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Effects of 3-week total meal replacement vs. typical food-based diet on human brain functional magnetic resonance imaging food-cue reactivity and functional connectivity in people with obesity.
Kahathuduwa, CN, Davis, T, O'Boyle, M, Boyd, LA, Chin, SH, Paniukov, D, Binks, M
Appetite. 2018;120:431-441
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Weight loss diets that use total meal replacement shakes have been shown to reduce food cravings compared to typical reduced-calorie diets. The mechanism for this is unclear. This study examined the effects of a 3-week 1120 kcal per day meal replacement diet compared to a reduced calorie diet on activity in areas of the brain associated with food cravings. Thirty-two obese adults participated in the study. Before and after the study, the participants were given magnetic resonance imaging (MRI) scans to measure activity in different areas of the brain. They were also questioned on food cravings and weighed. The group following the meal replacement diet experienced a significant weight loss of 4.87 kg, a reduction in body fat of 2.19 kg and reduced their overall food cravings. The reduced calorie diet group also experienced significant weight loss and a reduction in body fat (2.37kg and 1.64kg, respectively) but less than the meal replacement group. The meal replacement group experienced reduced cravings compared to the reduced calorie diet group. MRI scans suggested that this was due to changes in activity in the food reward related regions in several areas of the brain, resulting in an increase in executive control. The authors concluded that meal replacement diets may increase executive control within the brain, leading to a reduction in food cravings and weight loss.
Abstract
OBJECTIVES Calorie restriction via total meal replacement (TMR) results in greater reduction of food cravings compared to reduced-calorie typical diet (TD). Direct evidence of the impact of these interventions on human brain fMRI food-cue reactivity (fMRI-FCR) and functional connectivity is absent. We examined the effects of a 3-week 1120 kcal/d TMR intervention as compared to an iso-caloric TD intervention using an fMRI-FCR paradigm. METHODS Thirty-two male and female subjects with obesity (19-60 years; 30-39.9 kg/m2) participated in a randomized two-group repeated measures dietary intervention study consisting of 1120 kcal/d from either 1) TMR (shakes), 2) TD (portion control). Pre-intervention and following the 3-week diet fMRI-FCR, functional connectivity, food cravings (Food Craving Inventory) and weight were considered. RESULTS Compared to TD, TMR showed increased fMRI-FCR of the bilateral dorsolateral prefrontal (dlPFC), orbitofrontal, anterior cingulate, primary motor and left insular cortices and bilateral nucleus accumbens regions in the post-intervention state relative to the pre-intervention state. Compared to TD, TMR was also associated with negative modulation of fMRI-FCR of the nucleus accumbens, orbitofrontal cortex and amygdala by dlPFC. Reduced body weight (4.87 kg, P < 0.001), body fat (2.19 kg, P = 0.004) and overall food cravings (0.41, P = 0.047) were seen in the TMR group. In the TD group reduced body weight (2.37 kg, P = 0.004) and body fat (1.64 kg, P = 0.002) were noted. Weight loss was significantly greater in TMR versus TD (2.50 kg, P = 0.007). CONCLUSIONS Greater weight loss and reduced cravings, coupled with stronger activations and potential negative modulation of the food reward related regions by the dlPFC during exposure to visual food cues is consistent with increased executive control in TMR vs. TD.
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Effects of exercise improves muscle strength and fat mass in patients with high fracture risk: A randomized control trial.
Chan, DC, Chang, CB, Han, DS, Hong, CH, Hwang, JS, Tsai, KS, Yang, RS
Journal of the Formosan Medical Association = Taiwan yi zhi. 2018;117(7):572-582
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Sarcopenia is the loss of muscle mass, strength and function related to ageing. It can lead to problems such as reduced mobility and an increased risk of falls in older people. Regular exercise may slow down the deterioration of muscle, but there is no consensus on what type of exercise is best. This study, carried out in Taiwan, aimed to compare different types of exercise on the fat free mass, muscle strength and physical performance in adults over the age of 50 who were at a high risk of bone fractures. The participants were split into two groups and assigned to either the integrated care (IC) or lower extremity exercise (LEE) group for 12 weeks. All participants received education including home-based exercise. The IC group consisted of different modalities of exercise which included upper- and lower-body training with resistance bands and balance training, while the LEE group performed machine-based leg exercises. Fat free mass, muscle strength, and physical performance were measured at the start and end of the study. Both groups demonstrated significant improvements in fat free mass, muscle strength (4 indicators) and physical performance (3 indicators), with the two exercises regimes giving similar results. Both men and women saw similar benefits from regular exercise. The authors concluded that both regimes were equally effective in decreasing fat mass and increasing physical performance, muscle mass and strength. However, the IC group required less equipment and therefore could be more financially feasible in a community setting.
