Influence of vitamin C supplementation on oxidative and salivary IgA changes following an ultramarathon

The Impact Plant-Based Diets Have on Athletic Performance and Body Composition: A Systematic Review

Plant-based diets have gained popularity among athletes in recent years. Some believe that plant-based diets will improve performance owing to higher intakes of carbohydrates and antioxidants. Some believe it that will harm performance due to lower intakes of complete protein and creatine. This systemic review was conducted using Covidence software. A literature search of PubMed, Embase (Elsevier), CINAHL Plus (EBSCO), and Web of Science was completed on 22 March 2022. Following the development of clear objectives and a research question that identified the population, intervention, comparison, and outcomes, initial search criteria and keywords were identified. Extracted results totaled 2249, including 797 duplicates. The initial screening resulted in 1437 articles being excluded. The remaining 15 articles proceeded to full-text screening. A final 8 articles were included in the review, with 7 excluded. This paper will review the impact plant-based diets have on athletic performance and body composition in healthy young adults aged 18 to 45 years.

Effects of swimming activity and feed restriction on antioxidant and digestive enzymes in juvenile rainbow trout: Implications for nutritional and exercise strategies in aquaculture

BACKGROUND

In this study, we investigated the effects of swimming activity and feed restriction on digestion and antioxidant enzyme activities in juvenile rainbow trout (average body weight of 26.54 ± 0.36 g).

METHODS

The stomach, liver and kidney tissues were obtained from four distinct groups: the static water group (fish were kept in static water and fed to satiation), the feeding restricted group (fish were kept in static water with a 25% feed restriction), the swimming exercised group (fish were forced to swimming at a flow rate of 1 Body Length per second (BL/s)) and the swimming exercised-feed restricted group (subjected to swimming exercise at a 1 BL/s flow rate along with a 25% feed restriction). We determined the levels of glutathione, lipid peroxidation and the activities of catalase, superoxide dismutase, glutathione peroxidase, glutathione reductase, glucose-6-phosphate dehydrogenase and lactate dehydrogenase, as well as the presence of reactive oxygen species in the tissues obtained from the fish. Additionally, the activities of pepsin, protease, lipase and arginase in these tissues were measured.

RESULTS

Swimming activity and feed restriction showed different effects on the enzyme activities of the fish in the experimental groups.

CONCLUSION

It can be concluded that proper nutrition and exercise positively influence the antioxidant system and enzyme activities in fish, reducing the formation of free radicals. This situation is likely to contribute to the fish's development.

Effect of SunGold Kiwifruit and Vitamin C Consumption on Ameliorating Exercise-Induced Stress Response in Women

INTRODUCTION

Markers of oxidative and psychological stress are elevated during high-intensity exercise. Additionally, when energy intake does not match expenditure, women who actively participate in sports and exercise are at risk of developing menstrual dysfunction, infertility, and osteoporosis. Vitamin C is known to reduce exercise-induced stress. Here, this study investigates the efficacy of consuming vitamin C from SunGold kiwifruit compared to in isolation, in ameliorating exercise-induced stress in recreationally active women.

METHODS AND RESULTS

Ten eumenorrheic women are recruited in this crossover study and attended three exercise and one rest trial. In the exercise trials, participants consumed 300 mg vitamin C from kiwifruit or drink, or have a placebo drink, followed by 30-min exercise on a cycle ergometer at 60% power. During rest visit, participants sat quietly and consumed a placebo drink. Salivary uric acid (oxidative stress) and cortisol (psychological stress) are measured before and immediately after exercise for 2 h. Both vitamin C and kiwifruit reduced exercise-induced uric acid, immediately after exercise. Vitamin C drink continued to decrease uric acid for a further 30 min and slightly attenuated exercise-induced cortisol.

CONCLUSIONS

Consuming liquid vitamin C prior to high-intensity cycling appears more effective than eating kiwifruit, in ameliorating exercise-induced stress in recreationally active women of reproductive age.

