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Peltonen JE, Leppävuori A, Lehtonen E, Mikkonen RS, Kettunen O, Nummela A, Ohtonen O, Gagnon DD, Wehrlin JP, Wilber RL, Linnamo V. Combined intermittent hypoxic exposure at rest and continuous hypoxic training can maintain elevated hemoglobin mass after a hypoxic camp. J Appl Physiol (1985) 2024; 137:409-420. [PMID: 38961820 DOI: 10.1152/japplphysiol.00017.2024] [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: 01/08/2024] [Revised: 06/20/2024] [Accepted: 07/01/2024] [Indexed: 07/05/2024] Open
Abstract
Athletes use hypoxic living and training to increase hemoglobin mass (Hbmass), but Hbmass declines rapidly upon return to sea level. We investigated whether intermittent hypoxic exposure (IHE) + continuous hypoxic training (CHT) after return to sea level maintained elevated Hbmass, and if changes in Hbmass were transferred to changes in maximal oxygen uptake (V̇o2max) and exercise performance. Hbmass was measured in 58 endurance athletes before (PRE), after (POST1), and 30 days after (POST2) a 27 ± 4-day training camp in hypoxia (n = 44, HYP) or at sea level (n = 14, SL). After returning to sea level, 22 athletes included IHE (2 h rest) + CHT (1 h training) in their training every third day for 1 mo (HYPIHE + CHT), whereas the other 22 HYP athletes were not exposed to IHE or CHT (HYPSL). Hbmass increased from PRE to POST1 in both HYPIHE + CHT (4.4 ± 0.7%, means ± SE) and HYPSL (4.1 ± 0.6%) (both P < 0.001). Compared with PRE, Hbmass at POST2 remained 4.2 ± 0.8% higher in HYPIHE + CHT (P < 0.001) and 1.9 ± 0.5% higher in HYPSL (P = 0.023), indicating a significant difference between the groups (P = 0.002). In SL, no significant changes were observed in Hbmass with mean alterations between -0.5% and 0.4%. V̇o2max and time to exhaustion during an incremental treadmill test (n = 35) were elevated from PRE to POST2 only in HYPIHE + CHT (5.8 ± 1.2% and 5.4 ± 1.4%, respectively, both P < 0.001). IHE + CHT possesses the potential to mitigate the typical decline in Hbmass commonly observed during the initial weeks after return to sea level.NEW & NOTEWORTHY Sets of 2-h intermittent hypoxic exposure + 1-h continuous hypoxic training, every third day, possess the potential to mitigate the typical decline in Hbmass that is commonly observed during the initial weeks after return to sea level from an altitude camp. Inclusion of IHE + CHT in the training regimen was also accompanied by improvements in V̇o2max and exercise performance in most but not all Tier 3-Tier 5 level endurance athletes during the training season.
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Affiliation(s)
- Juha E Peltonen
- Helsinki Sports and Exercise Medicine Clinic (HULA), Foundation for Sports and Exercise Medicine, Helsinki, Finland
- Sports and Exercise Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Antti Leppävuori
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Elias Lehtonen
- Helsinki Sports and Exercise Medicine Clinic (HULA), Foundation for Sports and Exercise Medicine, Helsinki, Finland
- Sports and Exercise Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ritva S Mikkonen
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Oona Kettunen
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Ari Nummela
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland
| | - Olli Ohtonen
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Dominique D Gagnon
- Helsinki Sports and Exercise Medicine Clinic (HULA), Foundation for Sports and Exercise Medicine, Helsinki, Finland
- Sports and Exercise Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jon P Wehrlin
- Section for Elite Sport, Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland
| | - Randall L Wilber
- United States Olympic & Paralympic Committee (USOPC), Colorado Springs, Colorado, United States
| | - Vesa Linnamo
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
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2
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Scott JM, Deuster PA. Role of nutrition in human performance in military populations. BMJ Mil Health 2024; 170:415-419. [PMID: 36792226 DOI: 10.1136/military-2022-002311] [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: 11/08/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
The role of nutrition and performance is well established. Service members' physical and cognitive performance, sleep and mood are impacted by nutritional choices. Although many eating patterns have emerged, consensus among experts recommend a dietary pattern focused on predominantly whole plant-based foods. Adequate intakes of fruits, vegetables, whole grains, beans, legumes, nuts and seeds should be prioritised. Implementation of strategic and intentional fuelling strategies around times of activity maintain adequate energy stores, enhance recovery and protect against training injuries. Carbohydrates are prioritised before, during and after activity or a mission, although the type and amount will vary based on duration and intensity of activity. Protein is generally the focus after activity or a mission and may be included before activity depending on individual tolerance. There are no specific recommendations for fat consumption before, during and after exercise that will improve performance. That said, Service members generally tolerate low-fat meals/snacks prior to exercise, limit fat intake during exercise, may include fat as part of the post exercise meal/snack, and generally consume most fat during the maintenance and growth phase. Careful consideration and planning for food and fluid requirements should be made when Service members are exposed to heat, cold and/or altitude. Operational rations are formulated to meet the nutritional needs of all Service members across a variety of diverse climates, environments and altitudes. Service members may use dietary supplements to improve their performance and need to be aware of available resources to help them make informed decisions.
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Affiliation(s)
- Jonathan M Scott
- Consortium for Health and Military Performance, Military and Emergency Medicine, Uniformed Services University, Bethesda, MD, USA
| | - P A Deuster
- Consortium for Health and Military Performance, Military and Emergency Medicine, Uniformed Services University, Bethesda, MD, USA
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3
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Fensham N, McKay AKA, Sim M, Peeling P. Parenteral Iron Therapy: Examining Current Evidence for Use in Athletes. Int J Sports Med 2024; 45:496-503. [PMID: 37963599 DOI: 10.1055/a-2211-0813] [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: 11/16/2023]
Abstract
A high prevalence of iron deficiency exists in athlete populations. Various mechanisms, including increased losses through sweat, haemolysis, haematuria, and gastrointestinal micro-ischemia; inadequate dietary intake; and transient exercise-induced increases in the regulatory hormone, hepcidin, contribute to the increased prevalence in athletes. Indeed, hepcidin has been shown to peak around 3-6 hours post-exercise, limiting iron absorption from the gut. As the practitioner's ability to control losses is limited, the key to treatment of iron deficiency in athletes is optimal timing of dietary and oral iron supplementation around these periods of reduced gut absorption. While timing and dosing schedule strategies might be sufficient to treat iron deficiency non-anaemia, the significant lag to impact iron status is relatively long. Therefore, in iron deficiency anaemia, the use of parenteral iron has the benefit of rapid repletion of iron stores and normalisation of haemoglobin status, while bypassing the action of hepcidin at the gut. Furthermore, newer intravenous formulations can be administered as a single total dose over 15-60 min and have a similar safety profile to oral treatment. This review discusses the existing evidence for parenteral iron use in athletes and the unique context for consideration when choosing the parenteral route in this population.
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Affiliation(s)
- Nikita Fensham
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Alannah Kelly Anne McKay
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Medical School, The University of Western Australia, Perth, Australia
| | - Peter Peeling
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Australia
- Western Australian Institute of Sport, Mt Claremont, Australia
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Santangelo C, Verratti V, Mrakic-Sposta S, Ciampini F, Bonan S, Pignatelli P, Pietrangelo T, Pilato S, Moffa S, Fontana A, Piccinelli R, Donne CL, Lobefalo L, Beccatelli M, Rizzini PL, Seletti D, Mecca R, Beccatelli T, Bondi D. Nutritional physiology and body composition changes during a rapid ascent to high altitude. Appl Physiol Nutr Metab 2024; 49:723-737. [PMID: 38320257 DOI: 10.1139/apnm-2023-0338] [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] [Indexed: 02/08/2024]
Abstract
Exposure to high altitude might cause the body to adapt with negative energy and fluid balance that compromise body composition and physical performance. In this field study involving 12 healthy adults, sex-balanced, and aged 29 ± 4 years with a body mass index of 21.6 ± 1.8 kg/m2, we investigated the effects of a 4-day trekking up to 4556 m a.s.l. on Monte Rosa (Alps, Italy). The food intake was recorded using food diaries and nutrient averages were calculated. The bio-impedance analysis was performed at low and high altitudes, and a wearable biosensor (Swemax) was used to track hydro-saline losses in two participants. Daily total energy intake was 3348 ± 386 kcal for males and 2804 ± 415 kcal for females (13%-14% protein, 35% fat, 44%-46% carbohydrates). Although there was a significant body weight loss (65.0 ± 9.3 vs. 64.2 ± 9.10 kg, p < 0.001, d = 1.398), no significant changes in body composition parameter were found but a trend in the increase of the bioelectrical phase angle in males (p = 0.059, d = -0.991). Body water percentage significantly changed (p = 0.026, η2 p = 0.440), but the absolute water did not, suggesting that the weight loss was not due to water loss. Salivary and urinary osmolality did not change. A reduction in sweat rate at higher altitudes was observed in both participants. Interestingly, salivary leptin increased (p = 0.014, η2 p = 0.510), and salivary ghrelin decreased (p = 0.036, η2 p = 0.403). Therefore, the 4-day trekking at altitude of hypoxia exposure induced changes in satiety and appetite hormones. High altitude expeditions require more specific nutritional guidance, and using multiplex analysis could help in monitoring fluid balance and body composition.
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Affiliation(s)
- Carmen Santangelo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Simona Mrakic-Sposta
- Institute of Clinical Physiology, National Research Council (ICF-CNR), Milano, Italy
| | - Federica Ciampini
- School of Medicine and Health Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Sofia Bonan
- School of Medicine and Health Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Pamela Pignatelli
- Department of Medical and Oral Sciences and Biotechnologies, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Serena Pilato
- Department of Pharmacy, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Samanta Moffa
- Department of Pharmacy, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Antonella Fontana
- Department of Pharmacy, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Raffaela Piccinelli
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Roma, Italy
| | - Cinzia Le Donne
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Roma, Italy
| | - Lucio Lobefalo
- Department of Medical and Oral Sciences and Biotechnologies, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | | | | | | | | | | | - Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
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5
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Burtscher J, Pasha Q, Chanana N, Millet GP, Burtscher M, Strasser B. Immune consequences of exercise in hypoxia: A narrative review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:297-310. [PMID: 37734549 PMCID: PMC11116970 DOI: 10.1016/j.jshs.2023.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Abstract
Immune outcomes are key mediators of many health benefits of exercise and are determined by exercise type, dose (frequency/duration, intensity), and individual characteristics. Similarly, reduced availability of ambient oxygen (hypoxia) modulates immune functions depending on the hypoxic dose and the individual capacity to respond to hypoxia. How combined exercise and hypoxia (e.g., high-altitude training) sculpts immune responses is not well understood, although such combinations are becoming increasingly popular. Therefore, in this paper, we summarize the impact on immune responses of exercise and of hypoxia, both independently and together, with a focus on specialized cells in the innate and adaptive immune system. We review the regulation of the immune system by tissue oxygen levels and the overlapping and distinct immune responses related to exercise and hypoxia, then we discuss how they may be modulated by nutritional strategies. Mitochondrial, antioxidant, and anti-inflammatory mechanisms underlie many of the adaptations that can lead to improved cellular metabolism, resilience, and overall immune functions by regulating the survival, differentiation, activation, and migration of immune cells. This review shows that exercise and hypoxia can impair or complement/synergize with each other while regulating immune system functions. Appropriate acclimatization, training, and nutritional strategies can be used to avoid risks and tap into the synergistic potentials of the poorly studied immune consequences of exercising in a hypoxic state.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne 1015, Switzerland
| | - Qadar Pasha
- Institute of Hypoxia Research, New Delhi 110067, India
| | - Neha Chanana
- Department of Biochemistry, Jamia Hamdard, New Delhi 110062, India
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne 1015, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck 6020, Austria.
