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Understanding the Interaction between Physical Activity and Diet for the Promotion of Health and Fitness

published: 13 January 2022
doi: 10.3389/fnut.2021.835535
Frontiers in Nutrition | 1January 2022 | Volume 8 | Article 835535
Edited and reviewed by:
David Christopher Nieman,
Appalachian State University,
United States
Karsten Koehler
Specialty section:
This article was submitted to
Sport and Exercise Nutrition,
a section of the journal
Frontiers in Nutrition
Received: 14 December 2021
Accepted: 20 December 2021
Published: 13 January 2022
Koehler K and Drenowatz C (2022)
Editorial: Understanding the
Interaction Between Physical Activity
and Diet for the Promotion of Health
and Fitness. Front. Nutr. 8:835535.
doi: 10.3389/fnut.2021.835535
Editorial: Understanding the
Interaction Between Physical Activity
and Diet for the Promotion of Health
and Fitness
Karsten Koehler 1
*and Clemens Drenowatz 2
1Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany, 2Division of Sport, Physical
Activity and Health, University of Education Upper Austria, Linz, Austria
Keywords: exercise, eating behavior, weight loss, lifestyle, long-term health, energy balance
Editorial on the Research Topic
Understanding the Interaction Between Physical Activity and Diet for the Promotion of Health
and Fitness
The benefits of regular physical activity and a healthy diet are well-documented in the literature
(1,2). However, efforts to counter the global obesity epidemic and related metabolic diseases
through interventions focusing on either physical activity or diet alone have been of limited success
(3,4), highlighting the need for new, more refined and integrated approaches. Although it appears
intuitive that interventions combining both lifestyle components have the capacity to result in
greater health benefits than singular approaches (5), it is also possible that changing behavior related
to one component may result in compensatory changes in the other. For example, the obvious
health benefits of increased physical activity may be overridden when the resulting increase in
energy expenditure is compensated by an increase in dietary energy intake and unhealthier food
choices (6). Likewise, dietary interventions such as caloric restriction may result in compensatory
reductions in physical activity behavior (7), which could negatively affect physical fitness and
performance, undermine weight loss success, and expose individuals to greater risk for future
weight regain and other associated diseases (810).
The goal of this Research Topic was to strengthen our understanding of how physical activity
and diet are related with each other in the context of health and fitness promotion. As such, this
Research Topic includes research targeting physical activity, which refers to any bodily movement
that results in energy expenditure, as well as exercise, a subset of physical activity with the goal
of maintaining or improving physical fitness (11). The Research Topic combines a total of 9
original studies and systematic reviews, which cover three basic themes ranging from the interplay
between nutrition and physical activity for weight loss (theme 1), the impact of exercise on food
intake regulation (theme 2) and the potential for negative health consequences of excessive exercise
(theme 3).
Despite considerable efforts, global rates of overweight, and obesity continue to rise and excess body
weight is considered a major threat to future public health (12). Accordingly, various strategies,
including attempts to alter diet and physical activity, have been implemented to tackle the obesity
Koehler and Drenowatz Editorial: Physical Activity and Diet Interaction
epidemic. In their systematic review Correia et al. highlight
beneficial effects of intermittent fasting on body weight.
Diet-induced changes in body weight, however, are generally
short lived and even greater benefits can be accomplished
with the inclusion of exercise training. Exercise also plays
an important role for maintaining lean body mass during
caloric restriction as indicated by Roth et al. who reported
a decline in lean mass during caloric restriction despite
assuring a high protein intake. In addition to structured
programs, lifestyle adjustments also play a critical role in
weight loss. Myers et al. show that particularly vigorous
physical activity, along with a reduction in energy-dense
foods, was associated with a more pronounced weight loss
in women. Similarly, van Baak et al. report greater weight
loss during caloric restriction in participants who increase
their physical activity. Furthermore, increased physical activity
was associated with beneficial changes in various cardio-
metabolic risk factors and weight loss maintenance beyond the
intervention period.
