The role of metabolic and behavioral compensations in weight management

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Changes in food reward and intuitive eating after weight loss and maintenance in former athletes with overweight or obesity

Publication . Nunes, Catarina L.; Carraça, Eliana V.; Jesus, Filipe; Finlayson, Graham; Francisco, Ruben; Silva, Marlene N.; Santos, Inês; Bosy‐Westphal, Anja; Martins, Paulo Jorge; Minderico, Cláudia; Sardinha, Luís B.; Silva, Analiza M

Objective: This study aimed to explore the following: 1) the impact of Champ4Life's intervention on intuitive eating and food reward; and 2) associations between changes in eating behavior and changes in body composition. Methods: A total of 94 former athletes (mean [SD], BMI = 31.1 [4.3] kg/m2 , age = 43.0 [9.4] years, 34% female) assigned to intervention (n = 49) and control groups (n = 45) underwent 4 months of active weight loss (WL) followed by 8 months of WL maintenance. Intuitive eating and food reward were assessed by the Intuitive Eating Scale and the Leeds Food Preference Questionnaire, respectively. Results: The WL was -4.8% (4.9%) and 0.3% (2.6%) for the intervention and control groups, respectively. Participants reported a decrease in fat bias for explicit/implicit wanting and explicit liking after 4 months and 1 year. For intuitive eating, the unconditional permission to eat decreased after 4 months, and the body-food choice congruence increased after 1 year. Changes in unconditional permission to eat and in body-food choice congruence were positively and negatively associated with both Δweight and with Δfat mass, respectively. Changes in explicit wanting for fat and taste bias were associated with Δweight. Conclusions: Food reward decreased after a moderate WL intervention. Participants successfully maintained their reduced weight, and most of the changes in eating behavior remained significant at the end of the follow-up period. Lifestyle interventions aiming at WL should also consider intuitive eating and food reward.

2022Journal article

Restricted access

Coordination patterns and brain activition during the demi-plié movement in its different roles in classical ballet

Publication . Quadrado, Virgínia Helena; Passos, Pedro José Madaleno; Ferreira, Hugo Alexandre; Ferreira, Hugo Alexandre

Introduction: A basic coordinated movement in classical ballet is the demi-plié, involving a smooth, continuous bend of the knees, keeping the thighs in external rotation (turn out) and heels on the ground. It consists of descending and ascending phases, the latter often preparing for the next move. Task goals may influence its coordination patterns, which raises questions regarding hypothetical changes in coordination modes varying with the demi-plié end-goal, with possible implications on interlimb coordination, muscular activation patterns, and brain cortical activation. Therefore, the aim of the present dissertation is to demonstrate whether or not different task goals require specific modes of coordination during the demi-plié performance linked to other ballet movements. Methods: Thirteen classical dancers (10 female, 3 male) voluntarily participated in the experiments. Sensing technology such as motion capture, surface electromyography (EMG), and electroencephalography (EEG) were used to collect data. The experimental design involved the simple demi-plié performance and in preparation for four other ballet movements such as: demi-plié prior to relevé (i.e., heel rises); demi-plié prior to sauté (i.e., vertical jumps); demi-plié prior to sissone fermée de côté (i.e., jumps with lateral body displacement), and; demi-plié prior to pirouette en dehors (i.e., outward turns). Data analysis involved isolating the demi-plié from the subsequent movements, followed by analysis involving the dissimilarities of the hip vertical trajectory, knees joint angles and angular velocities, muscular activation patterns, and brain activation of the sensorimotor cortex. Results: The results obtained from all analysis showed distinctions in the coordination patterns, muscular activation pattern, and brain cortical activation when the demi-plié has different end-goals. Dissimilarities of the maximum hip trajectory differences were observed in 40% for demi-plié prior to sauté, 30% prior to sissonne fermée de cõté, 20% prior to relevé, and 10% prior to pirouette en dehors. Dissimilarities began in the descending phase of the demi-plié. ANOVAs for repeated measures and Bonferroni’s post-hoc showed that the standard deviation of dissimilarity had the largest effect size for the comparison demi-plié - demi-plié prior to sauté, and the smallest for the comparison demi-plié - demi-plié prior to pirouette. Differences in coordination patterns in regards to the knees joint angles and angular velocities were found during the demi-plié performance in all five experimental conditions, showing coherence amongst all participants. Descriptive analysis focused on each muscle individually, and comparisons were made amongst the muscles for each experimental condition. Results showed significantly different patterns of muscular activation depending on the demi-plié end-goal. Effect size was high for each muscle, but small when compared together for each experimental condition. Significant differences were prevalent amongst the demi-plié in preparation for complex movements such as jumps and turns. Wavelet spectrograms showed distinct patterns of brain activation for all experimental conditions, and statistical analysis showed differences in synchronizations amongst the frequency bands alpha, low-beta, and high-beta. Discussion: Ballet dancers may learn multiple patterns of execution of the demi-plié when it comes to performing subsequent complex ballet movements. Demi-plié prior to jumps demands plyometric forces and have open-loop motor planning, requiring acceleration, whereas demi-plié is a closed-loop, relying on proprioceptive updating. Differences in muscular activation during the demi-plié prior to other ballet movements seem to occur due to strategic anticipation foreseeing the next movement. The sensorimotor cortex seems to display different orders of activation depending on the demi-plié end-goal. Despite the differences in coordination patterns, some demi-pliés are more similar than others. We assume that the level of complexity of the ballet movement plays a role in making anticipatory adjustments in the coordination of the demi-plié.

