Eccentric Cycling Doubles Fat Loss: 24 Obese Teens Lose -3.4kg ('-10%') Body Fat in 12-Wk W/Out Dieting Efforts

This is how ecc. cycling works + it also happens to show the bike used in the study!

Eccentric cycling? How does it even work? I admit that I was asking myself the very same thing when I hit on Valérie Julian's (2018) latest paper... until I found the video on the right and realized: it's just a modern day torture machine.

A torture machine that doubled the urgently needed fat loss in 24 obese adolescents, though, and hence probably is worth considering - not only, but also because the benefits of eccentric endurance training on fat mass "remain underexplored" (Julian 2018).

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As the authors point out in the introduction to their paper, said lack of research is mostly due to several methodological:

"(a) the difficulty in isolating ECC and CON actions during typical everyday movements; (b) the rigorous methodology required to compare ECC and CON exercise in standardized experimental conditions of power output (ie, at the same mechanical power) or oxygen consumption (ie, at the same metabolic rate or oxygen consumption level, with mechanical power 3‐5 times higher during ECC cycling); and (c) specific ECC pedal ergometers have only acquired widespread usage in the last decade" (Julian 2018).

In obese adolescents, the study at hand is even the first to probe the impact of eccentric cycling. Now the question is: Why on earth would one even want to do that, i.e. cycling eccentrically? Well, here's the rationale: During #EccentricTraining, which forces your muscles to generate force by lengthening (developing tension to either decelerate movement or acting against gravity), your muscles are subjected to greater mechanical stress and respond with increased adaptational effects - that's at least the theory ;-)

Hold on, eccentric training is the thing you do for biceps curls, isn't it?

For most athletes eccentric training belongs into the realms of strength training and bodybuilding, though. To use it in endurance athletes and/or as "cardio" exercise to burn fat, is not exactly what people think aout when they hear about eccentric training. Few people know that there are at least three distinct types of ECC training, namely (a) #plyometricExercises (such as drop jumps, with contractions lasting milliseconds and producing thousands of watts of negative power), (b) classical ECC resistance exercises (protocols consisting of near maximal ECC contractions lasting few seconds, used to lift and lower weights), and (c) “continuous moderate load ECC exercises” as discussed by Hoppeler et al. in their 2016 paper in Frontiers of Physiology:

"This type of training has been characterizes as moderate load eccentric exercise. It has also been denoted RENEW (Resistance Exercise via Negative Eccentric Work by LaStayo et al., 2014). It is distinct from plyometric exercises (i.e., drop jumps) that impose muscle loads of several thousand Watts on muscles and tendons. It is also distinct from eccentric overload training whereby loads in a conventional strength training setting are increased in the eccentric phase of the movement to match concentric loads. Moderate load eccentric exercise (or RENEW) has been shown to be similarly effective as conventional strength training in increasing muscle strength and muscle volume.

Figure 1: Eccentric ergometer custom built for the Swiss National ski-team, capable of providing loads up to 2000 W. As shown, this ergometer can be used in a sitting and in a standing position (from Hoppeler 2014). You can see the machine that was used in the study at hand in the YouTube video at the top of this article.

However, as carried out at higher angular velocities of joint movement, it reduces joint loads. A hallmark of moderate load eccentric exercise is the fact that the energy requirements are typically 4-fold smaller than in concentric exercise of the same load. This makes moderate load eccentric exercise training the tool of choice in medical conditions with limitations in muscle energy supply. The use and effectiveness of moderate load eccentric exercise has been demonstrated mostly in small-scale studies for cardiorespiratory conditions, sarcopenia of old age, cancer, diabetes type 2, and neurological conditions. It has also been used effectively in the prevention and rehabilitation of injuries of the locomotor system, in particular the rehabilitation after anterior cruciate ligament surgery" (Hoppeler 2016).

As you can see in the video at the top of this article, as well as the photos from Hoppeler 2014 (Figure 1), a special motorized device is necessary to power this alternative training modality, which includes, next to cycling on special motorized ECC cycle ergometers, also downhill walking or running, and stepping exercises. As Juliann et al. point out, all four training modalities share one important characteristic: they lower the metabolic demand, compared with concentric training when performed at the same mechanical power (Peñailillo 2017).

