Supplementary information files for "Fasting appetite-related gut hormone responses after weight loss induced by calorie restriction, exercise, or both in people with overweight or obesity: a meta‐analysis"

Supplementary files for article " Fasting appetite-related gut hormone responses after weight loss induced by calorie restriction, exercise, or both in people with overweight or obesity: a meta‐analysis "ObjectivesAltered appetite-related gut hormone concentrations may reflect a physiological adaptation facilitating weight regain after weight loss. This review investigates hormonal changes after weight loss achieved through calorie restriction (CR), exercise (EX), or both combined (CREX).MethodsA systematic search of PubMed (MEDLINE), EMBASE, SPORTDiscus, Cochrane Library, Web of Science, and ClinicalTrials.gov was conducted to identify randomised controlled trials (RCTs) and non-RCTs reporting in a fasting state either pre- and post-intervention appetite-related hormone concentrations or the changes therein after weight loss. The hormones examined were ghrelin, peptide tyrosine tyrosine (PYY), glucagon-like peptide -1 (GLP-1), and cholecystokinin (CCK), in their total and/or active form. Standardised mean differences (SMD) were extracted as the effect size.Results127 studies were identified: 19 RCTs, 108 non-RCTs, 1305 and 4725 participants, respectively. In response to weight loss induced by CR, EX or CREX, the meta-analysis revealed an increase in total ghrelin from both RCTs (SMD: 0.55, 95% CI: 0.07–1.04) and non-RCTs (SMD: 0.24, 95% CI: 0.14–0.35). A decrease in acylated ghrelin was identified for RCTs (SMD: –0.58, 95% CI: –1.09 to –0.06) but an increase was observed for non-RCTs (SMD: 0.15, 95% CI: 0.03 to 0.27). Findings also revealed a decrease in PYY (total PYY: SMD: –0.17, 95%CI: –0.28 to –0.06; PYY3-36: SMD: –0.17, 95%CI: –0.32 to –0.02) and active GLP-1 (SMD: -0.16, 95% CI: –0.28 to –0.05) from non-RCTs. Changes in hormones did not differ among the three interventions when controlling for weight loss. Meta-regression indicated that greater weight loss was associated with a greater increase in total ghrelin.ConclusionsWeight loss induced by CR, EX, or CREX elicits an increase in total ghrelin, but varied responses in other appetite-related hormones. The extent of weight loss influences changes in appetite-related gut hormone concentrations.© The Authors CC BY-NC 4.0