Exercise, Immunity, and Illness

It is generally accepted that moderate amounts of exercise improve immune system functions and hence reduce the risk of infection whereas athletes engaged in regular prolonged and/or intensive training have a higher than “normal” incidence of minor infections, especially of the upper respiratory tract (URT, e.g., common cold and influenza). This is likely related to regular acute (and possibly chronic) periods of exercise-induced changes in immune function. URT infections can compromise performance directly if suffered shortly before or during competition or indirectly if suffered at other times via effects on training and/or physiological adaptations. This chapter covers the effects of exercise (acute and chronic), both positive and negative, on immune function and consequent infection risk, and considers the current state-of-the-art for monitoring and assessing this in athletes.

Strategies to decrease oxidative stress biomarker levels in human medical conditions: A meta-analysis on 8-iso-prostaglandin F2α

The widespread detection of elevated oxidative stress levels in many medical conditions has led to numerous efforts to design interventions to reduce its effects. Efforts have been wide-ranging, from dietary changes to administration of antioxidants, supplements, e.g., omega-3-fatty acids, and many medications. However, there is still no systemic assessment of the efficacy of treatments for oxidative stress reduction across a variety of medical conditions. The goal of this meta-analysis is, by combining multiple studies, to quantitate the change in the levels of the popular oxidative stress biomarker 8-iso-prostaglandin F2α (8-iso-PGF2α) after a variety of treatment strategies in human populations. Nearly 350 unique publications with 180 distinct strategies were included in the analysis. For each strategy, the difference between pre- or placebo and post-treatment levels calculated using Hedges' g value of effect. In general, administration of antibiotics, antihyperlipidemic agents, or changes in lifestyle (g = - 0.63, - 0.54, and 0.56) had the largest effect. Administration of supplements, antioxidants, or changes in diet (g = - 0.09, - 0.28, - 0.12) had small quantitative effects. To fully interpret the effectiveness of these treatments, comparisons to the increase in g value for each medical condition is required. For example, antioxidants in populations with coronary artery disease (CAD) reduce the 8-iso-PGF2α levels by g = - 0.34 ± 0.1, which is quantitatively considered a small effect. However, CAD populations, in comparison to healthy populations, have an increase in 8-iso-PGF2α levels by g = 0.38 ± 0.04; therefore, the overall reduction of 8-iso-PGF2α levels is ≈ 90% by this treatment in this specific medical condition. In conclusion, 8-iso-PGF2α levels can be reduced not only by antioxidants but by many other strategies. Not all strategies are equally effective at reducing 8-iso-PGF2α levels. In addition, the effectiveness of any strategy can be assessed only in relation to the medical condition investigated.

Debunking the Myth of Exercise-Induced Immune Suppression: Redefining the Impact of Exercise on Immunological Health Across the Lifespan

Epidemiological evidence indicates that regular physical activity and/or frequent structured exercise reduces the incidence of many chronic diseases in older age, including communicable diseases such as viral and bacterial infections, as well as non-communicable diseases such as cancer and chronic inflammatory disorders. Despite the apparent health benefits achieved by leading an active lifestyle, which imply that regular physical activity and frequent exercise enhance immune competency and regulation, the effect of a single bout of exercise on immune function remains a controversial topic. Indeed, to this day, it is perceived by many that a vigorous bout of exercise can temporarily suppress immune function. In the first part of this review, we deconstruct the key pillars which lay the foundation to this theory-referred to as the "open window" hypothesis-and highlight that: (i) limited reliable evidence exists to support the claim that vigorous exercise heightens risk of opportunistic infections; (ii) purported changes to mucosal immunity, namely salivary IgA levels, after exercise do not signpost a period of immune suppression; and (iii) the dramatic reductions to lymphocyte numbers and function 1-2 h after exercise reflects a transient and time-dependent redistribution of immune cells to peripheral tissues, resulting in a heightened state of immune surveillance and immune regulation, as opposed to immune suppression. In the second part of this review, we provide evidence that frequent exercise enhances-rather than suppresses-immune competency, and highlight key findings from human vaccination studies which show heightened responses to bacterial and viral antigens following bouts of exercise. Finally, in the third part of this review, we highlight that regular physical activity and frequent exercise might limit or delay aging of the immune system, providing further evidence that exercise is beneficial for immunological health. In summary, the over-arching aim of this review is to rebalance opinion over the perceived relationships between exercise and immune function. We emphasize that it is a misconception to label any form of acute exercise as immunosuppressive, and, instead, exercise most likely improves immune competency across the lifespan.

