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Background People with cystic fibrosis (pwCF) derive several physiological and psychological benefits from regular physical activity (PA), but the practice is lower than recommended. Knowledge about the facilitators of and barriers to PA at the individual level is important to act positively on PA behaviors. This study validated the Cystic Fibrosis Decisional Balance for Physical Activity scale (CF-DB-PA) for adults with CF. Methods French adults with CF were recruited in several specialist centres in France. The CF-DB-PA scale was validated following a quantitative study protocol comprising four stages: (1) tests of the clarity and relevance of a preliminary 44-item version and reduction analysis, (2) confirmatory factor analysis and tests of dimensionality through equation modelling analysis, (3) tests of reliability with Cronbach alphas for the internal consistency and a test–retest with a 2-to-3 week interval for temporal stability, and 4) tests of construct validity with Spearman correlations to measure the associations between each subscale and the theoretically related constructs (i.e., quality of life, PA and exercise tolerance). Results A total of 201 French adults with CF participated in the validation study. The CF-DB-PA comprises 23 items divided into two factors: facilitators of and barriers to PA. Each factor is divided into three subscales: physical, psychological and environmental. The factors (facilitators and barriers) can be used independently or combined as a whole. A general score of decisional balance for PA can also be calculated. The bi-factor model presented satisfactory adjustment indexes: χ2 (194) = 362.33; p < .001; TLI = .87; CFI = .90; RMSEA = .067. The scale showed satisfactory internal consistency (Cronbach’s α = .77). The test–retest reliability was not significant for either subscale, indicating stability over time. The facilitators subscale correlated significantly with the self-reported score of PA (r = .33, p < .01) and quality of life (r = .24, p < .05). The barriers subscale correlated significantly with the self-reported scores of PA (r =  − .42, p > .01), quality of life (r =  − .44, p < .01), exercise tolerance (r =  − .34, p < .01) and spirometry tests (r =  − .30, p < .05). Conclusions The CF-DB-PA is a reliable and valid questionnaire assessing the decisional balance for PA, the facilitators of and the barriers to PA for adults with CF in French-speaking samples.

Nutritional advice to optimise athletic performance is often not applicable for the majority of people who exercise for health or weight maintenance. A common perception by laypersons is that exercising on an empty stomach (fasted) increases fat oxidation, hence aids fat loss (1) . However research on feeding around exercise mainly focuses on performance in trained or semi-trained individuals (2) . Furthermore, research is most commonly undertaken on males, despite accepted gender difference in substrate metabolism and energy expenditure (EE) (3) . This study aimed to investigate the impact of CHO consumption before and after treadmill exercise on substrate utilization and total EE in untrained men and women.Fifteen healthy, untrained subjects (7 male, 8 female) aged 21-33 years undertook a randomised crossover study. Subjects completed 2 treatments, separated by a washout period ( ‡ 3 days), following an overnight fast. At each treatment subjects exercised for £ 30 min on a treadmill at approximately 70 % VO2 max, with 30 g of maltodextrin or placebo ingested either before or after exercise. EE (kJ/min), and Fat and CHO utilization (g/hr) during and over 3 hours post exercise were estimated by indirect calorimetry. This study was approved by the University of Surrey Faculty of Health and Medical Sciences Ethics Committee.Fat oxidation rates between CHO and placebo were only significantly different during exercise for males (placebo > CHO), and during recovery for females (placebo > CHO). Over the whole study a significant difference in total fat oxidation (g) between the two feeding regimes was observed in females (P = 0.034) but not males (see Table 1). Males had a significantly greater difference in total fat oxidation (g) (P = 0.018) and % EE from fat oxidation (P = 0.037) compared with females between treatments. Significant gender differences in EE (kcal/d/kg) were observed during recovery following CHO intake only with males expended 160 kcal/d/kg more than females (P = 0.05).

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