| | - Barbara Strasser
- Faculty of Medicine, Sigmund Freud Private University, Vienna 1020, Austria; Ludwig Boltzmann Institute for Rehabilitation Research, Vienna 1100, Austria
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Burtscher J, Raberin A, Brocherie F, Malatesta D, Manferdelli G, Citherlet T, Krumm B, Bourdillon N, Antero J, Rasica L, Burtscher M, Millet GP. Recommendations for Women in Mountain Sports and Hypoxia Training/Conditioning. Sports Med 2024; 54:795-811. [PMID: 38082199 PMCID: PMC11052836 DOI: 10.1007/s40279-023-01970-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 04/28/2024]
Abstract
The (patho-)physiological responses to hypoxia are highly heterogeneous between individuals. In this review, we focused on the roles of sex differences, which emerge as important factors in the regulation of the body's reaction to hypoxia. Several aspects should be considered for future research on hypoxia-related sex differences, particularly altitude training and clinical applications of hypoxia, as these will affect the selection of the optimal dose regarding safety and efficiency. There are several implications, but there are no practical recommendations if/how women should behave differently from men to optimise the benefits or minimise the risks of these hypoxia-related practices. Here, we evaluate the scarce scientific evidence of distinct (patho)physiological responses and adaptations to high altitude/hypoxia, biomechanical/anatomical differences in uphill/downhill locomotion, which is highly relevant for exercising in mountainous environments, and potentially differential effects of altitude training in women. Based on these factors, we derive sex-specific recommendations for mountain sports and intermittent hypoxia conditioning: (1) Although higher vulnerabilities of women to acute mountain sickness have not been unambiguously shown, sex-dependent physiological reactions to hypoxia may contribute to an increased acute mountain sickness vulnerability in some women. Adequate acclimatisation, slow ascent speed and/or preventive medication (e.g. acetazolamide) are solutions. (2) Targeted training of the respiratory musculature could be a valuable preparation for altitude training in women. (3) Sex hormones influence hypoxia responses and hormonal-cycle and/or menstrual-cycle phases therefore may be factors in acclimatisation to altitude and efficiency of altitude training. As many of the recommendations or observations of the present work remain partly speculative, we join previous calls for further quality research on female athletes in sports to be extended to the field of altitude and hypoxia.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Antoine Raberin
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Franck Brocherie
- Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport, Paris, France
| | - Davide Malatesta
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Giorgio Manferdelli
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Tom Citherlet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Bastien Krumm
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Nicolas Bourdillon
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Juliana Antero
- Institut de Recherche Bio-Médicale Et d'Épidémiologie du Sport (EA 7329), French Institute of Sport, Paris, France
| | - Letizia Rasica
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Grégoire P Millet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland.
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Xiao J, Guo X, Wang Z. Crosstalk between hypoxia-inducible factor-1α and short-chain fatty acids in inflammatory bowel disease: key clues toward unraveling the mystery. Front Immunol 2024; 15:1385907. [PMID: 38605960 PMCID: PMC11007100 DOI: 10.3389/fimmu.2024.1385907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
The human intestinal tract constitutes a complex ecosystem, made up of countless gut microbiota, metabolites, and immune cells, with hypoxia being a fundamental environmental characteristic of this ecology. Under normal physiological conditions, a delicate balance exists among these complex "residents", with disruptions potentially leading to inflammatory bowel disease (IBD). The core pathology of IBD features a disrupted intestinal epithelial barrier, alongside evident immune and microecological disturbances. Central to these interconnected networks is hypoxia-inducible factor-1α (HIF-1α), which is a key regulator in gut cells for adapting to hypoxic conditions and maintaining gut homeostasis. Short-chain fatty acids (SCFAs), as pivotal gut metabolites, serve as vital mediators between the host and microbiota, and significantly influence intestinal ecosystem. Recent years have seen a surge in research on the roles and therapeutic potential of HIF-1α and SCFAs in IBD independently, yet reviews on HIF-1α-mediated SCFAs regulation of IBD under hypoxic conditions are scarce. This article summarizes evidence of the interplay and regulatory relationship between SCFAs and HIF-1α in IBD, pivotal for elucidating the disease's pathogenesis and offering promising therapeutic strategies.
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Affiliation(s)
- Jinyin Xiao
- Graduate School, Hunan University of Traditional Chinese Medicine, Changsha, China
- Department of Anorectal, the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, China
| | - Xiajun Guo
- Department of Geriatric, the First People’s Hospital of Xiangtan City, Xiangtan, China
| | - Zhenquan Wang
- Department of Anorectal, the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, China
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Andjelkovic M, Paal P, Kriemler S, Mateikaite-Pipiriene K, Rosier A, Beidleman BA, Derstine M, Pichler Hefti J, Hillebrandt D, Horakova L, Jean D, Keyes LE. Nutrition in Women at High Altitude: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2024; 25:9-15. [PMID: 37971430 DOI: 10.1089/ham.2023.0047] [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] [Indexed: 11/19/2023] Open
Abstract
Andjelkovic, Marija, Peter Paal, Susi Kriemler, Kaste Mateikaite-Pipiriene, Alison Rosier, Beth Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, Lenka Horakova, Dominique Jean, and Linda E. Keyes. Nutrition in women at high altitude: a scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 25:9-15, 2024. Background: Nutritional concerns such as food composition, energy intake, and nutrient absorption are essential for performance at high altitude and may differ between men and women. We performed a scoping review to summarize what is currently known on nutrition for women during short-term, high-altitude, physically active sojourns. Methods: The UIAA Medical Commission convened an international team to review women's health issues at high altitude and to publish updated recommendations. Pertinent literature from PubMed and Cochrane was identified by keyword search combinations (including nutrition, metabolism, energy composition, micronutrients) with additional publications found by hand search. Results: We found 7,165 articles, of which 13 original articles assessed nutritional aspects in physically active women on short-term high-altitude sojourns, with other articles found by hand search. We summarize the main findings. Conclusions: Data on women's nutrition at altitude are very limited. Reduction in energy intake plus increased energy expenditure at high altitude can lead to unbalanced nutrition, negatively influencing high-altitude adaptation and physical performance. Therefore, adequate dietary and fluid intake is essential to maintaining energy balance and hydration at high altitude in women as in men. Iron supplementation should be considered for women with iron depletion before travel.
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Affiliation(s)
- Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Institute of Pharmacy, Singidunum University, Belgrade, Serbia
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Kaste Mateikaite-Pipiriene
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Dialysis Clinic, Elektrėnai, Lithuania
| | - Alison Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Beth A Beidleman
- U.S. Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massachusetts, USA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | - Jacqueline Pichler Hefti
- Swiss Sportclinic, Bern, Switzerland
- Department of Internal Medicine, Hospital Biel/Bienne, Biel, Switzerland
| | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, Devon
| | - Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anaesthesiology, Perioperative and Intensive Care, Masaryk Hospital, Usti nad Labem, Czech Republic
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Paediatrics, Infectious Diseases and Altitude Medicine, Grenoble, France
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
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Saenz C, Jordan A, Loriz L, Schill K, Colletto M, Rodriguez J. Low Energy Intake Leads to Body Composition and Performance Decrements in a Highly-Trained, Female Athlete: The WANDER (Woman's Activity and Nutrition during an Extensive Hiking Route) Case Study. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:296-303. [PMID: 38019616 DOI: 10.1080/27697061.2023.2282614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE This case study's purpose was to quantify energy intake vs energy expenditure during a thru-hiker's trek and assess its relationship to performance and health. METHODS A highly trained, female thru-hiker (Age (yrs): 62, Ht (cm): 157, Wt (kg): 53.5, BMI (kg/m2): 21.7, %BF: 26.0) embarked on a 4-month journey through the Pacific Crest Trail, USA. The athlete's body composition and 3-day diet record were assessed before (PRE) and after the hike (POST). During the hike, she tracked her diet and performance daily and completed a wellness survey each time she reached a town-check point. Data were analyzed for descriptive (weekly averages, means ± SD) and frequency statistics. RESULTS She spent 10 wk (∼70 days) on the trail and hiked 1,506.35 km (26.1 ± 3.2 km/day) with an estimated energy expenditure of ∼2334 ± 351 kcal/day. During the hike, she under consumed calories (1285.3 ± 103 kcal) and dietary carbohydrate (169.5 ± 19.5g), fat (49.7 ± 5.8g), protein (41.9 ± 4.8g; 0.8 g/kg), fiber (11.8 ± 2.1g) and sodium (1642.4 ± 298.6 mg) when compared to ultra-endurance nutrition recommendations. She was unable to complete the trail due to fatigue and anthropometric changes. By POST, she had decreased total mass (PRE: 53.5 kg vs POST: 48.4 kg), BMI (PRE 21.6 vs POST: 19.5), fat-free mass (PRE: 39.6 vs POST: 38.8), and body fat (PRE: 26% vs POST: 19.6%) when compared to PRE. CONCLUSION Trail-related challenges combined with high energy expenditures led to low nutrient intake which contributed to trail-ending injuries and performance decrements. Research aimed at addressing the barriers associated with thru-hike fueling is needed to identify nutritional opportunities to support hikers' performance and reduce injury risks.
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Affiliation(s)
- Catherine Saenz
- Exercise Science-Kinesiology Program, Department of Human Sciences, Ohio State University, Columbus, Ohio, USA
| | - Aydan Jordan
- Exercise Science-Kinesiology Program, Department of Human Sciences, Ohio State University, Columbus, Ohio, USA
| | - Lillia Loriz
- School of Nursing, Brooks College of Health, University of North Florida, Jacksonville, Florida, USA
| | | | | | - Judith Rodriguez
- Department of Nutrition & Dietetics, Brooks College of Health, University of North Florida, Jacksonville, Florida, USA
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Martín-Rodríguez A, Belinchón-deMiguel P, Rubio-Zarapuz A, Tornero-Aguilera JF, Martínez-Guardado I, Villanueva-Tobaldo CV, Clemente-Suárez VJ. Advances in Understanding the Interplay between Dietary Practices, Body Composition, and Sports Performance in Athletes. Nutrients 2024; 16:571. [PMID: 38398895 PMCID: PMC10892519 DOI: 10.3390/nu16040571] [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: 01/19/2024] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
The dietary practices of athletes play a crucial role in shaping their body composition, influencing sports performance, training adaptations, and overall health. However, despite the widely acknowledged significance of dietary intake in athletic success, there exists a gap in our understanding of the intricate relationships between nutrition, body composition, and performance. Furthermore, emerging evidence suggests that many athletes fail to adopt optimal nutritional practices, which can impede their potential achievements. In response, this Special Issue seeks to gather research papers that delve into athletes' dietary practices and their potential impacts on body composition and sports performance. Additionally, studies focusing on interventions aimed at optimizing dietary habits are encouraged. This paper outlines the key aspects and points that will be developed in the ensuing articles of this Special Issue.
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Affiliation(s)
- Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (A.M.-R.); (A.R.-Z.); (V.J.C.-S.)
| | - Pedro Belinchón-deMiguel
- Faculty of Biomedical and Health Sciences, Department of Nursing and Nutrition, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
| | - Alejandro Rubio-Zarapuz
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (A.M.-R.); (A.R.-Z.); (V.J.C.-S.)
| | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (A.M.-R.); (A.R.-Z.); (V.J.C.-S.)
| | - Ismael Martínez-Guardado
- Faculty of Health Sciences, Camilo José Cela University, C. Castillo de Alarcón, 49, Villafranca del Castillo, 28692 Madrid, Spain;
| | | | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (A.M.-R.); (A.R.-Z.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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11
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Urdampilleta Otegui A, Roche Collado E. Intermittent hypoxia in sport nutrition, performance, health status and body composition. NUTR HOSP 2024; 41:224-229. [PMID: 38095103 DOI: 10.20960/nh.04692] [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] [Indexed: 02/16/2024] Open
Abstract
Introduction Intermittent hypoxia refers to the discontinuous use of low oxygen levels in normobaric environment. These conditions can be reproduced in hypoxic tents or chambers while the individual is training in different physical activity protocols. Intermittent hypoxia can affect several body systems, impacting nutrition, physical performance, health status and body composition. Therefore, it is necessary to assess protocols, regarding time and frequency of exposure, passive exposure or training in hypoxia, and the simulated altitude. At the molecular level, the hypoxia-inducible factor-1α is the primary factor mediating induction of target genes, including vascular endothelial growth factor and erythropoietin. The goal of these molecular changes is to preserve oxygen supply for cardiac and neuronal function. In addition, hypoxia produces a sympathetic adrenal activation that can increase the resting metabolic rate. Altogether, these changes are instrumental in protocols designed to improve physical performance as well as functional parameters for certain pathological disorders. In addition, nutrition must adapt to the increased energy expenditure. In this last context, performing physical activity in intermittent hypoxia improves insulin sensitivity by increasing the presence of the glucose transporter GLUT-4 in muscle membranes. These changes could also be relevant for obesity and type 2 diabetes treatment. Also, the anorectic effect of intermittent hypoxia modulates serotonin and circulating leptin levels, which may contribute to regulate food intake and favor body weight adaptation for optimal sport performance and health. All these actions suggest that intermittent hypoxia can be a very effective tool in sports training as well as in certain clinical protocols.
