Nutrition and Athletic Performance

[Vitamin D Deficiency in Sports]

Vitamin D Deficiency in Sports Abstract. A deficiency in vitamin D is very common in the general population as well as in athletes. The aim of this overview is to assess the level of knowledge about the importance of vitamin D for athletes. A deficiency in vitamin D is present in up to 90 % of athletes. Risk groups are young athletes, female athletes, athletes with a limitation such as paraplegia, vegetarians, athletes with a resorption disorder such as celiac disease, athletes training and competing indoors (e.g. ice hockey, basketball, boxing, rhythmic gymnastics), and older athletes. Dark skin pigmentation, the use of sunscreen, the time of day of the training (early morning, late evening) and the geographical location influence the risk for a deficiency in vitamin D. Exposure to the sun and a balanced diet are often not enough to prevent a vitamin D deficiency.

The Consumption of Caffeine-Containing Products to Enhance Sports Performance: An Application of an Extended Model of the Theory of Planned Behavior

Caffeine is the most-used psychoactive substance in the world. About 80% of the world's population consumes caffeine every day, including athletes and lifestyle users. Thus, it is important to understand the consumer drivers of caffeine-containing beverages and food. This research study aims to explore consumers' behaviors, perceptions, attitudes, and drivers towards caffeine-containing products to enhance sports performance. The research applies the Theory of Planned Behavior (TPB) in order to understand consumers' behavior, extended with utilitarian aspects for a comprehensive understanding of consumers' behavior and attitudes. We interviewed consumers with the support of Qualtrics online software. The data were then processed with SPSS (statistical analysis software). The data elaboration includes a multivariate linear regression model to analyze the consumers' intention to consume caffeine to enhance the sports performance, and to explore consumers' preference of marketing leverages for this product category. The results contribute to an understanding of consumers' consumption and purchasing behavior towards caffeine, and support the validity of the extended TPB to develop a more comprehensive picture of consumer behavior. Consumers have a positive attitude towards caffeine-containing products to enhance sports performance. The main consumer behavior drivers are subjective norms and utilitarian aspects. The present research results may support companies in the development of caffeine-containing products to enhance sports performance.

Prevalence of Low Energy Availability in Collegiate Women Soccer Athletes

(1) Background: Limited information exists on the prevalence of low energy availability (LEA) in collegiate team sports. The purpose of this study was to examine the prevalence of LEA in collegiate women soccer players. (2) Methods: Collegiate women soccer athletes (n = 18, height: 1.67 ± 0.05 m; body mass: 65.3 ± 7.9 kg; body fat %: 24.9 ± 5.6%) had their body composition and sport nutrition knowledge assessed in the pre-season. Energy availability was assessed mid-season using a 4-day dietary log and activity energy expenditure values from a team-based monitoring system. A validated screening tool was used to screen for LEA. (3) Results: The screening tool classified 56.3% of athletes as at risk of LEA (<30 kcal/kg of FFM); however, the actual dietary intake identified 67% as LEA. Athletes identified as non-LEA consumed significantly more absolute (p = 0.040) and relative (p = 0.004) energy than LEA athletes. (4) Conclusions: There was a high prevalence of LEA among collegiate women soccer athletes. Although previously validated in women endurance athletes, the LEA screening tool was not effective in identifying those at risk of LEA in this sample of athletes.

Evaluation of Protein Content in the Diet of Amateur Male Bodybuilder

Public gyms and fitness clubs promote active lifestyles. At the same time, numerous nutritional errors and the phenomenon of incorrect supplementation are being observed among the given study group. Behavior can lead to malaise, injury, or lack of progression. One of the most serious mistakes is the incorrect level of protein in the diet. The aim of the study is to assess the quantity and quality of protein consumed by men undertaking recreational strength training in Szczecin. The study involved 35 men aged 18–35, practicing amateur strength training, from Szczecin (Poland). The author’s questionnaire collected information on supplementation, physical activity, and subjective assessment of nutritional knowledge. The obtained test results were subjected to statistical analysis performed in the Statistica12 program. On average, respondents consumed 1.8 g of protein/kg, with the highest recorded conversion rate of 3.7 g of protein/kg of body weight, and the lowest of 0.9 g/kg of body weight. Total protein consumption ranged from 70.2 to 295.7 g, and the average value was 147.8 g (22%), which differs from the study group, that is, 129–133 g, which gives 14% energy proteins. It was found that the protein supplementation, on average, provided 31% of the total protein intake of the study group. The results show inappropriate dietary behavior regarding food supplementation among the examined group. Further education on the nutritional value of the food and a healthy and balanced diet is being recommended for the individuals practicing strength sports.

The Mediterranean Athlete's Nutrition: Are Protein Supplements Necessary?

(1) Background: It is recommended that an athlete, in order to ensure correct nutrition and performance, should consume between 1.2 and 2.0 g/kg/day of protein, while the daily recommended protein intake for a non-athlete is 0.8and 0.9 mg/kg/day. It is unclear if athletes living in Mediterranean countries are able to meet protein requirements without supplementation, since Mediterranean diet de-emphasizes meat and meat products. (2) Methods: 166 athletes (125 males) enrolled between 2017 and 2019 were required to keep a dietary journal for three consecutive days (2 workdays and 1 weekend day). Athletes had to be >18 years old, train in a particular sport activity more than 3 h a week and compete at least at an amateur level. Journal data were collected and then translated into macro-nutrient content (grams of protein, carbohydrates, and lipids) by a nutritionist. (3) Results: The protein intake reported by this specific population vary slightly from the Academy of Nutrition and Dietetics (AND), Dietitians of Canada (DC), and the American College of Sports Medicine (ACSM) joint statement recommendation level. Average protein levels without protein supplementation fell within the protein guidelines. Counterintuitively, the intake among those who supplemented their diet with protein was higher compared with those who did not, even when excluding the contribution of supplements. Although the majority of subjects participating in the study were able to meet protein intake recommended for athletes without protein supplementation, 27% of athletes were below the guideline range. (4) Conclusions: these data suggest that athletes' nutrition should be more often evaluated by a nutritionist and that they will benefit from increasing their nutritional knowledge in order to make better food choices, resorting to protein supplementation only when effectively needed.

Functionally Relevant Differences in Plasma Fatty Acid Composition and Expression of Cytotoxic and Inhibitory NK Cell Receptors between Healthy Young and Healthy Elder Adults

(1) Background: In the healthy ageing, NK cell number is not modified; however, their spontaneous cytotoxicity decreases. We postulated that the age-dependent decline in metabolic activities might be responsible for this effect. (2) Methods: The fatty acid profile of 30 healthy young males (23 ± 4 years old, BMI 22.1 ± 1.3) and 30 older males (63 ± 5 years old, BMI 22.9 ± 2.5) donors were evaluated along with the expression of killing (KR) and inhibitory NK receptors (KIR) at basal level and after cultivation with fatty acids for 24 h. (3) Results: Significantly higher levels of oleic (p < 0.01), arachidonic (p < 0.001), lignoceric (p < 0.001), and nervonic acids (p < 0.0001) and significantly lower levels of docosapentaenoic and docosahexaenoic acids (p < 0.01) were found in elders as compared to young adults. At basal levels, significant (p < 0.005) differences in KR and KIR expression were encountered; 12/16 antigens. Treatment of cells with saturated fatty acids or arachidonic acid (AA) significantly enhanced KR expressions (p < 0.001). AA treatment decreased inhibitory KIR expression while docosahexaenoic, and eicosapentaenoic acid increased them. (4) Conclusions: Changes in fatty acids blood levels, and KR and KIR expression in NK cell, are age-dependent. Supplementation of NK cells with eicosapentaenoic or docosahexaenoic acid enhanced inhibitory KIR receptors’ expression which may improve their cell function.

