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The increasing prevalence of overweight and obesity has called for actions already in place for years. Unfortunately, the results so far have been mostly disappointing. The role of science in combating obesity is to provide evidence for decision-making at political (national and local) level, in food industry, in health care settings and in educational planning. Evidently, more data are needed to understand the detailed aetiology of obesity and how to combat obesity at population and individual levels.

The aim of this study was to examine changes in body composition, energy metabolites and electrolytes during a 10-day winter survival training period. Two groups of male soldiers were examined: the REC group (n = 26; age 19.7 ± 1.2 years; BMI 23.9 ± 2.7) had recovery period between days 6 and 8 in the survival training, whereas the EXC group (n = 42; age 19.6 ± 0.8 years; BMI 23.1 ± 2.8) did not. The following data were collected: body composition (bioimpedance), energy balance (food diaries, heart rate variability measurements), and biomarkers (blood samples). In survival training, estimated energy balance was highly negative: −4,323 ± 1,515 kcal/d (EXC) and −4,635 ± 1,742 kcal/d (REC). Between days 1 and 10, body mass decreased by 3.9% (EXC) and 3.0% (REC). On day 6, free fatty acid and urea levels increased, whereas leptin, glucose and potassium decreased in all. Recovery period temporarily reversed some of the changes (body mass, leptin, free fatty acids, and urea) toward baseline levels. Survival training caused a severe energy deficit and reductions in body mass. The early stage of military survival training seems to alter energy, hormonal and fluid metabolism, but these effects disappear after an active recovery period. ; peerReviewed

The aim of this study was to examine changes in body composition, energy metabolites and electrolytes during a 10-day winter survival training period. Two groups of male soldiers were examined: the REC group (n = 26; age 19.7 ± 1.2 years; BMI 23.9 ± 2.7) had recovery period between days 6 and 8 in the survival training, whereas the EXC group (n = 42; age 19.6 ± 0.8 years; BMI 23.1 ± 2.8) did not. The following data were collected: body composition (bioimpedance), energy balance (food diaries, heart rate variability measurements), and biomarkers (blood samples). In survival training, estimated energy balance was highly negative: −4,323 ± 1,515 kcal/d (EXC) and −4,635 ± 1,742 kcal/d (REC). Between days 1 and 10, body mass decreased by 3.9% (EXC) and 3.0% (REC). On day 6, free fatty acid and urea levels increased, whereas leptin, glucose and potassium decreased in all. Recovery period temporarily reversed some of the changes (body mass, leptin, free fatty acids, and urea) toward baseline levels. Survival training caused a severe energy deficit and reductions in body mass. The early stage of military survival training seems to alter energy, hormonal and fluid metabolism, but these effects disappear after an active recovery period.

Introduction: Optimal diet together with good physical fitness maintains readiness and military performance during longer deployments. The purpose of this study was to describe changes in dietary macronutrient and energy intake, total physical activity and body composition during a 6-month deployment in South Lebanon. Furthermore, associations of diet macronutrient intake and physical activity on body composition were also studied. - Materials and Methods: Forty male soldiers kept a 3-day food diary and their body composition was measured via bioimpedance and ultrasonography. Total physical activity was evaluated by accelerometers in a subgroup of participants. Measurements were conducted in the PRE-, MID-, and POST-deployment. - Results: Mean carbohydrate intakes were 39.5–42.6 E%, protein intakes 18.7–22.3 E%, and fat intakes 34.9–35.7 E%. Daily energy intake remained stable (10.1–10.3 MJ/D). Total physical activity was decreased during deployment (e.g., step count from 9,835 ± 2,743 to 8,388 ± 2,875 steps/day, p = 0.007). Skeletal muscle mass and subcutaneous fat increased by 1.3% (p = 0.019) and 1.9% (p = 0.006), respectively. Energy and fat intake associated positively with body mass and skeletal muscle mass (r = 0.31–0.48, p < 0.05–0.001). - Conclusions: Carbohydrate intakes and physical activity were low, compared with the general recommendations. Protein intakes were relatively high. Skeletal muscle mass and subcutaneous fat increased. Suboptimal diet together with low level of physical activity may have a negative impact on body composition, physical performance, and cardiometabolic health. Consequently, soldiers should be encouraged to consume more fiber-rich carbohydrates and less saturated fatty acids as well as maintain a high level of physical fitness to sustain military readiness during long-term deployments. ; peerReviewed