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Affiliation(s)
| | - Enrique Roche Collado
- Department of Applied Biology-Nutrition. Institute of Bioengineering. Universidad Miguel Hernández
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12
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Absatirova V, Shandaulov A, Khamchiyev K, Shukurov F, Khalimova F. Changes in the pulmonary circulation due to gravitational loads in high altitude conditions. Clin Hemorheol Microcirc 2024; 86:419-432. [PMID: 38108346 DOI: 10.3233/ch-231910] [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] [Indexed: 12/19/2023]
Abstract
BACKGROUND The impact of gravity on the existence of all living things has long been of interest to scientists. The force of the Earth's gravity combined with hypoxia significantly affects blood circulation and blood accumulation in various parts of the human and animal body. To date, the relationship between body position and blood circulation in pulmonary circulation under hypobaric hypoxia has not been sufficiently studied. OBJECTIVES Therefore, the research aims to determine the possibility of changing the body position in space on the reactions in the pulmonary circulation in the plains and highlands. METHODS For this purpose, research was conducted on male Wistar rats, 44 of whom spent 150 days at an altitude of 3200 m above sea level, and 25 representatives of the control group - at an altitude of 164 m. RESULTS The study revealed that gravitational redistribution of blood in mountainous conditions is less pronounced compared to the control group. This is explained by the remodeling of the vascular wall and an increase in its stiffness. It was found that a change in pulmonary artery pressure at the time of a change in body position was recorded both on the plains and in the highlands. On the plains, when the body position of rats was changed to passive orthostatic, a decrease in systolic and diastolic pulmonary artery pressure was noted, and when the body position was changed to passive anti-orthostatic, an increase in pulmonary artery pressure was observed. The increase in pulmonary artery pressure was a compensatory mechanism due to the increased stiffness of the pulmonary vasculature. CONCLUSIONS The practical significance of this research is to expand the understanding of the pathogenesis of pulmonary hypertension in high-altitude hypoxia.
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Affiliation(s)
- Venera Absatirova
- Department of Normal Physiology, Astana Medical University, Astana, Kazakhstan
| | - Assylbek Shandaulov
- Department of Normal Physiology, Astana Medical University, Astana, Kazakhstan
| | - Kureysh Khamchiyev
- Department of Normal Physiology, Astana Medical University, Astana, Kazakhstan
| | - Firuz Shukurov
- Department of Normal Physiology, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
| | - Fariza Khalimova
- Department of Normal Physiology, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
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13
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Wang R, Yan Y, Tie Y, Zhang Q, Pan Y, Li S, Fan J, Li C, Li X, Wang Y, Sun X, Zhang T, Zhao X. Hypoxic acclimatization training improves the resistance to motion sickness. Front Neurosci 2023; 17:1216998. [PMID: 38125401 PMCID: PMC10731277 DOI: 10.3389/fnins.2023.1216998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Objective Vestibular provocation is one of the main causes of flight illusions, and its occurrence is closely related to the susceptibility of motion sickness (MS). However, existing training programs have limited effect in improving the resistance to motion sickness. In this study, we investigated the effects of hypoxia acclimatization training (HAT) on the resistance to motion sickness. Methods Healthy military college students were identified as subjects according to the criteria. MS model was induced by a rotary chair. Experimental groups included control, HAT, 3D roller training (3DRT), and combined training. Results The Graybiel scores were decreased in the HAT group and the 3DRT group and further decreased in the combined training group in MS induced by the rotary chair. Participants had a significant increase in blood pressure after the rotary chair test and a significant increase in the heart rate during the rotary chair test, but these changes disappeared in all three training groups. Additionally, LFn was increased, HFn was decreased, and LF/HF was increased accordingly during the rotary chair test in the control group, but the changes of these three parameters were completely opposite in the three training groups during the rotary chair test. Compared with the control group, the decreasing changes in pupillary contraction velocity (PCV) and pupillary minimum diameter (PMD) of the three training groups were smaller. In particular, the binocular PCV changes were further attenuated in the combined training group. Conclusion Our research provides a possible candidate solution for training military pilots in the resistance to motion sickness.
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Affiliation(s)
- Rui Wang
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yiquan Yan
- Department of Aerospace Physiology, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yateng Tie
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Qi Zhang
- School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yikai Pan
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Shuhan Li
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Jieyi Fan
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Chengfei Li
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Xi Li
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yongchun Wang
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Xiqing Sun
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Tongmei Zhang
- School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Xingcheng Zhao
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
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14
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Carr AJ, McKay AKA, Burke LM, Smith ES, Urwin CS, Convit L, Jardine WT, Kelly MK, Saunders B. Use of Buffers in Specific Contexts: Highly Trained Female Athletes, Extreme Environments and Combined Buffering Agents-A Narrative Review. Sports Med 2023; 53:25-48. [PMID: 37878211 PMCID: PMC10721675 DOI: 10.1007/s40279-023-01872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 10/26/2023]
Abstract
This narrative review evaluated the evidence for buffering agents (sodium bicarbonate, sodium citrate and beta-alanine), with specific consideration of three discrete scenarios: female athletes, extreme environments and combined buffering agents. Studies were screened according to exclusion and inclusion criteria and were analysed on three levels: (1) moderating variables (supplement dose and timing, and exercise test duration and intensity), (2) design factors (e.g., use of crossover or matched group study design, familiarisation trials) and (3) athlete-specific factors (recruitment of highly trained participants, buffering capacity and reported performance improvements). Only 19% of the included studies for the three buffering agents reported a performance benefit, and only 10% recruited highly trained athletes. This low transferability of research findings to athletes' real-world practices may be due to factors including the small number of sodium citrate studies in females (n = 2), no studies controlling for the menstrual cycle (MC) or menstrual status using methods described in recently established frameworks, and the limited number of beta-alanine studies using performance tests replicating real-world performance efforts (n = 3). We recommend further research into buffering agents in highly trained female athletes that control or account for the MC, studies that replicate the demands of athletes' heat and altitude camps, and investigations of highly trained athletes' use of combined buffering agents. In a practical context, we recommend developing evidence-based buffering protocols for individual athletes which feature co-supplementation with other evidence-based products, reduce the likelihood of side-effects, and optimise key moderating factors: supplement dose and timing, and exercise duration and intensity.
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Affiliation(s)
- Amelia J Carr
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Ella S Smith
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Charles S Urwin
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Lilia Convit
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - William T Jardine
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Monica K Kelly
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Bryan Saunders
- Applied Physiology and Nutrition Research Group, Rheumatology Division, Faculdade de Medicina FMUSP, School of Physical Education and Sport, Universidade de São Paulo, University of São Paulo, São Paulo, Brazil
- Institute of Orthopaedics and Traumatology, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
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15
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Peeling P, Sim M, McKay AKA. Considerations for the Consumption of Vitamin and Mineral Supplements in Athlete Populations. Sports Med 2023; 53:15-24. [PMID: 37358750 PMCID: PMC10721676 DOI: 10.1007/s40279-023-01875-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/27/2023]
Abstract
Vitamins and minerals are of fundamental importance to numerous human functions that are essential to optimise athlete performance. Athletes incur a high turnover of key vitamins and minerals and are therefore dependent on sufficient energy intake to replenish nutrient stores. However, many athletes are poor at servicing their energy replenishment needs, especially female athletes, and although a 'food first approach' to meeting nutrient requirements is the primary goal, it may be important for some athletes to consider a vitamin and/or mineral supplement to meet their daily needs. When working to determine if an athlete requires vitamin or mineral supplements, practitioners should use a robust framework to assess the overall energy requirements, current dietary practices and the biological and clinical status of their athletes. Of note, any supplementation plan should account for the various factors that may impact the efficacy of the approach (e.g. athlete sex, the nutrient recommended dietary intake, supplement dose/timing, co-consumption of other foods and any food-drug interactions). Importantly, there are numerous vitamins and minerals of key importance to athletes, each having specific relevance to certain situations (e.g. iron and B vitamins are significant contributors to haematological adaptation, calcium and vitamin D are important to bone health and folate is important in the female athlete); therefore, the appropriate supplement for a given situation should be carefully considered and consumed with the goal to augment an athlete's diet.
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Affiliation(s)
- Peter Peeling
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, 6009, Australia.
- Western Australian Institute of Sport, Mt Claremont, WA, 6010, Australia.
| | - Marc Sim
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6067, Australia
- Medical School, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, 3000, Australia
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16
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Best R, Williams JM, Pearce J. The Physiological Requirements of and Nutritional Recommendations for Equestrian Riders. Nutrients 2023; 15:4977. [PMID: 38068833 PMCID: PMC10708571 DOI: 10.3390/nu15234977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
Equestrian sport is under-researched within the sport science literature, creating a possible knowledge vacuum for athletes and support personnel wishing to train and perform in an evidence-based manner. This review aims to synthesise available evidence from equitation, sport, and veterinary sciences to describe the pertinent rider physiology of equestrian disciplines. Estimates of energy expenditure and the contribution of underpinning energy systems to equestrian performance are used to provide nutrition and hydration recommendations for competition and training in equestrian disciplines. Relative energy deficiency and disordered eating are also considered. The practical challenges of the equestrian environment, including competitive, personal, and professional factors, injury and concussion, and female participation, are discussed to better highlight novelty within equestrian disciplines compared to more commonly studied sports. The evidence and recommendations are supported by example scenarios, and future research directions are outlined.
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Affiliation(s)
- Russ Best
- Centre for Sport Science & Human Performance, Waikato Institute of Technology, Te Pūkenga, Hamilton 3200, New Zealand
| | - Jane M. Williams
- Department of Animal Science, Hartpury University, Hartpury Gl19 3BE, UK;
| | - Jeni Pearce
- High Performance Sport New Zealand, Auckland 0632, New Zealand;
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17
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Lai Y, Loy F, Isola M, Noli R, Rinaldi A, Lobina C, Vargiu R, Cesare Marincola F, Isola R. Male and Female Mitochondria Respond Differently after Exercising in Acute Hypoxia. Biomedicines 2023; 11:3149. [PMID: 38137370 PMCID: PMC10740434 DOI: 10.3390/biomedicines11123149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/10/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
The use of hypoxic devices among athletes who train in normobaric hypoxia has become increasingly popular; however, the acute effects on heart and brain metabolism are not yet fully understood. This study aimed to investigate the mitochondrial bioenergetics in trained male and female Wistar rats after acute hypoxia training. The experimental plan included exercising for 30 min on a treadmill in a Plexiglas cage connected to a hypoxic generator set at 12.5% O2 or in normoxia. After the exercise, the rats were sacrificed, and their mitochondria were isolated from their brains and hearts. The bioenergetics for each complex of the electron transport chain was tested using a Clark-type electrode. The results showed that following hypoxia training, females experienced impaired oxidative phosphorylation through complex II in heart subsarcolemmal mitochondria, while males had an altered ADP/O in heart interfibrillar mitochondria, without any change in oxidative capacity. No differences from controls were evident in the brain, but an increased electron transport system efficiency was observed with complex I and IV substrates in males. Therefore, the study's findings suggest that hypoxia training affects the heart mitochondria of females more than males. This raises a cautionary flag for female athletes who use hypoxic devices.