Ergogenic potential of foods for performance and recovery: a new alternative in sports supplementation? A systematic review

In recent years, there have been studies in the literature reporting the ergogenic effect of some different foods on sports performance. Given the reasonable number of studies in which some food has shown improvement in some physiological variables related to physical performance, a review is pertinent in order to produce a compilation of these studies, providing new elements for athletes and coaches which aim to optimize their performance. Thus, the objective of this work was to present a systematic review of the findings regarding the potential ergogenic effect of food for athletes. Researchers performed a double-blind research in Medline/PubMed considering articles published until January 2019 which resulted in 71 articles. Increased time until exhaustion, improved aerobic capacity and strength recovery were the most commonly reported physical effects. In general, food showed equal or superior ergogenic activity over supplements. Although the number of foods investigated is reasonable, there is still no body of evidence for each studied food, except beets. The current data support the possibility of certain foods being able to enhance athletic performance, as well as serving as an energy source. However, a larger volume of studies is needed to form a body of evidence on each of these foods.

Acute Hormone Responses Subsequent to Agonist-Antagonist Paired Set vs. Traditional Straight Set Resistance Training

Miranda, H, de Souza, JAAA, Scudese, E, Paz, GA, Salerno, VP, Vigário, PdS, and Willardson, JM. Acute hormone responses subsequent to agonist-antagonist paired set vs. traditional straight set resistance training. J Strength Cond Res 34(6): 1591-1599, 2020-The purpose of this study was to compare acute hormone responses and rating of perceived exertion (OMNI-Res) subsequent to the agonist-antagonist paired set (PS) vs. the traditional straight set (TS) resistance training method. Twelve recreationally trained men (25.7 ± 4.7 years, 173 ± 6.3 cm and 71.5 ± 6.6 kg) participated in the current study. After 10 repetition maximum (RM) load determination, each subject performed the following 2 experimental sessions in random order: TS session-3 sets of 10 repetitions at 85% of 10RM for the machine seated row and barbell bench press with 2-minute rest intervals between sets; and PS-3 sets of 10 repetitions with 85% of 10RM alternating machine seated row and barbell bench press for the total of 6 PSs with 2-minute rest intervals between sets. Total testosterone (TT), free testosterone (FT), cortisol, TT/cortisol ratio, growth hormone (GH), and blood lactate concentrations were measured before workout and immediately after workout and 15 and 30 minutes after workout. The OMNI-RES was recorded at the end of each set for both exercises within each session. Under the TS session, TT significantly increased immediately post-workout vs. the pre-workout time point. For the PS session, TT significantly decreased at 30-minute post-workout vs. the immediate post-workout time point, whereas, FT significantly increased immediately post-workout and 15-minute post-workout vs. the pre-workout time point. For the TS session, GH significantly increased immediately post-workout, and at the 15- and 30-minute post-workout time points vs. the pre-workout time point, respectively. For the PS session, GH was significantly increased immediately post-workout vs. the pre-workout time point. Blood lactate significantly increased at all post-workout time points vs. the pre-workout time point under both sessions. The cortisol and TT/cortisol ratio showed no differences between sessions. In conclusion, from an acute standpoint, the TS approach showed a tendency to cause greater disruption in hormone levels, despite the lack of significant differences vs. the PS approach at all time points. However, both strategies may promote similar acute hormone responses.

Comparison of Energy and Nutrient Intake vs. Estimated Needs in Warfighters: an Update

Active members of the military must perform optimally under conditions of thermal stress and/or energy deficiency. Military dietary reference intakes (MDRIs) provide guidelines for energy and nutrient intakes but is based studies largely conducted in Army. Needs may vary by service branch and/or position. New protein recommendations have emerged, which are not reflected in MDRIs. PURPOSE OF REVIEW: Compare reported dietary intake in active duty members to MDRIs and 2016 American College of Sports Medicine (ACSM) sports nutrition guidelines. RECENT FINDINGS: Active duty members are not meeting their energy and carbohydrate needs with low-to-adequate protein intake and adequate-to-high fat intake. Other nutrients of concern are vitamin D, calcium, iron, B-vitamins, and fiber. Thermal stress increases energy needs and suppresses appetite and thus increase risk for energy and nutrition deficiencies. Energy and nutrients needs can vary by branch of armed service, job responsibility, and external stressors.

A New Strategy to Integrate Heath-Carter Somatotype Assessment with Bioelectrical Impedance Analysis in Elite Soccer Player

Easy-to-apply and quick methods for evaluate body composition are often preferred when assessing soccer teams. This study aimed to develop new equations for the somatotype quantification that would reduce the anthropometric measurements required by the Heath and Carter method, integrating the somatotype assessment to the bioelectrical impedance analysis (BIA). One hundred and seventy-six male elite soccer players (age 26.9 ± 4.5 years), registered in the Italian first division (Serie A), underwent anthropometric measurements and BIA. Endomorphy, mesomorphy, and ectomorphy were obtained according to the Heath and Carter method, while fat mass (FM) and fat free mass (FFM) estimated using a BIA-derived equation specific for athletes. The participants were randomly split into development (n = 117) and validation groups (n = 59, 1/3 of sample). The developed models including resistance2/stature, FM%, FFM, contracted arm and calf circumference, triceps, and supraspinal skinfolds had high predictive ability for endomorphy (R2 = 0.83, Standard Error of Estimate (SEE) = 0.16) mesomorphy (R2 = 0.80, SEE = 0.36), and ectomorphy (endomorphy (R2 = 0.87, SEE = 0.22). Cross validation revealed R2 of 0.80, 0.84, 0.87 for endomorphy, mesomorphy, and ectomorphy, respectively. The proposed strategy allows the integration of somatotype assessment to BIA in soccer players, reducing the number of instruments and measurements required by the Heath and Carter approach.

Carbohydrate supplementation: a critical review of recent innovations

PURPOSE

To critically examine the research on novel supplements and strategies designed to enhance carbohydrate delivery and/or availability.

METHODS

Narrative review.

RESULTS

Available data would suggest that there are varying levels of effectiveness based on the supplement/supplementation strategy in question and mechanism of action. Novel carbohydrate supplements including multiple transportable carbohydrate (MTC), modified carbohydrate (MC), and hydrogels (HGEL) have been generally effective at modifying gastric emptying and/or intestinal absorption. Moreover, these effects often correlate with altered fuel utilization patterns and/or glycogen storage. Nevertheless, performance effects differ widely based on supplement and study design. MTC consistently enhances performance, but the magnitude of the effect is yet to be fully elucidated. MC and HGEL seem unlikely to be beneficial when compared to supplementation strategies that align with current sport nutrition recommendations. Combining carbohydrate with other ergogenic substances may, in some cases, result in additive or synergistic effects on metabolism and/or performance; however, data are often lacking and results vary based on the quantity, timing, and inter-individual responses to different treatments. Altering dietary carbohydrate intake likely influences absorption, oxidation, and and/or storage of acutely ingested carbohydrate, but how this affects the ergogenicity of carbohydrate is still mostly unknown.

CONCLUSIONS

In conclusion, novel carbohydrate supplements and strategies alter carbohydrate delivery through various mechanisms. However, more research is needed to determine if/when interventions are ergogenic based on different contexts, populations, and applications.

Disordered eating and eating disorders in male elite athletes: a scoping review

Background

Eating disorders (ED) and disordered eating (DE) among male elite athletes share some of the characteristics seen in female elite athletes and the population, but also exhibit some key differences.

Objective

Scoping review of ED and DE in male elite athletes.

Methods

In May 2020, a comprehensive systematic literature search was conducted for DE and ED in male elite athletes.

Results

We identified 80 studies which included 47 uncontrolled, 14 controlled studies, one interventional trial and 18 reviews.

