13 Utilitarianism: overview & implications for
coaching.
By Jaebien Rosario
16 Probiotics as an ergogenic aid?
By David Galvin, MS, CISSN, CSCS
Copyright © March 1st, 2021 by Alan Aragon
Home: www.alanaragon.com
Correspondence: support@alanaragon.com
2
Behavior change vs metabolic adaptation: Are
you doomed by your genetics or do we have a
chance?
By Nuno Casanova, PhD
7
Total number of sets as a training volume
quantification
method
for
muscle
hypertrophy: a systematic review.
Baz-Valle E, Fontes-Villalba M, Santos-Concejero J.
Sports Med. J Strength Cond Res. 2021 Mar
1;35(3):870-878. [PubMed]
9
The effect of exercise interventions on resting
metabolic rate: A systematic review and metaanalysis.
MacKenzie-Shalders K, Kelly JT, So D, Coffey VG,
Byrne NM. J Sports Sci. 2020 Jul;38(14):1635-1649.
[PubMed]
11 Increasing protein distribution has no effect
on changes in lean mass during a rugby
preseason.
MacKenzie-Shalders KL, King NA, Byrne NM, Slater
GJ. Int J Sport Nutr Exerc Metab. 2016 Feb;26(1):1-7.
[PubMed]
Alan Aragon’s Research Review – March 2021
[Back to Contents]
Page 1
Behavior change vs metabolic adaptation: Are
you doomed by your genetics or do we have a
chance?
As previously mentioned, a series of metabolic,
psychological and behavioral compensatory responses may
occur in an attempt to reduce the initially defined energy
gap,8 which can be divided into obligatory or facultative,
aiming to restore a neutral state of energy balance.
By Nuno Casanova, PhD
__________________________________________________________
Our body hates losing
It is well known that a negative energy balance is required
to induce weight loss, independently of macronutrient
composition or dietary pattern.1-3 However, when a
negative energy balance is created, a cascade of metabolic,
psychological and behavioral compensatory responses may
occur, affecting both sides of the energy balance equation
in an attempt to reduce the initially prescribed energy
deficit.4
These compensatory responses have been postulated to
contribute to the large inter-individual variability
commonly observed during weight management
interventions. Furthermore, a topic that has been largely
debated in the past few decades is whether metabolic
adaptation, also known as adaptive thermogenesis, has a
stronger impact on weight management than behavioral
change (e.g., lifestyle modifications such as voluntary
changes in physical activity levels). This article will aim to
summarize the main compensatory responses occurring
during periods of negative energy balance, and potentially
disclose whether an individual’s genetic predisposition
determines the ability to achieve a certain body
composition.
What happens during weight loss?
The energy balance equation, albeit a simple concept that
represents the relationship between energy expenditure and
energy intake, reflects a complex and dynamic system in
which changes on one side will induce concomitant
changes on the other. For instance, increases in physical
activity through exercise have been found to influence
appetite and thus energy intake,5 although a large interindividual variability is usually observed.6,7
Alan Aragon’s Research Review – March 2021
Obligatory changes, which are expected to always occur
and are out of an individual’s control, include decreases in
energy expenditure mainly due to:
• A reduced body size - Which decreases resting
metabolic rate and physical activity energy
expenditure.
• Lower energy intake - Which reduces the energy
expenditure associated with the thermic effect of
feeding.
Facultative (or conditional) responses may not always
occur, are highly variable between individuals, and may
be, at least partially, under conscious and voluntary
control. These include:
• Metabolic adaptation / adaptive thermogenesis
• Increases in muscular efficiency
• Changes in physical activity behaviors
Although changes in appetite may also occur during
weight loss,9,10 which in turn may lead to spontaneous
increases in energy intake, these will not be explored in
this article.
What is adaptive thermogenesis?
Adaptive thermogenesis (used interchangeably with
metabolic adaptation in this article), refers to a greater than
predicted decrease in energy expenditure after accounting
for changes in body composition.11,12 For instance, if an
individual’s resting metabolic rate was predicted to
decrease from 1600 kcal/d to 1400 kcal/d due to losses of
fat mass and fat-free mass, it is possible that the true value
is closer to 1300kcal/d when measured through indirect
calorimetry. This would mean that a 100kcal/d metabolic
adaptation was present (Figure 1).
[Back to Contents]
Page 2
Although it has been suggested that adaptive
thermogenesis may occur in all energy expenditure
components,13 and that it could influence longer-term
weight outcomes, this remains a topic of debate.14
Furthermore, while potential mechanisms remain to be
fully elucidated, it has also been questioned whether
adaptive thermogenesis occurs, or is a clinically relevant
adaptation, as studies using higher quality methodological
designs usually report lower values. For instance, a 2009
study using magnetic resonance imaging to assess body
composition reported an adaptive thermogenesis of only
~55kcal/d.15 However, it is important to acknowledge that
most of the research has been conducted in individuals
with overweight and obesity and thus, whether this
compensatory response would be larger and stronger in
leaner athletes aiming for lower levels of body fat (e.g.,
bodybuilders) remains unknown.
Lastly, although adaptive thermogenesis in resting
metabolic rate (the energy expenditure component in
which metabolic adaptation has been most examined) has
been consistently shown during periods of energy deficit, a
recent study suggested that it may disappear, or becoming
clinically irrelevant, after periods of neutral energy
balance.16 Therefore, more research is needed to fully
understand whether adaptive thermogenesis occurs, or
whether it is a transient response occurring exclusively
during periods of energy deprivation.
lower total daily energy expenditure. However, although a
mean decrease in physical activity is commonly observed,
a large inter-individual variability is usually reported.17 For
instance, in a study from our laboratory (currently under
review), we observed a variability of -130 to +200min/d
between individuals in the amount of physical activity
from baseline to post-intervention, with a mean value of
+5min/d, a statistically non-significant change (Figure 2).
This means that while some individuals may present
significant reductions in physical activity, others
demonstrate the opposite response, but whether these are
voluntary and conscious remains unknown.
Although these concepts are conceptually different, it is
hard to disentangle physical activity behaviors from nonexercise activity thermogenesis (NEAT). The first refers to
the behavior itself, usually measured in minutes or counts
per day via accelerometers. On the other hand, NEAT
refers to the associated energy expenditure, in which
factors such as body size and muscular efficiency may
exert an influence, and doubly labelled water is commonly
considered the gold-standard method of assessment in
free-living conditions (metabolic chambers may be used
under inpatient conditions). Throughout this article,
physical activity behaviors and NEAT will be used
interchangeably, although the limitations of this approach
should be acknowledged as they do not always perfectly
correlate.
Another mechanism by which energy expenditure may
decrease during periods of negative energy balance is a
reduction in physical activity behaviors that, in turn, may
The role of physical activity and exercise on weight
management is usually overlooked and undermined, with
catching phrases such as ‘you can’t outrun a bad diet’
commonly appearing, potentially due to the lower than
predicted changes in body weight following exercise
Alan Aragon’s Research Review – March 2021
[Back to Contents]
Do we become more sedentary during weight loss?
Page 3
interventions. Indeed, exercise-only interventions usually
lead to lower than predicted magnitudes of weight loss,18
and individuals usually overestimate the energy
expenditure associated to physical activity and exercise
while underreporting their energy intake.19
However, it has been estimated that NEAT may vary by
close to 2.000kcal/d between individuals at extreme
opposite levels of occupational work.20 Fascinatedly, a
landmark work by Levine in 1999 reported that after 8
weeks of 1000-kcal overfeeding, which lead to a weight
gain ranging from 1.4 to 7.2kg, changes in NEAT (which
ranged from -98 to +692kcal/d), but not in basal metabolic
rate of thermic effect of feeding, were strongly associated
with weight change (r=-0.77; p<0.001). Therefore, it is
important that the potential effect of physical activity and
exercise on weight management success is not overlooked,
especially considering the amount of research highlighting
higher levels of physical activity as a robust factor
associated with longer-term weight maintenance.21
Adaptive thermogenesis vs physical activity – which is
the stronger influence?