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Affiliation(s)
- Ylenia Lai
- Department of Biological Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
| | - Francesco Loy
- Department of Biological Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
| | - Michela Isola
- Department of Biological Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
| | - Roberta Noli
- Department of Biological Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
| | - Andrea Rinaldi
- Department of Biological Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
| | - Carla Lobina
- Neuroscience Institute, Division of Cagliari, National Research Council of Italy, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
| | - Romina Vargiu
- Department of Biological Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
| | - Flaminia Cesare Marincola
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
| | - Raffaella Isola
- Department of Biological Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Italy
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18
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Yuan Z, Zou Y, Liu X, Wang L, Chen C. Longitudinal study on blood and biochemical indexes of Tibetan and Han in high altitude area. Front Public Health 2023; 11:1282051. [PMID: 38035283 PMCID: PMC10685451 DOI: 10.3389/fpubh.2023.1282051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Objective This study aims to review the blood routine and biochemical indicators of the plateau population for three consecutive years, and analyze the impact of the plateau on these blood indicators of the Tibetan population and the Han immigrant population. Method These parameters were extracted from the Laboratory Department of Ali District People's Hospital in Tibet from January 2019 to December 2021, including blood routine, liver and kidney function, blood lipids, myocardial enzyme spectrum, and rheumatic factor indicators. Changes in these parameters were analyzed over 3 consecutive years according to inclusion and exclusion criteria. Result A total of 114 Tibetans and 93 Hans participated in the study. These parameters were significantly different between Tibetan and Han populations. Red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), mean hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cells (WBC), lymphocytes (LYMPH) and monocytes (MONO) were significantly higher in Hans than Tibetans (p < 0.05). Biochemically, total bilirubin (TBIL), direct bilirubin (DBIL), albumin (ALB), urea nitrogen (Urea), creatinine (Cr), uric acid (UA), glucose (GLU), triglycerides (TG) and creatine kinase isoenzyme (CKMB) were significantly higher in Hans than Tibetans; aspartate aminotransferase (AST), glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), antistreptolysin (ASO), and C-reactive protein (CRP) were significantly higher in Tibetans than Hans (p < 0.05). There were no obvious continuous upward or downward trend of the parameters for 3 consecutive years. Conclusion In high-altitude areas, Han immigrants have long-term stress changes compared with Tibetans. The main differences are reflected in the blood system, liver and kidney functions, etc., which provide basic data for further research on the health status of plateau populations.
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Affiliation(s)
- ZhiMin Yuan
- Department of Clinical Laboratory, Shaanxi Provincial Cancer Hospital Affiliated to Xi'an Jiaotong University, Xi'an, China
- Department of Clinical Laboratory, Ali District People's Hospital, Tibet Ali, China
| | - YuanWu Zou
- Department of Clinical Laboratory, Tuberculosis Prevent and Care Hospital of Shanxi Province, Xi’an, China
| | - XiaoXing Liu
- Department of Clinical Laboratory, Ali District People's Hospital, Tibet Ali, China
| | - LongHao Wang
- Department of Otolaryngology and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Cheng Chen
- Department of Clinical Laboratory, Ali District People's Hospital, Tibet Ali, China
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
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19
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Karpęcka-Gałka E, Mazur-Kurach P, Szyguła Z, Frączek B. Diet, Supplementation and Nutritional Habits of Climbers in High Mountain Conditions. Nutrients 2023; 15:4219. [PMID: 37836503 PMCID: PMC10574574 DOI: 10.3390/nu15194219] [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: 09/07/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Appropriate nutritional preparation for a high-mountain expedition can contribute to the prevention of nutritional deficiencies affecting the deterioration of health and performance. The aim of the study was to analyze the dietary habits, supplementation and nutritional value of diets of high mountain climbers. The study group consisted of 28 men (average age 33.12 ± 5.96 years), taking part in summer mountaineering expeditions at an altitude above 3000 m above sea level, lasting at least 3 weeks. Food groups consumed with low frequency during the expedition include vegetables, fruits, eggs, milk and milk products, butter and cream, fish and meat. The energy demand of the study participants was 4559.5 ± 425 kcal, and the energy supply was 2776.8 ± 878 kcal. The participants provided 79.6 ± 18.5 g of protein (1.1 ± 0.3 g protein/kg bw), 374.0 ± 164.5 g of carbohydrates (5.3 ± 2.5 g/kg bw) and 110.7 ± 31.7 g of fat (1.6 ± 0.5 g/kg bw) in the diet. The climbers' diet was low in calories, the protein supply was too low, and the fat supply was too high. There is a need to develop nutritional and supplementation recommendations that would serve as guidelines for climbers, improving their well-being and exercise capacity in severe high-mountain conditions, which would take their individual taste preferences into account.
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Affiliation(s)
- Ewa Karpęcka-Gałka
- Doctoral School of Physical Culture Sciences, University School of Physical Education in Krakow, Jana Pawla II 78, 31-571 Krakow, Poland
| | - Paulina Mazur-Kurach
- Department of Sports Medicine and Human Nutrition, Institute of Biomedical Sciences, University School of Physical Education in Krakow, Jana Pawla II 78, 31-571 Krakow, Poland; (P.M.-K.); (Z.S.); (B.F.)
| | - Zbigniew Szyguła
- Department of Sports Medicine and Human Nutrition, Institute of Biomedical Sciences, University School of Physical Education in Krakow, Jana Pawla II 78, 31-571 Krakow, Poland; (P.M.-K.); (Z.S.); (B.F.)
| | - Barbara Frączek
- Department of Sports Medicine and Human Nutrition, Institute of Biomedical Sciences, University School of Physical Education in Krakow, Jana Pawla II 78, 31-571 Krakow, Poland; (P.M.-K.); (Z.S.); (B.F.)
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20
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Feng X, Zhao L, Chen Y, Wang Z, Lu H, Wang C. Optimal type and dose of hypoxic training for improving maximal aerobic capacity in athletes: a systematic review and Bayesian model-based network meta-analysis. Front Physiol 2023; 14:1223037. [PMID: 37745240 PMCID: PMC10513096 DOI: 10.3389/fphys.2023.1223037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
Objective: This study aimed to compare and rank the effect of hypoxic practices on maximum oxygen consumption (VO2max) in athletes and determine the hypoxic dose-response correlation using network meta-analysis. Methods: The Web of Science, PubMed, EMBASE, and EBSCO databases were systematically search for randomized controlled trials on the effect of hypoxc interventions on the VO2max of athletes published from inception until 21 February 2023. Studies that used live-high train-high (LHTH), live-high train-low (LHTL), live-high, train-high/low (HHL), intermittent hypoxic training (IHT), and intermittent hypoxic exposure (IHE) interventions were primarily included. LHTL was further defined according to the type of hypoxic environment (natural and simulated) and the altitude of the training site (low altitude and sea level). A meta-analysis was conducted to determine the standardized mean difference between the effects of various hypoxic interventions on VO2max and dose-response correlation. Furthermore, the hypoxic dosage of the different interventions were coordinated using the "kilometer hour" model. Results: From 2,072 originally identified titles, 59 studies were finally included in this study. After data pooling, LHTL, LHTH, and IHT outperformed normoxic training in improving the VO2max of athletes. According to the P-scores, LHTL combined with low altitude training was the most effective intervention for improving VO2max (natural: 0.92 and simulated: 0.86) and was better than LHTL combined with sea level training (0.56). A reasonable hypoxic dose range for LHTH (470-1,130 kmh) and HL (500-1,415 kmh) was reported with an inverted U-shaped curve relationship. Conclusion: Different types of hypoxic training compared with normoxic training serve as significant approaches for improving aerobic capacity in athletes. Regardless of the type of hypoxic training and the residential condition, LHTL with low altitude training was the most effective intervention. The characteristics of the dose-effect correlation of LHTH and LHTL may be associated with the negative effects of chronic hypoxia.
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Affiliation(s)
- Xinmiao Feng
- Sports Coaching College, Beijing Sports University, Beijing, China
| | - Linlin Zhao
- Sports Coaching College, Beijing Sports University, Beijing, China
| | | | - Zihao Wang
- Capital Institute of Physical Education and Sports, Beijing, Beijing, China
| | - Hongyuan Lu
- Sports Coaching College, Beijing Sports University, Beijing, China
| | - Chuangang Wang
- Sports Coaching College, Beijing Sports University, Beijing, China
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21
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Pühringer R, Muckenthaler M, Burtscher M. Association Between Ferritin Levels and Altitude-Dependent Cardiorespiratory Fitness in Mountain Guides. High Alt Med Biol 2023; 24:139-143. [PMID: 37134197 DOI: 10.1089/ham.2023.0016] [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] [Indexed: 05/05/2023] Open
Abstract
Pühringer, Reinhard, Martina Muckenthaler, and Martin Burtscher. Association between ferritin levels and altitude-dependent cardiorespiratory fitness in mountain guides. High Alt Med Biol. 24:139-143, 2023. Background: Higher ferritin levels may be associated with lower cardiorespiratory fitness (CRF; i.e., maximal oxygen uptake, VO2max) and may represent early markers of cardiovascular risk but may also support high-altitude acclimatization. To evaluate these potential associations, data recordings from a large sample of male mountain guides have been analyzed. Methods: A total of 154 data sets (including anthropometric data, VO2max, blood lipids, hemoglobin, ferritin, and transferrin levels) of regularly physically active and well-acclimatized mountain guides were available for analyses. Participants performed equal incremental cycle ergometer tests to exhaustion at low (600 m) and (∼1 week later) at moderate altitude (2,000 m). Results: Ferritin levels were positively correlated with levels of hemoglobin (r = 0.29, p < 0.01), total cholesterol (r = 0.18, p < 0.05), triglycerides (r = 0.23, p < 0.01), and low-density lipoprotein (r = 0.22, p < 0.01), and negatively with high-density lipoprotein levels (r = -0.16, p < 0.05) and also with baseline (taken at low altitude) VO2max values (r = -0.19, p < 0.05). In contrast, higher ferritin levels were associated with less VO2max decline from low-to-moderate altitude (r = 0.26, p < 0.01). Conclusion: Higher ferritin levels in male mountain guides are weakly associated with lower CRF and higher prevalence of cardiovascular risk factors but with slightly less reduction in VO2max when acutely exposed to moderate altitude. The clinical relevance of these observations needs further investigation.
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Affiliation(s)
- Reinhard Pühringer
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Austrian Society for Alpine- and High-Altitude Medicine, Innsbruck, Austria
| | - Martina Muckenthaler
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Centre for Translational Biomedical Iron Research, Molecular Medicine Partnership Unit (MMPU) Group Leader, University Hospital Heidelberg, Heidelberg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Austrian Society for Alpine- and High-Altitude Medicine, Innsbruck, Austria
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22
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Kettunen O, Leppävuori A, Mikkonen R, Peltonen JE, Nummela A, Wikström B, Linnamo V. Hemoglobin mass and performance responses during 4 weeks of normobaric "live high-train low and high". Scand J Med Sci Sports 2023. [PMID: 37114394 DOI: 10.1111/sms.14378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE To investigate whether 4 weeks of normobaric "live high-train low and high" (LHTLH) causes different hematological, cardiorespiratory, and sea-level performance changes compared to living and training in normoxia during a preparation season. METHODS Nineteen (13 women, 6 men) cross-country skiers competing at the national or international level completed a 28-day period (∼18 h day-1 ) of LHTLH in normobaric hypoxia of ∼2400 m (LHTLH group) including two 1 h low-intensity training sessions per week in normobaric hypoxia of 2500 m while continuing their normal training program in normoxia. Hemoglobin mass (Hbmass ) was assessed using a carbon monoxide rebreathing method. Time to exhaustion (TTE) and maximal oxygen uptake (VO2max ) were measured using an incremental treadmill test. Measurements were completed at baseline and within 3 days after LHTLH. The control group skiers (CON) (seven women, eight men) performed the same tests while living and training in normoxia with ∼4 weeks between the tests. RESULTS Hbmass in LHTLH increased 4.2 ± 1.7% from 772 ± 213 g (11.7 ± 1.4 g kg-1 ) to 805 ± 226 g (12.5 ± 1.6 g kg-1 ) (p < 0.001) while it was unchanged in CON (p = 0.21). TTE improved during the study regardless of the group (3.3 ± 3.4% in LHTLH; 4.3 ± 4.8% in CON, p < 0.001). VO2max did not increase in LHTLH (61.2 ± 8.7 mL kg-1 min-1 vs. 62.1 ± 7.6 mL kg-1 min-1 , p = 0.36) while a significant increase was detected in CON (61.3 ± 8.0-64.0 ± 8.1 mL kg-1 min-1 , p < 0.001). CONCLUSIONS Four-week normobaric LHTLH was beneficial for increasing Hbmass but did not support the short-term development of maximal endurance performance and VO2max when compared to the athletes who lived and trained in normoxia.