Induction of cellular and molecular Immunomodulatory pathways by vitamin E and vitamin C

INTRODUCTION

Vitamins E and C are well known small molecules that have been used to maintain health for decades. Recent studies of the cellular and molecular pathways leading to immunomodulation by these molecules have been of interest, as have their anti-oxidant properties and signal transduction pathways for curing or improving infectious diseases and cancer. Areas covered: Herein, the authors provide a definition and the structural classification of vitamins E and C and how these molecules influence cellular function. The studies include in vitro, ex vivo and in vivo studies in animal models as well as clinical trials. The authors give particular focus to the scientifically factual and putative roles of these molecules in innate and adaptive immunomodulation and prevention or cure of diseases. Expert opinion: The antioxidant properties of vitamins E and C are well studied. However, whether there is a link between their antioxidant and immunomodulation properties is unclear. In addition, there is a strong, albeit putative, prevailing notion that vitamin C can prevent or cure infectious diseases or cancer. Presently, while there is proven evidence that vitamin E possesses immunomodulatory properties that may play a positive role in disease outcomes, this evidence is less available for vitamin C.

Nutritional and Physical Activity Interventions to Improve Immunity

Physical activity and nutrition are important in a healthy lifestyle with potential benefits to immunity often overlooked. Infection of the upper respiratory tract, and the associated symptoms, are the most frequent presentations to general practitioners and may have significant economic and social impact. In this review, we consider the role of physical activity and nutrition in improving immunity. Evidence suggests that regular moderate activity is particularly beneficial for immune enhancement and reducing the risk of infection. We also discuss some nutritional strategies. Unfortunately, the evidence for many is weak. Avoiding nutritional deficiencies seems the most pragmatic recommendation. This can be achieved with a balanced diet. Including a variety of fruits and vegetables may help ensure adequate intake of essential nutrients with little risk of excess intake of any single nutrient. Supplementation with individual nutrients is generally not recommended. Multinutrients may be beneficial for those with a preexisting deficiency but not if normal dietary intake is sufficient. Further benefit may be gained from some supplements including probiotics, bovine colostrum, and some plant-derived products (Echinacea, black elderberry, and some polyphenols) but only in specific situations/contexts. Individuals should consider their personal needs, use caution, and avoid the indiscriminate use of supplements.

Changes in salivary hormones, immunoglobulin A, and C-reactive protein in response to ultra-endurance exercises

The aim of the study was to determine the influence of the exercise duration on the changes in salivary stress markers in response to ultra-endurance exercises. The study was developed in 2 ultra-endurance exercise tests: the Ultra-trail Serra de Tramuntana (UTST), a 104 km ultra-marathon competition (n = 64) and the 25 km Cabrera Open Water Race (COWR) (n = 43). Participants in the COWR completed the 25 km at a constant pace of 3 km/h (3K group) or 2.5 km /h (2.5K group). Saliva samples were taken before and after the exercises. Salivary flow rate as well as cortisol, testosterone, C-reactive protein (CRP), and immunoglobulin A (IgA) levels were measured. Salivary flow rate decreased after the UTST but increased after the COWR. The UTST induced significant increases in cortisol and CRP levels and decreases in testosterone and IgA levels. Furthermore, a negative correlation was found between the time the athletes took to complete the exercise and the changes in salivary cortisol. After the COWR, higher increases in salivary cortisol levels were observed in the 3K group than in the 2.5K group. A significant effect of exercise decreasing testosterone and IgA levels was observed in both groups. No changes in the CRP levels were observed during the COWR. In conclusion, shorter times to complete the ultra-endurance exercise were associated with higher increases in cortisol. However, no relationships were found between the time to complete the exercises and the changes in testosterone, CRP, and IgA levels.

