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Tiemeier L, Nikolaidis PT, Chlíbková D, Wilhelm M, Thuany M, Weiss K, Knechtle B. Ultra-Cycling- Past, Present, Future: A Narrative Review. SPORTS MEDICINE - OPEN 2024; 10:48. [PMID: 38679655 PMCID: PMC11056358 DOI: 10.1186/s40798-024-00715-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/06/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Ultra-endurance events are gaining popularity in multiple exercise disciplines, including cycling. With increasing numbers of ultra-cycling events, aspects influencing participation and performance are of interest to the cycling community. MAIN BODY The aim of this narrative review was, therefore, to assess the types of races offered, the characteristics of the cyclists, the fluid and energy balance during the race, the body mass changes after the race, and the parameters that may enhance performance based on existing literature. A literature search was conducted in PubMed, Scopus, and Google Scholar using the search terms 'ultracycling', 'ultra cycling', 'ultra-cycling', 'ultra-endurance biking', 'ultra-bikers' and 'prolonged cycling'. The search yielded 948 results, of which 111 were relevant for this review. The studies were classified according to their research focus and the results were summarized. The results demonstrated changes in physiological parameters, immunological and oxidative processes, as well as in fluid and energy balance. While the individual race with the most published studies was the Race Across America, most races were conducted in Europe, and a trend for an increase in European participants in international races was observed. Performance seems to be affected by characteristics such as age and sex but not by anthropometric parameters such as skin fold thickness. The optimum age for the top performance was around 40 years. Most participants in ultra-cycling events were male, but the number of female athletes has been increasing over the past years. Female athletes are understudied due to their later entry and less prominent participation in ultra-cycling races. A post-race energy deficit after ultra-cycling events was observed. CONCLUSION Future studies need to investigate the causes for the observed optimum race age around 40 years of age as well as the optimum nutritional supply to close the observed energy gap under consideration of the individual race lengths and conditions. Another research gap to be filled by future studies is the development of strategies to tackle inflammatory processes during the race that may persist in the post-race period.
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Affiliation(s)
- Lucas Tiemeier
- Centre for Rehabilitation & Sports Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | | | - Daniela Chlíbková
- Centre of Sports Activities, Brno University of Technology, 61669, Brno, Czech Republic
| | - Matthias Wilhelm
- Centre for Rehabilitation & Sports Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | | | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.
- Medbase St. Gallen Am Vadianplatz, Vadianstrasse 26, 9001, St. Gallen, Switzerland.
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Aragón-Vela J, González-Acevedo O, De la Cruz-Márquez JC, Rojas Ruíz FJ, Marín MM, Casuso RA, Plaza-Diaz J, Huertas JFR. The Effects of Acute Deep Seawater Supplementation on Muscle Function after Triathlon. J Clin Med 2024; 13:2258. [PMID: 38673531 PMCID: PMC11051008 DOI: 10.3390/jcm13082258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: Trainers and athletes have always sought to reduce the failure of muscle function during long endurance events. However, nowadays, it is a topic that is generating much debate in the scientific field. Currently, deep-sea water (DSW) intake seems to be a suitable hydration alternative for this type of endurance event. Therefore, the aim of this study was to determine whether DSW consumption during a triathlon event could preserve muscle function after exercise. (2) Methods: Nineteen trained male triathletes (age = 39.0 ± 4.25 years; BMI = 23.67 ± 1.81 kg/m2) randomly performed three triathlons, one of them consuming DSW (Totum SPORT 30 AB, Laboratories Quinton International, S.L., Spain), the other consuming isotonic placebo and the last with tap water-hydration. A vertical jump test with countermovement and an isometric muscle strength test were conducted before and after the triathlon test. (3) Results: There was a significant difference between treatment × time during the isometric muscle strength test. Based on the Tukey post hoc analysis, the peak net force decreased statistically in the placebo (p = 0.045) and control conditions (p = 0.026), but not in the experimental condition (p = 0.121). In addition, all of the conditions studied obtained similar results in the countermovement vertical jump after exercise. (4) Conclusions: As a result, consumption of DSW seems to delay the failure of muscle function specifically in isometric exercises but does not improve performance in sports. Thus, DSW does not alter muscle capacity in a negative way; therefore, its consumption may be recommended.
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Affiliation(s)
- Jerónimo Aragón-Vela
- Department of Health Sciences, Area of Physiology, Campus “Las Lagunillas”, Building B3, University of Jaen, 23071 Jaén, Spain;
| | - Olivia González-Acevedo
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18016 Granada, Spain; (O.G.-A.); (J.F.R.H.)
| | - Juan Carlos De la Cruz-Márquez
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain; (F.J.R.R.); (M.M.M.)
| | - Francisco Javier Rojas Ruíz
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain; (F.J.R.R.); (M.M.M.)
| | - Manuel Martínez Marín
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain; (F.J.R.R.); (M.M.M.)
| | - Rafael A. Casuso
- Departamento de Ciencias de la Salud, Universidad Loyola Andalucía, 41704 Sevilla, Spain;
| | - Julio Plaza-Diaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Jesus F. Rodriguez Huertas
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18016 Granada, Spain; (O.G.-A.); (J.F.R.H.)
- Department of Physiology, School of Pharmacy, Campus de Cartuja s/n, University of Granada, 18071 Granada, Spain
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3
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Deshayes TA, Sodabi DGA, Dubord M, Gagnon D. Shifting focus: Time to look beyond the classic physiological adaptations associated with human heat acclimation. Exp Physiol 2024; 109:335-349. [PMID: 37885125 PMCID: PMC10988689 DOI: 10.1113/ep091207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Planet Earth is warming at an unprecedented rate and our future is now assured to be shaped by the consequences of more frequent hot days and extreme heat. Humans will need to adapt both behaviorally and physiologically to thrive in a hotter climate. From a physiological perspective, countless studies have shown that human heat acclimation increases thermoeffector output (i.e., sweating and skin blood flow) and lowers cardiovascular strain (i.e., heart rate) during heat stress. However, the mechanisms mediating these adaptations remain understudied. Furthermore, several possible benefits of heat acclimation for other systems and functions involved in maintaining health and performance during heat stress remain to be elucidated. This review summarizes recent advances in human heat acclimation, with emphasis on recent studies that (1) advanced our understanding of the mechanisms mediating improved thermoeffector output and (2) investigated adaptations that go beyond those classically associated with heat acclimation. We highlight that these studies have contributed to a better understanding of the integrated physiological responses underlying human heat acclimation while leaving key unanswered questions that will need to be addressed in the future.
