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Purpose: To determine whether adherence to a repeating 30-d non-linear diet intervention while participating in a supervised exercise program that includes resistance-exercise would promote weight and fat loss without weight loss plateau and whether alterations in carbohydrate and protein intake may influence results. Methods: Fifty sedentary and obese pre-menopausal females (35.2±7.6 years; 88.7±18 kg, 32.6±6 kg/m2, 42.5±4.2% fat) were randomly assigned to an exercise-only (EX) or EX plus diets containing higher proportions of carbohydrate or protein. Diets were hypoenergetic for 30-d (7-d at 1,200 kcals/d, 21-d at 1,500 kcal/d), more isoenergetic for 30-d (2,200 kcals/d), and repeated three times during a 24-wk intervention. Diets were either 45:30:24 (HCD) or 30:45:25 (HPD) carbohydate:protein:fat. All participants performed 30-min resistance exercise (3 d/wk) and a brisk walking program (3 d/wk). Data were analyzed by general linear model (GLM) statistics with repeated measures and presented as mean changes from baseline (mean [UL, LL]). Results: Participants experienced a significant and reduction in body weight (EX -2.24 [-6.5, 2.0], EX+HCD -6.99 [-9.4, -4.5], EX+HPD -4.49 [-7.1, -1.8] %), fat mass (EX -3.45 [-10.9, 4.03], EX+HCD -12.15 [-16.4, -7.9], EX+HPD -8.54 [-13.2, -3.9] %), and percent body fat (EX -1.30 [-5.6, 3.0], EX+HCD -5.91 [-8.3, -3.5], EX+HPD -4.31 [-7.0, -1.6] %) with those in the EX+HCD experiencing a more linear response. Participants in the EX and EX+HCD groups maintained fat-free mass to a better degree (EX -0.89 [-4.0, 2.2], EX+HCD -3.21 [-5.0, -1.2], EX+HPD -1.92 [-3.8, 0.002] %). Participants dieting generally experiencing greater benefit with some evidence that those in the EX+HPD experienced greater changes in blood lipids. Conclusion: A 30-day repeated non-linear diet can promote fat and weight loss without a plateau. Consuming a HPD may help maintain fat-free mass during weight loss and improve some markers of health compared to HCD interventions.

While commercial dietary weight-loss programs typically advise exercise, few provide actual programing. The goal of this study was to compare the Curves Complete 90-day Challenge (CC, n = 29), which incorporates exercising and diet, to programs advocating exercise (Weight Watchers Points Plus (WW, n = 29), Jenny Craig At Home (JC, n = 27), and Nutrisystem Advance Select (NS, n = 28)) or control (n = 20) on metabolic syndrome (MetS) and weight loss. We randomized 133 sedentary, overweight women (age, 47 ± 11 years; body mass, 86 ± 14 kg; body mass index, 35 ± 6 kg/m2) into respective treatment groups for 12 weeks. Data were analyzed using chi square and general linear models adjusted for age and respective baseline measures. Data are means ± SD or mean change ± 95% confidence intervals (CIs). We observed a significant trend for a reduction in energy intake for all treatment groups and significant weight loss for all groups except control: CC (−4.32 kg; 95% CI, −5.75, −2.88), WW (−4.31 kg; 95% CI, −5.82, −2.96), JC (−5.34 kg; 95% CI, −6.86, −3.90), NS (−5.03 kg; 95% CI, −6.49, −3.56), and control (0.16 kg, 95% CI, −1.56, 1.89). Reduced MetS prevalence was observed at follow-up for CC (35% vs. 14%, adjusted standardized residuals (adjres.) = 3.1), but not WW (31% vs. 28% adjres. = 0.5), JC (37% vs. 42%, adjres. = −0.7), NS (39% vs. 50% adjres. = −1.5), or control (45% vs. 55% adjres. = −1.7). While all groups improved relative fitness (mL·kg−1·min−1) because of weight loss, only the CC group improved absolute fitness (L/min). In conclusion, commercial programs offering concurrent diet and exercise programming appear to offer greater improvements in MetS prevalence and cardiovascular function after 12 weeks of intervention.