Dietary oxidative stress and antioxidant defense with an emphasis on plant extract administration

Eukaryotic cells generally function in a reduced state, but an amount of reactive species is essential for several biochemical processes. The antioxidant network is the defensive mechanism that occurs when the concentration of reactive species exceeds a threshold. Polyphenolic compounds present in plant extracts are potent antioxidants in vitro, but they may promote oxidative stress when administered in animals and humans, especially when given as supplements in exercise, a modality usually adopted as an oxidant stimulus. This is mainly observed when antioxidant molecules are administered separately and not as part of a diet. Exercise is usually adopted as a physiological model for examining the effects of reactive species in human or animal physiology. The use of exercise as a model demonstrates that reactive species do not always have adverse effects, but are necessary in physiological processes that are beneficial for human health. This review summarizes what is known about antioxidant supplementation and demonstrates the need for a meticulous examination of the in vitro findings before applying them to in vivo models. The term "antioxidant" seems elusive, and it is more appropriate to characterize a compound as "antioxidant" if we know in which concentration it is used, when it is used, and under which conditions.

Effect of vitamin supplementation on lung injury and running performance in a hot, humid, and ozone-polluted environment

In this study, the effect of vitamin C and E supplementation on lung injury and performance of runners were analyzed. Using a randomized, double-blinded, crossover design, nine runners participated in two experimental trials: a 2-week Vitamin trial (vitamin C = 500  mg/day + vitamin E = 100  IU/day) and a 2-week Placebo trial. At the end of each supplementation period the runners performed an 8-km time-trial run in a hot (31°C), humid (70% rh), and ozone-polluted (0.10  ppm O(3)) environmental chamber. Nasal lavage and blood samples were collected pre-, post-, and 6-h post-exercise to assess antioxidant status and CC16 as lung injury marker. Higher plasma (pre- and post-exercise) and nasal lavage (post-exercise) antioxidant concentration were found for the Vitamin trial. Nevertheless, this did not result in performance differences (Vitamin trial: 31:05  min; Placebo trial: 31:54  min; P = 0.075) even though significant positive correlations were found between antioxidant concentration and improvement in time to complete the run. CC16 was higher post-exercise in the Placebo trial (P < 0.01) in both plasma and nasal lavage. These findings suggest that antioxidant supplementation might help to decrease the lung injury response of runners when exercising in adverse conditions, but has little effect on performance.

Blood reflects tissue oxidative stress depending on biomarker and tissue studied

This study investigated whether selected oxidative stress markers measured in blood adequately reflect redox status in skeletal muscle, heart, and liver. Several markers were determined after implementing two treatments known to affect redox status, namely exercise and allopurinol administration. Xanthine oxidase, thiobarbituric acid-reactive substances (TBARS), protein carbonyls (PC), reduced glutathione (GSH), oxidized glutathione (GSSG), catalase, and total antioxidant capacity were determined in blood, skeletal muscle, heart, and liver. Correlation between blood and tissues in each marker was performed through the Spearman rank correlation coefficient. GSSG in erythrocytes was correlated with all tissues, ranging in the five experimental groups as follows: skeletal muscle r(s)=0.656-0.874, heart r(s)=0.742-0.981, liver r(s)=0.646-0.855. Xanthine oxidase and TBARS measured in blood satisfactorily described the redox status of the heart (0.753-0.964 and 0.705-1.000, respectively) and liver (0.755-0.902 and 0.656-1.000, respectively). Skeletal muscle and heart redox status can be adequately described by PC (0.652-1.000 and 0.656-0.964, respectively), GSH (0.693-1.000 and 0.656-1.000, respectively), and catalase (0.745-1.000 and 0.656-1.000, respectively) measured in blood. In conclusion, this study suggests that a combination of markers measured in blood provides a reliable indication about the redox status in skeletal muscle, heart, and liver.

Acute exercise and oxidative stress: a 30 year history

The topic of exercise-induced oxidative stress has received considerable attention in recent years, with close to 300 original investigations published since the early work of Dillard and colleagues in 1978. Single bouts of aerobic and anaerobic exercise can induce an acute state of oxidative stress. This is indicated by an increased presence of oxidized molecules in a variety of tissues. Exercise mode, intensity, and duration, as well as the subject population tested, all can impact the extent of oxidation. Moreover, the use of antioxidant supplements can impact the findings. Although a single bout of exercise often leads to an acute oxidative stress, in accordance with the principle of hormesis, such an increase appears necessary to allow for an up-regulation in endogenous antioxidant defenses. This review presents a comprehensive summary of original investigations focused on exercise-induced oxidative stress. This should provide the reader with a well-documented account of the research done within this area of science over the past 30 years.