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Affiliation(s)
- Thomas A. Deshayes
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Dèwanou Gilles Arnaud Sodabi
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Marianne Dubord
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Daniel Gagnon
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
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4
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Notley SR, Mitchell D, Taylor NAS. A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 3: Heat and cold tolerance during exercise. Eur J Appl Physiol 2024; 124:1-145. [PMID: 37796292 DOI: 10.1007/s00421-023-05276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/04/2023] [Indexed: 10/06/2023]
Abstract
In this third installment of our four-part historical series, we evaluate contributions that shaped our understanding of heat and cold stress during occupational and athletic pursuits. Our first topic concerns how we tolerate, and sometimes fail to tolerate, exercise-heat stress. By 1900, physical activity with clothing- and climate-induced evaporative impediments led to an extraordinarily high incidence of heat stroke within the military. Fortunately, deep-body temperatures > 40 °C were not always fatal. Thirty years later, water immersion and patient treatments mimicking sweat evaporation were found to be effective, with the adage of cool first, transport later being adopted. We gradually acquired an understanding of thermoeffector function during heat storage, and learned about challenges to other regulatory mechanisms. In our second topic, we explore cold tolerance and intolerance. By the 1930s, hypothermia was known to reduce cutaneous circulation, particularly at the extremities, conserving body heat. Cold-induced vasodilatation hindered heat conservation, but it was protective. Increased metabolic heat production followed, driven by shivering and non-shivering thermogenesis, even during exercise and work. Physical endurance and shivering could both be compromised by hypoglycaemia. Later, treatments for hypothermia and cold injuries were refined, and the thermal after-drop was explained. In our final topic, we critique the numerous indices developed in attempts to numerically rate hot and cold stresses. The criteria for an effective thermal stress index were established by the 1930s. However, few indices satisfied those requirements, either then or now, and the surviving indices, including the unvalidated Wet-Bulb Globe-Thermometer index, do not fully predict thermal strain.
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Affiliation(s)
- Sean R Notley
- Defence Science and Technology Group, Department of Defence, Melbourne, Australia
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Duncan Mitchell
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Sciences, University of Western Australia, Crawley, Australia
| | - Nigel A S Taylor
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
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5
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Goulet EDB, Claveau P, Simoneau IL, Deshayes TA, Jolicoeur-Desroches A, Aloui F, Hoffman MD. Repeatability of Ad Libitum Water Intake during Repeated 1 h Walking/Jogging Exercise Sessions Conducted under Hot Ambient Conditions. Nutrients 2023; 15:4500. [PMID: 37960153 PMCID: PMC10650651 DOI: 10.3390/nu15214500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
A drinking strategy aiming to replace a given percentage of the sweat losses incurred during exercise should result in reproducible fluid intake volume and, hence, fluid balance from one exercise session to the other performed under similar scenarios. Whether this may also be the case with ad libitum drinking during exercise is unclear. We characterized the repeatability of ad libitum water intake during repeated 1 h exercise sessions and examined its effect over time on fluid balance and selected physiological functions and perceptual sensations. Twelve (3 women) healthy individuals participated in this study. At weekly intervals, they completed four 2 × 30 min walking/jogging exercise bouts (55% V˙O2max, 40 °C, 20-30% relative humidity) interspersed by a 3 min recovery period. During exercise, participants consumed water (20 °C) ad libitum. There were no significant differences among the four exercise sessions for absolute water intake volume (~1000 mL·h-1), percent body mass loss (~0.4%), sweat rate (~1300 mL·h-1) and percent of sweat loss replaced by water intake (~80%). Heart rate, rectal temperature, and perceived thirst and heat stress did not differ significantly between the first and fourth exercise sessions. Perceived exertion was significantly lower during the fourth vs. the first exercise session, but the difference was trivial (<1 arbitrary unit). In conclusion, ad libitum water intake during four successive identical 1 h walking/jogging sessions conducted in the heat will result in similar water intake volumes and perturbations in fluid balance, heart rate, rectal temperature, and perceived thirst, heat stress and exertion.
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Affiliation(s)
- Eric D. B. Goulet
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
- Research Center on Aging, University of Sherbrooke, Sherbrooke, PQ J1H 4C4, Canada
| | - Pascale Claveau
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
| | - Ivan L. Simoneau
- Centre de Recherche et de Formation par Simulation, Cégep of Sherbrooke, Sherbrooke, PQ J1E 4K1, Canada;
| | - Thomas A. Deshayes
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
- Research Center on Aging, University of Sherbrooke, Sherbrooke, PQ J1H 4C4, Canada
| | - Antoine Jolicoeur-Desroches
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
| | - Fedi Aloui
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, PQ J1K 2R1, Canada; (P.C.); (T.A.D.); (A.J.-D.); (F.A.)
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Wei RJ, Orbeta L, Hatamiya NS, Chang CJ. Nutritional Strategies for Endurance Cyclists - Periodized Nutrition, Ketogenic Diets, and Other Considerations. Curr Sports Med Rep 2023; 22:248-254. [PMID: 37417661 DOI: 10.1249/jsr.0000000000001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
ABSTRACT Cycling is a growing sport worldwide since the COVID-19 pandemic. With the growing availability and interest in long distance events, professional and amateur cyclists are pushing themselves further and harder than ever before. Training and nutrition should be understood by the sports medicine professional in order to guide counseling toward proper fueling to avoid health consequences. This article reviews macronutrients and micronutrients, periodized training and nutrition, and the relevance of the ketogenic diet for endurance cyclists riding greater than 90 min.