Discussion

There was a wide range of definitions of DE and a high level of heterogeneity regarding competitive level, age and sport type. In adult male elite athletes, ED prevalence rates up to 32.5% were found, higher than in the general population. Prevalence was not higher in young/adolescent male elite athletes. The most frequently associated factor was competing in weight-sensitive sports. Male elite athletes tended to exhibit less body dissatisfaction than controls and were not always associated with DE. There were no studies looking at the prognosis or reporting an evidence-based approach for the management of DE in male elite athletes.

Conclusion

Existing literature indicates high prevalence of DE and ED in male elite athletes, with a wide range of aetiopathogenesis. There is a need for longitudinal studies to characterise the pathology and long-term outcomes, as well as develop standardised tools for assessment and treatments.

Falsehoods and facts about dietary sugars: a call for evidence-based policy

Sugar, tobacco, and alcohol have been demonized since the seventeenth century. Yet unlike tobacco and alcohol, there is indisputable scientific evidence that dietary sugars were essential for human evolution and are essential for human health and development. Therefore, the purpose of this analytic review and commentary is to demonstrate that anti-sugar rhetoric is divorced from established scientific facts and has led to politically expedient but ill-informed policies reminiscent of those enacted about alcohol a century ago in the United States. Herein, we present a large body of interdisciplinary research to illuminate several misconceptions, falsehoods, and facts about dietary sugars. We argue that anti-sugar policies and recommendations are not merely unscientific but are regressive and unjust because they harm the most vulnerable members of our society while providing no personal or public health benefits.

Curcumin Improves Delayed Onset Muscle Soreness and Postexercise Lactate Accumulation

The efficacy of curcumin supplementation is traditionally limited due to its poor bioavailability. Despite this, curcumin has previously been shown to improve biomarkers of muscle damage. The addition of a novel drug delivery system that improves bioavailability could improve exercise recovery. The purpose of this randomized double-blind placebo-controlled study was to assess the effect of curcumin (combined with LipiSperse) when consumed as a drink on exercise recovery in recreationally trained healthy males aged 18-35 yrs. The study included 28 young healthy males with strength training experience. The participants undertook lower limb resistance exercise to exhaustion. Fourteen participants received curcumin dispersed in water pre and postexercise and 14 received a matched placebo drink. Pain (visual analogue scale), thigh circumference (TC), lactate, creatine kinase, lactate dehydrogenase, high sensitivity C-reactive protein, myoglobin, interleukin-6, interleukin-10, and tumor necrosis factor-alpha were assessed pre, postexercise and 1, 2, 3, 24, 48, and 72 h postexercise. There was less appearance of postexercise capillary lactate in the curcumin group compared to placebo (7.4 vs 8.8 mmol/L). The placebo group rated overall muscle pain as higher compared to the curcumin group at 48- and 72-h postexercise. TC was reduced in the curcumin group compared to the placebo group at 24- and 48-h postexercise. The results suggest curcumin may facilitate a quicker return to exercise training and/or allow a higher training intensity than a placebo by reducing postexercise pain, modulating inflammatory pathways and reducing lactate accumulation in an exercising population.

Dietary Acid-Base Balance in High-Performance Athletes

Physical exercise leads to metabolic changes that affect the acid-base balance in skeletal muscles and other tissues. Nutrition is one of the factors that may influence the acid-base balance in the body. Keeping alkaline circumstances in the body is important not only for health and athletic performance in training but also during competition in many sport events. This is especially significant for athletes who practice in sport at the highest level of competition. The aim of the study was to determine the dietary acid-base balance in competitive Lithuanian high-performance athletes, and to evaluate the effect of actual diets of athletes on NEAP (net endogenous acid production), muscle mass and body mineral content during a four-year Olympic cycle. The research participants were 18.1 ± 3.3-year-old Lithuanian high performance athletes (n = 323). The actual diet was investigated using the 24 h recall dietary survey method. The measurements of body composition were performed using BIA (bioelectrical impedance analysis). The potential renal acid load of the diets of athletes (dietary PRAL) and NEAP were calculated. In 10.2% of athletes, NEAP exceeds 100 mEq · day-1 and is on average 126.1 ± 32.7 mEq · day-1. Higher NEAP in athletes is associated with lower muscle mass (β -1.2% of body weight, p < 0.001) but has no effect on the amount of minerals in the body (β 0.01% of body weight, p = 0.073). Overall, 25-30% of Lithuanian high-performance athletes use high-protein diets (2.0-4.8 g · kg-1 · day-1) leading to a dietary acid-base imbalance as well as an excessive production of endogenous acids in the body. Athletes are recommended to consume higher amounts of potassium and magnesium. An increase in calcium intake up to 1500 mg per day is recommended. In exceptional cases, periodised nutrition for athletes may involve diets complemented with bicarbonate and/or beta-alanine supplements.

Whey protein supplementation and its potentially adverse effects on health: a systematic review

Whey protein comprises soluble whey proteins and its benefits are well described in the literature. However, there are not many studies investigating the potential adverse effect of a diet with indiscriminate use of this supplement. The aim of this study was to perform a systematic review of papers that addressed this theme. A search was conducted in Medline, LILACS, TOXNET, Web of science, and Scopus electronic databases. In the end, 11 documents comprised this review. The majority of the papers associated the damaging effect with the chronic and abusive use of whey protein, with the kidneys and liver being the main organs affected. The other studies related whey protein to aggravation of aggression, presence of acne, and modification of the microbiota. Therefore, excessive consumption over a long period of protein supplementation may have some adverse effects on the body, which is aggravated when associated with sedentary lifestyle. PROSPERO registration no.: CRD42020140466. Novelty: A systematic review of experimental and randomized studies about the use of whey proteins supplements and its impact on physical health. Analysis revealed that chronic and without professional guidance use of whey protein supplementation may cause some adverse effects specially on kidney and liver function. Presented data support a need for future studies co-relating the use of different types of whey protein with and without exercise to better see the impact on human physical health.

Effects of Acute Exercise and Training on the Sarcoplasmic Reticulum Ca2+ Release and Uptake Rates in Highly Trained Endurance Athletes

Little is presently known about the effects of acute high-intensity exercise or training on release and uptake of Ca²⁺ by the sarcoplasmic reticulum (SR). The aims here were to characterize this regulation in highly trained athletes following (1) repeated bouts of high-intensity exercise and (2) a period of endurance training including high-intensity sessions. Eleven cross-country skiers (25 ± 4 years, 65 ± 4 mL O₂⋅kg⁻¹⋅min^–1) performed four self-paced sprint time-trials (STT 1-4) lasting ≈ 4 min each (STT 1–4) and separated by 45 min of recovery; while 19 triathletes and road cyclists (25 ± 4 years, 65 ± 5 mL O₂⋅kg⁻¹⋅min^–1) completed 4 weeks of endurance training in combination with three sessions of high-intensity interval cycling per week. Release (μmol⋅g^–1 prot⋅min^–1) and uptake [tau (s)] of Ca²⁺ by SR vesicles isolated from m. triceps brachii and m. vastus lateralis were determined before and after STT 1 and 4 in the skiers and in m. vastus lateralis before and after the 4 weeks of training in the endurance athletes. The Ca²⁺ release rate was reduced by 17–18% in both limbs already after STT 1 (arms: 2.52 ± 0.74 to 2.08 ± 0.60; legs: 2.41 ± 0.45 to 1.98 ± 0.51, P < 0.0001) and attenuated further following STT 4 (arms: 2.24 ± 0.67 to 1.95 ± 0.45; legs: 2.13 ± 0.51 to 1.83 ± 0.36, P < 0.0001). Also, there was a tendency toward an impairment in the SR Ca²⁺ uptake from pre STT1 to post STT4 in both arms and legs (arms: from 22.0 ± 3.7 s to 25.3 ± 6.0 s; legs: from 22.5 ± 4.7 s to 25.5 ± 7.7 s, P = 0.05). Endurance training combined with high-intensity exercise increased the Ca²⁺ release rate by 9% (1.76 ± 0.38 to 1.91 ± 0.44, P = 0.009), without altering the Ca²⁺ uptake (29.6 ± 7.0 to 29.1 ± 8.7 s; P = 0.98). In conclusion, the Ca²⁺ release and uptake rates by SR in exercising limbs of highly trained athletes declines gradually by repetitive bouts of high-intensity exercise. We also demonstrate, for the first time, that the SR Ca²⁺ release rate can be enhanced by a specific program of training in highly trained athletes, which may have important implications for performance parameters.