Important note on the relevance of the practical results: The CON group trained on an Optibike Med 600, a regular ergometer no fancy special machine - CON's thus just plain cycling as you know it. This is different to resistance training studies in which subjects in the CON groups perform only the concentric portion of the exercise and hence don't represent regular training. CON-cycling, in the study at hand, on the other hand, is regular cycling.

Now, while this makes eccentric training "particularly suitable for patients with chronic pathologies, resulting in cardiac, respiratory, or muscular limitations to their exercise capacities" (Julian 2018), it is, indeed, not obvious why training less metabolically demanding would still promote greater fat loss than regular concentric training... Unless, however, you consider the energy demands of repairing muscle damage and the corresponding increase in resting energy expenditure, that is:

"Moreover, [eccentric training] modifies metabolic substrate use, increasing fat oxidation, and favors a postexercise decrease in blood lipid (which would participate in synthesize new cell membranes of injured muscles)" (Julian 2018 | my emphasis).

Thus, you will be getting more "calorie burning buck" for your bang... or, as the scientists phrase it:

"considering the similar or superior potential effects of ECC training on body composition and its lower metabolic demand, ECC training would be more efficient than CON training given the ratio of energy expenditure to net force or work production" (Julian 2018 | my emphasis).

In conjunction with increasing the energetic demands for muscle repair, eccentric training will - as previously highlighted - also provide a(n allegedly) more pronounced stimulus to skeletal muscle adaptation. Hence, it is not totally surprising that the body fat levels of the subjects were not the only parameter the scientists measured that improved more in the ECC vs. CON group.

Figure 2: The macronutrient composition of the diet the subjects were taught, but not forced to eat isn't exactly what contemporary research would describe as ideal for overall health, fat loss and lean mass preservation (Philipps 2018). 

Believe it or not, the fat was shed without dieting: Yeah, ... there were nutritional education sessions lasting 45 minutes every 2 weeks, but "there was no dietary restriction per se" (Julian 2018). Neither were the adolescents low-carbing or following a diet devoid of fat.

The diet the subjects were taught to consume had an age-dependent energy content of 40 to 50 kcal/kg/d (for 12-15 years) with a mean daily composition of macronutrients of 35% lipids, 55% carbohydrates, and 15% proteins (not exceed 0.9 g/kg/d) - protein deficient for weight loss if you go by the latest research.

Speaking of which, said subjects were twenty‐four adolescents aged 13.4 ± 1.3 years (BMI > 90th percentile), who were randomized to ECC or CON.

All subjects performed three cyclo‐ergometer sessions per week (30 min per session) for 12 weeks: two habituation, 5 at 50% VO2peak, and 5 at 70% VO2peak. 

Anthropometric measurements, body composition (using DXA), maximal incremental CON tests, strength tests, and blood samples were assessed pre‐ and post‐training. About the training protocol, the scientists write:

Figure 3: Study design (Julian 2018)

"The training program consisted of three phases. Phase 1 involved 2 weeks of habituation (ie, progressive increase in exercise intensity and session length) in order to protect subjects from DOMS. During the first sessions, a load corresponding to 20% VO2Peak was imposed, with exercise duration gradually increased by 10‐minute increments up to 30 minutes. Once the exercise duration reached 30 minutes, the exercise intensity ramped up progressively by 10% until achieving 50% VO2Peak.

Phase 2 consisted of 45‐minute sessions with a 10‐minute warm‐up on CON cycle ergometers at 30% VO2Peak then 30 minutes ECC or CON cycling at 50% VO2Peak, and a 5‐minute cool down. Phase 3 consisted of 45‐minute sessions with a 10‐minute warm‐up on CON ergocycles at 30% VO2Peak, 30 minutes ECC or CON cycling at 70% VO2Peak, and a 5‐minute cool down.

Patients were asked for a rating of their perceived exertion (RPE) during each exercise. During the whole 12‐week training, the duration of the session and loads was not increased if participants suffered from DOMS, as indicated by scores >3 on a visual analogic scale (0‐10 scale) or when the rating of the perceived exertion (RPE) of the session was >13 according to BORG (6‐20 scale)" (Julian 2018).