Vitamin C Supplementation and Salivary Immune Function Following Exercise-Heat Stress

Purpose:

Prolonged physical exertion and environmental heat stress may elicit postexercise depression of immune cell function, increasing upper respiratory tract infection (URTI) susceptibility. We investigated the effects of acute and short-term vitamin C (VC) compared with placebo (PL) supplementation on URTI susceptibility, salivary immunoglobulin A (s-IgA), and cortisol responses in healthy individuals following prolonged exercise-heat stress.

Methods:

Twelve participants were randomized into the VC or PL group in a double-blind design. For 12 days, participants consumed 3 × 500 mg tablets of VC or PL per day, with testing completed at baseline, then following acute (1 d) and short-term (8 d) supplementation. Participants performed 120.1 ± 49.6 min of cycling at 54 ± 6% VO2max in a hot (34.8 ± 1.0°C and 13 ± 3% relative humidity) environment, with saliva samples collected at pre-, post-, and 72 h postexercise. Health logs specifying URTI symptoms were completed for 7 days postexercise.

Results:

A 2 × 3 × 3 mixed ANOVA with a post hoc Bonferroni correction factor revealed a significant linear trend in postexercise cortisol attenuation in the VC group, 21.7 ± 15.1 nmol/L (mean ± SD) at baseline, to 13.5 ± 10.0 at acute, to 7.6 ± 4.2 after short term (P = .032). No differences were detected in ratio of s-IgA to protein or URTI symptoms between groups.

Conclusions:

These data suggest that vitamin C supplementation can decrease postexercise cortisol in individuals performing exercise similar to that of a half-marathon or marathon in hot conditions. However, no changes in s-IgA and URTI were evident, possibly due to previous moderate training and reduced physical and psychological stress compared with athletes participating in ultramarathons.

Effects of aerobic exercise on uric acid, total antioxidant activity, oxidative stress, and nitric oxide in human saliva

The aim of this study was to determine the effect of aerobic exercise on uric acid (UA), total antioxidant activity (TAA), lipid hydroperoxides, and nitric oxide (NO) metabolites in human saliva. Twenty-four healthy male and female subjects were studied during a 10,000-m race. Saliva samples were collected 1 h before and immediately after exercise. The NO concentration was determined by the Griess reaction, UA by enzymatic method, TAA by the ABTS method, and lipid hydroperoxide by the ferrous iron/xylenol orange (FOX) method. A repeated measures ANOVA was used to examine the effect of aerobic exercise on salivary UA, TAA, lipid hydroperoxides, and NO metabolites. Aerobic exercise caused an increase in both salivary UA and TAA, and a decrease in salivary lipid hydroperoxide. There was no, however, change in nitrite concentration. These results suggested that aerobic exercise-induced increment in both UA and TAA seems to inhibit lipid hydroperoxide generation, a marker of oxidative stress in human saliva.

A rat model of saliva secretory immunoglobulin: a suppression caused by intense exercise

We aimed to develop a valid model of immunosuppression induced by intense exercise in rats. Rats were divided into three groups. In the rest (Rest) group, saliva was collected from resting rats on 4 consecutive days. In the exercise (Ex) group, rats ran on a treadmill until exhaustion (exercise time: 60.0 +/- 3.7 min), and their saliva was collected before and after exercise; the salivary glands were removed after exercise. In the control (Con) group, saliva collection and gland removal were also performed, but the rats did not exercise. Secretory immunoglobulin A (SIgA) concentrations in saliva and polymeric immunoglobulin receptor (pIgR) mRNA expression in the glands were measured. There was no significant change in SIgA concentration in the Rest group over 4 days. In the Ex group, SIgA concentration decreased significantly after exercise compared with before, whereas there was no significant change in the Con group. The expression of pIgR mRNA was significantly lower in the Ex group post-exercise than in the Con group. Our procedure for saliva collection appeared suitable, and the exercise-induced SIgA suppression was probably caused by a decline in pIgR mRNA expression. We propose to use this reproducible and reliable rat model of exercise-induced SIgA suppression in future studies.

