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Despite growing popularity of high intensity interval training (HIIT) for improving health and fitness, limited data exist identifying the effects of HIIT on muscle characteristics. The purpose of the current study was to investigate the effects of a 3-week HIIT intervention on muscle size and quality in overweight and obese men and women. Randomized controlled trial. Forty-four overweight and obese men and women (mean±SD; age: 35.4±12.3years; height: 174.9±9.7cm; weight: 94.6±17.0kg; %fat: 32.7±6.5%) completed the current study. During baseline and post testing, muscle cross sectional area (mCSA) and echo intensity (EI) were determined from a panoramic scan of the vastus lateralis obtained by B-mode ultrasonography. Body composition variables were measured using dual energy X-ray absorptiometry. Participants were randomized into either a 1:1 work-to-rest ratio HIIT group (SIT; n=16), a 2:1 work-to-rest ratio HIIT group (LIT; n=19), or control (CON; n=9). HIIT participants performed five, 2-min bouts (LIT) or 10, 1-min bouts (SIT) at 85–100% VO2peak for 9 sessions over three weeks. Analysis of covariance demonstrated a significant increase in mCSA for SIT (p=0.038; change (Δ)=3.17±3.36cm2) compared to CON (Δ=−0.34±2.36cm2). There was no significant difference in EI across groups (p=0.672). HIIT may be an effective exercise modality to influence muscle size in overweight and obese individuals. Future studies should investigate muscle characteristics and remodeling in an overweight population following interventions of longer duration and varying work-to-rest protocols.

High-intensity interval training (HIIT) promotes positive cardiometabolic and body composition changes. Essential amino acids (EAA) may support changes associated with HIIT, but evaluation of potential synergistic effects is lacking. The purpose of this study was to compare independent and combined effects of HIIT and EAA on total body composition and metabolism in men and women considered overweight/obese; an exploratory aim was to evaluate the modulatory effects of sex. Sixty-six healthy adults (50% female; Age: 36.7 ± 6.0 years; BMI: 32.0 ± 4.2 kg/m2) completed 8 weeks of: (1) HIIT, 2 days/weeks; (2) EAA supplementation, 3.6 g twice daily; (3) HIIT + EAA; or (4) control. Body composition, resting metabolic rate (RMR), substrate metabolism (respiratory exchange ratio; RER), and cardiorespiratory fitness were measured at baseline, 4 weeks, and 8 weeks; cardiometabolic blood markers were measured at baseline and 8 weeks. Differences between groups were assessed by linear mixed models covaried for baseline values, followed by 95% confidence intervals (CI) on adjusted mean change scores. There were no significant changes in body composition (p > 0.05) for any group. Changes in RER, but not RMR, occurred with HIIT (mean change; [95% CI]: − 0.04; [− 0.07, − 0.02]) and EAA (− 0.03; [− 0.06, − 0.01]) after 8 weeks. Cardiorespiratory fitness increased following 8 weeks of HIIT (+ 5.1 ml/kg/min [3.3,6.8]) and HIIT + EAA (+ 4.1 ml/kg/min [1.0,6.4]). Changes with HIIT + EAA were not significantly different from HIIT. There were no changes in cardiometabolic markers (p > 0.05) and no sex interaction (p > 0.05). HIIT is efficacious for promoting positive changes in cardiorespiratory fitness and resting substrate metabolism in adults considered overweight/obese. Addition of EAA did not significantly enhance HIIT-induced adaptations. ClinicalTrials.gov ID#NCT04080102.