Although it is important to recognize that metabolic
adaptation and changes in physical activity may occur, it is
critical to look into the research and examine how these
are associated with weight loss and weight maintenance
outcomes.
‘slow’ vs ‘fast’ metabolisms, respectively) was not
associated with longer-term weight change.23
In 2012, a landmark paper by Johannsen et al. reported a
substantial metabolic adaptation after The Biggest Loser
contest (-504kcal/day after 30 weeks).24 Although this
finding was alarming and got the attention of the media,
the following secondary analyses reported fascinating
results. Despite the apparent massive reduction in
metabolic rate, there was no association between adaptive
thermogenesis after 30-weeks of severe energy restriction
through diet and physical activity with 6-year weight
regain.25 In fact, there was an association between adaptive
thermogenesis after 6 years and weight change during this
time period, in which a greater reduction in energy
expenditure was present in those that had a better weight
maintenance.
Lastly, a 3rd analyses from this dataset reported that the
strongest factor associated with 6-year weight change were
changes in physical activity.26 These data suggest that
although adaptive thermogenesis may indeed be present
under conditions of negative energy balance, this does not
seem to predispose an individual for poorer weight
management outcomes, while changes in physical activity
behaviors seem to exert a stronger influence, being a
critical determinant of weight control success.
Regarding adaptive thermogenesis, the current evidence is
more conceptual than experimental, meaning that although
it has been postulated that metabolic adaptation
complicates weight management, scientific evidence
corroborating this hypothesis is lacking or even
contradictory. For instance, adaptive thermogenesis in
resting metabolic rate has been shown to be associated
with increases in energy intake5 and hunger sensations,22
although these have never been replicated. However,
recent research has reported that no associations between
adaptive thermogenesis in resting metabolic rate and
weight loss, or 1 and 2-year weight change existed.14
Interestingly, a 2016 paper observed that baseline basal
metabolic rate (lower or greater than predicted values, or
While these data seem reassuring by highlighting the role
of behavior on weight management success, it is important
to highlight a final piece of data. In the past decade, the
concept of thrifty and spendthrifty phenotypes has been
proposed as a way to understand the inter-individual
variability regarding weight change.27 Individuals with a
thrifty phenotype are usually characterized by a greater
reduction in energy expenditure in response to a negative
energy balance, decreasing the energy deficit and thus
slowing the rate of weight loss. Furthermore, in response
to overfeeding, the energy expenditure of these individuals
remains almost unchanged and, consequently, the excess
calories will be mostly efficiently stored.28 On the other
hand, individuals with a spendthrifty phenotype are
characterized by the opposite responses, presenting almost
Alan Aragon’s Research Review – March 2021
[Back to Contents]
Page 4
no change in energy expenditure during periods of
negative energy balance (maintaining faster rates of weight
loss) while having greater increases in response to
overfeeding (storing fewer extra calories).
While it remains unknown which factors contribute to
these phenotypic responses (although several factors have
been proposed), or which energy expenditure component
contributes the most to this variability, it is likely that
changes in NEAT exert the most influence, as it is the
most volatile component.28,29 However, while this could
suggest that simply trying to increase physical activity
levels would be the solution, it has been suggested that not
only this may be in part under genetic control,30 but
increases in physical activity may not always lead to a
higher energy expenditure, a concept named constrained
model, coined by Herman Pontzer,31 although this may
only be applicable at very high levels of physical activity.
Brandon Nuno Casanova has an
Undergraduate in Sports Science
(Faculty of Human Kinetics, University of
Lisbon), Masters in Exercise and Health
(Faculty of Human Kinetics, University of
Lisbon) and a PhD in Weight
Management and Appetite Control
(School of Food Science and Nutrition,
University of Leeds). Currently, Nuno
Casanova is a Post-Doctoral Researcher
in the University of Leeds extending the
work from his PhD by understanding the
factors that explain the inter-individual variability in weight
management interventions, as well the mechanisms that influence
appetite control.
Publications: https://www.researchgate.net/profile/Nuno_Casanova
Social media: https://linktr.ee/nunomfit
__________________________________________________________________________
References
From the available data, it is important to recognize that
some individuals may have a harder time in controlling
their weight, possibly due to a combination of both genetic
predisposition and environmental factors. However, it is
critical to highlight that metabolic adaptation, although it
may occur under conditions of negative energy balance, it
does not seem to be associated with less weight loss or
greater weight regain. On the other hand, changes in
physical activity and associated energy expenditure, which
are in part under voluntary control, seem to have a stronger
impact on weight management, being a robust predictor of
longer-term weight loss and maintenance success.
Importantly, it is critical to recognize that while metabolic
adaptation is not under voluntary control, physical activity
behaviors may at least in part be. Therefore, this
information should be used to empower individuals as
although the genetic cards we were dealt with may not be
the most favorable, we can still play the best we can with
them and win the game by taking the appropriate
behavioral decisions and optimizing our physical and
social environment.
1. Aragon, A. A., Schoenfeld, B. J., Wildman, R., Kleiner,
S., VanDusseldorp, T., Taylor, L., et al. International
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2. Hall, K. D., Guo, J. Obesity energetics: body weight
regulation and the effects of diet composition.
Gastroenterology. 2017,152:1718-27.e3. [PubMed]
3. Alhassan, S., Kim, S., Bersamin, A., King, A. C.,
Gardner, C. D. Dietary adherence and weight loss
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4. Casanova, N., Beaulieu, K., Finlayson, G., Hopkins, M.
Metabolic adaptations during negative energy balance
and their potential impact on appetite and food intake.
The Proceedings of the Nutrition Society. 2019,78:27989. [PubMed]
5. Hopkins, M., Gibbons, C., Caudwell, P., Hellström, P.
M., Näslund, E., King, N., et al. The adaptive metabolic
response to exercise-induced weight loss influences both
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6. Blundell, J., Gibbons, C., Caudwell, P., Finlayson, G.,
Hopkins, M. Appetite control and energy balance: impact
of exercise. Obesity Reviews. 2015,16:67-76. [PubMed]
7. Flack, K. D., Ufholz, K., Johnson, L., Fitzgerald, J. S.,
Roemmich, J. N. Energy compensation in response to
aerobic exercise training in overweight adults. American
journal of physiology. Regulatory, integrative and
comparative physiology. 2018,315:R619-r26. [PubMed]
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[Back to Contents]
Are we doomed or do we have a chance?
Page 5
8. Melby, C. L., Paris, H. L., Foright, R. M., Peth, J.
Attenuating the biologic drive for weight regain
following weight loss: Must what goes down always go
back up? Nutrients. 2017,9. [PubMed]
9. Hintze, L. J., Mahmoodianfard, S., Auguste, C. B.,
Doucet, É. Weight loss and appetite control in women.
Current Obesity Reports. 2017,6:334-51. [PubMed]
10. Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell,
K., Shulkes, A., Kriketos, A., et al. Long-term
persistence of hormonal adaptations to weight loss. The
New England journal of medicine. 2011,365:1597-604.