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Affiliation(s)
| | - Lindsay Orbeta
- Human Performance Center, University of California, San Francisco, San Francisco, CA
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7
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Limited Effect of Dehydrating via Active vs. Passive Heat Stress on Plasma Volume or Osmolality, Relative to the Effect of These Stressors per Se. Nutrients 2023; 15:nu15040904. [PMID: 36839262 PMCID: PMC9959915 DOI: 10.3390/nu15040904] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
The physiological, perceptual, and functional effects of dehydration may depend on how it is incurred (e.g., intense exercise releases endogenous water via glycogenolysis) but this basic notion has rarely been examined. We investigated the effects of active (exercise) heat- vs. passive heat-induced dehydration, and the kinetics of ad libitum rehydration following each method. Twelve fit participants (five females and seven males) completed four trials in randomised order: DEHydration to -3% change in body mass (∆BM) under passive or active heat stress, and EUHydration to prevent ∆BM under passive or active heat stress. In all trials, participants then sat in a temperate-controlled environment, ate a standard snack and had free access to water and sports drink during their two-hour recovery. During mild dehydration (≤2% ∆BM), active and passive heating caused comparable increases in plasma osmolality (Posm: ~4 mOsmol/kg, interaction: p = 0.138) and reductions in plasma volume (PV: ~10%, interaction: p = 0.718), but heat stress per se was the main driver of hypovolaemia. Thirst in DEHydration was comparably stimulated by active than passive heat stress (p < 0.161) and shared the same relation to Posm (r ≥ 0.744) and ∆BM (r ≥ 0.882). Following heat exposures, at 3% gross ∆BM, PV reduction was approximately twice as large from passive versus active heating (p = 0.003), whereas Posm perturbations were approximately twice as large from EUHydration versus DEHydration (p < 0.001). Rehydrating ad libitum resulted in a similar net fluid balance between passive versus active heat stress and restored PV despite the incomplete replacement of ∆BM. In conclusion, dehydrating by 2% ∆BM via passive heat stress generally did not cause larger changes to PV or Posm than via active heat stress. The heat stressors themselves caused a greater reduction in PV than dehydration did, whereas ingesting water to maintain euhydration produced large reductions in Posm in recovery and therefore appears to be of more physiological significance.
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Racinais S, Hosokawa Y, Akama T, Bermon S, Bigard X, Casa DJ, Grundstein A, Jay O, Massey A, Migliorini S, Mountjoy M, Nikolic N, Pitsiladis YP, Schobersberger W, Steinacker JM, Yamasawa F, Zideman DA, Engebretsen L, Budgett R. IOC consensus statement on recommendations and regulations for sport events in the heat. Br J Sports Med 2023; 57:8-25. [PMID: 36150754 PMCID: PMC9811094 DOI: 10.1136/bjsports-2022-105942] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 01/07/2023]
Abstract
This document presents the recommendations developed by the IOC Medical and Scientific Commission and several international federations (IF) on the protection of athletes competing in the heat. It is based on a working group, meetings, field experience and a Delphi process. The first section presents recommendations for event organisers to monitor environmental conditions before and during an event; to provide sufficient ice, shading and cooling; and to work with the IF to remove regulatory and logistical limitations. The second section summarises recommendations that are directly associated with athletes' behaviours, which include the role and methods for heat acclimation; the management of hydration; and adaptation to the warm-up and clothing. The third section explains the specific medical management of exertional heat stroke (EHS) from the field of play triage to the prehospital management in a dedicated heat deck, complementing the usual medical services. The fourth section provides an example for developing an environmental heat risk analysis for sport competitions across all IFs. In summary, while EHS is one of the leading life-threatening conditions for athletes, it is preventable and treatable with the proper risk mitigation and medical response. The protection of athletes competing in the heat involves the close cooperation of the local organising committee, the national and international federations, the athletes and their entourages and the medical team.
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Affiliation(s)
- Sebastien Racinais
- Research and Scientific Support Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | | | - Xavier Bigard
- Union Cycliste Internationale (UCI), Aigle, Switzerland
| | - Douglas J Casa
- Korey Stringer Institiute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Andrew Grundstein
- Department of Geography, University of Georgia, Athens, Georgia, USA
| | - Ollie Jay
- Heat and Health Research Incubator, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Andrew Massey
- Medical Department, Federation Internationale de Football Association, Zurich, Switzerland
| | | | | | | | | | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine & Health Tourism (ISAG), UMIT Tirol – Private University for Health Sciences and technology, Hall, Austria,University Hospital/Tirol Kliniken, Innsbruck, Austria
| | | | | | - David Anthony Zideman
- International Olympic Committee Medical and Scientific Games Group, Pinner, Middlesex, UK
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
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Aragón-Vela J, González-Acevedo O, Plaza-Diaz J, Casuso RA, Huertas JR. Physiological Benefits and Performance of Sea Water Ingestion for Athletes in Endurance Events: A Systematic Review. Nutrients 2022; 14:nu14214609. [PMID: 36364871 PMCID: PMC9657671 DOI: 10.3390/nu14214609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/07/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
In different endurance events, athletes have limited access to fluid intake, such as ultra-endurance running. For this reason, it is necessary to establish an adequate hydration strategy for this type of long-duration sporting event. Indeed, it seems that the intake of seawater is a suitable hydration alternative to improve post-exercise recovery in this type of endurance event. This seawater is characterized by being a deep natural mineral water of moderate mineralization, which is usually extracted from a depth of about 700 m. Therefore, the aim of this systematic review is to evaluate the efficacy of seawater consumption in both performance and post-exercise recovery in long-duration sport events. A systematic and comprehensive literature search was performed in PubMed, Scopus, and Web of Science in September 2022. Initially, 8 out of 558 articles met the inclusion criteria. Among these eight studies, six were randomized clinical trials, and two were observational studies (one cross-sectional and one prospective study in well-conditioned student athletes). The results showed that deep sea water consumption accelerated the recovery of aerobic capacity and leg muscle capacity on running performance. In addition, the lactate production after the running exercise in seawater was significantly lower than in pure water. In conclusion, the present review demonstrates that seawater consumption could significantly improve the capacity of recovery after exercise.