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Affiliation(s)
- Oona Kettunen
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Antti Leppävuori
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Ritva Mikkonen
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Juha E Peltonen
- Helsinki Sports and Exercise Medicine Clinic (HULA), Foundation for Sports and Exercise Medicine, Helsinki, Finland
- Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland
| | - Ari Nummela
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland
| | - Bettina Wikström
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Vesa Linnamo
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
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23
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Girard O, Levine BD, Chapman RF, Wilber R. "Living High-Training Low" for Olympic Medal Performance: What Have We Learned 25 Years After Implementation? Int J Sports Physiol Perform 2023; 18:563-572. [PMID: 37116895 DOI: 10.1123/ijspp.2022-0501] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/16/2023] [Accepted: 03/28/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Altitude training is often regarded as an indispensable tool for the success of elite endurance athletes. Historically, altitude training emerged as a key strategy to prepare for the 1968 Olympics, held at 2300 m in Mexico City, and was limited to the "Live High-Train High" method for endurance athletes aiming for performance gains through improved oxygen transport. This "classical" intervention was modified in 1997 by the "Live High-Train Low" (LHTL) model wherein athletes supplemented acclimatization to chronic hypoxia with high-intensity training at low altitude. PURPOSE This review discusses important considerations for successful implementation of LHTL camps in elite athletes based on experiences, both published and unpublished, of the authors. APPROACH The originality of our approach is to discuss 10 key "lessons learned," since the seminal work by Levine and Stray-Gundersen was published in 1997, and focusing on (1) optimal dose, (2) individual responses, (3) iron status, (4) training-load monitoring, (5) wellness and well-being monitoring, (6) timing of the intervention, (7) use of natural versus simulated hypoxia, (8) robustness of adaptative mechanisms versus performance benefits, (9) application for a broad range of athletes, and (10) combination of methods. Successful LHTL strategies implemented by Team USA athletes for podium performance at Olympic Games and/or World Championships are presented. CONCLUSIONS The evolution of the LHTL model represents an essential framework for sport science, in which field-driven questions about performance led to critical scientific investigation and subsequent practical implementation of a unique approach to altitude training.
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Affiliation(s)
- Olivier Girard
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA,Australia
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX,USA
- University of Texas Southwestern Medical Center, Dallas, TX,USA
| | - Robert F Chapman
- Human Performance Laboratory, Department of Kinesiology, Indiana University Bloomington, Bloomington, IN,USA
| | - Randall Wilber
- United States Olympic Committee, Colorado Springs, CO,USA
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24
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Li X, Li Y, Zhao S, Chen X, Wang L, Zhang X. Early cognitive dysfunction after stroke and related risk factors in the high-altitude and multi-ethnic region of Qinghai, China: A multi-center cross-sectional study. Clin Neurol Neurosurg 2023; 225:107607. [PMID: 36696845 DOI: 10.1016/j.clineuro.2023.107607] [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: 05/19/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Cognitive impairment is a common outcome of stroke, but there is limited evidence regarding its prevalence at high altitude, especially within the context of specific ethnic groups or lifestyle habits. This prospective exploratory study investigated early cognitive impairment after stroke in Qinghai Province, 3000 m above sea level. METHODS Patients with acute stroke (n = 1047) were enrolled from 3 hospitals in Qinghai Province. Cognitive performance was measured by Montreal Cognitive Assessment (MoCA) scores within 5 days of stroke symptom onset; MoCA < 26 defined impairment. Patient data included demographics, education, vascular risk factors, diet, and activities of daily living rated by Barthel index. RESULTS Cognitive impairment within 5 days of stroke symptom onset affected 77.65% of these patients. The factors independently associated with early cognitive impairment were: older age (mean difference [MD]: -4.857, 95% confidence interval [CI]: 6.685-3.030, P < 0.001); female gender (odds ratio [OR]: 1.674, 95% CI: 1.212-2.313, P = 0.002); and a diet containing yak butter (OR: 1.587, 95% CI: 1.247-2.021, P < 0.001). Progressively lesser odds were accounted to beef (Yak) and mutton consumption (OR: 0.804, 95% CI: 0.655-0.987, P = 0.037); fruit (OR: 0.792, 95% CI: 0.672-0.933, P = 0.005); status as an immigrant (OR: 0.666, 95% CI: 0.445-0.996, P = 0.048); education (OR: 0.514, 95% CI: 0.400-0.660, P < 0.001); and multiple daily leisure activities (OR: 0.999, 95% CI: 0.999-0.999, P < 0.001). CONCLUSION Persons in Qinghai province who experience stroke are likely to show signs of early cognitive dysfunction. Preventive modifiable features include diet and daily activities.
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Affiliation(s)
- Xiaofang Li
- Qinghai Provincial People's Hospital, Xining 81007, China
| | - Yuemei Li
- Qinghai Provincial People's Hospital, Xining 81007, China
| | - Shengxiu Zhao
- Qinghai Provincial People's Hospital, Xining 81007, China.
| | | | - Limei Wang
- Third People's Hospital of Xining, Xining 81000, China
| | - Xiaoxia Zhang
- Qinghai Provincial People's Hospital, Xining 81007, China
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25
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Mallet RT, Burtscher J, Pialoux V, Pasha Q, Ahmad Y, Millet GP, Burtscher M. Molecular Mechanisms of High-Altitude Acclimatization. Int J Mol Sci 2023; 24:ijms24021698. [PMID: 36675214 PMCID: PMC9866500 DOI: 10.3390/ijms24021698] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/17/2023] Open
Abstract
High-altitude illnesses (HAIs) result from acute exposure to high altitude/hypoxia. Numerous molecular mechanisms affect appropriate acclimatization to hypobaric and/or normobaric hypoxia and curtail the development of HAIs. The understanding of these mechanisms is essential to optimize hypoxic acclimatization for efficient prophylaxis and treatment of HAIs. This review aims to link outcomes of molecular mechanisms to either adverse effects of acute high-altitude/hypoxia exposure or the developing tolerance with acclimatization. After summarizing systemic physiological responses to acute high-altitude exposure, the associated acclimatization, and the epidemiology and pathophysiology of various HAIs, the article focuses on molecular adjustments and maladjustments during acute exposure and acclimatization to high altitude/hypoxia. Pivotal modifying mechanisms include molecular responses orchestrated by transcription factors, most notably hypoxia inducible factors, and reciprocal effects on mitochondrial functions and REDOX homeostasis. In addition, discussed are genetic factors and the resultant proteomic profiles determining these hypoxia-modifying mechanisms culminating in successful high-altitude acclimatization. Lastly, the article discusses practical considerations related to the molecular aspects of acclimatization and altitude training strategies.
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Affiliation(s)
- Robert T. Mallet
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Johannes Burtscher
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
- Institute of Sport Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Vincent Pialoux
- Inter-University Laboratory of Human Movement Biology EA7424, University Claude Bernard Lyon 1, University of Lyon, FR-69008 Lyon, France
| | - Qadar Pasha
- Institute of Hypoxia Research, New Delhi 110067, India
| | - Yasmin Ahmad
- Defense Institute of Physiology & Allied Sciences (DIPAS), Defense Research & Development Organization(DRDO), New Delhi 110054, India
| | - Grégoire P. Millet
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
- Institute of Sport Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria
- Austrian Society for Alpine and High-Altitude Medicine, A-6020 Innsbruck, Austria
- Correspondence:
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26
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Tee CCL, Cooke MB, Chong MC, Yeo WK, Camera DM. Mechanisms for Combined Hypoxic Conditioning and Divergent Exercise Modes to Regulate Inflammation, Body Composition, Appetite, and Blood Glucose Homeostasis in Overweight and Obese Adults: A Narrative Review. Sports Med 2023; 53:327-348. [PMID: 36441492 PMCID: PMC9877079 DOI: 10.1007/s40279-022-01782-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2022] [Indexed: 11/29/2022]
Abstract
Obesity is a major global health issue and a primary risk factor for metabolic-related disorders. While physical inactivity is one of the main contributors to obesity, it is a modifiable risk factor with exercise training as an established non-pharmacological treatment to prevent the onset of metabolic-related disorders, including obesity. Exposure to hypoxia via normobaric hypoxia (simulated altitude via reduced inspired oxygen fraction), termed hypoxic conditioning, in combination with exercise has been increasingly shown in the last decade to enhance blood glucose regulation and decrease the body mass index, providing a feasible strategy to treat obesity. However, there is no current consensus in the literature regarding the optimal combination of exercise variables such as the mode, duration, and intensity of exercise, as well as the level of hypoxia to maximize fat loss and overall body compositional changes with hypoxic conditioning. In this narrative review, we discuss the effects of such diverse exercise and hypoxic variables on the systematic and myocellular mechanisms, along with physiological responses, implicated in the development of obesity. These include markers of appetite regulation and inflammation, body conformational changes, and blood glucose regulation. As such, we consolidate findings from human studies to provide greater clarity for implementing hypoxic conditioning with exercise as a safe, practical, and effective treatment strategy for obesity.
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Affiliation(s)
- Chris Chow Li Tee
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
- Sport and Exercise Medicine Group, Swinburne University, Room SPW224, Mail H21, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Matthew B Cooke
- Sport and Exercise Medicine Group, Swinburne University, Room SPW224, Mail H21, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Mee Chee Chong
- Sport and Exercise Medicine Group, Swinburne University, Room SPW224, Mail H21, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Wee Kian Yeo
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Donny M Camera
- Sport and Exercise Medicine Group, Swinburne University, Room SPW224, Mail H21, PO Box 218, Hawthorn, VIC, 3122, Australia.
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27
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Guerrero-Pinzón JJ, Alcantara JM, García-Buendia G, Mochón-Benguigui S, Ramírez-Maldonado M, Ruiz JR, Jurado-Fasoli L. A nutritional intervention for moderate altitude endurance preparation: A case report. J Int Soc Sports Nutr 2022; 19:650-663. [DOI: 10.1080/15502783.2022.2140596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Juan J. Guerrero-Pinzón
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Department of Physical Education and Sports, Faculty of Sport Sciences, Granada, Spain
| | - Juan M.A. Alcantara
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Department of Physical Education and Sports, Faculty of Sport Sciences, Granada, Spain
| | - Gustavo García-Buendia
- University of Granada, Department Physical Education and Sports, Faculty of Sport Sciences, Granada, Spain
| | - Sol Mochón-Benguigui
- University of Granada, Department of Physiology. Faculty of Medicine, Granada, Spain
| | - Mauricio Ramírez-Maldonado
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Department of Physical Education and Sports, Faculty of Sport Sciences, Granada, Spain
| | - Jonatan R. Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Department of Physical Education and Sports, Faculty of Sport Sciences, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain
| | - Lucas Jurado-Fasoli
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Department of Physical Education and Sports, Faculty of Sport Sciences, Granada, Spain
- University of Granada, Department of Physiology. Faculty of Medicine, Granada, Spain
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28
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Yu Y, Wang R, Li D, Lu Y. Monitoring Physiological Performance over 4 Weeks Moderate Altitude Training in Elite Chinese Cross-Country Skiers: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:266. [PMID: 36612586 PMCID: PMC9820022 DOI: 10.3390/ijerph20010266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
The current observational study aimed to monitor the physiological performance over 4 weeks of living and training at a moderate altitude in elite Chinese cross-country skiers (8 males, mean age 20.83 ± 1.08 years). Lactate threshold, maximal oxygen uptake, blood, and body composition tests were performed at different time points to investigate the changes in physiological performance. The data were analysed by a one-way repeated measures ANOVA and a paired sample T-test between the test results. During the training camp, systematic load monitoring was carried out. Lactate threshold velocity, lactate threshold heart rate, and upper body muscle mass increased significantly (p < 0.01) after moderate altitude training. Maximum oxygen uptake was reduced compared to pre-tests (p < 0.05). Aerobic capacity parameters (maximal oxygen uptake, haemoglobin, red blood cell count) did not significantly increase after athletes returned to sea level (p > 0.05). These findings suggest that 4 weeks of moderate altitude training can significantly improve athletes’ lactate threshold and upper body muscle mass; no significant improvement in other aerobic capacity was seen. Exposure time, training load, and nutritional strategies should be thoroughly planned for optimal training of skiers at moderate altitudes.