As highlighted as early as in the headline of this SuppVersity article, the analysis of the data the scientists generated with the protocol that is illustrated in Figure 3 yielded a quite astonishing result: The young, obese subjects reduced their body fat percentage by -10% while the subjects in the concentric training group lost only -4.2% (P < 0.05 | note: those are relative values, you can see the absolute changes in body fat percentage over the bars in Figure 4).

Figure 4: Changes in body composition and central parameters of glucose management (calculated based on Julian 2018 | the values for the body fat % and lean mass % differ because I didn't calculate them as the relative change in a parameter that is already expressed relative to the total body weight; I simply subtracted them -subjects went from 31% to 27% BF).

What the headline doesn't tell you, though, is that the increases in whole‐body lean mass (LM) percentage, as small as they were, was also significantly higher in the ECC compared to the CON group (ECC: 3.8% vs CON: 1.5%, P <0.05) - a result that seems to confirm the superior adaptive stimulus of ECC vs. CON training.

The large effect sizes shall not go unmentioned, either

By now, you'll probably not be surprised that the improvement in leg FM and LM percentages were greater in the ECC group (−6.5% and 3.0%, P = 0.01 and P < 0.01 | note: that's the difference between the relative values; the absolute changes were -1kg and -0.8kg), as well and came with significantly elevated increases in quadriceps strength in the ECC group (28.3% and 21.3%, P < 0.05).

Figure 5: Three of the changes in body composition were 'large' - that's something you don't see in every study.

Now, this is great, but let's be honest: Being strong and diabetic is a bummer, so the -19% reduction in HOMA-IR that occurred in the absence of significant differences in VO2peak improvement (ECC: 15.4% vs CON: 10.3%) may be the most important improvement the scientists observed in their 12-week study. And who knows if the subjects had eaten more protein (0.9g/kg is clearly not enough for optimal body composition changes in adolescents) the subjects would probably not just have seen relative gains in lean mass (lean mass:body weight), but actual gains.

Speaking of which, it is probably worth mentioning that the effect sizes for the lean leg mass and the reduction in leg fat were all 'large' (ES 1.07, 0.66, and 0.95, respectively). A 'large' effect (ES 0.85) was also observed for the reduction in waist circumference the scientists do not even report in the abstract to their study (see Figure 5 for an overview of 'large' effects).

Figure 6: Due to the increased training stimulus, the subjects conditioning (VO2Peak), cycling power and quadriceps strength increased significantly more in response to the eccentric vs concentric cyclic protocol. As the authors point out this makes eccentric cycling interesting even for endurance athletes who want to diversify and hopefully optimize their training routine (Julian 2018)

So what's the verdict, then? As highlighted in the previous infobox, there's a fundamental difference between resistance training and cycling training studies that compare the effects of eccentric vs. concentric training. After all, cycling is innately concentric. In the study at hand, the CON group was thus actually what you would usually call a regular control group (this would be different in an RT study where CON-only training is by no means "regular" training).

So, a realistic study protocol, a fair comparison, no diet and still exciting results? Well, yes and no. The way the scientists report their results are quite misleading. How's that? Well, with the percent change in body fat percentage, Julian et al. report the relative change of a relative parameter as their main outcome... the 10% reduction in body fat percentage, for example, is effectively only a 3% reduction in the body fat percentage measured by DXA - or, to put it differently: the actual values decreased from 31% to 28% and hence by 3%... obviously, 3% are 10% of the baseline level of 31% body fat percentage, so the scientists didn't misreport their results, but I have to say that I was a bit disappointed when I saw the actual values after having read about a "-10%" reduction in body fat percentage in the abstract of the study.

But let's not freak out. The most important message of the study at hand is that 12 weeks of progressive eccentric cycling training burns 2x more body fat than "regular" concentric cycling and induces profound improvements in glucose management - in the absence of deliberate dietary restrictions!

Whether that warrants Julian's conclusion that eccentric cycling training "represents an optimal modality to recommend for obese adolescents" (Julian 2018 | my emphasis) is imho still questionable. If you have access to the corresponding torture instruments, though, it's certainly worth trying - for fat loss and performance, by the way | Comment on Facebook!

