EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH, Clermont Auvergne University, Clermont-Ferrand, Auvergne, France.
International Research Chair Health in Motion, Clermont Auvergne University Foundation, Clermont-Ferrand, France.
Obes Rev. 2024 Dec;25(12):e13832. doi: 10.1111/obr.13832. Epub 2024 Sep 12.
This systematic review and meta-analysis synthesized evidence pertaining to consummatory and appetitive responses to acute exercise in children and adolescents with and without obesity (5-18 years). Articles reporting on supervised, controlled trials of any modality, duration, or intensity with laboratory-measured food intake were found using MEDLINE, EMBASE, and Cochrane up to July 2023. Differences between conditions in laboratory energy and macronutrient intake, appetite sensations, and food reward were quantitatively synthesized using random-effects meta-analyses. Thirty-five studies were eligible for the systematic review of energy intake, consisting of 60 distinct intervention arms with lean (n = 374) and overweight/obesity participants (n = 325; k = 51 eligible for meta-analysis). Study quality as indicated by the Effective Public Healthy Practice Project tool was rated as low and moderate risk of bias for 80% and 20% of studies, respectively. Acute exercise had no significant effect on energy intake during an ad libitum test meal (mean difference [MD] = -4.52 [-30.58, 21.54] kcal, p = .729). Whilst absolute carbohydrate intake was lower after exercise (23 arms; MD = -6.08 [-11.26, -0.91] g, p = .023), the proportion of carbohydrate was not (30 arms; MD = -0.62 [-3.36, 2.12] %, p = .647). A small elevation in hunger (27 arms; MD = 4.56 [0.75, 8.37] mm, p = .021) and prospective food consumption (27 arms; PFC; MD = 5.71 [1.62, 9.80] mm, p = .008) was observed post-exercise, but not immediately prior to the test meal (Interval: Mdn = 30 min, Range = 0-180). Conversely, a modest decrease in explicit wanting for high-fat foods was evident after exercise (10 arms; MD = -2.22 [-3.96, -0.47] mm, p = .019). Exercise intensity (p = .033) and duration (p = .013) moderated food intake only in youth with overweight/obesity, indicating lower intake at high intensity and short duration. Overall, acute exercise does not lead to compensation of energy intake or a meaningful elevation of appetite or food reward and might have a modest benefit in youth with overweight/obesity if sufficiently intense. However, conclusions are limited by substantial methodological heterogeneity and the small number of trials employing high-intensity exercise, especially in youth with overweight/obesity.
本系统评价和荟萃分析综合了有关肥胖（5-18 岁）和非肥胖儿童和青少年急性运动对摄食和食欲反应的证据。使用 MEDLINE、EMBASE 和 Cochrane 数据库，截至 2023 年 7 月，检索到了关于任何模式、持续时间或强度的监督、对照试验的文章，这些试验都进行了实验室测量的食物摄入量。使用随机效应荟萃分析对实验室能量和宏量营养素摄入、食欲感觉和食物奖励方面的条件差异进行了定量综合。有 35 项研究符合能量摄入的系统评价标准，其中包括 60 个不同的干预组，分别有瘦组（n=374）和超重/肥胖组（n=325；k=51 项符合荟萃分析标准）。根据有效公共卫生实践项目工具进行的研究质量评估，80%的研究为低质量，20%的研究为中度偏倚风险。在随意测试餐中，急性运动对能量摄入没有显著影响（平均差异[MD]=-4.52[-30.58, 21.54]kcal，p=0.729）。虽然运动后绝对碳水化合物摄入量较低（23 组；MD=-6.08[-11.26, -0.91]g，p=0.023），但碳水化合物的比例并没有变化（30 组；MD=-0.62[-3.36, 2.12]%，p=0.647）。运动后观察到饥饿感（27 组；MD=4.56[0.75, 8.37]mm，p=0.021）和预期食物消费（27 组；PFC；MD=5.71[1.62, 9.80]mm，p=0.008）略有升高，但在测试餐前即刻没有升高（间隔：中位数=30 分钟，范围=0-180）。相反，运动后明显降低了对高脂肪食物的明确渴望（10 组；MD=-2.22[-3.96, -0.47]mm，p=0.019）。运动强度（p=0.033）和持续时间（p=0.013）仅在超重/肥胖的青少年中调节食物摄入，表明高强度和短时间运动的摄入较低。总的来说，急性运动不会导致能量摄入的补偿，也不会显著增加食欲或食物奖励，在超重/肥胖的青少年中，如果运动强度足够大，可能会有适度的益处。然而，结论受到方法学异质性较大和采用高强度运动的试验数量较少的限制，尤其是在超重/肥胖的青少年中。