While physical activity and exercise increase energy expenditure,
most exercisers increase their dietary energy intake. This
phenomenon, often referred to compensatory eating, was
also described in a recent study by Horner et al. who
showed that neither gastric emptying nor appetite-regulating
hormones were significantly altered after a 4-week exercise
intervention, suggesting that short-term changes in gastro-
intestinal regulation play no major role in compensatory
eating. Post-exercise food intake was also studied by Okada
et al. who reported that administration of exogenous ketones
impacted appetite-regulating hormones but failed to affect
appetite perception and post-exercise energy intake. These two
interventions are complemented by a systematic review and
meta-analysis by Hubner et al. on the effects of exercise
on appetite regulation in older adults. Despite limited
research in this demographic, exercise, and physical activity
appear to promote satiety sensitivity and appetite control,
thereby providing an avenue for reducing disease burden later
in life.
Besides the beneficial effects of physical activity and exercise
there are also some possible harmful effects that need
to be acknowledged. Ribeiro et al. discuss the potential
detrimental effects of exacerbated exercise on the gastrointestinal
environment that can, among others, impair gastric motility, and
nutrient absorption. Moore et al. further address the increased
risk for low energy availability in endurance athletes, and
emphasize the need for adequate dietary energy intake during
periods of high energy demands. The overall benefits of physical
activity, however, should not be questioned by these results.
Rather, these studies highlight the complex interaction between
diet and physical activity and their effects on the human body
and health.
This overview of current research related to physical activity and
diet highlights the importance of integrating both components
regardless whether the goal is to maximize weight loss or to
diminish the potential negative effects at the upper end of the
activity spectrum. A deeper understanding of the interaction
between these two critical lifestyle approaches is required for
the development of combined interventions involving physical
activity and diet that result in successful, long-term health
improvements while avoiding unhealthy compensatory behavior
in the other domain.
KK and CD wrote the introduction and the summary. CD
summarized the publications pertaining to weight loss and
excessive exercising. KK wrote the summaries of publications
relating to the impact of exercise on food intake regulation. Both
authors approved the submitted version.
1. Warburton DER, Bredin SSD. Health benefits of physical activity:
a systematic review of current systematic reviews. Curr Opin
Cardiol. (2017) 32:541–56. doi: 10.1097/HCO.000000000000
2. Yu E, Malik VS, Hu FB. Cardiovascular disease prevention by diet
modification: JACC health promotion series. J Am Coll Cardiol. (2018)
72:914–26. doi: 10.1016/j.jacc.2018.02.085
3. Freire R. Scientific evidence of diets for weight loss: different macronutrient
composition, intermittent fasting, and popular diets. Nutrition. (2020)
69:110549. doi: 10.1016/j.nut.2019.07.001
4. Swift DL, McGee JE, Earnest CP, Carlisle E, Nygard M, Johannsen NM. The
effects of exercise and physical activity on weight loss and maintenance. Prog
Cardiovasc Dis. (2018) 61:206–13. doi: 10.1016/j.pcad.2018.07.014
5. Clark JE. Diet, exercise or diet with exercise: comparing the effectiveness of
treatment options for weight-loss and changes in fitness for adults (18-65 years
old) who are overfat, or obese; systematic review and meta-analysis. J Diabetes
Metab Disord. (2015) 14:31. doi: 10.1186/s40200-015-0154-1
6. King NA, Horner K, Hills AP, Byrne NM, Wood RE, Bryant E, et al. Exercise,
appetite and weight management: understanding the compensatory responses
in eating behaviour and how they contribute to variability in exercise-induced
weight loss. Br J Sports Med. (2012) 46:315–22. doi: 10.1136/bjsm.2010.082495
7. Redman LM, Heilbronn LK, Martin CK, de Jonge L, Williamson DA, Delany
JP, et al. Metabolic and behavioral compensations in response to caloric
restriction: implications for the maintenance of weight loss. PLoS One. (2009)
4:e4377. doi: 10.1371/journal.pone.0004377
8. Weiss EP, Racette SB, Villareal DT, Fontana L, Steger-May K, Schechtman
KB, et al. Lower extremity muscle size and strength and aerobic capacity
decrease with caloric restriction but not with exercise-induced weight loss. J
Appl Physiol. (2007) 102:634–40. doi: 10.1152/japplphysiol.00853.2006
9. Wang X, Lyles MF, You T, Berry MJ, Rejeski WJ, Nicklas BJ. Weight regain
is related to decreases in physical activity during weight loss. Med Sci Sports
Exerc. (2008) 40:1781–8. doi: 10.1249/MSS.0b013e31817d8176
Frontiers in Nutrition | 2January 2022 | Volume 8 | Article 835535
Koehler and Drenowatz Editorial: Physical Activity and Diet Interaction
10. Locher JL, Goldsby TU, Goss AM, Kilgore ML, Gower B, Ard JD. Calorie
restriction in overweight older adults: do benefits exceed potential risks? Exp
Gerontol. (2016) 86:4–13. doi: 10.1016/j.exger.2016.03.009
11. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and
physical fitness: definitions and distinctions for health-related research. Public
Health Rep. (1985) 100:126–31.
