PHB-10386; No of Pages 6 Physiology & Behavior xxx (2014) xxx–xxx

Contents lists available at ScienceDirect

Physiology & Behavior journal homepage: www.elsevier.com/locate/phb

Exercise patterns, ingestive behaviors, and energy balance

2Q1

Jia Li, Lauren E. O'Connor, Jing Zhou, Wayne W. Campbell ⁎ Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907, USA

5

H I G H L I G H T S

a r t i c l e

i n f o

20 21 22 23 24 25 26

Keywords: Absolute and relative energy intake Body composition Energy expenditure Exercise patterns Food intake Weight loss

a b s t r a c t

Ingestive and exercise behaviors are important determinants of whole body energy balance and weight control. An acute bout of exercise generates a transient energy deficit, which is only partially compensated for by food intake at the next eating occasion or within the next day (loose dietary coupling). Such an energy deficit, when repeated chronically, leads to moderate weight loss and improved body composition. For this narrative review, we assessed the effects of exercise patterns on energy intake, energy balance, and weight control in adults primarily using results from randomized acute exercise and chronic training studies. The patterns assessed were exercise mode (e.g. resistance, aerobic exercise), intensity, duration, time of day, and frequency. The body of evidence indicates that exercise training frequency and quantity are influential for weight loss. Aerobic training is superior to resistance training for weight loss, although resistance training helps preserve lean body mass better. Weight loss does not differ among different intensities when energy expenditure is matched by adjusting duration. Differing patterns of physical activity exhibited by normal weight, overweight, and obese people during weekdays and weekend days are consistent with their weight status; leaner people are more physically active. Collectively, these findings support acute and chronic exercise patterns as important modifiable behaviors to improve energy balance and weight control in adults while having minor effects on absolute energy intake. © 2014 Published by Elsevier Inc.

27 28 29 30 31 32 33 34 35 36 37 38 39 40

The American College of Sports Medicine (ACSM) recommends 150– 250 minutes of moderate intensity physical activity per week to prevent weight gain, and greater than 250 minutes of moderate intensity physical activity for clinically significant weight loss and prevention of weight re-gain after weight loss [6]. The national weight control registry reported that people who successfully maintain their weight for at least 3 years after weight loss (≥30 lbs) spend significantly more time at a higher intensity of physical activity than normal weight individuals (25 vs. 17 minutes/day) [7]. Exercise characteristics other than duration and intensity of exercise were discussed in the ACSM position statement but no recommendation was made. Interestingly, a cross-sectional study conducted with 3,867 adults in Norway presented the patterns of physical activity on weekdays and weekends between normal weight, overweight, and obese adults [8]. They found that the groups of people in higher weight classifications were progressively less physically active, and the differences were most profound on weekends compared to weekdays [8]. These results underscored the importance of assessing and comparing the utility of different patterns of exercise for weight control.

58

C

T

E

Article history: Received 1 March 2014 Received in revised form 7 April 2014 Accepted 8 April 2014 Available online xxxx

D

1 4 1 3 15 16 17 18 19

R

R

41 44

N C O

45 43 42

1. Introduction

47 48

For the past two decades, the prevalence of overweight and obesity among adults in the United States has increased from 56% and 22.9% to 68.8% and 35.7%, respectively [1]. Obesity is a major concern due to the associated health risks including type 2 diabetes, cardiovascular disease, and some cancers [2,3]. Some researchers suggest that the obesity epidemic is primarily driven by increased energy intake [4]. However, energy expenditure from physical activity, ranging from 5% of total energy expenditure in sedentary individuals to as much as 45–50% in extremely active individuals, is also important to consider when recommending exercise strategies for weight control [5].

51 52 53 54 55 56 57

U

46

49 50

R O

Absolute energy intake is not affected by exercise mode, duration, and intensity. Aerobic training aids weight loss while resistance training preserves lean mass. Exercise intensity does not affect weight loss when energy expenditure is matched. Higher within-week exercise frequency and quantity lead to more weight loss.

P

• • • •

E

6 7 8 9 10 11 12

O

3 4

F

1

⁎ Corresponding author. Tel.: +1 765 494 8236. E-mail addresses: [email protected] (J. Li), [email protected] (L.E. O'Connor), [email protected] (J. Zhou), [email protected] (W.W. Campbell).

http://dx.doi.org/10.1016/j.physbeh.2014.04.023 0031-9384/© 2014 Published by Elsevier Inc.

Please cite this article as: Li J, et al, Exercise patterns, ingestive behaviors, and energy balance, Physiol Behav (2014), http://dx.doi.org/10.1016/j. physbeh.2014.04.023

59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75

85 86 87 88 89 90

2. Relationships between energy intake and exercise-related energy expenditure

122 123

3. Exercise patterns and their impact on energy balance and weight control

124

3.1. Mode

125

3.1.1. Mode: resistance vs. aerobic exercise In this section, the effects of resistance and aerobic exercise on energy balance and weight control are compared. Generally, aerobic exercise is associated with higher energy expenditure per unit of time and is recommended over resistance training for weight management purposes [12]. However, resistance training may offer greater improvements in body composition [13].