References:

• Hoppeler, Hans. Eccentric Exercise: physiology and application in sport and rehabilitation. Routledge, 2014.
• Hoppeler, Hans. "Moderate load eccentric exercise; a distinct novel training modality." Frontiers in physiology 7 (2016): 483.
• Julian V, Thivel D, Miguet M, et al. Eccentric cycling is more efficient in reducing fat mass than concentric cycling in adolescents with obesity. Scand J Med Sci Sports. (2018): Ahead of print.
• Peñailillo, Luis, Anthony J. Blazevich, and Kazunori Nosaka. "Factors contributing to lower metabolic demand of eccentric compared with concentric cycling." Journal of Applied Physiology 123.4 (2017): 884-893.
• Phillips, Stuart M. "Higher Dietary Protein During Weight Loss: Muscle Sparing?." Obesity 26.5 (2018): 789-789.

Breakfast: Eat it or Skip it? Making it High Protein Will Have Habitually Skipping Teens Lose Fat & Curbs Their Hunger

This could have been the HP breakfast. Egg-based pancakes + ham.

It is almost like the question "to carb" or "not to carb" and the almost religiously maddish discussions between carb-eaters and ketophiles: The debate revolving around the useful- or uselessness of breakfast, when it comes to health and physique issues.

In my more recent articles about the topic I have repeatedly exposed the claim that "not having breakfast is bad for everyone" is total bogus; and while I am not going to go back on that I am about to discuss a study that demonstrates that the right breakfast, i.e. one that's high in protein, may be extremely better than having no breakfast at all.

Learn more about fasting and eating / skipping breakfast at the SuppVersity

Breakfast and Circadian Rhythm

Does Meal Timing Matter?

Breakfast & Glucose Metab.

Break the Fast, Cardio & the Brain

Does the Break- Fast-Myth Break?

Breakfast? (Un?) Biased Review

Said study has been conducted by scientists from the University of Missouri and the Purdue University (Leidy. 2015). It's an investigation into the effects of normal-protein (NP) vs. high-protein (HP) breakfast meals on appetite control, food intake, and body composition in “breakfast skipping” young people with overweight/obesity.

As a SuppVersity reader you'll know that previous studies suggest that as habitual breakfast skippers, the youths are actually not the ideal study object for a study to show beneficial effects of breakfast. After all, a recent study by Thomas et al. showed quite convincingly that "Whether Skipping Breakfast Increases Insulin, Hunger and Blood Lipids Depends on One's Breakfast Habits" (read the article). Is this a problem? Well, it could be if the new study yielded negative results. After all, we'd have to argue that this was to be expected if the subjects were habitual breakfast skippers.

Table 1: Subject characteristics at baseline (Leidy. 2015). As you can see the subjects were randomly assigned to the three groups at a ratio of 1:2:2 to breakfast skipping, normal protein (NP) and high protein (HP) breakfast.

Luckily, the results were positive and the study with its 12-week study period probably long enough to overcome the effects of habituation which mess with the results of all studies which test the effect of having vs. skipping breakfast on only one or two occasions.

Figure 1: Macronutrient composition (g) of the test meals used in the study (Leidy. 2015)

The study at hand, however, had its fifty-seven adolescent subjects (age: 19 +/- years; BMI: 29.7 +/- 4.6 kg/m²) complete a 12-week randomized controlled trial in which the adolescents consumed either a 1,464 kJ NP breakfast (13 g protein), an isocaloric breakfast with a high protein content (HP | 35 g protein), or continued to skip breakfast (CON). The main outcome variables were the subjects' pre- and post-study appetite, their food intake, body weight, and body composition, which was assessed assessed via DXA scans (which are as you know still the "gold standard" for measuring the body composition of subjects in scientific studies)

In Schlundt's 12-week study in which the subjects had to follow the same energy reduced diet pattern one time with, one time without breakfast the marginal differences in weight loss and fat loss (the former favors breakfast, the latter skipping it) were just as statistically non-significant as the other inter-group differences the US scientists observed (Schlundt. 1992).