2023Doctoral thesis

Open access

Interindividual variability in energy intake and expenditure during a weight loss intervention

Publication . Nunes, Catarina L.; Jesus, Filipe; Rosa, Gil B.; Marianito, Mariana; Francisco, Ruben; Bosy-Westphal, Anja; Minderico, Cláudia; Martins, Paulo Jorge; Sardinha, Luís B.; Silva, Analiza M

Introduction: Behavioral compensations may occur as a response to a negative energy balance. The aim of this study was to explore the associations between changes in energy intake (EI) and changes in physical activity (PA, min/day; kcal/d) as a response to a weight loss (WL) intervention and to understand if interindividual differences occur in EI and energy expenditure (EE). Methods: Eighty-one participants [mean (SD): age = 42.8 (9.4)y, BMI = 31.2 (4.4)kg/m2, 37% females] divided in intervention (IG, n = 43) and control group (CG, n = 38) were included. The IG underwent a moderate energy restriction (300-500 kcal/d). EI was measured through the intake-balance method. Non-exercise PA (NEPA) and exercise (through logbook) were assessed by accelerometery. The EE in NEPA (NEAT) and in exercise (EiEE) was calculated by applying the Freedson Combination'98 algorithm over the time spent in these activities. Pearson correlations were performed in IG to examine associations between EE components, EI and body composition. To understand if interindividual differences were observed, the SD of individual response (SDIR) and the smallest worthwhile change (SWC, SDbaselineCG×0.2) were calculated. Results: Changes in EI [Δ EI, (kcal/d)] was negatively associated with Δ exercise (min/d:r = -0.413, p = 0.045; %:r = -0.846, p = 0.008) and with Δ EiEE (kcal/d:r = -0.488, p = 0.016; %:r = -0.859, p = 0.006). A negative correlation was found between Δ sedentary time and Δ NEPA (min/d:r = -0.622, p = 0.002; %:r = -0.487, p = 0.018). An interindividual variability was found for EI(SDIR = 151.6, SWC = 72.3) and EE (SDIR = 165, SWC = 134). Conclusions: Decreases in EI were not associated to compensatory responses such as decreases in PA and/or increases in sedentary time. Interindividual variability was found for EI and EE. Nevertheless, behavioral compensations and the interindividual variability should be considered when implementing WL interventions, to increase the likelihood of achieving sustainable results. (clinicaltrials.gov ID: NCT03031951).

2024Journal article

Restricted access

Effectiveness of a lifestyle weight-loss intervention targeting inactive former elite athletes: the Champ4Life randomised controlled trial

Publication . Silva, Analiza M; Nunes, Catarina L.; Jesus, Filipe; Francisco, Ruben; Matias, Catarina N.; Cardoso, Miguel; Santos, Inês; Carraça, Eliana V.; Finlayson, Graham; Silva, Marlene N.; Dickinson, Stephanie; Allison, David; Minderico, Cláudia; Martins, Paulo Jorge; Sardinha, Luís B.