106 107 108 109 110 111 112 113 114 115 116 117 118 119

126 127 128 129 130 131 132 133 134 135

C

104 105

E

102 103

R

101

R

99 100

O

97 98

C

95 96

N

93 94

U

91 92

143 144

3.1.2. Mode: high-intensity interval exercise and continuous endurance exercise Another pair of exercise regimens, high intensity interval exercise (HIIE) and continuous endurance exercise, can be viewed as a second example of exercise mode. A session of HIIE involves alternating between short bouts of high-intensity exercise and periods of lower intensities or inactivity [20]. When compared to traditional endurance exercise, HIIE offers similar health benefits, including improved insulin sensitivity, postprandial lipidemia, and endothelial function [21]. Participants preferred HIIE over continuous endurance exercise, which could potentially lead to higher compliance to the exercise regimen [22].

179 180

3.1.2.1. Mode: high-intensity interval exercise and continuous endurance exercise: acute effects. Two research groups recently compared HIIE with continuous endurance exercise for their effects on subsequent AEI and energy balance [21,22]. Sim et al. compared high intensity (HIIE, alternating 60 seconds of 100% Vo2peak and 240 seconds of 50% Vo2peak) and very high intensity intermittent exercise (VHIIE, alternating between 15 seconds of 170% Vo2peak and 60 seconds of 32% Vo2peak) with continuous exercise (CE, 60% Vo2peak) and a non-exercising control condition in 17 overweight, physically inactive men [22]. The exercise

190 191

T

120 121

To achieve weight loss, a negative energy balance needs to be created. The achievement of exercise-induced weight loss is based on the premise that the increase in energy expenditure is not completely compensated for by increased energy intake. In this scenario, exercise creates a net energy deficit that favors weight loss. However, it is suggested that exercise not only increases energy expenditure but also affects appetite and subsequent energy intake [9]. In order to understand the impact of exercise on energy balance, researchers have described both absolute energy intake (AEI) and relative energy intake (REI). Absolute energy intake is the total energy intake from foods and beverages, while REI is obtained by subtracting the energy expended during exercise (ExEE) from AEI. A recent meta-analysis using data from 29 articles showed that acute bouts of exercise had a minimal impact on subsequent AEI (~ 200 kJ or ~ 50 kcal, P = 0.059), but suppressed REI by ~ 2000 kJ or ~ 500 kcal, compared to nonexercising controls [10]. This indicates that in response to an acute bout of exercise, subsequent AEI does not fully compensate for the ExEE. Similar results were observed with a short-term aerobic exercise program where the doubly labeled water technique was used to approximate total energy expenditure [11]. Only 30% of exerciseinduced energy expenditure was compensated for by increased energy intake during an exercise intervention that lasted for 14 days. This short-term disconnect between exercise-induced energy deficit and energy intake may create an opportunity for weight loss. It is generally recognized from the studies reviewed in this article that chronic exercise training leads to a decrease or no change in body weight, body fat, and self-reported energy intake, but the results for fat-free mass vary. There are multiple modifiable facets of an exercise pattern, such as the different components mentioned previously. Whether a certain pattern is superior to another for energy balance and weight control is unknown. The following sections are devoted to delineating the effects of each exercise pattern on energy intake, energy balance, and weight control.

3.1.1.2. Mode: resistance vs. aerobic exercise: chronic effects. When resistance and aerobic training are used as tools for weight loss purposes, resistance training is shown to improve body composition (i.e., increasing fat-free mass) compared to aerobic training. However, limited reductions in body weight are achieved with resistance training due to lower energy expenditure compared to aerobic training [16]. Fig. 1 presents the results from a meta-analysis of 53 exercise studies principally conducted in the 1970–1980s in men. Overall, body mass decreased with aerobic training and increased with resistance training. Reductions in fat mass did not differ but resistance training increased fat-free mass more than running/walking or cycling [16]. Recent studies revealed similar improvement in fat-free mass among women who perform resistance training [17,18]. Since aerobic and resistance training have different effects on energy expenditure and body composition, investigating the combined effect of the two regimens would be informative. In a recent 8-month randomized controlled trial with 117 men and women, participants were assigned to 3 exercise regimens: aerobic training only, resistance training only, or aerobic training and resistance training combined [19]. At the end of the intervention, body weight decreased in the groups containing an aerobic exercise component (aerobic training: − 1.3 kg body weight; aerobic training + resistance training: − 1.5 kg body weight). Fat mass decreased the most with the combination of both types of exercise (aerobic training + resistance training: − 2.3 kg fat mass). Resistance training alone had no effect on fat mass, corroborating the results from the meta-analysis study conducted by Ballor et al. [16]. Fat-free mass increased in the resistance training only group (+1.0 kg) but not in the others. Reported AEI decreased when the aerobic component was included [19]. Interestingly, this is inconsistent with the results from the acute studies, where aerobic and resistance training does not affect subsequent AEI differently. In summary, acute aerobic and resistance exercise does not affect subsequent AEI differently, but with long-term exercise training, AEI may decrease when aerobic exercise is performed. In addition, longterm aerobic training leads to greater improvements in body weight, but resistance training leads to better improvements in fat-free mass.

