The Effects of Exercise on Appetite in Older Adults: A Systematic Review and Meta-Analysis

Abstract

Background: The effect of physical activity and exercise on hunger and satiety has been well-studied in younger adults, but the influence of aging is less understood. While some evidence suggests that acute bouts of exercise induce a compensatory eating drive, long-term activity may improve satiety sensitivity. The objective of this study was to investigate the effects of exercise on appetite in older adults.Methods: We systematically reviewed available literature investigating the effect of exercise on appetite in older adults adults (CRD42020208953). PubMed, PsycINFO, Academic Search Complete, the Sports Medicine & Education Index, and Web of Science, were searched for peer-reviewed articles published in English with no date restriction. Included studies implemented a primary exercise or physical activity intervention with a control group, on a generally healthy population ≥60 years of age. Selected studies included at least one appetite outcome. Risk of bias was assessed using the 11-point Physiotherapy Evidence Database (PEDro) tool. Standardized mean difference summary statistics (Hedge's g effect sizes) and 95% confidence intervals were reported.Results: We identified 15 reports (13 studies) which met all inclusion criteria (5 resistance training, 3 aerobic, 6 mixed modalities). Studies included 443 participants (Age = 68.9 ± 5.2, 82.3% female) and had generally “good” bias scores (PEDro = 6.4 ± 0.88). Random effects meta-analyses revealed that the exercising group showed statistically significant reductions in glucose [SMD = −0.34 (95% CI: −0.67, −0.02), p < 0.05, PEDro =6.4 ± 0.45] and leptin [SMD = −0.92 (95% CI: −1.28, −0.57), p < 0.00001, PEDro = 6.2 ± 0.75].Discussion: This systematic review revealed that exercise and physical activity may modulate resting hunger and satiety in older adults. Decreases in fasting leptin and glucose hormones suggest that exercise promotes satiety sensitivity in adults aged 60+. This review highlights that engaging in exercise and activity programs may provide a meaningful avenue for improving chronic and functional disease burden in later life by promoting appetite control and balanced energy intake. Recommendations for future research include investigations of appetite in response to varied exercise modalities within more diverse and representative samples of older adults.

Lifestyle Factors Associated with Undernutrition in Older People after the Great East Japan Earthquake: A Prospective Study in the Fukushima Health Management Survey

“…On the other hand, although physical activity was not associated with the occurrence of undernutrition after adjusting for BMI, there is still a possibility that physical activity before the disaster may work to prevent undernutrition. A systematic review found that physical activity promotes appetite control and balanced energy intake [ 30 ]. It also reports that physical activity is the least expensive day drug therapy because enhanced physical activity lowers the depression risk and shows a preventive effect [ 31 ].…”

Sarcopenia is associated with mortality in non-critical elderly patients visiting the emergency department

“…Gut dysbiosis, the imbalance of gut microbiota, affects nutrition absorption in the entericus and causes malnutrition to some extent ( 58 , 59 ). Increased daily activities or physical exercises improve the appetite, which may reduce the risk of sarcopenia ( 60 , 61 ). Moreover, exercises can trigger gut microbiota secreting short-chain fatty acids with anti-inflammatory effects, reduce oxidative stress, and maintain muscle mass ( 62 – 64 ).…”

Association between dietary patterns and subjective and objective measures of physical activity among Japanese adults aged 85 years and older: a cross-sectional study

“…This may eventually lead to phenotypic outcomes such as weight loss and loss of muscle mass (37) , while it has been argued that PA has the potential to modulate resting hunger and satiety in the older population and may benefit the older population by promoting EBRB. However, increased lean body mass and RMR have been observed but may not necessarily be associated with increased energy intake (38)(39)(40) . The association between a healthy or high-quality diet and PA could be explained by the participants' socio-economic status and living status (41,42) .…”