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The acute effect of fasted exercise on energy intake, energy expenditure, subjective hunger and gastrointestinal hormone release compared to fed exercise in healthy individuals: a systematic review and network meta-analysis.
Frampton, J, Edinburgh, RM, Ogden, HB, Gonzalez, JT, Chambers, ES
International journal of obesity (2005). 2022;(2):255-268
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Abstract
OBJECTIVE To determine the acute effect of fasted and fed exercise on energy intake, energy expenditure, subjective hunger and gastrointestinal hormone release. METHODS CENTRAL, Embase, MEDLINE, PsycInfo, PubMed, Scopus and Web of Science databases were searched to identify randomised, crossover studies in healthy individuals that compared the following interventions: (i) fasted exercise with a standardised post-exercise meal [FastEx + Meal], (ii) fasted exercise without a standardised post-exercise meal [FastEx + NoMeal], (iii) fed exercise with a standardised post-exercise meal [FedEx + Meal], (iv) fed exercise without a standardised post-exercise meal [FedEx + NoMeal]. Studies must have measured ad libitum meal energy intake, within-lab energy intake, 24-h energy intake, energy expenditure, subjective hunger, acyl-ghrelin, peptide YY, and/or glucagon-like peptide 1. Random-effect network meta-analyses were performed for outcomes containing ≥5 studies. RESULTS 17 published articles (23 studies) were identified. Ad libitum meal energy intake was significantly lower during FedEx + Meal compared to FedEx + NoMeal (MD: -489 kJ; 95% CI, -898 to -80 kJ; P = 0.019). Within-lab energy intake was significantly lower during FastEx + NoMeal compared to FedEx + NoMeal (MD: -1326 kJ; 95% CI, -2102 to -550 kJ; P = 0.001). Similarly, 24-h energy intake following FastEx + NoMeal was significantly lower than FedEx + NoMeal (MD: -2095 kJ; 95% CI, -3910 kJ to -280 kJ; P = 0.024). Energy expenditure was however significantly lower during FastEx + NoMeal compared to FedEx+NoMeal (MD: -0.67 kJ/min; 95% CI, -1.10 to -0.23 kJ/min; P = 0.003). Subjective hunger was significantly higher during FastEx + Meal (MD: 13 mm; 95% CI, 5-21 mm; P = 0.001) and FastEx + NoMeal (MD: 23 mm; 95% CI, 16-30 mm; P < 0.001) compared to FedEx + NoMeal. CONCLUSION FastEx + NoMeal appears to be the most effective strategy to produce a short-term decrease in energy intake, but also results in increased hunger and lowered energy expenditure. Concerns regarding experimental design however lower the confidence in these findings, necessitating future research to rectify these issues when investigating exercise meal timing and energy balance. PROSPERO REGISTRATION NUMBER CRD42020208041. KEY POINTS Fed exercise with a standardised post-exercise meal resulted in the lowest energy intake at the ad libitum meal served following exercise completion. Fasted exercise without a standardised post-exercise meal resulted in the lowest within-lab and 24-h energy intake, but also produced the lowest energy expenditure and highest hunger. Methodological issues lower the confidence in these findings and necessitate future work to address identified problems.
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The influence of fasting and energy-restricted diets on leptin and adiponectin levels in humans: A systematic review and meta-analysis.
