training on energy intake was shown in 59% of cross-sectional studies (n = 17), 69% of acute (n = 40), 50% of short-term (n = 10), 92% of non-randomized (n = 12) and 75% of randomized trials (n = 24). Ninety-four percent of acute, 57% of short-term, 100% of non-randomized and 74% of randomized trials found no effect of exercise on macronutrient intake. Forty-six percent of cross-sectional trials found lower fat intake with increased physical activity.
The literature is limited by the lack of adequately powered trials of sufficient duration, which have prescribed and measured exercise energy expenditure, or employed adequate assessment methods for energy and macronutrient intake.
We found no consistent evidence that increased physical activity or exercise effects energy or macronutrient intake.
PURPOSEThe current study examined the relationship between children’s performance on the Progressive Aerobic Cardiovascular Endurance Run subtest of the FitnessGram® and aspects of cognitive control ...that are believed to support academic success.
METHODSHierarchical linear regression analyses were conducted on a sample of second- and third-grade children (n = 397) who completed modified versions of a flanker task and spatial n-back task to assess inhibitory control and working memory, respectively.
RESULTSGreater aerobic fitness was significantly related to shorter reaction time and superior accuracy during the flanker task, suggesting better inhibitory control and the facilitation of attention in higher-fit children. A similar result was observed for the n-back task such that higher-fit children exhibited more accurate target detection and discrimination performance when working memory demands were increased.
CONCLUSIONSThese findings support the positive association between aerobic fitness and multiple aspects of cognitive control in a large sample of children, using a widely implemented and reliable field estimate of aerobic capacity. Importantly, the current results suggest that this relationship is consistent across methods used to assess fitness, which may have important implications for extending this research to more representative samples of children in a variety of experimental contexts.
Differences in biological changes from weight loss by energy restriction and/or exercise may be associated with differences in long-term weight loss/regain.
To assess the effect of weight loss method ...on long-term changes in weight, body composition and chronic disease risk factors.
PubMed and Embase were searched (January 1990-October 2013) for studies with data on the effect of energy restriction, exercise (aerobic and resistance) on long-term weight loss. Twenty articles were included in this review.
Primary source, peer reviewed randomized trials published in English with an active weight loss period of >6 months, or active weight loss with a follow-up period of any duration, conducted in overweight or obese adults were included.
Considerable heterogeneity across trials existed for important study parameters, therefore a meta-analysis was considered inappropriate. Results were synthesized and grouped by comparisons (e.g. diet vs. aerobic exercise, diet vs. diet + aerobic exercise etc.) and study design (long-term or weight loss/follow-up).
Forty percent of trials reported significantly greater long-term weight loss with diet compared with aerobic exercise, while results for differences in weight regain were inconclusive. Diet+aerobic exercise resulted in significantly greater weight loss than diet alone in 50% of trials. However, weight regain (∼ 55% of loss) was similar in diet and diet+aerobic exercise groups. Fat-free mass tended to be preserved when interventions included exercise.
Background Despite representing nearly 20% of the U.S. population, individuals with disabilities are invisible in obesity surveillance and intervention efforts. Purpose The current study (1) compares ...obesity and extreme obesity prevalence between Americans with and without disabilities and (2) examines the association between BMI category and weight-related chronic disease risk factors in both groups. Methods In 2012, six waves of data from the National Health and Nutrition Examination Survey (NHANES, 1999–2010) were pooled to compare the prevalence of obesity and extreme obesity between adults (aged ≥20 years, N=31,990) with disabilities ( n =11,556) versus without disabilities ( n = 20,434). Chronic disease risk factors (blood pressure, lipids, C-reactive protein CRP, glucose) were compared across weight categories, by disability severity, and disability status. Results Obesity (41.6%) and extreme obesity (9.3%) prevalence among those with disabilities were significantly higher than they were among those without disabilities (29.2% and 3.9%, respectively). Disability severity and disability status negatively affected nearly all chronic disease risk factors. Additionally, there was a disability-by-weight interaction: people with disabilities at all weight categories were significantly more likely to report being told they had hypertension, high cholesterol, or diabetes and to have been prescribed antihypertensive and lipid-lowering medications. Conclusions The prevalence of obesity (41.6%) and extreme obesity (9.3%) found in individuals with disabilities is high. When compared to obese adults without disabilities, obese adults with disabilities are more likely to have diabetes, high cholesterol, hypertension, and higher CRP. Thus, the study provides convincing evidence of obesity-related health disparities between Americans with and without disabilities.
