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Objectives: Commercially available wearable activity monitors can promote physical activity behaviour. Clinical trials typically quantify physical activity with research grade activity monitors prior to testing interventions utilising commercially available wearable activity monitors aimed at increasing step count. Therefore, it is important to test the agreement of these two types of activity monitors., Objectives: Observational., Methods: Thirty adults (20-65 years, n = 19 females) were provided a Fitbit Charge 4©. To determine reliability using an intraclass correlation coefficient, two, one-minute bouts of treadmill walking were performed at a self-selected pace. Subsequently, participants wore both an ActiGraph wGT3X-BT and the Fitbit for seven days. To determine agreement, statistical equivalence and the mean absolute percentage error were calculated and represented graphically with a Bland-Altman plot. Ordinary least products regression was performed to identify fixed or proportional bias., Results: The Fitbit showed 'good' step count reliability on the treadmill (intraclass correlation coefficient = 0.75, 95 % CI = 0.53-0.87, p < 0.001). In free-living however, it overestimated step count when compared to the ActiGraph wGT3X-BT (mean absolute percentage error = 26.02 % ± 14.63). Measurements did not fall within the ± 10 % equivalence region and proportional bias was apparent (slope 95 % CI = 1.09-1.35)., Conclusions: The Fitbit Charge 4© is reliable when measuring step count on a treadmill. However, there is an overestimation of daily steps in free-living environments which may falsely indicate compliance with physical activity recommendations., Competing Interests: Declaration of interest statement The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The aim of this rapid review is to examine the research evidence that presents the effects of physical activity and exercise on Nucleobindin-2 (NUCB2) gene expression and Nesfatin-1 concentration. Five databases (PubMed, Science Direct, Springer, Wiley, and Google Scholar) were searched for eligible studies from the earliest available date to August 2023. In human studies, Nesfatin-1 concentration either remains unchanged or increases after exercise training. It appears that higher exercise intensity and longer duration of training accentuate the increase of blood Nesfatin-1 concentration. The few human studies that have examined the acute response of exercise on Nesfatin-1 concentration from blood draws show conflicting results. There is a severe lack of biopsy studies in humans which warrants attention. All published animal studies have used the mouse model. The majority show that regular exercise training increases tissue NUCB2/Nesfatin-1. In some animal studies, where the effects of exercise on tissue Nesfatin-1 concentration has been seen as significant, there has been no significant effect of exercise on plasma Nesfatin-1 concentration. All animal studies evaluated the effect of endurance training except one which used resistance training. No animal studies have investigated the effects of acute exercise, which warrants investigation. In conclusion, human and animal studies have shown that physical training can increase NUCB2/Nesfatin-1, but research evidence examining the effect of acute exercise is in its infancy. In addition, future comparative studies are needed to compare the effects of different training protocols on NUCB2/Nesfatin-1 in humans and animals., (© 2023 John Wiley & Sons Ltd.)

Background: Digital advancement of power assisted exercise equipment will advance exercise prescription for people with stroke (PwS). This article reports on the remote usability evaluation of a co-designed graphical user interface (GUI) and denotes an example of how video-conference software can increase reach to participants in the testing of rehabilitation technologies. The aim of this study was to evaluate the usability of two sequential versions of the GUI., Methods: We adopted a mixed methods approach. Ten professional user (PU) (2M/8F) and 10 expert user (EU) participants (2M/8F) were recruited. Data collection included a usability observation, a 'think aloud' walk through, task completion, task duration and user satisfaction as indicated by the Post Study System Usability Questionnaire (PSSUQ). Identification of usability issues informed the design of version 2 which included an additional submenu. Descriptive analysis was conducted upon usability issues and number of occurrences detected on both versions of the GUI. Inferential analysis enabled comparison of task duration and PSSUQ data between the PU and EU groups., Results: Analysis of the 'think aloud' walkthrough data enabled identification of 22 usability issues on version 1 from a total of 100 usability occurrences. Task completion for all tasks was 100%. Eight usability issues were directly addressed in the development of version 2. Two recurrent and 24 new usability issues were detected in version 2 with a total of 86 usability occurrences. Paired two tailed T-tests on task duration data indicated a significant decrease amongst the EU group for task 1.1 on version 2 (P = 0.03). The mean PSSUQ scores for version 1 was 1.44 (EU group) and 1.63 (PU group) compared with 1.40 (EU group) and 1.41 (PU group) for version 2., Conclusions: The usability evaluation enabled identification of usability issues on version 1 of the GUI which were effectively addressed on the iteration of version 2. Testing of version 2 identified usability issues within the new submenu. Application of multiple usability evaluation methods was effective in identifying and addressing usability issues in the GUI to improve the experience of PAE for PwS. The use of video-conference software to conduct synchronous, remote usability testing is an effective alternative to face to face testing methods., (© 2023. The Author(s).)

Community-based group physical activity programs promote exercise opportunities for older people. The aim of this study was to examine the short-term, new participant effect after joining Vitality, a community-based group physical activity program available in the East of England for older adults. Two independent groups of participants were assessed before and after an 8 week period: a group recruited from the 'Vitality' program (VP) (n 15, age: Age = 69.4 ± 6.4 y), and; a non-intervention control (CON) group (n 14, age: 64.5 ± 5.8 y). Assessment outcomes included basic physical health measures, a fitness test battery, and three psychological scales. The VP group recorded statistically significant improvements on the following outcomes: body mass (VP: -1.39 kg/CON: -0.2 kg), body mass index (VP: -1.5 kg/CON: -0.2 kg), 6 min walk (VP: +42.81 m/CON: -0.45 m), 30 s sit-to-stand (VP: -1.7 s/CON: -0.7 s), the chair sit-and-reach (VP: +3.12 cm/CON: +1.90 cm), and the 30 s arm curl test (VP: + 2 reps/CON: +0.9 reps). No significant differences were found with the other outcomes assessed. New members to the Vitality program achieved several physical and functional benefits without regression on any aspects of physical or psychological health.