Varkaneh Kord, H, M Tinsley, G, O Santos, H, Zand, H, Nazary, A, Fatahi, S, Mokhtari, Z, Salehi-Sahlabadi, A, Tan, SC, Rahmani, J, et al
Clinical nutrition (Edinburgh, Scotland). 2021;(4):1811-1821
Abstract
BACKGROUND & AIMS Fasting and energy-restricted diets have been evaluated in several studies as a means of improving cardiometabolic biomarkers related to body fat loss. However, further investigation is required to understand potential alterations of leptin and adiponectin concentrations. Thus, we performed a systematic review and meta-analysis to derive a more precise estimate of the influence of fasting and energy-restricted diets on leptin and adiponectin levels in humans, as well as to detect potential sources of heterogeneity in the available literature. METHODS A comprehensive systematic search was performed in Web of Science, PubMed/MEDLINE, Cochrane, SCOPUS and Embase from inception until June 2019. All clinical trials investigating the effects of fasting and energy-restricted diets on leptin and adiponectin in adults were included. RESULTS Twelve studies containing 17 arms and a total of 495 individuals (intervention = 249, control = 246) reported changes in serum leptin concentrations, and 10 studies containing 12 arms with a total of 438 individuals (intervention = 222, control = 216) reported changes in serum adiponectin concentrations. The combined effect sizes suggested a significant effect of fasting and energy-restricted diets on leptin concentrations (WMD: -3.690 ng/ml, 95% CI: -5.190, -2.190, p ≤ 0.001; I2 = 84.9%). However, no significant effect of fasting and energy-restricted diets on adiponectin concentrations was found (WMD: -159.520 ng/ml, 95% CI: -689.491, 370.451, p = 0.555; I2 = 74.2%). Stratified analyses showed that energy-restricted regimens significantly increased adiponectin (WMD: 554.129 ng/ml, 95% CI: 150.295, 957.964; I2 = 0.0%). In addition, subsequent subgroup analyses revealed that energy restriction, to ≤50% normal required daily energy intake, resulted in significantly reduced concentrations of leptin (WMD: -4.199 ng/ml, 95% CI: -7.279, -1.118; I2 = 83.9%) and significantly increased concentrations of adiponectin (WMD: 524.04 ng/ml, 95% CI: 115.618, 932.469: I2 = 0.0%). CONCLUSION Fasting and energy-restricted diets elicit significant reductions in serum leptin concentrations. Increases in adiponectin may also be observed when energy intake is ≤50% of normal requirements, although limited data preclude definitive conclusions on this point.
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The effect of higher versus lower protein delivery in critically ill patients: a systematic review and meta-analysis of randomized controlled trials.
Lee, ZY, Yap, CSL, Hasan, MS, Engkasan, JP, Barakatun-Nisak, MY, Day, AG, Patel, JJ, Heyland, DK
Critical care (London, England). 2021;(1):260
Abstract
BACKGROUND The optimal protein dose in critical illness is unknown. We aim to conduct a systematic review of randomized controlled trials (RCTs) to compare the effect of higher versus lower protein delivery (with similar energy delivery between groups) on clinical and patient-centered outcomes in critically ill patients. METHODS We searched MEDLINE, EMBASE, CENTRAL and CINAHL from database inception through April 1, 2021.We included RCTs of (1) adult (age ≥ 18) critically ill patients that (2) compared higher vs lower protein with (3) similar energy intake between groups, and (4) reported clinical and/or patient-centered outcomes. We excluded studies on immunonutrition. Two authors screened and conducted quality assessment independently and in duplicate. Random-effect meta-analyses were conducted to estimate the pooled risk ratio (dichotomized outcomes) or mean difference (continuous outcomes). RESULTS Nineteen RCTs were included (n = 1731). Sixteen studies used primarily the enteral route to deliver protein. Intervention was started within 72 h of ICU admission in sixteen studies. The intervention lasted between 3 and 28 days. In 11 studies that reported weight-based nutrition delivery, the pooled mean protein and energy received in higher and lower protein groups were 1.31 ± 0.48 vs 0.90 ± 0.30 g/kg and 19.9 ± 6.9 versus 20.1 ± 7.1 kcal/kg, respectively. Higher vs lower protein did not significantly affect overall mortality [risk ratio 0.91, 95% confidence interval (CI) 0.75-1.10, p = 0.34] or other clinical or patient-centered outcomes. In 5 small studies, higher protein significantly attenuated muscle loss (MD -3.44% per week, 95% CI -4.99 to -1.90; p < 0.0001). CONCLUSION In critically ill patients, a higher daily protein delivery was not associated with any improvement in clinical or patient-centered outcomes. Larger, and more definitive RCTs are needed to confirm the effect of muscle loss attenuation associated with higher protein delivery. PROSPERO registration number: CRD42021237530.
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Sugary drink warnings: A meta-analysis of experimental studies.