Understanding the effects of acute feeding on body composition and metabolic measures is essential to the translational component and practical application of measurement and clinical use. To investigate the influence of acute feeding on the validity of dual-energy X-ray absorptiometry (DXA), a four-compartment model (4C) and indirect calorimetry metabolic outcomes, thirty-nine healthy young adults (n 19 females; age: 21·8 (sd 3·1) years, weight; 71·5 (sd 10·0) kg) participated in a randomised cross-over study. Subjects were provided one of four randomised meals on separate occasions (high carbohydrate, high protein, ad libitum or fasted baseline) prior to body composition and metabolic assessments. Regardless of macronutrient content, acute feeding increased DXA percent body fat (%fat) for the total sample and females (average constant error (CE):–0·30 %; total error (TE): 2·34 %), although not significant (P = 0·062); the error in males was minimal (CE: 0·11 %; TE: 0·86 %). DXA fat mass (CE: 0·26 kg; TE: 0·75 kg) and lean mass (LM) (CE: 0·83 kg; TE: 1·23 kg) were not altered beyond measurement error for the total sample. 4C %fat was significantly impacted from all acute feedings (avg CE: 0·46 %; TE: 3·7 %). 4C fat mass (CE: 0·71 kg; TE: 3·38 kg) and fat-free mass (CE: 0·55 kg; TE: 3·05 kg) exceeded measurement error for the total sample. RMR was increased for each feeding condition (TE: 1666·9 kJ/d; 398 kcal/d). Standard pre-testing fasting guidelines may be important when evaluating DXA and 4C %fat, whereas additional DXA variables (fat mass and LM) may not be significantly impacted by an acute meal. Measuring body composition via DXA under less stringent pre-testing guidelines may be valid and increase feasibility of testing in clinical settings.

Analysis of Brightness-mode ultrasound-captured fascicle angle (FA) and fascicle length (FL) can be completed manually with computer-based programs or by automated programs. Insufficient data exists regarding reliability and accuracy of automated tools. Therefore, the purpose of this study was to determine the test-retest reliability of automatic and manual ultrasound analyses, while determining accuracy of the automatic tool against the manual equivalent. Twenty-three participants (mean ± SD; age = 24 ± 4 years; height = 172.2 ± 10.5 cm; body mass = 73.1 ± 16.1 kg) completed one laboratory visit consisting of two trials where vastus lateralis muscle architecture was assessed with ultrasound. Images were taken at both lower (10 MHz) and higher frequency (12 MHz). Images were analyzed manually in an open-source imaging program and automatically using a separate open-source macro function. Test-retest reliability statistics were calculated for automatic and manual analyses. Accuracy was determined with validity statistics and were calculated for automatic analyses. The results show that manual ultrasound analyses for FA and FL for both lower and higher frequency displayed good reliability (ICC 2,1 = 0.75–0.86). However, automatic ultrasound analyses for FA and FL revealed moderate reliability (ICC 2,1 = 0.61–0.72) for the lower frequency images and poor reliability (ICC 2,1 = 0.16–0.27) for higher frequency images. When assessed against manual techniques, automatic analyses presented greater total error (TE) and standard error of the estimate (SEE) for FA at lower frequency (constant error (CE) = −3.91°, TE = 5.57°, SEE = 3.45°) than higher (CE = −2.78°, TE = −4.54°, SEE = 2.45°). For FL, the higher frequency error (CE = 0.92 cm, TE = 2.12 cm, SEE = 1.15 cm) was similar to lower frequency error (CE = 1.98 cm, TE = 3.66 cm, SEE = 1.57 cm). The findings overall show that manual analyses had good reliability and low absolute error, while demonstrating the automated counterpart had poor to moderate reliability and large errors in analyses. These findings may be impactful as they highlight the good reliability and low error associated with manually analyzed ultrasound images and validate a novel automatic tool for analyzing ultrasound images. Future work should focus on improving reliability and decreasing error in automated image analysis tools. Automated tools are promising for the field as they eliminate biases between analysts and may be more time efficient than manual techniques.

The purpose of this study was to determine the effects of pre- vs. post-workout nutrition on strength, body composition, and metabolism in trained females over 6 weeks of high intensity resistance training (HIRT). Forty-three trained females (mean±SD; age: 20.5±2.2 yrs; height: 165.2±5.7cm; body mass: 66.5±11.4kg) were measured for strength, body composition, and metabolic variables before and after a HIRT intervention. Participants were randomized using a 2:2:1 matched block randomization scheme by baseline leg press strength into a group that consumed a 1:1.5 carbohydrate-protein supplement (16g CHO/25g PRO) pre-training (PRE), post-training (POST), or no supplement (CON). Dual-energy X-ray absorptiometry was used to evaluate fat mass (FM), lean mass (LM), and percent fat (%fat). Strength was analyzed using a one repetition max on the leg and bench press (LP1RM and BP1RM, respectively). Participants completed HIRT twice per week for 6 weeks. At the first and last trainings, metabolic variables [resting energy expenditure (REE) and respiratory exchange ratio, RER] were measured. There were no significant differences between groups for any changes in body composition variables or LP1RM (p=0.170–0.959). There were significant differences for BP1RM (p=0.007), with PRE and POST experiencing greater increases than CON (p=0.010 and 0.015, respectively). REE changes were not significant between groups (p=0.058–0.643). PRE demonstrated greater fat oxidation (RER) at 30min post-exercise (p=0.008–0.035). Peri-workout nutrition is potentially important for upper body strength and metabolism. PRE may be more effective for promoting fat utilization immediately post-workout.