Body composition and dietary patterns in professional and amateur bodybuilders

Significant factors affecting body composition and consequently professional and amateur bodybuilders’ performance are both training loads and diet. The aim was to assess dissimilarities in anthropometrical traits and body composition between males practicing bodybuilding professionally and as amateurs, considering their diet and training. The study comprised 55 athletes, i.e. 29 professionals attending national championships and 26 amateur bodybuilders. All participants underwent anthropometric measurements involving body height, waist, arm and thigh circumferences and skinfolds covering trunk and extremities. The original nutritional behavior questionnaire and a 24-hour survey were used. An electronic scale was used to measure body weight and body composition was analyzed with the BIA method. In statistical analysis, the Shapiro-Wilk (W-test), t-student and Mann-Whitney U test were applied. An adipose tissue, assessed on the basis of skinfolds was significantly lower in professionals (p<0.05), whereas lower mean values of body fat free mass (FFM) were found in amateur bodybuilders (p<0.01). Diet survey presented differentiation both in the amount of consumed protein in the diet (1.98 g/kg), in its percentage participation in the diet (21.2%) in favor of the professionals (p<0.05). Significant differentiation was between the groups in the amount of consumed fats (p<0.05). In case of resistance trainings time, energy expenditure and number of trainings were higher for professionals (p<0.05). Bodybuilders feature better developed muscle mass of extremities and a smaller share of percentage of fat mass in body composition in comparison to amateurs. Professional bodybuilders consume proper amount of carbohydrates and fats and significantly higher level of protein, fiber and energy in diet compared to amateur group. In contrary, higher intake of fats is typical for amateur bodybuilders.

The Role of Nutri(epi)genomics in Achieving the Body's Full Potential in Physical Activity

Physical activity represents a powerful tool to achieve optimal health. The overall activation of several molecular pathways is associated with many beneficial effects, mainly converging towards a reduced systemic inflammation. Not surprisingly, regular activity can contribute to lowering the “epigenetic age”, acting as a modulator of risk toward several diseases and enhancing longevity. Behind this, there are complex molecular mechanisms induced by exercise, which modulate gene expression, also through epigenetic modifications. The exercise-induced epigenetic imprint can be transient or permanent and contributes to the muscle memory, which allows the skeletal muscle adaptation to environmental stimuli previously encountered. Nutrition, through key macro- and micronutrients with antioxidant properties, can play an important role in supporting skeletal muscle trophism and those molecular pathways triggering the beneficial effects of physical activity. Nutrients and antioxidant food components, reversibly altering the epigenetic imprint, have a big impact on the phenotype. This assigns a role of primary importance to nutri(epi)genomics, not only in optimizing physical performance, but also in promoting long term health. The crosstalk between physical activity and nutrition represents a major environmental pressure able to shape human genotypes and phenotypes, thus, choosing the right combination of lifestyle factors ensures health and longevity.

Riboflavin Deficiency-Implications for General Human Health and Inborn Errors of Metabolism

As an essential vitamin, the role of riboflavin in human diet and health is increasingly being highlighted. Insufficient dietary intake of riboflavin is often reported in nutritional surveys and population studies, even in non-developing countries with abundant sources of riboflavin-rich dietary products. A latent subclinical riboflavin deficiency can result in a significant clinical phenotype when combined with inborn genetic disturbances or environmental and physiological factors like infections, exercise, diet, aging and pregnancy. Riboflavin, and more importantly its derivatives, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), play a crucial role in essential cellular processes including mitochondrial energy metabolism, stress responses, vitamin and cofactor biogenesis, where they function as cofactors to ensure the catalytic activity and folding/stability of flavoenzymes. Numerous inborn errors of flavin metabolism and flavoenzyme function have been described, and supplementation with riboflavin has in many cases been shown to be lifesaving or to mitigate symptoms. This review discusses the environmental, physiological and genetic factors that affect cellular riboflavin status. We describe the crucial role of riboflavin for general human health, and the clear benefits of riboflavin treatment in patients with inborn errors of metabolism.

Actual Nutrition and Dietary Supplementation in Lithuanian Elite Athletes

Background and objectives: Health is partly determined by the state of one's nutrition; it stimulates the body's functional and metabolic adaptations to physical strain and helps one prevent sports injuries and get in shape in terms of body composition. This study aims to investigate the actual nutrition and dietary supplements taken by elite Lithuanian athletes and to identify the relationship between the dietary intake, dietary supplementation and body composition of elite athletes. Materials and Methods: The research subjects were 76.7% of Lithuanian elite athletes (N = 247). The actual diet was investigated using the 24 h recall dietary survey method. Dietary supplementation was studied applying the questionnaire method. Measurements of body composition were performed using the BIA (bioelectrical impedance analysis) tetra-polar electrodes and measuring resistivity with 8-12 tangent electrodes at different frequencies of signal: 5, 50 and 250 kHz. Results: Results indicate that among the athletes, 62% use too few carbohydrates and 77% use too much fat. Although the 3.5% increase in lean body mass (95% CI: -0.107, 7.070) helps gain an increased protein intake with food (p = 0.057), 38% of athletes consume too little protein with food. The athletes mostly use carbohydrates (86%), vitamins (81%), protein supplements (70%), and multivitamins (62%). We did not determine the impact (p > 0.05) of individual or complex supplement use on the lean body mass (%) or fat mass (%) values of athletes. Conclusions: Athletes consume insufficient carbohydrates, vitamin D, calcium, polyunsaturated fatty acids, omega-3 and omega-6 fatty acids and too much fat, saturated fatty acids, cholesterol, and they use proteins irrationally. Sport nutritionists should also focus on the risk of malnutrition for female athletes. Nutritional supplements partially offset macronutrient and micronutrient deficiency. Nevertheless, the effect of food supplements on the body composition of athletes is too small compared to the normal diet. Athletes ought to prioritize the formation of eating habits and only then use supplements.

Energy Drink before Exercise Did Not Affect Autonomic Recovery Following Moderate Aerobic Exercise: A Crossover, Randomized and Controlled Trial

Introduction: Energy drink (ED) intake could initiate physiological changes owing to its stimulant characteristics and, it improves endurance and athletic performance. We evaluated the acute effects of ED on autonomic heart rate (HR) control during recovery after a session of submaximal aerobic exercise.Method: The study was completed by submitting 29 healthy males between 18 and 30 years old to three conventions: (A) Maximum exercise test by the adapted Bruce protocol; (B) Placebo protocol (PP) - water intake 15 minutes prior to exercise, rest in dorsal decubitus for 15 minutes followed by 5 minutes of treadmill running at 1% inclination, initial speed of 5 km/h for 5 minutes 25 minutes with 60% of the velocity consistent to the maximum oxygen consumption (VO2max), and finally 60 minutes of recovery at rest in the supine position; (C) Experimental protocol (PE) - similar to PP previously, but with ED intake 15 minutes before physical exercise. The time, frequency and geometric indexes of HR variability (HRV) were inspected before and after exercise.Results: There was a significant (p < 0.05, <5%) effect on the HRV index (HR-nu and ms², LF-nu and ms², LF/HF, SD1, SDNN and RMSSD), indicating a reduction in HRV in the first 5 minutes after exercise in both protocols (PP and PE). Yet, no protocol interaction was detected, suggesting no effect of ED on HRV throughout recovery after submaximal aerobic exercise.Conclusion: There was no significant effect of ED on the autonomic control of HR in the recovery phase after submaximal aerobic exercise.