12. Hruby A, Hu FB. The epidemiology of obesity: a big picture.
Pharmacoeconomics. (2015) 33:673–89. doi: 10.1007/s40273-014-0243-x
Conflict of Interest: The authors declare that the research was conducted in the
absence of any commercial or financial relationships that could be construed as a
potential conflict of interest.
Publisher’s Note: All claims expressed in this article are solely those of the authors
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Copyright © 2022 Koehler and Drenowatz. This is an open-access article distributed
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author(s) and the copyright owner(s) are credited and that the original publication
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Frontiers in Nutrition | 3January 2022 | Volume 8 | Article 835535
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Full-text available
There are number of means of methods to alter body composition, and metabolic issues, available for the adult who is overfat. The following is a systematic review and meta-analysis focused on comparing changes from treatment program for adults who are overfat based on analysis of aggregated effect size (ES) of inducing changes. So as to determine the relative effectiveness of such protocols and intervention plans of choice. This tiered meta-analysis of 66-population based studies, and 162-studywise groups, a clear pattern of ES being established across and within treatments. First, hypocaloric balance is necessary for changing body composition, but the effectiveness for establishing imbalance does not equate with the effectiveness for body compositional changes, or any biomarkers associated with metabolic issues. With analysis showing that there is a necessity to include exercise in combination with diet effectively elicit changes in body composition and biomarkers of metabolic issues. More importantly, the combination, resistance training (RT) was more effective than endurance training (ET) or combination of RT and ET, particularly when progressive training volume of 2-to-3 sets for 6-to-10 reps at an intensity of ≥75% 1RM, utilizing whole body and free-weight exercises, at altering body compositional measures (ES of 0.47, 0.30, and 0.40 for loss of BM, FM, and retention of FFM respectively) and reducing total cholesterol (ES = 0.85), triglycerides (ES = 0.86) and low-density lipoproteins (ES = 0.60). Additionally RT was more effective at reducing fasting insulin levels (ES = 3.5) than ET or ET and RT. Even though generally lower ES than RT, the inclusion of ET was more effective when performed at high intensity (e.g. ≥70% VO2max or HRmax for 30-minutes 3-4x’s/wk), or in an interval training style than when utilizing the relatively common prescribed method of low-to-moderate (e.g., 50-70% VO2max or HRmax for at least equal time) steady state method, ES of 0.35, 0.39, and 0.13 for BM, FM, and FFM respectively. Thus indicating that focus of treatment should be on producing a large metabolic stress (as induced by RT or high levels of ET) rather than an energetic imbalance for adults who are overfat.
Full-text available
The epidemic of overweight and obesity presents a major challenge to chronic disease prevention and health across the life course around the world. Fueled by economic growth, industrialization, mechanized transport, urbanization, an increasingly sedentary lifestyle, and a nutritional transition to processed foods and high-calorie diets over the last 30 years, many countries have witnessed the prevalence of obesity in its citizens double and even quadruple. A rising prevalence of childhood obesity, in particular, forebodes a staggering burden of disease in individuals and healthcare systems in the decades to come. A complex, multifactorial disease, with genetic, behavioral, socioeconomic, and environmental origins, obesity raises the risk of debilitating morbidity and mortality. Relying primarily on epidemiologic evidence published within the last decade, this non-exhaustive review discusses the extent of the obesity epidemic, its risk factors-known and novel-, sequelae, and economic impact across the globe.
