Effects of Dietary Supplements on Adaptations to Endurance Training

NLRP3 inflammasome and pyroptosis in cardiovascular diseases and exercise intervention

NOD-like receptor protein 3 (NLRP3) inflammasome is an intracellular sensing protein complex that possesses NACHT, leucine-rich repeat, and pyrin domain, playing a crucial role in innate immunity. Activation of the NLRP3 inflammasome leads to the production of pro-inflammatory cellular contents, such as interleukin (IL)-1β and IL-18, and induction of inflammatory cell death known as pyroptosis, thereby amplifying or sustaining inflammation. While a balanced inflammatory response is beneficial for resolving damage and promoting tissue healing, excessive activation of the NLRP3 inflammasome and pyroptosis can have harmful effects. The involvement of the NLRP3 inflammasome has been observed in various cardiovascular diseases (CVD). Indeed, the NLRP3 inflammasome and its associated pyroptosis are closely linked to key cardiovascular risk factors including hyperlipidemia, diabetes, hypertension, obesity, and hyperhomocysteinemia. Exercise compared with medicine is a highly effective measure for both preventing and treating CVD. Interestingly, emerging evidence suggests that exercise improves CVD and inhibits the activity of NLRP3 inflammasome and pyroptosis. In this review, the activation mechanisms of the NLRP3 inflammasome and its pathogenic role in CVD are critically discussed. Importantly, the purpose is to emphasize the crucial role of exercise in managing CVD by suppressing NLRP3 inflammasome activity and proposes it as the foundation for developing novel treatment strategies.

Effects of Particulate Matter Inhalation during Exercise on Oxidative Stress and Mitochondrial Function in Mouse Skeletal Muscle

Particulate matter (PM) has deleterious consequences not only on the respiratory system but also on essential human organs, such as the heart, blood vessels, kidneys, and liver. However, the effects of PM inhalation on skeletal muscles have yet to be sufficiently elucidated. Female C57BL/6 or mt-Keima transgenic mice were randomly assigned to one of the following four groups: control (CON), PM exposure alone (PM), treadmill exercise (EX), or PM exposure and exercise (PME). Mice in the three-treatment group were subjected to treadmill running (20 m/min, 90 min/day for 1 week) and/or exposure to PM (100 μg/m3). The PM was found to exacerbate oxidative stress and inflammation, both at rest and during exercise, as assessed by the levels of proinflammatory cytokines, manganese-superoxide dismutase activity, and the glutathione/oxidized glutathione ratio. Furthermore, we detected significant increases in the levels of in vivo mitophagy, particularly in the PM group. Compared with the EX group, a significant reduction in the level of mitochondrial DNA was recorded in the PME group. Moreover, PM resulted in a reduction in cytochrome c oxidase activity and an increase in hydrogen peroxide generation. However, exposure to PM had no significant effect on mitochondrial respiration. Collectively, our findings in this study indicate that PM has adverse effects concerning both oxidative stress and inflammatory responses in skeletal muscle and mitochondria, both at rest and during exercise.

Combined Exercise Training and Nutritional Interventions or Pharmacological Treatments to Improve Exercise Capacity and Body Composition in Chronic Obstructive Pulmonary Disease: A Narrative Review

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that is associated with significant morbidity, mortality, and healthcare costs. The burden of respiratory symptoms and airflow limitation can translate to reduced physical activity, in turn contributing to poor exercise capacity, muscle dysfunction, and body composition abnormalities. These extrapulmonary features of the disease are targeted during pulmonary rehabilitation, which provides patients with tailored therapies to improve the physical and emotional status. Patients with COPD can be divided into metabolic phenotypes, including cachectic, sarcopenic, normal weight, obese, and sarcopenic with hidden obesity. To date, there have been many studies performed investigating the individual effects of exercise training programs as well as nutritional and pharmacological treatments to improve exercise capacity and body composition in patients with COPD. However, little research is available investigating the combined effect of exercise training with nutritional or pharmacological treatments on these outcomes. Therefore, this review focuses on exploring the potential additional beneficial effects of combinations of exercise training and nutritional or pharmacological treatments to target exercise capacity and body composition in patients with COPD with different metabolic phenotypes.

Low Carbohydrate, High Fat Diet Alters the Oral Microbiome without Negating the Nitrite Response to Beetroot Juice Supplementation

A low carbohydrate, high fat (LCHF) diet in athletes increases fat oxidation but impairs sports performance, potentially due to impaired exercise economy. Dietary nitrate supplementation can improve exercise economy via an increase in nitric oxide production, which is initiated by the reduction of nitrate to nitrite within the oral cavity. This reaction is dependent on the presence of nitrate-reducing oral bacteria, which can potentially be altered by dietary changes, including a LCHF diet. This study explored the effect of a LCHF diet on the oral microbiome and subsequent changes to plasma nitrite concentration following nitrate supplementation. Following five days of LCHF or high carbohydrate (HCHO) control dietary intervention, highly trained male race walkers consumed 140 mL beetroot juice containing 8.4 mmol nitrate; they then provided (a) blood samples for plasma nitrate and nitrite analysis and (b) saliva samples for 16S rRNA sequencing of the oral microbiome. The LCHF diet (n = 13) reduced oral bacterial diversity and changed the relative abundance of the genera Neisseria (+10%), Fusobacteria (+3%), Prevotella (-9%), and Veillonella (-4%), with no significant changes observed following the HCHO diet (n = 11). Following beetroot juice ingestion, plasma nitrite concentrations were higher for the LCHF diet compared to the HCHO diet (p = 0.04). However, the absence of an interaction with the trial (pre-post) (p = 0.71) suggests that this difference was not due to the dietary intervention. In summary, we found an increase in plasma nitrate and nitrite concentrations in response to nitrate supplementation independent of diet. This suggests the oral microbiome is adaptive to dietary changes and can maintain a nitrate reduction capacity despite a decrease in bacterial diversity following the LCHF diet.