In the long run, calories count. So if you are counting calories it doesn't matter if you have breakfast or don't. There are bazillions of "breakfast eating vs. skipping"-studies, but this is only study #3 to test the long-term effects. Yes, sometimes science is pathetic and stupid - and trying to elucidate the health effects of eating vs. skipping breakfast in studies on three testing days is both: pathetic and stupid.

One of the two non-pathetic studies comes from Schlundt et al. who examined the effects of consuming breakfast vs. breakfast skipping during a 12-week energy restriction weight loss diet in 52 adult women with obesity without finding significant differences.

More recently, Dhurandhar et al. completed a 16-week study in 309 adults with obesity and included a general recommendation to either "eat breakfast" or "skip breakfast". As it was to be expected when energy intake is controlled for, again, no differences in weight loss were observed in those who began eating breakfast compared to those who continued to skip breakfast.

The NP and HP groups were provided with specific breakfast meals to consume between 6:00 and 9:45am each day, while the CON group continued to skip breakfast (with nothing to eat/drink, besides water) before 10:00am - with significant consequences as the in parts significant inter-group differences in Figure 2 can tell you.

Figure 2: Comparison of the changes in fat mass, the daily food intake, hunger and fullness ratings in the subjects from the CON (=kept skipping breakfast), NP (normal protein) and HP (high protein) breakfast groups (Leidy. 2015).

The superiority of (a) having breakfast and (b) consuming a high protein breakfast are not debatable. With its 12-week study duration, the study at hand obviously allowed for a full habituation and did thus - much in contrast to many short-term studies - yield all the benefits that are usually ascribed to having breakfast. In particular, having breakfast...

• 

  "Breakfast!? An (Un-)Biased (?) Review of the Breakfast Myth" | read it!

  made the subjects magically lose (HP) or at least not gain (NP) superfluous body fat.
• significantly reduced the daily energy intake in the high protein condition and buffered the significant increase in energy intake in the no breakfast condition if the breakfast had a normal protein content,
• reduced the total time during which the subjects were hungry not just in the morning, but 24/7, and
• increased the subjects' fullness, especially in the morning.

In that it's important to highlight that the high protein breakfast outperformed the normal protein breakfast in all relevant categories, i.e. change in body fat, change in daily energy intake and change in hunger ratings, Accordingly, Leidy et al. are right when they highlight only the high protein breakfast in their conclusion which says that

"daily addition of a HP breakfast improved indices of weight management as illustrated by the prevention of body fat gain, voluntary reductions in daily intake, and reductions in daily hunger in breakfast skipping adolescents with overweight/obesity." (Leidy. 2015)

In spite of that, we should not forget that even a regular breakfast which contained 15% protein, 65% carbohydrates, and 20% fat and consisted of (you guessed it) ready-to-eat cereals with milk outperformed not having breakfast at all. That's in contrast to some previous studies, most of which used shorter study durations and didn't allow for the habituation that's necessary for breakfast to have effects on the total energy intake, for example, to take place.

The study at hand is an excellent example that shows that the previously observed effects of habitation can be overcome if you adhere to your new breakfast protocol meticulously. 

So what? If you have a teenage son or daughter, serve him / her a high protein breakfast containing 40% protein, 40% carbohydrates, and 20% fat, like an egg-based pancakes and ham; egg-based waffles with pork-sausage; egg and pork scramble; and an egg and pork burrito (all these were options the subjects in the study at hand were provided with on a weekly basis. It's going to help them manage their weight, food cravings, and hunger pangs and it's not going to take you an hour to prepare (rather 15 min - max). The scientists assertion that "it is unclear as to whether the daily consumption of a high-protein breakfast, containing 35 g of protein, is feasible in a free-living environment" (Leidy. 2015) is just more pathetic evidence that people care so little about their health that they'd rather die from eating ready-made cereals than to invest the 10-15 minutes to prepare delicious and healthy protein pancakes into their health.

