Sex differences in exercise metabolism and the role of 17-beta estradiol

The ACTN3 R577X polymorphism is associated with metabolic alterations in a sex-dependent manner in subjects from western Mexico

BACKGROUND

The ACTN3 gene is primarily expressed in fast skeletal muscle fibres. A common nonsense polymorphism in this gene is ACTN3 R577X (rs1815739), which causes an absolute deficiency of α-actinin-3 protein and alterations in muscle metabolism. Considering metabolic alterations are influenced by nutrition and genetic factors, as well as lifestyle factors, we hypothesise a possible association of the ACTN3 R577X polymorphism with metabolic alterations.

METHODS

In this cross-sectional study, 397 adults met the inclusion criteria. Body composition was measured by electrical bioimpedance. Dietary data were analysed using Nutritionist Pro™ software. Biochemical variables were determined by dry chemistry. Genomic DNA was extracted from peripheral leukocytes and genotyping of the ACTN3 R577X polymorphism was determined by allelic discrimination using TaqMan probes. The statistical analyses were performed using SPSS statistical software. p < 0.05 was considered statistically significant.

RESULTS

The ACTN3 577XX genotype was associated with high glucose, triglyceride and very low density lipoprotein-cholesterol levels and a higher frequency of hypertriglyceridaemia and insulin resistance in women. In males, the genetic variant showed a trend towards significance for insulin resistance.

CONCLUSIONS

The ACTN3 R577X polymorphism was associated with metabolic alterations in women and a tendency was observed in men variant carriers. Thus, this common genetic variant could be implicated in the development of chronic metabolic diseases.

Skeletal muscle methylome and transcriptome integration reveals profound sex differences related to muscle function and substrate metabolism

Nearly all human complex traits and diseases exhibit some degree of sex differences, with epigenetics being one of the main contributing factors. Various tissues display sex differences in DNA methylation; however, this has not yet been explored in skeletal muscle, despite skeletal muscle being among the tissues with the most transcriptomic sex differences. For the first time, we investigated the effect of sex on autosomal DNA methylation in human skeletal muscle across three independent cohorts (Gene SMART, FUSION, and GSE38291) using a meta-analysis approach, totalling 369 human muscle samples (222 males and 147 females), and integrated this with known sex-biased transcriptomics. We found 10,240 differentially methylated regions (DMRs) at FDR < 0.005, 94% of which were hypomethylated in males, and gene set enrichment analysis revealed that differentially methylated genes were involved in muscle contraction and substrate metabolism. We then investigated biological factors underlying DNA methylation sex differences and found that circulating hormones were not associated with differential methylation at sex-biased DNA methylation loci; however, these sex-specific loci were enriched for binding sites of hormone-related transcription factors (with top TFs including androgen (AR), estrogen (ESR1), and glucocorticoid (NR3C1) receptors). Fibre type proportions were associated with differential methylation across the genome, as well as across 16% of sex-biased DNA methylation loci (FDR < 0.005). Integration of DNA methylomic results with transcriptomic data from the GTEx database and the FUSION cohort revealed 326 autosomal genes that display sex differences at both the epigenome and transcriptome levels. Importantly, transcriptional sex-biased genes were overrepresented among epigenetic sex-biased genes (p value = 4.6e−13), suggesting differential DNA methylation and gene expression between male and female muscle are functionally linked. Finally, we validated expression of three genes with large effect sizes (FOXO3A, ALDH1A1, and GGT7) in the Gene SMART cohort with qPCR. GGT7, involved in antioxidant metabolism, displays male-biased expression as well as lower methylation in males across the three cohorts. In conclusion, we uncovered 8420 genes that exhibit DNA methylation differences between males and females in human skeletal muscle that may modulate mechanisms controlling muscle metabolism and health.

Maximal Fat Oxidation Rate Is Higher in Fit Women and Unfit Women With Obesity, Compared to Normal-weight Unfit Women

CONTEXT

The maximal fat oxidation rate (MFO) is higher in aerobically fit vs unfit young men, but this training-related increase in MFO is attenuated in middle-aged men. Further, it has also been found that unfit men with obesity may have an elevated MFO compared to unfit normal-weight men.

OBJECTIVE

Based hereupon, we aimed to investigate whether a fitness-related higher MFO were attenuated in middle-aged women compared to young women. Also, we aimed to investigate if unfit women with obesity have a higher MFO compared to unfit normal-weight women. We hypothesized that the training-related elevated MFO was attenuated in middle-aged women, but that unfit women with obesity would have an elevated MFO compared to unfit normal-weight women.

METHODS

We recruited 70 women stratified into 6 groups: young fit (n = 12), young unfit (n = 12) middle-aged fit (n = 12), middle-aged unfit (n = 12), unfit young women with obesity (n = 12), and unfit middle-aged women with obesity (n = 10). Body composition and resting blood samples were obtained and MFO was measured by a graded exercise test on a cycle ergometer via indirect calorimetry. Subsequently, a maximal exercise test was performed to establish peak oxygen uptake (V̇O2peak).

RESULTS

Young and middle-aged fit women had a higher MFO compared to age-matched unfit women, and young fit women had a higher MFO compared to fit middle-aged women. Unfit women with obesity, independent of age, had a higher MFO compared to their normal-weight and unfit counterparts.

CONCLUSION

The training-related increase in MFO seems maintained in middle-aged women, and we find that unfit women with obesity, independent of age, have a higher MFO compared to unfit normal-weight women.

Untargeted metabolomics reveals sex-specific differences in lipid metabolism of adult rats exposed to dexamethasone in utero

Prenatal stress through glucocorticoid (GC) exposure leads to an increased risk of developing diseases such as cardiovascular disease, metabolic syndrome and hypertension in adulthood. We have previously shown that administration of the synthetic glucocorticoid, dexamethasone (Dex), to pregnant Wistar-Kyoto dams produces offspring with elevated blood pressures and disrupted circadian rhythm signaling. Given the link between stress, circadian rhythms and metabolism, we performed an untargeted metabolomic screen on the livers of offspring to assess potential changes induced by prenatal Dex exposure. This metabolomic analysis highlighted 18 significantly dysregulated metabolites in females and 12 in males. Pathway analysis using MetaboAnalyst 4.0 highlighted key pathway-level metabolic differences: glycerophospholipid metabolism, purine metabolism and glutathione metabolism. Gene expression analysis revealed significant upregulation of several lipid metabolism genes in females while males showed no dysregulation. Triglyceride concentrations were also found to be significantly elevated in female offspring exposed to Dex in utero, which may contribute to lipid metabolism activation. This study is the first to conduct an untargeted metabolic profile of liver from GC exposed offspring. Corroborating metabolic, gene expression and lipid profiling results demonstrates significant sex-specific lipid metabolic differences underlying the programming of hepatic metabolism.

Feeding female soldiers: Consideration of sex-specific nutrition recommendations to optimise the health and performance of military personnel

Appropriate nutrition recommendations are required to optimise the health and performance of military personnel, yet limited data are available on whether male and female military personnel have different nutrition requirements.

OBJECTIVES

To consider the evidence for sex-specific nutrition requirements to optimise the health and performance of military personnel.

DESIGN

Narrative review.

METHODS

Published literature was reviewed, with a focus on sex-specific requirements, in the following areas: nutrition for optimising muscle mass and function, nutrition during energy deficit, and nutrition for reproductive and bone health.

RESULTS

There are limited data on sex differences in protein requirements but extant data suggest that, despite less muscle mass, on average, in women, sex-specific protein feeding strategies are not required to optimise muscle mass in military-aged individuals. Similarly, despite sex differences in metabolic and endocrine responses to energy deficit, current data do not suggest a requirement for sex-specific feeding strategies during energy deficit. Energy deficit impairs health and performance, most notably bone and reproductive health and these impairments are greater for women. Vitamin D, iron and calcium are important nutrients to protect the bone health of female military personnel due to increased risk of stress fracture.

CONCLUSIONS

Women have an increased incidence of bone injuries, less muscle mass and are more susceptible to the negative effects of energy deficit, including compromised reproductive health. However, there are limited data on sex differences in response to various nutrition strategies designed to improve these elements of health and performance. Future studies should evaluate whether sex-specific feeding recommendations are required.

