The Influence of Training Status on the Physiological Responses to Exercise of Young Girls

Exercise training represents a potent stimulus to the parameters of aerobic and anaerobic fitness in adults; whether the same is true in young girls is unclear. For some parameters, such as peak oxygen uptake, the influence of training status remains controversial whilst for other parameters, such as oxygen uptake kinetics, the influence of training status remains simply uninvestigated in young girls. Despite this lack of empirical evidence, it has been suggested for some time now that children may lack trainability and that this may be related to the presence of a maturational threshold below which significant adaptations to training cannot occur. This suggestion requires investigation, not least because the findings of some studies which appear to support this contention may in reality be a reflection of the use of an inappropriate test modality for the investigation of training status influences. The purpose of this thesis was therefore to determine the physiological trainability of girls at different stages of maturation and to investigate the interaction between training status, maturity and exercise modality. To achieve this purpose a series of 5 studies was completed, in which trained and untrained girls completed ramp incremental exercise, constant-work-rate exercise and Wingate exercise on two exercise modalities, one upper (arm crank) and one lower body (cycle). During these tests, cardiovascular, respiratory, metabolic and mechanical power parameters were assessed. In response to ramp incremental exercise, trained girls were shown to have a higher peak O2, SV and at all stages of maturity, along with an altered SV and fractional muscle oxygen extraction pattern, irrespective of exercise modality. The importance of exercise modality was evident during heavy intensity constant-work-rate exercise in pre-pubertal girls, where training status was only associated with significant influences on O2 kinetics (faster phase II time constant in trained girls) during upper body ergometry. In contrast, pubertal trained girls had faster O2 kinetics during both exercise modalities, an influence which may suggest both central and peripheral adaptations to the delivery and utilisation of oxygen. Exercise modality was also revealed to be an important factor in the demonstration of training status influences during a 30 s Wingate test, with trained girls at all stages of maturity exhibiting higher mechanical power indices during upper body ergometry only. An influence of training status was also evident in the lower fatigue index found in the trained girls at all stages of maturity during both modalities, but no influence was found in the oxidative contribution to the Wingate test. None of these studies revealed an influence of maturity status in determining the magnitude of training status effects. Overall, the 5 studies encompassed within this thesis demonstrate that children are trainable and that this is not moderated by maturity

The Effect of Body Size on Countermovement Jump Kinetics in Children aged 7 to 11 years

The purpose this study was to examine the effect of body size oncountermovement jump (CMJ)kinetics in children.Participants(n = 160) aged 7-11 years, divided equally by sex and into primary school year groups(years 3, 4, 5 and 6), each performedone CMJ on aforce platform. The variables bodyweight(BW), peak force (Fmax), in-jump minimum force (IMF), in-jump vertical force range (IFR) and basic rate of force development (BRFD)wereattained from the force-time history and then subsequently scaled to account for body size. A significant age, sex and interaction effect werefound for theabsolutevariables BW, IMF, Fmaxand IFR (P 0.05). No significant age or sex differences were observed for normalised or allometrically scaled values(P > 0.05). The results indicate thatgirls and boys can be grouped together but that body size must be accounted for to enable accurate conclusions to be drawn independent of growth.Bodysizesignificantlyeffects the representation of CMJ kinetic results and therefore, future studies should report both absolute and scaled values.Future research should developan age-appropriate criterion method for children in order to determine processed CMJ variables to further investigate neuromuscular performance of children

A Compositional Analysis of Physical Activity, Sedentary Time, and Sleep and Associated Health Outcomes in Children and Adults with Cystic Fibrosis

This study sought to investigate the association of light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time (SED), and sleep with lung function in children and adults with CF. In total, 86 children (41 females; 13.6 ± 2.8 years; FEV1%predicted: 86 ± 1%) and 43 adults (21 females; 24.6 ± 4.7 years; FEV1%predicted: 63 ± 21%) with CF participated in this study. Wrist-worn accelerometery was used to assess PA, SED and sleep. Compositional linear regression models were conducted following normalisation via isometric log-ratio transformations. Sequential binary partitioning was applied to investigate the impact of reallocating 10 to 30 min between each behaviour on FEV1%predicted. A decline in FEV1%predicted was predicted with the reallocation of 30 min from MVPA to SED or LPA or sleep to any other behaviour in children (−3.04–−0.005%) and adults (−3.58–−0.005%). Conversely, improvements in FEV1%predicted were predicted when 30 min was reallocated to MVPA from LPA or SED in children (0.12–1.59%) and adults (0.77–2.10%), or when 30 min was reallocated to sleep from any other behaviour in both children (0.23–2.56%) and adults (1.08–3.58%). This study supports the importance of MVPA and sleep for maintaining and promoting lung function in people with CF