The involvement of people with lived experience in the design of exercise programmes is more likely to lead to a more needs-sensitive and population-specific intervention. There is limited evidence of the integration of people with lived experience, particularly regarding home-based exercise programmes for adults living with overweight and obesity, despite this being a population that would significantly benefit from a suitably tailored programme. Semi-structured interviews were virtually conducted to explore 20 participants' experiences of exercising at home and their preferences for the design of future home-based exercise programmes. Codes were generated through thematic analysis, highlighting considerations such as comfort within a home-based environment, a desire for social connection, and the integration of technology. Four corresponding themes were generated, encapsulating participants' choice reasoning for home-based exercise, difficulties of engaging in home-based exercise, undertaking and adhering to home-based exercise, and factors that constitute the perfect programme. Although the involvement of people with lived experience in research can be time-consuming, this process is fundamental to the design of an effective and efficacious programme. These findings will inform the design and development of a home-based exercise programme for adults living with overweight and obesity.

In this manifesto, we make the case that Exercise Science can and must do more to improve the health of the public and the planet. Post pandemic, our vision for Exercise Science is one of a maturing scientific discipline reaching outwards from a base of strong empirical evidence to have a profound and sustained positive global impact on health. In each of the three main areas of the discipline - research, teaching, and professional practice - a new and distinctive approach is needed. We propose 12 points of action, in no particular order, for a). quality, rigour, and professional standing, and b). reach, relevance, and public engagement and make numerous suggestions for action and change. We encourage the teachers, researchers and practitioners of Exercise Science to consider and act on these recommendations. We hope that this manifesto can help create a shared sense of purpose amongst the global Exercise Science community and further the principles of equality, diversity and inclusion. To act on these principles, we need to cultivate a discipline that encourages more women, people who experience racism and other forms of discrimination, and people with a disability to become involved in the discipline.

Background: In 2017 Public Health England and Sport England commissioned a Consultant-led Sport and Exercise Medicine (SEM) pilot to test the feasibility and acceptability of embedding physical activity interventions in secondary care clinical pathways. The aim of this paper is to report qualitative findings exploring the experience of healthcare professionals (HCPs) and patients involved in the Active Hospital pilot., Methods: Qualitative data was collected by semi-structured interviews with Active Hospital pilot SEM Consultants, and staff and patients involved in three clinical pathways. Interviews with SEM Consultants explored the experience of developing and implementing the pilot. Interviews with staff and patients explored the experience of delivering and receiving Active Hospital interventions. Data were analysed thematically., Results: Interviews identified the importance of the Active Hospital pilot being Consultant-led for the following reasons; i) having trusting relationships with decision makers, ii) having sufficient influence to effect change, iii) identifying champions within the system, and iv) being adaptable to change and ensuring the programme fits within the wider strategic frameworks. HCPs emphasised the importance of the Active Hospital interventions fitting easily within existing work practices, the need for staff training and to tailor interventions for individual patient needs. The Active Hospital pilot was well received by patients, however a lack of dedicated resource and capacity to deliver the intervention was highlighted as a challenge by both patients and HCPs., Conclusion: The SEM Consultants' ability to navigate the political climate of a large National Health Service (NHS) Trust with competing agendas and limited resource was valuable. The interventions were well received and a valued addition to usual clinical care. However, implementation and ongoing delivery of the pilot encountered challenges including lack of capacity within the system and delays with recruiting to the delivery teams in each pathway., Competing Interests: The authors have declared that no competing interests exist.

Background: Polycystic ovary syndrome (PCOS) affects up to 20% of women and is characterised by higher amounts of visceral fat, obesity, insulin resistance, dyslipidemia and reproductive and cardiometabolic complications. Increased oxidised low-density lipoprotein (LDL) concentrations have been associated with an increased risk of cardiovascular disease (CVD)-related events. Oxidised LDL is rarely used as a marker for CVD risk in PCOS-related studies despite its widely accepted role in atherogenesis and the increased risk factors associated with PCOS. Additionally, prolonged periods of sedentary behaviour can negatively affect metabolic health. No studies have specifically examined the effects of reducing sedentary behaviour on CVD risk in PCOS with a lifestyle physical activity intervention. The aim of the current study is to measure the feasibility of a randomised controlled trial (RCT) examining the effects of supervised exercise and reducing sedentary behaviour in women with PCOS on CVD risk., Methods/design: A feasibility, exploratory RCT will be conducted. Fifty-one pre-menopausal females will be randomly allocated between an exercise group (EG), a lifestyle physical activity group (LPAG) and a control group. Participants in the EG will undertake a 12-week supervised aerobic exercise programme. The LPAG will aim to increase daily physical activity and reduce sedentary behaviour for 12 weeks. The control group will not take part in any intervention. Primary outcomes are feasibility and acceptability of the intervention and procedures. Secondary outcomes are oxidised LDL, aerobic fitness, blood lipid profile, fasting glucose and insulin, testosterone and inflammatory markers., Discussion: PCOS is associated with various increased risk factors for CVD, including hypertension, dyslipidemia, abdominal obesity, insulin resistance, and inflammation. Whether oxidised LDL has a role in this increased risk is not yet known. The present study aims to measure the feasibility of implementing structured exercise training and/or increased lifestyle physical activity in women with PCOS, so that a subsequent adequately powered RCT can be designed. The results from the study will be used to refine the interventions and determine the acceptability of the study design. A limitation is that some self-monitoring in the lifestyle physical activity group may not be reliable or replicable, for example inputting information about time spent cleaning/gardening., Trial Registration: ClinicalTrials.gov, NCT03678714. Registered 20 September 2018.

