Acute exercise and gastric emptying: a meta-analysis and implications for appetite control.
BACKGROUND
Gastric emptying (GE) could influence exercise-induced changes in appetite and energy intake. GE also could contribute to changes in gastric symptoms and the availability of nutrients during exercise, which will subsequently affect performance.


OBJECTIVE
The objective of this review was to determine the effects of acute exercise on GE using a systematic review and meta-analysis. The most common parameters to determine GE were selected, consisting of half-emptying time and volume emptied. Oral-caecal transit time (OCTT) was also examined.


METHODS
Research databases (PubMed, Scopus, Google Scholar, EBSCOhost, SPORTDiscus) were searched through November 2013 for original studies, abstracts, theses and dissertations that examined the influence of acute exercise on GE.


METHODS
Studies were included if they evaluated GE or OCTT during and/or after exercise and involved a resting control trial.


METHODS
Initially, 195 studies were identified. After evaluation of study characteristics and quality and validity, data from 20 studies (35 trials) involving 221 participants (157 men; 52 women; 12 unknown) were extracted for meta-analysis. Random-effects meta-analyses were utilised for the three main outcome variables, and effect sizes (ES) are reported as Hedge's g due to numerous small sample sizes.


RESULTS
Random-effects modelling revealed non-significant and small/null main effect sizes for volume emptied (ES = 0.195; 95% CI -0.25 to 0.64), half-time (ES = -0.109, 95% CI -0.66 to 0.44) and OCTT (ES = 0.089; 95% CI -0.64 to 0.82). All analyses exhibited significant heterogeneity and numerous variables moderated the results. There was a dose response of exercise intensity; at lower intensities GE was faster, and at high exercise intensities GE was slower. Walking was associated with faster GE and cycling with slower GE. Greater volume of meal/fluid ingested, higher osmolality of beverage and longer exercise duration were also associated with slower GE with exercise.


CONCLUSIONS
The major limitation is that the majority of studies utilised a liquid bolus administered pre-exercise to determine GE; the relationship to post-exercise appetite and energy intake remains unknown. Study populations were also generally active or trained individuals. Furthermore, our review was limited to English language studies and studies that utilised resting control conditions.


CONCLUSIONS
These results suggest that exercise intensity, mode, duration and the nature of meal/fluid ingested all influence GE during and after acute exercise. The relationship of GE parameters with appetite regulation after exercise remains largely unexplored. Further integrative studies combining GE and alterations in gut hormones, as well as in populations such as overweight and obese individuals are needed.
School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
Katy M
KM
Horner
Matthew M
MM
Schubert
Ben
B
Desbrow
Nuala M
NM
Byrne
Neil A
NA
King
D001628:Beverages; D015444:Exercise / Q000502:physiology*; D005502:Food; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D009994:Osmolar Concentration; D005082:Physical Exertion / Q000502:physiology; D064787:Portion Size; D013997:Time Factors