Effect of a high protein/low glycaemic index diet on insulin resistance in adolescents with overweight/obesity-APREVIEWrandomized clinical trial

Background Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity. Objectives The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA-IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity. Methods Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI >= 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI < 50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA-IR were analyzed. Results 126 adolescents were included in this study (13.6 +/- 2.2 years, BMI z-score 3.04 +/- 0.66, HOMA-IR 3.48 +/- 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed. Conclusions The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.Peer reviewe

Objectively Measured Physical Activity and Sedentary Time Are Associated With Cardiometabolic Risk Factors in Adults With Prediabetes: The PREVIEW Study

OBJECTIVE The aim of the present cross-sectional study was to examine the association among physical activity (PA), sedentary time (ST), and cardiometabolic risk in adults with prediabetes.RESEARCH DESIGN AND METHODS Participants (n = 2,326; 25–70 years old, 67% female) from eight countries, with a BMI >25 kg ⋅ m−2 and impaired fasting glucose (5.6–6.9 mmol ⋅ L−1) or impaired glucose tolerance (7.8–11.0 mmol ⋅ L−1 at 2 h), participated. Seven-day accelerometry objectively assessed PA levels and ST.RESULTS Multiple linear regression revealed that moderate-to-vigorous PA (MVPA) was negatively associated with HOMA of insulin resistance (HOMA-IR) (standardized β = −0.078 [95% CI −0.128, −0.027]), waist circumference (WC) (β = −0.177 [−0.122, −0.134]), fasting insulin (β = −0.115 [−0.158, −0.072]), 2-h glucose (β = −0.069 [−0.112, −0.025]), triglycerides (β = −0.091 [−0.138, −0.044]), and CRP (β = −0.086 [−0.127, −0.045]). ST was positively associated with HOMA-IR (β = 0.175 [0.114, 0.236]), WC (β = 0.215 [0.026, 0.131]), fasting insulin (β = 0.155 [0.092, 0.219]), triglycerides (β = 0.106 [0.052, 0.16]), CRP (β = 0.106 [0.39, 0.172]), systolic blood pressure (BP) (β = 0.078 [0.026, 0.131]), and diastolic BP (β = 0.106 [0.39, −0.172]). Associations reported between total PA (counts ⋅ min−1) and all risk factors were comparable or stronger than for MVPA: HOMA-IR (β = −0.151 [−0.194, −0.107]), WC (β = −0.179 [−0.224, −0.134]), fasting insulin (β = −0.139 [−0.183, −0.096]), 2-h glucose (β = −0.088 [−0.131, −0.045]), triglycerides (β = −0.117 [−0.162, −0.071]), and CRP (β = −0.104 [−0.146, −0.062]).CONCLUSIONS In adults with prediabetes, objectively measured PA and ST were associated with cardiometabolic risk markers. Total PA was at least as strongly associated with cardiometabolic risk markers as MVPA, which may imply that the accumulation of total PA over the day is as important as achieving the intensity of MVPA

Age- and sex-specific effects of a long-term lifestyle intervention on body weight and cardiometabolic health markers in adults with prediabetes : results from the diabetes prevention study PREVIEW

Peer reviewe

Associations of quantity and quality of carbohydrate sources with subjective appetite sensations during 3-year weight-loss maintenance : Results from the PREVIEW intervention study