F

83 84

O

82

136

R O

80 81

after exercising. Post-exercise AEI was higher [15] or the same [14] compared to AEI after a non-exercise control period. Finding from both studies indicated that AEI after exercise did not differ between Aex or Rex trials. Since the ExEE was higher for Aex vs. Rex, REI was lower after Aex than Rex and Control [15], consistent with the understanding that an acute bout of Aex generates a more favorable energy balance compared to Rex.

P

78 79

For this narrative review we describe and evaluate the acute and chronic effects of different patterns of exercise on energy intake, energy balance, and weight control (body weight, body composition) in adults. An exercise pattern can be defined by a combination of several components, such as mode, intensity, duration, time of day, and frequency of exercise. In order to delineate the impact of exercise patterning, each component will be examined separately. Studies with acute exercise or chronic training, whenever applicable, are included under each component of the pattern for discussion. We performed in depth but not exhaustive searches of topic-specific literature, thus this is not a systematic review.

D

76 77

J. Li et al. / Physiology & Behavior xxx (2014) xxx–xxx

E

2

3.1.1.1. Mode: resistance vs. aerobic exercise: acute effects. Two research groups, Balaguera et al. [14] and Laan et al. [15] directly compared the effect of an acute bout of resistance exercise (Rex) with moderate aerobic exercise (Aex) on energy intake at the next eating occasion soon

Please cite this article as: Li J, et al, Exercise patterns, ingestive behaviors, and energy balance, Physiol Behav (2014), http://dx.doi.org/10.1016/j. physbeh.2014.04.023

137 138 139 140 141 142

145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178

181 182 183 184 185 186 187 188 189

192 193 194 195 196 197 198

J. Li et al. / Physiology & Behavior xxx (2014) xxx–xxx

3

3 Control

2.5

Running/Walking

Cycling

Resistance Training

1.5 1 0.5 0

- 0.5

€ *, € *

1-

- 1.5

F

Weight Change (kg)

2

*,€ *,€ *

2-

*

Fat Mass

Fat-free Mass

R O

Body Weight

*

O

*

- 2.5

Fig. 1. Chronic effects of exercise modes on weight, fat mass and fat-free mass changes in males based on a meta-analysis research‡ (adapted from Table 3 in Ballor et al. [16]). ‡Ballor et al. performed a meta-analysis of data from 29 articles. Detailed information about subjects and study designs was not provided in the original article. *Significantly different from nonexercising control, P b 0.05. €Means significantly different from resistance training, P b 0.05.

210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239

3.1.2.2. Mode: high-intensity interval exercise and continuous endurance exercise: chronic effects. Several research groups compared long-term HIIT with traditional endurance and/or resistance training on weight loss and body composition and the results are inconclusive. Some groups reported no difference in changes in body fat and weight among between HIIT and continuous endurance training in overweight/obese individuals [23] or type 2 diabetic patients [24]. However, Keating et al. showed that continuous aerobic exercise offers greater improvement in fat mass and fat distribution, particularly android fat than HIIT [25]. Nybo and colleagues showed that endurance exercise reduced body weight and resistance training increased lean mass, with HITT having no impact on body weight and body composition [26]. HITT seems to be a solution for the “lack of time” barrier for individuals who want to increase physical activity but its effect on weight loss needs further investigation. 3.1.3. Mode: aquatic- vs. land-based aerobic exercise: chronic effects The environment in which an exercise regimen is performed can be viewed as the third aspect of mode. Land-based and water-based exercises are different in several aspects, including the environmental

240 241

3.2. Intensity

253

The different effects of resistance and aerobic training on energy balance, body weight, and body composition may also be a result of varying degrees of exercise intensity. Intensity is defined by the amount of physical power the body uses when performing an activity. Intuitively, it is understandable that by modifying exercise intensity only (without adjusting exercise duration), energy expenditure varies. As a result, changes in AEI/REI, body weight, and body composition may be due to different energy expenditures instead of intensities. In this case, it is helpful to consider energy expenditure when comparing different exercise intensities. There are two commonly used research designs in the current literature. One design adjusts the duration of exercise for different intensities to achieve the same energy expenditure (i.e., isoenergetic); the other design has fixed exercise duration which results in different energy expenditures (i.e. non-isoenergetic).