14/191) and University of Auckland Faculty Research Development Fund. The Cambridge Weight Plan© donated all products for the 8-week LED period. The Danish Agriculture & Food Council. The Danish Meat and Research Institute. National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK). Engineering and Physical Sciences Research Council (EPSRC) (UK). Nutritics (Dublin) donated all dietary analyses software used by UNOTT. Juho Vainio Foundation (FIN), Academy of Finland (grant numbers: 272376, 314383, 266286, 314135), Finnish Medical Foundation, Gyllenberg Foundation, Novo Nordisk Foundation, Finnish Diabetes Research Foundation, University of Helsinki, Government Research Funds for Helsinki University Hospital (FIN), Jenny and Antti Wihuri Foundation (FIN), Emil Aaltonen Foundation (FIN). China Scholarship Council. ; Plant-based diets are recommended by dietary guidelines. This secondary analysis aimed to assess longitudinal associations of an overall plant-based diet and specific plant foods with weight-loss maintenance and cardiometabolic risk factors. Longitudinal data on 710 participants (aged 26–70 years) with overweight or obesity and pre-diabetes from the 3-year weight-loss maintenance phase of the PREVIEW intervention were analyzed. Adherence to an overall plant-based diet was evaluated using a novel plant-based diet index, where all plant-based foods received positive scores and all animal-based foods received negative scores. After adjustment for potential confounders, linear mixed models with repeated measures showed that the plant-based diet index was inversely associated with weight regain, but not with cardiometabolic risk factors. Nut intake was inversely associated with regain of weight and fat mass and increments in total cholesterol and LDL cholesterol. Fruit intake was inversely associated with increments in diastolic blood pressure, total cholesterol, and LDL cholesterol. Vegetable intake was inversely associated with an increment in diastolic blood pressure and triglycerides and was positively associated with an increase in HDL cholesterol. All reported associations with cardiometabolic risk factors were independent of weight change. Long-term consumption of nuts, fruits, and vegetables may be beneficial for weight management and cardiometabolic health, whereas an overall plant-based diet may improve weight management only. ; publishersversion ; published

Abstract. Individuals at risk of Type 2 Diabetes are advised to change health habits. This study investigated how the PREMIT behavior modification intervention and its association with socio-economic variables influenced weight maintenance and habit strength in the PREVIEW study. Overweight adults with pre-diabetes were enrolled ( n = 2,224) in a multi-center RCT including a 2-month weight-loss phase and a 34-month weight-maintenance phase for those who lost ≥ 8% body weight. Initial stages of the PREMIT covered the end of weight-loss and the beginning of weight-maintenance phase (18 weeks). Cross-sectional and longitudinal data were explored. Frequent PREMIT sessions attendance, being female, and lower habit strength for poor diet were associated with lower weight re-gain. Being older and not in employment were associated with lower habit strength for physical inactivity. The PREMIT appeared to support weight loss maintenance. Younger participants, males, and those in employment appeared to struggle more with inactivity habit change and weight maintenance.

14/191 ) and University of Auckland Faculty Research Development Fund. The Cambridge Weight Plan© donated all products for the 8-weeks LED period. The Danish Agriculture & Food Council. The Danish Meat and Research Institute. National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK). Engineering and Physical Sciences Research Council (EPSRC) (UK). Nutritics (Dublin) donated all dietary analyses software used by UNOTT. Juho Vainio Foundation (FIN), Academy of Finland (grant numbers: 272376 , 314383 , 266286 , 314135 ), Finnish Medical Foundation, Gyllenberg Foundation, Novo Nordisk Foundation, Finnish Diabetes Research Foundation, University of Helsinki, Government Research Funds for Helsinki University Hospital (FIN), Jenny and Antti Wihuri Foundation (FIN), Emil Aaltonen Foundation (FIN). China Scholarship Council. The funding sources had no role in the study design and conduct, data analysis, or manuscript preparation. 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. ; publishersversion ; published

