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Introduction Can intermittent energy restriction (IER) improve fat loss and fat-free mass retention compared with continuous energy restriction (CER) in resistance-trained adults? Methods Sixty-one adults (32 women) with mean (SD) age 28.7 (6.5) years, body weight 77.2 (16.1) kg and body fat 25.5 (6.1)% were randomized to 12 weeks of (1) 4 x 3-weeks of moderate (m) energy restriction interspersed with 3 x 1-weeks of energy balance (mIER; n=30; 15 weeks total), or (2) 12 weeks of continuous moderate energy restriction (mCER; n=31). Analyses of all outcome measures were by intention-to-treat. Results After accounting for baseline differences, mIER did not result in lower fat mass or body weight, or greater fat-free mass, compared to mCER after energy restriction. Mean (and 97.5% confidence interval, CI) for fat mass at the end of mIER versus mCER was 15.3 (12.5 to 18.0) kg versus 18.0 (14.3 to 21.7) kg (P=0.321), for fat-free mass was 56.7 (51.5 to 61.9) kg versus 56.7 (51.4 to 62.0) kg (P=0.309), and for body weight (with 95% CI) was 72.1 (66.4 to 77.9) versus 74.6 (69.3 to 80.0) (P=0.283). There were no differences between interventions in muscle strength or endurance or in resting energy expenditure, leptin, testosterone, insulin like growth factor-1, free 3,3',5-triiodothyronine or active ghrelin, nor in sleep, muscle dysmorphia or eating disorder behaviours. However, participants in mIER exhibited lower hunger (P=0.002) and desire to eat (P=0.014) compared to those in mCER, and greater satisfaction (P=0.016) and peptide YY (P=0.034). Conclusions Similar fat loss and fat-free mass retention are achieved with mIER and mCER during 12 weeks of energy restriction; however, mIER is associated with reduced appetite. Trial registration ACTRN12618000638235p.

BackgroundHeated tobacco products (HTP) generate nicotine-containing aerosol by heating tobacco rather than burning it. The US Food and Drug Administration (FDA) has recently authorised the sale of one HTP brand, iQOS, in the USA. This study examined the awareness, use and risk perceptions of HTP in the USA following FDA authorisation.MethodsA national probability sample of 20 449 US adults completed an online survey between November 2019 and February 2020. In addition to assessing awareness and use of HTP, two ratios were calculated: the ratio of those who experimented with HTP given that they had heard about it (E/H) and the ratio of those who currently used HTP given experimentation (C/E). These ratios for HTP were compared against those for e-cigarettes from a similar national survey in 2012.ResultsOverall, 8.1% of respondents had heard of HTP. Only 0.55% had tried and 0.10% were current users. The rate of experimentation among those who heard about HTP and the rate of current use among experimenters were, however, similar to those for e-cigarettes in 2012: E/H and C/E for HTP were 6.8% and 18.2%, respectively; and 10.7% and 17.8%, respectively for e-cigarettes. The majority of respondents considered HTP either less harmful than (11.6%), or equally harmful as e-cigarettes (42.7%).ConclusionsOnly a small fraction of US population in 2020 have tried any HTP. However, the similarity in early adoption rates following awareness, suggests that future adoption for HTP may be similar to that for e-cigarettes, if HTP are marketed more aggressively.

Topical 2-octylcyanoacrylate tissue (OCA) adhesive has been used as an alternative to close wounds with a comparable cosmetic outcome. The use of 2-OCA in the closure of abdominal laparotomy wounds has not been thoroughly evaluated. Our aim was to compare 2-OCA with conventional skin stapling devices in colorectal surgery. A prospective randomised study was conducted in which 74 consecutive patients above the age of 21 undergoing open elective colectomies for benign or malignant indications were allocated to skin closure with 2-OCA or skin staples. Cosmetic outcome as assessed with the Hollander Cosmesis Scale with a single assessor, complication rates, and patient satisfaction were recorded at discharge (4–10POD) 2 weeks after discharge and then at 3 months. Of the 74 patients, 38 were randomised to skin staples and 36 to 2-OCA. There was no significant difference in cosmetic outcomes between the two groups as assessed with a visual analogue scale or the Hollander Cosmesis Scale but showed a trend to better cosmetic outcomes in the 2-OCA group. Patient satisfaction scores were higher but did not reach statistical significance. The time taken to close a wound with 2-OCA was significantly longer than with skin staples. There was no statistical difference in rates of wound infection. 2-OCA is a safe and effective means of skin closure in patients undergoing elective colectomies with a good and at least equivalent outcome to traditional methods of closure.