Grummon, AH, Hall, MG
PLoS medicine. 2020;(5):e1003120
Abstract
BACKGROUND Policymakers worldwide are considering requiring warnings for sugary drinks. A growing number of experimental studies have examined sugary drink warnings' impacts, but no research to our knowledge has synthesized this literature. To inform ongoing policy debates, this study aimed to identify the effects of sugary drink warnings compared with control conditions. METHODS AND FINDINGS We systematically searched 7 databases on June 21, 2019, and October 25, 2019. We also searched reference lists of relevant articles. Two investigators independently screened titles, abstracts, and full texts to identify peer-reviewed articles that used an experimental protocol to examine the effects of sugary drink warnings compared to a control condition. Two investigators independently extracted study characteristics and effect sizes from all relevant full-text articles. We meta-analyzed any outcome assessed in at least 2 studies, combining effect sizes using random effects meta-analytic procedures. Twenty-three experiments with data on 16,241 individuals (mean proportion female, 58%) were included in the meta-analysis. Most studies took place in Latin America (35%) or the US or Canada (46%); 32% included children. Relative to control conditions, sugary drink warnings caused stronger negative emotional reactions (d = 0.69; 95% CI: 0.25, 1.13; p = 0.002) and elicited more thinking about the health effects of sugary drinks (d = 0.65; 95% CI: 0.29, 1.01; p < 0.001). Sugary drink warnings also led to lower healthfulness perceptions (d = -0.22; 95% CI: -0.27, -0.17; p < 0.001) and stronger disease likelihood perceptions (d = 0.15; 95% CI: 0.06, 0.24; p = 0.001). Moreover, sugary drink warnings reduced both hypothetical (d = -0.32; 95% CI: -0.44, -0.21; p < 0.001) and actual consumption and purchasing behavior (d = -0.17; 95% CI: -0.30, -0.04; p = 0.012). Statistically significant effects were not observed for perceptions of added sugar or positive sugary drink attitudes (p's > 0.10). Moderation analyses revealed that health warnings (e.g., "Beverages with added sugar contribute to obesity") led to greater reductions in hypothetical sugary drink purchases than did nutrient warnings (e.g., "High in sugar"; d = -0.35 versus -0.18; Qb = 4.04; p = 0.04). Limitations of this study include that we did not review grey literature and that we were unable to conduct moderation analyses for several prespecified moderators due to an insufficient number of studies. CONCLUSIONS This international body of experimental literature supports sugary drink warnings as a population-level strategy for changing behavior, as well as emotions, perceptions, and intentions. PROTOCOL REGISTRY PROSPERO ID 146405.
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Dietary energy density and appetite: A systematic review and meta-analysis of clinical trials.
Moosavian, SP, Haghighatdoost, F
Nutrition (Burbank, Los Angeles County, Calif.). 2020;:110551
Abstract
Studies have suggested that dietary energy density (DED) may affect weight gain by altering appetite. Although many studies have investigated the effect of DED on appetite, findings are inconsistent and, to our knowledge, there are no systematic reviews and meta-analyses on this topic. Therefore, the aim of this systematic review and meta-analysis was to summarize the effect of DED on appetite. The current meta-analysis revealed changing the DED had no significant effect on hunger but increased fullness. More high-quality randomized controlled trials are needed to investigate the effects of DED on appetite components. We searched titles, abstracts, and keywords of articles indexed in ScienceDirect, MEDLINE, and Google Scholar databases up to July 2018 to identify eligible RCT studies. Random effects model was used to estimate the pooled effect of DED on appetite. Among the 21 studies identified in the systematic literature search, 11 reports were included in the meta-analysis. Based on the Cochrane Collaboration Risk of Bias tool, 6 studies were considered as good quality, two were fair, and three studies were poor. The mean ± standard deviation for energy density, in studies which assessed fullness, was 1.65 ± 1 in high energy dense (HED) diet and 0.93 ± 0.93 in low energy dense (LED) diet. The corresponding values for hunger were 1.67 ± 0.69 and 0.70 ± 0.32, respectively. Compared with a LED diet, consumption of HED increased fullness (weighed mean difference [WMD] 2.95 mm; 95% CI 0.07-5.82, P = 0.044, I2 98.1%) but had no significant effect on hunger (WMD 1.31 mm; 95% CI -7.20 to 9.82, P = 0.763, I2 99.1%). The current meta-analysis revealed changing the DED had no significant effect on hunger but increased fullness. More high-quality RCTs are needed to investigate the effects of DED on appetite components.