Abstract
BACKGROUND The deterioration of the musculoskeletal system imposes significant impact on physical activity. Exercise is an important strategy which minimizes these changes. It is not clear which type of exercise provides better improvement on low physical performance, low muscle mass and low strength of sarcopenia. We aim to develop an integrated care (IC) model and compare its relative efficacy in limb fat free mass, muscle strength, and physical performance with low extremities exercise (LEE) in community dwelling older adults with high risk of fractures (Fracture Risk Assessment Tool (FRAX®)) ≧3% for hip fracture, ≧20% for major osteoporotic fracture or 1-min osteoporosis risk test (≧1 point) or fall (≧2 falls in previous year). METHODS Patients were assigned randomized to participate in either IC or LEE group (n = 55 each) for 3 months. All participants received education including home-based exercise. The IC group consisted of different modalities of exercise while the LEE group performed machine-based low extremities exercise. Fat free mass, muscle strength, and physical performance were measured at their baseline and 3-months follow-up. RESULTS Mean age was 73.8 ± 7 years with 69.1% women. Entire cohort demonstrated significant increment in fat free mass, muscle strength (4 indicators) and physical performance (3 indicators). However, between group differences were not significant. CONCLUSION With regular supervise exercise; both groups are equally effective in decreasing fat mass and increasing physical performance, muscle mass and strength. However, the IC group required fewer resources and thus more financially feasible in a community setting.
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Positive effects on bone mineralisation and muscular fitness after 10 months of intense school-based physical training for children aged 8-10 years: the FIT FIRST randomised controlled trial.
Larsen, MN, Nielsen, CM, Helge, EW, Madsen, M, Manniche, V, Hansen, L, Hansen, PR, Bangsbo, J, Krustrup, P
British journal of sports medicine. 2018;52(4):254-260
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Fractures in older people are a huge public health challenge. Low bone strength in childhood is associated with a higher fracture risk in later life. Weight-bearing activities during childhood can improve muscle and bone strength, potentially reducing the risk of falls and fractures in later life. This study looked at the impact of frequent exercise sessions on bone strength in children aged 8-10 years. 295 Danish school children were divided into three groups: a small-sided ball game group (SSG), a circuit strength training group (CST) or a control group. Exercise sessions lasted for 40 minutes, three times a week for 10 months. Scans were used to determine bone mineral density (BMD), bone mineral content (BMC) and lean body mass (LBM). A variety of tests to determine muscular fitness were carried out at the beginning and end of the study. Both exercise groups saw significant improvements in BMD. Both training types resulted in significant improvements in postural balance and jump length. No differences between the groups were observed for sprint performance or LBM. The authors concluded that 40 min sessions 3 times a week with SSG or CST over a full school year improves bone mineralisation and several aspects of muscular fitness of children aged 8-10 years, suggesting that well-organised physical education classes can contribute positively to musculoskeletal health in young children.
Abstract
OBJECTIVES We investigated whether musculoskeletal fitness of school children aged 8-10 years was affected by frequent intense PE sessions. DESIGN AND PARTICIPANTS 295 Danish school children aged 8-10 years were cluster randomised to a small-sided ball game group (SSG) (n=96, four schools, five classes), a circuit strength training group (CST) (n=83, four schools, four classes) or a control group (CON, n=116, two schools, five classes). INTERVENTION SSG or CST was performed 3×40 min/week over 10 months. Whole-body dual-energy X-ray absorptiometry (DXA) scans were used to determine areal bone mineral density (aBMD), bone mineral content (BMC) and lean body mass (LBM). Flamingo balance, standing long jump and 20-m sprint tests were used to determine muscular fitness. RESULTS Analysis of baseline-to-10 months change scores showed between-group differences in favour of the interventions in whole-body aBMD (SSG vs CON: 8 mg/cm2, 95% CI 3 to 13; CST vs CON: 7 mg/cm2, 95% CI 2 to 13, p<0.05) and leg BMC (SSG vs CON: 11 g, 95% CI 4 to 18; CST vs CON: 11 g, 95% CI 3 to 18, p<0.05). SSG had higher change scores in leg aBMD compared with CON and CST (SSG vs CON: 19 mg/cm2, 95% CI 11 to 39, p<0.05; SSG vs CST: 12 mg/cm2, 95% CI 3 to 21, p<0.05), and CST had higher change scores in whole-body BMC compared with CON (CST vs CON: 25 g, 95% CI 10 to 39, p<0.05). Both training types resulted in higher change scores in postural balance (SSG vs CON: 2.4 fewer falls/min, 95% CI 0.3 to 4.5, CST vs CON: 3.6 fewer falls/min, 95% CI 1.3 to 5.9, p<0.05) and jump length (SSG vs CON: 10%, 95% CI 5 to 16%; CST vs CON: 9%, 95% CI 3 to 15%, p<0.05). No between-group differences were observed for sprint performance or LBM (p>0.05). CONCLUSIONS In conclusion, 3×40 min/week with SSG or CST over a full school year improves bone mineralisation and several aspects of muscular fitness of children aged 8-10 years, suggesting that well-organised intense physical education classes can contribute positively to develop musculoskeletal health in young children. TRIAL REGISTRATION NUMBER NCT02000492, post results.