Publisher Copyright: © 2021 The Author(s)Background & aims: The association of quantity and quality of carbohydrate sources with appetite during long-term weight-loss maintenance (WLM) after intentional weight loss (WL) is unclear. We aimed to investigate longitudinal associations of quantity and quality of carbohydrate sources with changes in subjective appetite sensations during WLM. Methods: This secondary analysis evaluated longitudinal data from the 3-year WLM phase of the PREVIEW study, a 2 × 2 factorial (diet–physical activity arms), multi-center, randomized trial. 1279 individuals with overweight or obesity and prediabetes (25–70 years; BMI≥25 kg m−2) were included. Individuals were merged into 1 group to assess longitudinal associations of yearly changes in appetite sensations. Quantity and quality of carbohydrate sources including total carbohydrate, glycemic index (GI), glycemic load (GL), and total dietary fiber were assessed via 4-day food diaries at 4 timepoints (26, 52, 104, and 156 weeks) during WLM. Visual analog scales were used to assess appetite sensations in the previous week. Results: During WLM, participants consumed on average 160.6 (25th, 75th percentiles 131.1, 195.8) g·day−1 of total carbohydrate, with GI 53.8 (48.7, 58.8) and GL 85.3 (67.2, 108.9) g day−1, and 22.3 (17.6, 27.3) g·day−1 of dietary fiber. In the available-case analysis, multivariable-adjusted linear mixed models with repeated measures showed that each 30-g increment in total carbohydrate was associated with increases in hunger (1.36 mm year−1, 95% CI 0.77, 1.95, P < 0.001), desire to eat (1.10 mm year−1, 0.59, 1.60, P < 0.001), desire to eat something sweet (0.99 mm year−1, 0.30, 1.68, P = 0.005), and weight regain (0.20%·year−1, 0.03, 0.36, P = 0.022). Increasing GI was associated with weight regain, but not associated with increases in appetite sensations. Each 20-unit increment in GL was associated with increases in hunger (0.92 mm year−1, 0.33, 1.51, P = 0.002), desire to eat (1.12 mm year−1, 0.62, 1.62, P < 0.001), desire to eat something sweet (1.13 mm year−1, 0.44, 1.81, P < 0.001), and weight regain (0.35%·year−1, 0.18, 0.52, P < 0.001). Surprisingly, dietary fiber was also associated with increases in desire to eat, after adjustment for carbohydrate or GL. Conclusions: In participants with moderate carbohydrate and dietary fiber intake, and low to moderate GI, we found that higher total carbohydrate, GL, and total fiber, but not GI, were associated with increases in subjective desire to eat or hunger over 3 years. This study was registered as ClinicalTrials.gov, NCT01777893.Peer reviewe

The PREVIEW intervention study : Results from a 3-year randomized 2 x 2 factorial multinational trial investigating the role of protein, glycaemic index and physical activity for prevention of type 2 diabetes

Aim To compare the impact of two long-term weight-maintenance diets, a high protein (HP) and low glycaemic index (GI) diet versus a moderate protein (MP) and moderate GI diet, combined with either high intensity (HI) or moderate intensity physical activity (PA), on the incidence of type 2 diabetes (T2D) after rapid weight loss. Materials and Methods A 3-year multicentre randomized trial in eight countries using a 2 x 2 diet-by-PA factorial design was conducted. Eight-week weight reduction was followed by a 3-year randomized weight-maintenance phase. In total, 2326 adults (age 25-70 years, body mass index >= 25 kg/m(2)) with prediabetes were enrolled. The primary endpoint was 3-year incidence of T2D analysed by diet treatment. Secondary outcomes included glucose, insulin, HbA1c and body weight. Results The total number of T2D cases was 62 and the cumulative incidence rate was 3.1%, with no significant differences between the two diets, PA or their combination. T2D incidence was similar across intervention centres, irrespective of attrition. Significantly fewer participants achieved normoglycaemia in the HP compared with the MP group (P <.0001). At 3 years, normoglycaemia was lowest in HP-HI (11.9%) compared with the other three groups (20.0%-21.0%, P <.05). There were no group differences in body weight change (-11% after 8-week weight reduction; -5% after 3-year weight maintenance) or in other secondary outcomes. Conclusions Three-year incidence of T2D was much lower than predicted and did not differ between diets, PA or their combination. Maintaining the target intakes of protein and GI over 3 years was difficult, but the overall protocol combining weight loss, healthy eating and PA was successful in markedly reducing the risk of T2D. This is an important clinically relevant outcome.Peer reviewe

The Tangibility of Personalized 3D-Printed Feedback May Enhance Youths' Physical Activity Awareness, Goal Setting, and Motivation: Intervention Study