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy affecting both the metabolism and reproductive system of women of reproductive age. Prevalence ranges from 6.1-19.9% depending on the criteria used to give a diagnosis. PCOS accounts for approximately 80% of women with anovulatory infer-tility, and causes disruption at various stages of the reproductive axis. Evidence suggests lifestyle modification should be the first line of therapy for women with PCOS. Several studies have examined the impact of exercise interventions on reproductive function, with results indicating improvements in menstrual and/or ovulation frequency following exercise. Enhanced insulin sensitivity underpins the mechanisms of how exercise restores reproductive function. Women with PCOS typically have a cluster of metabolic abnormalities that are risk factors for CVD. There is irrefutable evidence that exercise mitigates CVD risk factors in women with PCOS. The mechanism by which exercise improves many CVD risk factors is again associated with improved insulin sensitivity and decreased hyperinsulinemia. In addition to cardiometabolic and reproductive complications, PCOS has been associated with an increased prevalence of mental health disorders. Exercise improves psychological well-being in women with PCOS, dependent on certain physiological factors. An optimal dose-response relationship to exercise in PCOS may not be feasible because of the highly individualised characteristics of the disorder. Guidelines for PCOS suggest at least 150 min of physical activity per week. Evidence confirms that this should form the basis of any clinician or healthcare professional prescription.

Identifying the difference in barriers and motivators between middle-age and older adults could contribute toward the development of age-specific health promotion interventions. The aim of this review was to synthesize the literature on barriers and motivators for physical activity in middle-aged (50-64 years) and older adults (65-70 years). The review examined qualitative and quantitative studies using the theoretical domain framework as the guiding theory. The search generated 9400 results from seven databases. A total of fifty-five articles meeting the inclusion criteria. Results indicate that barriers are comparable across the two age groups with environmental factors and resources being the most commonly identified barriers. In older adults, social influences, reinforcement and assistance in managing change were the most identified motivators. Middle-aged identified goals settings, believe that activity will be beneficial and social influences were most important. Findings can be used by professionals to encourage engagement with and adherence to physical activity.

Objective: The objective was to examine differences in physical activity, sitting time and perceptions of physical activity and health between Pokémon Go users and nonusers at baseline (launch of the application in the United Kingdom) and 3-month follow-up. Materials and Methods: The self-administered, short version of the 7-day recall, International Physical Activity Questionnaire, was adapted to develop the "Physical Activity and Pokémon Go questionnaire," which was distributed using social media. Four weeks after the launch of the application, 461 participants ( n  = 193 male, n  = 265 female, n  = 3 transgender) had completed the questionnaire. At 3-month follow-up, 127 participants repeated the questionnaire. Results: At baseline, mixed models analysis of variance (ANOVA) revealed main effects for Pokémon Go users versus nonusers in the amount of days of vigorous physical activity, moderate physical activity, and walking (All P  < 0.01). Users reported that they undertook less days of vigorous physical activity than nonusers, but more days of moderate physical activity and walking. There were no differences in body mass index, minutes of vigorous or moderate physical activity, and walking, or sitting on weekdays (All P  > 0.05). Repeated measures ANOVA identified increased sitting on weekdays ( P  < 0.05), but maintained vigorous, moderate and walking physical activity behaviors in users who remained users. Conclusion: Pokémon Go use can increase the frequency of days of physical activity benefitting health. Users at both time points maintained their physical activity behaviour, but increased sitting time on weekdays, highlighting that another intervention to prevent sitting is needed.

Exercise facilitates weight control, partly through effects on appetite regulation. Single bouts of exercise induce a short-term energy deficit without stimulating compensatory effects on appetite, whilst limited evidence suggests that exercise training may modify subjective and homeostatic mediators of appetite in directions associated with enhanced meal-induced satiety. However, a large variability in responses exists between individuals. This article reviews the evidence relating to how adiposity, sex, and habitual physical activity modulate exercise-induced appetite, energy intake, and appetite-related hormone responses. The balance of evidence suggests that adiposity and sex do not modify appetite or energy intake responses to acute or chronic exercise interventions, but individuals with higher habitual physical activity levels may better adjust energy intake in response to energy balance perturbations. The effect of these individual characteristics and behaviours on appetite-related hormone responses to exercise remains equivocal. These findings support the continued promotion of exercise as a strategy for inducing short-term energy deficits irrespective of adiposity and sex, as well as the ability of exercise to positively influence energy balance over the longer term. Future well-controlled studies are required to further ascertain the potential mediators of appetite responses to exercise.

Purpose: This study aimed to characterize the immediate and extended effect of acute exercise on hunger, energy intake, and circulating acylated ghrelin concentrations using a large data set of homogenous experimental trials and to describe the variation in responses between individuals., Methods: Data from 17 of our group's experimental crossover trials were aggregated yielding a total sample of 192 young, healthy males. In these studies, single bouts of moderate to high-intensity aerobic exercise (69% ± 5% V˙O2 peak; mean ± SD) were completed with detailed participant assessments occurring during and for several hours postexercise. Mean hunger ratings were determined during (n = 178) and after (n = 118) exercise from visual analog scales completed at 30-min intervals, whereas ad libitum energy intake was measured within the first hour after exercise (n = 60) and at multiple meals (n = 128) during the remainder of trials. Venous concentrations of acylated ghrelin were determined at strategic time points during (n = 118) and after (n = 89) exercise., Results: At group level, exercise transiently suppressed hunger (P < 0.010, Cohen's d = 0.77) but did not affect energy intake. Acylated ghrelin was suppressed during exercise (P < 0.001, Cohen's d = 0.10) and remained significantly lower than control (no exercise) afterward (P < 0.024, Cohen's d = 0.61). Between participants, there were notable differences in responses; however, a large proportion of this spread lay within the boundaries of normal variation associated with biological and technical assessment error., Conclusion: In young men, acute exercise suppresses hunger and circulating acylated ghrelin concentrations with notable diversity between individuals. Care must be taken to distinguish true interindividual variation from random differences within normal limits.