Exogenous ketosis impacts neither performance nor muscle glycogen breakdown in prolonged endurance exercise

Available evidence indicates that ketone bodies inhibit glycolysis in contracting muscles. Therefore, we investigated whether acute exogenous ketosis by oral ketone ester (KE) intake early in a simulated cycling race can induce transient glycogen sparing by glycolytic inhibition, thereby increasing glycogen availability in the final phase of the event. In a randomized crossover design, 12 highly trained male cyclists completed a simulated cycling race (RACE), which consisted of 3-h intermittent cycling (IMT_180′), a 15-min time trial (TT_15′), and a maximal sprint (SPRINT). During RACE, subjects received 60 g carbohydrates/h combined with three boluses (25, 20, and 20 g) (R)-3-hydroxybutyl (R)-3-hydroxybutyrate (KE) or a control drink (CON) at 60 and 20 min before and at 30 min during RACE. KE intake transiently increased blood d-β-hydroxybutyrate to ~3 mM (range: 2.6–5.2 mM) during the first half of RACE (P < 0.001 vs. CON). Blood pH concomitantly decreased from approximately 7.42 to 7.36 (range: 7.29–7.40), whereas bicarbonate dropped from 26.0 to 21.6 mM (range: 20.1–23.7; both P < 0.001 vs. CON)_. Net muscle glycogen breakdown during IMT_180′ [KE: −78 ± 30 (SD); CON: −60 ± 22 mmol/kg wet wt; P = 0.08] and TT_15′ (KE: −9 ± 18; CON: −18 ± 18 mmol/kg wet wt; P = 0.35) was similar between KE and CON. Accordingly, mean power output during TT_15′ (KE: 273 ± 38; CON: 272 ± 37 W; P = 0.83) and time-to-exhaustion in the SPRINT (KE: 59 ± 16; CON: 58 ± 17 s; P = 0.66) were similar between conditions. In conclusion, KE intake during a simulated cycling race does not cause glycogen sparing, nor does it affect all-out performance in the final stage of a simulated race.

NEW & NOTEWORTHY Exogenous ketosis produced by oral ketone ester ingestion during the early phase of prolonged endurance exercise and against the background of adequate carbohydrate intake neither causes muscle glycogen sparing nor improves performance in the final stage of the event. However, such exogenous ketosis may decrease buffering capacity in the approach of the final episode of the event. Furthermore, ketone ester intake during exercise may reduce appetite immediately after exercise.

LDH isoenzyme 5 is an index of early onset muscle soreness during prolonged running

BACKGROUND

Muscle soreness is also induced during prolonged running such as a full marathon, and muscle soreness and increased damage markers are detected immediately after such a running. We named this muscle soreness, early onset muscle soreness (EOMS). Additionally, lactate dehydrogenase (LDH) level which has some isoenzyme is increased immediately after prolonged exercise. However, it is unclear that EOMS is related to muscle damage markers on prolonged running. This study aimed to determine at which point EOMS, and muscle damage markers are related to EOMS during prolonged running.

METHODS

We studied 11 male subjects who habitually perform aerobic exercise. They ran 30 km at 90% of ventilatory threshold intensity. Every 10 km, we estimated perceived muscle soreness, and sampled blood to measure muscle and liver damage, inflammation, and oxidative stress (d-ROM and BAP) markers.

RESULTS

Muscle soreness score lower limbs were significantly appeared at 20 km compared to that at 0 km. Serum lactate dehydrogenase (LDH) level increased at 30 km compared to that at 0 km. LDH isoenzymes 3, 4, and 5, and neutrophils significantly increased at 30 km compared to those at 0 km. Serum LDH isoenzyme 5 and change in aspartate aminotransferase significantly increased at 20 km. In addition, there was a significant correlation between the thigh NRS and amount of serum LDH isoenzyme 5 from 0 km to 20 km. d-ROM and BAP increased at 10 km compared to those at 0 km.

CONCLUSIONS

EOMS started to occur at 20 km during a 30 km running task. Our data suggest that LDH isoenzyme 5 is a marker of occurrence in EOMS during prolonged running.

Skeletal muscle lipid droplets are resynthesized before being coated with perilipin proteins following prolonged exercise in elite male triathletes

Intramuscular triglycerides (IMTG) are a key substrate during prolonged exercise, but little is known about the rate of IMTG resynthesis in the postexercise period. We investigated the hypothesis that the distribution of the lipid droplet (LD)-associated perilipin (PLIN) proteins is linked to IMTG storage following exercise. Fourteen elite male triathletes (27 ± 1 yr, 66.5 ± 1.3 mL·kg^-1·min^-1) completed 4 h of moderate-intensity cycling. During the first 4 h of recovery, subjects received either carbohydrate or H₂O, after which both groups received carbohydrate. Muscle biopsies collected pre- and postexercise and 4 and 24 h postexercise were analyzed using confocal immunofluorescence microscopy for fiber type-specific IMTG content and PLIN distribution with LDs. Exercise reduced IMTG content in type I fibers (-53%, P = 0.002), with no change in type IIa fibers. During the first 4 h of recovery, IMTG content increased in type I fibers (P = 0.014), but was not increased more after 24 h, where it was similar to baseline levels in both conditions. During recovery the number of LDs labeled with PLIN2 (70%), PLIN3 (63%), and PLIN5 (62%; all P < 0.05) all increased in type I fibers. Importantly, the increase in LDs labeled with PLIN proteins only occurred at 24 h postexercise. In conclusion, IMTG resynthesis occurs rapidly in type I fibers following prolonged exercise in highly trained individuals. Furthermore, increases in IMTG content following exercise preceded an increase in the number of LDs labeled with PLIN proteins. These data, therefore, suggest that the PLIN proteins do not play a key role in postexercise IMTG resynthesis.

Impact of Dining Hall Structural Changes on Food Choices: A Pre-Post Observational Study

Change that benefits individuals and organisations while delivering health outcomes and benefits society requires a research focus that extends ‘beyond the individual’ to environment shapers. A pre-post observational study assessed two food provision structural changes to understand the role food service environments had on food selections. Diners were observed prior to (lunch n = 1294; dinner n = 787) and following (lunch n = 1230; dinner n = 843) structural changes in a buffet-style dining room—including provision of a healthy convenient meal alternative for lunch (healthy lunch bag), and a pleasurable dinner (make-your-own pizza). Food choices shifted with 19% of diners opting for a healthy lunch bag and 29% of diners selecting a pizza dinner, moving away from the existing buffet. Examination of selections by those continuing to select from the concurrent buffet selections established that the availability of healthy alternatives in the buffet partially explained food choices, moderating any observed changes in food selections. The food service sector is a promising avenue through which dietary behaviours can be improved. Further studies, particularly those that measure selections over the longer term, and that include measures of satisfaction and profit, are needed.

