Showing posts with label adolescents. Show all posts
Showing posts with label adolescents. Show all posts

Wednesday, November 4, 2015

Trying to Shed That Belly? Step Off the Treadmill and Grab Some Weights, Boys & Girls! 19x More Visceral, 1.5x Higher Subcutaneous Fat Loss W/ Resistance Training in Youths

Specifically for teenagers it may be important to work out in both aerobic and anaerobic workouts. So, this would be another reason to favor the combined over the other regimen.
You will probably have overheard the "knowledgeable" trainers at the gym tell their credulous clients, who just told them they "want to lose that belly fat", that the best thing they could do was to "stop spending that much time with weight training" and to do some more (steady state) cardio. Well, in general, there's nothing wrong about steady state cardio - in fact, many studies show that it is superior to resistance training when it comes to "merely" shedding body weight (in the obese). If "weight loss" is still everything you're aspiring, though, you are either new to the waredownloadsoft or another of the "headline skimmers" who happen to ask questions that are answered not just in the article, but actually in one of the red boxes... ah, I am digressing.

So, what I actually wanted to tell you is that a recent study from the Universities of Ottawa and Calgary (Alberta. 2015), clearly contradicts the average commercial gym chain trainer's recommendation and shows that belly fat loss is better achieved with diet + resistance training.
Are you looking for muscle builders for the year 2015? Find inspiration in these articles:

Tri- or Multi-Set Training for Body Recomp.?

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Pre-Exhaustion Exhausts Your Growth Potential

Full ROM ➯ Full Gains - Form Counts!

Battle the Rope to Get Ripped & Strong

Study Indicates Cut the Volume Make the Gains!
The subjects of the study were youngsters, 304 (! the high number of participants is a huge plus of the study) 14-18 year-old overweight and obese teenagers (mean body fat almost 50%!), to be specific, who were randomized to four different treatments for 22 weeks:
Table 1: Training progression in the Aerobic
and Resistance group (Alberga. 2015)
  • aerobic training (Aerobic), 
  • resistance training (Resistance),
  • combined aerobic + resistance training (Combined) or 
  • non-exercising control group (Control)
Adolescents,... ok, but unless they're too sarcopenic (=suffer from pronounced age-induced muscle loss) to hit the weights, your overweight clients or you, yourself, should be able to follow the same training programs the adolescents did and see similar results if you fully adhere to the following training prescriptions:
  • Resistance: The duration of each session progressed to a maximum of about 45 min. Exercises were primarily performed on weight machines, and when required with dumbbells (lateral raise, shrugs, bicep curls, front raise, preacher curl, dumbbell pullover) or by using one's own body weight as resistance (lunges, sit-ups and abdominal crunches).
    Table 2: Overview of the individual workouts in the Resistance group (Alberga. 2015).
    Participants alternated among exercises from groups A1, A2, B1 and B2 shown in Table 2. Participants were asked to rest for ~ 2 min between sets and were instructed on proper breathing techniques.
  • Aerobic: Participants randomized to the aerobic training group underwent a 22-week program (Table 1, left) wherein the exercise intensity and duration increased progressively to a maximum of 45 min per session. Exercise was performed on a cycle ergometer, elliptical or treadmill and participants were free to vary the machine(s) used. Exercise intensity was standardized using heart rate monitors (Polar Electro Oy, Kempele, Finland).
  • Combined: This group performed the full exercise programs done by both the aerobic and resistance training groups (Table 1, left + right) during each session for a total of 4 times per week for a maximum of 90 min per session.
Now for simplicity we assume that you'd actually achieve not just similar, but rather the exact same results as the virtual "average" study participant from Alberta's trial. In this case, I bet that most of you would prefer to lose -22.7 cm² subcutaneous body fat with resistance training than -16.2 cm² or -18.7 cm² with either aerobic or combined training. Specifically in view of the fact that only resistant and combined training triggered measurable reductions in visceral body fat, too.
Figure 1: Changes in subcutaneous (SAT) and visceral (VAT) body fat at different regions; L4L5 represents area between 4th and 5th Lumbar vertebrae; * indicates sign. difference to control; # sign. difference to aerobic (Alberga. 2015).
On the other hand, a closer look at the body fat data in Figure 1 also shows that aerobic training is the only form of training that will reduce the deep subcutaneous fat, significantly. Plus: When it's done in combination with resistance training the reductions in subcutaneous fat at L4L5, which represents the area between 4th and 5th Lumbar vertebrae, are still statistically significant and not significantly smaller than those the subjects in the resistance training only arm of the study achieved. 
Figure 2: Changes in Apo-B and Apo-B/A ratio in the three exercise and the control group (Alberta. 2015).
What may eventually tip the scale in favor of the combined training regimen, though, is not the body composition data, but rather the fact that only the combined training routine triggered statistically significant, heart healthy changes in Apolipoprotein B and the Apolipoprotein A/B ratio. After all, the latter has "repeatedly been shown to be a better marker than lipids, lipoproteins and lipid ratios" (Walldius. 2006) - scoring in the top tertile for the ApoB/A ratio, for example has consistently been associated with 89% increased risk of heart disease (Thompson. 2006) .
Figure 3: In their 2005 trial, Tufts scientists were able to show that dietary adherence, not macronutrient comp. or other diet-specific parameters is the main determinant of weight loss (Dansinger. 2005).
You must never forget, however, ... that (a) the beneficial of all four exercise regimen were achieved in the context of an energy deficit of albeit relatively, but consistent -250 kcal/day, that (b) the study had a 4-week lead-in during which all participants that didn't show at least 80% adherence to the dietary + exercise baseline intervention were kicked out, and that (c) subjects who did not attend an average 2.8 out of 3.0 workouts per week were not included in the analysis the data in Figures 1-2 is based.

