Fotini Tsofliou

Effect of a conjugated linoleic acid and omega-3 fatty acid mixture on body composition and adiponectin

This study aimed to determine the effect of supplementation with conjugated linoleic acids (CLAs) plus n‐3 long‐chain polyunsaturated fatty acids (n‐3 LC‐PUFAs) on body composition, adiposity, and hormone levels in young and older, lean and obese men. Young (31.4 ± 3.9 years) lean (BMI, 23.6 ± 1.5 kg/m2; n = 13) and obese (BMI, 32.4 ± 1.9 kg/m2; n = 12) and older (56.5 ± 4.6 years) lean (BMI, 23.6 ± 1.5 kg/m2; n = 20) and obese (BMI, 32.0 ± 1.6 kg/m2; n = 14) men participated in a double‐blind placebo‐controlled, randomized crossover study. Subjects received either 6 g/day control fat or 3 g/day CLA (50:50 cis‐9, trans‐11:trans‐10, cis‐12) and 3 g/day n‐3 LC‐PUFA for 12 weeks with a 12‐week wash‐out period between crossovers. Body composition was assessed by dual‐energy X‐ray absorptiometry. Fasting adiponectin, leptin, glucose, and insulin concentrations were measured and insulin resistance estimated by homeostasis model assessment for insulin resistance (HOMA‐IR). In the younger obese subjects, CLA plus n‐3 LC‐PUFA supplementation compared with control fat did not result in increased abdominal fat and raised both fat‐free mass (2.4%) and adiponectin levels (12%). CLA plus n‐3 LC‐PUFA showed no significant effects on HOMA‐IR in any group but did increase fasting glucose in older obese subjects. In summary, supplementation with CLA plus n‐3 LC‐PUFA prevents increased abdominal fat mass and raises fat‐free mass and adiponectin levels in younger obese individuals without deleteriously affecting insulin sensitivity, whereas these parameters in young and older lean and older obese individuals were unaffected, apart from increased fasting glucose in older obese men.

Moderate physical activity permits acute coupling between serum leptin and appetite–satiety measures in obese women

OBJECTIVES: To investigate whether moderate physical activity or snack intake influence appetite sensations and subsequent food intake in obese women. Associations between serum leptin and appetite ratings were also investigated.METHODS: In all, 10 obese women (mean age±s.d.: 50.0±8.5 y; mean body mass index (BMI)±s.d.: 37.2±6.5 kg m−2) were submitted in random order to three trials: Moderate physical activity (20 min brisk walking), Snack (58.5 g chocolate-based) and Control (sitting, TV-watching). Appetite and satiety were assessed by visual analogue scales, and serum leptin, blood glucose and plasma free fatty acids were measured at baseline, pre- and postintervention and 1 h postintervention (ie, before dinner). A buffet-style dinner was provided subsequent to the three trials.RESULTS: The moderate physical activity and snack intake both produced lower appetite and higher satiety and fullness perceptions, compared to control, following the intervention. No significant differences were found in subsequent food intake. Serum leptin concentrations did not differ between trials. Serum leptin was not associated with appetite or satiety sensations at any time during the control or the snack trials, but was correlated following moderate physical activity (prospective food consumption r s=−0.83, P=0.003; hunger r s=−0.79, P=0.007; desire to eat r s=−0.69, P=0.02; satiety r s=0.71, P=0.02; fullness r s=0.66, P=0.04). These associations were not influenced by BMI or fat mass.CONCLUSIONS: Moderate physical activity and snack intake suppress the appetite of obese women acutely. The associations between circulating leptin and appetite–satiety ratings suggest leptin involvement in short-term appetite regulation in response to physical activity-induced factors.

Influence of caffeine on perception of effort, metabolism and exercise performance following a high-fat meal

Abstract This study examined the effects of caffeine, co-ingested with a high fat meal, on perceptual and metabolic responses during incremental (Experiment 1) and endurance (Experiment 2) exercise performance. Trained participants performed three constant-load cycling tests at approximately 73% of maximal oxygen uptake ([Vdot]O2max) for 30 min at 20°C (Experiment 1, n = 8) and to the limit of tolerance at 10°C (Experiment 2, n = 10). The 30 min constant-load exercise in Experiment 1 was followed by incremental exercise (15 W · min−1) to fatigue. Four hours before the first test, the participants consumed a 90% carbohydrate meal (control trial); in the remaining two tests, the participants consumed a 90% fat meal with (fat + caffeine trial) and without (fat-only trial) caffeine. Caffeine and placebo were randomly assigned and ingested 1 h before exercise. In both experiments, ratings of perceived leg exertion were significantly lower during the fat + caffeine than fat-only trial (Experiment 1: P < 0.001; Experiment 2: P < 0.01). Ratings of perceived breathlessness were significantly lower in Experiment 1 (P < 0.01) and heart rate higher in Experiment 2 (P < 0.001) on the fat + caffeine than fat-only trial. In the two experiments, oxygen uptake, ventilation, blood [glucose], [lactate] and plasma [glycerol] were significantly higher on the fat + caffeine than fat-only trial. In Experiment 2, plasma [free fatty acids], blood [pyruvate] and the [lactate]:[pyruvate] ratio were significantly higher on the fat + caffeine than fat-only trial. Time to exhaustion during incremental exercise (Experiment 1: control: 4.9, s = 1.8 min; fat-only: 5.0, s = 2.2 min; fat + caffeine: 5.0, s = 2.2 min; P > 0.05) and constant-load exercise (Experiment 2: control: 116 (88 – 145) min; fat-only: 122 (96 – 144) min; fat + caffeine: 127 (107 – 176) min; P > 0.05) was not different between the fat-only and fat + caffeine trials. In conclusion, while a number of metabolic responses were increased during exercise after caffeine ingestion, perception of effort was reduced and this may be attributed to the direct stimulatory effect of caffeine on the central nervous system. However, this caffeine-induced reduction in effort perception did not improve exercise performance.