Effects of Energy Gel Ingestion on Blood Glucose, Lactate, and Performance Measures During Prolonged Cycling

Kozlowski, KF, Ferrentino-DePriest, A, and Cerny, F. Effects of energy gel ingestion on blood glucose, lactate, and performance measures during prolonged cycling. J Strength Cond Res XX(X): 000-000, 2020-Endurance athletes have long used carbohydrate supplementation during prolonged exercise (most recently with energy gels) to enhance performance. The purpose of this study was to determine the effect of carbohydrate energy gel ingestion schedules (e.g., manufacturer's recommendations vs. a more frequent ingestion schedule) during 2 hours of steady-state cycling exercise on (a) blood glucose, (b) blood lactate, and (c) performance of a subsequent 15-minute time trial (TT). Ten trained cyclists (5 men and 5 women, mean age = 28.4 ± 3.66 years; body mass = 68.9 ± 10.63 kg; and V[Combining Dot Above]O2max = 54.57 ± 9.45 mlO2·kg·min) performed 3 exercise trials in a randomized order. One gel was ingested 15 minutes before exercise during all trials. The 3 experimental trials included gel ingestion every 30 minutes (T1), every 45 minutes (T2) during exercise, and no gel ingested during exercise (T3). Subjects cycled at 70% of V[Combining Dot Above]O2max for 2 hours, followed by a 15-minute fixed gear TT. The blood glucose level at 60 minutes of exercise was higher during T1 (125.5 ± 30.96 mg·dl) and T2 (127.6 ± 14.82 mg·dl) compared with T3 (102.8 ± 15.85 mg·dl). Time trial distance was significantly greater for T1 (7.56 ± 0.77 km) and T2 (7.16 ± 0.92 km) than T3 (6.69 ± 0.74 km) (p = 0.003) with moderate to strong effect sizes between trials. There were no differences in blood lactate concentrations across trials. Ingestion of energy gels during prolonged cycling elevates blood glucose levels and enhances subsequent performance, whereas a more frequent ingestion elicits additional performance benefits.

Champ4life Study Protocol: A One-Year Randomized Controlled Trial of a Lifestyle Intervention for Inactive Former Elite Athletes with Overweight/Obesity

Preventive and educational programs directed to former elite athletes in the areas of healthy living are required. This is particularly relevant as obesity and health-related problems are observed in retired athletes, especially in those whose current levels of physical activity are below the recommendations. During their sports career, elite athletes are supported by a multidisciplinary team; upon retirement, no support is provided for the transition to a different lifestyle. So far, no program has been implemented to promote sustained healthy lifestyle behaviors in the post-career transition and evidence is lacking for such an intervention. Firstly, we aim to determine if Champ4life, a 1-year lifestyle intervention targeting inactive former athletes with overweight and obesity, is effective for reducing total and abdominal fat. Secondly, our purpose is to assess the effectiveness of the intervention on the levels of physical activity and sedentary behavior, resting energy expenditure, cardio-metabolic markers, physical fitness, energy balance components, eating self-regulation markers, and quality of life over 12 months. Champ4life is an evidence- and theory-based program using a randomized control trial design (intervention vs. control group) that will be conducted on 94 inactive former elite athletes with overweight and obesity. The first four months of the Champ4Life program include a nutritional appointment and 12 weekly, 90-min sessions. Classroom sessions seek to provide participants with key information and a toolbox of behavior change techniques to initiate and sustain long-term lifestyle changes. Participants will undergo baseline, 4-month, and 12-month measurements of body composition (primary outcomes), resting energy expenditure, physical fitness, metabolic markers, energy balance related-markers, and quality of life (secondary outcome). This trial will provide evidence on the effectiveness of the Champ4life program, a pioneer lifestyle intervention for retired athletes, offering tools for sustained changes in physical activity, sedentary behavior and diet, aiming to improve body composition and overall health-related markers.

Mutual Interactions among Exercise, Sport Supplements and Microbiota

The adult gut microbiota contains trillions of microorganisms of thousands of different species. Only one third of gut microbiota are common to most people; the rest are specific and contribute to enhancing genetic variation. Gut microorganisms significantly affect host nutrition, metabolic function, immune system, and redox levels, and may be modulated by several environmental conditions, including physical activity and exercise. Microbiota also act like an endocrine organ and is sensitive to the homeostatic and physiological changes associated with training; in turn, exercise has been demonstrated to increase microbiota diversity, consequently improving the metabolic profile and immunological responses. On the other side, adaptation to exercise might be influenced by the individual gut microbiota that regulates the energetic balance and participates to the control of inflammatory, redox, and hydration status. Intense endurance exercise causes physiological and biochemical demands, and requires adequate measures to counteract oxidative stress, intestinal permeability, electrolyte imbalance, glycogen depletion, frequent upper respiratory tract infections, systemic inflammation and immune responses. Microbiota could be an important tool to improve overall general health, performance, and energy availability while controlling inflammation and redox levels in endurance athletes. The relationship among gut microbiota, general health, training adaptation and performance, along with a focus on sport supplements which are known to exert some influence on the microbiota, will be discussed.

The Health Benefits of Exercise in Overweight and Obese Patients

More than 30% of U.S. adults are obese or overweight. A program of regular physical activity is recommended as part of an effective lifestyle intervention for weight loss and weight management. However, more than 40% of adults do not engage in sufficient physical activity to realize these beneficial effects on body weight. Physicians may encounter many barriers to counseling physical activity, such as lack of knowledge or self-efficacy for counseling patients about physical activity. Obese individuals may be reluctant to exercise because of weight stigma, physique anxiety, and other factors; therefore, referral to a weight management specialist or clinical exercise physiologist can be helpful in facilitating exercise and assisting in achieving a clinically meaningful weight loss. Exercise has many benefits on physical and mental health and well-being that go well beyond weight loss, and it is for these reasons that exercise is particularly important for overweight and obese individuals.

Changes in Weight and Substrate Oxidation in Overweight Adults Following Isomaltulose Intake During a 12-Week Weight Loss Intervention: A Randomized, Double-Blind, Controlled Trial

Low-glycemic compared to high-glycemic diets have been shown to improve metabolic status and enhance fat oxidation. The randomized, double-blind, controlled intervention study aimed to evaluate the effects of an energy-reduced diet containing isomaltulose (ISO, Palatinose™) versus sucrose (SUC) on body weight loss. Sixty-four healthy overweight/obese adults were allocated to consume either 40 g/day ISO or SUC added to an energy-reduced diet for 12 weeks. Anthropometric measurements, body composition, and energy metabolism were assessed at baseline and after 4, 8, and 12 weeks. Fifty participants (age: 40.7 ± 11.7 y; BMI: 29.4 ± 2.7 kg/m²) completed the study. During the 12 weeks, both groups significantly lost weight (p < 0.001), which was more pronounced following ISO (−3.2 ± 2.9 vs. −2.1 ± 2.6 kg; p = 0.258). Moreover, for participants in the ISO group, this was accompanied by a significant reduction in fat mass (ISO: −1.9 ± 2.5, p = 0.005; SUC: −0.9 ± 2.6%, p = 0.224). The overall decrease in energy intake was significantly higher in the ISO compared to that in the SUC group (p = 0.022). In addition, breakfast containing ISO induced a significantly lower increase in postprandial respiratory quotient (RQ) (mean incremental area under the curve (iAUC)_2h for ISO vs. SUC: 4.8 ± 4.1 vs. 6.9 ± 3.1, p = 0.047). The results suggest that ISO in exchange for SUC may help to facilitate body weight reduction, lower postprandial RQ associated with higher fat oxidation, and reduce energy intake.

New opportunities: Drosophila as a model system for exercise research

Because of the growing rates of obesity in much of the world, exercise as a treatment option for obesity and as part of a healthy lifestyle is of great interest to the general public, health policy makers, and scientists alike. Despite the long history of exercise promotion and exercise research, there are still significant gaps in our understanding of how exercise impacts individuals and what role genetics plays in determining an individual’s response to exercise. Model organisms are positioned uniquely to help address these questions because of the challenges associated with carrying out large-scale, well-controlled studies in humans. The fruit fly model system, Drosophila melanogaster, has joined the models used for exercise research only recently but already has made significant contributions to the field. In this review, we highlight the opportunities for exercise research in Drosophila. We review the resources available to researchers interested in using Drosophila for exercise research, focusing on the existing systems to induce exercise in Drosophila, to measure the amount of exercise performed, and to assess physical fitness. We illustrate the potential of the Drosophila system by drawing attention to pioneering studies in Drosophila exercise research and emphasize the unique opportunities this model system represents.