Metabolic effects of high-intensity interval training and essential amino acids

High-intensity interval training (HIIT) promotes positive cardiometabolic and body composition changes. Essential amino acids (EAA) may support changes associated with HIIT, but evaluation of potential synergistic effects is lacking. The purpose of this study was to compare independent and combined effects of HIIT and EAA on total body composition and metabolism in men and women considered overweight/obese; an exploratory aim was to evaluate the modulatory effects of sex. Sixty-six healthy adults (50% female; Age: 36.7 ± 6.0 years; BMI: 32.0 ± 4.2 kg/m²) completed 8 weeks of: (1) HIIT, 2 days/weeks; (2) EAA supplementation, 3.6 g twice daily; (3) HIIT + EAA; or (4) control. Body composition, resting metabolic rate (RMR), substrate metabolism (respiratory exchange ratio; RER), and cardiorespiratory fitness were measured at baseline, 4 weeks, and 8 weeks; cardiometabolic blood markers were measured at baseline and 8 weeks. Differences between groups were assessed by linear mixed models covaried for baseline values, followed by 95% confidence intervals (CI) on adjusted mean change scores. There were no significant changes in body composition (p > 0.05) for any group. Changes in RER, but not RMR, occurred with HIIT (mean change; [95% CI]: - 0.04; [- 0.07, - 0.02]) and EAA (- 0.03; [- 0.06, - 0.01]) after 8 weeks. Cardiorespiratory fitness increased following 8 weeks of HIIT (+ 5.1 ml/kg/min [3.3,6.8]) and HIIT + EAA (+ 4.1 ml/kg/min [1.0,6.4]). Changes with HIIT + EAA were not significantly different from HIIT. There were no changes in cardiometabolic markers (p > 0.05) and no sex interaction (p > 0.05). HIIT is efficacious for promoting positive changes in cardiorespiratory fitness and resting substrate metabolism in adults considered overweight/obese. Addition of EAA did not significantly enhance HIIT-induced adaptations. ClinicalTrials.gov ID#NCT04080102.

Peak Fat Oxidation Rate Is Closely Associated With Plasma Free Fatty Acid Concentrations in Women; Similar to Men

Introduction: In men, whole body peak fat oxidation (PFO) determined by a graded exercise test is closely tied to plasma free fatty acid (FFA) availability. Men and women exhibit divergent metabolic responses to fasting and exercise, and it remains unknown how the combined fasting and exercise affect substrate utilization in women. We aimed to investigate this, hypothesizing that increased plasma FFA concentrations in women caused by fasting and repeated exercise will increase PFO during exercise. Then, that PFO would be higher in women compared with men (data from a previous study).

Methods: On two separate days, 11 young endurance-trained women were investigated, either after an overnight fast (Fast) or 3.5 h after a standardized meal (Fed). On each day, a validated graded exercise protocol (GXT), used to establish PFO by indirect calorimetry, was performed four times separated by 3.5 h of bed rest both in the fasted (Fast) or fed (Fed) state.

Results: Peak fat oxidation increased in the fasted state from 11 ± 3 (after an overnight fast, Fast 1) to 16 ± 3 (mean ± SD) mg/min/kg lean body mass (LBM) (after ~22 h fast, Fast 4), and this was highly associated with plasma FFA concentrations, which increased from 404 ± 203 (Fast 1) to 865 ± 210 μmol/L (Fast 4). No increase in PFO was found during the fed condition with repeated exercise. Compared with trained men from a former identical study, we found no sex differences in relative PFO (mg/min/kg LBM) between men and women, in spite of significant differences in plasma FFA concentrations during exercise after fasting.

Conclusion: Peak fat oxidation increased with fasting and repeated exercise in trained women, but the relative PFO was similar in young trained men and women, despite major differences in plasma lipid concentrations during graded exercise.

The good and the BAT of metabolic sex differences in thermogenic human adipose tissue

Thermogenic adipose tissue, which comprises classical brown and beige adipose tissue, has the ability to improve systemic metabolism. Its identification in adult humans has fostered extensive investigations on the therapeutic value to counteract obesity and metabolic disorders. Sex and gender differences of human thermogenic adipose tissue, however, are still understudied despite their importance for personalized treatment options. Here, we review studies reporting human sex differences of thermogenic adipose tissue and related potential improvements of systemic energy metabolism. An increasing body of evidence suggests higher prevalence, mass and activity of thermogenic adipose tissue in women, but the consequences for metabolic disease progression and mechanisms are largely unknown. Therefore, we also discuss observations on sex-specific adipose metabolism in experimental mouse and rat studies that may assist to establish molecular mechanisms and instruct future investigations in humans.

Sex Differences in Muscle Metaboreflex Activation following Static Handgrip Exercise

PURPOSE

Larger blood pressure (BP) responses to relative-intensity static exercise in males vs. females is thought to involve altered muscle metaboreflex activation, but whether this is due to an intrinsic sex difference in metabolite production or to differences in muscle strength and absolute load is unknown.

METHODS

Continuous BP and heart rate were recorded in 200 healthy young males and females (females: n = 109) during 2 minutes of static handgrip exercise at 30% of maximal voluntary contraction (MVC), followed by 2 minutes of post-exercise circulatory occlusion (PECO). Muscle sympathetic nerve activity (MSNA) was recorded in a subset of participants (n = 39; female n = 21), permitting calculation of signal-averaged resting sympathetic transduction (MSNA-diastolic BP). Sex differences were examined with and without statistical adjustment for MVC. Multivariate regression analyses were performed to identify predictors of BP responses.

RESULTS

Males had larger systolic BP responses (interactions, P < 0.0001) to static handgrip exercise (24 ± 10 vs. 17 ± 9 mmHg [mean ± SD], P < 0.0001) and PECO (20 ± 11 vs. 16 ± 9 mmHg, P < 0.0001). Adjustment for MVC abolished these sex differences in BP (interactions, P > 0.7). In the subset with MSNA, neither burst frequency or incidence responses to static handgrip exercise or PECO differed between males and females (interactions, P > 0.2). Resting sympathetic transduction was also similar (P = 0.8). Multivariate analysis showed that MVC, the change in MSNA, and sympathetic transduction were predictors of the systolic BP response to static handgrip but only MVC was associated with responses during PECO.

CONCLUSION

Sex differences in absolute contraction load contribute to differences in BP responses during muscle metaboreflex isolation using PECO. These data do not support an intrinsic effect of sex as being responsible for exercise BP differences between males and females.

Substrate metabolism during exercise: sexual dimorphism and women's specificities

The aim of this review is to discuss sexual dimorphism of energy metabolism, and to describe the impact of women's hormonal status on substrate oxidation during exercise. Many evidences indicate that sex steroids play a pivotal role in the sex-related differences of body composition and energy substrate storage. Compared with men, women rely more on fat and less on carbohydrates at the same relative exercise intensity. Scientific data suggest that 17-β oestradiol is a key hormone for the regulation of body composition and substrate metabolism. However, in women, measurements with stable isotopic tracers did not highlight any difference in whole-body substrate oxidation rates between the follicular and luteal phases of the menstrual cycle during endurance exercise. The remaining discrepancies about the effect of menstrual cycle-related hormone fluctuations on substrate oxidation could be partly explained by the exercise intensity, which is an important regulator of substrate oxidation. Due to their specific nature and concentration, the synthetic ovarian hormones contained in oral contraceptives also influence substrate metabolism during endurance exercise. However, more studies are needed to confirm that oral contraceptives increase lipolytic activity during endurance exercise without any substantial (or detectable) effect on substrate utilization. Pregnancy and menopause also modify body composition and substrate utilization during exercise through specific hormonal fluctuations.This review highlights that the hormonal status is likely to affect substrate oxidation during exercise in women emphasizing the need to take it into consideration to optimize their health and performance.

Astaxanthin supplementation enhances metabolic adaptation with aerobic training in the elderly

Endurance training (ET) is recommended for the elderly to improve metabolic health and aerobic capacity. However, ET-induced adaptations may be suboptimal due to oxidative stress and exaggerated inflammatory response to ET. The natural antioxidant and anti-inflammatory dietary supplement astaxanthin (AX) has been found to increase endurance performance among young athletes, but limited investigations have focused on the elderly. We tested a formulation of AX in combination with ET in healthy older adults (65-82 years) to determine if AX improves metabolic adaptations with ET, and if AX effects are sex-dependent. Forty-two subjects were randomized to either placebo (PL) or AX during 3 months of ET. Specific muscle endurance was measured in ankle dorsiflexors. Whole body exercise endurance and fat oxidation (FATox) was assessed with a graded exercise test (GXT) in conjunction with indirect calorimetry. Results: ET led to improved specific muscle endurance only in the AX group (Pre 353 ± 26 vs. Post 472 ± 41 contractions), and submaximal GXT duration improved in both groups (PL 40.8 ± 9.1% and AX 41.1 ± 6.3%). The increase in FATox at lower intensity after ET was greater in AX (PL 0.23 ± 0.15 g vs. AX 0.76 ± 0.18 g) and was associated with reduced carbohydrate oxidation and increased exercise efficiency in males but not in females.