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Affiliation(s)
- Jerónimo Aragón-Vela
- Department of Physiology, School of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18016 Granada, Spain
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
- Correspondence: (J.A.-V.); (J.P.-D.)
| | - Olivia González-Acevedo
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18016 Granada, Spain
| | - Julio Plaza-Diaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
- Correspondence: (J.A.-V.); (J.P.-D.)
| | - Rafael A. Casuso
- Departamento de Ciencias de la Salud, Universidad Loyola Andalucía, 41704 Sevilla, Spain
| | - Jesús R. Huertas
- Department of Physiology, School of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18016 Granada, Spain
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
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10
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Acevedo OG, Aragón-Vela J, De la Cruz Márquez JC, Marín MM, Casuso RA, Huertas JR. Seawater Hydration Modulates IL-6 and Apelin Production during Triathlon Events: A Crossover Randomized Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159581. [PMID: 35954937 PMCID: PMC9368587 DOI: 10.3390/ijerph19159581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 12/11/2022]
Abstract
A triathlon is an endurance event in which athletes need an efficient hydration strategy since hydration is restricted at different stages. However, it seems that seawater intake can be a suitable hydration alternative for this type of endurance event. Therefore, the aim of this study was to evaluate the efficacy of seawater hydration during a triathlon on cytokine production. Fifteen trained male triathletes (age = 38.8 ± 5.62 years old; BMI = 22.58 ± 2.51 kg/m2) randomly performed three triathlons, one of them consuming seawater (Totum SPORT, Laboratories Quinton International, S.L., Valencia, Spain), the other one consuming tap water ad libitum, and the last a physiologic saline solution as placebo. The triathlon consisted of an 800 m swim, a 90 km bike ride, and a 10 km run. Blood samples were taken at rest and after training, where markers of inflammation, hemoglobin, and hematocrit concentration were assessed. While the seawater was not ergogenic, it significantly increased the release of IL-6 and apelin post-exercise. However, no differences were found between the fractalkine, IL-15, EPO, osteonectin, myostatin, oncostatin, irisin, FSTL1, osteocrin, BDNF, and FGF-21 values over those of the placebo group. The present study demonstrates that hydration with seawater stimulates myokine production, which could lead to improved performance recovery after exercise.
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Affiliation(s)
- Olivia González Acevedo
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18106 Granada, Spain
| | - Jerónimo Aragón-Vela
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18106 Granada, Spain
- Department of Physiology, School of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain
- Correspondence: (J.A.-V.); (J.R.H.)
| | | | - Manuel Martínez Marín
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18001 Granada, Spain
| | - Rafael A. Casuso
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18106 Granada, Spain
- Department of Health Sciences, Loyola Andalucía University, 41704 Sevilla, Spain
| | - Jesús R. Huertas
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, 18106 Granada, Spain
- Department of Physiology, School of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain
- Correspondence: (J.A.-V.); (J.R.H.)
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11
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Deshayes TA, Pancrate T, Goulet ED. Impact of dehydration on perceived exertion during endurance exercise: A systematic review with meta-analysis. J Exerc Sci Fit 2022; 20:224-235. [PMID: 35601980 PMCID: PMC9093000 DOI: 10.1016/j.jesf.2022.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/09/2022] [Accepted: 03/28/2022] [Indexed: 11/20/2022] Open
Abstract
Background Understanding the impact of stressors on the rating of perceived exertion (RPE) is relevant from a performance and exercise adherence/participation standpoint. Athletes and recreationally active individuals dehydrate during exercise. No attempt has been made to systematically determine the impact of exercise-induced dehydration (EID) on RPE. Objective The present meta-analysis aimed to determine the effect of EID on RPE during endurance exercise and examine the moderating effect of potential confounders. Data analyses Performed on raw RPE values using random-effects models weighted mean effect summaries and meta-regressions with robust standard errors, and with a practical meaningful effect set at 1 point difference between euhydration (EUH) and EID. Only controlled crossover studies measuring RPE with a Borg scale in healthy adults performing ≥30 min of continuous endurance exercise while dehydrating or drinking to maintain EUH were included. Results Sixteen studies were included, representing 147 individuals. Mean body mass loss with EUH was 0.5 ± 0.4%, compared to 2.3 ± 0.5% with EID (range 1.7-3.1%). Within an EID of 0.5-3% body mass, a maximum difference in RPE of 0.81 points (95% CI: 0.36-1.27) was observed between conditions. A meta-regression revealed that RPE increases by 0.21 points for each 1% increase in EID (95% CI: 0.12-0.31). Humidity, ambient temperature and aerobic capacity did not alter the relationship between EID and RPE. Conclusion Therefore, the effect of EID on RPE is unlikely to be practically meaningful until a body mass loss of at least 3%.
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Affiliation(s)
- Thomas A. Deshayes
- Faculty of Physical Activity Sciences, University of Sherbrooke, P.Q., Canada
- Research Center on Aging, University of Sherbrooke, P.Q., Canada
| | - Timothée Pancrate
- Faculty of Physical Activity Sciences, University of Sherbrooke, P.Q., Canada
| | - Eric D.B. Goulet
- Faculty of Physical Activity Sciences, University of Sherbrooke, P.Q., Canada
- Research Center on Aging, University of Sherbrooke, P.Q., Canada
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12
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Eda N, Nakamura N, Inai Y, Sun Z, Sone R, Watanabe K, Akama T. Changes in the skin characteristics associated with dehydration and rehydration. Eur J Sport Sci 2022; 23:552-560. [PMID: 35179449 DOI: 10.1080/17461391.2022.2044914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThe present study aimed to test the hypothesis that changes in the dermal tissue dielectric constant (TDC) and biomechanical properties of the skin would be correlated with the indicators related to dehydration. Ten healthy adult men were enrolled in three trials: no fluid intake (DEH), ad libitum fluid intake (AL-HYD), and programmed fluid intake (P-HYD) after exercise in a randomized crossover design. The participants performed a pedaling exercise at 60% heart rate reserve until 2% body mass loss. At 120 min after exercise, an incremental exercise test was carried out. Aerobic capacity, body composition, TDC, biomechanical properties of the skin (pliability, viscoelasticity, and total recovery), and indicators related to dehydration in the serum and urine were measured before and 120 min after exercise. Higher values of the pliability and viscoelasticity, and lower value of the total recovery on the hand were demonstrated in the P-HYD trial compared to the DEH trial (all P < 0.05). Changes in the TDC were significantly correlated with changes in body mass (P < 0.05), total body water (P < 0.05), serum osmolarity (P < 0.05), and hematocrit (P < 0.01). Changes in the biomechanical properties of the hand were significantly correlated with changes in body mass, hematocrit, and urine specific gravity (all P < 0.05). The present study showed that the changes in skin characteristics correlated with the body water and dehydration-associated indicators in the serum and urine, thus suggesting that skin characteristics may be useful in the assessment of dehydration.