This obviously leads back to Energy restriction and adherence - the two usual suspects. Without them, any effort to shed the hated body fat must fail. With them, however, only perseverance and consistency may keep from achieving your fat loss goals.

You don't believe that? Well, check out the data in Figure 3. Dansiger and his colleagues from the Tufts University tried to find out which diet, i.e. Ornish, Zone, Weight Watchers, or Atkins die, would cut the most body weight. What they found, though, was that it's always the diet the subjects could adhere to that worked the best. Against that background, it's no wonder that, in the study at hand, only those participants who had more than the minimal 70% adherence to their (aerobic) workout regimen actually lost significant amounts of deep subcutaneous fat tissue.. speaking of adherence, there were no significant differences in adherence between the three training regimen; only the control treatment on the couch obviously had 100% adherence ;-) | Comment on FB!
References:
  • Alberga, A. S., et al. "Effects of aerobic and resistance training on abdominal fat, apolipoproteins and high-sensitivity C-reactive protein in adolescents with obesity: the HEARTY randomized clinical trial." International journal of obesity (2005) (2015).
  • Dansinger, Michael L., et al. "Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial." Jama 293.1 (2005): 43-53.
  • Thompson, A., and J. Danesh. "Associations between apolipoprotein B, apolipoprotein AI, the apolipoprotein B/AI ratio and coronary heart disease: a literature‐based meta‐analysis of prospective studies." Journal of internal medicine 259.5 (2006): 481-492.
  • Walldius, G., and I. Jungner. "The apoB/apoA‐I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid‐lowering therapy–a review of the evidence." Journal of internal medicine 259.5 (2006): 493-519.
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Breakfast: Eat it or Skip it? Making it High Protein Will Have Habitually Skipping Teens Lose Fat & Curbs Their Hunger

This could have been the HP breakfast. Egg-based pancakes + ham.
It is almost like the question "to carb" or "not to carb" and the almost religiously maddish discussions between carb-eaters and ketophiles: The debate revolving around the useful- or uselessness of breakfast, when it comes to health and physique issues.