Cytochrome P450-mediated estrogen catabolism therapeutic avenues in epilepsy

Epilepsy is a neuropsychiatric disorder, which does not have any identifiable cause. However, experimental and clinical results have asserted that the sex hormone estrogen level and endocrine system function influence the seizure and epileptic episodes. There are available drugs to control epilepsy, which passes through the metabolism process. Cytochrome P-450 family 1 (CYP1A1) is a heme-containing mono-oxygenase that are induced several folds in most of the tissues and cells contributing to their differential expression, which regulates various metabolic processes upon administration of therapeutics. CYP1A1 gene family has been found to metabolize estrogen, a female sex hormone, which plays a central role in maintaining the health of brain altering the level of estrogen active neuropsychiatric disorder like epilepsy. Hence, in this article, we endeavor to provide an opinion of estrogen, its effects on epilepsy and catamenial epilepsy, their metabolism by CYP1A1 and new way forward to differential diagnosis and clinical management of epilepsy in future.

The Effects of Menstrual Cycle Phase on Elite Athlete Performance: A Critical and Systematic Review

Background: In elite athletes, training individualization is widely recommended to optimize competitive performance. Previous studies have evidenced the impact of hormonal fluctuations on different performance parameters among female athletes. While consideration of menstrual cycle (MC) phases as a parameter in training individualization strategies is necessary, systematic evidence identifying such impacts in elite athletes should be evaluated. Objective: Systematically review publications that have investigated the link between MC phases and performance in elite female athletes. The overarching aim is to identify whether a consensus across studies exists enabling evidence-based recommendations for training individualization depending on menstrual cycle phases. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three major scientific publication databases were searched from inception until November 3, 2020. Studies included focused on the influence of physiological or psychological parameters throughout at least one phase of the menstrual cycle of elite athletes. Results: A total of 780 search results were yielded and 26 references from a past bibliography were added manually. About 662 papers were reviewed of which 218 studies were assessed for eligibility. Of these, only seven (1%) precisely investigated the influence of a performance or physical parameter during at least one menstrual cycle phase. These seven studies included a total of 314 elite female participants (20.58 ± 1.91 years). Three used interviews, questionnaires or prospective analyses of reports. Four conducted several performance tests or included physical measures although only two performed tests during training or before/during competition. Among the seven studies, five performed hormonal testing through sampling of blood, saliva, or urine. The remaining relied on athletes' menstruation diaries. The current evidence suggests a variable association between menstrual cycle and a few performance-related outcomes, such as endurance or power resistance, ligament stiffness, decision making skills, psychology, or competitiveness. Conclusion: Different sports performance-related parameters are affected during the menstrual cycle among elite athletes, but the parameters themselves and the magnitude and the direction of the effects are inconclusive. Additional longitudinal and prospective studies to systematically monitor on-field performance parameters are urgently required in order to enable recommendations and training individualization in female elite athletes.

Regulation of Energy Substrate Metabolism in Endurance Exercise

The human body requires energy to function. Adenosine triphosphate (ATP) is the cellular currency for energy-requiring processes including mechanical work (i.e., exercise). ATP used by the cells is ultimately derived from the catabolism of energy substrate molecules—carbohydrates, fat, and protein. In prolonged moderate to high-intensity exercise, there is a delicate interplay between carbohydrate and fat metabolism, and this bioenergetic process is tightly regulated by numerous physiological, nutritional, and environmental factors such as exercise intensity and duration, body mass and feeding state. Carbohydrate metabolism is of critical importance during prolonged endurance-type exercise, reflecting the physiological need to regulate glucose homeostasis, assuring optimal glycogen storage, proper muscle fuelling, and delaying the onset of fatigue. Fat metabolism represents a sustainable source of energy to meet energy demands and preserve the ‘limited’ carbohydrate stores. Coordinated neural, hormonal and circulatory events occur during prolonged endurance-type exercise, facilitating the delivery of fatty acids from adipose tissue to the working muscle for oxidation. However, with increasing exercise intensity, fat oxidation declines and is unable to supply ATP at the rate of the exercise demand. Protein is considered a subsidiary source of energy supporting carbohydrates and fat metabolism, contributing to approximately 10% of total ATP turnover during prolonged endurance-type exercise. In this review we present an overview of substrate metabolism during prolonged endurance-type exercise and the regulatory mechanisms involved in ATP turnover to meet the energetic demands of exercise.

Maternal exercise during pregnancy modulates mitochondrial function and redox status in a sex-dependent way in adult offspring's skeletal muscle

Maternal exercise has shown beneficial effects on mother and child. Literature confirm progeny's cognition improvement, and upregulation in neurotrophins, antioxidant network, and DNA repair system. Considering that there is a lack of information demonstrating the impact of maternal exercise on offspring's skeletal muscle, we aimed to investigate the mitochondrial and redox effects elicited by maternal swimming. Adult female Wistar rats were divided into three groups: control sedentary, free swimming, and swimming with overload (2% of the body weight). Exercised groups were submitted weekly to five swimming sessions (30 min/day), starting 1 week prior to the mating and lasting to the delivery. Gastrocnemius and soleus muscle from 60-day-old offspring were analyzed. Our results clearly showed a sex-dependent effect. Male soleus showed increased mitochondrial functionality in the overload group. Female muscle from the overload group adapted deeply. Considering the redox status, the female offspring delivered to overload exercised dams presented reduced oxidants levels and protein damage, allied to downregulated antioxidant defenses. We also observed an increase in the mitochondrial function in the gastrocnemius muscle of the female offspring born from overload exercised dams. Soleus from female delivered to the overload exercise group presented reduced mitochondrial activity, as well as reduced reactive species, protein carbonyls, and antioxidant network, when compared to the male. In conclusion, maternal exercise altered the redox status and mitochondrial function in the offspring's skeletal muscle in a sex-dependent way. The clinical implication was not investigated; however, the sexual dimorphism in response to maternal exercise might impact exercise resilience in adulthood.

Nutrition for Older Athletes: Focus on Sex-Differences

Regular physical exercise and a healthy diet are major determinants of a healthy lifespan. Although aging is associated with declining endurance performance and muscle function, these components can favorably be modified by regular physical activity and especially by exercise training at all ages in both sexes. In addition, age-related changes in body composition and metabolism, which affect even highly trained masters athletes, can in part be compensated for by higher exercise metabolic efficiency in active individuals. Accordingly, masters athletes are often considered as a role model for healthy aging and their physical capacities are an impressive example of what is possible in aging individuals. In the present review, we first discuss physiological changes, performance and trainability of older athletes with a focus on sex differences. Second, we describe the most important hormonal alterations occurring during aging pertaining regulation of appetite, glucose homeostasis and energy expenditure and the modulatory role of exercise training. The third part highlights nutritional aspects that may support health and physical performance for older athletes. Key nutrition-related concerns include the need for adequate energy and protein intake for preventing low bone and muscle mass and a higher demand for specific nutrients (e.g., vitamin D and probiotics) that may reduce the infection burden in masters athletes. Fourth, we present important research findings on the association between exercise, nutrition and the microbiota, which represents a rapidly developing field in sports nutrition.

Pacing in Long-Distance Running: Sex and Age Differences in 10-km Race and Marathon

Background and objective: The recent availability of data from mass-participation running events has allowed researchers to examine pacing from the perspective of non-elite distance runners. Based on an extensive analysis of the literature, we concluded that no study utilizing mass-participation events data has ever directly compared pacing in the 10-km race, with other long-distance races. Therefore, the main aim of this study was to assess and compare pacing between 10-km runners and marathoners, in regards to their sex and age. Materials and methods: For the purpose of this study, official results from the Oslo marathon (n = 8828) and 10-km race (n = 16,315) held from 2015 to 2018 were included. Results: Both 10-km runners and marathoners showed positive pacing strategies. Moreover, two-way analysis of variance showed that women were less likely to slow in the marathon than men (9.85% in comparison to 12.70%) however, not in the 10-km race (3.99% in comparison to 3.38%). Finally, pace changing is more prominent in youngest and oldest marathoners comparing to the other age groups (12.55% in comparison to 10.96%). Conclusions: Based on these findings, practitioners should adopt different training programmes for marathoners in comparison to shorter long-distance runners.

Carbohydrate Drink Use During 30 Minutes of Variable-Intensity Exercise Has No Effect on Exercise Performance in Premenarchal Girls

PURPOSE

This study examined the physiological, perceptual, and performance effects of a 6% carbohydrate (CHO) drink during variable-intensity exercise (VIE) and a postexercise test in premenarchal girls.

METHODS

A total of 10 girls (10.4 [0.7] y) participated in the study. VO2peak was assessed, and the girls were familiarized with VIE and performance during the first visit. The trial order (CHO and placebo) was randomly assigned for subsequent visits. The drinks were given before VIE bouts and 1-minute performance (9 mL/kg total). Two 15-minute bouts of VIE were completed (10 repeated sequences of 20%, 55%, and 95% power at VO2peak and maximal sprints) before a 1-minute performance sprint.

RESULTS

The mean power, peak power, heart rate (HR), %HRpeak, and rating of perceived exertion during VIE did not differ between trials. However, the peak power decreased, and the rating of perceived exertion increased from the first to the second bout. During the 1-minute performance, there were no differences between the trial (CHO vs placebo) for HR (190 [9] vs 189 [9] bpm), %HRpeak (97.0% [3.2%] vs 96.6% [3.0%]), rating of perceived exertion (7.8 [2.3] vs 8.1 [1.9]), peak power (238 [70] vs 235 [60] W), fatigue index (54.7% [10.0%] vs 55.9% [12.8%]), or total work (9.4 [2.6] vs 9.4 [2.1] kJ).