254

3.2.1. Intensity: acute effects Three research groups employed the non-isoenergetic design and compared cycling at different intensities with the same duration [30–32]. As a result, energy expenditure increases as exercise intensity increases. None of the studies observed an increase in AEI even after exercise at a high intensity compared with non-exercising control group. More specifically, among obese individuals, Kissileff et al. reported that AEI did not differ among exercise and control trials [31]. Among lean individuals, post-exercise AEI was unchanged [30] or decreased [31,32] after high intensity exercise. Moderate intensity exercise, on the other hand, seems less likely to have an impact on AEI. Among the 3 studies discussed, only Ueda et al. showed a decrease in AEI after

268

D

P

temperature and the amount of weight-bearing stresses on the skeletal joints [27]. As a result, their effects on energy balance and weight loss may vary from each other. Findings are mixed from the limited number of studies comparing land-based and aquatic-based aerobic training (e.g., swimming) regarding body weight and body composition changes. Some research indicated that aquatic- versus land-based exercise does not influence body composition and weight loss differently [27,28], while a recent study suggested that swimming is superior to walking for weight loss and improved body fat distribution among older women [29]. The authors showed that after 12 months of intervention, a swimming group lost 1.1 kg more body weight than a walking group and waist circumference was lower in swimmers by 1.5 cm. More research seems warranted for this topic.

E

T

C

208 209

E

206 207

R

204 205

R

202 203

regimens were designed to result in the same absolute energy expenditure (~ 230 kJ). After an acute bout of exercise, ad libitum AEI was reduced in both HIIE and VHIIE groups compared to the control group, with AEI after VHIIE 486 kJ lower than CE while AEI after HIIE and CE was not different. The reduction in AEI after VHIIE was sustained for the subsequent 38 hours of the study period. Test day and 2nd day AEI did not differ among HIIE, CE and control groups. Deighton et al. compared cycling at 68% Vo2peak (continuous endurance, CE) with six 30-second periods of cycling at maximum speed Wingate tests (sprint interval exercise, SIE) and a non-exercising control condition among 12 healthy, young men [21]. The energy expenditure of CE was higher than SIE by 413 kJ. Absolute energy intake was not different among the 3 interventions at 3 different meals through the day. The resulting REI after continuous exercise was lower compared to control. There was a tendency toward lower REI in the continuous exercise group than that in the sprint interval exercise group (P = 0.082) due to the higher energy expenditure achieved with CE. In these two studies, neither high intensity interval nor continuous endurance exercise increased daily AEI, but VHIIE suppressed AEI. However, which regimen offers greater benefits regarding REI is inconclusive because of variations in the exercise protocols used and limited data reported in the above two studies.

N C O

200 201

U

199

Please cite this article as: Li J, et al, Exercise patterns, ingestive behaviors, and energy balance, Physiol Behav (2014), http://dx.doi.org/10.1016/j. physbeh.2014.04.023

242 243 244 245 246 247 248 249 250 251 252

255 256 257 258 259 260 261 262 263 264 265 266 267

269 270 271 272 273 274 275 276 277 278 279

305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323

3.2.2. Intensity: chronic effects Consistent with results observed from acute studies, when exercise regimens differing in intensity and duration but with the same energy expenditure are used for weight loss purposes, their effects are comparable [37–42]. As a result of equal energy deficits and unchanged reported AEI, weight changes were not different among subjects training at different intensities. Nicklas and colleagues further provided evidence that when equal energy deficits are achieved, either as a result of dietary restriction or exercise, weight loss does not differ [42]. They conducted a 20-week weight loss study in 112 postmenopausal women assigned to 3 groups: energy restriction only (ER only), energy restriction plus moderate intensity exercise (ER + MI) and energy restriction plus vigorous intensity exercise (ER + VI). An energy deficit of ~400 kcal/day was applied to all subjects. The ER only group's energy deficit was achieved by dietary restriction, while the energy deficit in the ER + MI and the ER + VI groups came from a combination of dietary restriction and exercise. As

345

O

F

3.3. Duration

R O

303 304

P

301 302

324 325

Duration is defined as the amount of time a single bout of exercise lasts. One way to reach the recommended amount of physical activity is by increasing the duration of exercise. However, evidence suggests that prolonged exercise duration may not offer additional benefits on energy balance and weight loss [30,33,43,44].

D

299 300

shown in Fig. 2, changes in body weight, fat mass, and fat-free mass were not different among the groups. Therefore, successful weight loss can be achieved when an energy deficit is present and it is independent of the strategies used. Jakicic et al. also found that non-isoenergetic exercise trials with the same duration but different intensities did not affect weight loss differently [41]. They conducted a 12-month trial among 184 overweight, sedentary women divided into four groups (vigorous intensity/high duration, moderate intensity/high duration, moderate intensity/moderate duration, or vigorous intensity/moderate duration). Changes in body weight were not different among groups. No apparent compensation was identified as energy intake and nonexercise physical activities were not different among groups. However, post-hoc analysis revealed that the percentage weight loss was associated with the amount of physical activity actually performed. Overall, low intensity training was found to be as effective as high intensity training for improving energy balance and reducing body weight among overweight/obese adults when the exercise durations were adjusted to achieve the same energy expenditure [37–42]. Whether greater weight loss may be achieved by increasing intensity with the same duration is inconclusive [41].