Adequacy of Daily Fluid Intake Volume Can Be Identified From Urinary Frequency and Perceived Thirst in Healthy Adults

Objective: Achieving and maintaining an optimal level of hydration has significant implications for both acute and chronic health, yet many hydration assessments are not feasible for the general public. Urinary frequency (UF) is a reliable method to self-assess hydration status in healthy individuals, and thirst can provide additional sensory information on adequacy of daily fluid intake volume (DFI). However, threshold values for these indices to detect optimal hydration have not been determined. In this study, we sought to determine threshold values for 24-hour UF and perceived thirst that could accurately distinguish between optimal and suboptimal hydration states.Methods: Thirty-two healthy adults (age 22 ± 3 years, body mass index 24.9 ± 4.1 kg/m²) collected urine over 24 hours on four separate occasions, where UF was recorded as well as thirst at each void using a numbered perceptual scale. Using urine osmolality as the criterion standard, all samples were either classified as representing an optimal (≤500 mOsm·kg^-1) or suboptimal hydration status (>500 mOsm·kg^-1).Results: A 24-hour UF ≤6 was able to detect suboptimal hydration with good accuracy (area under the curve [AUC] 0.815) and a 24-hour average perceived thirst rating > 3 ("a little thirsty") could detect it with reasonable accuracy (AUC 0.725). In addition, a UF ≤4 had a considerably higher positive likelihood ratio to detect suboptimal hydration versus a UF ≤6 (9.03 versus 2.18, respectively).Conclusions: These analyses suggest that individuals with a 24-hour UF ≤6 or perceiving themselves to be, on average, "a little thirsty" throughout the day are likely to be suboptimally hydrated and thus underconsuming an adequate DFI.

Necessary Knowledge and Skills for Dietitians in Saudi Arabia: A Qualitative Study

Background

Dietitians play a major role in health promotion and chronic diseases prevention. Graduates from clinical nutrition and dietetics major should be equipped with the necessary knowledge and skills for their role to be more effective. The purpose of this study is to investigate the knowledge and skills needed by current and future graduates in clinical nutrition and dietetics.

Methods

In this qualitative study, structured interviews by focus groups were conducted. Dietitians from different governmental and private sectors were invited to participate in the study. Focus groups were stratified based on the participants’ gender and years of experience to promote self-disclosure. Abridged transcript of relevant and useful points was performed. The transcripts were coded and cross-validated by two researchers.

Results

A total of four focus groups were conducted. Two focus groups comprise 9 male participants and the other two comprise 10 females. The age of participants ranged 25–40 years old. Participants were employees in Riyadh city with experience that ranged 3–10 years old. Nine themes of the necessary knowledge and skills were identified.

Conclusion

It is recommended for the Saudi government to create standards specialised for clinical nutrition and dietetics undergraduate and graduate programmes.

Honey Supplementation and Exercise: A Systematic Review

Honey is a natural substance formed primarily of carbohydrates (~80%) which also contains a number of other compounds purported to confer health benefits when consumed. Due to its carbohydrate composition (low glycaemic index, mostly fructose and glucose), honey may theoretically exert positive effects when consumed before, during or after exercise. This review therefore appraised research examining the effects of honey consumption in combination with exercise in humans. Online database (PubMed, MEDLINE, SPORTDiscus) searches were performed, yielding 273 results. Following duplicate removal and application of exclusion criteria, nine articles were reviewed. Large methodological differences existed in terms of exercise stimulus, population, and the nutritional interventions examined. All nine studies reported biochemical variables, with four examining the effects of honey on exercise performance, whilst five described perceptual responses. Acute supplementation around a single exercise session appeared to elicit similar performance, perceptual, and immunological responses compared with other carbohydrate sources, although some performance benefit has been observed relative to carbohydrate-free comparators. When consumed over a number of weeks, honey may dampen immunological perturbations arising from exercise and possibly improve markers of bone formation. More well-controlled research is required to better understand the role for honey in a food-first approach to exercise nutrition.

Nutrition Recommendations for Bodybuilders in the Off-Season: A Narrative Review

Many nutrition practices often used by bodybuilders lack scientific support and can be detrimental to health. Recommendations during the dieting phase are provided in the scientific literature, but little attention has been devoted to bodybuilders during the off-season phase. During the off-season phase, the goal is to increase muscle mass without adding unnecessary body fat. This review evaluated the scientific literature and provides nutrition and dietary supplement recommendations for natural bodybuilders during the off-season phase. A hyper-energetic diet (~10–20%) should be consumed with a target weight gain of ~0.25–0.5% of bodyweight/week for novice/intermediate bodybuilders. Advanced bodybuilders should be more conservative with the caloric surplus and weekly weight gain. Sufficient protein (1.6–2.2 g/kg/day) should be consumed with optimal amounts 0.40–0.55 g/kg per meal and distributed evenly throughout the day (3–6 meals) including within 1–2 hours pre- and post-training. Fat should be consumed in moderate amounts (0.5–1.5 g/kg/day). Remaining calories should come from carbohydrates with focus on consuming sufficient amounts (≥3–5 g/kg/day) to support energy demands from resistance exercise. Creatine monohydrate (3–5 g/day), caffeine (5–6 mg/kg), beta-alanine (3–5 g/day) and citrulline malate (8 g/day) might yield ergogenic effects that can be beneficial for bodybuilders.

What drives athletes toward dietary supplement use: objective knowledge or self-perceived competence? Cross-sectional analysis of professional team-sport players from Southeastern Europe during the competitive season

BACKGROUND

Issues related to knowledge of nutrition and dietary supplementation (DS) are understudied in professional athletes. This study aimed to examine the possible association between knowledge of nutrition and DS (KN&DS) and dietary supplement use (DSU) among professional athletes involved in team sports.

METHODS

The sample comprised professional team-sport athletes (N = 912, age: 22.11 ± 3.37 years, 356 females) involved in four Olympic sports: basketball (N = 228), soccer (N = 324), volleyball (N = 154), and handball (N = 206). The participants were tested by previously validated questionnaires to examine their self-perceived competence on nutrition and DS (S/KN&DS), their objectively evaluated (tested) KN&DS (O/KN&DS), sociodemographic and sport-specific variables (predictors), and DSU (criterion). Associations between the predictors and the criterion (No-DSU - Irregular-DSU - Regular-DSU) were determined by multinomial regression analysis for the total sample and separately for the studied sports.

RESULTS

DSU was found to be less prevalent in older and more successful players. The O/KN&DS and S/KN&DS were positively correlated with DSU, but S/KN&DS was a stronger predictor of DSU than O/KN&DS. Sport-specific associations between predictors and criterion were identified, with stronger correlations in sports with a higher prevalence of DSU.

CONCLUSIONS

Due to the low correlations between O/KN&DS and S/KN&DS in the studied players, this study highlights the necessity for more frequent monitoring of biomarkers of nutritional status and its usage by coaches and practitioners to provide quantitative instruction.

Macronutrient Intake in Soccer Players-A Meta-Analysis

The nutrition of soccer players is an important topic and its knowledge may help to increase the quality of this popular game and prevent possible health problems and injuries in players. This meta-analysis aims to estimate the current dietary trends of three basic macronutrients in junior and senior soccer players during the first two decades of the 21st century. We analyzed data from 647 junior players (mean age 10.0–19.3) from 27 groups, and 277 senior (mean age 20.7–27.1) players from 8 groups from altogether 21 papers in this meta-analysis. Weighted averages were calculated for each macronutrients. Protein intake is higher than recommended in both juniors, 1.9 95% confidence interval (CI) 1.8–2.0 g/kg/day, and seniors 1.8 95% CI 1.6–2.0 g/kg/day. However, carbohydrate intake is still below the recommended values in both groups (5.7 95% CI 5.5–5.9 g/kg/day in junior and 4.7 95% CI 4.3–5.0 g/kg/day in senior players). The proportion of fat as total energy intake is in concordance with the recommendations (31.5 95% CI 32.0–35.9% in junior and 33.1 95% CI 29.9–36.2% in senior players). In particular, due to possible health complications, the small carbohydrate intake should be alarming for coaches, nutritional experts, and parents.