CONCLUSION

CHO supplementation did not alter physiological, perceptual, or performance responses during 30 minutes of VIE or postexercise sprint performance in premenarchal girls.

Resting skeletal muscle PNPLA2 (ATGL) and CPT1B are associated with peak fat oxidation rates in men and women but do not explain observed sex differences

NEW FINDINGS

What is the central question of this study? What is the relationship between proteins in skeletal muscle and adipose tissue determined at rest and at peak rates of fat oxidation in men and women? What is the main finding and its importance? The resting contents of proteins in skeletal muscle involved in triglyceride hydrolysis and mitochondrial lipid transport were more strongly associated with peak fat oxidation rates than proteins related to lipid transport or hydrolysis in adipose tissue. Although females displayed higher relative rates of fat oxidation than males, this was not explained by the proteins measured in this study, suggesting that other factors determine sex differences in fat metabolism.

ABSTRACT

We explored key proteins involved in fat metabolism that might be associated with peak fat oxidation (PFO) and account for sexual dimorphism in fuel metabolism during exercise. Thirty-six healthy adults [15 women; 40 ± 11 years of age; peak oxygen consumption 42.5 ± 9.5 ml (kg body mass)^-1  min^-1 ; mean ± SD] completed two exercise tests to determine PFO via indirect calorimetry. Resting adipose tissue and/or skeletal muscle biopsies were obtained to determine the adipose tissue protein content of PLIN1, ABHD5 (CGI-58), LIPE (HSL), PNPLA2 (ATGL), ACSL1, CPT1B and oestrogen receptor α (ERα) and the skeletal muscle protein content of FABP 3 (FABPpm), PNPLA2 (ATGL), ACSL1, CTP1B and ESR1 (ERα). Moderate strength correlations were found between PFO [in milligrams per kilogram of fat-free mass (FFM) per minute] and the protein content of PNPLA2 (ATGL) [r_s  = 0.41 (0.03-0.68), P < 0.05] and CPT1B [r_s  = 0.45 (0.09-0.71), P < 0.05] in skeletal muscle. No other statistically significant bivariate correlations were found consistently. Females had a greater relative PFO than males [7.1 ± 1.9 vs. 4.5 ± 1.3 and 7.3 ± 1.7 vs. 4.8 ± 1.2 mg (kg FFM)^-1  min^-1 in the adipose tissue (n = 14) and skeletal muscle (n = 12) subgroups, respectively (P < 0.05)]. No statistically significant sex differences were found in the content of these proteins. The regulation of PFO might involve processes relating to intramyocellular triglyceride hydrolysis and mitochondrial fatty acid transport, and adipose tissue is likely to play a more minor role than muscle. Sex differences in fat metabolism are likely to be attributable to factors other than the resting content of proteins in skeletal muscle and adipose tissue relating to triglyceride hydrolysis and fatty acid transport.

Methodological Considerations for Studies in Sport and Exercise Science with Women as Participants: A Working Guide for Standards of Practice for Research on Women

Until recently, there has been less demand for and interest in female-specific sport and exercise science data. As a result, the vast majority of high-quality sport and exercise science data have been derived from studies with men as participants, which reduces the application of these data due to the known physiological differences between the sexes, specifically with regard to reproductive endocrinology. Furthermore, a shortage of specialist knowledge on female physiology in the sport science community, coupled with a reluctance to effectively adapt experimental designs to incorporate female-specific considerations, such as the menstrual cycle, hormonal contraceptive use, pregnancy and the menopause, has slowed the pursuit of knowledge in this field of research. In addition, a lack of agreement on the terminology and methodological approaches (i.e., gold-standard techniques) used within this research area has further hindered the ability of researchers to adequately develop evidenced-based guidelines for female exercisers. The purpose of this paper was to highlight the specific considerations needed when employing women (i.e., from athletes to non-athletes) as participants in sport and exercise science-based research. These considerations relate to participant selection criteria and adaptations for experimental design and address the diversity and complexities associated with female reproductive endocrinology across the lifespan. This statement intends to promote an increase in the inclusion of women as participants in studies related to sport and exercise science and an enhanced execution of these studies resulting in more high-quality female-specific data.

Osteocalcin and its forms respond similarly to exercise in males and females

INTRODUCTION

Acute exercise increases osteocalcin (OC), a marker of bone turnover, and in particular the undercarboxylated form (ucOC). Males and females differ in baseline levels of total OC and it is thought the hormonal milieu may be driving these differences. Males and females adapt differently to the same exercise intervention, however it is unclear whether the exercise effects on OC are also sex-specific. We tested whether the responses of OC and its forms to acute High Intensity Interval Exercise (HIIE) and High Intensity Interval Training (HIIT) differed between males and females. Secondly, we examined whether sex hormones vary with OC forms within sexes to understand if these are driving factor in any potential sex differences.

METHODS

Total OC (tOC), undercarboxylated OC (ucOC), and carboxylated OC (cOC) were measured in serum of 96 healthy participants from the Gene SMART cohort (74 males and 22 females) at rest, immediately after, and 3 h after a single bout of HIIE, and at rest, 48 h after completing a four week HIIT intervention. Baseline testosterone and estradiol were also measured for a subset of the cohort (Males = 38, Females = 20). Linear mixed models were used to a) uncover the sex-specific effects of acute exercise and short-term training on OC forms and b) to examine whether the sex hormones were associated with OC levels.

RESULTS

At baseline, males had higher levels of tOC, cOC, and ucOC than females (q < 0.01). In both sexes tOC, and ucOC increased to the same extent after acute HIIE. At baseline, in males only, higher testosterone was associated with higher ucOC (β = 3.37; q < 0.046). Finally, tOC and ucOC did not change following 4 weeks of HIIT.

CONCLUSION/DISCUSSION

While there were no long-term changes in OC and its forms. tOC and ucOC were transiently enhanced after a bout of HIIE similarly in both sexes. This may be important in metabolic signalling in skeletal muscle and bone suggesting that regular exercise is needed to maintain these benefits. Overall, these data suggest that the sex differences in exercise adaptations do not extend to the bone turnover marker, OC.

Determinants of Peak Fat Oxidation Rates During Cycling in Healthy Men and Women

This study explored lifestyle and biological determinants of peak fat oxidation (PFO) during cycle ergometry, using duplicate measures to account for day-to-day variation. Seventy-three healthy adults (age range: 19-63 years; peak oxygen consumption [V˙O2peak]: 42.4 [10.1] ml·kg BM-1·min-1; n = 32 women]) completed trials 7-28 days apart that assessed resting metabolic rate, a resting venous blood sample, and PFO by indirect calorimetry during an incremental cycling test. Habitual physical activity (combined heart rate accelerometer) and dietary intake (weighed record) were assessed before the first trial. Body composition was assessed 2-7 days after the second identical trial by dual-energy X-ray absorptiometry scan. Multiple linear regressions were performed to identify determinants of PFO (mean of two cycle tests). A total variance of 79% in absolute PFO (g·min-1) was explained with positive coefficients for V˙O2peak (strongest predictor), FATmax (i.e the % of V˙O2peak that PFO occurred at), and resting fat oxidation rate (g·min-1), and negative coefficients for body fat mass (kg) and habitual physical activity level. When expressed relative to fat-free mass, 64% of variance in PFO was explained: positive coefficients for FATmax (strongest predictor), V˙O2peak, and resting fat oxidation rate, and negative coefficients for male sex and fat mass. This duplicate design revealed that biological and lifestyle factors explain a large proportion of variance in PFO during incremental cycling. After accounting for day-to-day variation in PFO, V˙O2peak and FATmax were strong and consistent predictors of PFO.

Echo intensity is weakly associated with muscular strength and endurance in young, healthy adults

The purpose of this study was to evaluate the relationships between echo intensity (EI) and muscular strength (maximal voluntary isometric contraction [MVIC]) and endurance (time-to task-failure [TTF]) in young adults. Ultrasonography was used to examine the dominant vastus lateralis of 15 young men and 15 young women. The participants completed an MVIC to assess muscular strength and sustained a bilateral, leg extension at 45% MVIC to assess muscular endurance. There was a significant (r = -0.354, p = 0.028) correlation between EI and normalized MVIC force for the combined sample (n = 30). There was also a significant (r = -0.520, p = 0.002) correlation between EI and absolute MVIC force for the combined sample. The correlation between EI and TTE was significant for the men (r = -0.449, p = 0.047) and the combined sample (r = -0.477, p = 0.004). Overall, muscle quality as assessed by EI does not appear to be strongly related to muscular strength, but there may be a modest correlation with muscular endurance.

