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- Effect of exercise training interventions on energy intake and appetite control in adults with overweight or obesity: A systematic review and metaāanalysisPublication . Beaulieu, Kristine; Blundell, John; Van Baak, Marleen; Battista, Francesca; Busetto, Luca; CarraƧa, Eliana V.; Dicker, Dror; Encantado, Jorge; Ermolao, Andrea; Farpour-Lambert, Nathalie; Pramono, Adriyan; Woodward, Euan; Bellicha, Alice; Oppert, Jean-MichelThis systematic review examined the impact of exercise training interventions on energy intake (EI) and appetite control in adults with overweight/obesity (ā„18āyears including older adults). Articles were searched up to October 2019. Changes in EI, fasting appetite sensations, and eating behavior traits were examined with random effects meta-analysis, and other outcomes were synthesized qualitatively. Forty-eight articles were included (median [range] BMIā=ā30.6 [27.0-38.4] kg/m2 ). Study quality was rated as poor, fair, and good in 39, seven, and two studies, respectively. Daily EI was assessed objectively (Nā=ā4), by self-report (Nā=ā22), with a combination of the two (Nā=ā4) or calculated from doubly labeled water (Nā=ā1). In studies rated fair/good, no significant changes in pre-post daily EI were found and a small but negligible (SMDā<ā0.20) postintervention difference when compared with no-exercise control groups was observed (five study arms; MDā=ā102 [1, 203] kcal). There were negligible-to-small pre-post increases in fasting hunger and dietary restraint, decrease in disinhibition, and some positive changes in satiety and food reward/preferences. Within the limitations imposed by the quality of the included studies, exercise training (median duration of 12āweeks) leads to a small increase in fasting hunger and a small change in average EI only in studies rated fair/good. Exercise training may also reduce the susceptibility to overconsumption (PROSPERO: CRD42019157823).
- Keep on running ā a randomized controlled trial to test a digital evidence-based intervention for sustained adoption of recreational running: rationale, design and pilot feasibility studyPublication . Pereira, Hugo V.; Teixeira, Pedro J.; Marques, Marta M.; CarraƧa, Eliana V.; Silva, Marlene N.; Encantado, Jorge; Santos, InĆŖs; Palmeira, AntĆ³nio L.Background: This paper describes the rationale, intervention development, study design and results from the pilot feasibility study of the Keep On Running (KOR) trial. KOR aims to test a web-based brief theory-based intervention, targeting maintenance of recreational running behavior over time (i.e. relapse preventing). Methods: Intervention development was based both on Self- Determination Theory and on Self-Regulation Theory. As part of it, a pilot study was implemented (n=18) to measure intervention adherence and participant satisfaction in order to establish the feasibility and acceptability of the intervention toolkit. Furthermore, this pilot study was also used to test the feasibility and acceptability of the questionnaires selected to be part of the later RCT. Results: Pilot intervention acceptability was good, but overall adherence was low. Features such as feedback and social sharing should be added to the toolkit. The main trial should lessen questionnaire length and include data from usual monitoring gadgets and apps (APIs). The protocol of the RCT was adjusted to test the efficacy of the refined final version of the intervention, and the RCT that will test it, contributing to the understanding of recreational running sustainability, allowing the optimization of future interventions aimed at physical activity promotion.
