Perspective: Is the Response of Human Energy Expenditure to Increased Physical Activity Additive or Constrained?

Gonzalez, Javier T.; Batterham, Alan M.; Atkinson, Greg; Thompson, Dylan

doi:10.1016/j.advnut.2023.02.003

Cited by 12 publications

(7 citation statements)

References 75 publications

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“…149 150 However, whether increased physical exercise alone, without LEA, is additive or constrained total daily energy expenditure remains debated. 151 Accordingly, it is well established that problematic LEA can result in energy conservation reflected in reduced RMR. 152 While some studies have reported lower RMR in athletes with apparent LEA compared with healthy counterparts, 62 153 154 others have failed to demonstrate this.…”

Section: Potential Indicatorsmentioning

confidence: 99%

Review of the scientific rationale, development and validation of the International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool: V.2 (IOC REDs CAT2)—by a subgroup of the IOC consensus on REDs

Stellingwerff,

Mountjoy,

McCluskey

et al. 2023

Br J Sports Med

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Relative Energy Deficiency in Sport (REDs) has various different risk factors, numerous signs and symptoms and is heavily influenced by one’s environment. Accordingly, there is no singular validated diagnostic test. This 2023 International Olympic Committee’s REDs Clinical Assessment Tool—V.2 (IOC REDs CAT2) implements a three-step process of: (1) initial screening; (2) severity/risk stratification based on any identified REDs signs/symptoms (primary and secondary indicators) and (3) a physician-led final diagnosis and treatment plan developed with the athlete, coach and their entire health and performance team. The CAT2 also introduces a more clinically nuanced four-level traffic-light (green, yellow, orange and red) severity/risk stratification with associated sport participation guidelines. Various REDs primary and secondary indicators have been identified and ‘weighted’ in terms of scientific support, clinical severity/risk and methodological validity and usability, allowing for objective scoring of athletes based on the presence or absence of each indicator. Early draft versions of the CAT2 were developed with associated athlete-testing, feedback and refinement, followed by REDs expert validation via voting statements (ie, online questionnaire to assess agreement on each indicator). Physician and practitioner validity and usability assessments were also implemented. The aim of the IOC REDs CAT2 is to assist qualified clinical professionals in the early and accurate diagnosis of REDs, with an appropriate clinical severity and risk assessment, in order to protect athlete health and prevent prolonged and irreversible outcomes of REDs.

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Section: Potential Indicatorsmentioning

confidence: 99%

Review of the scientific rationale, development and validation of the International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool: V.2 (IOC REDs CAT2)—by a subgroup of the IOC consensus on REDs

Stellingwerff,

Mountjoy,

McCluskey

et al. 2023

Br J Sports Med

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“…The constrained energy model is intriguing and explains REDs as a necessary reduction in metabolic rate in athletes with high EEE. However, it has been noted that its support comes from cross-sectional observational data and statistical models that compare extremely varied populations 101. It is likely that the level of Constraint vs Addition with respect to physical activity varies across populations, according to factors such as individual characteristics, the level of energy expenditure and the presence of energy balance vs energy deficit 96 101.…”

Section: Methodsmentioning

confidence: 99%

“…However, it has been noted that its support comes from cross-sectional observational data and statistical models that compare extremely varied populations 101. It is likely that the level of Constraint vs Addition with respect to physical activity varies across populations, according to factors such as individual characteristics, the level of energy expenditure and the presence of energy balance vs energy deficit 96 101. Indeed, insights from endurance athletes have contributed to a model that predicts that at low activity levels, exercise is added to total energy expenditure, with moderate to high EEE leading to some partial compensation to achieve energy savings, including behavioural changes to reduce non-exercise activity thermogenesis (NEAT) 94.…”