Sexual dimorphism in cardiometabolic health: the role of adipose tissue, muscle and liver

Obesity is associated with many adverse health effects, such as an increased cardiometabolic risk. Despite higher adiposity for a given BMI, premenopausal women are at lower risk of cardiometabolic disease than men of the same age. This cardiometabolic advantage in women seems to disappear after the menopause or when type 2 diabetes mellitus develops. Sexual dimorphism in substrate supply and utilization, deposition of excess lipids and mobilization of stored lipids in various key metabolic organs (such as adipose tissue, skeletal muscle and the liver) are associated with differences in tissue-specific insulin sensitivity and cardiometabolic risk profiles between men and women. Moreover, lifestyle-related factors and epigenetic and genetic mechanisms seem to affect metabolic complications and disease risk in a sex-specific manner. This Review provides insight into sexual dimorphism in adipose tissue distribution, adipose tissue, skeletal muscle and liver substrate metabolism and tissue-specific insulin sensitivity in humans, as well as the underlying mechanisms, and addresses the effect of these sex differences on cardiometabolic health. Additionally, this Review highlights the implications of sexual dimorphism in the pathophysiology of obesity-related cardiometabolic risk for the development of sex-specific prevention and treatment strategies.

High-intensity interval training and essential amino acid supplementation: Effects on muscle characteristics and whole-body protein turnover

The purpose of this study was to compare the independent and combined effects of high-intensity interval training (HIIT) and essential amino acids (EAA) on lean mass, muscle characteristics of the quadriceps, and 24-hr whole-body protein turnover (WBPT) in overweight and obese adults. An exploratory aim was to evaluate potential modulatory effects of sex. Sixty-six adults (50% female; Age: 36.7 ± 6.0 yrs; %BF: 36.0 ± 7.8%) were assigned to 8 wks of: (a) HIIT, 2 days/wk; (b) EAA supplementation, 3.6 g twice daily; (c) HIIT + EAA; or (d) control. At baseline, 4 wks, and 8 wks, total body, thigh LM and muscle characteristics were measured via dual-energy x-ray absorptiometry and B-mode ultrasound, respectively. In a subsample, changes in WBPT was measured using [N15 ]alanine. Differences between groups were assessed using linear mixed models adjusted for baseline values, followed by 95% confidence intervals on adjusted mean change scores (Δ). HIIT and HIIT + EAA improved thigh LM (Δ: +0.17 ± 0.05 kg [0.08, 0.27]; +0.22 ± 0.05 kg [0.12,0.31]) and vastus lateralis cross-sectional area (Δ: +2.73 ± 0.52 cm2 [1.69,3.77]; +2.64 ± 0.53 cm2 [1.58,3.70]), volume (Δ: +54.50 ± 11.69 cm3 [31.07, 77.92]; +62.39 ± 12.05 cm3 [38.26, 86.52]), and quality (Δ: -5.46 ± 2.68a.u. [-10.84, -0.09]; -7.97 ± 2.76a.u.[-13.49, -2.45]). Protein synthesis, breakdown, and flux were greater with HIIT + EAA and EAA compared to HIIT (p < .05). Sex differences were minimal. Compared to women, men tended to respond more to HIIT, with or without EAA. For women, responses were greater with HIIT + EAA than HIIT. In overweight and obese adults, 8 weeks of HIIT, with or without EAA, improved thigh LM size and quality; EAA may enhance muscular adaptation via increases in protein turnover, supporting greater improvements in muscular size and quality.

Barriers in translating preclinical rodent exercise metabolism findings to human health

Physical inactivity and low aerobic capacity are primary drivers of chronic disease pathophysiology and are independently associated with all-cause mortality. Conversely, increased physical activity and exercise are central to metabolic disease prevention and longevity. Although these relationships are well characterized in the literature, what remains incompletely understood are the mechanisms by which physical activity/exercise prevents disease. Given methodological constraints of clinical research, investigators must often rely on preclinical rodent models to investigate these potential underlying mechanisms. However, there are several key barriers to applying exercise metabolism findings from rodent models to human health. These barriers include housing temperature, nutrient metabolism, exercise modality, exercise testing, and sex differences. Increased awareness and understanding of these barriers will enhance the ability to impact human health through more appropriate experimental design and interpretation of data within the context of these factors.

Protein Requirements of Pre-Menopausal Female Athletes: Systematic Literature Review

This systematic literature review aimed to determine the protein requirements of pre-menopausal (e.g., 18-45 years) female athletes and identify if the menstrual cycle phase and/or hormonal contraceptive use influence protein requirements. Four databases were searched for original research containing pre-menopausal female athletes that ingested protein alongside exercise. The Academy of Nutrition and Dietetics Quality Criteria Checklist was used to determine study quality. Fourteen studies, which included 204 recreationally active or competitive females, met the eligibility criteria for inclusion in this review, and all were assessed as positive quality. The estimated average requirement (EAR) for protein intake of pre-menopausal recreational and/or competitive female athletes is similar for those undertaking aerobic endurance (1.28-1.63 g/kg/day), resistance (1.49 g/kg/day) and intermittent exercise (1.41 g/kg/day) of ~60-90 min duration. The optimal acute protein intake and influence of menstrual cycle phase or hormonal contraceptive use on protein requirements could not be determined. However, pre- and post-exercise protein intakes of 0.32-0.38 g/kg have demonstrated beneficial physiological responses in recreational and competitive female athletes completing resistance and intermittent exercise. The protein requirements outlined in this review can be used for planning and assessing protein intakes of recreational and competitive pre-menopausal female athletes.

Sex differences in health and disease: A review of biological sex differences relevant to cancer with a spotlight on glioma

The influence of biological sex differences on human health and disease, while being increasingly recognized, has long been underappreciated and underexplored. While humans of all sexes are more alike than different, there is evidence for sex differences in the most basic aspects of human biology and these differences have consequences for the etiology and pathophysiology of many diseases. In a disease like cancer, these consequences manifest in the sex biases in incidence and outcome of many cancer types. The ability to deliver precise, targeted therapies to complex cancer cases is limited by our current understanding of the underlying sex differences. Gaining a better understanding of the implications and interplay of sex differences in diseases like cancer will thus be informative for clinical practice and biological research. Here we review the evidence for a broad array of biological sex differences in humans and discuss how these differences may relate to observed sex differences in various diseases, including many cancers and specifically glioblastoma. We focus on areas of human biology that play vital roles in healthy and disease states, including metabolism, development, hormones, and the immune system, and emphasize that the intersection of sex differences in these areas should not go overlooked. We further propose that mathematical approaches can be useful for exploring the extent to which sex differences affect disease outcomes and accounting for those in the development of therapeutic strategies.

Association Between Diet Quality and Cardiorespiratory Fitness in Korean Adults: The 2014-2015 National Fitness Award Project

Cardiorespiratory fitness (CRF) is a strong and meaningful indicator for predicting mortality, including cardiovascular disease, as well as simple physical capacity. Healthy eating is thought to be one of the crucial factors associated with an individual’s CRF status, although little research has been done on the relationship between healthy eating and CRF. This study aimed to investigate the association between overall diet quality and CRF among Korean adults. The study involved 937 adults (380 men and 557 women) aged 19‒64 years who participated in the 2014‒2015 Korea Institute of Sports Science Fitness Standards project. Diet quality was assessed by the recommended food score (RFS), and CRF was determined by maximal oxygen uptake (VO_2max) during a treadmill exercise test. Multiple regression model analyses were stratified by age (19–34, 35–49, and 50–64 years) and sex, because both factors greatly influence CRF. After multivariate adjustment, only the 19‒34 age group in both sexes showed a positive association between RFS and VO_2max. Additionally, when physical activity was adjusted, it was still significant in men but only marginally related in women. Our results suggest that better overall diet quality may be associated with a better CRF among young adults aged 19‒34 years in Korea.

Effect of the Glycemic Index of Meals on Physical Exercise: A Case Report

Carbohydrate uptake before physical exercise allows to maintain plasma glucose concentration. Though, foods or beverages containing the same carbohydrate concentration do not produce the same glycemic and insulin responses which are related to their glycemic index (GI). Last, most studies of CHO loading have been conducted with male subjects, with the assumption that the results also apply to female athletes.

Sixteen volunteer amateur athletes, eight men and eight women (age 39.1 ± 7.8 y; VO2max 55,7 ± 11,7 ml/kg/min), were selected and then divided into four groups of four people each one. The trial was divided into several days, one for each group. A carbohydrate source or a placebo (energy 86,5 ± 6,7 kcal; CHO 20,0 g; fat 0,3 ± 0,3 g; protein 0,8 ± 0,8 g) was assigned randomly to each athlete in the group: these supplements differed in the ability to increase blood glucose (banana: high-GI; dried apricots: low-GI; energy gel: mixture of CHO with different blood release), while the placebo was composed of water, sodium cyclamate, sodium saccharin and acesulfame potassium. Three blood samples were taken from each athlete from finger, by glucometer: one before supplementation, one half an hour later – at the start of the run – and one at the end of the exercise.