Belief in the need for sodium supplementation during ultramarathons remains strong: findings from the Ultrarunners Longitudinal TRAcking (ULTRA) study

In the past, ultramarathon runners have commonly believed that consuming sodium supplements, as capsules or tablets, will prevent exercise-associated hyponatremia (EAH), dehydration, muscle cramping, and nausea, but accumulating evidence indicates that sodium supplementation during ultramarathons is not necessary and may be potentially dangerous. In this work, beliefs about whether sodium supplements should be made available at ultramarathons were assessed during 2018 among 1152 participants of the Ultrarunners Longitudinal TRAcking (ULTRA) study, of which 85.2% had completed an ultramarathon during 2014-2018. Two-thirds (66.4%) of study participants indicated that sodium supplements should be made available at ultramarathons, supported by beliefs that they prevent EAH (65.5%) and muscle cramping (59.1%). Of those indicating that sodium supplements should not be made available, 85.0% indicated it is because runners can provide their own, 27.9% indicated it is because they are not necessary, and 12.1% indicated they could increase thirst drive and cause overhydration. In general, there was a tendency for those who were older, less active in running ultramarathons in recent years, and with a longer history of ultramarathon running to be less likely to know that sodium supplements do not help prevent EAH, muscle cramping, and nausea. Novelty Ultramarathon runners continue to have misunderstandings about the need for sodium supplementation during ultramarathons. Few ultramarathon runners recognize that supplementing sodium intake beyond that in food and drink is generally not necessary during ultramarathons or that it could result in overhydration. Continued educational efforts are warranted to help ensure safe participation in the sport.

A systematic review of the nutritional implications of military rations

BACKGROUND

The objective of this study was to assess military rations. Military rations must provide military personnel with suitable nutrition, as high-quality nutrition is crucial for promoting health.

AIM

This systematic review provides information regarding the nutritional design of military rations according to energy and protein intake and supplements.

METHODS

A systematic search was conducted for articles published to date regarding the nutritional needs involved in a military diet for an active population of either gender, ranging from 18 to 60 years old, without excluding material by year, type of document, location, or author. The pertinent articles found were published from 1994 to 2017.

RESULTS

Physical activity and environmental factors directly affect calculating energy needs and carbohydrate intake when designing military rations. However, the results showed no influence on protein, fat and/or sodium intake. Furthermore, the search revealed that military populations have a high intake of dietary supplements; it is thus worth considering their incorporation into campaign rations.

CONCLUSION

Military personnel macro- and micro-nutrient needs depend on physical activity and nutrient intake measurement methodologies. The data regarding military personnel dietary supplement consumption indicated that this is a niche worth considering when designing military rations. Research on nutritional needs for military rations could concentrate on optimizing the amount of macro- and micro-nutrients and their biological value, according to physical activity, as well as maintaining their sensory quality, safety and shelf life using different processing technologies.

Type 1 Muscle Fiber Hypertrophy after Blood Flow-restricted Training in Powerlifters

PURPOSE

To investigate the effects of blood flow-restricted resistance exercise (BFRRE) on myofiber areas (MFA), number of myonuclei and satellite cells (SC), muscle size and strength in powerlifters.

METHODS

Seventeen national level powerlifters (25 ± 6 yr [mean ± SD], 15 men) were randomly assigned to either a BFRRE group (n = 9) performing two blocks (weeks 1 and 3) of five BFRRE front squat sessions within a 6.5-wk training period, or a conventional training group (Con; n = 8) performing front squats at 60%-85% of one-repetition maximum (1RM). The BFRRE consisted of four sets (first and last set to voluntary failure) at ~30% of 1RM. Muscle biopsies were obtained from m. vastus lateralis (VL) and analyzed for MFA, myonuclei, SC and capillaries. Cross-sectional areas (CSA) of VL and m. rectus femoris were measured by ultrasonography. Strength was evaluated by maximal voluntary isokinetic torque (MVIT) in knee extension and 1RM in front squat.

RESULTS

BFRRE induced selective increases in type I MFA (BFRRE: 12% vs Con: 0%, P < 0.01) and myonuclear number (BFRRE: 18% vs Con: 0%, P = 0.02). Type II MFA was unaltered in both groups. BFRRE induced greater changes in VL CSA (7.7% vs 0.5%, P = 0.04), which correlated with the increases in MFA of type I fibers (r = 0.81, P = 0.02). No group differences were observed in SC and strength changes, although MVIT increased with BFRRE (P = 0.04), whereas 1RM increased in Con (P = 0.02).

CONCLUSIONS

Two blocks of low-load BFRRE in the front squat exercise resulted in increased quadriceps CSA associated with preferential hypertrophy and myonuclear addition in type 1 fibers of national level powerlifters.

Effect of the Health Tourism weight loss programme on body composition and health outcomes in healthy and excess-weight adults

Excess weight loss while minimising fat-free mass (FFM) loss is important for health. Travel is a particular period at risk for weight gain and for which the effects of a short-term intensive weight loss programme have not been studied. Therefore, we studied the effect of a novel, 1-week supervised health travel programme combining high volume, low-to-moderate intensity exercise and energy intake restriction on weight, body composition and health outcomes in adults. Weight was also monitored for 12 weeks after the programme. In all, thirty-six subjects (nineteen men, seventeen women) consisting of sixteen excess-weight (BMI: 27·1 (sd 1·7) kg/m2) and twenty healthy-weight (BMI: 22·3 (sd 1·8) kg/m2) individuals participated. Subjects performed 1 h of slow-paced intermittent jogging three times per d and other leisure activities, whereas consuming only provided foods without water restriction. Body mass significantly decreased from pre- to post-intervention in excess-weight and healthy-weight individuals (-3·5 (sd 1·5) and -3·5 (sd 1·3) %, respectively; P<0·001 for both), and losses were maintained at 12 weeks post-intervention in both groups (-6·3 (sd 3·8) and -1·7 (sd 4·0) %, respectively; P<0·01 for both). Fat mass also significantly decreased in both groups (excess weight: -9·2 (sd 4·6) %: healthy weight: -13·4 (sd 9·0) %; P<0·01 for both), whereas FFM was maintained. Similar improvements were observed for blood biochemistry and pressure in both groups. This short-term weight loss intervention yielded favourable outcomes in both excess- and healthy-weight adults, particularly a 3·5 % weight loss with no significant change to FFM. In addition, participants maintained weight loss for at least 12 weeks. Of multiple programme choices, the Health Tourism weight loss programme's results indicate that it is a viable option.

Evaluation and Behavior of Spanish Bodybuilders: Doping and Sports Supplements

The use of doping agents has these days become a public health problem, as it also affects young and non-competitive amateurs in different sports. To prepare for competition, bodybuilders perform aggressive dietary protocols, so, bodybuilders frequently consume nutritional supplements (NS) and banned substances in large dosages. Thus, the aim of this study is to analyze the prevalence of banned substances consumption and NS intake in competitive level bodybuilders. A total of 48 bodybuilders (44 males and 4 females) completed a validated online questionnaire on NS consumption. The quantitative data was presented as a mean (M) ± standard deviation (SD), as well as having minimum and maximum values. The categorical variables were expressed using frequencies and percentages. 83.3% of the participants declared that they had consumed or would consume banned substances, the most consumed being anabolic steroids (72.9%). One hundred percent of those sampled use NS. Whey protein (96%), branched-chain amino acids (BCAA) (94%), creatine (85%) and vitamin complexes (83%) were the most consumed, however, there is a low consumption of certain NS which could also increase athletic performance.