Objectives: Many athletes struggle in managing the end of their career, often gaining weight and adopting unhealthy lifestyles. Lifestyle programmes targeting former athletes who have gained substantial fat mass (FM) postsports career are lacking. We studied the effects of the Champ4Life programme on body composition and other health-related outcomes in former elite athletes with overweight or obesity. Methods: Ninety-four former athletes(42.4±7.3 y, 34.0% female) were recruited and randomly assigned to either an intervention group (IG; n=49) or a control group (CG; n=45). The IG attended 12 educational sessions addressing physical activity, weight management and nutrition. They also had a nutrition appointment aimed to prescribe a moderate caloric deficit(~300-500 kcal/day). Dual-energy X-ray absorptiometry was used to assess body composition. The Short-Form Health Survey-36 questionnaire was used to measure general health-related quality of life. Blood samples were collected to assess cardiometabolic health parameters. Results: At 12 months, the IG lost more weight (estimated difference (ED)=-5.3 kg; -6.9 to -3.8), total FM (ED=-4.1 kg; -5.4 to -2.8) and abdominal FM (ED=-0.49 kg; -0.64 to -0.33) than did the CG (p's<0.001). Cardiometabolic health markers also improved significantly (p<0.05) more in the IG at 12 months (insulin (ED=-4.9 μU/mL;-8.0 to -1.8); homoeostatic model assessment (ED=-1.2; -2.1 to -0.4); total cholesterol (ED=-21.8 mg/dL; -35.4 to -8.2); low-density lipoprotein (ED=18.2 mg/dL;-29.2 to -7.1)), as did quality-of-life dimensions (physical functioning (ED=11.7; 6.5 to 16.9); physical role (ED=17.6; 2.1 to 33.0); general health (ED=19.4; 11.4 to 27.4); vitality (ED=13.3; 5.3 to 21.3) and mental health (ED=12.3; 4.1 to 20.6)). Conclusions: The Champ4Life programme was effective in substantially reducing total and abdominal FM while preserving fat-free mass and improving health-related markers. These findings will enable evidence-based decisions when implementing lifestyle interventions targeting retired elite athletes.

2022Journal article

Restricted access

The role of metabolic and behavioral compensations in weight management

Publication . Nunes, Catarina Lucas; Silva, Analiza Mónica Lopes de Almeida; Bosy-Westphal, Anja

The lack of efficacy of weight loss (WL) interventions can be mostly attributed to low adherence to dietary/physical activity (PA) recommendations. However, metabolic and behavioral compensations are expected to occur as a response to WL. These include decreases in energy expenditure (EE) components, reductions in PA and increases in energy intake (EI). Adaptive thermogenesis (AT), defined as a higher-than-expected decrease in any EE component that is not explained by changes in body composition stores (fat mass and fat-free mass) has been considered a possible barrier to WL and its maintenance. Regardless, evidence is still scarce about the presence and the assessment of these compensatory responses after a moderate WL, as well as some methodological limitations when assessing AT. Therefore, this dissertation presents 6 research papers that results from the Champ4life project, a randomized clinical trial involving a lifestyle intervention aimed to promote a moderate WL targeting former elite athletes who developed overweight/obesity and became inactive. The first study consisted in a systematic review regarding the existence of AT in resting EE (REE), sleeping EE (SEE) and total daily EE as a response to an WL intervention. The results pointed out for some fragilities that needed to be studied further, such as the large variability between and within studies and the lack of consistency among methodologies to predict REE and/or to assess AT. Therefore, the second investigation aimed to compare 13 different methodologies varying in how REE was predicted and/or how AT was calculated. The findings of this study emphasized the substantial impact of the used methodological approach, as AT values varied among participants. The third manuscript aimed to understand if AT occurs after a moderate WL (<10%) and if it is still persists after a period of weight stabilization (8 months). AT occurred after 4 months of WL and remained significant after a successful WL maintenance. Study 4 aimed to understand if AT occurs in other EE components, namely in non-exercise activity thermogenesis (NEAT). Study 5 comprised behavioral compensations, aimed to evaluate the interindividual variability in EI and EE after WL and to understand how changes in EI are associated with changes in PA duration and PAEE. For studies 4 and 5, neither an energy conservation in NEAT nor the existence of behavioral compensations after WL were found. Still, the large variability among participants were considered in both studies, emphasizing the need of analyzing not only the mean values but also the individual WL responses. The last study aimed to explore the impact of WL on intuitive eating and food reward outcomes. The findings revealed that food reward decreased after a moderate WL, as well as a decrease in willingness to allow themselves to eat whatever food is desired when hungry and an increase in better food choices (in terms of matching one’s physical needs). This dissertation contributes substantially to the available literature considering metabolic and behavioral compensations and the large individual variability observed that may occur as a response to WL, emphasizing the challenges that researchers and practitioners might face in WL management. Understanding these compensator responses is crucial to better implement WL interventions that will lead to a successful WL and maintenance of a reduced weight state.

2023Doctoral thesis

Open access