Gum chewing while walking increases walking distance and energy expenditure: A randomized, single-blind, controlled, cross-over study.

"Declaration of competing interest K.S., S.K. and K.O. are employees of Lotte Co., Ltd. and were not involved in the data acquisition, statistical analysis and interpretation of the results - K.S., S.K. and K.O. were involved in the study design, and the decision to submit the manuscript for publication. M.M. has no professional relationships with the company involved in this study. M.M. received a research grant from Lotte Co., Ltd. For the remaining authors none were declared conflicts of interest."

"Lotte Co., Ltd."

"This study was approved by the Institutional Ethics Committee on Human Research (Approval number: 2019-015) and was conducted according to the Declaration of Helsinki. All participants gave written informed consent before participating in the study. This study was registered in advance with the University Hospital Medical Information Network Center (UMIN), a system for registering clinical trials (ID: UMIN000036534). A flow diagram of participants is shown in . This study enrolled 50 participants aged between 20 and 69 years and 5 male and 5 female participants enrolled in each 10-year age group. Fifty participants who gave informed consent and underwent screening were invited to complete two trials in a random order. The lead investigator enrolled participants to the study and randomly assigned the trial sequence in a counterbalanced manner using computer-generated random numbers to avoid order effects. Because of the nature of the study design, it was not possible to blind participants to the trial order allocation. The selection criteria for this study were as follows: aged between 20 and 69 years, body mass index (BMI) between 22 and 30 kg/m2, and a habit of gum chewing (minimum once per week). Baseline physical characteristics of the participants are shown in .Fig. 1Study recruitment and design.Fig. 1"