Acute exercise transiently suppresses the orexigenic gut hormone acylated ghrelin, but the extent to which exercise intensity and duration determine this response is not fully understood. The effects of manipulating exercise intensity and duration on acylated ghrelin concentrations and hunger were examined in two experiments. In experiment one, nine healthy males completed three, 4-h conditions (control, moderate-intensity running (MOD) and vigorous-intensity running (VIG)), with an energy expenditure of ~2.5 MJ induced in both MOD (55-min running at 52% peak oxygen uptake (V.O 2peak )) and VIG (36-min running at 75% V.O 2peak ). In experiment two, nine healthy males completed three, 9-h conditions (control, 45-min running (EX45) and 90-min running (EX90)). Exercise was performed at 70% V.O 2peak In both experiments, participants consumed standardised meals, and acylated ghrelin concentrations and hunger were quantified at predetermined intervals. In experiment one, delta acylated ghrelin concentrations were lower than control in MOD (ES = 0.44, P = 0.01) and VIG (ES = 0.98, P < 0.001); VIG was lower than MOD (ES = 0.54, P = 0.003). Hunger ratings were similar across the conditions (P = 0.35). In experiment two, delta acylated ghrelin concentrations were lower than control in EX45 (ES = 0.77, P < 0.001) and EX90 (ES = 0.68, P < 0.001); EX45 and EX90 were similar (ES = 0.09, P = 0.55). Hunger ratings were lower than control in EX45 (ES = 0.20, P = 0.01) and EX90 (ES = 0.27, P = 0.001); EX45 and EX90 were similar (ES = 0.07, P = 0.34). Hunger and delta acylated ghrelin concentrations remained suppressed at 1.5 h in EX90 but not EX45. In conclusion, exercise intensity, and to a lesser extent duration, are determinants of the acylated ghrelin response to acute exercise., (© 2017 Society for Endocrinology.)

This study examined effects of 12 weeks of moderate-intensity aerobic exercise on eating behaviour, food cravings, and weekly energy intake and expenditure in inactive men. Eleven healthy men (mean ± SD: age, 26 ± 5 years; body mass index, 24.6 ± 3.8 kg·m -2 ; maximum oxygen uptake, 43.1 ± 7.4 mL·kg -1 ·min -1 ) completed the 12-week supervised exercise programme. Body composition, health markers (e.g., blood pressure), eating behaviour, food cravings, and weekly energy intake and expenditure were assessed before and after the exercise intervention. There were no intervention effects on weekly free-living energy intake (p = 0.326, d = -0.12) and expenditure (p = 0.799, d = 0.04) or uncontrolled eating and emotional eating scores (p > 0.05). However, there was a trend with a medium effect size (p = 0.058, d = 0.68) for cognitive restraint to be greater after the exercise intervention. Total food cravings (p = 0.009, d = -1.19) and specific cravings of high-fat foods (p = 0.023, d = -0.90), fast-food fats (p = 0.009, d = -0.71), and carbohydrates/starches (p = 0.009, d = -0.56) decreased from baseline to 12 weeks. Moreover, there was a trend with a large effect size for cravings of sweets (p = 0.052, d = -0.86) to be lower after the exercise intervention. In summary, 12 weeks of moderate-intensity aerobic exercise reduced food cravings and increased cognitive restraint, but these changes were not accompanied by changes in other eating behaviours or weekly energy intake and expenditure. The results indicate the importance of exercising for health improvements even when reductions in body mass are modest.

Unlabelled: This study examined the effects of an acute bout of exercise of low-intensity on food intake and energy expenditure over four days in women taking oral contraceptives. Twenty healthy, active (n = 10) and inactive (n = 10) pre-menopausal women taking oral contraceptives completed two conditions (exercise and control), in a randomised, crossover fashion. The exercise experimental day involved cycling for one hour at an intensity equivalent to 50% of maximum oxygen uptake and two hours of rest. The control condition comprised three hours of rest. Participants arrived at the laboratory fasted overnight; breakfast was standardised and an ad libitum pasta lunch was consumed on each experimental day. Participants kept a food diary to measure food intake and wore an Actiheart to measure energy expenditure for the remainder of the experimental days and over the subsequent 3 days. There was a condition effect for absolute energy intake (exercise vs., Control: 3363 ± 668 kJ vs. 3035 ± 752 kJ; p = 0.033, d = 0.49) and relative energy intake (exercise vs., Control: 2019 ± 746 kJ vs. 2710 ± 712 kJ; p <0.001, d = -1.00) at the ad libitum lunch. There were no significant differences in energy intake over the four days in active participants and there was a suppression of energy intake on the first day after the exercise experimental day compared with the same day of the control condition in inactive participants (mean difference = -1974 kJ; 95% CI -1048 to -2900 kJ, p = 0.002, d = -0.89). There was a group effect (p = 0.001, d = 1.63) for free-living energy expenditure, indicating that active participants expended more energy than inactive participants during this period. However, there were no compensatory changes in daily physical activity energy expenditure. These results support the use of low-intensity aerobic exercise as a method to induce a short-term negative energy balance in inactive women taking oral contraceptives., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: This study compared the effects of a 2-week program of low-volume high-intensity interval training (HIT) with the effects of higher-volume moderate-intensity continuous training (CT) on cardiopulmonary and vascular functions in postmenopausal women., Methods: Twenty-two postmenopausal women were randomly assigned to undertake six HIT (n = 12) or CT (n = 10) sessions for 2 weeks. HIT sessions consisted of ten 1-minute intervals of cycling exercise at 100% of peak power output separated by 1 minute of active recovery. CT sessions involved 40 minutes of continuous cycling at 65% of peak power output. Variables assessed at baseline and 2 weeks included cardiopulmonary function (ventilatory threshold, peak oxygen uptake), macrovascular endothelial function (flow-mediated dilation of the brachial artery), and microvascular function (reactive hyperemia and local thermal hyperemia of forearm skin)., Results: Eighteen participants completed the study (HIT, 11; CT, 7). Adherence to the exercise programs was excellent, with 107 of 108 sessions completed. Despite substantially lower total time commitment (∼2.5 vs. ∼5 h) and training volume (558 vs. 1,237 kJ) for HIT versus CT, increases from baseline in peak oxygen uptake achieved significance (P = 0.01) for the HIT group only (Δ = 2.2 mL kg min; P for interaction = 0.688). Improvements in exercise test duration were observed in both groups (HIT, 13%; CT, 5%; P for interaction = 0.194). There were no significant changes in macrovascular or microvascular function in either group., Conclusions: The findings suggest that low-volume HIT is feasible and can lead to rapid improvements in cardiopulmonary function in postmenopausal women.