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Partial sleep deprivation on dietary energy intake in healthy population: a systematic review and meta-analysis.
González-Ortiz, A, López-Bautista, F, Valencia-Flores, M, Espinosa Cuevas, Á
Nutricion hospitalaria. 2020;(5):1052-1060
Abstract
Background: the restriction of nocturnal sleep has immediate effects, including the presence of excessive daytime sleepiness, general fatigue, or impaired concentration. In the long term, it increases the risk of death from cardiac, respiratory, and metabolic disorders, and the prevalence of obesity in healthy populations. However, despite the existence of a large number of studies on this topic, results have been controversial. Objective: to discuss and analyze the evidence on the effects of nocturnal sleep restriction versus habitual sleep on dietary energy intake, including specific meals, as well as the relationship between ghrelin and leptin levels in a healthy population. Methods: a systematic search of the literature was conducted in October 2016 and February 2019 using the PubMed, Scopus, Lilacs, and Embase databases. Terms used were "sleep," "feeding behavior," "dietary energy intake," "energy intake," "meal," "ghrelin," and "leptin." Results: the bibliographic search identified 384 potential articles. Of a total of eight articles accepted in the review, six contain information available for the analysis of total energy intake. The overall result shows a significant difference in energy intake between study groups (149.86 (95 % CI: 10.09-289.63); p = 0.04), and a higher intake of all macronutrients. Conclusions: the present systematic review and meta-analysis demonstrated that partial sleep deprivation increases total energy intake, as well as all macronutrients, when compared to habitual sleep.
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Effects of cereal beta-glucan consumption on body weight, body mass index, waist circumference and total energy intake: A meta-analysis of randomized controlled trials.
Rahmani, J, Miri, A, Černevičiūtė, R, Thompson, J, de Souza, NN, Sultana, R, Kord Varkaneh, H, Mousavi, SM, Hekmatdoost, A
Complementary therapies in medicine. 2019;:131-139
Abstract
BACKGROUND & OBJECTIVE(S): Obesity is a worldwide epidemic and a common medical condition associated with a variety of chronic diseases. Cereal beta-glucans are soluble fibers with potential health benefits. A number of randomized controlled trials (RCTs) have investigated the effect of cereal beta-glucan consumption on weight, but these results have not been summarized in a meta-analysis. The purpose of this study was to investigate the effect of cereal beta-glucan consumption on body weight, body mass index, waist circumference and a total energy intake. METHODS Studies were identified using MEDLINE/PubMed, Scopus and Cochrane databases. Screening of relevant articles and references was carried out until December 2018. There were no language restrictions. This systematic review and meta-analysis was performed using the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Twenty eligible studies were identified and analyzed. Our study found a significant reduction in body weight and body mass index (BMI) following beta-glucan consumption (weighted mean difference [WMD]: -0.77 kg, 95% CI: -1.49, -0.04) and (WMD: -0.62 kg/cm2, 95% CI: -1.04, -0.21), respectively. There was no significant effect on waist circumference and energy intake. A subgroup analysis showed that a beta-glucan dose of ≥ 4 g/day lead to an increase in energy intake. CONCLUSION The findings of this study indicates that cereal beta-glucan consumption seems to decrease body weight and BMI, but has no effect on waist circumference and energy intake.
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Mindful eating and common diet programs lower body weight similarly: Systematic review and meta-analysis.