0 -2 -4 -6 -8

ER only

ER+ MI

ER + VI

-10 -12 -14 Body Weight

Fat Mass

Fat-free mass

Fig. 2. Changes in body weight, fat mass, and lean mass were not different among interventional groups when equal energy deficit was applied* (adapted from Table 3 in Nicklas [42]). *20-week interventional study, 112 postmenopausal women. ER only: energy restriction only. ER + MI: energy restriction + 55 minutes of moderate intensity aerobic exercise. ER + VI: energy restriction + 10 minutes of vigorous intensity aerobic exercise.

326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344

346 347 348 349 350

3.3.1. Duration: acute effects Limited research suggests that exercise duration does not alter AEI when exercise is performed up to 60 minutes. King et al. compared high intensity cycling for 30 vs. 60 minutes on energy intakes immediately following the exercise and the rest of the day [33]. Even though energy expenditure was higher with longer duration exercise, postexercise and daily AEI were not different between control and exercise groups. In contrast, post-exercise and daily REI was progressively lower from control to 30 to 60 minutes of exercise, consistent with longer-duration exercise improving energy balance. Similarly, Erdmann et al. reported unchanged AEI after low-intensity cycling for 30 and 60 minutes. REI was not reported, but it is likely that REI was reduced, as ExEE increased from 357 kJ to 717 kJ [30]. Erdmann et al. [30] did report an increase in AEI after subjects exercised for 2 hours, which suggests that a threshold may exist where dietary compensation occurs in response to higher ExEE. Whether this increase in AEI completely compensated for the high energy expenditure is unclear as REI was not reported. These two studies suggest that increased energy expenditure as a result of longer duration exercise may not be fully compensated for via AEI. As a result, a greater reduction in REI, and consequently, higher energy deficit can be achieved by extending the duration of exercise (up to 60 minutes).

351 352

3.3.2. Duration: chronic effects In addition to the acute studies, two interventional studies were published after the latest ACSM position stand and addressed the issue of an upper limit for the duration of exercise regimens. Rosenkilde et al. showed no additional benefits of doubling exercise duration on weight loss and body composition with 62 participants over 13 weeks [44]. Subjects were divided into a moderate duration (30 minutes/day), a long duration (60 minutes/day) or a non-exercising control group. Subjects participated in an exercise training program on a daily basis. At the end of the intervention, changes in body weight and body composition were not different between exercise groups. Similar to what is observed in acute studies, Rosenkilde et al. suggest that there is a “threshold”

374

T

297 298

C

295 296

E

293 294

R

291 292

R

289 290

O

287 288

C

286

N

284 285

U

282 283

cycling at moderate intensity compared to control [32]. These studies did not report REI, but it may be inferred that REI was reduced as exercise intensity increased, since the elevated energy expenditure was not compensated for via increased AEI. Another four research groups used the isoenergetic design and investigated the acute effect of exercise intensity on AEI when energy expenditure was matched by adjusting exercise duration [33–36]. Test day AEI did not differ across exercise and control groups in all studies [33–35]. Only Pomerleau et al. reported that AEI increased by 532 kJ among subjects in the high intensity group at the meal immediately after exercise compared to control [35]. However, this did not result in an increase in total daily AEI [35]. Klausen et al. reported that AEI on the second day after exercise did not differ among groups [34]. As a result the isoenergetic design, REI did not differ among the exercise groups in 3 out of the 4 studies presented [33–35]. Only Imbeault et al. reported a small but significantly lower REI (923 kJ) after highintensity exercise compared with moderate intensity exercise [36]. This is potentially due to a tendency of increased AEI (P N 0.05) after moderate intensity exercise observed in their study [36]. These acute studies suggest that independent of energy expenditure with exercise higher intensity exercise does not increase AEI, but may reduce it. For exercises with the same duration, higher energy expenditure is achieved at higher intensity without complete compensation via AEI, which could potentially generate a greater energy deficit. When energy expenditure is matched, most studies [33–35] but not all [36] showed that exercise regimens with different intensities tend not to impact REI

Changes in kg

280 281

J. Li et al. / Physiology & Behavior xxx (2014) xxx–xxx

E

4

Please cite this article as: Li J, et al, Exercise patterns, ingestive behaviors, and energy balance, Physiol Behav (2014), http://dx.doi.org/10.1016/j. physbeh.2014.04.023

353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373

375 376 377 378 379 380 381 382 383 384 385

J. Li et al. / Physiology & Behavior xxx (2014) xxx–xxx

427 428

In addition to the mode, intensity, and duration of exercise, the time of the day when exercise is performed may affect energy balance. Appetitive and ingestive behavior responses to exercise might be different in the morning vs. evening due to diurnal appetite hormone regulations [45]. To test this hypothesis, studies were done to assess the acute effects of exercising in the morning vs. evening on energy balance in young, healthy males [46] and females [47]. Both studies showed that AEI on the test days was not different among control and exercise trials [46,47]. A reduced REI at the meals immediately after exercise in the morning and afternoon was observed, which suggests that a transient negative energy balance is generated post-exercise at both times. However, when considering REI through the entire test day, O'Donoghue et al. reported that daily REI was similar across the control and exercise trials [46]. It is noted that Maraki et al. did not compare the REI between morning and afternoon groups directly [47]. Long-term studies with exercise specifically at different times of day were not identified. With the limited data, it is hence inconclusive if exercising at different times of day has an effect on energy balance and weight control.

