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Chang G, Moiteiro Manteigas H, Strutton PH, Mullington CJ. An evaluation of a healthy participant laboratory model of epidural hyperthermia: a physiological study. Int J Obstet Anesth 2024; 57:103961. [PMID: 38199895 DOI: 10.1016/j.ijoa.2023.103961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 11/01/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Hyperthermia complicates 21% of cases of intrapartum epidural analgesia, but the mechanism is unclear. One hypothesis is that blockade of cholinergic sympathetic nerves prevents active vasodilation and sweating, thus limiting heat loss. Because labour increases heat production, this could create a situation in which heat production exceeds loss, causing body temperature to rise. This physiological study tested a novel laboratory model of epidural-related hyperthermia, using exercise to simulate the increased heat production of labour and surface insulation to simulate the effect of epidural analgesia. METHODS Twelve healthy non-pregnant participants (six female) cycled an ergometer for two hours at 20 Watts (W) on two occasions: once with surface insulation (intervention) and once without (control). Core temperature, skin temperature (eight sites), and heat loss (eight sites) were recorded. Mean body temperature and heat production were calculated. Values are mean (SD). RESULTS Exercise increased heat production on both visits (intervention 38 (18) W; control 37 (31) W; P = 0.94). Total heat loss was less on the intervention visit (intervention 115 (19) W; control 129 (23) W; P = 0.002). Core temperature increased on both visits (intervention 0.21 (0.37)°C; control 0.19 (0.27)°C; P < 0.001). The increase in mean body temperature was greater on the intervention visit (intervention 0.47 (0.41)°C; control 0.25 (0.19)°C; P = 0.007). CONCLUSIONS This laboratory model predicts that labour epidural analgesia limits heat loss by >14 W. Once the model is validated, it could be used to test the efficacy of potential interventions to prevent and treat epidural-related maternal hyperthermia.
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Affiliation(s)
- G Chang
- MSk Lab, Imperial College London, London, UK
| | - H Moiteiro Manteigas
- MSk Lab, Imperial College London, London, UK; Theatres and Anaesthetics, Imperial College Healthcare NHS Trust, London, UK
| | | | - C J Mullington
- MSk Lab, Imperial College London, London, UK; Theatres and Anaesthetics, Imperial College Healthcare NHS Trust, London, UK.
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Blasco-Lafarga C, Monferrer-Marín J, Roldán A, Monteagudo P, Chulvi-Medrano I. Metabolic Flexibility and Mechanical Efficiency in Women Over-60. Front Physiol 2022; 13:869534. [PMID: 35464093 PMCID: PMC9019701 DOI: 10.3389/fphys.2022.869534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/21/2022] [Indexed: 01/12/2023] Open
Abstract
Purpose: Aging deteriorates metabolic flexibility (MF). Moreover, recent studies show that glycolysis is barely increased despite impoverished lipid metabolism, in addition to increased relevance of muscle power in older adults. This study aims to analyze MF, i.e., fat and carbohydrates oxidation rates (FATox and CHOox), and the point of maximal fat oxidation (MFO), in a group of active women over-60. It also aims to delve into the role of power production and mechanical efficiency regarding MF. This will help to decipher their metabolic behavior in response to increasing intensity. Methods: Twenty-nine women (66.13 ± 5.62 years) performed a submaximal graded cycling test, increasing 10 W each 3-min15-s, from 30 W to the second ventilatory threshold (VT2). Muscle power was adjusted with a Saris-H3 roller, together with a continuous gas analysis by indirect calorimetry (Cosmed K4b2). Pre and post-test blood lactate (BLa) samples were included. Frayn's equations, MFO and CHOoxpeak (mg/min/kg FFM) were considered for MF analysis (accounting for average VO2 and VCO2 in each last 60-s), whilst delta and gross efficiencies (DE%, GE%), and exercise economy (EC), were added for Mechanical Efficiency. Mean comparisons regarding intensities 60, 80 and 100% at VT2, completed the study together with correlation analysis among the main variables. Results: MFO and CHOoxpeak were small (6.35 ± 3.59 and 72.79 ± 34.76 g/min/kgFFM respectively) for a reduced muscle power (78.21 ± 15.84 W). Notwithstanding, GE% and EC increased significantly (p < 0.01) with exercise intensity. Importantly, coefficients of variation were very large confirming heterogeneity. Whilst muscle power outcomes correlated significantly (p < 0.01) with MFO (r = 0.66) and age (r = -0.62), these latter failed to be associated. Only GE% correlated to CHOoxpeak (r = -0.61, p < 0.01) regarding mechanical efficiency. Conclusions: Despite being active, women over-60 confirmed impaired substrates switching in response to exercise, from both FAT and CHO pathways. This limits their power production affecting exercise capacity. Our data suggest that decreased power with age has a key role above age per se in this metabolic inflexibility. Vice versa, increasing power seems to protect from mitochondrial dysfunction with aging. New studies will confirm if this higher efficiency when coming close to VT2, where GE is the more informative variable, might be a protective compensatory mechanism.
