The current obesity epidemic is staggering in terms of its magnitude and public health impact. Current guidelines recommend continuous energy restriction (CER) along with a comprehensive lifestyle intervention as the cornerstone of obesity treatment, yet this approach produces modest weight loss on average. Recently, there has been increased interest in identifying alternative dietary weight loss strategies that involve restricting energy intake to certain periods of the day or prolonging the fasting interval between meals (i.e., intermittent energy restriction, IER). These strategies include intermittent fasting (IMF; >60% energy restriction on 2–3 days per week, or on alternate days) and time-restricted feeding (TRF; limiting the daily period of food intake to 8–10 h or less on most days of the week). Here, we summarize the current evidence for IER regimens as treatments for overweight and obesity. Specifically, we review randomized trials of ≥8 weeks in duration performed in adults with overweight or obesity (BMI ≥ 25 kg/m²) in which an IER paradigm (IMF or TRF) was compared to CER, with the primary outcome being weight loss. Overall, the available evidence suggests that IER paradigms produce equivalent weight loss when compared to CER, with 9 out of 11 studies reviewed showing no differences between groups in weight or body fat loss.

Background: A single bout of exercise improves postprandial glycemia and insulin sensitivity in prediabetic patients; however, the impact of exercise intensity is not well understood. The present study compared the effects of acute isocaloric moderate (MIE) and high-intensity (HIE) exercise on glucose disposal and insulin sensitivity in prediabetic adults. Methods: Subjects (n = 18; age 49 ± 14 y; fasting glucose 105 ± 11 mg/dL; 2 h glucose 170 ± 32 mg/dL) completed a peak O₂ consumption/lactate threshold (LT) protocol plus three randomly assigned conditions: 1) control, 1 hour of seated rest, 2) MIE (at LT), and 3) HIE (75% of difference between LT and peak O₂ consumption). One hour after exercise, subjects received an oral glucose tolerance test (OGTT). Plasma glucose, insulin, and C-peptide concentrations were sampled at 5- to 10-minute intervals at baseline, during exercise, after exercise, and for 3 hours after glucose ingestion. Total, early-phase, and late-phase area under the glucose and insulin response curves were compared between conditions. Indices of insulin sensitivity (SI) were derived from OGTT data using the oral minimal model. Results: Compared with control, SI improved by 51% (P = .02) and 85% (P < .001) on the MIE and HIE days, respectively. No differences in SI were observed between the exercise conditions (P = .62). Improvements in SI corresponded to significant reductions in the glucose, insulin, and C-peptide area under the curve values during the late phase of the OGTT after HIE (P < .05), with only a trend for reductions after MIE. Conclusion: These results suggest that in prediabetic adults, acute exercise has an immediate and intensity-dependent effect on improving postprandial glycemia and insulin sensitivity.

Whole‐room indirect calorimeters have been used to study human metabolism for more than a century. These studies have contributed substantial knowledge to the assessment of nutritional needs and the regulation of energy expenditure and substrate oxidation in humans. However, comparing results from studies conducted at different sites is challenging because of a lack of consistency in reporting technical performance, study design, and results. In May 2019, an expert panel was convened to consider minimal requirements for conducting and reporting the results of human whole‐room indirect calorimeter studies. We propose Room Indirect Calorimetry Operating and Reporting Standards, version 1.0 (RICORS 1.0) to provide guidance to ensure consistency and facilitate meaningful comparisons of human energy metabolism studies across publications, laboratories, and clinical sites.

Strength training often combines closed-kinetic-chain exercises (CKCEs) and open kinetic-chain exercises (OKCEs). The CKCE may be more effective for improving performance in lower-body training. Recently, we reported upper-body CKCE (using a commercially available system of ropes and slings, Redcord AS, Staubo, Norway) was as effective as OKCE training for strength gains and that CKCE was more effective than OKCE for improving throwing performance. To our knowledge the effectiveness of a strength training program that uses exclusively CKCE is unknown. In this study, we examined the effectiveness of CKCE vs. OKCE strength training programs in women enrolled in an introductory strength training program. Twenty-six participants were randomized to OKCE (traditional exercises) or CKCE (sling-based exercises). Participants completed 6 sets per week for 13 weeks. Pre and posttraining evaluations included the following: 1 repetition maximum (1RM) leg and bench press; sling exercise push-ups; isokinetic dynamometry; lateral step-down test; and the Star Excursion Balance Test. Both groups significantly improved bench press (by an average of 4-6 kg) and leg press (by an average of 23-35 kg) (p < 0.001). There was a significant group × time interaction (p < 0.001) for sling exercise push-ups (OKCE pre = 5.5 ± 8.6, OKCE post = 6.1 ± 8.2, CKCE pre = 6.8 ± 6.0, CKCE post = 16.9 ± 6.6). Isokinetic measures of knee extension, knee flexion, shoulder internal rotation, and shoulder external rotation increased (improvements ranged from 2.7 to 27.7%), with no group differences. Both OKCE and CKCE strength training elicited similar changes in balance. We conclude that CKCE training is equally as effective as OKCE training during the initial phases of a strength training program in women. The fact that only CKCE improved sling exercise push-ups supports previous findings suggesting functional superiority of CKCE.