[PubMed]
11. [11] Doucet, E., St-Pierre, S., Almaras, N., Despras, J.-P.,
Bouchard, C., Tremblay, A. Evidence for the existence of
adaptive thermogenesis during weight loss. British
Journal of Nutrition. 2001,85:715-23. [PubMed]
12. Muller, M. J., Bosy-Westphal, A. Adaptive
thermogenesis with weight loss in humans. Obesity
(Silver Spring, Md.). 2013,21:218-28. [PubMed]
13. Dulloo, A., Jacquet, J., Montani, J., Schutz, Y. Adaptive
thermogenesis in human body weight regulation: more of
a concept than a measurable entity? Obesity Reviews.
2012,13:105-21. [PubMed]
14. Martins, C., Gower, B. A., Hill, J. O., Hunter, G. R.
Metabolic adaptation is not a major barrier to weight-loss
maintenance. The American journal of clinical nutrition.
2020. [PubMed]
15. Bosy-Westphal, A., Kossel, E., Goele, K., Later, W.,
Hitze, B., Settler, U., et al. Contribution of individual
organ mass loss to weight loss-associated decline in
resting energy expenditure. The American journal of
clinical nutrition. 2009,90:993-1001. [PubMed]
16. Martins, C., Roekenes, J., Salamati, S., Gower, B. A.,
Hunter, G. R. Metabolic adaptation is an illusion, only
present when participants are in negative energy balance.
The American journal of clinical nutrition. 2020.
[PubMed]
17. Silva, A. M., Judice, P. B., Carraca, E. V., King, N.,
Teixeira, P. J., Sardinha, L. B. What is the effect of diet
and/or exercise interventions on behavioral compensation
in non-exercise physical activity and related energy
expenditure of free-living adults? A systematic review.
The British journal of nutrition. 2018,119:1327-45.
[PubMed]
18. King, N. A., Hopkins, M., Caudwell, P., Stubbs, R.,
Blundell, J. E. Individual variability following 12 weeks
of supervised exercise: identification and characterization
of compensation for exercise-induced weight loss.
International journal of obesity. 2008,32:177-84.
[PubMed]
19. Willbond, S. M., Laviolette, M. A., Duval, K., Doucet, E.
Normal weight men and women overestimate exercise
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20. Levine, J. A. Nonexercise activity thermogenesis-liberating the life-force. Journal of internal medicine.
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21. Paixão, C., Dias, C. M., Jorge, R., Carraça, E. V.,
Yannakoulia, M., de Zwaan, M., et al. Successful weight
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2020,21:e13003. [PubMed]
22. Tremblay, A., Royer, M. M., Chaput, J. P., Doucet, E.
Adaptive thermogenesis can make a difference in the
ability of obese individuals to lose body weight.
International journal of obesity (2005). 2013,37:759-64.
[PubMed]
23. Anthanont, P., Jensen, M. D. Does basal metabolic rate
predict weight gain? The American journal of clinical
nutrition. 2016,104:959-63. [PubMed]
24. Johannsen, D. L., Knuth, N. D., Huizenga, R., Rood, J.
C., Ravussin, E., Hall, K. D. Metabolic slowing with
massive weight loss despite preservation of fat-free mass.
The Journal of clinical endocrinology and metabolism.
2012,97:2489-96. [PubMed]
25. Fothergill, E., Guo, J., Howard, L., Kerns, J. C., Knuth,
N. D., Brychta, R., et al. Persistent metabolic adaptation
6 years after "The Biggest Loser" competition. Obesity
(Silver Spring, Md.). 2016,24:1612-9. [PubMed]
26. Kerns, J. C., Guo, J., Fothergill, E., Howard, L., Knuth,
N. D., Brychta, R., et al. Increased physical activity
associated with less weight regain six years after “the
biggest loser” competition. 2017,25:1838-43. [PubMed]
27. Reinhardt, M., Thearle, M. S., Ibrahim, M., Hohenadel,
M. G., Bogardus, C., Krakoff, J., et al. A human thrifty
phenotype associated with less weight loss during caloric
restriction. Diabetes. 2015,64:2859-67. [PubMed]
28. Piaggi, P. Metabolic determinants of weight gain in
humans. Obesity (Silver Spring, Md.). 2019,27:691-9.
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31. Pontzer, H., Durazo-Arvizu, R., Dugas, L. R., PlangeRhule, J., Bovet, P., Forrester, T. E., et al. Constrained
total energy expenditure and metabolic adaptation to
physical activity in adult humans. Current Biology.
2016,26:410–7. [PubMed]
Alan Aragon’s Research Review – March 2021
[Back to Contents]
Page 6
Total number of sets as a training volume
quantification method for muscle hypertrophy: a
systematic review.
Baz-Valle E, Fontes-Villalba M, Santos-Concejero J.
Sports Med. J Strength Cond Res. 2021 Mar 1;35(3):870878. [PubMed]
BACKGROUND/PURPOSE: This review aimed to
determine whether assessing the total number of sets is a
valid method to quantify training volume in the context of
hypertrophy training. METHODS: A literature search on
2 databases (PubMed and Scopus) was conducted on May
18, 2018. After analyzing 2,585 resultant articles, studies
were included if they met the following criteria: (a) studies
were randomized controlled trials, (b) studies compared
the total number of sets, repetition range, or training
frequency, (c) interventions lasted at least 6 weeks, (d)
subjects had a minimum of 1 year of resistance training
experience, (e) subjects' age ranged from 18 to 35 years,
(f) studies reported morphologic changes through direct or
indirect assessment methods, (g) studies involved subjects
with no known medical conditions, and (h) studies were
published in peer-reviewed journals. RESULTS &
CONCLUSION: Fourteen studies met the inclusion
criteria. According to the results of this review, the total
number of sets to failure, or near to, seems to be an
adequate method to quantify training volume when the
repetition range lies between 6 and 20+ if all the other
variables are kept constant. This approach requires further
development to assess whether specific numbers of sets are
key to inducing optimal muscle gains. FUNDING
SOURCE: There is no disclosure of funding to report for
this study.
and quality control. Methodological quality of the studies
was assessed by two separate ranking systems - Oxford's
level of evidence2 and the Physiotherapy Evidence
Database (PEDro) scale.3
Limitations
The authors acknowledged the following limitations:
•
•
•
•
Moderate quality of some the studies analyzed.
One of the studies used skinfolds as an assessment
tool and, although it is validated, has reliability
issues in those with higher body fat levels.4
One of the studies used air displacement
plethysmography (ADP), which like skinfolds,
have been validated, but have shown reliability in
subjects with high body fat.5
The results of this review might be limited to the
subject profile: trained subjects, mostly male (352
men, 7 women).
Comment/application
Strengths
This paper investigates a relevant and practical question
for a very relevant and practical goal: getting yooge.
Another strength was its adherence to the Preferred
Reporting Items for Systematic Reviews and Metaanalysis (PRISMA) guidelines for reporting in systematic
reviews and meta-analyses,1 which enforces transparency
The flow chart above sums up the findings of this
systematic review. For the goal of muscle hypertrophy,
using total number of sets to failure (or close to it; no more
than 3 reps short of failure) per muscle group can be a
Alan Aragon’s Research Review – March 2021
[Back to Contents]
Page 7
viable strategy to quantify training volume in resistancetrained individuals. In the present review, the studies
involved mostly subjects with a minimum of This is a
simpler alternative to quantifying volume load, which
accounts for sets, reps, and load. An important stipulation
here is that this way of accounting for volume necessitates
6 reps per set, at minimum. So, in a given mesocycle
(month-long training block), individuals can count the
increase in total sets as a reliable marker of progression.
Another finding of this review was that weekly training
frequency lacked influence on muscle hypertrophy in
comparisons where set volume was matched. This finding
reflects the results of a relatively recent meta-analysis by
Schoenfeld et al,6 which concluded that, “…there is strong
evidence that resistance training frequency does not
significantly or meaningfully impact muscle hypertrophy
when volume is equated. Thus, for a given training
volume, individuals can choose a weekly frequency per
muscle groups based on personal preference.”