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Affiliation(s)
- Yichao Yu
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing 100084, China
- The Graduate School, Beijing Sport University, Beijing 100084, China
| | - Ruolin Wang
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC 3053, Australia
| | - Dongye Li
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing 100084, China
- The Graduate School, Beijing Sport University, Beijing 100084, China
| | - Yifan Lu
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing 100084, China
- Key Laboratory of Sports and Physical Fitness of the Ministry of Education, Beijing Sport University, Beijing 100084, China
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29
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Haugen T, Sandbakk Ø, Seiler S, Tønnessen E. The Training Characteristics of World-Class Distance Runners: An Integration of Scientific Literature and Results-Proven Practice. SPORTS MEDICINE - OPEN 2022; 8:46. [PMID: 35362850 PMCID: PMC8975965 DOI: 10.1186/s40798-022-00438-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/22/2022] [Indexed: 11/23/2022]
Abstract
In this review we integrate the scientific literature and results-proven practice and outline a novel framework for understanding the training and development of elite long-distance performance. Herein, we describe how fundamental training characteristics and well-known training principles are applied. World-leading track runners (i.e., 5000 and 10,000 m) and marathon specialists participate in 9 ± 3 and 6 ± 2 (mean ± SD) annual competitions, respectively. The weekly running distance in the mid-preparation period is in the range 160–220 km for marathoners and 130–190 km for track runners. These differences are mainly explained by more running kilometers on each session for marathon runners. Both groups perform 11–14 sessions per week, and ≥ 80% of the total running volume is performed at low intensity throughout the training year. The training intensity distribution vary across mesocycles and differ between marathon and track runners, but common for both groups is that volume of race-pace running increases as the main competition approaches. The tapering process starts 7–10 days prior to the main competition. While the African runners live and train at high altitude (2000–2500 m above sea level) most of the year, most lowland athletes apply relatively long altitude camps during the preparation period. Overall, this review offers unique insights into the training characteristics of world-class distance runners by integrating scientific literature and results-proven practice, providing a point of departure for future studies related to the training and development in the Olympic long-distance events.
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30
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Burtscher J, Strasser B, Millet GP, Burtscher M. Can melatonin be used as a potential antioxidant and sleep aid supplement for high-altitude travelers? J Travel Med 2022; 29:6495956. [PMID: 34983055 DOI: 10.1093/jtm/taab198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/10/2021] [Accepted: 12/27/2021] [Indexed: 11/14/2022]
Abstract
Traveling to high-altitude destinations is associated with risks such as high-altitude sicknesses and impaired sleep and performance. Although antioxidant supplementation may be beneficial, conflicting study results impede clear clinical guidelines. Herein, we highlight the potential of the antioxidant compound melatonin that is surprisingly poorly investigated in high-altitude settings.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland.,Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Barbara Strasser
- Medical Faculty, Sigmund Freud Private University, A-1020 Vienna, Austria
| | - Gregoire P Millet
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland.,Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria.,Austrian Society for Alpine- and High-Altitude Medicine, A-6020 Innsbruck, Austria
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31
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Hydration Strategies for Physical Activity and Endurance Events at High (>2500 m) Altitude: A Practical Management Article. Clin J Sport Med 2022; 32:407-413. [PMID: 33852437 DOI: 10.1097/jsm.0000000000000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/11/2021] [Indexed: 02/02/2023]
Abstract
A growing number of adventurous athletes are seeking new challenges through endurance events or physical activities held at high altitude (>2500 m). This coincides with a significant increase in the numbers of trekkers who ascend into the world's mountains. Altitude itself influences and complicates the athlete's effective and safe hydration. This article considers the physiology of adaptation to altitude and the effects on hydration at altitude compared with sea level, reviews the "ad libitum versus programmed hydration" controversy in conventional endurance event hydration, examines the evidence for extrapolation of sea level hydration strategies to the high-altitude environment, and synthesizes these disparate factors into a set of practical recommendations for hydration management during high-altitude physical activity. The guidelines will be relevant to participants of physical activity at altitude and health care staff who may care for them in the preparation or performance phases of their adventure.
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32
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Differences in stress response between two altitudes assessed by salivary cortisol levels within circadian rhythms in long-distance runners. Sci Rep 2022; 12:9749. [PMID: 35697776 PMCID: PMC9192635 DOI: 10.1038/s41598-022-13965-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
There are conflicting reports regarding the efficacy of cortisol as a stress marker in altitude training due to the influence of the circadian rhythm. This study aimed to verify whether the automated measurement of salivary cortisol concentration via sequential sampling could detect the differences in exercise stress between two altitudes. We enrolled 12 elite female long-distance runners living near sea level. For the first higher-altitude camp, the runners lived at 1800 m and trained at 1700 m for 7 days. For the second lower-altitude camp, they lived at 1550 m and trained at 1300 m for 7 days. Their saliva was sequentially collected on the last 2 days during each camp which involved different intensity exercises in the morning and afternoon. The salivary cortisol concentrations were measured using electrochemiluminescence immunoassay. Before dinner, the basal salivary cortisol concentrations were significantly higher in the higher-altitude camp. The rate of change in the salivary cortisol concentration during the morning exercise was significantly higher in the higher-altitude camp than in lower-altitude camp (p = 0.028) despite the same exercise programs and intensities. Salivary cortisol level measurements during the athletes' circadian rhythms could detect the differences in acclimatization and exercise stress between two altitudes.
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33
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Karlsson Ø, Laaksonen MS, McGawley K. Monitoring Acclimatization and Training Responses Over 17–21 Days at 1,800 m in Elite Cross-Country Skiers and Biathletes. Front Sports Act Living 2022; 4:852108. [PMID: 35647539 PMCID: PMC9130592 DOI: 10.3389/fspor.2022.852108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To monitor the daily variations and time course of changes in selected variables during a 17–21-day altitude training camp at 1,800 m in a group of elite cross-country skiers (9 women, 12 men) and biathletes (7 women, 4 men). Methods Among other variables, resting peripheral oxygen saturation (SpO2rest), resting heart rate (HRrest) and urine specific gravity (USG) were monitored daily at altitude, while illness symptoms were monitored weekly. Before and after the camp, body composition (i.e., lean and fat mass) and body mass were assessed in all athletes, while roller-skiing speed at a blood lactate concentration of 4 mmol·L−1 (Speed@4mmol) was assessed in the biathletes only. Results Neither SpO2rest, HRrest nor USG changed systematically during the camp (p > 0.05), although some daily time points differed from day one for the latter two variables (p < 0.05). In addition, body composition and body mass were unchanged from before to after the camp (p > 0.05). Eleven out of 15 illness episodes were reported within 4 days of the outbound or homebound flight. The five biathletes who remained free of illness increased their Speed@4mmol by ~ 4% from before to after the camp (p = 0.031). Conclusions The present results show that measures typically recommended to monitor acclimatization and responses to altitude in athletes (e.g., SpO2rest and HRrest) did not change systematically over time. Further research is needed to explore the utility of these and other measures in elite endurance athletes at altitudes typical of competition environments.
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Effects of Prolonged Exposure to Hypobaric Hypoxia on Oxidative Stress: Overwintering in Antarctic Concordia Station. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:4430032. [PMID: 35535360 PMCID: PMC9078816 DOI: 10.1155/2022/4430032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/25/2022] [Accepted: 04/09/2022] [Indexed: 12/14/2022]
Abstract
Concordia Station is the permanent, research station on the Antarctic Plateau at 3230 m. During the eleventh winter-over campaign (DC11-2015; February 2015 to November 2015) at Antarctic Concordia Station, 13 healthy team members were studied and blood samples were collected at six different time points: baseline measurements (T0), performed at sea level before the departure, and during the campaign at 3, 7, 20, 90, and 300 days after arrival at Concordia Station. Reducing the partial pressure of O2 as barometric pressure falls, hypobaric hypoxia (HH) triggers several physiological adaptations. Among the others, increased oxidative stress and enhanced generation of reactive oxygen/nitrogen species (ROS/RNS), resulting in severe oxidative damage, were observed, which can share potential physiopathological mechanisms associated with many diseases. This study characterized the extent and time-course changes after acute and chronic HH exposure, elucidating possible fundamental mechanisms of adaptation. ROS, oxidative stress biomarkers, nitric oxide, and proinflammatory cytokines significantly increased (range 24-135%) during acute and chronic hypoxia exposure (peak 20th day) with a decrease in antioxidant capacity (peak 90th day: -52%). Results suggest that the adaptive response of oxidative stress balance to HH requires a relatively long time, more than 300th days, as all the observed variables do not return to the preexposition level. These findings may also be relevant to patients in whom oxygen availability is limited through disease (i.e., chronic heart and lung and/or kidney disease) and/or during long-duration space missions.
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Acute Exercise with Moderate Hypoxia Reduces Arterial Oxygen Saturation and Cerebral Oxygenation without Affecting Hemodynamics in Physically Active Males. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084558. [PMID: 35457425 PMCID: PMC9027900 DOI: 10.3390/ijerph19084558] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 01/02/2023]
Abstract
Hemodynamic changes during exercise in acute hypoxia (AH) have not been completely elucidated. The present study aimed to investigate hemodynamics during an acute bout of mild, dynamic exercise during moderate normobaric AH. Twenty-two physically active, healthy males (average age; range 23–40 years) completed a cardiopulmonary test on a cycle ergometer to determine their maximum workload (Wmax). On separate days, participants performed two randomly assigned exercise tests (three minutes pedaling at 30% of Wmax): (1) during normoxia (NORMO), and (2) during normobaric AH at 13.5% inspired oxygen (HYPO). Hemodynamics were assessed with impedance cardiography, and peripheral arterial oxygen saturation (SatO2) and cerebral oxygenation (Cox) were measured by near-infrared spectroscopy. Hemodynamic responses (heart rate, stroke volume, cardiac output, mean arterial blood pressure, ventricular emptying rate, and ventricular filling rate) were not any different between NORMO and HYPO. However, the HYPO test significantly reduced both SatO2 (96.6 ± 3.3 vs. 83.0 ± 4.5%) and Cox (71.0 ± 6.6 vs. 62.8 ± 7.4 A.U.) when compared to the NORMO test. We conclude that an acute bout of mild exercise during acute moderate normobaric hypoxia does not induce significant changes in hemodynamics, although it can cause significant reductions in SatO2 and Cox.
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New Horizons in Carbohydrate Research and Application for Endurance Athletes. Sports Med 2022; 52:5-23. [PMID: 36173597 PMCID: PMC9734239 DOI: 10.1007/s40279-022-01757-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 12/15/2022]
Abstract
The importance of carbohydrate as a fuel source for exercise and athletic performance is well established. Equally well developed are dietary carbohydrate intake guidelines for endurance athletes seeking to optimize their performance. This narrative review provides a contemporary perspective on research into the role of, and application of, carbohydrate in the diet of endurance athletes. The review discusses how recommendations could become increasingly refined and what future research would further our understanding of how to optimize dietary carbohydrate intake to positively impact endurance performance. High carbohydrate availability for prolonged intense exercise and competition performance remains a priority. Recent advances have been made on the recommended type and quantity of carbohydrates to be ingested before, during and after intense exercise bouts. Whilst reducing carbohydrate availability around selected exercise bouts to augment metabolic adaptations to training is now widely recommended, a contemporary view of the so-called train-low approach based on the totality of the current evidence suggests limited utility for enhancing performance benefits from training. Nonetheless, such studies have focused importance on periodizing carbohydrate intake based on, among other factors, the goal and demand of training or competition. This calls for a much more personalized approach to carbohydrate recommendations that could be further supported through future research and technological innovation (e.g., continuous glucose monitoring). Despite more than a century of investigations into carbohydrate nutrition, exercise metabolism and endurance performance, there are numerous new important discoveries, both from an applied and mechanistic perspective, on the horizon.