Fuentes Artiles, R, Staub, K, Aldakak, L, Eppenberger, P, Rühli, F, Bender, N
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2019;(11):1619-1627
Abstract
Common strategies for reducing body weight rely on limiting energy intake and restricting food choices. However, these strategies have often been proven ineffective in achieving long-term and sustainable weight reduction. More recently, mindful eating as an alternative weight management strategy has gained increasing attention, yet systematic reviews on intuitive or mindful eating published so far present contradictory results. We performed a systematic review and meta-analysis on randomized controlled trials on weight loss programs based on mindful or intuitive eating. We analyzed results using meta-regressions. We included a total of 10 studies and found a significant weight loss effect of mindful/intuitive eating strategies compared with nonintervention controls (-0.348 kg, 95% CI: -0.591 to -0.105, P = 0.005). However, there was no difference compared with conventional diet programs (P = 0.99). Reduction of BMI (-0.137 kg/m2 , 95% CI: -0.365 to 0.091, P = 0.240) or waist circumference (-0.358 cm, 95% CI: -0.916 to 0.200, P = 0.209) were not statistically significant. Mindful/intuitive eating could be a practical approach to weight control. Limitations of this study include the unbalanced sex, origin, place of residence of the participants, and the short duration of interventions. Future research should aim at investigating long-term effects and include a more heterogeneous study population.
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Comparison of Energy and Food Intake Between Gastric Bypass and Sleeve Gastrectomy: a Meta-analysis and Systematic Review.
Janmohammadi, P, Sajadi, F, Alizadeh, S, Daneshzad, E
Obesity surgery. 2019;(3):1040-1048
Abstract
AbstractObesity is a developed nutritional problem, and today, surgery is one of the approaches to cure it. A good understanding of the variations in food intake will be beneficial for sustaining long-term weight loss post-surgery and for improving nutrition care strategies. The purpose of this review was the comparison of the impact of two methods of gastric bypass (GBP) and sleeve gastrectomy (SG) on dietary intake. Databases of PubMed, Embase, Scopus, Google Scholar, and Web of science were used for the literature search up to June 2018. We concluded the studies that measured mean daily energy intake and the percent of macronutrients from total calorie intake of before and after GBP and SG. A total of 18 studies were finally included in the meta-analysis for the effect of bariatric surgery on food intake. Bariatric surgery significantly decreased energy intake by 1050.04 kcal/day (p < 0.001) compared with the baseline values of energy intake. The pooled effect of bariatric surgery on protein intake was 0.82 g/day (p = 0.004) compared with the baseline values. The pooled analysis found no significant impact of bariatric surgery on carbohydrate intake (WMD = 0.56 g/day; p = 0.40) compared with the baseline values. The pooled estimate of effect for bariatric surgery on fat intake was - 1.34 g/day (p = 0.006). This study demonstrates that bariatric surgery might be effective on energy and fat intake; however, there was no effect on carbohydrate intake.
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Influence of oral processing on appetite and food intake - A systematic review and meta-analysis.
Krop, EM, Hetherington, MM, Nekitsing, C, Miquel, S, Postelnicu, L, Sarkar, A
Appetite. 2018;:253-269
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Abstract
Food delivers energy, nutrients and a pleasurable experience. Slow eating and prolonged oro-sensory exposure to food during consumption can enhance the processes that promote satiation. This systematic review and meta-analysis investigated the effects of oral processing on subjective measures of appetite (hunger, desire to eat) and objectively measured food intake. The aim was to investigate the influence of oral processing characteristics, specifically "chewing" and "lubrication", on "appetite" and "food intake". A literature search of six databases (Cochrane library, PubMed, Medline, Food Science and Technology Abstracts, Web of Science, Scopus), yielded 12161 articles which were reduced to a set of 40 articles using pre-specified inclusion and exclusion criteria. A further two articles were excluded from the meta-analysis due to missing relevant data. From the remaining 38 papers, detailing 40 unique studies with 70 subgroups, raw data were extracted for meta-analysis (food intake n = 65, hunger n = 22 and desire to eat ratings n = 15) and analyzed using random effects modelling. Oral processing parameters, such as number of chews, eating rate and texture manipulation, appeared to influence food intake markedly but appetite ratings to a lesser extent. Meta-analysis confirmed a significant effect of the direct and indirect aspects of oral processing that were related to chewing on both self-reported hunger (-0.20 effect size, 95% confidence interval CI: -0.30, -0.11), and food intake (-0.28 effect size, 95% CI: -0.36, -0.19). Although lubrication is an important aspect of oral processing, few studies on its effects on appetite have been conducted. Future experiments using standardized approaches should provide a clearer understanding of the role of oral processing, including both chewing and lubrication, in promoting satiety.