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Affiliation(s)
- Cristina Blasco-Lafarga
- Sport Performance and Physical Fitness Research Group (UIRFIDE), Physical Education and Sport Department, University of Valencia, Valencia, Spain
| | - Jordi Monferrer-Marín
- Sport Performance and Physical Fitness Research Group (UIRFIDE), Physical Education and Sport Department, University of Valencia, Valencia, Spain
| | - Ainoa Roldán
- Sport Performance and Physical Fitness Research Group (UIRFIDE), Physical Education and Sport Department, University of Valencia, Valencia, Spain
| | - Pablo Monteagudo
- Sport Performance and Physical Fitness Research Group (UIRFIDE), Physical Education and Sport Department, University of Valencia, Valencia, Spain
- Department of Education and Specific Didactics, Jaume I University, Castellon, Spain
| | - Ivan Chulvi-Medrano
- Sport Performance and Physical Fitness Research Group (UIRFIDE), Physical Education and Sport Department, University of Valencia, Valencia, Spain
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Cuba-Dorado A, Álvarez-Yates T, García-García O. Elite Triathlete Profiles in Draft-Legal Triathlons as a Basis for Talent Identification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020881. [PMID: 35055706 PMCID: PMC8776141 DOI: 10.3390/ijerph19020881] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 02/02/2023]
Abstract
Draft-legal triathlons are the main short-distance races worldwide and are those on which talent-identification programs are usually focused. Performance in these races depends on multiple factors; however, many investigations do not focus on elite triathletes. Therefore, the aim of this narrative review was to carry out a systematic literature search to define the elite female and male triathlete profiles and their competition demands in draft-legal triathlons. This will allow us to summarize the main determinant factors of high-level triathletes as a basis for talent detection. A comprehensive review of Web of Science and Scopus was performed using the search strategy: Triathl* and (performance or competition or profile) and (elite or professional or “high performance” or “high level” or talent). A total of 1325 research documents were obtained, and after screening following the criteria, only 83 articles were selected. After data synthesis, elite triathlete aspects such as age, physiological, anthropometric, and psychosocial profile or competition demands were studied in the scientific literature. Thus, it is essential that when implementing talent identification programs, these factors must be considered. However, constant updating is needed due the continuous regulatory changes and the need of triathletes to adapt to these new competition demands.
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Bourdas DI, Souglis A, Zacharakis ED, Geladas ND, Travlos AK. Meta-Analysis of Carbohydrate Solution Intake during Prolonged Exercise in Adults: From the Last 45+ Years' Perspective. Nutrients 2021; 13:4223. [PMID: 34959776 PMCID: PMC8704222 DOI: 10.3390/nu13124223] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/02/2021] [Accepted: 11/22/2021] [Indexed: 12/17/2022] Open
Abstract
Carbohydrate (CHO) supplementation during prolonged exercise postpones fatigue. However, the optimum administration timing, dosage, type of CHO intake, and possible interaction of the ergogenic effect with athletes' cardiorespiratory fitness (CRF) are not clear. Ninety-six studies (from relevant databases based on predefined eligibility criteria) were selected for meta-analysis to investigate the acute effect of ≤20% CHO solutions on prolonged exercise performance. The between-subject standardized mean difference [SMD = ([mean post-value treatment group-mean post-value control group]/pooled variance)] was assessed. Overall, SMD [95% CI] of 0.43 [0.35, 0.51] was significant (p < 0.001). Subgroup analysis showed that SMD was reduced as the subjects' CRF level increased, with a 6-8% CHO solution composed of GL:FRU improving performance (exercise: 1-4 h); administration during the event led to a superior performance compared to administration before the exercise, with a 6-8% single-source CHO solution increasing performance in intermittent and 'stop and start' sports and an ~6% CHO solution appearing beneficial for 45-60 min exercises, but there were no significant differences between subjects' gender and age groups, varied CHO concentrations, doses, or types in the effect measurement. The evidence found was sound enough to support the hypothesis that CHO solutions, when ingested during endurance exercise, have ergogenic action and a possible crossover interaction with the subject's CRF.