- Effective behavior change techniques to promote physical activity in adults with overweight or obesity: A systematic review and metaāanalysisPublication . CarraƧa, Eliana V.; Encantado, Jorge; Battista, Francesca; Beaulieu, Kristine; Blundell, John; Busetto, Luca; Van Baak, Marleen; Dicker, Dror; Ermolao, Andrea; Farpour-Lambert, Nathalie; Pramono, Adriyan; Woodward, Euan; Bellicha, Alice; Oppert, JeanāMichelMulticomponent behavior change interventions are typically used in weight management, but results are largely heterogeneous and modest. Determining which techniques (behavior change technique [BCTs]) are more effective in changing behavior is thus required. This study aimed to identify the most effective BCTs for increasing physical activity (PA) in digital and face-to-face behavior change interventions in adults with overweight/obesity. Four databases were searched for eligible studies until October 2019. BCTs were coded using BCTTv1 and MBCT taxonomies. Sixty-two RCTs were included. Meta-regressions were performed to explore BCTs' moderating role. Five BCTs showed significant moderator effects on PA in digital interventions: goal setting behavior, goal setting outcome, graded tasks, social incentive, and self-monitoring of behavior (adjusted R2 'sā=ā0.15-0.51). One BCT showed significant moderator effects on PA in face-to-face interventions, behavioral practice and rehearsal (adjusted R2 ā=ā0.22). Multivariate and sensitivity analysis generally led to similar findings. Effective BCTs for increasing PA in adults with overweight/obesity in digital and face-to-face interventions seem to differ. Evidence suggests that using goal setting, social incentive, and graded tasks might help improve PA in digital interventions while avoiding inconsistent self-monitoring of behavior. In face-to-face interventions, prompting behavioral practice and rehearsal might lead to better PA outcomes. Still, further studies are needed. Implications of the current findings are discussed.
- Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fatāA systematic review and metaāanalysisPublication . Battista, Francesca; Ermolao, Andrea; Van Baak, Marleen; Beaulieu, Kristine; Blundell, John; Busetto, Luca; CarraƧa, Eliana V.; Encantado, Jorge; Dicker, Dror; Farpour-Lambert, Nathalie; Pramono, Adriyan; Bellicha, Alice; Oppert, Jean-MichelThis systematic review examined the impact of exercise intervention programs on selected cardiometabolic health indicators in adults with overweight or obesity. Three electronic databases were explored for randomized controlled trials (RCTs) that included adults with overweight or obesity and provided exercise-training interventions. Effects on blood pressure, insulin resistance (homeostasis model of insulin resistance, HOMA-IR), and magnetic resonance measures of intrahepatic fat in exercise versus control groups were analyzed using random effects meta-analyses. Fifty-four articles matched inclusion criteria. Exercise training reduced systolic and diastolic blood pressure (mean difference, MDā=ā-2.95āmmHg [95% CI -4.22, -1.68], pā<ā0.00001, I2 =ā63% and MDā=ā-1.93āmmHg [95% CI -2.73, -1.13], pā<ā0.00001, I2 =ā54%, 60 and 58 study arms, respectively). Systolic and diastolic blood pressure decreased also when considering only subjects with hypertension. Exercise training significantly decreased HOMA-IR (standardized mean difference, SMDā=ā-0.34 [-0.49, -0.18], pā<ā0.0001, I2 ā=ā48%, 37 study arms), with higher effect size in subgroup of patients with type 2 diabetes (SMDā=ā-0.50 [95% CI: -0.83, -0.17], pā=ā0.003, I2 ā=ā39%). Intrahepatic fat decreased significantly after exercise interventions (SMDā=ā-0.59 [95% CI: -0.78, -0.41], pā<ā0.00001, I2 =ā0%), with a larger effect size after high-intensity interval training. In conclusion, exercise training is effective in improving cardiometabolic health in adults with overweight or obesity also when living with comorbitidies.
- Effect of exercise training on psychological outcomes in adults with overweight or obesity: A systematic review and metaāanalysisPublication . CarraƧa, Eliana V.; Encantado, Jorge; Battista, Francesca; Beaulieu, Kristine; Blundell, John; Busetto, Luca; Van Baak, Marleen; Dicker, Dror; Ermolao, Andrea; Farpour-Lambert, Nathalie; Pramono, Adryan; Woodward, Euan; Bellicha, Alice; Oppert, Jean-MichelThis study systematically identified the effects of exercise on multiple psychological outcomes among adults with overweight/obesity, also assessing whether these effects differed across exercise types, genders, age, and body mass index (BMI) categories. Pubmed, Web of Science, PsychInfo, and SportDiscus were searched up to October 2019 for peer-reviewed papers assessing exercise training effects on psychosocial outcomes in adults with overweight/obesity. Thirty-six articles, 32 randomized controlled trials (RCTs), were included in this review. Most interventions were supervised (65%), ranging between 6 and 76āweeks (medianā=ā12). Sixteen psychological outcomes were studied. Exercise induced positive changes in quality of life but did not reduce depression. Large effect sizes were observed on quality of life's physical component, but exercise was also able to improve vitality and mental health. Most psychological outcomes (e.g., body image, anxiety, and perceived stress) are poorly studied, evidencing either conflicting or null exercise effects. Exercise self-efficacy and autonomous motivations were also consistently improved. Exercise types and gender seem to moderate exercise psychological effects. Exercise training programs might lead to positive changes in some psychological outcomes, especially in quality of life, in adults with overweight and obesity, but more studies, with greater systematization in program characteristics, and longer follow-ups are still required to allow more solid conclusions.