Abstract Objective To compare the effectiveness of 2 home-based behavioral interventions for wheelchair users to promote exercise adoption and maintenance over 12 months. Design Randomized controlled ...trial, with participants stratified into groups based on disability type (stable, episodic, progressive) and support partner availability. Setting Exercise occurred in participant-preferred locations (eg, home, recreation center), with physiological data collected at a university-based exercise laboratory. Participants Inactive wheelchair users (N=128; 64 women) with sufficient upper arm mobility for arm-based exercise were enrolled. Participants on average were 45 years of age and lived with their impairment for 22 years, with spinal cord injury (46.1%) most commonly reported as causing mobility impairment. Interventions Both groups received home-based exercise interventions. The staff-supported group (n=69) received intensive exercise support, while the self-guided group (n=59) received minimal support. Both received exercise information, resistance bands, instructions to self-monitor exercise, regularly scheduled phone calls, and handwritten cards. Main Outcome Measures The primary outcome derived from weekly self-reported exercise. Secondary outcomes included physical fitness (aerobic/muscular) and predictors of exercise participation. Results The staff-supported group reported significantly greater exercise (∼17min/wk) than the self-guided group over the year ( t =10.6, P =.00), with no significant between-group difference in aerobic capacity ( t =.76, P =.45) and strength ( t =1.5, P =.14). Conclusions Although the staff-supported group reported only moderately more exercise, the difference is potentially clinically significant because they also exercised more frequently. The staff-supported approach holds promise for encouraging exercise among wheelchair users, yet additional support may be necessary to achieve more exercise to meet national recommendations.
Abstract Background Physical Activity Across the Curriculum (PAAC) was a three-year cluster randomized controlled trial to promote physical activity and diminish increases in overweight and obesity ...in elementary school children. Methods Twenty-four elementary schools were cluster randomized to the Physical Activity Across the Curriculum intervention or served as control. All children in grades two and three were followed to grades four and five. Physical Activity Across the Curriculum promoted 90 min/wk of moderate to vigorous intensity physically active academic lessons delivered by classroom teachers. Body Mass Index was the primary outcome, daily Physical activity and academic achievement were secondary outcomes. Results The three-year change in Body Mass Index for Physical Activity Across the Curriculum was 2.0 ±1.9 and control 1.9 ± 1.9, respectively (NS). However, change in Body Mass Index from baseline to 3 years was significantly influenced by exposure to Physical Activity Across the Curriculum. Schools with ≥ 75 min of Physical Activity Across the Curriculum/wk showed significantly less increase in Body Mass Index at 3 years compared to schools that had < 75 min of Physical Activity Across the Curriculum (1.8 ± 1.8 vs. 2.4 ± 2.0, p = 0.02). Physical Activity Across the Curriculum schools had significantly greater changes in daily Physical activity and academic achievement scores. Conclusions The Physical Activity Across the Curriculum approach may promote daily Physical activity and academic achievement in elementary school children. Additionally, 75 min of Physical Activity Across the Curriculum activities may attenuate increases in Body Mass Index.
Abstract We compared changes in academic achievement across 3 years between children in elementary schools receiving the Academic Achievement and Physical Activity Across the Curriculum intervention ...(A + PAAC), in which classroom teachers were trained to deliver academic lessons using moderate-to-vigorous physical activity (MVPA) compared to a non-intervention control. Elementary schools in eastern Kansas ( n = 17) were cluster randomized to A + PAAC ( N = 9, target ≥ 100 min/w
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) or control ( N = 8). Academic achievement (math, reading, spelling) was assessed using the Wechsler Individual Achievement Test-Third Edition (WIAT-III) in a sample of children (A + PAAC = 316, Control = 268) in grades 2 and 3 at baseline (Fall 2011) and repeated each spring across 3 years. On average 55 min/w
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of A + PACC lessons were delivered each week across the intervention. Baseline WIAT-III scores (math, reading, spelling) were significantly higher in students in A + PAAC compared with control schools and improved in both groups across 3 years. However, linear mixed modeling, accounting for baseline between group differences in WIAT-III scores, ethnicity, family income, and cardiovascular fitness, found no significant impact of A + PAAC on any of the academic achievement outcomes as determined by non-significant group by time interactions. A + PAAC neither diminished or improved academic achievement across 3-years in elementary school children compared with controls. Our target of 100 min
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of active lessons was not achieved; however, students attending A + PAAC schools received an additional 55 min
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of MVPA which may be associated with both physical and mental health benefits, without a reduction in time devoted to academic instruction.