Background: In the United Kingdom, most youth fail to achieve the government guideline of 60 min of moderate to vigorous physical activity (MVPA) daily. Reasons that are frequently cited for the underachievement of this guideline include (1) a lack of awareness of personal physical activity levels (PALs) and (2) a lack of understanding of what activities and different intensities contribute to daily targets of physical activity (PA). Technological advances have enabled novel ways of representing PA data through personalized tangible three-dimensional (3D) models. Objective: The purpose of this study was to investigate the efficacy of 3D-printed models to enhance youth awareness and understanding of and motivation to engage in PA. Methods: A total of 39 primary school children (22 boys; mean age 7.9 [SD 0.3] years) and 58 secondary school adolescents (37 boys; mean age 13.8 [SD 0.3] years) participated in a 7-week fading intervention, whereby participants were given 3D-printed models of their previous week’s objectively assessed PALs at 4 time points. Following the receipt of their 3D model, each participant completed a short semistructured video interview (children, 4.5 [SD 1.2] min; adolescents, 2.2 [SD 0.6] min) to assess their PA awareness, understanding, and motivation. Data were transcribed verbatim and thematically analyzed to enable key emergent themes to be further explored and identified. Results: Analyses revealed that the 3D models enhanced the youths’ awareness of and ability to recall and self-evaluate their PA behaviors. By the end of the study, the youths, irrespective of age, were able to correctly identify and relate to the government’s PA guideline represented on the models, despite their inability to articulate the government's guideline through time and intensity. Following the fourth 3D model, 72% (71/97) of the youths used the models as a goal-setting strategy, further highlighting such models as a motivational tool to promote PA.Conclusions: The results suggest that 3D-printed models of PA enhanced the youths’ awareness of their PA levels and provided a motivational tool for goal setting, potentially offering a unique strategy for future PA promotion

The influence of training status on the physiological responses to exercise of young girls

Exercise training represents a potent stimulus to the parameters of aerobic and anaerobic fitness in adults; whether the same is true in young girls is unclear. For some parameters, such as peak oxygen uptake, the influence of training status remains controversial whilst for other parameters, such as oxygen uptake kinetics, the influence of training status remains simply uninvestigated in young girls. Despite this lack of empirical evidence, it has been suggested for some time now that children may lack trainability and that this may be related to the presence of a maturational threshold below which significant adaptations to training cannot occur. This suggestion requires investigation, not least because the findings of some studies which appear to support this contention may in reality be a reflection of the use of an inappropriate test modality for the investigation of training status influences. The purpose of this thesis was therefore to determine the physiological trainability of girls at different stages of maturation and to investigate the interaction between training status, maturity and exercise modality. To achieve this purpose a series of 5 studies was completed, in which trained and untrained girls completed ramp incremental exercise, constant-work-rate exercise and Wingate exercise on two exercise modalities, one upper (arm crank) and one lower body (cycle). During these tests, cardiovascular, respiratory, metabolic and mechanical power parameters were assessed. In response to ramp incremental exercise, trained girls were shown to have a higher peak O2, SV and at all stages of maturity, along with an altered SV and fractional muscle oxygen extraction pattern, irrespective of exercise modality. The importance of exercise modality was evident during heavy intensity constant-work-rate exercise in pre-pubertal girls, where training status was only associated with significant influences on O2 kinetics (faster phase II time constant in trained girls) during upper body ergometry. In contrast, pubertal trained girls had faster O2 kinetics during both exercise modalities, an influence which may suggest both central and peripheral adaptations to the delivery and utilisation of oxygen. Exercise modality was also revealed to be an important factor in the demonstration of training status influences during a 30 s Wingate test, with trained girls at all stages of maturity exhibiting higher mechanical power indices during upper body ergometry only. An influence of training status was also evident in the lower fatigue index found in the trained girls at all stages of maturity during both modalities, but no influence was found in the oxidative contribution to the Wingate test. None of these studies revealed an influence of maturity status in determining the magnitude of training status effects. Overall, the 5 studies encompassed within this thesis demonstrate that children are trainable and that this is not moderated by maturity.EThOS - Electronic Theses Online ServiceGBUnited Kingdo