Physical activity consisted of 40 minutes run at medium-high intensity, corresponding to 82% of maximum heart rate or 70% of VO2max. In order to improve the analysis of the results obtained from the detection of biological samples, a questionnaire was submitted to all participants to know their lifestyle and anthropometric and physiological data.

Results highlighted a different glycemic response between men and women, suggesting the consumption of low-GI food rather than high-GI before physical exercise in order to keep plasma glucose levels constant.

Physiological sex differences affect the integrative response to exercise: acute and chronic implications

NEW FINDINGS

What is the topic of this review? We review sex differences within physiological systems implicated in exercise performance; specifically, how they integrate to determine metabolic thresholds and fatigability. Thereafter, we discuss the implications that these sex differences might have for long-term adaptation to exercise. What advances does it highlight? The review collates evidence from recent physiological studies that have investigated sex as a biological variable, demonstrating that the physiological response to equivalent 'dosages' of exercise is not the same in males and females; thus, highlighting the need to research diversity in physiological responses to interventions.

ABSTRACT

The anatomical and physiological differences between males and females are thought to determine differences in the limits of human performance. The notion of studying sex as a biological variable has recently been emphasized in the biosciences as a vital step in enhancing human health. In this review, we contend that the effects of biological sex on acute and chronic responses must be studied and accounted for when prescribing aerobic exercise, much like any intervention targeting the optimization of physiological function. Emerging evidence suggests that the response of physiological systems to exercise differs between males and females, potentially mediating the beneficial effects in healthy and clinical populations. We highlight evidence that integrative metabolic thresholds during exercise are influenced by phenotypical sex differences throughout many physiological systems. Furthermore, we discuss evidence that female skeletal muscle is more resistant to fatigue elicited by equivalent dosages of high-intensity exercise. How the different acute responses affect the long-term trainability of males and females is considered, with discussion about tailoring exercise to the characteristics of the individual presented within the context of biological sex. Finally, we highlight the influence of endogenous and exogenous sex hormones on physiological responses to exercise in females. Sex is one of many mediating influences on the outcomes of exercise, and with careful experimental designs, physiologists can advance the collective understanding of diversity in physiology and optimize outcomes for both sexes.

Substrate oxidation in primary human skeletal muscle cells is influenced by donor age

Primary human myotubes represent an alternative system to intact skeletal muscle for the study of human diseases related to changes in muscle energy metabolism. This work aimed to study if fatty acid and glucose metabolism in human myotubes in vitro were related to muscle of origin, donor gender, age, or body mass index (BMI). Myotubes from a total of 82 donors were established from three different skeletal muscles, i.e., musculus vastus lateralis, musculus obliquus internus abdominis, and musculi interspinales, and cellular energy metabolism was evaluated. Multiple linear regression analyses showed that donor age had a significant effect on glucose and oleic acid oxidation after correcting for gender, BMI, and muscle of origin. Donor BMI was the only significant contributor to cellular oleic acid uptake, whereas cellular glucose uptake did not rely on any of the variables examined. Despite the effect of age on substrate oxidation, cellular mRNA expression of pyruvate dehydrogenase kinase 4 (PDK4) and peroxisome proliferator–activated receptor gamma coactivator 1 alpha (PPARGC1A) did not correlate with donor age. In conclusion, donor age significantly impacts substrate oxidation in cultured human myotubes, whereas donor BMI affects cellular oleic acid uptake.

NIRS-derived skeletal muscle oxidative capacity is correlated with aerobic fitness and independent of sex

Near-infrared spectroscopy (NIRS) provides a simple and reliable measure of skeletal muscle oxidative capacity; however, its relationship to aerobic fitness and sex are unclear. We hypothesized that NIRS-derived oxidative capacity in the vastus lateralis (VL) and medial gastrocnemius (MG) would be correlated with indices of aerobic fitness and independent of sex. Twenty-six participants (13 males, 13 females) performed ramp- and step-incremental tests to volitional exhaustion on separate days to establish maximal oxygen uptake (V̇o2max), peak power output (PPO), lactate threshold (LT), gas exchange threshold (GET), respiratory compensation point (RCP), and maximal fat oxidation (MFO). Data were normalized to lean body mass to account for sex-based differences in body composition. Exercise tests were preceded by duplicate measurements of NIRS-derived oxidative capacity on the VL and MG muscles (i.e., repeated arterial occlusions following a brief set of muscle contractions). Skeletal muscle oxidative capacity for the VL (means ± SD: 21.9 ± 4.6 s) and MG (22.5 ± 6.1 s) were similar but unrelated (r2 = 0.03, P = 0.39). Skeletal muscle oxidative capacity for the VL, but not the MG (P > 0.05 for all variables), was significantly correlated with V̇o2max (r2 = 0.24; P = 0.01), PPO (r2 = 0.23; P = 0.01), LT (r2 = 0.23; P = 0.01), GET (r2 = 0.23; P = 0.01), and RCP (r2 = 0.27; P = 0.006). MFO was not correlated with VL or MG skeletal muscle oxidative capacity (P > 0.05). Females (54.9 ± 4.5 mL·kg LBM-1·min-1) and males (56.0 ± 6.2 mL·kg LBM-1·min-1), matched for V̇o2max (P = 0.62), had similar NIRS-derived oxidative capacities for VL (20.7 ± 4.4 vs. 23.2 ± 4.6 s; P = 0.18) and MG (24.4 ± 6.8 vs. 20.5 ± 4.8 s; P = 0.10). Overall, NIRS-derived skeletal muscle oxidative capacity in VL is indicative of aerobic fitness and independent of sex in humans.NEW & NOTEWORTHY Near-infrared spectroscopy (NIRS) can be used to measure skeletal muscle oxidative capacity. Here, we demonstrated that NIRS-derived skeletal muscle oxidative capacity of the vastus lateralis was independent of sex, reliable across and within days, and correlated with maximal and submaximal indices of aerobic fitness, including maximal oxygen uptake, lactate threshold, and respiratory compensation point. These findings highlight the utility of NIRS for investigating skeletal muscle oxidative capacity in females and males.

Using Accelerometry for Evaluating Energy Consumption and Running Intensity Distribution Throughout a Marathon According to Sex

The proportion of females participating in long-distance races has been increasing in the last years. Although it is well-known that there are differences in how females and males face a marathon, higher research may be done to fully understand the intrinsic and extrinsic factors affecting sex differences in endurance performance. In this work, we used triaxial accelerometer devices to monitor 74 males and 14 females, aged 30 to 45 years, who finished the Valencia Marathon in 2016. Moreover, marathon split times were provided by organizers. Several physiological traits and training habits were collected from each participant. Then, we evaluated several accelerometry- and pace-estimated parameters (pacing, average change of speed, energy consumption, oxygen uptake, running intensity distribution and running economy) in female and male amateur runners. In general, our results showed that females maintained a more stable pacing and ran at less demanding intensity throughout the marathon, limiting the decay of running pace in the last part of the race. In fact, females ran at 4.5% faster pace than males in the last kilometers. Besides, their running economy was higher than males (consumed nearly 19% less relative energy per distance) in the last section of the marathon. Our results may reflect well-known sex differences in physiology (i.e., muscle strength, fat metabolism, VO_2max), and in running strategy approach (i.e., females run at a more conservative intensity level in the first part of the marathon compared to males). The use of accelerometer devices allows coaches and scientific community to constantly monitor a runner throughout the marathon, as well as during training sessions.

Leucine-Enriched Protein Supplementation Increases Lean Body Mass in Healthy Korean Adults Aged 50 Years and Older: A Randomized, Double-Blind, Placebo-Controlled Trial

Early prevention of sarcopenia could be an important strategy for muscle retention, but most studies have focused on subjects aged 65 or older. Therefore, in this study we investigated the effects of leucine-enriched protein supplementation on muscle condition in a sample including late middle-aged adults. A 12-week intervention was performed for 120 healthy community-dwelling adults by providing either leucine-enriched protein supplement [leucine 3 g, protein mixture (casein 50% + whey 40% + soy 10%) 17 g, vitamin D 800IU (20 µg), calcium 300 mg, fat 1.1 g, carbohydrate 2.5 g] or isocaloric carbohydrate supplement twice per day. Appendicular skeletal muscle mass index (ASMI) and lean body mass (LBM) were measured by dual-energy X-ray absorptiometry. A total of 111 participants completed the study, with a dropout rate of 9.2%. LBM normalized by height and body weight (LBM/Wt) was significantly increased (p < 0.001) in the intervention group (0 wk: 633.9 ± 8.5 vs. 12 wk 636.9 ± 8.4 in the intervention group; 0 wk: 638.6 ± 8.3 vs. 12 wk: 632.9 ± 8.1 in the control group). In subgroup analyses, significant differences remained only in subjects between 50 and 64 years of age. We concluded that leucine-enriched protein supplementation can have beneficial effects by preventing muscle loss, mainly for late middle-aged adults.