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Affiliation(s)
- Nobuhiko Eda
- Department of Fundamental Education, Dokkyo Medical University, Tochigi, Japan.,Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
| | | | - Yuto Inai
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Ziyue Sun
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Ryota Sone
- Japan Institute of Sports Sciences, Tokyo, Japan
| | - Koichi Watanabe
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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13
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Jeker D, Claveau P, Abed MEF, Deshayes TA, Lajoie C, Gendron P, Hoffman MD, Goulet EDB. Programmed vs. Thirst-Driven Drinking during Prolonged Cycling in a Warm Environment. Nutrients 2021; 14:nu14010141. [PMID: 35011016 PMCID: PMC8747324 DOI: 10.3390/nu14010141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 11/25/2022] Open
Abstract
We compared the effect of programmed (PFI) and thirst-driven (TDFI) fluid intake on prolonged cycling performance and exercise associated muscle cramps (EAMC). Eight male endurance athletes (26 ± 6 years) completed two trials consisting of 5 h of cycling at 61% V˙O2peak followed by a 20 km time-trial (TT) in a randomized crossover sequence at 30 °C, 35% relative humidity. EAMC was assessed after the TT with maximal voluntary isometric contractions of the shortened right plantar flexors. Water intake was either programmed to limit body mass loss to 1% (PFI) or consumed based on perceived thirst (TDFI). Body mass loss reached 1.5 ± 1.0% for PFI and 2.5 ± 0.9% for TDFI (p = 0.10). Power output during the 20 km TT was higher (p < 0.05) for PFI (278 ± 41 W) than TDFI (263 ± 39 W), but the total performance time, including the breaks to urinate, was similar (p = 0.48) between conditions. The prevalence of EAMC of the plantar flexors was similar between the drinking conditions. Cyclists competing in the heat for over 5 h may benefit from PFI aiming to limit body mass loss to <2% when a high intensity effort is required in the later phase of the race and when time lost for urination is not a consideration.
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Affiliation(s)
- David Jeker
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (D.J.); (P.C.); (M.E.F.A.); (T.A.D.)
| | - Pascale Claveau
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (D.J.); (P.C.); (M.E.F.A.); (T.A.D.)
| | - Mohamed El Fethi Abed
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (D.J.); (P.C.); (M.E.F.A.); (T.A.D.)
| | - Thomas A. Deshayes
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (D.J.); (P.C.); (M.E.F.A.); (T.A.D.)
- Research Center on Aging, University of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
| | - Claude Lajoie
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (C.L.); (P.G.)
| | - Philippe Gendron
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (C.L.); (P.G.)
| | - Martin D. Hoffman
- Department of Physical Medicine & Rehabilitation, University of California Davis, Sacramento, CA 95817, USA;
- Ultra-Endurance Sports Science & Medicine, Duluth, MN 55811, USA
| | - Eric D. B. Goulet
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (D.J.); (P.C.); (M.E.F.A.); (T.A.D.)
- Research Center on Aging, University of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Correspondence:
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14
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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: 15] [Impact Index Per Article: 5.0] [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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15
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Hydration Status and Fluid Replacement Strategies of High-Performance Adolescent Athletes: An Application of Machine Learning to Distinguish Hydration Characteristics. Nutrients 2021; 13:nu13114073. [PMID: 34836328 PMCID: PMC8625246 DOI: 10.3390/nu13114073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 11/23/2022] Open
Abstract
There are limited data on the fluid balance characteristics and fluid replenishment behaviors of high-performance adolescent athletes. The heterogeneity of hydration status and practices of adolescent athletes warrant efficient approaches to individualizing hydration strategies. This study aimed to evaluate and characterize the hydration status and fluid balance characteristics of high-performance adolescent athletes and examine the differences in fluid consumption behaviors during training. In total, 105 high-performance adolescent athletes (male: 66, female: 39; age 14.1 ± 1.0 y) across 11 sports had their hydration status assessed on three separate occasions—upon rising and before a low and a high-intensity training session (pre-training). The results showed that 20–44% of athletes were identified as hypohydrated, with 21–44% and 15–34% of athletes commencing low- and high-intensity training in a hypohydrated state, respectively. Linear mixed model (LMM) analyses revealed that athletes who were hypohydrated consumed more fluid (F (1.183.85)) = 5.91, (p = 0.016). Additional K-means cluster analyses performed highlighted three clusters: “Heavy sweaters with sufficient compensatory hydration habits,” “Heavy sweaters with insufficient compensatory hydration habits” and “Light sweaters with sufficient compensatory hydration habits”. Our results highlight that high-performance adolescent athletes with ad libitum drinking have compensatory mechanisms to replenish fluids lost from training. The approach to distinguish athletes by hydration characteristics could assist practitioners in prioritizing future hydration intervention protocols.
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16
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Claveau P, Deshayes TA, Jeker D, Pancrate T, Goulet EDB. Provision of instructions to drink ad libitum or according to thirst sensation: impact during 120 km of cycling in the heat in men. Appl Physiol Nutr Metab 2021; 47:1-8. [PMID: 34461024 DOI: 10.1139/apnm-2021-0476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The terms drinking to thirst and ad libitum drinking are used interchangeably, but should they? We investigated the differences in how athletes consumed fluids during exercise when instructed to drink according to thirst or ad libitum. Using a randomized, crossover, and counterbalanced design, 10 males (27 ± 4 y) cycled 120 km (48 ± 4% of peak power, 33 °C, 40% relative humidity) on 2 occasions, while drinking water according to thirst or ad libitum. Participants covered the cycling trials in 222 ± 11 min (p = 0.29). Although the body mass loss at the end of exercise and total volume of water consumed were similar between trials, thirst perception before each sip and the volume consumed per sip were significantly higher with thirst than ad libitum drinking, whereas the total number of sips was significantly lower with thirst than ad libitum drinking. Perceived exertion, rectal temperature, and heart rate were all significantly higher with thirst than ad libitum drinking, but the difference was trivial. In conclusion, thirst and ad libitum drinking are associated with different drinking patterns, but equally maintain fluid balance during prolonged exercise. The terms drinking to thirst and ad libitum drinking can be used interchangeably to guide fluid intake during prolonged exercise. Novelty: Both strategies are associated with different patterns of fluid ingestion during prolonged exercise, but are equally effective in maintaining fluid balance. Perceived exertion, rectal temperature, and heart rate are regulated dissimilarly by thirst and ad libitum drinking, but the difference is trivial.
