Evidence map›Paper›PMID 41814067›Full record

ArticleCommunications medicine2026

Multilevel metabolic adaptation to exercise training.

Tzachi Knaan, Eylam Ziv-Av, Gal Dubnov-Raz, Irit Markus, David Peled, Paulee Manich, Daniel Barazany, Maayan Ramati, Gal Aziel, Chen Luxenburg and 3 more

Abstract read
In one paragraph

Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Tzachi KnaanDepartment of Health Promotion, School of Public Health, Faculty of Medicine and Health Sciences, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel‑Aviv, Israel.ORCID http://orcid.org/0000-0002-6697-9894
Eylam Ziv-AvDepartment of Health Promotion, School of Public Health, Faculty of Medicine and Health Sciences, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel‑Aviv, Israel.
Gal Dubnov-RazNational Institute for Sports Medicine, Sheba Medical Center, Tel Hashomer, Faculty of Medicine, Tel Aviv, Israel.
Irit MarkusDepartment of Health Promotion, School of Public Health, Faculty of Medicine and Health Sciences, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel‑Aviv, Israel.
David PeledDepartment of Health Promotion, School of Public Health, Faculty of Medicine and Health Sciences, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel‑Aviv, Israel.
Paulee ManichDepartment of Human Genetics and computational medicine, Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel.ORCID http://orcid.org/0000-0002-0484-6543
Daniel BarazanyStrauss Computational Neuroimaging Center, life sciences faculty, Tel Aviv University, Tel‑Aviv, Israel.
Maayan RamatiThe Gonda Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel.ORCID http://orcid.org/0009-0005-3984-1469
Gal AzielStrauss Computational Neuroimaging Center, life sciences faculty, Tel Aviv University, Tel‑Aviv, Israel.
Chen LuxenburgDepartment of Cell and Developmental Biology, Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel.ORCID http://orcid.org/0000-0002-7801-3499
Carmit LevyDepartment of Human Genetics and computational medicine, Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Edward L MelansonDivision of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CL, USA. ed.melanson@cuanschutz.edu.
Yftach GepnerDepartment of Health Promotion, School of Public Health, Faculty of Medicine and Health Sciences, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel‑Aviv, Israel. gepner@tauex.tau.ac.il.ORCID http://orcid.org/0000-0002-3128-3539

Funding

PILOT STUDY--SUBSTRATE METABOLISM IN EXTREMELY LOW BIRTH WEIGHT INFANTSP30DK048520 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI Paul S. Maclean · 1995 to 2026
$32.6M
NIDDK NIH HHS P30 DK048520United States - Israel Binational Science Foundation (BSF) 2019313
6 · The paper itself

Abstract

backgroundExercise training often produces less weight loss than expected, a phenomenon termed exercise-induced energy compensation, but the underlying mechanisms remain unclear. This study aimed to quantify metabolic and behavioral compensation to aerobic exercise training.

methodsSixteen sedentary adults with overweight completed a 12-week supervised aerobic walking intervention targeting an energy expenditure of 20 kcal/kg/week. Total daily energy expenditure was measured using doubly labeled water, and whole-room calorimetry was used to assess changes in resting and sleeping metabolic rate (RMR, SMR) and diet-induced thermogenesis (DIT). Volumes of highly metabolic organs were quantified by magnetic resonance imaging. Physical activity was monitored objectively, walking economy was assessed during standardized treadmill walking, and dietary intake was evaluated using self-report and intake-balance methods. A parallel mouse exercise model was used to explore tissue-level adaptations.

resultsExercise training induces substantial energy compensation, resulting in minimal body weight loss despite improved body composition. Total daily energy expenditure increases, while RMR and SMR decrease, accounting for most of the compensatory response. Liver and kidney volumes decrease by 5%, while brain volume remains unchanged. Exercise improves walking economy and leads to smaller-than-expected increases in daily moderate-to-vigorous physical activity. Dietary intake and DIT remain unchanged. In mice, exercise is associated with increased cellular density and mitochondrial content in the liver, indicating structural and metabolic remodeling.

conclusionsAerobic exercise training engages compensatory physiological and behavioral mechanisms that constrain energy expenditure. Reductions in basal metabolism, improved movement efficiency, and selective remodeling of metabolically active organs may collectively limit exercise-induced weight loss.

Identifiers

PMID41814067
PMCPMC13111656

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.