The authors of the present review caution that this method
of merely tracking number of sets still needs further
refinement to pinpoint a specific number of sets that might
optimize muscle hypertrophy. The number of weekly sets
that optimizes hypertrophy has been a question of intense
interest in both the research and the athletic community. A
relatively recent review by Schoenfeld and Grgic7 reported
that a range of approximately 10-20 sets per muscle group
per week is appropriate for muscle growth, and that it’s
possible to periodize programming through the year across
the length of that range. Here’s a 1-yr example they gave,
where 7-10 sets hit a peak of 20-25, then drop to 5-7 sets:
Alan Aragon’s Research Review – March 2021
References
1. Liberati A, Altman DG, Tetzlaff J, Mulrow C,
Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ,
Kleijnen J, Moher D. The PRISMA statement for
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explanation and elaboration. BMJ. 2009 Jul
21;339:b2700. [PubMed]
2. Oxford Centre for Evidence-based Medicine. Levels of
Evidence. Oxford, UK: University of Oxford, 2009.
pp. 4–5. https://www.cebm.ox.ac.uk/resources/levelsof-evidence/oxford-centre-for-evidence-basedmedicine-levels-of-evidence-march-2009
3. de Morton NA. The PEDro scale is a valid measure of
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4. Institute of Medicine (US) Committee on Military
Nutrition Research; Marriott BM, Grumstrup-Scott J,
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Applications For the Military Services. Washington
(DC): National Academies Press (US); 1990. 14, Body
Composition Measurement: Accuracy, Validity, and
Comparability. Available from: [NCBI Bookshelf]
5. Ewane C, McConkey SA, Kreiter CD, Fuller M, Tabor
A, Bosch J, Mews J, Baldwin K, Van Dyke DC. Is airdisplacement plethysmography a reliable method of
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6. Schoenfeld BJ, Grgic J, Krieger J. How many times
per week should a muscle be trained to maximize
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training
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7. Schoenfeld BJ, Grgic J.
Evidence-Based Guidelines
for
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Volume to Maximize Muscle
Hypertrophy. December 2017
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Journal 40(4):1.
[ResearchGate]
[Back to Contents]
Page 8
The effect of exercise interventions on resting
metabolic rate: A systematic review and metaanalysis.
MacKenzie-Shalders K, Kelly JT, So D, Coffey VG,
Byrne NM. J Sports Sci. 2020 Jul;38(14):1635-1649.
[PubMed]
BACKGROUND/PURPOSE: The systematic review and
meta-analysis evaluated the effect of aerobic, resistance
and combined exercise on RMR (kCal·day-1) and
performed a methodological assessment of indirect
calorimetry protocols within the included studies.
METHODS: Subgroup analyses included energy/diet
restriction and body composition changes. Randomized
control trials (RCTs), quasi - RCTs and cohort trials
featuring a physical activity intervention of any form and
duration excluding single exercise bouts were included.
Participant exclusions included medical conditions
impacting upon RMR, the elderly (≥65 years of age) or
pregnant, lactating or post-menopausal women. The
review was registered in the International Prospective
Register of Systematic Reviews (CRD 42,017,058,503).
RESULTS: 1669 articles were identified; 22 were
included in the qualitative analysis and 18 were metaanalysed. Exercise interventions (aerobic and resistance
exercise combined) did not increase resting metabolic rate
(mean difference (MD): 74.6 kCal·day-1[95% CI: -13.01,
161.33], P = 0.10). While there was no effect of aerobic
exercise on RMR (MD: 81.65 kCal·day-1[95% CI: -57.81,
221.10], P = 0.25), resistance exercise increased RMR
compared to controls (MD: 96.17 kCal·day-1[95% CI:
45.17, 147.16], P = 0.0002). CONCLUSIONS: This
systematic review effectively synthesizes the effect of
exercise interventions on RMR in comparison to controls;
despite heterogenous methodologies and high risk of bias
within included studies. FUNDING: The authors
acknowledge no direct funding sources for the study.
Strengths
This meta-analysis includes a relatively large number of
studies (22 included in qualitative analysis, 18 in
quantitative analysis). Data from 392 participants and 270
controls were analyzed. Most of the studies were a parallel
design (one study was a crossover). A random-effects
Alan Aragon’s Research Review – March 2021
model was used to produce a pooled estimate of the mean
difference, and a fixed-effects model was used to check for
potential outliers. Preferred Reporting Items for
Systematic Reviews and Meta-analysis (PRISMA)
guidelines for reporting in systematic reviews and metaanalyses1 were used for bolstering quality & transparency.
Limitations
The authors acknowledged the following limitations:
•
•
•
There was high variability in the data, as seen in
the wide confidence intervals.
The systematic review included exercise
interventions of any type and duration, excluding
single exercise bouts, and thus compared different
study designs and methodologies. This
heterogeneity across studies limits the confidence
we can have in generalizing the findings.
Although there was a clear effect of resistance
exercise on resting metabolic rate (RMR), it was
not possible to assess differences in the type of
resistance exercise and its specific performance
objective (i.e., changes in power, strength or
muscular endurance).
I would add to these limitations that the majority of
subjects in this analysis were involved sedentary,
overweight/obese individuals. Questions still remain about
the generalizability to other populations, such as physically
active, athletic, or in various disease states.
Comment/application
The main findings were as follows:
•
•
Resistance exercise increased RMR significantly
beyond control conditions, as measured by indirect
calorimetry. Mean increase was 96.17 kcal/day.
Aerobic exercise on its own, or combined with
resistance exercise did not significantly increase
RMR compared to control conditions. It should be
noted that although these increases did not reach
statistical significance, they were 81.65 and 74.6
kcal/day, respectively. It thus might be more
accurate to say that resistance training is more
effective than aerobic training at raising RMR.
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Page 9
•
Due to a lack of body composition assessment
data, it remains unclear how changes in body
composition interacted with changes in RMR.
Exercise-only versus exercise plus dietary
intervention had no significantly different effect
on RMR.
Loss of total bodyweight was associated with no
change in RMR, while bodyweight stability was
associated with an increase in RMR.
Major design/methodological differences between
studies leave a lot of gray area open for
investigation into which specific types &
programming of resistance training are most
effective at raising RMR.
alongside purposeful exercise. It’s easy to overlook the
fact that NEAT’s contribution to TDEE ranges widely, but
can be substantial (15-50% of TDEE).5
The practical take-away of these findings is that resistance
training is slightly superior to aerobic training for stoking
the metabolic fire (that’s a catchphrase from the 1990’s).
However, when we look at the difference in terms of
absolute numbers derived by this analysis, it might be
statistically significant, but it’s too small to have practical
significance (resistance training, combination training, and
aerobic training had an average RMR increase of 96.17,
74.6, and 81.65 kcal/day, respectively). These differences
are minuscule.
