Is the Small Changes programme clinically effective for adults who are obese?

This thesis concerns the treatment of (N=148) male and female clients in a weight management programme: Small Changes the thesis compares treatment as usual with a new approach using motivational interviewing. Firstly a preface sets out the historical context of Small Changes and how it developed and was originally funded before the aims of the thesis and the detail encompassed in each chapter are set out. Following this an introduction chapter presents the key constructs and theories surrounding motivational interviewing. This leads into study 1, a systematic review addressing the question: What should be included in a comprehensive weight management programme? The conclusion to this question is a mixture of input from: nutrition and exercise expertise combined with a clear behavioural approach, measures that encompass important clinical parameters, other than just weight, and sufficient length of follow-up post treatment. This conclusion forms the basis of the study 2 literature review which focusses on the contribution of motivational interviewing for affecting exercise and nutrition behaviours with the aim of improving weight management outcomes. The literature review leads into the methodology for study 2 which outlines the measures used, the follow-up period and the detail of what was done in study 2; sufficiently clearly for others to replicate what was done. From this chapter a separate results chapter reveals the statistical results for the outcome measures included in study 2. The discussion chapter then follows and focusses on the interpretation, critique and analysis of the results and relates these back to the literature presented in the literature review for study 2. Finally conclusions and short-comings of the study 2 investigation are explored and further research considerations made

Biopsychosocial effects of competition preparation in natural bodybuilders.

Bodybuilders are judged on the subjective visual assessment of their muscular size, proportion, and leanness. This case series tracked four drug-free bodybuilders (3 male) during the off-season, pre-competition and recovery phases. This study aimed to comprehensively profile key biopsychosocial changes occurring pre/post competition in a group of British natural bodybuilders. We measured: resting metabolic rate (RMR), body composition (via BIA, ultrasound and sum of 7 skinfolds), lipid profiles, fasted glucose, blood pressure, power output (Wingate), grip strength, and carried out psychometric questionnaires (EAT-26, STAI, BUT) over an eight-month period. Mean weight loss from 5 months (5M) to pre-contest (PRE) was 8.6 +/- 4.1 kg, followed by an increase of 7.9 +/- 1.6 kg two months post contest (POST). The mean RMR of the cohort was stable from 1899 +/- 630 kcal (5M) to 1897 +/- 598 kcal (PRE), before decreasing to 1797 +/- 242 kcal (POST). Mean peak power declined from 770 +/- 113.0 w (5M), to 700.0 +/- 134.4 w (PRE), before increasing to 816.0 +/- 116.2 w (POST). Competition dieting had no effect on EAT-26 or BUT scores, suggesting no body dysmorphic or eating disorder concerns, although trait anxiety was elevated in three out of the four participants throughout the observation. Many of the biopsychosocial changes that occur to bodybuilders as they prepare for competition return to baseline measurements 2 months post competition

Citrulline Malate fails to improve German volume training performance in healthy young men and women

Background: Citrulline malate (CM) is purported to buffer lactic acid, enhance oxygen delivery, and attenuate muscle soreness. Anaerobic exercise trials with CM have produced conflicting results. Objective: The aim of the current investigation was to test the efficacy of CM on resistance training (RT) with the hypothesis that CM would improve performance. Design: A double-blind, counter-balanced, randomised control trial was utilised to assess the effects of CM on RT. 19 subjects (8 female) (25.7 ± 7.7 years), regularly engaged in RT consumed either 8 g of CM (1.1 : 1 ratio) or a placebo (6 g citric acid). Subjects attempted to perform a German Volume Training (GVT) protocol comprising 10 sets of 10 repetitions of barbell curls at 80 % of their one repetition maximum. Results: Repeated ANOVA suggested no effect of CM on RT performance (treatment × time × order p = 0.217). There was no difference (p = 0.320) in the total number of reps over the ten sets (CM median = 57, IQR 45 to 73; placebo median = 61, IQR 51 to 69). Blood lactate and creatine kinase did not differ between CM and placebo (p > 0.05). Finally, total muscle soreness was reduced significantly in CM compared to placebo (treatment × time × order p = 0.004). Conclusions: These results require corroboration; an ergogenic benefit is yet to be established and weight trainers should exercise caution when assessing the efficacy of CM. Future research should focus on the potential effects of loading doses of CM

Effect of bilberry juice on indices of muscle damage and inflammation in runners completing a half-marathon: a randomised, placebo-controlled trial.

Background: Emerging evidence indicates that fruits rich in polyphenols may attenuate exercise-induced muscle damage and associated markers of inflammation and soreness. This study was conducted to determine whether bilberry juice (BJ), which is particularly rich in polyphenols, reduces markers of muscle damage in runners completing a half marathon. Methods: A total of 21 recreationally trained runners (age 30.9 ± 10.4 y; mass 71.6 ± 11.0 kg; M=16; F=5) were recruited to a single blind, randomised, placebo-controlled, parallel study. Participants were block randomised to consume 2 x 200 ml of BJ or energy-matched control drink (PLA) for 5 d before the Sheffield Half Marathon, on race day, and for 2 days post-race. Measurements of delayed onset muscle soreness (DOMS), muscle damage (creatine kinase; CK) and inflammation (c-reactive protein ; CRP) were taken at baseline, pre-race, post-race, 24 h post-race and 48 h post-race. The effect of treatment on outcome measures was analysed using magnitude-based inferences based on data from 19 participants; 2 participants were excluded from the analyses because they did not provide samples for all time points. Results: The half marathon caused elevations in DOMS, CRP and CK. BJ had a possibly harmful effect on DOMS from pre-race to immediately post-race (11.6%, 90% CI ± 14.7%), a likely harmful effect on CRP from pre-race to 24 h post-race (mean difference ES 0.56, 90% CI ± 0.72) and a possibly harmful effect on CRP from pre-race to 48 h post-race (ES 0.12, 90% CI ± 0.69). At other time points, the differences between the BJ and PLA groups in DOMS and CRP were unclear, possibly trivial or likely trivial. Differences in the changes in CK between BJ and PLA were unclear at every time point other than from baseline to pre-race, where BJ had a possibly harmful effect on reducing muscle damage (ES 0.23, 90% CI ± 0.57). Conclusion: Despite being a rich source of antioxidant and anti-inflammatory phytochemicals, BJ evoked small to moderate increases in exercise-induced DOMS and CRP. Further larger studies are required to confirm these unexpected preliminary results