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Exogenous Ketone Supplements in Athletic Contexts: Past, Present, and Future. Sports Med 2022; 52:25-67. [PMID: 36214993 PMCID: PMC9734240 DOI: 10.1007/s40279-022-01756-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 12/15/2022]
Abstract
The ketone bodies acetoacetate (AcAc) and β-hydroxybutyrate (βHB) have pleiotropic effects in multiple organs including brain, heart, and skeletal muscle by serving as an alternative substrate for energy provision, and by modulating inflammation, oxidative stress, catabolic processes, and gene expression. Of particular relevance to athletes are the metabolic actions of ketone bodies to alter substrate utilisation through attenuating glucose utilisation in peripheral tissues, anti-lipolytic effects on adipose tissue, and attenuation of proteolysis in skeletal muscle. There has been long-standing interest in the development of ingestible forms of ketone bodies that has recently resulted in the commercial availability of exogenous ketone supplements (EKS). These supplements in the form of ketone salts and ketone esters, in addition to ketogenic compounds such as 1,3-butanediol and medium chain triglycerides, facilitate an acute transient increase in circulating AcAc and βHB concentrations, which has been termed 'acute nutritional ketosis' or 'intermittent exogenous ketosis'. Some studies have suggested beneficial effects of EKS to endurance performance, recovery, and overreaching, although many studies have failed to observe benefits of acute nutritional ketosis on performance or recovery. The present review explores the rationale and historical development of EKS, the mechanistic basis for their proposed effects, both positive and negative, and evidence to date for their effects on exercise performance and recovery outcomes before concluding with a discussion of methodological considerations and future directions in this field.
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de Sousa MV, Lundsgaard AM, Christensen PM, Christensen L, Randers MB, Mohr M, Nybo L, Kiens B, Fritzen AM. Nutritional optimization for female elite football players-topical review. Scand J Med Sci Sports 2021; 32 Suppl 1:81-104. [PMID: 34865242 DOI: 10.1111/sms.14102] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/13/2021] [Accepted: 11/17/2021] [Indexed: 11/29/2022]
Abstract
Women's football is an intermittent sport characterized by frequent intense actions throughout the match. The high number of matches with limited recovery time played across a long competitive season underlines the importance of nutritional strategies to meet these large physical demands. In order to maximize sport performance and maintain good health, energy intake must be optimal. However, a considerable proportion of female elite football players does not have sufficient energy intake to match the energy expenditure, resulting in low energy availability that might have detrimental physiologic consequences and impair performance. Carbohydrates appear to be the primary fuel covering the total energy supply during match-play, and female elite football players should aim to consume sufficient carbohydrates to meet the requirements of their training program and to optimize the replenishment of muscle glycogen stores between training bouts and matches. However, several macro- and micronutrients are important for ensuring sufficient energy and nutrients for performance optimization and for overall health status in female elite football players. The inadequacy of macro-and micronutrients in the diet of these athletes may impair performance and training adaptations, and increase the risk of health disorders, compromising the player's professional career. In this topical review, we present knowledge and relevant nutritional recommendations for elite female football players for the benefit of sports nutritionists, dietitians, sports scientists, healthcare specialists, and applied researchers. We focus on dietary intake and cover the most pertinent topics in sports nutrition for the relevant physical demands in female elite football players as follows: energy intake, macronutrient and micronutrient requirements and optimal composition of the everyday diet, nutritional and hydration strategies to optimize performance and recovery, potential ergogenic effects of authorized relevant supplements, and future research considerations.
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Affiliation(s)
- Maysa V de Sousa
- Laboratory of Medical Investigation, LIM-18, Endocrinology Division, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Anne-Marie Lundsgaard
- Department of Nutrition, Exercise and Sports, Section of Molecular Physiology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Lars Christensen
- Department of Nutrition, Exercise and Sports, Section of Obesity Research, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Morten B Randers
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark.,School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Magni Mohr
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark.,Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section of Integrative Physiology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Bente Kiens
- Department of Nutrition, Exercise and Sports, Section of Molecular Physiology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Andreas M Fritzen
- Department of Nutrition, Exercise and Sports, Section of Molecular Physiology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Pasiakos SM, Karl JP, Margolis LM. Challenging traditional carbohydrate intake recommendations for optimizing performance at high altitude. Curr Opin Clin Nutr Metab Care 2021; 24:483-489. [PMID: 34284412 DOI: 10.1097/mco.0000000000000782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To highlight emerging evidence challenging traditional recommendations to increase carbohydrate intake to optimize performance at high altitude. RECENT FINDINGS Several studies have now clearly demonstrated that, compared with sea level, exogenous carbohydrate oxidation during aerobic exercise is blunted in lowlanders during initial exposure to high altitude. There is also no apparent ergogenic effect of ingesting carbohydrate during aerobic exercise on subsequent performance at high altitude, either initially after arriving or even after up to 22 days of acclimatization. The inability to oxidize and functionally benefit from exogenous carbohydrate intake during exercise after arriving at high altitude coincides with hyperinsulinemia, accelerated glycogenolysis, and reduced peripheral glucose uptake. Collectively, these responses are consistent with a hypoxia-mediated metabolic dysregulation reflective of insulin resistance. Parallel lines of evidence have also recently demonstrated roles for the gut microbiome in host metabolism, bioenergetics, and physiologic responses to high altitude, implicating the gut microbiome as one potential mediator of hypoxia-mediated metabolic dysregulation. SUMMARY Identification of novel and well tolerated nutrition and/or pharmacological approaches for alleviating hypoxia-mediated metabolic dysregulation and enhancing exogenous carbohydrate oxidation may be more effective for optimizing performance of lowlanders newly arrived at high altitude than traditional carbohydrate recommendations.
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Affiliation(s)
- Stefan M Pasiakos
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
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Hrozanova M, Talsnes R, Karlsson Ø, McGawley K, Moen F. An observational study of sleep characteristics in elite endurance athletes during an altitude training camp at 1800 m. Sleep Health 2021; 7:691-698. [PMID: 34635445 DOI: 10.1016/j.sleh.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/05/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To observe changes in sleep from baseline and during an altitude training camp in elite endurance athletes. DESIGN Prospective, observational. SETTING Baseline monitoring at <500 m for 2 weeks and altitude monitoring at 1800 m for 17-22 days. PARTICIPANTS Thirty-three senior national-team endurance athletes (mean age 25.8 ± S.D. 2.8 years, 16 women). MEASUREMENTS Daily measurements of sleep (using a microwave Doppler radar at baseline and altitude), oxygen saturation (SpO2), training load and subjective recovery (at altitude). RESULTS At altitude vs. baseline, sleep duration (P = .036) and light sleep (P < .001) decreased, while deep sleep (P < .001) and respiration rate (P = .020) increased. During the first altitude week vs. baseline, deep sleep increased (P = .001). During the first vs. the second and third altitude weeks, time in bed (P = .005), sleep duration (P = .001), and light sleep (P < .001) decreased. Generally, increased SpO2 was associated with increased deep sleep while increased training load was associated with increased respiration rate. CONCLUSION This is the first study to document changes in sleep from near-sea-level baseline and during a training camp at 1800 m in elite endurance athletes. Ascending to altitude reduced total sleep time and light sleep, while deep sleep and respiration rate increased. SpO2 and training load at altitude were associated with these responses. This research informs our understanding of the changes in sleep occurring in elite endurance athletes attending training camps at competition altitudes.
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Affiliation(s)
- Maria Hrozanova
- Center for Elite Sports Research, Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Rune Talsnes
- Meråker High School, Trøndelag County Council, Meråker, Norway; Department of Sports Science and Physical Education, Nord University, Bodø, Norway
| | - Øyvind Karlsson
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Kerry McGawley
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Frode Moen
- Faculty of Social and Educational Sciences, Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
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Paris HL, Sinai EC, Shei RJ, Keller AM, Mickleborough TD. The influence of carbohydrate ingestion on peripheral and central fatigue during exercise in hypoxia: A narrative review. Eur J Sport Sci 2021; 21:1423-1435. [PMID: 33106121 PMCID: PMC8140067 DOI: 10.1080/17461391.2020.1842512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Hypoxia impairs aerobic performance by accelerating fatiguing processes. These processes may originate from sites either distal (peripheral) or proximal (central) to the neuromuscular junction, though these are not mutually exclusive. Peripheral mechanisms include decrements in muscle glycogen or fluctuations in intramuscular metabolites, whereas central responses commonly refer to reductions in central motor drive elicited by alterations in blood glucose and neurotransmitter concentrations as well as arterial hypoxemia. Hypoxia may accelerate both peripheral and central pathways of fatigue, with the level of hypoxia strongly dictating the degree and primary locus of impairment. As more people journey to hypoxic settings for work and recreation, developing strategies to improve work capacity in these environments becomes increasingly relevant. Given that sea level performance improves with nutritional interventions such as carbohydrate (CHO) ingestion, a similar strategy may prove effective in delaying fatigue in hypoxia, particularly considering how the metabolic pathways enhanced with CHO supplementation overlap the fatiguing pathways upregulated in hypoxia. Many questions regarding the relationship between CHO, hypoxia, and fatigue remain unanswered, including specifics on when to ingest, what to ingest, and how varying altitudes influence supplementation effectiveness. Therefore, the purpose of this narrative review is to examine the peripheral and central mechanisms contributing to fatigue during aerobic exercise at varying degrees of hypoxia and to assess the role of CHO ingestion in attenuating fatigue onset.
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Affiliation(s)
- Hunter L Paris
- Department of Sports Medicine, Pepperdine University, Malibu, CA, USA
| | - Erin C Sinai
- Department of Sports Medicine, Pepperdine University, Malibu, CA, USA
| | - Ren-Jay Shei
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, and Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Timothy D Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
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Anemia in Sports: A Narrative Review. Life (Basel) 2021; 11:life11090987. [PMID: 34575136 PMCID: PMC8472039 DOI: 10.3390/life11090987] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/06/2021] [Accepted: 09/16/2021] [Indexed: 12/12/2022] Open
Abstract
Recent years have brought about new understandings regarding the pathogenesis of anemia in sports. From hemodilution and redistribution considered to contribute to the so-called “sports anemia” to iron deficiency caused by increased demands, dietary restrictions, decreased absorption, increased losses, hemolysis, and sequestration, to genetic determinants of different types of anemia (some related to sport), the anemia in athletes deserves a careful and multifactorial approach. Dietary factors that reduce iron absorption (e.g., phytate, polyphenols) and that augment iron’s bioavailability (e.g., ascorbic acid) should be considered. Celiac disease, more prevalent in female athletes, may underlie an unexplained iron deficiency anemia. Iron loss during exercise occurs in several ways: sweating, hematuria, gastrointestinal bleeding, inflammation, and intravascular and extravascular hemolysis. From a practical point of view, assessing iron status, especially in the athletes at risk for iron deficiency (females, adolescents, in sports with dietary restrictions, etc.), may improve the iron balance and possibly the performance. Hemoglobin and serum ferritin are measures that are easily employable for the evaluation of patients’ iron status. Cutoff values should probably be further assessed with respect to the sex, age, and type of sport. A healthy gut microbiome influences the iron status. Athletes at risk of iron deficiency should perform non-weight-bearing, low-intensity sports to avoid inducing hemolysis.
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Macuh M, Knap B. Effects of Nitrate Supplementation on Exercise Performance in Humans: A Narrative Review. Nutrients 2021; 13:3183. [PMID: 34579061 PMCID: PMC8465461 DOI: 10.3390/nu13093183] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 12/20/2022] Open
Abstract
Nitrates have become increasingly popular for their potential role as an ergogenic aid. The purpose of this article was to review the current scientific evidence of nitrate supplementation on human performance. The current recommendation of nitrate supplementation is discussed, as well as possible health complications associated with nitrate intake for athletes, and dietary strategies of covering nitrate needs through sufficient intake of nitrate-rich foods alone are presented. Pubmed, Scopus, and Web of Science were searched for articles on the effects of nitrate supplementation in humans. Nitrates are an effective ergogenic aid when taken acutely or chronically in the range of ~5-16.8 mmol (~300-1041 mg) 2-3 h before exercise and primarily in the case of exercise duration of ~10-17 min in less trained individuals (VO2max < 65 mL/kg/min). Nitrate needs are most likely meet by ingesting approximately 250-500 g of leafy and root vegetables per day; however, dietary supplements might represent a more convenient and accurate way of covering an athlete's nitrate needs. Athletes should refrain from mouthwash usage when nitrate supplementation benefits are desired. Future research should focus on the potential beneficial effects of nitrate supplementation on brain function, possible negative impacts of chronic nitrate supplementation through different nitrate sources, and the effectiveness of nitrate supplementation on strength and high-intensity intermittent exercise.