429

3.5. Frequency

430 431 432 433

3.5.1. Within-day frequency Frequency of exercise can be defined as how often an exercise session is performed within a certain time frame. One example is withinday frequency. For the purpose of this article, it is defined as exercise

t1:1 t1:2

Table 1 Generalization of results from research studies focusing on different exercise patterns.

414 415 416 417 418 419 420 421 422 423 424 425 426

3.5.2. Within-week frequency Within-week frequency is defined as the number of days during the week exercise is performed by an individual and represents the distribution of exercise. It is another way to increase physical activity in order to meet the ACSM recommendation. As discussed earlier, when the within-week frequency is fixed, increasing the duration of exercise does not seem to offer greater benefits for weight loss [43,44]. However, available evidence suggests that by increasing the frequency of exercise within a week, greater weight loss can be achieved (data available for up to 3 times/week). In a 12-week study conducted on 45 healthy sedentary women, weight loss and fat mass loss were greater with a greater frequency of exercise per week [50]. The subjects were assigned to participate in a 90-minute exercise program once, twice, or 3 times per week. The group that exercised 3 times per week had a significant decrease in body weight (− 2.8%) compared to the other exercise groups (1 ×/week, + 0.4%; 2 ×/week, + 0.1%) and the nonexercising control (+ 1.1%). Only the 3 times per week group showed a significant decrease in body fat compared to the control group (− 2.3% and + 2.0%, respectively). Westcott et al. further confirmed the benefits of exercising at higher frequency on weight control with a 10-week trial consisting of 1,725 adults [51]. Subjects were divided into 3 groups and were asked to participate in a 60-minute exercise program once, twice, or 3 times per week [51]. An increase in lean mass was observed among the subjects who exercised twice and 3 times per week, while only the 3 times per week group had a decrease in body fat pre- and post-intervention. To our knowledge, there were no studies that directly compared frequencies higher than 3 times per week with lower frequencies. It may be perceived that meeting the recommended amount of exercise per week by increasing the frequency of exercise (up to 3 times/week), instead of increasing exercise duration, could improve weight loss.

440

4. Conclusion

472

In this review we described and evaluated the acute and chronic effects of different exercise patterns on energy intake, energy balance, and weight control (body weight, body composition) in adults. A summary of the evidence based on acute and chronic studies is shown in Table 1. Generally, exercise regimens within a given pattern, despite having varying degrees of energy expenditure, do not impact absolute energy intake differently. Hence, by adopting different exercise patterns, a favorable energy balance may be achieved to improve weight loss and body composition.

473 474

D

412 413

T

405 406

C

403 404

E

401 402

R

399 400

R

397 398

N C O

395 396

U

393 394

F

410 411

392

O

3.4. Time of day: acute effects

390 391

434 435

R O

409

388 389

regimens of the same duration performed either in one long bout or multiple short bouts within the course of 1 day. For weight loss, two research groups reported equally beneficial effects of exercise with one continuous bout vs. multiple short bouts within a day when the total duration of exercise was the same [48,49]. The results are consistent among men [48] and women [49].

P

407 408

above which the body begins to compensate for the increased energy expenditure therefore exercise for excessive durations may not confer the additional benefits in weight loss. However, the compensatory mechanisms were not identified. In particular, no detectable changes in AEI and nonexercise physical activity were observed pre- and postintervention. Church et al. found similar results with a larger population (N = 411) over a 6-month intervention [43]. All subjects participated in the exercise program for the same number of visits each week. Weight loss was not different among groups when the duration of exercise increased (low duration: 18–24 minutes/day; medium duration: 34–45 minutes/day; high duration: 49–65 minutes/day). In addition, they found that the actual weight loss matched the predicted weight loss among subjects in the low and moderate duration groups. However the actual weight loss of the higher duration exercise group was less than predicted by 1.2 kg. Similar to findings of Rosenkilde and colleagues [44], Church et al. did not find differences in AEI among groups pre- and post-intervention. Results from the abovementioned studies conducted by Rosenkilde et al. and Church et al. suggest that increasing exercise duration may not yield further improvements in body weight as expected, even without detectable compensation. Future studies designed to identify the threshold would be of interest to for people trying to lose weight in a more time-efficient manner.