Aspectos atuais sobre estresse oxidativo, exercícios físicos e suplementação

As espécies reativas de oxigênio (ERO) são normalmente produzidas pelo metabolismo corporal. Todavia, ERO apresentam a capacidade de retirar elétrons de outros compostos celulares, sendo capazes de provocar lesões oxidativas em várias moléculas, fato que leva à perda total da função celular. A realização de exercícios físicos aumenta a síntese de ERO, além de promover lesão muscular e inflamação. Após uma sessão de exercícios físicos, inicia-se normalmente a fase de recuperação, quando são observados diversos efeitos positivos à saúde, incluindo o aumento da resistência a novas lesões induzidas ou não por exercícios, fato que é considerado como um processo "adaptativo". Diversos estudos, porém, relatam que essa recuperação não é alcançada por indivíduos que se submetem a exercícios intensos e prolongados, ou, ainda, que possuem elevada freqüência de treinamento. Alternativas nutricionais têm sido muito estudadas, a fim de reduzir os efeitos promovidos pelo exercício extenuante, dentre as quais está a suplementação com vitamina E, vitamina C, creatina e glutamina. Esta revisão tem como objetivo abordar os aspectos atuais envolvendo a formação das ERO, os processos de lesão celular e inflamação, a adaptação aos tipos de exercício aeróbio e anaeróbio e possíveis intervenções nutricionais.

Update: effects of antioxidant and non-antioxidant vitamin supplementation on immune function

The purpose of this manuscript is to review the impact of supplementation with vitamins E and C, carotenoids, and the B vitamins on parameters of innate and adaptive immune function as reported from clinical trials in humans. There is evidence to support causal effects of supplementation with vitamins E and C and the carotenoids singly and in combination on selected aspects of immunity, including the functional capacity of innate immune cells, lymphocyte proliferation, and the delayed-type hypersensitivity (DTH) response. Controlled intervention trials of B vitamin-containing multivitamin supplements suggest beneficial effects on immune parameters and clinical outcomes in HIV-positive individuals.

Effect of Free-Living Daily Physical Activity on Salivary Secretory IgA in Elderly

PURPOSE

The aim of this work was to assess the relationship in elderly subjects between free-living daily physical activity and mucosal immunity, especially salivary secretory immunoglobulin A (SIgA).

METHODS

Elderly volunteers (114 men and 170 women) aged 71.3 +/- 0.3 yr (range: 65-86 yr) participated in this study. Resting saliva samples were collected in the morning. Saliva samples stimulated by chewing a sterile cotton ball at a frequency of 60/60 s were collected. The SIgA concentration was measured using enzyme-linked immunosorbent assay (ELISA), and the SIgA secretion rate was calculated. Free-living step count (steps per day), energy expenditure (kJ x kg(-1) x d(-1)), and activity durations (min x d(-1)) at specific intensity levels (inactive, light, moderate, and vigorous) were evaluated using an electric pedometer. The data obtained were stratified by pedometer-determined steps per day using quartiles (Q1-Q4) for distribution.

RESULTS

Elderly in quartiles showed step counts of 2962 +/- 94, 5118 +/- 62, 6832 +/- 59, and 9951 +/- 264 steps per day. Significant differences were found in the mean step count (P<0.0001), energy expenditure (P<0.0001), and activity duration (P<0.0001) with increasing pedometer-determined activity quartiles. Both SIgA concentration and SIgA-secretion rate were significantly higher for Q3 than for Q1 (P<0.05). Meanwhile, saliva flow rates showed no significant differences across quartiles.

CONCLUSION

These results suggest that a free-living daily physical activity level of approximately 7000 steps per day might be regarded as a moderate daily physical activity target for elderly people to improve mucosal immune function.

Changes in plasma cortisol and ascorbic acid in horses with and without recurrent airway obstruction upon exercise and ascorbic acid supplementation