BackgroundMusculoskeletal injuries are a significant burden to United States Army Special Operations Forces. The advanced tactical skill level and physical training required of Army Special Operators highlights the need to optimize musculoskeletal characteristics to reduce the likelihood of suffering a recurrent injury.PurposeTo identify the residual impact of previous injury on musculoskeletal characteristics.Study DesignCross-sectional study; Level of evidence, 3.MethodsIsokinetic strength of the knee, shoulder, and back and flexibility of the shoulder and hamstrings were assessed as part of a comprehensive human performance protocol, and self-reported musculoskeletal injury history was obtained. Subjects were stratified based on previous history of low back, knee, or shoulder injury, and within-group and between-group comparisons were made for musculoskeletal variables.ResultsKnee injury analysis showed no significant strength or flexibility differences. Shoulder injury analysis found internal rotation strength of the healthy subjects (H) was significantly higher compared with injured (I) and uninjured (U) limbs of the injured group (H, 60.8 ± 11.5 percent body weight [%BW]; I, 54.5 ± 10.5 %BW; U, 55.5 ± 11.3 %BW) ( P = .014 [H vs I] and P = .05 [H vs U]). The external rotation/internal rotation strength ratio was significantly lower in the healthy subjects compared with injured and uninjured limbs of the injured group (H, 0.653 ± 0.122; I, 0.724 ± 0.121; U, 0.724 ± 0.124) ( P = .026 [H vs I] and P = .018 [H vs U]). Posterior shoulder tightness was significantly different between the injured and uninjured limb of the injured group (I, 111.6° ± 9.4°; U, 114.4° ± 9.3°; P = .008). The back injury analysis found no significant strength differences between the healthy and injured groups.ConclusionFew physical differences existed between operators with prior knee or back injury. However, operators with a previous history of shoulder injury demonstrated significantly less shoulder strength than uninjured operators as well as decreased shoulder flexibility on the injured side. All operators, regardless of prior injury, must perform the same tasks; therefore, a targeted injury rehabilitation/human performance training specifically focused on internal rotation strength and tightness of the posterior capsule may help reduce the risk for recurrence of injury. Operators presenting with musculoskeletal asymmetries and/or insufficient strength ratios may be predisposed to musculoskeletal injury.Clinical RelevanceSpecific fitness programs to compensate for deficiencies in strength and flexibility need to be designed that may reduce the risk of injuries in Special Forces Operators.

Background The purpose of this study was to examine the short-term and chronic effects of β-ALA supplementation with and without creatine monohydrate on body composition, aerobic and anaerobic exercise performance, and muscle carnosine and creatine levels in college-aged recreationally active females. Methods Thirty-two females were randomized in a double-blind, placebo-controlled manner into one of four supplementation groups: β-ALA only (BA, n = 8), creatine only (CRE, n = 8), β-ALA and creatine combined (BAC, n = 9) and placebo (PLA, n = 7). Participants supplemented for four weeks included a loading phase for the creatine for week 1 of 0.3 g/kg of body weight and a maintenance phase for weeks 2–4 of 0.1 g/kg of body weight, with or without a continuous dose of β-ALA of 0.1 g/kg of body weight with doses rounded to the nearest 800 mg capsule providing an average of 6.1 ± 0.7 g/day of β-ALA. Participants reported for testing at baseline, day 7 and day 28. Testing sessions consisted of obtaining a resting muscle biopsy of the vastus lateralis, body composition measurements, performing a graded exercise test on the cycle ergometer for VO2peak with lactate threshold determination, and multiple Wingate anaerobic capacity tests. Results Although mean changes were consistent with prior studies and large effect sizes were noted, no significant differences were observed among groups in changes in muscle carnosine levels (BA 35.3 ± 45; BAC 42.5 ± 99; CRE 0.72 ± 27; PLA 13.9 ± 44%, p = 0.59). Similarly, although changes in muscle phosphagen levels after one week of supplementation were consistent with prior reports and large effect sizes were seen, no statistically significant effects were observed among groups in changes in muscle phosphagen levels and the impact of CRE supplementation appeared to diminish during the maintenance phase. Additionally, significant time × group × Wingate interactions were observed among groups for repeated sprint peak power normalized to bodyweight (p = 0.02) and rate of fatigue (p = 0.04). Conclusions Results of the present study did not reveal any consistent additive benefits of BA and CRE supplementation in recreationally active women.

The purpose of this study was to determine if different types of exercise and diet interventions promote greater changes in visceral adipose tissue (VAT). 54 sedentary women (34±8 yrs, BMI 35±6) we...

The purpose of this study was to determine if different diet and exercise programs differentially affect android and/or gynoid body composition changes in sedentary women. 54 sedentary women (34±8 ...

