The acute effect of fasted exercise on energy intake, energy expenditure, subjective hunger and gastrointestinal hormone release compared to fed exercise in healthy individuals: A systematic review and network meta-analysis
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Published version
Author(s)
Frampton, James
Edinburgh, Robert
Ogden, Henry
Gonzalez, Javier
Chambers, Edward
Type
Journal Article
Abstract
Objective
To determine the acute effect of fasted and fed exercise on energy intake, energy expenditure, subjective hunger and gastrointestinal hormone release.
Methods
CENTRAL, Embase, MEDLINE, PsycInfo, PubMed, Scopus and Web of Science databases were searched to identify randomised, crossover studies in healthy individuals that compared the following interventions: (i) fasted exercise with a standardised post-exercise meal [FastEx + Meal], (ii) fasted exercise without a standardised post-exercise meal [FastEx + NoMeal], (iii) fed exercise with a standardised post-exercise meal [FedEx + Meal], (iv) fed exercise without a standardised post-exercise meal [FedEx + NoMeal]. Studies must have measured ad libitum meal energy intake, within-lab energy intake, 24-h energy intake, energy expenditure, subjective hunger, acyl-ghrelin, peptide YY, and/or glucagon-like peptide 1. Random-effect network meta-analyses were performed for outcomes containing ≥5 studies.
Results
17 published articles (23 studies) were identified. Ad libitum meal energy intake was significantly lower during FedEx + Meal compared to FedEx + NoMeal (MD: −489 kJ; 95% CI, −898 to −80 kJ; P = 0.019). Within-lab energy intake was significantly lower during FastEx + NoMeal compared to FedEx + NoMeal (MD: −1326 kJ; 95% CI, −2102 to −550 kJ; P = 0.001). Similarly, 24-h energy intake following FastEx + NoMeal was significantly lower than FedEx + NoMeal (MD: −2095 kJ; 95% CI, −3910 kJ to −280 kJ; P = 0.024). Energy expenditure was however significantly lower during FastEx + NoMeal compared to FedEx+NoMeal (MD: −0.67 kJ/min; 95% CI, −1.10 to −0.23 kJ/min; P = 0.003). Subjective hunger was significantly higher during FastEx + Meal (MD: 13 mm; 95% CI, 5–21 mm; P = 0.001) and FastEx + NoMeal (MD: 23 mm; 95% CI, 16–30 mm; P < 0.001) compared to FedEx + NoMeal.
Conclusion
FastEx + NoMeal appears to be the most effective strategy to produce a short-term decrease in energy intake, but also results in increased hunger and lowered energy expenditure. Concerns regarding experimental design however lower the confidence in these findings, necessitating future research to rectify these issues when investigating exercise meal timing and energy balance.
PROSPERO registration number
CRD42020208041.
To determine the acute effect of fasted and fed exercise on energy intake, energy expenditure, subjective hunger and gastrointestinal hormone release.
Methods
CENTRAL, Embase, MEDLINE, PsycInfo, PubMed, Scopus and Web of Science databases were searched to identify randomised, crossover studies in healthy individuals that compared the following interventions: (i) fasted exercise with a standardised post-exercise meal [FastEx + Meal], (ii) fasted exercise without a standardised post-exercise meal [FastEx + NoMeal], (iii) fed exercise with a standardised post-exercise meal [FedEx + Meal], (iv) fed exercise without a standardised post-exercise meal [FedEx + NoMeal]. Studies must have measured ad libitum meal energy intake, within-lab energy intake, 24-h energy intake, energy expenditure, subjective hunger, acyl-ghrelin, peptide YY, and/or glucagon-like peptide 1. Random-effect network meta-analyses were performed for outcomes containing ≥5 studies.
Results
17 published articles (23 studies) were identified. Ad libitum meal energy intake was significantly lower during FedEx + Meal compared to FedEx + NoMeal (MD: −489 kJ; 95% CI, −898 to −80 kJ; P = 0.019). Within-lab energy intake was significantly lower during FastEx + NoMeal compared to FedEx + NoMeal (MD: −1326 kJ; 95% CI, −2102 to −550 kJ; P = 0.001). Similarly, 24-h energy intake following FastEx + NoMeal was significantly lower than FedEx + NoMeal (MD: −2095 kJ; 95% CI, −3910 kJ to −280 kJ; P = 0.024). Energy expenditure was however significantly lower during FastEx + NoMeal compared to FedEx+NoMeal (MD: −0.67 kJ/min; 95% CI, −1.10 to −0.23 kJ/min; P = 0.003). Subjective hunger was significantly higher during FastEx + Meal (MD: 13 mm; 95% CI, 5–21 mm; P = 0.001) and FastEx + NoMeal (MD: 23 mm; 95% CI, 16–30 mm; P < 0.001) compared to FedEx + NoMeal.
Conclusion
FastEx + NoMeal appears to be the most effective strategy to produce a short-term decrease in energy intake, but also results in increased hunger and lowered energy expenditure. Concerns regarding experimental design however lower the confidence in these findings, necessitating future research to rectify these issues when investigating exercise meal timing and energy balance.
PROSPERO registration number
CRD42020208041.
Date Issued
2021-11-03
Date Acceptance
2021-10-11
Citation
International Journal of Obesity, 2021, 46, pp.255-268
ISSN
0307-0565
Publisher
Springer Nature [academic journals on nature.com]
Start Page
255
End Page
268
Journal / Book Title
International Journal of Obesity
Volume
46
Copyright Statement
© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
https://www.nature.com/articles/s41366-021-00993-1
Subjects
Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
Nutrition & Dietetics
COGNITIVE PERFORMANCE
METABOLIC-RESPONSES
APPETITE REGULATION
BREAKFAST OMISSION
PHYSICAL-ACTIVITY
FOOD-INTAKE
FED-STATE
FAT
BALANCE
OBESITY
Endocrinology & Metabolism
11 Medical and Health Sciences
13 Education
Publication Status
Published
Date Publish Online
2021-11-03