Background Pain management strategies following shoulder arthroplasty vary significantly. Liposomal bupivacaine (LB) is an extended-release delivery of a phospholipid bilayer encapsulating ...bupivacaine that can result in drug delivery up to 72 hours. Prior studies in lower extremity surgery demonstrated efficacy of LB in comparison to a single-shot peripheral nerve block; however, no study has investigated LB in a total shoulder arthroplasty population. Therefore, this study compared LB vs. an indwelling interscalene nerve block (IINB). Methods This is a prospective, randomized study of 83 consecutive shoulder arthroplasty patients; 36 patients received LB and a “bridge” of 30 mL of 0.5% bupivacaine, and 47 patients received an IINB. Postoperative visual analog scale pain levels, opiate consumption measured with oral morphine equivalents, length of hospital stay, and postoperative complications were recorded. Continuous variables were compared using an analysis of variance with significance set at P < .05. Results Visual analog scale pain scores were statistically higher in the LB cohort immediately postoperatively in the postanesthesia care unit (7.25 vs. 1.91; P = .000) as well as for the remainder of postoperative day 0 (4.99 vs. 3.20; P = .005) but not for the remainder of admission. Opiate consumption was significantly higher among the LB cohort in the postanesthesia care unit (31.79 vs. 7.47; P = .000), on postoperative day 0 (32.64 vs. 15.04; P = .000), and for the total hospital admission (189.50 vs. 91.70, P = .000). Complication numbers and length of stay were not statistically different. Conclusion Use of an IINB provides superior pain management in the immediate postoperative setting as demonstrated by decreased narcotic medication consumption and lower subjective pain scores.
Participation in classroom physical activity (PA) may improve time-on-task (TOT); however, the influence of sustained moderate-to-vigorous PA (MVPA) on TOT is unknown.
To explore the influence of ...classroom PA delivered with academic lessons on TOT, determine if the relationship between classroom PA and TOT differs by age, sex, race/ethnicity, weight or baseline fitness, and identify the influence of MVPA on TOT when controlling for demographic variables.
Teachers in intervention schools were asked to deliver two 10-min PA lessons per day, 5 d·wk. PA was observed in both intervention and control schools to determine the amount and intensity of PA. Time-on-task was observed before and immediately after PA. Anthropometrics and fitness were assessed at baseline and end of the school year for 3 yr. Multilevel modeling was used to estimate overall group difference, change over the study, and group difference in change while accounting for covariates.
Students who participated in PA lessons engaged in significantly more MVPA than those in the control schools in all 3 yr (all P < 0.001). There was a significant linear increase in the percent of TOT before PA lessons for both control and intervention groups over the 3-yr period (P < 0.001), with no group difference. The intervention group spent significantly more TOT (P = 0.01) after PA than the control group. The percent of time spent in MVPA was significantly associated with the percent of TOT (P < 0.01).
Results indicate that children who received PA lessons participated in significantly more MVPA than those who did not and that PA was significantly associated with more TOT. These findings provide support for classroom PA as a means of increasing TOT in elementary age children.
ABSTRACT Introduction Moderate-to-vigorous physical activity (MVPA) is inadequate in adolescents with intellectual and developmental disabilities (IDD). This report describes the results of an 18-mo. ...clinical trial in adolescents with IDD which compared changes in accelerometer assessed daily MVPA, gross motor quotient and leg press strength between participants randomized to an exercise intervention delivered to adolescents only (AO) or to the adolescent and a parent (A + P). Methods The 18-mo. trial included a 6-mo. active intervention, 6-mo. maintenance interventions, and a 6-mo. no-contact follow-up. Adolescents in both arms were asked to attend 40 min. remotely delivered group video exercise sessions (0-6 mos. =3 sessions·wk −1 ., 7-12 mos. =1 session·wk −1 ). In the A + P arm, one parent/guardian was asked to attend all group remote video exercise sessions and a monthly remotely delivered 30-min. educations/support session with their adolescent across the 12-mo. intervention. Results Adolescents ( n = 116) with IDD (age ~ 16 yrs., 52% female) were randomized to the AO ( n = 59) or A + P ( n = 57) arms. Mixed modeling, controlling for baseline MVPA and season, indicated minimal but statistically significant changes in MVPA across 6 ( p = 0.006), 12 ( p < 0.001), and 18 mos. ( p < 0.001). However, the change in MVPA in the two intervention arms did not differ significantly at any time point (all p > 0.05). Similarly, gross motor quotient and leg press strength improved significantly over time ( p < 0.001) and these changes did not differ between intervention arms (all p > 0.05). Conclusions Parental involvement had no impact on changes in daily MVPA, gross motor quotient or leg press strength in response to a remotely delivered exercise intervention in adolescents with IDD.
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