Section: Methodsmentioning

confidence: 99%

Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs

Burke,

Ackerman,

Heikura

et al. 2023

Br J Sports Med

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The 2023 International Olympic Committee (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) notes that exposure to low energy availability (LEA) exists on a continuum betweenadaptableandproblematicLEA, with a range of potential effects on both health and performance. However, there is variability in the outcomes of LEA exposure between and among individuals as well as the specific manifestations of REDs. We outline a framework for a ‘systems biology’ examination of the effect of LEA on individual body systems, with the eventual goal of creating an integrated map of body system interactions. We provide a template that systematically identifies characteristics of LEA exposure (eg, magnitude, duration, origin) and a variety of moderating factors (eg, medical history, diet and training characteristics) that could exacerbate or attenuate the type and severity of impairments to health and performance faced by an individual athlete. The REDs Physiological Model may assist the diagnosis of underlying causes of problems associated with LEA, with a personalised and nuanced treatment plan promoting compliance and treatment efficacy. It could also be used in the strategic prevention of REDs by drawing attention to scenarios of LEA in which impairments of health and performance are most likely, based on knowledge of the characteristics of the LEA exposure or moderating factors that may increase the risk of harmful outcomes. We challenge researchers and practitioners to create a unifying and dynamic physiological model for each body system that can be continuously updated and mapped as knowledge is gained.

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“…Die empirische Evidenz des energy constraint-model beruht wesentlich auf Ergebnissen von Beobachtungsstudien, es gibt bisher keine überzeugende Interventionsstudie [6]. Die Hypothese bleibt also zu hinterfragen (siehe hierzu und im Folgenden [36]). Kritisch bleibt, dass in den Studien der Energieverbrauch für körperliche Aktivitäten nicht direkt gemessen, sondern indirekt aus der Differenz von 24-Stunden-und Ruheenergieverbrauch berechnet und der constraint modelliert wurde.…”

Section: ) Eine Hohe Körperliche Aktivität Und Eine Gewichtsabnahme B...unclassified

Die Energiebilanz charakterisiert Adipositas, sie erklärt sie aber nicht und sie ermöglicht keine Strategien für eine nachhaltige Behandlung

Bosy-Westphal,

Müller

2023

Adipositas - Ursachen, Folgeerkrankungen, Therapie

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ZusammenfassungDie Energiebilanz dient häufig zur Erklärung der Entstehung von Übergewicht sowie als Basis für konservative Therapiemaßnahmen. Dies impliziert, dass Übergewicht durch eine zu hohe Energieaufnahme und/oder einen Mangel an Bewegung erklärt ist und somit eine Verringerung der Energiezufuhr oder eine Erhöhung des Energieverbrauchs zu einem Energiedefizit und damit zu einer Gewichtsabnahme führen. Dieses vereinfachende Paradigma lässt jedoch die Regulation der Energiebilanz außer Acht und verkennt damit die eigentlichen Ursachen und Therapieoptionen von Übergewicht. Die Kontrolle der Energiebilanz ist ein dynamischer Prozess, bei dem Veränderungen in einer Komponente der Energiebilanz eine Kompensation in anderen Komponenten des Systems zur Folge haben. Darüber hinaus haben Kalorien aus verschiedenen Makronährstoffquellen oder zu unterschiedlichen Tageszeiten verzehrt metabolische Auswirkungen, die über ihren Wert als Brennstoff hinausgehen, zu einer Änderung der Partitionierung der Energie im Stoffwechsel führen und damit den Appetit steigern. Die Energiebilanz dient nicht einer Lösung des Adipositasproblems. Diese ergeben sich aus dem Verständnis der Determinanten und Interaktion von Lebensstilfaktoren wie Zuckerkonsum, Snacking-Behavior und körperlicher Aktivität im Hinblick auf adipogene Stoffwechselveränderungen.

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Perspective: Is the Response of Human Energy Expenditure to Increased Physical Activity Additive or Constrained?

Cited by 12 publications

References 75 publications

Review of the scientific rationale, development and validation of the International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool: V.2 (IOC REDs CAT2)—by a subgroup of the IOC consensus on REDs

Review of the scientific rationale, development and validation of the International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool: V.2 (IOC REDs CAT2)—by a subgroup of the IOC consensus on REDs

Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs

Die Energiebilanz charakterisiert Adipositas, sie erklärt sie aber nicht und sie ermöglicht keine Strategien für eine nachhaltige Behandlung

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