If you are now contemplating to switch back to having breakfast, yourself, let me remind you that it is not possible to extrapolate study results that were generated with a specific group of subjects, in this case overweight, but still healthy adolescents to whomever you want. If you are on an energy controlled diet and skipping breakfast as a means to do intermittent fasting and reduce your overall energy intake, you won't reduce your 24h energy intake (after all, you're eating X kcal everyday, anyway).  It is thus unlikely that you'd lose more weight than you'd do without breakfast and if you are like many people you will probably even feel hungrier now that you're able to eat only 3 small vs. 1-2 large(r) meals | Comment on Facebook!

References:

• Dhurandhar, Emily J., et al. "The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial." The American journal of clinical nutrition 100.2 (2014): 507-513.
• Leidy, Heather J., et al. "A high‐protein breakfast prevents body fat gain, through reductions in daily intake and hunger, in “Breakfast skipping” adolescents." Obesity (2015).
• Schlundt, David G., et al. "The role of breakfast in the treatment of obesity: a randomized clinical trial." The American journal of clinical nutrition 55.3 (1992): 645-651.
• Thomas, Elizabeth A., et al. "Usual breakfast eating habits affect response to breakfast skipping in overweight women." Obesity 23.4 (2015): 750-759.

High School Athletes on Dope? Not Really, But Roughly 1/3 Uses "Performance Enhancing Supplements"

"Don't you take those steroids!" Does this remind you of your mother, when, back in high school, you bought your first tub of creatine monohydrate? Recent doping "scandals" have, yet again, raised the awareness, or should I say panicky fear of parents and coaches that their children and wards are going to be delinquent, when they save their allowances for a shopping spree at the local GNC. Accordingly, many of them will not be happy to hear that a recent study published in the Journal of Strength & Conditioning Research (Piattolly. 2011) found that "[a]lmost a third [32.2%] of the high school sample surveyed reported using nutritional or performance enhancement supplements."

Figure 1: Type of performance enhancing supplement used by high school athletes (data adapted from Piattolly. 2011)

Interestingly, of those 32.2% of the young athletes that reported using supplements, the majority were male (87%) and in the age group of 15-17 year-olds. Prevalent sports were baseball (17.8%), football (32.7%), and track and field (22.3%) and the most popular supplements were protein shakes, multivitamins, NO2 boosters and creatine (cf. figure 1), of which more than 50% of the respondent used two or more in combination.

An interesting secondary finding of the study relates to gender differences and the afore mentioned role of parents in their children's choice and consumption of performance enhancing supplements:

When gender comparisons were made, significant t-tests demonstrated that young women rated higher on taking supplements to improve strength, increase size, decrease body fat (p < 0.05) to become a better athlete, and increase physique. With the exception of decrease body fat, all p-values were < 0.001. Significantly more young women reported learning about the supplement from a teammate or friend (p < 0.05), while young men reported learning about the supplement from their parents (p < 0.05).

It is, however, unsettling to know that other than the 25% of the athletes who "said they would consult a nutritionist or physician (25%)" to make sure they chose the right supplements, 26% of the young athletes conceded that "they would take a supplement that could harm their health if they could receive a scholarship".

In view of this last-mentioned result, the fears and anxieties of parents appear in a very different light. Banning or restricting the consumption of harmless supplements like protein shakes will yet hardly solve a dilemma that is rooted much more deeply within a scholarship system where athletic and lately cognitive performance is so tightly bound to the future prospects of adolescents that "doping" muscle and/or brain are on the verge of becoming the norm rather than the exception.

Gender Dependent Effects of TV Consumption on Body Fat Percentage of Canadian Teens

A longitudinal study (57 months) published by the American Journal of Epidemiology on July 8, 2010 found that although there is a negative effect of increased TV-consumption on boys (12–13y), no such correlation exists for the girls:

"Relative to that of steady-low screen-time trajectory group boys, percent body fat was 2.9 (95% confidence interval: 0.7, 5.0) and 2.4 (95% confidence interval: 0.5, 4.2) percentage units higher on average among "increasers" and "steady-high" trajectory group boys, respectively. There was no evidence that screen time has an effect on percent body fat in girls overall, although physical activity modified the association between screen time and percent body fat in both sexes."

Despite these findings, the scientists conclusion,

"Efforts to prevent obesity in youth should emphasize reducing screen time,"

unquestionably holds true, even if it is your daughter who is sitting in front of her TV-screen 24/7 ;-)