While numerous guidelines for the prescription of physical activity are released each year, the quality and practicability of these guidelines is unknown. We assessed the quality of 95 guidance documents published since 2000 that included recommendations about physical activity for the promotion of general health and prevention of cardiometabolic disease. We used three tools: AGREE II, the National Academy of Medicine’s (NAM) Standards for Trustworthy Clinical Practice Guidelines, and the FITT score (Frequency, Intensity, Time and Type). Average AGREE II domain scores ranged from 38% - 84%, and the portion of criteria fulfilled per NAM domain ranged from 7% – 39%. The average FITT score for all recommendations was 2.48 out of 4. While guidelines improved according to both AGREE II and the NAM standards over time, their practicability as assessed by FITT score did not improve. Guidelines produced by governmental agencies or other non-profits, using the GRADE approach, or fulfilling a higher number of NAM criteria tended to be higher-quality. Organizations producing physical activity guidelines can improve their quality by establishing and reporting processes for public representation, external review, and conflict of interest management. Future recommendations about physical activity should be more specific and include strategies to improve implementation. Registration Number: PROSPERO CRD42019126364
Novelty bullets:
• Most physical activity recommendations are not sufficiently specific to be practically implemented.
• The overall quality of guidelines has improved over time, but the specificity of recommendations has not.
• Improved public representation, external review, and COI disclosure and management processes would improve guideline quality.
The purpose of this study was to examine the effects of intermittent versus continuous energy restriction on body composition, resting metabolic rate, and eating behaviors in resistance-trained females. Thirty-eight resistance-trained females (mean ± standard deviation age: 22.3±4.2 years) were randomized to receive either six weeks of a continuous 25% reduction in energy intake (n= 18), or one week of energy balance after every two weeks of 25% energy restriction (eight weeks total; n= 20). Participants were instructed to ingest 1.8 g protein/kilogram bodyweight per day and completed three weekly supervised resistance training sessions throughout the intervention. There were no differences between groups for changes over time in body composition, resting metabolic rate, or seven of the eight measured eating behavior variables (p > 0.05). However, a significant group-by-time interaction for disinhibition (p < 0.01) from the Three-Factor Eating Questionnaire was observed, with values (± standard error) in the continuous group increasing from 4.91 ± 0.73 to 6.17 ± 0.71, while values in the intermittent group decreased from 6.80 ± 0.68 to 6.05 ± 0.68. Thus, diet breaks do not appear to induce improvements in body composition or metabolic rate in comparison with continuous energy restriction over six weeks of dieting, but may be employed for those who desire a short-term break from an energy-restricted diet without fear of fat regain. While diet breaks may reduce the impact of prolonged energy restriction on measures of disinhibition, they also require a longer time period that may be less appealing for some individuals.
Purpose: Evaluate the effectiveness of a commercially-available nutraceutical product on levels of exercise-related energy, fatigue, and exertion before and after 4 weeks of supplementation. Primary ingredients within the product include a proprietary blend of blueberry extract, green tea extract, L-carnosine, and Vitamin D3 (NT-020) and rhodiola rosea, a plant that purports to boost energy.Methods: Twenty-seven participants (12 female, 15 male, mean BMI = 23) completed baseline assessment of aerobic fitness (mean VO2 peak = 40 mL x kg-1 x min-1) before being randomized into a placebo or supplement condition for four weeks. All participants were involved in regular physical activity three or more days per week. Assessment of energy, fatigue, and perceived exertion responses during and immediately following moderately intense cycle ergometry exercise was conducted before and after the 4-week ingestion period during which participants were instructed to maintain existing exercise activities.Results: Data were analyzed by way of repeated measures ANOVA and dependent t-tests to determine the presence of significant differences across time and between the supplement and placebo conditions. Participants receiving the supplement reported: greater levels of energy and lower levels of fatigue during the initial moments after completing the exercise trial (p < 0.05), greater levels of energy at the midpoint of the exercise trial (p < 0.05) but not at the end of the exercise session (p > 0.05), and lower perceived exertion at four of the six measurement points during exercise (p < 0.05). No differences were observed from pre to post intervention within the placebo condition (p > 0.05).Conclusions: Findings indicate that a commercially available supplement marketed to boost energy and reduce fatigue can deliver the purported benefits at least in part. Related findings that supplementation for a 4-week period can allow for equal work at a lower rating of perceived exertion provides further, though limited support that this product may have efficacy.
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