In my more recent articles about the topic I have repeatedly exposed the claim that "not having breakfast is bad for everyone" is total bogus; and while I am not going to go back on that I am about to discuss a study that demonstrates that the right breakfast, i.e. one that's high in protein, may be extremely better than having no breakfast at all.
Learn more about fasting and eating / skipping breakfast at the waredownloadsoft

Breakfast and Circadian Rhythm

Does Meal Timing Matter?

Breakfast & Glucose Metab.

Break the Fast, Cardio & the Brain

Does the Break- Fast-Myth Break?

Breakfast? (Un?) Biased Review
Said study has been conducted by scientists from the University of Missouri and the Purdue University (Leidy. 2015). It's an investigation into the effects of normal-protein (NP) vs. high-protein (HP) breakfast meals on appetite control, food intake, and body composition in “breakfast skipping” young people with overweight/obesity.

As a waredownloadsoft reader you'll know that previous studies suggest that as habitual breakfast skippers, the youths are actually not the ideal study object for a study to show beneficial effects of breakfast. After all, a recent study by Thomas et al. showed quite convincingly that "Whether Skipping Breakfast Increases Insulin, Hunger and Blood Lipids Depends on One's Breakfast Habits" (read the article). Is this a problem? Well, it could be if the new study yielded negative results. After all, we'd have to argue that this was to be expected if the subjects were habitual breakfast skippers.
Table 1: Subject characteristics at baseline (Leidy. 2015). As you can see the subjects were randomly assigned to the three groups at a ratio of 1:2:2 to breakfast skipping, normal protein (NP) and high protein (HP) breakfast.
Luckily, the results were positive and the study with its 12-week study period probably long enough to overcome the effects of habituation which mess with the results of all studies which test the effect of having vs. skipping breakfast on only one or two occasions.
Figure 1: Macronutrient composition (g) of the test meals used in the study (Leidy. 2015)
The study at hand, however, had its fifty-seven adolescent subjects (age: 19 +/- years; BMI: 29.7 +/- 4.6 kg/m²) complete a 12-week randomized controlled trial in which the adolescents consumed either a 1,464 kJ NP breakfast (13 g protein), an isocaloric breakfast with a high protein content (HP | 35 g protein), or continued to skip breakfast (CON). The main outcome variables were the subjects' pre- and post-study appetite, their food intake, body weight, and body composition, which was assessed assessed via DXA scans (which are as you know still the "gold standard" for measuring the body composition of subjects in scientific studies)
In Schlundt's 12-week study in which the subjects had to follow the same energy reduced diet pattern one time with, one time without breakfast the marginal differences in weight loss and fat loss (the former favors breakfast, the latter skipping it) were just as statistically non-significant as the other inter-group differences the US scientists observed (Schlundt. 1992).
In the long run, calories count. So if you are counting calories it doesn't matter if you have breakfast or don't. There are bazillions of "breakfast eating vs. skipping"-studies, but this is only study #3 to test the long-term effects. Yes, sometimes science is pathetic and stupid - and trying to elucidate the health effects of eating vs. skipping breakfast in studies on three testing days is both: pathetic and stupid.

One of the two non-pathetic studies comes from Schlundt et al. who examined the effects of consuming breakfast vs. breakfast skipping during a 12-week energy restriction weight loss diet in 52 adult women with obesity without finding significant differences.