Of relevance to the idea of increasing total daily energy
expenditure (TDEE), it might be helpful to recognize the
potential impact of non-exercise activity thermogenesis
(NEAT) on TDEE. Refer to the September 2019 issue for
an in-depth discussion of NEAT, which I call the “Big
Foot” of program variables. TDEE consists of two major
categories: active and resting EE (the latter is synonymous
with RMR). NEAT falls under the category of active EE,
1. Liberati A, Altman DG, Tetzlaff J, Mulrow C,
Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ,
Kleijnen J, Moher D. The PRISMA statement for
reporting systematic reviews and meta-analyses of
studies that evaluate healthcare interventions:
explanation and elaboration. BMJ. 2009 Jul
21;339:b2700. [PubMed]
2. Ainsworth BE, Haskell WL, Herrmann SD, Meckes N,
Bassett DR Jr, Tudor-Locke C, Greer JL, Vezina J,
Whitt-Glover MC, Leon AS. 2011 Compendium of
Physical Activities: a second update of codes and
MET values. Med Sci Sports Exerc. 2011
Aug;43(8):1575-81. [PubMed]
3. Gillen JB, Gibala MJ. Is high-intensity interval
training a time-efficient exercise strategy to improve
health and fitness? Appl Physiol Nutr Metab. 2014
Mar;39(3):409-12. [PubMed]
4. Gillen JB, Gibala MJ. Interval training: a timeefficient exercise strategy to improve cardiometabolic
health. Appl Physiol Nutr Metab. 2018 Oct;43(10):iiiiv. [PubMed]
5. Aragon AA, Schoenfeld BJ, Wildman R, Kleiner S,
VanDusseldorp T, Taylor L, Earnest CP, Arciero PJ,
Wilborn C, Kalman DS, Stout JR, Willoughby DS,
Campbell B, Arent SM, Bannock L, Smith-Ryan AE,
Antonio J. International society of sports nutrition
position stand: diets and body composition. J Int Soc
Sports Nutr. 2017 Jun 14;14:16. [PubMed]
6. Markwald RR, Melanson EL, Smith MR, Higgins J,
Perreault L, Eckel RH, Wright KP Jr. Impact of
insufficient sleep on total daily energy expenditure,
food intake, and weight gain. Proc Natl Acad Sci U S
A. 2013 Apr 2;110(14):5695-700. [PubMed]
Alan Aragon’s Research Review – March 2021
[Back to Contents]
•
•
•
For individuals concerned with getting the most bang-forthe-buck in terms of energy expenditure during exercise
(and non-exercise activity), a good resource is the
Compendium of Physical Activities,2 which organizes a
multitude of physical activities according to metabolic
equivalents (METs). The greater the METs, the more
calories burned per hour. Here is the collection of
compendia. Along these lines, it’s noteworthy that various
forms of high-intensity interval training (HIIT) have been
demonstrated to have profound cardiometabolic health
effects with minimal time commitment.3,4
On a related note, chronically insufficient sleep has the
potential to antagonize efforts to increase energy
expenditure for the goal of weight loss. Markwald et al6
found that insufficient sleep for ~2 weeks increased total
daily energy expenditure by ∼5%. However, energy intake
increased to the degree of causing an average weight gain
of 0.82 kg. Lacking sleep is an insidious and overlooked
driver of appetite, and can thereby defeat various efforts to
increase energy expenditure.
References:
Page 10
Increasing protein distribution has no effect on
changes in lean mass during a rugby preseason.
MacKenzie-Shalders KL, King NA, Byrne NM, Slater GJ.
Int J Sport Nutr Exerc Metab. 2016 Feb;26(1):1-7.
[PubMed]
BACKGROUND: Increasing the frequency of protein
consumption is recommended to stimulate muscle
hypertrophy with resistance exercise. PURPOSE: This
study manipulated dietary protein distribution to assess the
effect on gains in lean mass during a rugby preseason.
METHODS: Twenty-four developing elite rugby athletes
(age 20.1 ± 1.4 years, mass 101.6 ± 12.0 kg; M ± SD) were
instructed to consume high biological value (HBV) protein
at their main meals and immediately after resistance
exercise while limiting protein intake between meals. To
manipulate protein intake frequency, the athletes
consumed 3 HBV liquid protein supplements (22 g
protein) either with main meals (bolus condition) or
between meals (frequent condition) for 6 weeks in a 2 × 2
crossover design. Dietary intake and change in lean mass
values were compared between conditions by analysis of
covariance and correlational analysis. The dietary
manipulation successfully altered the protein distribution
score (average number of eating occasions containing > 20
g of protein) to 4.0 ± 0.8 and 5.9 ± 0.7 (p < .01) for the
bolus and frequent conditions, respectively. RESULTS:
There was no difference in gains in lean mass between the
bolus (1.4 ± 1.5 kg) and frequent (1.5 ± 1.4 kg) conditions
(p = .91). CONCLUSIONS: There was no clear effect of
increasing protein distribution from approximately 4-6
eating occasions on changes in lean mass during a rugby
preseason. However, other dietary factors may have
augmented adaptation. FUNDING: This investigation was
supported by technical support and an Australian
Postgraduate Award PhD scholarship from the Queensland
University of Technology.
subjects were used (elite rugby athletes). The subjects of
this study resistance trained to promote muscle
hypertrophy more than 3 times per week. The use of
untrained subjects can mask actual treatment differences
due to a uniformly robust response to novel training
stimuli. Each week (for 6 weeks), a 24-hr dietary recall
was done. This is a higher degree of control than the
typical single 24-hour recall at the start & end of the trial.
Measuring cups and spoons were used to quantify intake.
All food records were analyzed by the same sports
dietitian. Limitations
Eating occasions were deemed separate if they were over
30 minutes apart. This interval is too short to consider
meals as separate. Illustrating this point, Power et al1
found that a dose of 45 g whey protein took approximately
45 minutes for blood amino acid levels to peak, and over 3
hours to return to baseline levels. Another limitation is that
although a high-biological value protein supplement was
used (22 g doses of whey protein), questions till remain
about how effects might have differed with other protein
sources. Although six 24-hour recalls were done per trial
period, a daily journaling of food intake would have
tightened up the control. To improve this design, a strict
comparison of 3 versus 6 protein feedings should have
been done.
Comment/application
Strengths
This study asked an interesting question – can protein
distribution through the day be manipulated to influence
body composition (lean mass gain in particular). Trained
The main finding (shown in the table above) was a lack of
difference in body composition change between the lower-
Alan Aragon’s Research Review – March 2021
[Back to Contents]
Page 11
& higher-frequency of protein intake. Both conditions
caused lean mass gain and fat loss, but none of these
changes were statistically significant between groups. It’s
worth reiterating that this study did not end up comparing
a lower versus significantly higher daily frequency of
protein doses. The “bolus” group averaged 5.6 eating
occasions (defined by >20 g protein intake), while the
“frequent” condition averaged 6.9 eating occasions per
day. This is not a disparate comparison at all.
In a paper I recently co-authored,2 we hypothesized that
the feeding distribution the maximizes muscle growth is a
minimum of 4 protein feedings dosed at 0.4-0.55 g/kg.
This hypothesis is based on piecing together the evidence,
and combining likely the optimal range of protein intake
for muscle growth3 with dosing that’s likely to max-out the
anabolic response on a per-meal basis.3,4 Our suggestion
(0.4-0.55 g/kg per meal) has gotten further support from
recent research by Park et al.5
A noteworthy detail is that total daily protein was very
high in both groups (2.7 & 2.6 g/kg in the lower vs higherfrequency groups, respectively). Given that the whey
protein supplementation provided 66 g protein, and total
intakes of the lower- & higher frequency groups’ total
protein intakes were 206 & 196 g; this amounts to 2.0 &
1.9 g/kg, respectively. It’s interesting that these amounts
are presumed to already be more than sufficient to
maximize muscle growth,3 yet pushing protein up by 3235% beyond these habitually high levels still resulted in
favorable body composition in well-trained subjects.
Another point to consider is that the subjects did not
experience a net increase in bodyweight despite the
addition of protein to the diet. Instead, they experienced
recomposition (simultaneous increase in lean mass and
decrease in fat mass). It’s noteworthy that this occurred
despite subjects being resistance-trained. A review by
Barakat et al7 reported that very high protein intakes (2.63.5 g/kg of fat-free mass) may increase the likelihood or
magnitude of recomposition in trained individuals.