Full-text available
Does exercise promote weight loss? One of the key problems with studies assessing the efficacy of exercise as a method of weight management and obesity is that mean data are presented and the individual variability in response is overlooked. Recent data have highlighted the need to demonstrate and characterise the individual variability in response to exercise. Do people who exercise compensate for the increase in energy expenditure via compensatory increases in hunger and food intake? The authors address the physiological, psychological and behavioural factors potentially involved in the relationship between exercise and appetite, and identify the research questions that remain unanswered. A negative consequence of the phenomena of individual variability and compensatory responses has been the focus on those who lose little weight in response to exercise; this has been used unreasonably as evidence to suggest that exercise is a futile method of controlling weight and managing obesity. Most of the evidence suggests that exercise is useful for improving body composition and health. For example, when exercise-induced mean weight loss is <1.0 kg, significant improvements in aerobic capacity (+6.3 ml/kg/min), systolic (-6.00 mm Hg) and diastolic (-3.9 mm Hg) blood pressure, waist circumference (-3.7 cm) and positive mood still occur. However, people will vary in their responses to exercise; understanding and characterising this variability will help tailor weight loss strategies to suit individuals.
Full-text available
Metabolic and behavioral adaptations to caloric restriction (CR) in free-living conditions have not yet been objectively measured. Forty-eight (36.8+/-1.0 y), overweight (BMI 27.8+/-0.7 kg/m(2)) participants were randomized to four groups for 6-months; Control: energy intake at 100% of energy requirements; CR: 25% calorie restriction; CR+EX: 12.5% CR plus 12.5% increase in energy expenditure by structured exercise; LCD: low calorie diet (890 kcal/d) until 15% weight reduction followed by weight maintenance. Body composition (DXA) and total daily energy expenditure (TDEE) over 14-days by doubly labeled water (DLW) and activity related energy activity (AREE) were measured after 3 (M3) and 6 (M6) months of intervention. Weight changes at M6 were -1.0+/-1.1% (Control), -10.4+/-0.9% (CR), -10.0+/-0.8% (CR+EX) and -13.9+/-0.8% (LCD). At M3, absolute TDEE was significantly reduced in CR (-454+/-76 kcal/d) and LCD (-633+/-66 kcal/d) but not in CR+EX or controls. At M6 the reduction in TDEE remained lower than baseline in CR (-316+/-118 kcal/d) and LCD (-389+/-124 kcal/d) but reached significance only when CR and LCD were combined (-351+/-83 kcal/d). In response to caloric restriction (CR/LCD combined), TDEE adjusted for body composition, was significantly lower by -431+/-51 and -240+/-83 kcal/d at M3 and M6, respectively, indicating a metabolic adaptation. Likewise, physical activity (TDEE adjusted for sleeping metabolic rate) was significantly reduced from baseline at both time points. For control and CR+EX, adjusted TDEE (body composition or sleeping metabolic rate) was not changed at either M3 or M6. For the first time we show that in free-living conditions, CR results in a metabolic adaptation and a behavioral adaptation with decreased physical activity levels. These data also suggest potential mechanisms by which CR causes large inter-individual variability in the rates of weight loss and how exercise may influence weight loss and weight loss maintenance. NCT00099151.
New dietary strategies have been created to treat overweight and obesity and have become popular and widely adopted. Nonetheless, they are mainly based on personal impressions and reports published in books and magazines, rather than on scientific evidence. Animal models and human clinical trials have been employed to study changes in body composition and metabolic outcomes to determine the most effective diet. However, the studies present many limitations and should be carefully analyzed. The aim of this review was to discuss the scientific evidence of three categories of diets for weight loss. There is no one most effective diet to promote weight loss. In the short term, high-protein, low-carbohydrate diets and intermittent fasting are suggested to promote greater weight loss and could be adopted as a jumpstart. However, owing to adverse effects, caution is required. In the long term, current evidence indicates that different diets promoted similar weight loss and adherence to diets will predict their success. Finally, it is fundamental to adopt a diet that creates a negative energy balance and focuses on good food quality to promote health.
Reduction in excess calories and improvement in dietary composition may prevent many primary and secondary cardiovascular events. Current guidelines recommend diets high in fruits, vegetables, whole grains, nuts, and legumes; moderate in low-fat dairy and seafood; and low in processed meats, sugar-sweetened beverages, refined grains, and sodium. Supplementation can be useful for some people but cannot replace a good diet. Factors that influence individuals to consume a low-quality diet are myriad and include lack of knowledge, lack of availability, high cost, time scarcity, social and cultural norms, marketing of poor-quality foods, and palatability. Governments should focus on cardiovascular disease as a global threat and enact policies that will reach all levels of society and create a food environment wherein healthy foods are accessible, affordable, and desirable. Health professionals should be proficient in basic nutritional knowledge to promote a sustainable pattern of healthful eating for cardiovascular disease prevention for both healthy individuals and those at higher risk.