Sex Differences in Adipose Tissue Function

Regional adipose tissue distribution differs between men and women. Differences in the accumulation of adipose tissue as well as the regulation of secretion of a number of products from adipose tissue are under the control of sex steroids, which act through a wide variety of mechanisms, both direct and indirect, to tailor metabolism to the unique needs of each sex. A fuller understanding of sex-based differences in adipose tissue function may help with tailored strategies for disease prevention and treatment and provide insights into fundamental differences in the processes that regulate nutrient homeostasis and body weight.

Males and females exhibit similar muscle glycogen recovery with varied recovery food sources

PURPOSE

Research has elucidated the impact of post-exercise carbohydrate nutrition and environmental conditions on muscle glycogen re-synthesis. However, research has minimally considered the implications of glycogen recovery in females and has mostly focused on commercial sport nutrition products. The purpose of this study was to determine the effects of varied mixed macronutrient feedings on glycogen recovery and subsequent exercise performance in both sexes.

METHODS

Males (n = 8) and females (n = 8) participated in a crossover study. Subjects completed a 90-min cycling glycogen depletion trial, then rested for 4 h. Two carbohydrate feedings (1.6 g kg-1) of either sport supplements or potato-based products were delivered at 0 and 2 h post-exercise. Muscle biopsies (glycogen) and blood samples (glucose, insulin) were collected during the recovery. Afterwards, subjects completed a 20 km cycling time trial.

RESULTS

There was no difference between sexes or trials for glycogen recovery rates (male: 7.9 ± 2.7, female: 8.2 ± 2.7, potato-based: 8.0 ± 2.5, sport supplement: 8.1 ± 3.1 mM kg wet wt-1 h-1, p > 0.05). Time trial performance was not different between diets (38.3 ± 4.4 and 37.8 ± 3.9 min for potato and sport supplement, respectively, p > 0.05).

CONCLUSIONS

These results indicate that food items, such as potato-based products, can be as effective as commercially marketed sports supplements when developing glycogen recovery oriented menus and that absolute carbohydrate dose feedings (g kg-1) can be effectively applied to both males and females.

The effects of rapid weight loss on skeletal muscle in judo athletes

OBJECTIVE

To observe the effect of rapid weight loss (RWL) methods over 3 days on muscle damage in judokas.

METHODS

Eighteen judokas participated in this crossover study, meaning that judo athletes were subjected to exercise-only phase (4 days) and RWL phase (3 days). Subjects were tested for myoglobin, creatine kinase, aldolase, hemoglobin, and hematocrit values on seven consecutive days. These biomarkers served as indicators of acute muscle damage.

RESULTS

During the exercise-only phase, no significant changes were observed. Myoglobin (Mb) (p < 0.001), creatine kinase (CK) (p < 0.001) and aldolase (ALD) (p < 0.001) significantly increased only during the RWL phase, as well as hemoglobin (Hb) (p < 0.001) and hematocrit (Hct) (p < 0.005) values. It was detected that peak values for muscle damage biomarkers were reached on the sixth day, while Hct and Hb values were the highest on the seventh day of the study.

CONCLUSION

Our study showed significant muscle damage induced by RWL. The prevalence of RWL use by judokas is high but firm scientific evidence is lacking in the evaluation of the current practice of it. Therefore, further knowledge must be gained to evaluate the effectiveness of RWL on performance and its impact on judokas' wellbeing.

Peptides from Natural or Rationally Designed Sources Can Be Used in Overweight, Obesity, and Type 2 Diabetes Therapies

Overweight and obesity are among the most prominent health problems in the modern world, mostly because they are either associated with or increase the risk of other diseases such as type 2 diabetes, hypertension, and/or cancer. Most professional organizations define overweight and obesity according to individual body-mass index (BMI, weight in kilograms divided by height squared in meters). Overweight is defined as individuals with BMI from 25 to 29, and obesity as individuals with BMI ≥30. Obesity is the result of genetic, behavioral, environmental, physiological, social, and cultural factors that result in energy imbalance and promote excessive fat deposition. Despite all the knowledge concerning the pathophysiology of obesity, which is considered a disease, none of the existing treatments alone or in combination can normalize blood glucose concentration and prevent debilitating complications from obesity. This review discusses some new perspectives for overweight and obesity treatments, including the use of the new orally active cannabinoid peptide Pep19, the advantage of which is the absence of undesired central nervous system effects usually experienced with other cannabinoids.

Menstrual cycle phase does not affect whole body peak fat oxidation rate during a graded exercise test

Female sex hormones fluctuate in a predictable manner throughout the menstrual cycle in eumenorrheic women. In studies conducted in both animal and humans, estrogen and progesterone have been found to exert individual metabolic effects during both rest and exercise, suggesting that estrogen may cause an increase in fat oxidation during exercise. However, not all studies find these metabolic changes with the natural physiological variation in the sex hormones. To date, no studies have investigated whether whole body peak fat oxidation rate (PFO) and maximal fat oxidation intensity (FAT_max) are affected at different time points [mid-follicular (MF), late-follicular (LF), and mid-luteal (ML)] in the menstrual cycle, where plasma estrogen and progesterone are either at their minimum or maximum. We hypothesized that an increased plasma estrogen concentration together with low progesterone concentration in LF would result in a modest but significant increase in PFO. We found no differences in body weight, body composition, or peak oxygen uptake (V̇o_2peak) between any of the menstrual phases in the 19 healthy, young eumenorrheic women included in this study. PFO [MF: 0.379 (0.324-0.433) g/min; LF: 0.375 (0.329-0.421) g/min; ML: 0.382 (0.337-0.442) g/min; mean ± (95% CI)] and resting plasma free fatty acid concentrations [MF: 392 (293-492) µmol/l; LF: 477 (324-631) µmol/l; ML: 396 (285-508) µmol/L] were also similar across the menstrual cycle phases. Contrary to our hypothesis, we conclude that the naturally occurring fluctuations in the sex hormones estrogen and progesterone do not affect the whole body PFO and FAT_max in young eumenorrheic women measured during a graded exercise test.NEW & NOTEWORTHY Menstrual cycle phase does not affect the peak fat oxidation rate during a graded exercise test. Natural physiological fluctuations in estrogen do not increase peak fat oxidation rate. FAT_max is not influenced by menstrual cycle phase in healthy, young eumenorrheic women.

Supplements and Nutritional Interventions to Augment High-Intensity Interval Training Physiological and Performance Adaptations-A Narrative Review

High-intensity interval training (HIIT) involves short bursts of intense activity interspersed by periods of low-intensity exercise or rest. HIIT is a viable alternative to traditional continuous moderate-intensity endurance training to enhance maximal oxygen uptake and endurance performance. Combining nutritional strategies with HIIT may result in more favorable outcomes. The purpose of this narrative review is to highlight key dietary interventions that may augment adaptations to HIIT, including creatine monohydrate, caffeine, nitrate, sodium bicarbonate, beta-alanine, protein, and essential amino acids, as well as manipulating carbohydrate availability. Nutrient timing and potential sex differences are also discussed. Overall, sodium bicarbonate and nitrates show promise for enhancing HIIT adaptations and performance. Beta-alanine has the potential to increase training volume and intensity and improve HIIT adaptations. Caffeine and creatine have potential benefits, however, longer-term studies are lacking. Presently, there is a lack of evidence supporting high protein diets to augment HIIT. Low carbohydrate training enhances the upregulation of mitochondrial enzymes, however, there does not seem to be a performance advantage, and a periodized approach may be warranted. Lastly, potential sex differences suggest the need for future research to examine sex-specific nutritional strategies in response to HIIT.

Women Experience the Same Ergogenic Response to Caffeine as Men

PURPOSE

This study aimed to determine whether 1) consumption of caffeine improves endurance cycling performance in women and 2) sex differences exist in the magnitude of the ergogenic and plasma responses to caffeine supplementation.

METHODS

Twenty-seven (11 women and 16 men) endurance-trained cyclists and triathletes participated in this randomized, double-blind, placebo-controlled, crossover study. Participants completed an incremental exercise test to exhaustion, two familiarization trials, and two performance trials. Ninety minutes before the performance trials, participants ingested opaque capsules containing either 3 mg·kg body mass of anhydrous caffeine or a placebo. They then completed a set amount of work (75% of peak sustainable power output) in the fastest possible time. Plasma was sampled at baseline, preexercise, and postexercise for caffeine. Strict standardization and verification of diet, hydration, training volume and intensity, and contraceptive hormone phase (for women) were implemented.