Alan Aragon’s Research Review – March 2021
References
1. Power O, Hallihan A, Jakeman P. Human
insulinotropic response to oral ingestion of native and
hydrolysed whey protein. Amino Acids. 2009
Jul;37(2):333-9. [PubMed]
2. Schoenfeld BJ, Aragon AA. How much protein can
the body use in a single meal for muscle-building?
Implications for daily protein distribution. J Int Soc
Sports Nutr. 2018 Feb 27;15:10. [PubMed]
3. Morton RW, Murphy KT, McKellar SR, Schoenfeld
BJ, Henselmans M, Helms E, Aragon AA, Devries
MC, Banfield L, Krieger JW, Phillips SM. A
systematic review, meta-analysis and meta-regression
of the effect of protein supplementation on resistance
training-induced gains in muscle mass and strength in
healthy adults. Br J Sports Med. 2018 Mar;52(6):376384. [PubMed]
4. Moore DR, Churchward-Venne TA, Witard O, Breen
L, Burd NA, Tipton KD, Phillips SM. Protein
ingestion to stimulate myofibrillar protein synthesis
requires greater relative protein intakes in healthy
older versus younger men. J Gerontol A Biol Sci Med
Sci. 2015 Jan;70(1):57-62. [PubMed]
5. Macnaughton LS, Wardle SL, Witard OC, McGlory C,
Hamilton DL, Jeromson S, Lawrence CE, Wallis GA,
Tipton KD. The response of muscle protein synthesis
following whole-body resistance exercise is greater
following 40 g than 20 g of ingested whey protein.
Physiol Rep. 2016 Aug;4(15):e12893. [PubMed]
6. Park S, Jang J, Choi MD, Shin YA, Schutzler S, Azhar
G, Ferrando AA, Wolfe RR, Kim IY. The Anabolic
Response to Dietary Protein Is Not Limited by the
Maximal Stimulation of Protein Synthesis in Healthy
Older Adults: A Randomized Crossover Trial.
Nutrients. 2020 Oct 26;12(11):3276. [PubMed]
7. Barakat C, et al. Body recomposition: Can trained
individuals build muscle and lose fat at the same time?
Strength and Conditioning Journal: October 2020 Volume 42 - Issue 5 - p 7-21 [SCJ]
[Back to Contents]
Page 12
Utilitarianism:
coaching.
overview
&
implications
for
By Jaebien Rosario
_______________________________________________
Basics of utilitarianism
With the growing rise of chronic disease, issues with
healthcare, the decline with the global economy, and an
ensuing pandemic there is a need to think differently. In
the fitness industry we often stress personal responsibility.
We change our bodies and our clients bodies through a
variety of methods. These methods entail some form of
discipline and willpower. However, discipline and
willpower alone cannot confront some of the pressing
circumstances societies as a whole endure. Societies often
require collective action to function properly. This means
thinking not only of ourselves but about other people. But
we already do this when coaching clients, we often take
their needs into consideration when it comes to their goals.
This client-centered framework relates to utilitarian
reasoning. In order to be better coaches we need an ethical
system, that system can be utilitarianism.
Utilitarianism takes into account the happiness of
everyone. Happiness should be maximized from the
utilitarian perspective. For example, let’s think about
speed limit laws. Most countries do not allow you to drive
as fast as you want. Driving at faster speeds might cause
more accidents which can lead to death and slowing down
our morning commutes. So, it makes sense to maximize
happiness we should drive at a set speed limit to ensure
safety and convenience. A few people might not be happy
that they cannot drive as fast as they would like, but more
of us are happy as a result.
collective or cumulative outcome rather than the
individual. Utilitarians have this fixation on happiness but
an important question arises. What is happiness?
One answer comes to us philosopher Jeremy Bentham,
considered the founder of utilitarianism. Bentham defines
happiness in terms of pleasure and pain, this definition of
happiness relates to the ancient philosophical school of
hedonism. Essentially, we want to maximize pleasure
while minimizing pain.1 This concept of happiness can be
calculated by using the hedonistic calculus created by
Benthem.1 This piece will not deep dive into the hedonistic
calculus but the information was presented to exemplify
the fact utilitarianism is empirical. There is an emphasis on
quantifying happiness and weighing out alternative
options.
Utilitarian moral theory is best summarized by philosopher
John Stuart Mill. Mill argued morality dealt primarily with
the utility or usefulness of actions in his work
Utilitarianism. This is best summarized by the principle
of utility.2 Mill’s states, “Actions are right in proportion as
they tend to produce happiness, wrong as they tend to
produce the reverse of happiness.”2 This is essentially
consequentialism, we focus on the consequences of the
actions. Whatever leads to the most favorable outcome is
the right choice, we determine what leads to the most
favorable outcomes by evaluating the best evidence we
have available. Thus, to truly deploy the principle of utility
we need to be empirical. Classic utilitarians, like Mill, do
not care about the intrinsic motivation behind actions, only
the consequences. Therefore, it doesn’t matter whether
someone saves another person from drowning because it
was right or they want a reward. What only matters is the
outcome that a life was saved.
Strengths & limitations of utilitarianism
In order to maximize happiness we should weigh out the
benefits and cost of each alternative. The action with the
greatest net benefit is the best one to make. The end result
of each action has an outcome or consequence,
utilitarianism is focused on the consequences of actions so
it relies heavily on consequentialism. Consequentialism
considers actions morally better or worse depending on the
outcomes they produce. Utilitarianism focuses more on the
Classic utilitarians like Bentham and Mill were
progressive pioneers during their time. Bentham was a
champion of social reform, stressing the usefulness of
social programs. Mill is known as a major advocate of
personal liberty, freedom of speech, and the rights of
women during his time period. Many contemporary
utilitarians like Peter Singer, advocate for equal wealth
distribution and animal rights.3 It’s fair to say
Alan Aragon’s Research Review – March 2021
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Page 13
utilitarianism has connections with being democratic,
progressive, empiricist, and optimistic. Utilitarians are
typically at the forefront of many societal issues.
This philosophical school also makes sense as the basis of
many social programs, public health initiatives,
government policies, and current issues worldwide. The
truth is we are all dependent on one another in a
functioning society, even as coaches. Being a utilitarian
would stress that connectedness we all share and the
importance of collective action for improving society.
Focusing on outcomes by weighing out evidence is what
we do in science and as coaches. The philosophy is simple
to grasp and makes many important considerations.
Considerations such as the consequences of our actions, as
coaches our actions can have extremely detrimental or
favorable consequences.
Limitations can include the exclusion of personal integrity
or motivation. Utilitarians focus on consequences above
intention but many might argue the intention of an action
is important. Giving a gift to our loved ones can be done
with benevolent intentions yet if the gift isn’t well received
(the outcome), utilitarians might argue the action wasn’t
good since it did not maximize happiness. This contradicts
some of our common sense grasp or mortality, some might
argue we cannot control outcomes but only intentions (this
relates to Kant’s deontology).4 Nevertheless, the utilitarian
reliance on evidence could guide us towards actions that
can be supported as more beneficial than not. Maybe, for
instance, our loved ones didn’t want a gift or wanted a
different gift yet we failed to acknowledge the relevant
evidence for that fact.
ongoing debate within the field but a possible counter
argument could be to focus on long term happiness instead
of short term gratification or preferences. Perhaps
watching movies while eating potato chips causes short
term pleasure but does a disservice to oneself and society
as a whole over the long term.