Adherence to community based group exercise interventions for older people: A mixed-methods systematic review

OBJECTIVE Lifelong physical activity provides some of the best prospects for ageing well. Nevertheless, people tend to become less physically active as they age. This systematic review assessed the views and adherence of participants attending community based exercise programmes of ≥6months duration. METHOD Searches were carried out in eight online scientific databases (January 1995-May 2014) to identify relevant primary studies. Studies were assessed for quality and data extracted. Results were synthesised thematically and narratively. Qualitative findings were compared against quantitative studies. RESULTS A total of 2958 studies were identified and screened against the inclusion/exclusion criteria. Ten studies met the inclusion criteria (five quantitative, three qualitative and two mixed-methods study designs). None were excluded on the basis of quality. Six key themes were identified from the qualitative studies as important for adherence to group exercise programmes: social connectedness, participant perceived benefits, programme design, empowering/energising effects, instructor and individual behaviour. The mean adherence rate of studies with comparable measures was (69.1% SD 14.6). When the views of participants from the qualitative synthesis were juxtaposed against the quantitative studies, programme design was a common feature across all studies. CONCLUSION Evidence surrounding these programmes is limited both in terms of long-term adherence measures and the views of participants. However, based on limited findings there is some indication that community based group exercise programmes have long-term adherence rates of almost 70%. Incorporating the views of older people into programme designs may provide guidance for innovative interventions leading to sustained adherence.

Effects of conjugated linoleic acid plus n -3 polyunsaturated fatty acids on insulin secretion and estimated insulin sensitivity in men

Background/Objectives:Dietary addition of either conjugated linoleic acid (CLA) or n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs) has been shown to alter adiposity and circulating lipids, risk markers of cardiovascular diseases. However, CLA may decrease insulin sensitivity, an effect that may be reversed by n-3 LC-PUFA. Thus, the potential of CLA plus n-3 LC-PUFA to affect insulin secretion and sensitivity in non-diabetic young and old, lean and obese subjects was tested.Subjects/Methods:CLA (3 g daily) plus n-3 LC-PUFA (3 g daily) or control oil (6 g daily) was given to lean (n=12; BMI 20–26 kg/m2) or obese (n=10; BMI 29–35 kg/m2) young (20–37 years old) or lean (n=16) or obese (n=11) older men (50–65 years) for 12 weeks. The study had a double-blind, placebo-controlled randomized crossover design, and primary end points were insulin secretion and sensitivity during a standardized meal test, evaluated by modeling glucose, insulin and C-peptide data.Results:The combination was well tolerated. There was no significant difference in fasting levels of glucose, insulin or C-peptide after CLA/n-3 LC-PUFA treatment compared with control oil. Neither insulin secretion nor estimated sensitivity was affected by CLA/n-3 LC-PUFA in lean or obese young subjects or in older lean subjects. However, in older obese subjects, estimated insulin sensitivity was reduced with CLA/n-3 LC-PUFA compared with control (P=0.024).Conclusions:The results do not support beneficial effects of CLA/n-3 LC-PUFA for β-cell dysfunction or insulin resistance in humans but suggest that insulin sensitivity in older obese subjects is reduced.

Older people’s adherence to community-based group exercise programmes: a multiple-case study

BackgroundPhysical inactivity is a global phenomenon, with estimates of one in four adults not being active enough to achieve health benefits, thus heightening the risk of developing non-communicable diseases. In order to realise the health and wellbeing gains associated with physical activity the behaviour must be sustained. Community-based group exercise programmes (CBGEP) utilising social supports have been shown to be one means of not only increasing activity levels for older people, but sustaining physical activity.A gap in the literature was identified around older people’s long-term adherence to real-life CBGEP within a UK context. This study therefore sought to address this gap by understanding older people’s ongoing adherence to CBGEP with a view to gaining further insight about which factors contribute to enabling people to sustain their physical activity levels.MethodsA multiple case study research design was employed to understand older people’s (≥60 years, n = 27) adherence (≥ 69%, for ≥ 1 year) to three current CBGEP in the South- West of England. Qualitative data (participant observation, focus groups, documents, and interviews) were collected and analysed using inductive thematic analysis followed by the analytic technique of explanation building. Quantitative data were analysed using descriptive statistics and used to set the context of the study.ResultsThe current study offers five unique insights into real-life programmes which have been successful in helping older people maintain adherence for a year or longer. These included: factors relating to the individual, the instructor (particularly their personality, professionalism and humanised approach), programme design (including location, affordability, the use of music, and adaptable exercise content), social features which supported a sense of belonging, and participant perceived benefits (physical and psycho-social). These all served to explain older people’s adherence to CBGEP.ConclusionsThese factors related to participant adherence of CBGEP must be considered if we wish to support older people in sustaining a physically active lifestyle as they age. These findings are of interest to practitioners and policy makers in how CBGEP serve to aid older people in maintaining a physically active lifestyle with a view to preventing non-communicable diseases and in maintaining social connectivity.