Purpose of review: The health benefits of physical activity and exercise are clear; virtually everyone can benefit from becoming more physically active. Most international guidelines recommend a goal of 150 min/week of moderate-to-vigorous intensity physical activity. Many agencies have translated these recommendations to indicate that this volume of activity is the minimum required for health benefits. However, recent evidence has challenged this threshold-centered messaging as it may not be evidence-based and may create an unnecessary barrier to those who might benefit greatly from simply becoming more active. This systematic review evaluates recent systematic reviews that have examined the relationship between physical activity and health status. Recent findings: Systematic reviews and/or meta-analyses (based largely on epidemiological studies consisting of large cohorts) have demonstrated a dose-response relationship between physical activity and premature mortality and the primary and secondary prevention of several chronic medical conditions. The relationships between physical activity and health outcomes are generally curvilinear such that marked health benefits are observed with relatively minor volumes of physical activity. Summary: These findings challenge current threshold-based messaging related to physical activity and health. They emphasize that clinically relevant health benefits can be accrued by simply becoming more physically active. VIDEO ABSTRACT:
The evidence regarding recommendations of calorie restriction as part of a comprehensive lifestyle intervention to promote weight loss in obese older adults has remained equivocal for more than a decade. The older adult population is the fastest growing segment of the US population and a greater proportion of them are entering old age obese. These older adults require treatments based on solid evidence. Therefore the purpose of this review is three-fold: 1) to provide a more current status of the knowledge regarding recommendations of calorie restriction as part of a comprehensive lifestyle intervention to promote weight loss in obese older adults, 2) to determine what benefits and/or risks calorie restriction adds to exercise interventions in obese older adults, and 3) to consider not only outcomes related to changes in body composition, bone health, cardiometabolic disease risk, markers of inflammation, and physical function, but, also patient-centered outcomes that evaluate changes in cognitive status, quality of life, out-of-pocket costs, and mortality. Seven randomized controlled trials were identified that examined calorie restriction while controlling for exercise intervention effects. Overall, the studies found that calorie restriction combined with exercise is effective for weight loss. Evidence was mixed regarding other outcomes. The risk-benefit ratio regarding calorie restriction in older adults remains uncertain. Greater long-term follow-up is necessary, and complementary effectiveness studies are needed to identify strategies currently used by obese older adults in community settings.
To examine whether adaptations in physical activity energy expenditure (PAEE) and resting metabolic rate (RMR) during weight loss were associated with future weight regain in overweight/obese, older women. Thirty-four overweight/obese (BMI = 25-40 kg x m(-2)), postmenopausal women underwent a 20-wk weight loss intervention of hypocaloric diet with (low- or high-intensity) or without treadmill walking (weekly caloric deficit was approximately 11,760 kJ), with a subsequent 12-month follow-up. RMR (via indirect calorimetry), PAEE (by RT3 accelerometer), and body composition (by dual-energy x-ray absorptiometry) were measured before and after intervention. Body weight and self-reported information on physical activity were collected after intervention and at 6 and 12 months after intervention. The intervention resulted in decreases in body weight, lean mass, fat mass, percent body fat, RMR, and PAEE (P < 0.001 for all). Weight regain was 2.9 +/- 3.3 kg (-3.1 to +9.2 kg) at 6 months and 5.2 +/- 5.0 kg (-2.3 to +21.7 kg) at 12 months after intervention. The amount of weight regained after 6 and 12 months was inversely associated with decreases in PAEE during the weight loss intervention (r = -0.521, P = 0.002 and r = -0.404, P = 0.018, respectively), such that women with larger declines in PAEE during weight loss experienced greater weight regain during follow-up. Weight regain was not associated with changes in RMR during intervention or with self-reported physical activity during follow-up. This study demonstrates that although both RMR and PAEE decreased during weight loss in postmenopausal women, maintaining high levels of daily physical activity during weight loss may be important to mitigate weight regain after weight loss.