The final issue focuses on grime outcomes.5 This is best
exemplified by the trolly problem. Imagine there is a trolly
speeding towards a junction, ahead there are five workers
who will be killed if the trolly keeps going. However, you
have access to a switch, if you pull the switch the trolly
will be redirected to another track where it will kill one
worker instead. Utilitarianism would require someone to
pull the switch to save the five workers over the one
worker. This seems reasonable to most people, but let’s
change the situation a bit. Let’s say instead of pulling a
lever you would have to push a person in front of you to
slow down the trolly in order to save the five workers. The
second scenario sounds more morally incomprehensible
but the outcome would essentially be the same, so the
utilitarian would support it. Moral psychology has
researched some of these scenarios, there seems to be a
distinction between how we act and how we think we
should act.6 Some of the research into this area has even
supported the idea utilitarian moral judgements might be
associated with a lack of empathy.7 A rebuttal would be
emotionally driven moral choices might cause more harm
to more people which would be even more morally
incomprehensible. So is utilitarianism this cold calculating
way of judging how we ought to act? Not necessarily, in
fact using utilitarian reasoning we can argue empathy and
understanding causes greater positive impact.
Applying utilitarianism to coaching
An important consideration is the assumption we should
focus on happiness itself. Some philosophers, like Peter
Singer, argue we should focus on everyone’s interest
equally not happiness per se.3 We could also focus on
people’s preferences or what people state they prefer.
However, it is possible people's preferences could interfere
with their interest. It’s also possible focusing on happiness
as it relates to pleasure can have us commit actions that
might not maximize our well being. Someone can gain
great pleasure from and prefer to watch movies on the
couch all day while they munch on potato chips but it
doesn’t necessarily cater to their best interest. This is an
As coaches we influence our clients, they look up to us and
take our advice seriously. With great power comes great
responsibility (I didn’t steal that from spiderman promise).
Coaches do not just impact individual clients but societies
at large. With the growing epidemic of chronic diseases
like obesity, diabetes, and heart disease, coaches are
essential for combatting these issues. We teach skills,
habits, and techniques that can improve a person’s life for
a long time. Therefore, we need to consider the
consequences or outcomes of our decisions. Our decisions
as coaches can possibly lead someone to be happier or it
can put them at risk.
Alan Aragon’s Research Review – March 2021
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Page 14
A coach with a utilitarian perspective would probably want
to maximize the well being of clients. Wellbeing defined
by objective and subjective measures of health (e.g.. health
markers, sports performance, endurance, psychological
health, etc.). Being healthier in the long run can lead to
increased happiness. If we define happiness in terms of
pleasure, we can argue pleasure isn’t just about physical
gratification but it can have other forms. According to
Mill, there are a range of pleasures beyond just physical
which can include personal, intellectual, and aesthetic
pleasures.2 There is a personal pleasure of finishing a
workout well, an intellectual pleasure in learning how to
perform an Olympic lift, and the aesthetic pleasure of
seeing your biceps get bigger. Coaches should seek to
maximize well being as it can maximize happiness.
Evidence based coaches should let the evidence guide
them in practice, this is essentially what utilitarianism is all
about. Making the best possible choices for clients based
on the best available evidence possible while weighing out
the alternatives. The evidence we gather from research,
experience, and clients themselves should be the driving
force of decision making. This evidence can change and
should take into consideration who we are working with.
By stressing the evidence to make the best outcome more
likely, coaches are utilizing utilitarian reasoning.
faster, and eat better not only affects them but it also
affects those around them. That grandmother can finally
run around with her three grandchildren. That high school
athlete received a full scholarship to college for track and
field. The person with diabetes finally has control over
their blood sugar level… we don’t know the full range
impact our actions can have on the world. Coaches can
save lives and better society one person at a time.
_______________________________________________
Jaebien Rosario is a fitness and nutrition
writer who studies psychology and
philosophy at university.
www.substack.com/mrcogfit
www.mrcogfit.com
______________________________________________
References:
Beyond just the individual client, think about global
impact. Utilitarianism stresses not just the individual but
the sum total of individuals affected by any given action.
Teaching people how to move better, get stronger, get
1. Bentham, Jeremy. An Introduction to the Principles of
Morals and Legislation. Printed in the Year 1780, and
Now First Published.
2. Mill, John Stuart. Utilitarianism. London, Parker, son,
and Bourn, 1863.
3. Singer, Peter. Writings on an Ethical Life. New York:
Ecco Press, 2000.
4. Smart, J. J. C., & Williams, B. (1973). Utilitarianism: For
and against. Cambridge [England]: University Press.
5. Kagan, Shelly (1989). The Limits of Morality. Oxford
University Press.
6. Navarrete CD, McDonald MM, Mott ML, Asher B.
Virtual morality: emotion and action in a simulated threedimensional "trolley problem". Emotion. 2012
Apr;12(2):364-70. [PubMed]
7. Wiech K, Kahane G, Shackel N, Farias M, Savulescu J,
Tracey I. Cold or calculating? Reduced activity in the
subgenual cingulate cortex reflects decreased emotional
aversion to harming in counterintuitive utilitarian
judgment.
Cognition.
2013
Mar;126(3):364-72.
[PubMed]
8. Suarez-Lledo V, Alvarez-Galvez J. Prevalence of Health
Misinformation on Social Media: Systematic Review. J
Med Internet Res. 2021 Jan 20;23(1):e17187. [PubMed]
Alan Aragon’s Research Review – March 2021
[Back to Contents]
Gathering and utilizing the best evidence also includes
speaking up against false information and public
perception about health. Fake news is pervasive on social
media and other mass media outlets.8 To ensure client well
being we should make sure they’re informed in the best
way possible about the topics they seek us out for.
Empowering people to make the most well informed
choices for themselves and perhaps educating the people
around them. As coaches we are also educators, teaching
clients about exercise, nutrition, and overall health. Using
the utilitarian perspective, coaches have an obligation to
correct, protect, and educate clients against false
information. This can lead to increased well being for
clients, communities, and possibly the world at large.
Page 15
enhanced body composition, recovery, mood state,
reduced muscle damage.8
Probiotics as an ergogenic aid?
By David Galvin, MS, CISSN, CSCS
_______________________________________________
Background
Probiotics is a term derived from the Greek language; the
literal translation is “for-life,” as probiotics are considered
a health promoting live microorganism1 (typically lactic
acid bacteria) which when taken in adequate amounts, may
confer health benefits. Probiotics can contain bacterial or
yeast strains,2 and are available commercially in capsule,
tablet, powder, or liquid form – or in specific foods such as
yogurt and nutrition bars. The word “Ergogenic” is derived
from the Greek work “ergon”, meaning “work”; and the
suffix “-genic” meaning “producing.”. “Ergogenic”
translates to “work producing” or “tending to increase
work.”
Probiotics are purported to support immune function, and
reduce the incidence, severity, and duration of infections.
Upper-respiratory
tract
infections
(URTI)
and
Gastrointestinal (GIT) infections (or discomfort
symptoms) have been the focus of most active population
investigations, likely due to the prevalence of such
infections or symptoms associated with highly trained
athletes.4 When administered for several weeks,
probiotics may increase the quantity of beneficial bacteria
in the gut as well as modulate immune function.5
Probiotics complement the normal GI flora by enhancing
gut immunity against GIT.6
Performance effects of probiotics have been mixed.
Research shows that probiotics may not produce a direct
performance benefit, but may be useful for athletes’ health
and reduce the instances of sickness/infection, thus
reducing the time absent from training. This, in turn, can
aid in maximizing adaptations with higher levels of
adherence/consistency.