The purpose of this study was to determine if different types of exercise and diet interventions promote greater changes in visceral adipose tissue (VAT). 127 sedentary women (46±12 yr, 45.5±5% body fat, 35.1±5 kg/m2) were randomized to participate in a control group (C) or the Curves Complete® program with online support (CC), Weight Watchers® Points Plus (WW), Jenny Craig® (JC), or Nutrisystem® Advance Select™ (NS) weight loss programs for 12-wks. DEXA body composition with VAT determination was obtained at 0 & 12 wks. MANOVA revealed significant (p=

Background Obesity is associated with many negative health outcomes. Diet and exercise has been shown to reduce obesity and various other factors linked to poor health. One of the major concerns is the expense of diet and exercise programs. This study compared the cost effectiveness of four popular weight loss programs and controls in terms of weight loss success and outcomes. Methods

Background ISSN recommendations for individuals involved in a general fitness program are to ingest 25-35 kcal/kg/day consisting of 3-5 g/kg of carbohydrate and ≤30% of total calories from fat. Additionally, the ISSN recommends that individuals engaged in resistance-training should ingest 1.4-2.0 g/kg/d of protein and to ingest some protein after exercise. This study examined whether nutritional counseling and post-workout supplementation affects dietary intake during training.

Background A number of psychological interventions have been employed prior to and/or during exercise and weight loss interventions in an attempt to influence exercise adherence, compliance, and/or success. However, few studies have evaluated whether these types of efforts influence program efficacy. The purpose of this study was to determine whether having sedentary and overweight individuals experience the impact of losing weight on work capacity prior to initiation of an exercise and/or weight loss program would influence weight loss success.

Effects of high carbohydrate or high protein energy-restricted diets combined with resistanceexercise on weight loss and markers of health in women with serum triglyceride levels above or below median values Jonathan M Oliver, Julie Y Kresta, Mike Byrd, Claire Canon, Michelle Mardock, Sunday Simbo, Peter Jung, Brittanie Lockard, Deepesh Khanna, Majid Koozehchian, Chris Rasmussen, Chad Kerksick, Richard Kreider

Background The Curves fitness program involves a 30-minute circuit resistance-training program performed 3 days/week and an optional weight management program. While initial studies have shown this program to be highly effective (Nutri Metab 6/1/23, 2009), the long-term success rates of women participating in this program remains to be examined. This study examined the long-term efficacy of women participating in the Curves program from 6 months to 8 years on weight loss and maintenance.

Background A number of commercial diet and exercise programs are promoted to help people lose weight and improve fitness. However, few studies have compared the effects of following different types of exercise and diet interventions on weight loss. The purpose of this study was to compare the efficacy of a more structured meal plan based diet intervention and supervised exercise program to a traditional point based diet program with weekly counseling and encouragement to exercise.

Background The purpose of this study was to determine the effects of participating in a resistance-exercise based circuit training program while adhering to a higher protein diet designed to preserve fat free mass (FFM) during weight loss on body composition and markers of health. Then, in a companion paper, determine if exercise and diet-induced weight loss affect markers of inflammation.

Background A number of commercial diet and exercise programs are promoted to help people lose weight and improve fitness. However, few studies have compared the effects of following different types of exercise and diet interventions on weight loss, health, and quality of life. The purpose of this study was to compare the efficacy of a more structured meal plan based diet intervention and supervised exercise program that included resistance-exercise to a traditional point based diet program with weekly counseling and encouragement to exercise.

Background A number of commercial diet and exercise programs are promoted to help people lose weight and improve fitness. However, few studies have compared the effects of following different types of exercise and diet interventions on weight loss. The purpose of this study was to compare the efficacy of a more structured meal plan based diet intervention and supervised exercise program that included resistance-exercise to a traditional point based diet program with weekly counseling and encouragement to exercise. Methods Fifty-one sedentary women (35±8 yrs, 163±7 cm; 90±14 kg; 47±7% body fat, 34±5 kg/m 2 ) were randomized to participate in the Curves (C) or Weight Watchers (W) weight loss programs for 16-weeks. Participants in the C program were instructed to follow a 1,200 kcal/d diet for 1-week, 1,500 kcal/d diet for 3-weeks, and 2,000 kcals/d diet for 2-weeks, consisting of 30% carbohydrate, 45% protein, and 30% fat. Subjects repeated this diet for the 16-week period. Subjects also participated in the Curves circuit style resistance training program 3-days/week and were encouraged to walk at a brisk pace for 30-minutes on non-training days. This program involved performing 30-60 seconds of bi-directional hydraulic-based resistance exercise on 13 machines interspersed with 30-60 seconds of low-impact callisthenic or Zumba dance exercise. Participants in the W group followed the W pointbased diet program, received weekly counseling at a local W facility, and were encouraged to increase physical activity. Fasting blood samples were obtained at 0, 4, 10, & 16 weeks and analyzed by multivariate analysis of variance (MANOVA) with repeated measures for changes in triglycerides (TG), total cholesterol (CHL), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), the CHL:HDL-C ratio, and blood glucose. Data are presented as percent changes from baseline for the C and W groups, respectively, after 4, 10, and 16 weeks. Results