E

386 387

5

t1:3

Pattern

Acute AEI

Chronic AEI

Body Weight upon Chronic Training

t1:4 t1:5 t1:6 t1:7 t1:8

Mode Intensity Duration Time of day Frequency

↔⁎ between AT and RT [14,15] ↔ across intensity levels [30–36] ↔ (≤60 minutes) [30,33] ↔ between morning and evening groups [46] N/A

↓⁎ with AT and AT/RT, not with RT [19] ↔ across intensity levels [38,40,41] ↔ across duration levels [43,44] N/A§ N/A

↓ with AT and AT/RT, not RT [16] ↔ across intensity levels when energy expenditure is matched [37–42] ↔ when duration increases (upper limit may exist) [43,44] N/A Greater ↓ with higher within-week frequency (up to 3 times/week) [50,51]

t1:9 t1:10 t1:11

AEI, absolute energy intake; AT, aerobic training; RT, resistance training. ⁎ ↔ means there is no difference; ↓ means decrease in the parameters. § N/A means not available for a certain pattern.

Please cite this article as: Li J, et al, Exercise patterns, ingestive behaviors, and energy balance, Physiol Behav (2014), http://dx.doi.org/10.1016/j. physbeh.2014.04.023

436 437 438 439

441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471

475 476 477 478 479 480 481

J. Li et al. / Physiology & Behavior xxx (2014) xxx–xxx

C

E

R

R

O

C

F

O

N U

607

R O

[1] Selected health conditions and risk factors: United States, selected years 1988–1994 through 2009–2010. Center for Disease Control and Prevention; 2012. [2] Ogden CL, et al. Prevalence of obesity among adults: United States, 2011–2012. NCHS Data Brief 2013(131):1–8. [3] National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults — the evidence report. Obes Res 1998;6(Suppl. 2):51S–209S. [4] Jeffery RW, Harnack LJ. Evidence implicating eating as a primary driver for the obesity epidemic. Diabetes 2007;56(11):2673–6. [5] Westerterp KR. Impacts of vigorous and non-vigorous activity on daily energy expenditure. Proc Nutr Soc 2003;62(3):645–50. [6] Donnelly JE, et al. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009;41(2):459–71. [7] Phelan S, et al. Empirical evaluation of physical activity recommendations for weight control in women. Med Sci Sports Exerc 2007;39(10):1832–6. [8] Hansen BH, et al. Patterns of objectively measured physical activity in normal weight, overweight, and obese individuals (20–85 years): a cross-sectional study. PLoS One 2013;8(1):e53044. [9] Hopkins M, King NA, Blundell JE. Acute and long-term effects of exercise on appetite control: is there any benefit for weight control? Curr Opin Clin Nutr Metab Care 2010;13(6):635–40. [10] Schubert MM, et al. Acute exercise and subsequent energy intake. A meta-analysis. Appetite 2013;63:92–104. [11] Whybrow S, et al. The effect of an incremental increase in exercise on appetite, eating behaviour and energy balance in lean men and women feeding ad libitum. Br J Nutr 2008;100(5):1109–15. [12] Donnelly JE, et al. The role of exercise for weight loss and maintenance. Best Pract Res Clin Gastroenterol 2004;18(6):1009–29. [13] Peterson MD, Sen A, Gordon PM. Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sports Exerc 2011;43(2):249–58. [14] Balaguera-Cortes L, et al. Energy intake and appetite-related hormones following acute aerobic and resistance exercise. Appl Physiol Nutr Metab 2011;36(6):958–66. [15] Laan DJ, et al. Effects and reproducibility of aerobic and resistance exercise on appetite and energy intake in young, physically active adults. Appl Physiol Nutr Metab 2010;35(6):842–7. [16] Ballor DL, Keesey RE. A meta-analysis of the factors affecting exercise-induced changes in body mass, fat mass and fat-free mass in males and females. Int J Obes 1991;15(11):717–26. [17] Marques EA, et al. Effects of resistance and aerobic exercise on physical function, bone mineral density, OPG and RANKL in older women. Exp Gerontol 2011;46 (7):524–32. [18] Leenders M, et al. Elderly men and women benefit equally from prolonged resistance-type exercise training. J Gerontol A Biol Sci Med Sci 2013;68(7):769–79. [19] Bales CW, et al. Aerobic and resistance training effects on energy intake: the STRRIDE-AT/RT study. Med Sci Sports Exerc 2012;44(10):2033–9. [20] Laursen PB, Jenkins DG. The scientific basis for high-intensity interval training: optimising training programmes and maximising performance in highly trained endurance athletes. Sports Med 2002;32(1):53–73. [21] Deighton K, et al. Appetite, gut hormone and energy intake responses to low volume sprint interval and traditional endurance exercise. Eur J Appl Physiol 2013;113(5):1147–56. [22] Sim AY, et al. High-intensity intermittent exercise attenuates ad-libitum energy intake. Int J Obes (Lond) 2013. [23] Lunt H, et al. High intensity interval training in a real world setting: a randomized controlled feasibility study in overweight inactive adults, measuring change in maximal oxygen uptake. PLoS One 2014;9(1):e83256. [24] Terada T, et al. Feasibility and preliminary efficacy of high intensity interval training in type 2 diabetes. Diabetes Res Clin Pract 2013;99(2):120–9. [25] Keating SE, et al. Continuous exercise but not high intensity interval training improves fat distribution in overweight adults. J Obes 2014;2014:834865.