This study examined the effects of an acute bout of low-intensity cycling on food intake and energy expenditure over four days. Thirty healthy, active (n=15) and inactive (n=15) men completed two conditions (exercise and control), in a randomised crossover fashion. The exercise experimental day involved cycling for one hour at an intensity equivalent to 50% of maximum oxygen uptake and two hours of rest. The control condition comprised three hours of rest. Participants arrived at the laboratory fasted overnight; breakfast was standardised and an ad libitum pasta lunch was consumed on each experimental day. Participants kept a food diary and wore an Actiheart to estimate energy intake and expenditure for the remainder of the experimental days and over the subsequent 3 days. Ad libitum lunch energy intake did not differ between conditions (p=0.32, d=0.18) or groups (p=0.43, d=0.27). Energy intake in the active group was greater on the exercise experimental day than on the control experimental day (mean difference=2070 kJ; 95% CI 397 to 3743 kJ, p=0.024, d=0.56) while in the inactive group it was increased on only the third day after exercise (mean difference=2225 kJ; 95% CI 414 to 4036 kJ, p=0.024, d=0.80). There was only a group effect (p=0.032, d=0.89) for free-living energy expenditure, indicating that active participants expended more energy than inactive over this period. Acute low-intensity exercise did not affect energy intake at the meal immediately after exercise, but induces an acute (within the experimental day) and delayed (third day after the experimental day) increase in energy intake in active and inactive participants, respectively with no compensatory changes to daily energy expenditure. These results suggest that active individuals compensate for an acute exercise-induced energy deficit quicker than inactive individuals., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Resistance (muscle strengthening) exercise is a key component of exercise recommendations for weight control, yet very little is known about the effects of resistance exercise on appetite. We investigated the effects of resistance and aerobic exercise on hunger and circulating levels of the gut hormones acylated ghrelin and peptide YY (PYY). Eleven healthy male students: age 21.1 +/- 0.3 yr, body mass index 23.1 +/- 0.4 kg/m(2), maximum oxygen uptake 62.1 +/- 1.8 ml.kg(-1).min(-1) (means +/- SE) undertook three, 8-h trials, 1) resistance exercise: a 90-min free weight lifting session followed by a 6.5-h rest period, 2) aerobic exercise: a 60-min run followed by a 7-h rest period, 3) control: an 8-h rest, in a randomized crossover design. Meals were provided 2 and 5 h into each trial. Hunger ratings and plasma concentrations of acylated ghrelin and PYY were measured throughout. Two-way ANOVA revealed significant (P < 0.05) interaction effects for hunger, acylated ghrelin, and PYY, indicating suppressed hunger and acylated ghrelin during aerobic and resistance exercise and increased PYY during aerobic exercise. A significant trial effect was observed for PYY, indicating higher concentrations on the aerobic exercise trial than the other trials (8 h area under the curve: control 1,411 +/- 110, resistance 1,381 +/- 97, aerobic 1,750 +/- 170 pg/ml 8 h). These findings suggest ghrelin and PYY may regulate appetite during and after exercise, but further research is required to establish whether exercise-induced changes in ghrelin and PYY influence subsequent food intake.

Nesfatin-1 is involved in metabolic/feeding regulation and prevention of cardiovascular disease. Previous studies have shown that exercise and herb supplementation can influence nesfatin-1 concentration. The present study investigated the effects of high-intensity training (HIT) and Ziziphus jujuba (ZJ) extract on tissue nesfatin-1 in rats. Twenty-eight female rats were randomly assigned to one of four groups i.e. 1) Saline-Control (SC), 2) Saline-High Intensity Training (ST), 3) Ziziphus jujuba-Control (ZJC), and 4) Ziziphus jujuba-High Intensity Training (ZJT). Rats performed exercise on a treadmill and/or administered supplements intragastrically for 6 weeks, depending on group category. Seventy-two hours after the last training session, rats were anesthetized. Blood, hypothafi 2lamus tissue, heart and gastrocnemius muscles were sent to the laboratory for analyses. Significantly higher nesfatin-1 gene expression and concentration and ATP concentration were found in trained rat. HIT increased plasma High Density Lipoprotein (HDL) and insulin concentration and reduced plasma Triglyceride (TG) and cortisol. ZJ increased tissue nesftain-1 gene expression and concentration while only increasing heart ATP. The combination of exercise and ZJ showed an additive effect compared to each intervention alone on hypothalamus, heart and gastrocnemius NUCB2 gene expression, heart and gastrocnemius nesfatin-1 concentration, plasma HDL and cortisol concentration. The authors recommend both interventions as a means to improve cardiovascular health in rats with further work needed to confirm similar findings in homo sapiens. [ABSTRACT FROM AUTHOR]

The aims of this study were to investigate the influence of reduced-exertion, high-intensity interval training (REHIT), comparing a novel shortened-sprint protocol (SSREHIT) against a traditional protocol (TREHIT), on perceptual responses and to determine if changes in peak oxygen uptake (V˙O2peak) are attenuated with shorter sprints. Twenty-four healthy men undertook 15 sessions of SSREHIT or TREHIT. V˙O2peak was determined at baseline and after completion of each exercise condition. Affective (pleasure-displeasure) responses and perceived exertion were assessed during exercise to capture peak responses. Enjoyment was recorded 5-min after cessation of exercise. Compared to baseline, V˙O2peak increased in both groups (6% for SSREHIT [ d =− 0.36] and 9% for TREHIT [ d= − 0.53], p=0.01). Affective responses were more favourable for SSREHIT (p=0.001, d =1.62), but both protocols avoided large negative peaks of displeasure. Peak ratings of perceived exertion were lower for SSREHIT (p=0.001, d =− 1.71), although there were no differences in enjoyment (d =0.25). The results demonstrate both exercise conditions can increase V˙O2peak without overly compromising perceptual responses. Decreased sprint duration might further circumvent negative perceptual responses but might also attenuate physiological adaptations. [ABSTRACT FROM AUTHOR]