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Affiliation(s)
- Pascale Claveau
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Thomas A Deshayes
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
| | - David Jeker
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Timothée Pancrate
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Eric D B Goulet
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
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17
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Tan XR, Low ICC, Byrne C, Wang R, Lee JKW. Assessment of dehydration using body mass changes of elite marathoners in the tropics. J Sci Med Sport 2021; 24:806-810. [DOI: 10.1016/j.jsams.2021.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/30/2020] [Accepted: 01/19/2021] [Indexed: 11/27/2022]
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18
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Sports Dietitians Australia Position Statement: Nutrition for Exercise in Hot Environments. Int J Sport Nutr Exerc Metab 2021; 30:83-98. [PMID: 31891914 DOI: 10.1123/ijsnem.2019-0300] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/15/2019] [Indexed: 11/18/2022]
Abstract
It is the position of Sports Dietitians Australia (SDA) that exercise in hot and/or humid environments, or with significant clothing and/or equipment that prevents body heat loss (i.e., exertional heat stress), provides significant challenges to an athlete's nutritional status, health, and performance. Exertional heat stress, especially when prolonged, can perturb thermoregulatory, cardiovascular, and gastrointestinal systems. Heat acclimation or acclimatization provides beneficial adaptations and should be undertaken where possible. Athletes should aim to begin exercise euhydrated. Furthermore, preexercise hyperhydration may be desirable in some scenarios and can be achieved through acute sodium or glycerol loading protocols. The assessment of fluid balance during exercise, together with gastrointestinal tolerance to fluid intake, and the appropriateness of thirst responses provide valuable information to inform fluid replacement strategies that should be integrated with event fuel requirements. Such strategies should also consider fluid availability and opportunities to drink, to prevent significant under- or overconsumption during exercise. Postexercise beverage choices can be influenced by the required timeframe for return to euhydration and co-ingestion of meals and snacks. Ingested beverage temperature can influence core temperature, with cold/icy beverages of potential use before and during exertional heat stress, while use of menthol can alter thermal sensation. Practical challenges in supporting athletes in teams and traveling for competition require careful planning. Finally, specific athletic population groups have unique nutritional needs in the context of exertional heat stress (i.e., youth, endurance/ultra-endurance athletes, and para-sport athletes), and specific adjustments to nutrition strategies should be made for these population groups.
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19
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Kamran F, Le VC, Frischknecht A, Wiens J, Sienko KH. Noninvasive Estimation of Hydration Status in Athletes Using Wearable Sensors and a Data-Driven Approach Based on Orthostatic Changes. SENSORS (BASEL, SWITZERLAND) 2021; 21:4469. [PMID: 34210068 PMCID: PMC8271939 DOI: 10.3390/s21134469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 02/05/2023]
Abstract
Dehydration beyond 2% bodyweight loss should be monitored to reduce the risk of heat-related injuries during exercise. However, assessments of hydration in athletic settings can be limited in their accuracy and accessibility. In this study, we sought to develop a data-driven noninvasive approach to measure hydration status, leveraging wearable sensors and normal orthostatic movements. Twenty participants (10 males, 25.0 ± 6.6 years; 10 females, 27.8 ± 4.3 years) completed two exercise sessions in a heated environment: one session was completed without fluid replacement. Before and after exercise, participants performed 12 postural movements that varied in length (up to 2 min). Logistic regression models were trained to estimate dehydration status given their heart rate responses to these postural movements. The area under the receiver operating characteristic curve (AUROC) was used to parameterize the model's discriminative ability. Models achieved an AUROC of 0.79 (IQR: 0.75, 0.91) when discriminating 2% bodyweight loss. The AUROC for the longer supine-to-stand postural movements and shorter toe-touches were similar (0.89, IQR: 0.89, 1.00). Shorter orthostatic tests achieved similar accuracy to clinical tests. The findings suggest that data from wearable sensors can be used to accurately estimate mild dehydration in athletes. In practice, this method may provide an additional measurement for early intervention of severe dehydration.
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Affiliation(s)
- Fahad Kamran
- Division of Computer Science and Engineering, University of Michigan College of Engineering, Ann Arbor, MI 48109, USA; (F.K.); (J.W.)
| | - Victor C. Le
- Department of Mechanical Engineering, University of Michigan College of Engineering, Ann Arbor, MI 48109, USA;
| | | | - Jenna Wiens
- Division of Computer Science and Engineering, University of Michigan College of Engineering, Ann Arbor, MI 48109, USA; (F.K.); (J.W.)
| | - Kathleen H. Sienko
- Department of Mechanical Engineering, University of Michigan College of Engineering, Ann Arbor, MI 48109, USA;
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20
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Périard JD, Eijsvogels TMH, Daanen HAM. Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies. Physiol Rev 2021; 101:1873-1979. [PMID: 33829868 DOI: 10.1152/physrev.00038.2020] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.
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Affiliation(s)
- Julien D Périard
- University of Canberra Research Institute for Sport and Exercise, Bruce, Australia
| | - Thijs M H Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hein A M Daanen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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21
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Bouscaren N, Faricier R, Millet GY, Racinais S. Heat Acclimatization, Cooling Strategies, and Hydration during an Ultra-Trail in Warm and Humid Conditions. Nutrients 2021; 13:1085. [PMID: 33810371 PMCID: PMC8065615 DOI: 10.3390/nu13041085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to assess the history of exertional heat illness (EHI), heat preparation, cooling strategies, heat related symptoms, and hydration during an ultra-endurance running event in a warm and humid environment. This survey-based study was open to all people who participated in one of the three ultra-endurance races of the Grand Raid de la Réunion. Ambient temperature and relative humidity were 18.6 ± 5.7 °C (max = 29.7 °C) and 74 ± 17%, respectively. A total of 3317 runners (56% of the total eligible population) participated in the study. Overall, 78% of the runners declared a history of heat-related symptoms while training or competing, and 1.9% reported a previous diagnosis of EHI. Only 24.3% of study participants living in temperate climates declared having trained in the heat before the races, and 45.1% of all respondents reported a cooling strategy during the races. Three quarter of all participants declared a hydration strategy. The planned hydration volume was 663 ± 240 mL/h. Fifty-nine percent of the runners had enriched their food or drink with sodium during the race. The present study shows that ultra-endurance runners have a wide variability of hydration and heat preparation strategies. Understandings of heat stress repercussions in ultra-endurance running need to be improved by specific field research.