- Effect of different types of regular exercise on physical fitness in adults with overweight or obesity: Systematic review and metaāanalysesPublication . Van Baak, Marleen; Pramono, Adriyan; Battista, Francesca; Beaulieu, Kristine; Blundell, John; Busetto, Luca; CarraƧa, Eliana V.; Dicker, Dror; Encantado, Jorge; Ermolao, Andrea; FarpourāLambert, Nathalie; Woodward, Euan; Bellicha, Alice; Oppert, JeanāMichelThis systematic review examined the effect of exercise training interventions on physical fitness in adults with overweight or obesity and compared the effectiveness of different types of exercise training. Four electronic databases were searched. Articles were included if they described randomized controlled trials of exercise training interventions and their effect on maximal oxygen consumption or muscle strength in adults with overweight or obesity. Changes in outcome parameters were analyzed using random effects meta-analyses for different training types (aerobic, resistance, combined aerobic plus resistance, and high-intensity interval training). Eighty-eight articles satisfied the inclusion criteria of which 66 (3964 participants) could be included in the meta-analyses. All training types increased VO2max (mean difference 3.82 ml/min/kg (95% CI 3.17, 4.48), Pā<ā0.00001; I2 =ā48%). In direct comparisons, resistance training was less effective in improving VO2max than aerobic training, HIIT was slightly more effective than aerobic training, and no difference between aerobic and combined aerobic plus resistance training was found. For muscle strength benefits, incorporation of resistance exercise in the training program is indicated. Exercise training increases VO2max and muscle strength in adults with overweight or obesity. Differences between training types should be weighed with other needs and preferences when health professionals advise on exercise training to improve physical fitness.
- Effect of exercise training before and after bariatric surgery: A systematic review and metaāanalysisPublication . Bellicha, Alice; Baak, Marleen Van; Battista, Francesca; Beaulieu, Kristine; Blundell, John; Busetto, Luca; CarraƧa, Eliana V.; Dicker, Dror; Encantado, Jorge; Ermolao, Andrea; Farpour-Lambert, Nathalie; Pramono, Adriyan; Woodward, Euan; Oppert, Jean-MichelWe aimed to assess the effectiveness of exercise training programs in adults with severe obesity undergoing bariatric surgery. A systematic search of controlled trials published up to October 2019 that assigned participants to either a preoperative or postoperative exercise training group or a nonexercise group was performed. Meta-analyses were conducted using random-effects models. Twenty-two training programs were assessed (18 performed after bariatric surgery). The effect of preoperative exercise training on postsurgery outcomes was reported in only one study. Compared with the control condition without exercise, postoperative exercise training led to higher weight loss (Nā=ā14, mean difference [95% CI]ā=ā-1.8 [-3.2; -0.4] kg, Pā=ā0.01), fat loss (Nā=ā9, Pā=ā0.01), increase in VO2 max (Nā=ā8, Pā<ā0.0001), and increase in muscle strength (Nā=ā9, Pā<ā0.0001). No significant effect was found on lean body mass (Nā=ā11). Preliminary evidence suggests a beneficial effect of postoperative exercise training on bone mineral density (Nā=ā3, Pā<ā0.001) and weight maintenance after the end of the intervention (Nā=ā2, Pā<ā0.001) but no significant effect on quality of life (Nā=ā2), habitual physical activity (Nā=ā2), or cardiometabolic outcomes (Nā<ā4). In conclusion, exercise training performed after bariatric surgery improves physical fitness and leads to a small additional weight and fat loss and may prevent bone loss and weight regain after bariatric surgery.