The mechanisms for reduced frequency, severity and
duration of sickness occur through probiotics supporting
immune function. This may be achieved by improved
barrier function, stimulating cell activity and or mucus
production – each of which have a crucial role in the
immune system.10 Consumption of certain antiinflammatory probiotic strains have been linked to reduced
muscle soreness, and therefore enhanced recovery.1
Probiotics as an ergogenic aid has become a focal area in
research in the last decade. Literature reviews1,2,7-9 have
collectively examined 46 investigations, most are
randomized controlled trials of high quality; all are carried
out on active populations. 21 studies investigated health
outcomes only, 5 investigated performance outcomes only
and 20 studies examined both health and performance
outcomes.
Claims are variable dependent on marketing. Among the
claims for athletes are improved energy availability,
URTI were investigated in 14 studies of probiotic
supplementation, 9 studies showed reduced frequency,
duration or severity of URTI however 5 showed no
significant differences. Gastrointestinal discomfort
symptoms were investigated by 4 studies – 3 showed a
positive effect, and 1 study showing no differences
between groups. Reduced markers of inflammation were
noted in 6 of 8 studies. 1 study showed elevated mood
state from that of a depressed status.1 One study
investigated fatigue levels, and probiotics showed a
reversal of a T-cell deficit in comparison to controls. 13
studies investigated an aspect of immune support (i.e.
monocyte levels, salivary antimicrobial protein,
cytomegalovirus levels, zonulin levels/gut permeability,
and endotoxin levels) in which 6 showed a positive
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Probiotics act by producing anti-pathogenic compounds,
stimulate the production of defensins, and compete for
pathogen binding and receptor sites. Therefore, they
inhibit the growth of, and reduce the effects of potentially
harmful bacteria, antigens, toxins, and/or carcinogens in
the gut.7
Performance enhancement
Page 16
outcome for systemic immunity and 7 noted no changes.
No study found increased energy availability.
Positive health outcomes that may influence performance
could be identified. However, direct performance benefits
remain to be established. Where a direct performance
benefit was reported, the mechanisms were not
transparent. It was suggested this may have been achieved
from reduced infection and time absent from training; thus
indirect.
Probiotics are not on the world anti-doping agency list and
do not warrant regulation from the perspective of athlete
testing. There are safety regulations to ensure human
efficacy and safety.10 There are no guidelines surround the
dosage or consumption of probiotics, research does show
that multi-strain sources have a greater effect than single
strain sources.
While natural sources of probiotics are often marketed and
promoted in line with the benefits research has shown,
these sources (i.e. milk, cheese) generally have low
concentrations of probiotics. An effective daily dose for
athletes in research shows ~1010 colony-forming units
(CFUs) (about 10 billion bacteria) elicits positive
outcomes. Commercial probiotics contain ~110 CFUs per
serving.
A 14-day consumption period is recommended as is often
used in clinical studies to enable the GI tract to adapt to
administered microorganisms, this may result in mild GI
symptoms (i.e. flatulence). The long term effects of
probiotic use in athletes are unclear as most studies are
conducted in a 4-16 week timeline.1
A limiting factor in research is the strains used, form
consumed and duration of supplementation. A
generalization of probiotic recommendations cannot be
made until greater clarity surrounding the benefits of
probiotics and athletic performance can be established
(then we can #Probiotics4life, see what I did there).
a probiotic is successful in reducing the frequency of
infection, this may significantly improve an athlete’s
continuity of training and therefore result in better
adaptations and performance.
Decisions to prescribe or use probiotics should be
individualized to the prevalence of infection during highstress training times and the GI symptoms experienced
around event times. A probiotic in the appropriate dose
may reduce the risk of infections, improve immune
function and contribute to the athlete’s overall health.
Currently, the ergogenic evidence in this area is equivocal
and far from definitive, thus universal recommendations
remain elusive.
_______________________________________________
David Galvin CSCS CISSN MSc
Exercise Physiology. I have a
passion for science, health, sport
and human performance. I will
pursue progress in the trenches and
academically
indefinitely.
The
mission “Train with purpose, not
habit” (My Slogan), to spread
evidence-based knowledge to the
masses. Coached a variety of
athletes from various sports and
levels. Accolades; Professional soccer (NWSL champion), World record
holding Rowers, International podium level MMA athletes (2 Golds),
European level Sprinters, GAA (Google it !) inter-country level athletes.
Evidence Informed online coach.
Website: www.recalibratedbodies.com
Instagram: @david_galvin_
Facebook: www.facebook.com/momentumperformancecork
______________________________________________
References
There is a lack of evidence on probiotics directly
influencing performance. However, it is noteworthy that if
1. Deacon CF, Nauck MA, Toft-Nielsen M, Pridal L,
Willms B, Holst JJ. Both subcutaneously and
intravenously administered glucagon-like peptide I are
rapidly degraded from the NH2-terminus in type II
diabetic patients and in healthy subjects. Diabetes.
1995 Sep;44(9):1126-31. [PubMed]
2. Christou GA, Katsiki N, Blundell J, Fruhbeck G,
Kiortsis DN. Semaglutide as a promising antiobesity
drug. Obes Rev. 2019 Jun;20(6):805-815. [PubMed]
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Concluding perspectives
Page 17
3. Andreadis P, Karagiannis T, Malandris K, Avgerinos
I, Liakos A, Manolopoulos A, Bekiari E, Matthews
DR, Tsapas A. Semaglutide for type 2 diabetes
mellitus: A systematic review and meta-analysis.
Diabetes Obes Metab. 2018 Sep;20(9):2255-2263.
[PubMed]
4. Blundell J, Finlayson G, Axelsen M, Flint A, Gibbons
C, Kvist T, Hjerpsted JB. Effects of once-weekly
semaglutide on appetite, energy intake, control of
eating, food preference and body weight in subjects
with obesity. Diabetes Obes Metab. 2017
Sep;19(9):1242-1251. [PubMed]
5. Wilding JPH, Batterham RL, Calanna S, Davies M,
Van Gaal LF, Lingvay I, McGowan BM, Rosenstock
J, Tran MTD, Wadden TA, Wharton S, Yokote K,
Zeuthen N, Kushner RF; STEP 1 Study Group. OnceWeekly Semaglutide in Adults with Overweight or
Obesity. N Engl J Med. 2021 Feb 10. doi:
10.1056/NEJMoa2032183. [PubMed]
6. Helms ER, Aragon AA, Fitschen PJ. Evidence-based
recommendations for natural bodybuilding contest
preparation: nutrition and supplementation. J Int Soc
Sports Nutr. 2014 May 12;11:20. doi: 10.1186/15502783-11-20. [PubMed]
7. Garthe I, Raastad T, Refsnes PE, Koivisto A, SundgotBorgen J. Effect of two different weight-loss rates on
body composition and strength and power-related
performance in elite athletes. Int J Sport Nutr Exerc
Metab. 2011 Apr;21(2):97-104. [PubMed]
8. Bessesen DH, Van Gaal LF. Progress and challenges
in anti-obesity pharmacotherapy. Lancet Diabetes
Endocrinol. 2018 Mar;6(3):237-248. [PubMed]
9. American Diabetes Association. 8. Obesity
Management for the Treatment of Type 2 Diabetes:
Standards of Medical Care in Diabetes-2020. Diabetes
Care. 2020 Jan;43(Suppl 1):S89-S97. [PubMed]
10. Tchang BG, Kumar RB, Aronne LJ. Pharmacologic
Treatment of Overweight and Obesity in Adults.
[Updated 2020 Oct 7]. In: Feingold KR, Anawalt B,
Boyce A, et al., editors. Endotext [Internet]. South
Dartmouth (MA): MDText.com, Inc.; 2000-. [NCBI]
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Page 18
“It takes skill to notice what’s NOT wrong.”
– Shawne Duperon
If you have any questions, comments, suggestions, bones
of contention, cheers, jeers, guest articles you’d like to
submit for review/consideration, send them over to
support@alanaragon.com.
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