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Affiliation(s)
- Dimitrios I. Bourdas
- Section of Sport Medicine & Biology of Exercise, School of Physical Education and Sports Science, National and Kapodistrian University of Athens, 41 Ethnikis Antistasis, 17237 Athens, Greece;
| | - Athanasios Souglis
- Section of Didactics and Coaching in Sport Games, School of Physical Education & Sport Science, National and Kapodistrian University of Athens, 41 Ethnikis Antistasis, 17237 Athens, Greece; (A.S.); (E.D.Z.)
| | - Emmanouil D. Zacharakis
- Section of Didactics and Coaching in Sport Games, School of Physical Education & Sport Science, National and Kapodistrian University of Athens, 41 Ethnikis Antistasis, 17237 Athens, Greece; (A.S.); (E.D.Z.)
| | - Nickos D. Geladas
- Section of Sport Medicine & Biology of Exercise, School of Physical Education and Sports Science, National and Kapodistrian University of Athens, 41 Ethnikis Antistasis, 17237 Athens, Greece;
| | - Antonios K. Travlos
- Department of Sports Organization and Management, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Efstathiou and Stamatikis Valioti & Plataion Avenue, 23100 Tripoli, Greece;
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Oosthuyse T, Florence GE, Correia A, Smyth C, Bosch AN. Carbohydrate-Restricted Exercise With Protein Increases Self-Selected Training Intensity in Female Cyclists but Not Male Runners and Cyclists. J Strength Cond Res 2021; 35:1547-1558. [PMID: 33927115 DOI: 10.1519/jsc.0000000000004046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Oosthuyse, T, Florence, GE, Correia, A, Smyth, C, and Bosch, AN. Carbohydrate-restricted exercise with protein increases self-selected training intensity in female cyclists but not male runners and cyclists. J Strength Cond Res 35(6): 1547-1558, 2021-Carbohydrate-restricted training challenges preservation of euglycemia and exercise intensity that precludes ergogenic gains, necessitating countering strategies. We investigated the efficacy of ingesting casein protein hydrolysate in overnight-fasted male runners, male cyclists, and female cyclists. Twenty-four overnight-fasted athletes ingested 15.8 g·h-1 casein hydrolysate or placebo-water during exercise (60-80 minutes) comprising an incremental test to exhaustion, steady-state exercise (70% Vmax or 60% peak power output, 87 ± 4% HRmax), and 20-minute time trial (TT) in a double-blind randomized crossover design, with p < 0.05 accepted as significant. Ingesting protein vs. placebo increased metabolic demand {oxygen consumption, +4.7% (95% confidence interval [CI] ± 4%), p = 0.0297; +3.2% (95% CI ± 3.4%), p = 0.061}, heart rate (p = 0.0083; p = 0.007) and rating of perceived exertion (RPE) (p = 0.0266; p = 0.0163) in male cyclists and runners, respectively, but not female cyclists. Protein vs. placebo increased carbohydrate oxidation (+0.26 [95% CI ± 0.13] g·min-1, p = 0.0007) in female cyclists alone. Cyclists reported +2 ± 1 higher RPE than runners (p = 0.0062). Glycemia was maintained only in runners and increased with protein vs. placebo after 20 minutes of steady-state exercise (+0.63 [95% CI ± 0.56] mmol·L-1, p = 0.0285). TT performance with protein vs. placebo ingestion was modestly compromised in runners (-2.8% [95% CI ± 2.2%], p = 0.0018), unchanged in male cyclists (+1.9% [95% CI ± 5.6%], p = 0.5794), and modestly improved in female cyclists (+2.5% [95% CI ± 1.8%], p = 0.0164). Casein hydrolysate ingestion during moderate to hard carbohydrate-restricted exercise increases glycemia in runners, but not cyclists. Casein hydrolysate increases metabolic demand in male athletes and carbohydrate oxidation in female cyclists and is suitable for improving carbohydrate-restricted training intensity in female but not male endurance athletes.
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Affiliation(s)
- Tanja Oosthuyse
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Medical School, Johannesburg, South Africa ; and
| | - Gabriella E Florence
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Arron Correia
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Camilla Smyth
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Andrew N Bosch
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
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Loiselle DS, Taberner AJ, Tran K, Han JC. Thermodynamic inconsistency disproves the Suga-Sagawa theory of cardiac energetics. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2021; 164:81-91. [PMID: 33745881 DOI: 10.1016/j.pbiomolbio.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/13/2021] [Accepted: 03/11/2021] [Indexed: 11/24/2022]
Abstract
The theory proposed by Suga and Sagawa, encompassing the concepts of 'time-varying elastance', 'pressure-volume area' and 'isoefficiency', has been widely applied in cardiac research - albeit not without contention. In this Review, we commence with a brief history of striated muscle energetics as a prelude to re-visiting the Suga-Sagawa Theory. We conclude our discussion by including recent insights into the fundamental flaw underlying the metabolic component of the Theory.
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Affiliation(s)
- Denis S Loiselle
- Auckland Bioengineering Institute, The University of Auckland, New Zealand; Department of Physiology, The University of Auckland, New Zealand.
| | - Andrew J Taberner
- Auckland Bioengineering Institute, The University of Auckland, New Zealand; Department of Engineering Science, The University of Auckland, New Zealand
| | - Kenneth Tran
- Auckland Bioengineering Institute, The University of Auckland, New Zealand
| | - June-Chiew Han
- Auckland Bioengineering Institute, The University of Auckland, New Zealand
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