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Affiliation(s)
- Nicolas Bouscaren
- Inserm CIC1410, CHU Réunion, 97448 Saint Pierre, France
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
| | - Robin Faricier
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
| | - Guillaume Y. Millet
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
- Institut Universitaire de France (IUF), 75231 Paris, France
| | - Sébastien Racinais
- Research and Scientific Support Department, Aspetar Orthopedic and Sports Medicine Hospital, Doha 29222, Qatar;
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Morris NB, Jay O, Flouris AD, Casanueva A, Gao C, Foster J, Havenith G, Nybo L. Sustainable solutions to mitigate occupational heat strain - an umbrella review of physiological effects and global health perspectives. Environ Health 2020; 19:95. [PMID: 32887627 PMCID: PMC7487490 DOI: 10.1186/s12940-020-00641-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 08/12/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Climate change is set to exacerbate occupational heat strain, the combined effect of environmental and internal heat stress on the body, threatening human health and wellbeing. Therefore, identifying effective, affordable, feasible and sustainable solutions to mitigate the negative effects on worker health and productivity, is an increasingly urgent need. OBJECTIVES To systematically identify and evaluate methods that mitigate occupational heat strain in order to provide scientific-based guidance for practitioners. METHODS An umbrella review was conducted in biomedical databases employing the following eligibility criteria: 1) ambient temperatures > 28 °C or hypohydrated participants, 2) healthy adults, 3) reported psychophysiological (thermal comfort, heart rate or core temperature) and/or performance (physical or cognitive) outcomes, 4) written in English, and 5) published before November 6, 2019. A second search for original research articles was performed to identify interventions of relevance but lacking systematic reviews. All identified interventions were independently evaluated by all co-authors on four point scales for effectiveness, cost, feasibility and environmental impact. RESULTS Following screening, 36 systematic reviews fulfilled the inclusion criteria. The most effective solutions at mitigating occupational heat strain were wearing specialized cooling garments, (physiological) heat acclimation, improving aerobic fitness, cold water immersion, and applying ventilation. Although air-conditioning and cooling garments in ideal settings provide best scores for effectiveness, the limited applicability in certain industrial settings, high economic cost and high environmental impact are drawbacks for these solutions. However, (physiological) acclimatization, planned breaks, shading and optimized clothing properties are attractive alternative solutions when economic and ecological sustainability aspects are included in the overall evaluation. DISCUSSION Choosing the most effective solution or combinations of methods to mitigate occupational heat strain will be scenario-specific. However, this paper provides a framework for integrating effectiveness, cost, feasibility (indoors and outdoor) and ecologic sustainability to provide occupational health and safety professionals with evidence-based guidelines.
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Affiliation(s)
- Nathan B. Morris
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Denmark
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Andreas D. Flouris
- FAME Laboratory, School of Exercise Science, University of Thessaly, Thessaly, Greece
| | - Ana Casanueva
- Federal Office of Meteorology and Climatology, MeteoSwiss, Zurich Airport, Zurich, Switzerland
- Meteorology Group, Department of Applied Mathematics and Computer Sciences, University of Cantabria, Santander, Spain
| | - Chuansi Gao
- Thermal Environment Laboratory, Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering, Lund University, Lund, Sweden
| | - Josh Foster
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Denmark
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O’Neal E, Boy T, Davis B, Pritchett K, Pritchett R, Nepocatych S, Black K. Post-Exercise Sweat Loss Estimation Accuracy of Athletes and Physically Active Adults: A Review. Sports (Basel) 2020; 8:sports8080113. [PMID: 32796724 PMCID: PMC7466670 DOI: 10.3390/sports8080113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/29/2020] [Accepted: 08/05/2020] [Indexed: 11/22/2022] Open
Abstract
The main purposes of this review were to provide a qualitative description of nine investigations in which sweat losses were estimated by participants following exercise and to perform a quantitative analysis of the collective data. Unique estimations (n = 297) were made by 127 men and 116 women after a variety of exercise modalities in moderate to hot environmental conditions. Actual sweat loss exceeded estimated sweat loss (p < 0.001) for women (1.072 ± 0.473 vs. 0.481 ± 0.372 L), men (1.778 ± 0.907 vs. 0.908 ± 0.666 L) and when all data were combined (1.428 ± 0.806 vs. 0.697 ± 0.581 L), respectively. However, estimation accuracy did not differ between women (55.2 ± 51.5%) and men (62.4 ± 54.5%). Underestimation of 50% or more of sweat losses were exhibited in 168 (54%) of estimation scenarios with heavier sweaters displaying a higher prevalence and trend of greater underestimations in general. Most modern guidelines for fluid intake during and between training bouts are based on approximate sweat loss estimation knowledge. These guidelines will likely have minimal efficacy if greater awareness of how to determine sweat losses and accurate recognition of sweat losses is not increased by coaches and athletes.
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Affiliation(s)
- Eric O’Neal
- Department of Kinesiology, University of North Alabama, Florence, AL 35633, USA;
- Correspondence:
| | - Tara Boy
- Department of Kinesiology, University of North Alabama, Florence, AL 35633, USA;
| | - Brett Davis
- Department of Kinesiology, Auburn University at Montgomery, Montgomery, AL 36166, USA;
| | - Kelly Pritchett
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA; (K.P.); (R.P.)
| | - Robert Pritchett
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA; (K.P.); (R.P.)