More recently, Dhurandhar et al. completed a 16-week study in 309 adults with obesity and included a general recommendation to either "eat breakfast" or "skip breakfast". As it was to be expected when energy intake is controlled for, again, no differences in weight loss were observed in those who began eating breakfast compared to those who continued to skip breakfast.
The NP and HP groups were provided with specific breakfast meals to consume between 6:00 and 9:45am each day, while the CON group continued to skip breakfast (with nothing to eat/drink, besides water) before 10:00am - with significant consequences as the in parts significant inter-group differences in Figure 2 can tell you.
Figure 2: Comparison of the changes in fat mass, the daily food intake, hunger and fullness ratings in the subjects from the CON (=kept skipping breakfast), NP (normal protein) and HP (high protein) breakfast groups (Leidy. 2015).
The superiority of (a) having breakfast and (b) consuming a high protein breakfast are not debatable. With its 12-week study duration, the study at hand obviously allowed for a full habituation and did thus - much in contrast to many short-term studies - yield all the benefits that are usually ascribed to having breakfast. In particular, having breakfast...
  • "Breakfast!? An (Un-)Biased (?) Review of the Breakfast Myth" | read it!
    made the subjects magically lose (HP) or at least not gain (NP) superfluous body fat.
  • significantly reduced the daily energy intake in the high protein condition and buffered the significant increase in energy intake in the no breakfast condition if the breakfast had a normal protein content,
  • reduced the total time during which the subjects were hungry not just in the morning, but 24/7, and
  • increased the subjects' fullness, especially in the morning.
In that it's important to highlight that the high protein breakfast outperformed the normal protein breakfast in all relevant categories, i.e. change in body fat, change in daily energy intake and change in hunger ratings, Accordingly, Leidy et al. are right when they highlight only the high protein breakfast in their conclusion which says that
"daily addition of a HP breakfast improved indices of weight management as illustrated by the prevention of body fat gain, voluntary reductions in daily intake, and reductions in daily hunger in breakfast skipping adolescents with overweight/obesity." (Leidy. 2015)
In spite of that, we should not forget that even a regular breakfast which contained 15% protein, 65% carbohydrates, and 20% fat and consisted of (you guessed it) ready-to-eat cereals with milk outperformed not having breakfast at all. That's in contrast to some previous studies, most of which used shorter study durations and didn't allow for the habituation that's necessary for breakfast to have effects on the total energy intake, for example, to take place.
The study at hand is an excellent example that shows that the previously observed effects of habitation can be overcome if you adhere to your new breakfast protocol meticulously. 
So what? If you have a teenage son or daughter, serve him / her a high protein breakfast containing 40% protein, 40% carbohydrates, and 20% fat, like an egg-based pancakes and ham; egg-based waffles with pork-sausage; egg and pork scramble; and an egg and pork burrito (all these were options the subjects in the study at hand were provided with on a weekly basis. It's going to help them manage their weight, food cravings, and hunger pangs and it's not going to take you an hour to prepare (rather 15 min - max). The scientists assertion that "it is unclear as to whether the daily consumption of a high-protein breakfast, containing 35 g of protein, is feasible in a free-living environment" (Leidy. 2015) is just more pathetic evidence that people care so little about their health that they'd rather die from eating ready-made cereals than to invest the 10-15 minutes to prepare delicious and healthy protein pancakes into their health.

If you are now contemplating to switch back to having breakfast, yourself, let me remind you that it is not possible to extrapolate study results that were generated with a specific group of subjects, in this case overweight, but still healthy adolescents to whomever you want. If you are on an energy controlled diet and skipping breakfast as a means to do intermittent fasting and reduce your overall energy intake, you won't reduce your 24h energy intake (after all, you're eating X kcal everyday, anyway).  It is thus unlikely that you'd lose more weight than you'd do without breakfast and if you are like many people you will probably even feel hungrier now that you're able to eat only 3 small vs. 1-2 large(r) meals | Comment on Facebook!
References:
  • Dhurandhar, Emily J., et al. "The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial." The American journal of clinical nutrition 100.2 (2014): 507-513.
  • Leidy, Heather J., et al. "A high‐protein breakfast prevents body fat gain, through reductions in daily intake and hunger, in “Breakfast skipping” adolescents." Obesity (2015).
  • Schlundt, David G., et al. "The role of breakfast in the treatment of obesity: a randomized clinical trial." The American journal of clinical nutrition 55.3 (1992): 645-651.
  • Thomas, Elizabeth A., et al. "Usual breakfast eating habits affect response to breakfast skipping in overweight women." Obesity 23.4 (2015): 750-759.
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