A common barrier to exercise is "lack of time". Accordingly, interest in low-volume, high-intensity training has grown exponentially since this activity is considered time-efficient. However, the high-intensity nature of this exercise may frequently result in feelings of displeasure creating another barrier for many people. The purpose of this study was to compare affective (pleasure-displeasure) responses to three low-volume, high-intensity exercise conditions, including a novel shortened-sprint protocol. Using a within-subjects, randomised crossover experiment, healthy participants (N = 36) undertook a single bout of: 1) traditional reduced-exertion, high-intensity interval training (TREHIT), 2) a novel, shortened-sprint REHIT (SSREHIT) protocol, and 3) sprint continuous training (SCT). Affect and perceived efforts were recorded throughout exercise using the Feeling Scale (FS) and the 15-point Borg Rating of Perceived Exertion (RPE) scale, respectively. Enjoyment was recorded 5 min post-exercise using the Exercise Enjoyment Scale (EES). Differences were found for FS (condition by time interaction: P = 0.01GG, η2 = 0.26), RPE (P = 0.01GG, η2 = 0.23), and enjoyment (P < 0.01) with all outcomes favouring SSREHIT. Shortened-sprint protocols may diminish feelings of displeasure and might be a time-efficient yet tolerable exercise choice to help motivate some people to increase their physical activity and fitness. [ABSTRACT FROM AUTHOR]

Purpose: Women with polycystic ovary syndrome (PCOS) exhibit many metabolic abnormalities that are associated with an increased cardiovascular disease risk. Exercise may promote improvements in lipid profile and insulin sensitivity in women with PCOS. There is however, a knowledge gap on the optimal dose of exercise, regarding duration, intensity, type, and frequency of exercise. The aim of this systematic review and meta-analysis was to define effective types of exercise to improve cardiometabolic profile in PCOS. Methods: We included randomised controlled trials (RCT), quasi-RCT, and controlled clinical trials focusing on reproductive-aged women diagnosed with PCOS. Eligible interventions included those with at least two weeks of supervised exercise sessions. Primary outcomes were blood lipids, blood glucose, blood pressure, measures of abdominal adiposity, and inflammation markers. Secondary outcomes were total and free testosterone, sex hormone binding globulin, and measures of insulin resistance. Nine electronic databases were searched from inception to present for English language publications. The Cochrane Risk Assessment tool was used to assess bias in the included studies. Outcomes were quantitatively synthesised and a meta- analysis was performed. Pooled effect estimates and 95% confidence intervals were presented. Results: This systematic review identified three trials, including 231 participants with PCOS, that examined the effect of structured, supervised exercise on cardiometabolic outcomes. Analysis of pooled data indicated statistical favourable effects of exercise on total cholesterol, fasting glucose, waist circumference and waist-to-hip ratio, systolic blood pressure, C-reactive protein, total testosterone, and sex hormone binding globulin using post-intervention scores. Conclusions: Moderate aerobic exercise interventions ≥3 months in duration, with a frequency of 3/week for at least 30-min, may have favourable effects on various cardiometabolic risk factors in women with PCOS. However, results should be interpreted with caution. Many of the outcomes were based on studies with serious methodological limitations, and only one "gold-standard" RCT was identified. PROSPERO ID: CRD42018086117. [ABSTRACT FROM AUTHOR]

Background/Aims: Participation in physical activity and exercise presents a challenge for adults with complex neurological impairment. Power-assisted exercise facilitates combined limb and trunk movement and may be an option for people with movement impairment. The aim of this study was to determine whether power-assisted exercise is a feasible activity option for people with complex neurological impairment. Methods: Seven adults with complex neurological impairment were recruited to take part in a 4-week programme of twice weekly power-assisted exercise. Programme attendance and completion was recorded and adverse events or effects documented. Mobility was monitored using the Timed Up and Go test (TUG). Upon completion of the programme, participants were interviewed regarding their experience of using the equipment. Findings: All seven participants completed the programme and the overall attendance was 96%. No adverse events occurred; two participants reported minor adverse effects, which were temporary. The TUG scores improved and participants enjoyed the programme, reporting perceived benefits in physical function and wellbeing. Conclusions: The findings of this study demonstrate that people with complex neurological impairment can participate in a programme of power-assisted exercise. Reported improvements in physical mobility suggest that further research in this area is indicated. [ABSTRACT FROM AUTHOR]

Purpose: There is conflicting evidence whether a single bout of resistance exercise performed the day before a test meal can lower postprandial triacylglycerol (TAG) concentrations. The present study examined the effect of a single session of resistance exercise, performed the same day as a test meal, on postprandial TAG concentrations in resistance-trained males. Methods: Ten healthy males aged 25 (SD 2.6) yr performed two trials at least 1 wk apart in a counterbalanced, randomized design. In each trial, participants consumed a test meal (0.89 g of fat, 1.23 g of carbohydrate, 0.4 g of protein, 60 kJ·kg-1 body mass). Before one meal, participants performed a 90-min bout of resistance exercise. Before the other meal, participants were inactive (control trial). Resistance exercise was performed using free weights and included three sets of 12 repetitions of each of 10 exercises. Sets were performed at 80% of 12-repetition maximum with a 3-min work and rest interval. Venous blood samples were obtained in the fasted state and for 5 h postprandially. Results: Total area under the plasma TAG concentration versus time curve was higher (Student's t-test P = 0.008) on the exercise than control trial (mean ± SE: 11.76 ± 1.64 vs 7.94 ± 1.08 mmol·L-1·5 h-1, respectively). Total area under the plasma myoglobin concentration versus time curve was higher (Student's t-test P = 0.010) on the exercise than control trial (16.68 ± 3.34 vs 6.80 ± 0.64 nmol·L-1·5 h-1; respectively). Conclusion: A single bout of resistance exercise can cause a transient elevation in postprandial TAG concentrations. The elevations in plasma myoglobin suggest postexercise muscle damage. Further investigation is needed to see if these findings are linked. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy, affecting 4–12% of reproductive-aged women. Women with PCOS often exhibit many metabolic abnormalities that are associated with an increased cardiovascular disease (CVD) risk, independent of obesity. Exercise interventions from 12 to 24 weeks have been shown to have positive effects on blood lipid profile, ovulation and insulin resistance in women with PCOS. However, no consensus on which exercise interventions are effective (i.e. duration, type of exercise, frequency), including for different phenotypes, currently exists. The aim of this systematic review and meta-analysis is to define effective types of exercise interventions to improve cardiometabolic profile, across the range of phenotypes of PCOS. Methods: We will conduct electronic database searches, including randomised-controlled trials (RCT), quasi-RCT and clinical trials. Primary outcomes sought will be lipid profile, carotid-intima media thickness, fasting blood glucose, %HbA1c, blood pressure, waist circumference, waist-to-hip ratio, abdominal adiposity and inflammation markers. Secondary outcomes sought will be free and total testosterone, sex hormone binding globulin and insulin resistance. The Cochrane Risk Assessment Tool will be used to assess study quality. Data will be analysed in RevMan. Analysis of heterogeneity will be undertaken using the I2 statistic. Significant heterogeneity will be explored, and sensitivity analyses carried out as appropriate. A subgroup analysis based on androgen profile will be undertaken if data are sufficient. Discussion: A large proportion of women are affected by PCOS. It is prudent to examine how CVD risk can be mitigated in this high-risk population, and this review aims to provide evidence-driven recommendations on the types of exercise interventions that are effective for this. The review will seek to provide recommendations regarding type, frequency and duration of exercise interventions to improve cardiometabolic profile in PCOS. The subgroup analysis may be able to highlight difference in intervention effects between normo-androgenic and hyper-androgenic profile. Limitations include heterogeneity across studies and a scarcity of clinical trials involving a PCOS control group not undertaking any intervention. Systematic review registration: PROSPERO CRD42018086117 [ABSTRACT FROM AUTHOR]

