Investigation Of Behavioral And Energy Compensation In People Living With Liver Disease: a Scoping Review

Introduction: Most physical activity (PA) guidelines recommend 60 minutes of moderate-vigorous intensity PA (MVPA) daily for children and youth, and 150 minutes of MVPA weekly for adults and older adults. Furthermore, greater amounts of PA above the recommended levels are beneficial. However, studies have shown that when people increase their PA, especially at the vigorous level, they may compensate by engaging in less PA or more sitting at another time and/or decreasing their basal energy expenditure (EE). This is consisted with the ActivityStat hypothesis and suggests that an increase or decrease in PA greater to a certain set point activates behavioural and/or metabolic compensatory responses Even though this topic has been extensively explored in healthy and overweight/obese population, to our knowledge, no studies have investigated compensatory responses in patients with liver disease. Purpose: To investigate (1) whether liver disease patients display movement behavior (i.e., physical activity, sedentary behavior, and sleep) and/or EE compensation throughout the day and/or days, and (2) whether a prescribed physical activity or exercise intervention triggers compensatory responses. Methods: The protocol of this review followed recommendations for scoping reviews. Initially, the screening eligibility was independently reviewed and compared the results subsequently with the first author of this study. Thereafter, the data extraction was conducted using a codebook where the following information was collected: characteristics of the document, study, sample, research question 1 and 2, and the outcomes measured (i.e., behavioral and EE response). Results: Of 2,702 possible studies, 282 remained after a title and abstract scan, and 14 were included after a full-article scan. Most of the studies conducted a randomized trial (54%), and were done in adult and older populations (93%) with non-alcoholic fatty liver disease (72%). Of the 46 findings, 2% answered research question 1 and 98% related to research question 2. Overall, the vast majority of findings (91%) showed no compensation effects. Conclusion: Though little consistency existed in methodological approaches among the studies, the findings suggest that almost no behavioural or energy compensation responses were observed in liver patients.

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