Diminished basal plasma cortisol concentrations and a blunted cortisol response to exercise have been observed in human asthmatics. In horses with recurrent airway obstruction (RAO), plasma concentrations of cortisol at rest are not significantly different from those of healthy horses, but the effect of exercise on endogenous cortisol concentrations has not been described. Ascorbic acid is a non-enzymatic antioxidant with proposed immune-modulating properties. In man, supplementation with ascorbic acid has been shown to attenuate the exercise-induced increase in plasma cortisol following prolonged, submaximal exercise. The relationship between cortisol and ascorbic acid has not previously been investigated in the horse. In a blinded cross-over design, five horses with RAO and six healthy non-RAO controls performed a standard exercise test following 4 weeks of supplementation with either an antioxidant (providing 10 mg ascorbic acid kg−1day−1) or a placebo (<1 mg ascorbic acid kg−1day−1). Venous blood samples were obtained 1 h prior to exercise and at 0, 15, 60 min and 24 h thereafter. Exercise resulted in a significant increase in plasma cortisol concentrations in both groups of horses (P<0.05). Basal and post-exercise concentrations of plasma cortisol in the RAO group (136±16 and 210±16 μmol l−1, respectively) were not significantly different from those in the non-RAO group (129±43 and 218±30 μmol l−1, respectively). Antioxidant supplementation increased basal and post-exercise concentrations of plasma ascorbic acid in RAO and non-RAO horses (P<0.05) but had no effect on plasma cortisol concentration in either group, before or after exercise (RAO: rest 157±27 μmol l−1, post-exercise 222±21 μmol l−1; non-RAO: rest 140±11 μmol l−1, post-exercise 227±35 μmol l−1). In conclusion, RAO-affected horses in remission demonstrate the same cortisol response to exercise as healthy controls. Antioxidant supplementation had no impact on post-exercise concentrations of plasma cortisol in either healthy or RAO-affected horses in remission.

Nutritional modulation of exercise-induced immunodepression in athletes: a systematic review and meta-analysis

BACKGROUND

Heavy exercise induces marked immunodepression that is multifactorial in origin. Nutrition can modulate normal immune function.

OBJECTIVE

To assess the efficacy of nutritional supplements in exercise-induced immunodepression in athletes.

DESIGN

Systematic review.

REVIEW METHODS

Randomised and/or controlled trials of athletes undertaking nutritional supplements to minimise the immunodepression after exercise were retrieved. The primary outcome measure was incidence of upper respiratory tract (URT) illness symptoms after exercise, and secondary outcomes included cortisol, cell counts, plasma cytokine concentration, cell proliferative response, oxidative burst, natural killer cell activity and immunoglobulins. When data were available for a pooled estimate of the effect of intervention, meta-analyses were conducted for direct comparisons.

RESULTS

Forty-five studies were included (1603 subjects). The studies were heterogeneous in terms of exercise interventions, selection of athletes, settings and outcomes. The overall methodological quality of most of the trials was poor. Twenty studies addressed carbohydrate supplementation, eight glutamine, 13 vitamin C and four others interventions. Three trials assessed the effect of intervention on prevention of URT infections. The pooled rate ratio for URT infections after vitamin C supplementation against placebo was 0.49 (0.34-0.71). Carbohydrate supplementation attenuated the increase in cortisol and neutrophils after exercise; vitamin C attenuated the decrease in lymphocytes after exercise. No other interventions had significant or consistent effect on any of the studied outcomes.

CONCLUSIONS

Although the prevention of URT infections by vitamin C was supported by two trials, further studies are needed. The available evidence failed to support a role for other nutritional supplements in preventing exercise-induced immune suppression. Larger trials with clinically relevant and uniform end points are necessary to clarify the role of these nutritional interventions.

Oxidative stress : relationship with exercise and training

Free radicals are reactive compounds that are naturally produced in the human body. They can exert positive effects (e.g. on the immune system) or negative effects (e.g. lipids, proteins or DNA oxidation). To limit these harmful effects, an organism requires complex protection - the antioxidant system. This system consists of antioxidant enzymes (catalase, glutathione peroxidase, superoxide dismutase) and non-enzymatic antioxidants (e.g. vitamin E [tocopherol], vitamin A [retinol], vitamin C [ascorbic acid], glutathione and uric acid). An imbalance between free radical production and antioxidant defence leads to an oxidative stress state, which may be involved in aging processes and even in some pathology (e.g. cancer and Parkinson's disease). Physical exercise also increases oxidative stress and causes disruptions of the homeostasis. Training can have positive or negative effects on oxidative stress depending on training load, training specificity and the basal level of training. Moreover, oxidative stress seems to be involved in muscular fatigue and may lead to overtraining.