Nutritional interventions are not commonly a standard of care in rehabilitation interventions. A nutritional approach has the potential to be a low-cost, high-volume strategy that complements the existing standard of care. In this commentary, our aim is to provide an evidence-based, practical guide for athletes with injuries treated surgically or conservatively, along with healing and rehabilitation considerations. Injuries are a normal and expected part of exercise participation. Regardless of severity, an injury typically results in the athlete's short- or long-term removal from participation. Nutritional interventions may augment the recovery process and support optimal healing; therefore, incorporating nutritional strategies is important at each stage of the healing process. Preoperative nutrition and nutritional demands during rehabilitation are key factors to consider. The physiological response to wounds, immobilization, and traumatic brain injuries may be improved by optimizing macronutrient composition, caloric consumption, and nutrient timing and using select dietary supplements. Previous research supports practical nutrition recommendations to reduce surgical complications, minimize deficits after immobilization, and maximize the chance of safe return to play. These recommendations include identifying the individual's caloric requirements to ensure that energy needs are being met. A higher protein intake, with special attention to evenly distributed consumption throughout the day, will help to minimize loss of muscle and strength during immobilization. Dietary-supplement strategies may be useful when navigating the challenges of appropriate caloric intake and timing and a reduced appetite. The rehabilitation process also requires a strong nutritional plan to enhance recovery from injury. Athletic trainers, physical therapists, and other health care professionals should provide basic nutritional recommendations during rehabilitation, discuss the timing of meals with respect to therapy, and refer the patient to a registered dietitian if warranted. Because nutrition plays an essential role in injury recovery and rehabilitation, nutritional interventions should become a component of standard-of-care practice after injury. In this article, we address best practices for implementing nutritional strategies among patients with athletic injuries.

Few investigations have evaluated the validity of current body composition technology among racially and ethnically diverse populations. This study assessed the validity of common body composition methods in a multi-ethnic sample stratified by race and ethnicity. One hundred and ten individuals (55 % female, age: 26·5 (sd 6·9) years) identifying as Asian, African American/Black, Caucasian/White, Hispanic, Multi-racial and Native American were enrolled. Seven body composition models (dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), two bioelectrical impedance devices (BIS, IB) and three multi-compartment models) were evaluated against a four-compartment criterion model by assessing total error (TE) and standard error of the estimate. For the total sample, measures of % fat and fat-free mass (FFM) from multi-compartment models were all excellent to ideal (% fat: TE = 0·94–2·37 %; FFM: TE = 0·72–1·78 kg) compared with the criterion. % fat measures were very good to excellent for DXA, ADP and IB (TE = 2·52–2·89 %) and fairly good for BIS (TE = 4·12 %). For FFM, single device estimates were good (BIS; TE = 3·12 kg) to ideal (DXA, ADP, IB; TE = 1·21–2·15 kg). Results did not vary meaningfully between each race and ethnicity, except BIS was not valid for African American/Black, Caucasian/White and Multi-racial participants for % fat (TE = 4·3–4·9 %). The multi-compartment models evaluated can be utilised in a multi-ethnic sample and in each individual race and ethnicity to obtain highly valid results for % fat and FFM. Estimates from DXA, ADP and IB were also valid. The BIS may demonstrate greater TE for all racial and ethnic cohorts and results should be interpreted cautiously.