RESULTS

Performance time was significantly improved after caffeine administration in women (placebo: 3863 ± 419 s, caffeine: 3757 ± 312 s; P = 0.03) and men (placebo: 3903 ± 341 s, caffeine: 3734 ± 287 s; P < 0.001). The magnitude of performance improvement was similar for women (mean = 4.3%, 95% CI = 0.4%-8.2%) and men (4.6%, 2.3%-6.8%). Plasma caffeine concentrations were similar between sexes before exercise, but significantly greater in women after exercise (P < 0.001).

CONCLUSIONS

Ingestion of 3 mg·kg body mass of caffeine enhanced endurance exercise performance in women. The magnitude of the performance enhancement observed in women was similar to that of men, despite significantly greater plasma caffeine concentrations after exercise in women. These results suggest that the current recommendations for caffeine intake (i.e., 3-6 mg·kg caffeine before exercise to enhance endurance performance), which are derived almost exclusively from studies on men, may also be applicable to women.

Prediction of energy expenditure during activities of daily living by a wearable set of inertial sensors

Physical inactivity is responsible for 7-10% of all premature deaths worldwide. Thus, valid, reliable and unobtrusive methods for monitoring activities of daily living (ADL) to predict total energy expenditure (TEE) is desired. Multiple methods exist to quantify TEE, but microelectromechanical systems (MEMSs) are the only method, which has shown promising results and are applicable for long-term monitoring in the field. However, no perfect method exists for predicting TEE on a daily basis. The present study evaluates TEE estimation based on a MEMS (Xsens Link system) taking gender and heart rate into account. Fifteen individuals performed seven ADL wearing the Xsens Link system, a heart rate belt and an oxygen mask. Multiple linear regression models were established for sedentary and dynamic activities and evaluated by leave-one-out cross-validation and compared with indirect calorimetry. The linear regression model showed better prediction for dynamic activities (adjusted R² 0.95±0.16) compared to sedentary activities (adjusted R² 0.61±0.19). The root-mean-square error for the TEE estimation ranged between 0.02 and 0.08 kJ/min/kg for the sedentary and dynamic models, respectively. The study showed a viable approach to predict TEE in ADL compared to previously published results. Further studies are warranted to reduce the number of sensors in the estimation of TEE.

Effects of supplementing with an 18% carbohydrate-hydrogel drink versus a placebo during whole-body exercise in -5 °C with elite cross-country ski athletes: a crossover study

Background

Whilst the ergogenic effects of carbohydrate intake during prolonged exercise are well-documented, few investigations have studied the effects of carbohydrate ingestion during cross-country skiing, a mode of exercise that presents unique metabolic demands on athletes due to the combined use of large upper- and lower-body muscle masses. Moreover, no previous studies have investigated exogenous carbohydrate oxidation rates during cross-country skiing. The current study investigated the effects of a ¹³C-enriched 18% multiple-transportable carbohydrate solution (1:0.8 maltodextrin:fructose) with additional gelling polysaccharides (CHO-HG) on substrate utilization and gastrointestinal symptoms during prolonged cross-country skiing exercise in the cold, and subsequent double-poling time-trial performance in ~ 20 °C.

Methods

Twelve elite cross-country ski athletes (6 females, 6 males) performed 120-min of submaximal roller-skiing (69.3 ± 2.9% of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{\mathrm{V}} $$\end{document}V˙O₂peak) in −5 °C while receiving either 2.2 g CHO-HG·min^− 1 or a non-caloric placebo administered in a double-blind, randomized manner. Whole-body substrate utilization and exogenous carbohydrate oxidation was calculated for the last 60 min of the submaximal exercise. The maximal time-trial (2000 m for females, 2400 m for males) immediately followed the 120-min submaximal bout. Repeated-measures ANOVAs with univariate follow-ups were conducted, as well as independent and paired t-tests, and significance was set at P < 0.05. Data are presented as mean ± SD.

Results

Exogenous carbohydrate oxidation contributed 27.6 ± 6.6% to the total energy yield with CHO-HG and the peak exogenous carbohydrate oxidation rate reached 1.33 ± 0.27 g·min^− 1. Compared to placebo, fat oxidation decreased by 9.5 ± 4.8% with CHO-HG, total carbohydrate oxidation increased by 9.5 ± 4.8% and endogenous carbohydrate utilization decreased by 18.1 ± 6.4% (all P < 0.05). No severe gastrointestinal symptoms were reported in either trial and euhydration was maintained in both trials. Time-trial performance (8.4 ± 0.4 min) was not improved following CHO-HG compared to placebo (− 0.8 ± 3.5 s; 95% confidence interval − 3.0 to 1.5 s; P = 0.46). No sex differences were identified in substrate utilization or relative performance.

Conclusions

Ingestion of an 18% multiple-transportable carbohydrate solution with gelling polysaccharides was found to be well-tolerated during 120 min of submaximal whole-body exercise, but did not improve subsequent maximal double-poling performance.

Towards a personalised approach in exercise-based cardiovascular rehabilitation: How can translational research help? A 'call to action' from the Section on Secondary Prevention and Cardiac Rehabilitation of the European Association of Preventive Cardiology

The benefit of regular physical activity and exercise training for the prevention of cardiovascular and metabolic diseases is undisputed. Many molecular mechanisms mediating exercise effects have been deciphered. Personalised exercise prescription can help patients in achieving their individual greatest benefit from an exercise-based cardiovascular rehabilitation programme. Yet, we still struggle to provide truly personalised exercise prescriptions to our patients. In this position paper, we address novel basic and translational research concepts that can help us understand the principles underlying the inter-individual differences in the response to exercise, and identify early on who would most likely benefit from which exercise intervention. This includes hereditary, non-hereditary and sex-specific concepts. Recent insights have helped us to take on a more holistic view, integrating exercise-mediated molecular mechanisms with those influenced by metabolism and immunity. Unfortunately, while the outline is recognisable, many details are still lacking to turn the understanding of a concept into a roadmap ready to be used in clinical routine. This position paper therefore also investigates perspectives on how the advent of 'big data' and the use of animal models could help unravel inter-individual responses to exercise parameters and thus influence hypothesis-building for translational research in exercise-based cardiovascular rehabilitation.

Muscle strength is impaired in men but not in women living with HIV taking antiretroviral therapy

BACKGROUND

There is evidence that HIV antiretroviral therapy adverse effects may be sex-dependent, but data examining these sex differences in muscle strength is scarce. Our aim was to compare dynamic and isokinetic parameters of muscle strength between HIV-infected men and women to HIV-uninfected subjects.

METHODS

In this cross-sectional study, muscle strength was evaluated in 44 HIV-infected (20 men, 24 women) and 25 age-, race- and body mass index-matched HIV-uninfected subjects (11 men, 14 women). We assessed knee flexion and extension efforts in isokinetic dynamometer at angular velocities of 60° and 180°/s, and 1 repetition maximum test (1RM) for bench press, leg press and arm curl exercises, respectively. Lean body mass (LBM) was measured using bioelectrical impedance.

RESULTS

HIV-infected men had significantly less dynamic muscle strength for 1RM total (262.5 versus 357.2 kg), bench press (48.6 versus 60.3 kg), leg press (182.7 versus 261 kg) and arm curl (31.2 versus 36.5 kg) compared to HIV-uninfected men (P≤0.05); no differences were found among women. Men had lower values for peak torque in extension and flexion movements at 60°/s and 180°/s, while HIV-infected women presented higher peak torque in extension movement at 60°/s compared to controls. No differences were found in LBM. Moreover, isokinetic evaluation demonstrated that HIV-infected subjects showed greater acceleration and deceleration time in some variables, compared to controls, related to difficulty in activating motor units.

CONCLUSIONS

HIV infection is associated with impaired dynamic and isokinetic strength in men compared to HIV-uninfected controls, but not in women.

Age Differences in Pacing in Endurance Running: Comparison between Marathon and Half-MarathonMen and Women

Background and Objective: The increased popularity of marathons and half-marathons has led to a significant increase in the number of master runners worldwide. Since the age-related decrease in performance is dependent on race duration, pacing in long distance running might also vary by race distance in both men and women. Therefore, the main aim of this study was to assess pacing differences between marathon and half-marathon runners with regard to the runners’ age group, and independently for men and women. Materials and Methods: In total, 17,465 participants in the Vienna City marathon in 2017 were considered for this study (marathon, N = 6081; half-marathon, N = 11,384). Pacing was expressed as two variables (i.e., pace range and end spurt). Results: All runners showed positive pacing strategies (i.e., a fast start with gradual decrease of speed). However, marathon runners showed greater variability in pacing than half-marathon runners. Furthermore, women showed no differences in pace variability in regard to the age group, whereas men younger than 30 years of age, as well as older men (over the age of 60), showed a greater variability in pace than other age groups. Finally, younger half-marathon men and women showed the fastest end spurt compared to older age groups and marathon runners. Conclusions: The presented findings could help sports and medicine practitioners to create age specific training plans and pacing strategies. This approach could help long distance runners to improve their physical fitness, achieve better race times, reduce the potential risk of musculoskeletal injuries and increase the overall pleasure of long distance running.