Prevalence of overweight and obesity in preschool children in Thessaloniki, Greece.

OBJECTIVE: Data on obesity in preschoolers are scarce in Greece, a country particularly affected by the obesity epidemic. The present study aimed to assess overweight and obesity prevalence of preschoolers in Thessaloniki, Greece, by using three different standards for defining childhood overweight and obesity. DESIGN: One thousand two hundred and fifty (1250) preschool children (657 boys and 593 girls) aged 2.0–6.0 years old from all public municipality kindergartens of Thessaloniki, Greece, participated in this cross-sectional survey conducted from 2009 to 2010. Body weight and height were measured and detailed anthropometry measurement was undertaken. BMI was classified to weight categories based on the CDC (US Centers for Disease Control and Prevention), IOTF (the International Obesity Task Force) and WHO (the World Health Organization) references. RESULTS: Rates of excess body weight varied significantly according to the different international criteria: IOTF: overweight (including obesity) 21.2%, obesity 5.8%; CDC: overweight (including obesity) 30.5%, obesity 13.5%; and WHO: overweight (including obesity) 32.6%, obesity 5%. Boys and older children were particularly affected. CONCLUSIONS: Overweight prevalence is high in Greek preschoolers and varies significantly according to the different criteria used, from 21.2% (IOTF reference) to 32.6% (CDC reference).

Diet quality, overweight and daily monetary allowance of Greek adolescents

Abstract Objective To investigate cross-correlates of pocket-money on diet quality and weight status of Greek adolescents. Methods A total of 172 adolescents (55.2% boys), aged between 10 and 15 years old were recruited. Body weight and height were measured, body mass index (BMI) was computed. Weight status was assessed according to the International Obesity Task Force criteria and diet quality was evaluated via the Healthy Eating Index (HEI) – 2010. Results Adolescents were allowed a mean allowance of €4.63 ± 3.66 daily. Among boys participants, BMI correlated with pocket money (r = 0.311, p ≤ 0.002) and normoweight boys received statistically less money than their overweight peers (p ≤ 0.019). In both sexes, normoweight was more prevalent in the lowest monetary quartiles. Pocket money was not associated with HEI. Among boys, moderate HEI was more prevalent in the third quartile of pocket money, significantly higher compared to all others (p ≤ 0.01 for all). For girls, the prevalence of moderate HEI declined by each ascending pocket money quartile (p ≤ 0.05 for all). Conclusion In our sample, adolescents exhibited high rates of pooled overweight including obesity. The majority of the participants followed a diet of moderate quality. Pocket money was associated with BMI only among boys. As pocket money was not associated with diet quality, it is highly possible that adolescents might choose to spend their money on items other than foods. Our study shows that pocket money should be controlled during adolescence and teenagers should be educated on spending their money on healthier food choices.

Attending lunch clubs is associated with greater compliance for Dietary Reference Values (DRVs) among older people in South-West England

Poor health amongst older people in the community is often associated with reduced dietary intake linked to ageing and social isolation. Lunch clubs (LCs) have been found to increase dietary intake of older people and tackle poor nutritional health important for healthy ageing provided lunch club (LC) attendance is maintained in the long-term. The aim of this study was to compare the dietary intake of older people on the day of the LC with the dietary intake on days not attending LC. Five LCs were visited in Dorset, UK. Self-reported food intake was assessed using three 24-hr dietary recalls. A total of 40 participants aged 82 years (SD 8), with a mean BMI of 27 (SD 4) and waist circumference 100 cm (SD 13) were included in the original survey. Here we present preliminary analysis based on 12 individuals chosen at random. The first day assessed was on the day of the LC and included their lunch meal; the other two days included days in which participants did not attend a LC. Participants reported high levels of satisfaction with LC with 98 % ‘liking’ or ‘strongly liking’ their LC meals; the majority of participants reported attending LCs for over 1 year (85 %); 30 % of participants attended a LC once in the last week. The percentage of DRV for protein (p < 0·001), total carbohydrates (p = 0·05), energy (p < 0·001), potassium (p < 0·001), calcium (p = 0·01), vitamin A (p = 0·02), folate (p = 0·01) and vitamin C (p = 0·05) was significantly higher on the LC day compared to the mean dietary intake of the two non-LC days (See figure below). No significant differences were observed for total or saturated fat, sodium, dietary fibre, iron, vitamin D or water.