Funding: Open Access funding provided by University of Helsinki including Helsinki University Central Hospital. This research was supported by the EU Seventh Framework Programme (FP7; 2007– 2013) (grant no. 312057); National Health and Medical Research Council (EU Collaborative Grant AUS 8, ID 1067711); Glycemic Diabetologia Index Foundation Australia through royalties to the University of Sydney; Health Research Council of New Zealand (grant no. 14/191) and University of Auckland Faculty Research Development Fund; Cambridge Weight Plan, which donated all products for the 8 week weight loss period; Danish Agriculture & Food Council; Danish Meat Research Institute; National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK); Biotechnology and Biological Sciences Research Council (BBSRC) (UK); Engineering and Physical Sciences Research Council (EPSRC) (UK); Nutritics (Dublin), which donated all dietary analysis software used by the University of Nottingham; Juho Vainio Foundation (Finland); Academy of Finland (grant nos 272376, 314383, 266286 and 314135); Finnish Medical Foundation; Gyllenberg Foundation (Finland); Novo Nordisk Foundation; Finnish Diabetes Research Foundation; University of Helsinki; Government Research Funds for Helsinki University Hospital; Jenny and Antti Wihuri Foundation (Finland); Emil Aaltonen Foundation (Finland); and China Scholarship Council. The funders were not involved in the design of the study, the collection, analysis and interpretation of the data or writing of the report and did not impose any restrictions regarding the publication of the report. ; AIMS/HYPOTHESIS: Lifestyle interventions are the first-line treatment option for body weight and cardiometabolic health management. However, whether age groups or women and men respond differently to lifestyle interventions is under debate. We aimed to examine age- and sex-specific effects of a low-energy diet (LED) followed by a long-term lifestyle intervention on body weight, body composition and ...

14/191) and University of Auckland Faculty Research Development Fund. The Cambridge Weight Plan© donated all products for the 8-weeks LED period. The Danish Agriculture & Food Council. The Danish Meat and Research Institute. National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK). Engineering and Physical Sciences Research Council (EPSRC) (UK). Nutritics (Dublin) donated all dietary analyses software used by UNOTT. Juho Vainio Foundation (FIN), Academy of Finland (grant numbers: 272376, 314383, 266286, 314135), Finnish Medical Foundation, Gyllenberg Foundation, Novo Nordisk Foundation, Finnish Diabetes Research Foundation, University of Helsinki, Government Research Funds for Helsinki University Hospital (FIN), Jenny and Antti Wihuri Foundation (FIN), Emil Aaltonen Foundation (FIN). China Scholarship .The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. ; Background: Previous studies have shown an increase in hunger during weight-loss maintenance (WLM) after diet-induced weight loss. Whether a combination of a higher protein, lower glycemic index (GI) diet and physical activity (PA) can counteract this change remains unclear. Aim: To compare the long-term effects of two diets [high protein (HP)-low GI vs. moderate protein (MP)-moderate GI] and two PA programs [high intensity (HI) vs. moderate intensity (MI)] on subjective appetite sensations during WLM after ≥8% weight loss (WL). Methods: Data derived from the 3-years PREVIEW randomized intervention study. An 8-weeks WL phase using a low-energy diet was followed by a 148-weeks randomized WLM phase. For the WLM phase, participants were assigned to one of the four groups: HP-MI, HP-HI, MP-MI, and MP-HI. Available data from 2,223 participants with overweight or obesity (68% women; BMI ≥ 25 kg/m2). Appetite sensations including satiety, hunger, desire to eat, and desire to eat something sweet during the two phases (at 0, 8 weeks and 26, 52, 104, and 156 weeks) were assessed based on the recall of feelings during the previous week using visual analogue scales. Differences in changes in appetite sensations from baseline between the groups were determined using linear mixed models with repeated measures. Results: There was no significant diet × PA interaction. From 52 weeks onwards, decreases in hunger were significantly greater in HP-low GI than MP-moderate GI (Ptime × diet = 0.018, Pdietgroup = 0.021). Although there was no difference in weight regain between the diet groups (Ptime × diet = 0.630), hunger and satiety ratings correlated with changes in body weight at most timepoints. There were no significant differences in appetite sensations between the two PA groups. Decreases in hunger ratings were greater at 52 and 104 weeks in HP-HI vs. MP-HI, and greater at 104 and 156 weeks in HP-HI vs. MP-MI. Conclusions: This is the first long-term, large-scale randomized intervention to report that a HP-low GI diet was superior in preventing an increase in hunger, but not weight regain, during 3-years WLM compared with a MP-moderate GI diet. Similarly, HP-HI outperformed MP-HI in suppressing hunger. The role of exercise intensity requires further investigation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01777893. ; publishersversion ; published

BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries. RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries. RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

Background Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. Methods Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2–18 years) from 18 different European countries. Results Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. Conclusions Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe. ; info:eu-repo/semantics/publishedVersion

BACKGROUND:Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. METHODS:Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries. RESULTS:Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. CONCLUSIONS:Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries. RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

Background Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. Methods Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (>= 10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries. Results Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. Conclusions Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe. ; Peer reviewed