Background: Typically, management of PCOS focuses on lifestyle changes (exercise and diet), aiming to alleviate symptoms, and lower the associated risk of type 2 diabetes and cardiovascular disease. Our objective was to analyse evidence on the effectiveness of exercise in the management of PCOS, when compared to (i) usual care, (ii) diet alone, and (iii) exercise combined with diet, and also exercise combined with diet, compared to (i) control or usual care and (ii) diet alone. Methods: Relevant databases were searched (June 2017) with no time limit for trial inclusion. Eligible trials employed a randomised or quasi-randomised design to measure the chronic effects of exercise, or exercise and diet in women with PCOS. Results: Searches returned 2390 articles; of those, 27 papers from 18 trials were included. Results are presented as mean difference (MD) and 95% confidence intervals (95% CI). Compared with control, exercise had a statistical effect on change from baseline fasting insulin (MD − 2.44 μIU/mL, 95% CIs − 4.24 to − 0.64; very low-quality evidence), HOMA-IR (− 0.57, − 0.99 to − 0.14; very low-quality evidence), total cholesterol (− 5.88 mg/dL, − 9.92 to − 1.83; low-quality evidence), LDL cholesterol (− 7.39 mg/dL, − 9.83 to − 4.95; low-quality evidence), and triglycerides (− 4.78 mg/dL, − 7.52 to − 2.05; low-quality evidence). Exercise also improved VO2 max (3.84 ml/kg/min, 2.87 to 4.81), waist circumference (− 2.62 cm, − 4.13 to − 1.11), and body fat percentage (− 1.39%, − 2.61 to − 0.18) when compared with usual care. No effect was found for change value systolic/diastolic blood pressure, fasting glucose, HDL cholesterol (all low-quality evidence), or waist-to-hip ratio. Many favourable change score findings were supported by post-intervention value analyses: fasting insulin (− 2.11 μIU/mL, − 3.49 to − 0.73), total cholesterol (− 6.66 mg/dL, − 11.14 to − 2.17), LDL cholesterol (− 6.91 mg/dL, − 12.02 to − 1.80), and VO2 max (5.01 ml/kg/min, 3.48 to 6.54). Statistically lower BMI (− 1.02 kg/m2, − 1.81 to − 0.23) and resting heart rate (− 3.26 beats/min − 4.93 to − 1.59) were also revealed in post-intervention analysis. Subgroup analyses revealed the greatest improvements in overweight/obese participants, and more outcomes improved when interventions were supervised, aerobic in nature, or of a shorter duration. Based on limited data, we found no differences for any outcome between the effects of exercise and diet combined, and diet alone. It was not possible to compare exercise vs diet or exercise and diet combined vs diet. Conclusion: Statistically beneficial effects of exercise were found for a range of metabolic, anthropometric, and cardiorespiratory fitness-related outcomes. However, caution should be adopted when interpreting these findings since many outcomes present modest effects and wide CIs, and statistical effects in many analyses are sensitive to the addition/removal of individual trials. Future work should focus on rigorously designed, well-reported trials that make comparisons involving both exercise and diet. Systematic review registration: This systematic review was prospectively registered on the Prospero International Prospective Register of Systematic Reviews (CRD42017062576) [ABSTRACT FROM AUTHOR]

Background Consideration of psychological factors towards exercise participation is important, especially when placed within a cultural context. Objective The aim of this study was to translate the Exercise Benefits/Barriers Scale and Exercise Motivation Inventory-2 to Maltese and undertake psychometric testing. Methods Maltese-speaking participants (n = 170) aged 18 to 69 years were recruited. 72% completed both questionnaires twice within an 8-to 48-hour period. Reliability was calculated using the Spearman correlation, intraclass correlation coefficient, and Bland-Altman plots. Convergent construct validity was tested using Spearman correlation between theoretical variables. Results In total 155 participants completed the questionnaires at both time points. The test/ re-test reliability of the two questionnaires was >0.7 for all analyses. Correlations for validity were statistically significant (p < 0.05). Conclusion The translated tools have similar psychometric properties to the original version; the authors recommend that health care professionals and physical activity practitioners use these tools when examining population-level physical activity behaviour among Maltese-speaking individuals. [ABSTRACT FROM AUTHOR]

The article presents a study on the effect of brisk walking on energy intake, appetite, and appetite-stimulating hormone acylated ghrelin. The study was participated by 14 healthy young men who performed eight-hour brisk and control walking trials. It states that participants did brisk walking for one hour in the brisk walking trial, which commenced on a level-motorized treadmill, and rested for seven hours while they were requested to rest for the whole duration in the control trial. Furthermore, their appetite was assessed by offering them ad libitum buffet meals two times during the trials. The study discovers that brisk walking had no significant impact on appetite, acylated ghrelin, and energy intake despite the induced moderate energy deficit.