| | | | - Katherine Black
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand;
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24
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James LJ, Funnell MP, James RM, Mears SA. Does Hypohydration Really Impair Endurance Performance? Methodological Considerations for Interpreting Hydration Research. Sports Med 2020; 49:103-114. [PMID: 31696453 PMCID: PMC6901416 DOI: 10.1007/s40279-019-01188-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The impact of alterations in hydration status on human physiology and performance responses during exercise is one of the oldest research topics in sport and exercise nutrition. This body of work has mainly focussed on the impact of reduced body water stores (i.e. hypohydration) on these outcomes, on the whole demonstrating that hypohydration impairs endurance performance, likely via detrimental effects on a number of physiological functions. However, an important consideration, that has received little attention, is the methods that have traditionally been used to investigate how hypohydration affects exercise outcomes, as those used may confound the results of many studies. There are two main methodological limitations in much of the published literature that perhaps make the results of studies investigating performance outcomes difficult to interpret. First, subjects involved in studies are generally not blinded to the intervention taking place (i.e. they know what their hydration status is), which may introduce expectancy effects. Second, most of the methods used to induce hypohydration are both uncomfortable and unfamiliar to the subjects, meaning that alterations in performance may be caused by this discomfort, rather than hypohydration per se. This review discusses these methodological considerations and provides an overview of the small body of recent work that has attempted to correct some of these methodological issues. On balance, these recent blinded hydration studies suggest hypohydration equivalent to 2–3% body mass decreases endurance cycling performance in the heat, at least when no/little fluid is ingested.
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Affiliation(s)
- Lewis J James
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
| | - Mark P Funnell
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Ruth M James
- Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Stephen A Mears
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
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25
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Bennett BL, Hew-Butler T, Rosner MH, Myers T, Lipman GS. Wilderness Medical Society Clinical Practice Guidelines for the Management of Exercise-Associated Hyponatremia: 2019 Update. Wilderness Environ Med 2020; 31:50-62. [PMID: 32044213 DOI: 10.1016/j.wem.2019.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 11/07/2019] [Accepted: 11/13/2019] [Indexed: 11/25/2022]
Abstract
Exercise-associated hyponatremia (EAH) is defined by a serum or plasma sodium concentration below the normal reference range of 135 mmol·L-1 that occurs during or up to 24 h after prolonged physical activity. It is reported to occur in individual physical activities or during organized endurance events conducted in environments in which medical care is limited and often not available, and patient evacuation to definitive care is often greatly delayed. Rapid recognition and appropriate treatment are essential in the severe form to increase the likelihood of a positive outcome. To mitigate the risk of EAH mismanagement, care providers in the prehospital and in hospital settings must differentiate from other causes that present with similar signs and symptoms. EAH most commonly has overlapping signs and symptoms with heat exhaustion and exertional heat stroke. Failure in this regard is a recognized cause of worsened morbidity and mortality. In an effort to produce best practice guidelines for EAH management, the Wilderness Medical Society convened an expert panel in May 2018. The panel was charged with updating the WMS Practice Guidelines for Treatment of Exercise-Associated Hyponatremia published in 2014 using evidence-based guidelines for the prevention, recognition, and treatment of EAH. Recommendations are made based on presenting with symptomatic EAH, particularly when point-of-care blood sodium testing is unavailable in the field. These recommendations are graded on the basis of the quality of supporting evidence and balanced between the benefits and risks/burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians.
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Affiliation(s)
- Brad L Bennett
- Military & Emergency Medicine Department, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD.
| | - Tamara Hew-Butler
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI
| | - Mitchell H Rosner
- Division of Nephrology, University of Virginia Health System, Charlottesville, VA
| | - Thomas Myers
- Grand Canyon National Park, Branch of Emergency Services, Grand Canyon, AZ
| | - Grant S Lipman
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA
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26
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Pryor JL, Johnson EC, Yoder HA, Looney DP. Keeping Pace: A Practitioner-Focused Review of Pacing Strategies in Running. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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27
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Ad libitum water consumption off-sets the thermal and cardiovascular strain exacerbated by dehydration during a 3-h simulated heatwave. Eur J Appl Physiol 2019; 120:391-399. [DOI: 10.1007/s00421-019-04283-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/02/2019] [Indexed: 12/14/2022]
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28
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Impact of Pre-exercise Hypohydration on Aerobic Exercise Performance, Peak Oxygen Consumption and Oxygen Consumption at Lactate Threshold: A Systematic Review with Meta-analysis. Sports Med 2019; 50:581-596. [DOI: 10.1007/s40279-019-01223-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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29
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Effect of Thirst-Driven Fluid Intake on 1 H Cycling Time-Trial Performance in Trained Endurance Athletes. Sports (Basel) 2019; 7:sports7100223. [PMID: 31615028 PMCID: PMC6835292 DOI: 10.3390/sports7100223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/01/2019] [Accepted: 10/08/2019] [Indexed: 11/16/2022] Open
Abstract
A meta-analysis demonstrated that programmed fluid intake (PFI) aimed at fully replacing sweat losses during a 1 h high-intensity cycling exercise impairs performance compared with no fluid intake (NFI). It was reported that thirst-driven fluid intake (TDFI) may optimize cycling performance, compared with when fluid is consumed more than thirst dictates. However, how TDFI, compared with PFI and NFI, impacts performance during a 1 h cycling time-trial performance remains unknown. The aim of this study was to compare the effect of NFI, TDFI and PFI on 1 h cycling time-trial performance. Using a randomized, crossover and counterbalanced protocol, 9 (7 males and 2 females) trained endurance athletes (30 ± 9 years; Peak V · O2∶ 59 ± 8 mL·kg-1·min-1) completed three 1 h cycling time-trials (30 °C, 50% RH) with either NFI, TDFI or PFI designed to maintain body mass (BM) at ~0.5% of pre-exercise BM. Body mass loss reached 2.9 ± 0.4, 2.2 ± 0.3 and 0.6 ± 0.2% with NFI, TDFI and PFI, respectively. Heart rate, rectal and mean skin temperatures and ratings of perceived exertion and of abdominal discomfort diverged marginally among trials. Mean distance completed (NFI: 35.6 ± 1.9 km; TDFI: 35.8 ± 2.0; PFI: 35.7 ± 2.0) and, hence, average power output maintained during the time-trials did not significantly differ among trials, and the impact of both PFI and TDFI vs. NFI was deemed trivial or unclear. These findings indicate that neither PFI nor TDFI are likely to offer any advantage over NFI during a 1 h cycling time-trial.
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30
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Response to Armstrong and Bergeron. Eur J Appl Physiol 2019; 119:1453-1454. [PMID: 30900028 DOI: 10.1007/s00421-019-04121-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
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