The acute effects of exercise on appetite perceptions, gut hormones and food intake in females

In recent years there has been growing interest in the role of gut hormones in regulating appetite, energy balance and weight control. Prominent among these hormones is the hunger hormone ghrelin which is the only circulating hormone currently known to stimulate appetite. A variety of hormones are known to suppress appetite and notable among these is peptide YY (PYY). Both ghrelin and PYY exist in more than one form with acylated ghrelin and PYY3-36 representing the biologically active forms of these hormones i.e. the form of each hormone with the most potent effects on appetite. Many studies have investigated ghrelin responses to exercise in male participants and some studies have also examined PYY responses. Far fewer studies have examined ghrelin and PYY responses in female participants and this was the primary purpose of the studies reported here. This thesis comprises four main experimental chapters which collectively sought to clarify whether there is any evidence to support the hypothesis that appetite, gut hormone and food intake responses differ in female compared with male participants. A total of 123 participants took part in the studies reported in this thesis. The first of these studies was cross-sectional in nature and compared fasting appetite, plasma acylated ghrelin and dietary restraint questionnaire values (among other variables) in 34 males and 33 females. No significant differences were observed between sexes for any of these variables. In the second study, appetite, plasma acylated ghrelin and ad libitum food intake responses to cycling exercise were examined in 13 female participants taking the oral contraceptive pill in both the luteal and follicular phases of the menstrual cycle. Although fasting hunger and prospective food consumption values were higher in the follicular than the luteal phase there was no difference in appetite, plasma acylated ghrelin and food intake responses to exercise between menstrual cycle phases. In the third study, appetite, plasma acylated ghrelin, plasma PYY3-36 and food intake responses to energy deficits created via diet and exercise were compared in 13 young, healthy female participants who completed three separate trials (control, exercise deficit and food deficit) in a random order. The findings revealed that, as with male participants, females experience compensatory appetite, gut hormone and food intake responses to dietary induced energy deficits but not to exercise induced energy deficits (over the course of a nine hour observation period). The final study reported in this thesis compared appetite, plasma acylated ghrelin and ad libitum food intake responses to a one hour run in 10 male and 10 female participants. Suppressions of both hunger and plasma acylated ghrelin were noted during exercise but there was no significant difference in the responses of males and females during or after exercise. Collectively, the studies reported here suggest: 1) that fasting appetite and plasma acylated ghrelin concentrations do not differ between male and female participants; 2) that appetite, ghrelin and food intake responses to cycling exercise do not differ according to the phase of the menstrual cycle in females; 3) that dietary restriction is more likely to elicit compensatory feeding responses than elevated exercise levels in females and 4) that males and females do not differ in their acute appetite, ghrelin and food intake responses to an acute bout of running exercise. Hence the studies reported here do not support the hypothesis that exercise will be less effective for controlling appetite and food intake in females than in males

Salivary SIgA responses to acute moderate-vigorous exercise in monophasic oral contraceptive users

The purpose of this study was to examine the effect of oral contraceptive (OC) use on salivary secretory immunoglobulin A (SIgA) levels at rest and in response to an acute bout of moderate-vigorous exercise during two phases of the 4 week OC cycle corresponding to different phases of the synthetic menstrual cycle. Ten healthy active females completed a cycling at 70% V(・)O2peak for 45 min at two time points of an OC cycle: during the equivalent in time to the mid-follicular phase (day 8 ± 2) and the mid-luteal phase (day 20 ± 2). Timed unstimulated saliva samples were obtained before, immediately post exercise and 1 h post exercise and analyzed for salivary SIgA. Salivary SIgA secretion rate was 26 % (95% Confidence limits, CI, 6-46) lower at post-exercise compared with pre-exercise during the synthetic follicular phase (p = 0.019) but no differences were observed during the synthetic luteal trial. Saliva flow rate was 11% (95% CI, 8-30) lower at post-exercise compared with pre-exercise (main effect for time; p = 0.025). In conclusion, the pattern of salivary SIgA secretion rate response to moderate-vigorous exercise varies across the early and late phases of a monophasic OC cycle, with a transient reduction in salivary SIgA responses during the synthetic follicular phase. These findings indicate that monophasic OC use should be considered when assessing mucosal immune responses to acute exercise

Appetite and energy intake responses to acute energy deficits in females versus males

PURPOSE: To explore whether compensatory responses to acute energy deficits induced by exercise or diet differ by sex. METHODS: In experiment one, twelve healthy women completed three 9 h trials (control, exercise-induced (Ex-Def) and food restriction induced energy deficit (Food-Def)) with identical energy deficits being imposed in the Ex-Def (90 min run, ∼70% of VO2 max) and Food-Def trials. In experiment two, 10 men and 10 women completed two 7 h trials (control and exercise). Sixty min of running (∼70% of VO2 max) was performed at the beginning of the exercise trial. Participants rested throughout the remainder of the exercise trial and during the control trial. Appetite ratings, plasma concentrations of gut hormones and ad libitum energy intake were assessed during main trials. RESULTS: In experiment one, an energy deficit of ∼3500 kJ induced via food restriction increased appetite and food intake. These changes corresponded with heightened concentrations of plasma acylated ghrelin and lower peptide YY3-36. None of these compensatory responses were apparent when an equivalent energy deficit was induced by exercise. In experiment two, appetite ratings and plasma acylated ghrelin concentrations were lower in exercise than control but energy intake did not differ between trials. The appetite, acylated ghrelin and energy intake response to exercise did not differ between men and women. CONCLUSIONS: Women exhibit compensatory appetite, gut hormone and food intake responses to acute energy restriction but not in response to an acute bout of exercise. Additionally, men and women appear to exhibit similar acylated ghrelin and PYY3-36 responses to exercise-induced energy deficits. These findings advance understanding regarding the interaction between exercise and energy homeostasis in women

Appetite and Energy Intake Responses to Acute Energy Deficits in Females versus Males.

Purpose: To explore whether compensatory responses to acute energy deficits induced by exercise or diet differ by sex. Methods: In experiment one, twelve healthy women completed three 9 h trials (control, exercise-induced (Ex-Def) and food restriction induced energy deficit (Food-Def)) with identical energy deficits being imposed in the Ex-Def (90 min run, ~70% of VO2 max) and Food-Def trials. In experiment two, 10 men and 10 women completed two 7 h trials (control and exercise). Sixty min of running (~70% of VO2 max) was performed at the beginning of the exercise trial. Participants rested throughout the remainder of the exercise trial and during the control trial. Appetite ratings, plasma concentrations of gut hormones and ad libitum energy intake were assessed during main trials. Results: In experiment one, an energy deficit of ~3500 kJ induced via food restriction increased appetite and food intake. These changes corresponded with heightened concentrations of plasma acylated ghrelin and lower peptide YY3-36. None of these compensatory responses were apparent when an equivalent energy deficit was induced by exercise. In experiment two, appetite ratings and plasma acylated ghrelin concentrations were lower in exercise than control but energy intake did not differ between trials. The appetite, acylated ghrelin and energy intake response to exercise did not differ between men and women. Conclusions: Women exhibit compensatory appetite, gut hormone and food intake responses to acute energy restriction but not in response to an acute bout of exercise. Additionally, men and women appear to exhibit similar acylated ghrelin and PYY3-36 responses to exercise-induced energy deficits. These findings advance understanding regarding the interaction between exercise and energy homeostasis in women

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population