There is a clear need to improve understanding of the effects of physical activity and exercise on appetite control. Therefore, the acute and short-term effects (three days) of a single bout of cycling on energy intake and energy expenditure were examined in women not using hormonal contraceptives. Sixteen active (n = 8) and inactive (n = 8) healthy pre-menopausal women completed a randomised crossover design study with two conditions (exercise and control). The exercise day involved cycling for 1 h (50% of maximum oxygen uptake) and resting for 2 h, whilst the control day comprised 3 h of rest. On each experimental day participants arrived at the laboratory fasted, consumed a standardised breakfast and an ad libitum pasta lunch. Food diaries and combined heart rate-accelerometer monitors were used to assess free-living food intake and energy expenditure, respectively, over the subsequent three days. There were no main effects or condition (exercise vs control) by group (active vs inactive) interaction for absolute energy intake (P > 0.05) at the ad libitum laboratory lunch meal, but there was a condition effect for relative energy intake (P = 0.004, ηp2 = 0.46) that was lower in the exercise condition (1417 ± 926 kJ vs. 2120 ± 923 kJ). Furthermore, post-breakfast satiety was higher in the active than in the inactive group (P = 0.005, ηp2 = 0.44). There were no main effects or interactions (P > 0.05) for mean daily energy intake, but both active and inactive groups consumed less energy from protein (14 ± 3% vs. 16 ± 4%, P = 0.016, ηp2 = 0.37) and more from carbohydrate (53 ± 5% vs. 49 ± 7%, P = 0.031, ηp2 = 0.31) following the exercise condition. This study suggests that an acute bout of cycling does not induce compensatory responses in active and inactive women not using hormonal contraceptives, while the stronger satiety response to the standardised breakfast meal in active individuals adds to the growing literature that physical activity helps improve the sensitivity of short-term appetite control. [ABSTRACT FROM AUTHOR]

Single bouts of land-based exercise suppress appetite and do not typically alter energy intake in the short-term, whereas it has been suggested that water-based exercise may evoke orexigenic effects. The primary aim was to systematically review the available literature investigating the influence of water-based exercise on energy intake in adults (PROSPERO ID number CRD42022314349). PubMed, Medline, Sport-Discus, Academic Search Complete, CINAHL and Public Health Database were searched for peer-reviewed articles published in English from 1900 to May 2022. Included studies implemented a water-based exercise intervention versus a control or comparator. Risk of bias was assessed using the revised Cochrane 'Risk of bias tool for randomised trials' (RoB 2.0). We identified eight acute (same day) exercise studies which met the inclusion criteria. Meta-analysis was performed using a fixed effects generic inverse variance method on energy intake (8 studies (water versus control), 5 studies (water versus land) and 2 studies (water at two different temperatures)). Appetite and appetite-related hormones are also examined but high heterogeneity did not allow a meta-analysis of these outcome measures. We identified one chronic exercise training study which met the inclusion criteria with findings discussed narratively. Meta-analysis revealed that a single bout of exercise in water increased ad-libitum energy intake compared to a non-exercise control (mean difference [95% CI]: 330 [118, 542] kJ, P = 0.002). No difference in ad libitum energy intake was identified between water and land-based exercise (78 [-176, 334] kJ, P = 0.55). Exercising in cold water (18-20 °C) increased energy intake to a greater extent than neutral water (27-33 °C) temperature (719 [222, 1215] kJ; P < 0.005). The one eligible 12-week study did not assess whether water-based exercise influenced energy intake but did find that cycling and swimming did not alter fasting plasma concentrations of total ghrelin, insulin, leptin or total PYY but contributed to body mass loss 87.3 (5.2) to 85.9 (5.0) kg and 88.9 (4.9) to 86.4 (4.5) kg (P < 0.05) respectively. To conclude, if body mass management is a person's primary focus, they should be mindful of the tendency to eat more in the hours after a water-based exercise session, particularly when the water temperature is cold (18-20 °C). [ABSTRACT FROM AUTHOR]

Single bouts of land-based exercise (for example, walking, running, cycling) do not typically alter post-exercise energy intake on the day of exercise. However, anecdotal and preliminary empirical evidence suggests that swimming may increase appetite and energy intake. This study compared the acute effects of swimming on appetite, energy intake, and food preference and reward, versus exertion-matched cycling and a resting control. Thirty-two men (n = 17; mean ± SD age 24 ± 2 years, body mass index [BMI] 25.0 ± 2.6 kg/m2) and women (n = 15; age 22 ± 3 years, BMI 22.8 ± 2.3 kg/m2) completed three experimental trials (swimming, cycling, control) in a randomised, crossover design. The exercise trials involved 60-min of 'hard' exercise (self-selected rating of perceived exertion: 15) performed 90-min after a standardised breakfast. Food preference and reward were assessed via the Leeds Food Preference Questionnaire 15-min after exercise, whilst ad libitum energy intake was determined 30-min after exercise. The control trial involved identical procedures except no exercise was performed. Compared with control (3259 ± 1265 kJ), swimming increased ad libitum energy intake (3857 ± 1611 kJ; ES = 0.47, 95% CI of the mean difference between trials 185, 1010 kJ, P = 0.005); the magnitude of increase was smaller after cycling (3652 ± 1619 kJ; ES = 0.31, 95% CI -21, 805 kJ, P = 0.062). Ad libitum energy intake was similar between swimming and cycling (ES = 0.16, 95% CI -207, 618 kJ, P = 0.324). This effect was consistent across sexes and unrelated to food preference and reward which were similar after swimming and cycling compared with control. This study has identified an orexigenic effect of swimming. Further research is needed to identify the responsible mechanism(s), including the relevance of water immersion and water temperature per se. [ABSTRACT FROM AUTHOR]