- Exercise training in the management of overweight and obesity in adults: Synthesis of the evidence and recommendations from the European Association for the Study of Obesity Physical Activity Working GroupPublication . Oppert, Jean-Michel; Bellicha, Alice; Baak, Marleen Van; Battista, Francesca; Beaulieu, Kristine; Blundell, John; CarraƧa, Eliana V.; Encantado, Jorge; Ermolao, Andrea; Pramono, Adriyan; FarpourāLambert, Nathalie; Woodward, Euan; Dicker, Dror; Busetto, LucaThere is a need for updated practice recommendations on exercise in the management of overweight and obesity in adults. We summarize the evidence provided by a series of seven systematic literature reviews performed by a group of experts from across Europe. The following recommendations with highest strength (Grade A) were derived. For loss in body weight, total fat, visceral fat, intra-hepatic fat, and for improvement in blood pressure, an exercise training program based on aerobic exercise at moderate intensity is preferentially advised. Expected weight loss is however on average not more than 2 to 3ākg. For preservation of lean mass during weight loss, an exercise training program based on resistance training at moderate-to-high intensity is advised. For improvement in insulin sensitivity and for increasing cardiorespiratory fitness, any type of exercise training (aerobic, resistance, and combined aerobic or resistance) or high-intensity interval training (after thorough assessment of cardiovascular risk and under supervision) can be advised. For increasing muscular fitness, an exercise training program based preferentially on resistance training alone or combined with aerobic training is advised. Other recommendations deal with the beneficial effects of exercise training programs on energy intake and appetite control, bariatric surgery outcomes, and quality of life and psychological outcomes in management of overweight and obesity.
- Systematic Review of Psychological and Behavioral Correlates of Recreational RunningPublication . Pereira, Hugo Vieira; Palmeira, A.L.; Encantado, Jorge; Marques, Marta M.; Santos, InĆŖs; CarraƧa, Eliana V.; Teixeira, Pedro J.Introduction: The aim of this review was to systematically synthesize the published literature describing the psychological and behavioral correlates of recreational running in adults, defined as running for leisure, with or without a competitive component. Methods: Quantitative research published in peer-reviewed journals until January 2021 were included. Studies were identified through MEDLINE, PsycINFO, SPORTDiscus, and Web of Science and were included in this review if they (1) were aimed at recreational running, (2) included general adult samples (18 years or older, without a diagnosed medical condition or metabolic disorder), and (3) assessed psychological or behavioral correlates of recreational running. Results: Fifty-six articles reporting 58 studies met the eligibility criteria and were included. There were 27 cross-sectional studies, 12 longitudinal studies, and 19 trials (8 non-controlled trials, 5 controlled trials, and 6 randomized controlled trials) (n = 37,501, 1877 years old, 43% women). Twenty-eight studies assessed antecedents of running behavior, and 25 studies used running behavior as treatment or predictor of a given effect or outcome. Four studies examined both predictors and outcomes of running. Thirty-one studies showed poor quality, while 20 had fair and 7 good quality. Motives were the most frequently studied antecedent of running behavior (k = 19), and results suggest that the highest-ranked or more prevalent motives were physical health, psychological motives, and personal achievement. Additionally, perceived control, attitude toward running, intention and subjective norms, self-efficacy, and social support may have also played a role in the adoption of recreational running. Moreover, improvements in mood (k = 10) and well-being (k = 10) were the most frequently reported positive outcomes of running. Reductions in depression, anxiety, and stress were also reported in included studies. Discussion: To our knowledge, this is the first systematic review on this topic. The identification of behavioral and psychological correlates of recreational running across populations can contribute to inform and guide a public policy agenda, focused on helping people sustain regular physical activity, through a modality they have chosen and appear to enjoy. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=68954, identifier: CRD42017068954.