Objective To assess the feasibility and changes in outcomes of a 12‐week high‐intensity interval training (HIIT) program in individuals with symptomatic knee osteoarthritis (OA). Methods The single‐arm trial included 29 participants (mean ± SD age 63 ± 7 years; 66% women; 66% obese). Measures of participant flow, adherence, and tolerability were collected. Pain, function, and balance were assessed at baseline, 6 weeks, and 12 weeks using the Western Ontario and McMaster Universities Osteoarthritis Index, 20‐m fast‐paced walk test, 30‐second chair‐stand test, stair‐climb test, timed up and go test, and single leg stance. Cardiorespiratory fitness, strength, and body composition were evaluated using peak oxygen consumption (VO2peak), isometric knee extensor/flexor strength, and dual‐energy x‐ray absorptiometry, respectively. HIIT was completed two times/week (cycling or treadmill) and consisted of 10 repetitions of 1‐minute bouts at 90% VO2peak, with 1‐minute rest periods. Separate multivariable‐adjusted linear mixed models were fit for each outcome with fixed effects of time, age, sex, body mass index, and random effects of baseline values to estimate mean changes and 95% confidence intervals (CIs) between baseline and 12‐week assessments. Results Recruitment aligned with the anticipated enrollment rate, adherence was 70%, and no adverse events were reported. At 12 weeks, improvements were observed for most outcomes, with notable mean changes for the 20‐m fast‐paced walk (−1.13 [95% CI −1.61 to −0.64] seconds), 30‐second chair‐stand (2.6 [1.8‐3.4] stands), and VO2peak (0.14 [0.03‐0.24] liters/minute). Conclusion In this 12‐week pilot study, HIIT improved multiple aspects of health in individuals with knee OA; larger studies are needed.

The purpose of this paper was to determine the effect of replacing breakfast with a high-fat drink on fat mass (FM), lean mass (LM), percent body fat (%BF), visceral fat (VAT), resting metabolic rate (RMR), fuel utilization (RER), blood lipids and satiety in overweight and obese adults. Healthy adults (n = 42; 21 Females; body mass index (BMI): 32.8 ± 4.6 kg·m−2) were randomized to control (CON; n = 21) or meal replacement (MRP; n = 22) groups. Body composition was measured using a four-compartment model; RMR and RER were assessed from indirect calorimetry. The MRP (70% fat) was consumed once daily for eight weeks. For males, there was no change (p > 0.05) in FM (mean difference (MD) = 0.41 ± 1.19 kg], %BF MD = 0.50 ± 1.09%, LM MD = −0.64 ± 1.79 kg, or VAT MD = −0.31 ± 1.36 cm for MRP versus CON. Similarly, no differences for females for FM MD = −0.73 ± 1.37 kg, %BF MD = −0.57 ± 1.26%, LM MD = 0.31 ± 1.37 kg, or VAT MD: −0.83 ± 1.2 cm. HDL was significantly reduced in the MRP group for females (adjusted mean change: −6.41 ± 4.44 units, p = 0.018). There was no effect on RMR or RER. Satiety increased in the afternoon for MRP (p = 0.021). Despite high fat, no negative impact on lipids resulted; increased satiety may be beneficial for controlling afternoon cravings, but does not affect body composition.

Normal weight obesity (NWO) describes individuals who have a normal weight body mass index (BMI), but have an unhealthy amount of body fat. Based on the life-long habits that develop during college, exploring NWO among a college-aged population may be essential in identifying and preventing obesity that develops in early adulthood. This study aimed to characterize NWO among young adults with normal weight BMI. 94 college students (Mean ± SD: Age: 19.6 ± 1.5 yrs; BMI: 21.9 ± 1.8 kg/m ) enrolled during the Fall semester (Aug-Oct) were assessed for body composition by dual energy X-ray absorptiometry to determine body fat percentage, fat mass, lean mass and trunk fat; lifestyle habits were characterized from validated questionnaires. Mean arterial pressure and metabolic biomarkers [total cholesterol, high density lipoproteins, non-high density lipoproteins, and glucose] were evaluated for cardiometabolic health. NWO was defined using data from the National Health and Nutrition Examination Survey (NHANES) for body fat percentage. Data was analyzed by group (NWO vs NWL) and sex. with independent t-tests to investigate continuous data, and chi-square test of independence for categorical data. Rates of NWO for the total sample were 13.8%. Males (n=30) had a higher rate of NWO (26.7%) compared to females (n=64; 7.8%). NWO individuals had higher fat mass (p=0.024), trunk fat (p<0.001), and larger waist to hip ratio (p<0.001) than normal weight lean. NWO also engaged in less vigorous physical activity (p=0.043). The occurrence of NWO among otherwise healthy college students is evident. Identification of these individuals may be an effective component for obesity prevention and treatment. Determining feasible methods to measure body fat in this population is essential, as BMI may mask obesity in a young adult population.