P

483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 Q3 537 538 539 540 541 542 543

[26] Nybo L, et al. High-intensity training versus traditional exercise interventions for promoting health. Med Sci Sports Exerc 2010;42(10):1951–8. [27] Taunton JE, et al. Effect of land-based and water-based fitness programs on the cardiovascular fitness, strength and flexibility of women aged 65–75 years. Gerontology 1996;42(4):204–10. [28] Gappmaier E, et al. Aerobic exercise in water versus walking on land: effects on indices of fat reduction and weight loss of obese women. J Sports Med Phys Fitness 2006;46(4):564–9. [29] Cox KL, et al. A comparison of the effects of swimming and walking on body weight, fat distribution, lipids, glucose, and insulin in older women — the Sedentary Women Exercise Adherence Trial 2. Metabolism 2010;59(11):1562–73. [30] Erdmann J, et al. Plasma ghrelin levels during exercise — effects of intensity and duration. Regul Pept 2007;143(1–3):127–35. [31] Kissileff HR, et al. Acute effects of exercise on food intake in obese and nonobese women. Am J Clin Nutr 1990;52(2):240–5. [32] Ueda SY, et al. Comparable effects of moderate intensity exercise on changes in anorectic gut hormone levels and energy intake to high intensity exercise. J Endocrinol 2009;203(3):357–64. [33] King NA, Burley VJ, Blundell JE. Exercise-induced suppression of appetite: effects on food intake and implications for energy balance. Eur J Clin Nutr 1994;48(10):715–24. [34] Klausen B, et al. Increased intensity of a single exercise bout stimulates subsequent fat intake. Int J Obes Relat Metab Disord 1999;23(12):1282–7. [35] Pomerleau M, et al. Effects of exercise intensity on food intake and appetite in women. Am J Clin Nutr 2004;80(5):1230–6. [36] Imbeault P, et al. Acute effects of exercise on energy intake and feeding behaviour. Br J Nutr 1997;77(4):511–21. [37] Ballor DL, McCarthy JP, Wilterdink EJ. Exercise intensity does not affect the composition of diet- and exercise-induced body mass loss. Am J Clin Nutr 1990;51(2):142–6. [38] Grediagin A, et al. Exercise intensity does not effect body composition change in untrained, moderately overfat women. J Am Diet Assoc 1995;95(6):661–5. [39] Gutin B, et al. Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents. Am J Clin Nutr 2002;75(5):818–26. [40] Hansen D, et al. Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA(1c) in obese type 2 diabetes patients. Diabetologia 2009;52(9):1789–97. [41] Jakicic JM, et al. Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA 2003;290(10):1323–30. [42] Nicklas BJ, et al. Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: a randomized, controlled trial. Am J Clin Nutr 2009;89(4):1043–52. [43] Church TS, et al. Changes in weight, waist circumference and compensatory responses with different doses of exercise among sedentary, overweight postmenopausal women. PLoS One 2009;4(2):e4515. [44] Rosenkilde M, et al. Body fat loss and compensatory mechanisms in response to different doses of aerobic exercise — a randomized controlled trial in overweight sedentary males. Am J Physiol Regul Integr Comp Physiol 2012;303(6):R571–9. [45] Birketvedt GS, et al. Diurnal secretion of ghrelin, growth hormone, insulin binding proteins, and prolactin in normal weight and overweight subjects with and without the night eating syndrome. Appetite 2012;59(3):688–92. [46] O'Donoghue KJ, Fournier PA, Guelfi KJ. Lack of effect of exercise time of day on acute energy intake in healthy men. Int J Sport Nutr Exerc Metab 2010;20(4):350–6. [47] Maraki M, et al. Acute effects of a single exercise class on appetite, energy intake and mood. Is there a time of day effect? Appetite 2005;45(3):272–8. [48] DeBusk RF, et al. Training effects of long versus short bouts of exercise in healthy subjects. Am J Cardiol 1990;65(15):1010–3. [49] Jakicic JM, et al. Prescribing exercise in multiple short bouts versus one continuous bout: effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. Int J Obes Relat Metab Disord 1995;19(12):893–901. [50] Nakamura Y, et al. Effects of exercise frequency on functional fitness in older adult women. Arch Gerontol Geriatr 2007;44(2):163–73. [51] Westcott WL, et al. Prescribing physical activity: applying the ACSM protocols for exercise type, intensity, and duration across 3 training frequencies. Phys Sportsmed 2009;37(2):51–8.

D

References

T

482 Q2

E

6

Please cite this article as: Li J, et al, Exercise patterns, ingestive behaviors, and energy balance, Physiol Behav (2014), http://dx.doi.org/10.1016/j. physbeh.2014.04.023

544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606