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Affiliation(s)
- Matjaž Macuh
- Department of Food Science and Technology, Biotechnical Faculty, University of Ljubljana; Jamnikarjeva 10, 1000 Ljubljana, Slovenia
| | - Bojan Knap
- Department of Nephrology, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, Korytkova ulica 2, 1000 Ljubljana, Slovenia
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Hou Y, Wang X, Zhang Y, Wang S, Meng X. Highland mate: Edible and functional foods in traditional medicine for the prevention and treatment of hypoxia-related symptoms. Curr Opin Pharmacol 2021; 60:306-314. [PMID: 34508939 DOI: 10.1016/j.coph.2021.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/25/2021] [Accepted: 07/28/2021] [Indexed: 12/13/2022]
Abstract
The highlands evoke both fascination and awe. Regardless of the reason to live in the highlands, symptoms related to altitude sickness are unbearable because of low atmospheric pressure, low oxygen concentration, strong ultraviolet radiation, cold, and psychological factors. Food and herbal medicines and/or health-care foods have protected highland dwellers owing to their multisystem regulation. These versatile products combine health-care properties with medical values by enhancing immunity, relieving physical fatigue, improving sleep, and augmenting hypoxia tolerance, with rare side effects. We therefore aimed to provide a more comprehensive analysis of these nutraceuticals, which can be used to prevent and treat symptoms of altitude hypoxia in the Chinese market. Finally, we dissect a new perspective for their promotion and development from molecular aspects.
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Affiliation(s)
- Ya Hou
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China; State Key Laboratory of Southwestern Chinese Medicine Resources, Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaobo Wang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Ethnic Medicine Academic Heritage Innovation Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Yi Zhang
- Ethnic Medicine Academic Heritage Innovation Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China; School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shaohui Wang
- Ethnic Medicine Academic Heritage Innovation Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China; School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Xianli Meng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Commentaries on Viewpoint: Fragile bones of elite cyclists: to treat or not to treat? J Appl Physiol (1985) 2021; 131:29-33. [PMID: 34181462 DOI: 10.1152/japplphysiol.00335.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Koivisto-Mørk AE, Svendsen IS, Skattebo Ø, Hallén J, Paulsen G. Impact of baseline serum ferritin and supplemental iron on altitude-induced hemoglobin mass response in elite athletes. Scand J Med Sci Sports 2021; 31:1764-1773. [PMID: 33908091 DOI: 10.1111/sms.13982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/26/2021] [Accepted: 04/16/2021] [Indexed: 01/05/2023]
Abstract
The present study explored the impact of pre-altitude serum (s)-ferritin and iron supplementation on changes in hemoglobin mass (ΔHbmass) following altitude training. Measures of Hbmass and s-ferritin from 107 altitude sojourns (9-28 days at 1800-2500 m) with world-class endurance athletes (males n = 41, females n = 25) were analyzed together with iron supplementation and self-reported illness. Altitude sojourns with a hypoxic dose [median (range)] of 1169 (912) km·h increased Hbmass (mean ± SD) 36 ± 38 g (3.7 ± 3.7%, p < 0.001) and decreased s-ferritin -11 (190) µg·L-1 (p = 0.001). Iron supplements [27 (191) mg·day-1 ] were used at 45 sojourns (42%), while only 11 sojourns (10%) were commenced with s-ferritin <35 µg/L. Hbmass increased by 4.6 ± 3.7%, 3.4 ± 3.3%, 4.2 ± 4.3%, and 2.9 ± 3.4% with pre-altitude s-ferritin ≤35 µg·L-1 , 36-50 µg·L-1 , 51-100 µg·L-1 , and >100 µg·L-1 , respectively, with no group difference (p = 0.400). Hbmass increased by 4.1 ± 3.9%, 3.0 ± 3.0% and 3.7 ± 4.7% without, ≤50 mg·day-1 or >50 mg·day-1 supplemental iron, respectively (p = 0.399). Linear mixed model analysis revealed no interaction between pre-altitude s-ferritin and iron supplementation on ΔHbmass (p = 0.906). However, each 100 km·h increase in hypoxic dose augmented ΔHbmass by an additional 0.4% (95% CI: 0.1-0.7%; p = 0.012), while each 1 g·kg-1 higher pre-altitude Hbmass reduced ΔHbmass by -1% (-1.6 to -0.5; p < 0.001), and illness lowered ΔHbmass by -5.7% (-8.3 to -3.1%; p < 0.001). In conclusion, pre-altitude s-ferritin or iron supplementation were not related to the altitude-induced increase in Hbmass (3.7%) in world-class endurance athletes with clinically normal iron stores.
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Affiliation(s)
- Anu Elisa Koivisto-Mørk
- Norwegian Olympic Sports Centre, Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Ida Siobhan Svendsen
- Norwegian Olympic Sports Centre, Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Øyvind Skattebo
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jostein Hallén
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Gøran Paulsen
- Norwegian Olympic Sports Centre, Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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Sandbakk Ø, Solli GS, Talsnes RK, Holmberg HC. Preparing for the Nordic Skiing Events at the Beijing Olympics in 2022: Evidence-Based Recommendations and Unanswered Questions. JOURNAL OF SCIENCE IN SPORT AND EXERCISE 2021; 3:257-269. [PMID: 38624672 PMCID: PMC8107804 DOI: 10.1007/s42978-021-00113-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/26/2021] [Indexed: 11/06/2022]
Abstract
At the 2022 Winter Olympics in Beijing, the XC skiing, biathlon and nordic combined events will be held at altitudes of ~ 1700 m above sea level, possibly in cold environmental conditions and while requiring adjustment to several time zones. However, the ongoing COVID-19 pandemic may lead to sub-optimal preparations. The current commentary provides the following evidence-based recommendations for the Olympic preparations: make sure to have extensive experience of training (> 60 days annually) and competition at or above the altitude of competition (~ 1700 m), to optimize and individualize your strategies for acclimatization and competition. In preparing for the Olympics, 10-14 days at ~ 1700 m seems to optimize performance at this altitude effectively. An alternative strategy involves two-three weeks of training at > 2000 m, followed by 7-10 days of tapering off at ~ 1700 m. During each of the last 3 or 4 days prior to departure, shift your sleeping and eating schedule by 0.5-1 h towards the time zone in Beijing. In addition, we recommend that you arrive in Beijing one day earlier for each hour change in time zone, followed by appropriate timing of exposure to daylight, meals, social contacts, and naps, in combination with a gradual increase in training load. Optimize your own individual procedures for warming-up, as well as for maintaining body temperature during the period between the warm-up and competition, effective treatment of asthma (if necessary) and pacing at ~ 1700 m with cold ambient temperatures. Although we hope that these recommendations will be helpful in preparing for the Beijing Olympics in 2022, there is a clear need for more solid evidence gained through new sophisticated experiments and observational studies.
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Affiliation(s)
- Øyvind Sandbakk
- Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro Strøm Solli
- Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Sports Science and Physical Education, Nord University, Bodø, Norway
| | - Rune Kjøsen Talsnes
- Department of Sports Science and Physical Education, Nord University, Bodø, Norway
- Meråker High School, Trøndelag County Council, Steinkjer, Norway
| | - Hans-Christer Holmberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Gaur P, Prasad S, Kumar B, Sharma SK, Vats P. High-altitude hypoxia induced reactive oxygen species generation, signaling, and mitigation approaches. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:601-615. [PMID: 33156424 DOI: 10.1007/s00484-020-02037-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 10/05/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
Homeostasis between pro-oxidants and anti-oxidants is necessary for aerobic life, which if perturbed and shifted towards pro-oxidants results in oxidative stress. It is generally agreed that reactive oxygen species (ROS) production is accelerated with mountainous elevation, which may play a role in spawning serious health crisis. Exposure to increasing terrestrial altitude leads to a reduction in ambient O2 availability in cells producing a series of hypoxic oxidative stress reactions and altering the redox balance in humans. Enormous literature on redox signaling drove research activity towards understanding the role of oxidative stress under normal and challenging conditions like high-altitude hypoxia which grounds for disturbed redox signaling. Excessive ROS production and accumulation of free radicals in cells and tissues can cause various pulmonary, cardiovascular, and metabolic pathophysiological conditions. In order to counteract this oxidative stress and maintain the balance of pro-oxidants and anti-oxidants, an anti-oxidant system exists in the human body, which, however, gets surpassed by elevated ROS levels, but can be strengthened through the use of anti-oxidant supplements. Such cumulative studies of fundamentals on a global concept like oxidative stress and role of anti-oxidants can act as a foundation to further smoothen for researchers to study over health, disease, and other pathophysiological conditions. This review highlights the interconnection between high altitude and oxidative stress and the role of anti-oxidants to protect cells from oxidative damages and to lower the risk of altitude-associated sickness.
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Affiliation(s)
- Priya Gaur
- Endocrinology & Metabolism Division, Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO, Lucknow Road, Timarpur, Delhi, 110054,, India
| | - Suchita Prasad
- Department of Chemistry, University of Delhi, Delhi, 110007,, India
| | - Bhuvnesh Kumar
- Endocrinology & Metabolism Division, Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO, Lucknow Road, Timarpur, Delhi, 110054,, India
| | - Sunil K Sharma
- Department of Chemistry, University of Delhi, Delhi, 110007,, India.
| | - Praveen Vats
- Endocrinology & Metabolism Division, Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO, Lucknow Road, Timarpur, Delhi, 110054,, India.
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Kayser B, Verges S. Hypoxia, energy balance, and obesity: An update. Obes Rev 2021; 22 Suppl 2:e13192. [PMID: 33470528 DOI: 10.1111/obr.13192] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023]
Abstract
Because of the enduring rise in the prevalence of obesity worldwide, there is continued interest in hypoxia as a mechanism underlying the pathophysiology of obesity and its comorbidities and as a potential therapeutic adjunct for the management of the disease. Lifelong exposure to altitude is accompanied by a lower risk for obesity, whereas altitude sojourns are generally associated with a loss of body mass. A negative energy balance upon exposure to hypoxia can be due to a combination of changes in determinants of energy expenditure (resting metabolic rate and physical activity energy expenditure) and energy intake (appetite). Over the past 15 years, the potential therapeutic interest of hypobaric or normobaric hypoxic exposure in individuals with obesity-to lower body mass and improve health status-has become an active field of research. Various protocols have been implemented, using actual altitude sojourns or intermittent normobaric hypoxic exposures, at rest or in association with physical activity. Although several studies suggest benefits on body mass and cardiovascular and metabolic variables, further investigations are required before recommending hypoxic exposure in obesity management programs. Future studies should also better clarify the effects of hypoxia on appetite, the intestinal microbiota, and finally on overall energy balance.
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Affiliation(s)
- Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Samuel Verges
- HP2 Laboratory, INSERM, Grenoble Alpes University Hospital, Université Grenoble Alpes, Grenoble, France
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Sawada Y, Saito-Sasaki N, Nakamura M. Omega 3 Fatty Acid and Skin Diseases. Front Immunol 2021; 11:623052. [PMID: 33613558 PMCID: PMC7892455 DOI: 10.3389/fimmu.2020.623052] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/22/2020] [Indexed: 12/17/2022] Open
Abstract
Humans are exposed to various external environmental factors. Food intake is one of the most influential factors impacting daily lifestyle. Among nutrients obtained from foods, omega-3 polyunsaturated fatty acids (PUFAs) have various beneficial effects on inflammatory diseases. Furthermore, omega-3 PUFA metabolites, including resolvins, are known to demonstrate strong anti-inflammatory effects during allergic and inflammatory diseases; however, little is known regarding the actual impact of these metabolites on skin diseases. In this review, we focused on metabolites that have strong anti-inflammatory actions in various inflammatory diseases, as well as those that present antitumor actions in malignancies, in addition to the actual effect of omega-3 PUFA metabolites on various cells.
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Affiliation(s)
- Yu Sawada
- Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Natsuko Saito-Sasaki
- Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Motonobu Nakamura
- Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan
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