Does Co-Supplementation with Beetroot Juice and Other Nutritional Supplements Positively Impact Sports Performance?: A Systematic Review

In the pursuit of enhanced athletic prowess in different disciplines, athletes constantly look for strategies to increase their physical performance, encompassing technical skills and dietary components, which inevitably, in most cases, include the incorporation of sports supplements. In recent years, there has been an increase in the number of athletes using ergogenic aids. In this context, scientific evidence must play a prominent role in either endorsing or warning against the use of these products, ensuring the preservation of health while promoting the theoretically established positive benefits. In this vein, beetroot juice (BJ) stands out as a key supplement as an ergogenic aid to improve sports performance, given its demonstrated influence on both aerobic and anaerobic exercise. However, despite widespread global demand, there remains a lack of understanding regarding the potential synergistic effects of combining BJ with other supplements. Consequently, our study aims to determine whether the combination of BJ with another nutritional supplement can enhance its beneficial effects and, therefore, optimize physical performance in humans. A comprehensive literature search was conducted in two major databases-Web of Science and PubMed-from 1 January 2018 to 29 January 2023, using specific keywords. After the exclusion criteria, six articles were selected for analysis. Therefore, our study shows that the effectiveness of combining BJ with another supplement mainly depends on the duration of the chronic intervention, which is where the greatest benefits have been observed.

Effects of 12 Wk of Omega-3 Fatty Acid Supplementation in Long-Distance Runners

PURPOSE

This study aimed to investigate the effects of 12 wk of omega-3 fatty acid supplementation during endurance training on omega-3 index (O3I) and indicators of running performance in amateur long-distance runners.

METHODS

Twenty-six amateur male long-distance runners ≥29 yr old supplemented omega-3 fatty acid capsules (OMEGA group, n = 14; 2234 mg of eicosapentaenoic acid and 916 mg of docosahexaenoic acid daily) or medium-chain triglycerides capsules as placebo (medium-chain triglyceride [MCT] group, n = 12; 4000 mg of MCT daily) during 12 wk of endurance training. Before and after intervention, blood samples were collected for O3I assessment, and an incremental test to exhaustion and a 1500-m run trial were performed.

RESULTS

O3I was significantly increased in the OMEGA group (from 5.8% to 11.6%, P < 0.0001). A significant increase in V̇O 2peak was observed in the OMEGA group (from 53.6 ± 4.4 to 56.0 ± 3.7 mL·kg -1 ⋅min -1 , P = 0.0219) without such change in MCT group (from 54.7 ± 6.8 to 56.4 ± 5.9 mL·kg -1 ⋅min -1 , P = 0.1308). A positive correlation between the change in O3I and the change in running economy was observed when data of participants from both groups were combined (-0.1808 ± 1.917, P = 0.0020), without such an effect in OMEGA group alone ( P = 0.1741). No effect of omega-3 supplementation on 1500-m run results was observed.

CONCLUSIONS

Twelve weeks of omega-3 fatty acid supplementation at a dose of 2234 mg of eicosapentaenoic acid and 916 mg of docosahexaenoic acid daily during endurance training resulted in the improvement of O3I and running economy and increased V̇O 2peak without improvement in the 1500-m run trial time in amateur runners.

Running-Induced Metabolic and Physiological Responses Using New Zealand Blackcurrant Extract in a Male Ultra-Endurance Runner: A Case Study

Physical training for ultra-endurance running provides physiological adaptations for exercise-induced substrate oxidation. We examined the effects of New Zealand blackcurrant (NZBC) extract on running-induced metabolic and physiological responses in a male amateur ultra-endurance runner (age: 40 years, body mass: 65.9 kg, BMI: 23.1 kg·m−2, body fat: 14.7%, V˙O2max: 55.3 mL·kg−1·min−1, resting heart rate: 45 beats·min−1, running history: 6 years, marathons: 20, ultra-marathons: 28, weekly training distance: ~80 km, weekly running time: ~9 h). Indirect calorimetry was used and heart rate recorded at 15 min intervals during 120 min of treadmill running (speed: 10.5 km·h−1, 58% V˙O2max) in an environmental chamber (temperature: ~26 °C, relative humidity: ~70%) at baseline and following 7 days intake of NZBC extract (210 mg of anthocyanins·day−1) with constant monitoring of core temperature. The male runner had unlimited access to water and consumed a 100-kcal energy gel at 40- and 80 min during the 120 min run. There were no differences (mean of 8, 15 min measurements) for minute ventilation, oxygen uptake, carbon dioxide production and core temperature. With NZBC extract, the respiratory exchange ratio was 0.02 units lower, carbohydrate oxidation was 11% lower and fat oxidation was 23% higher (control: 0.39 ± 0.08, NZBC extract: 0.48 ± 0.12 g·min−1, p < 0.01). Intake of the energy gel did not abolish the enhanced fat oxidation by NZBC extract. Seven days’ intake of New Zealand blackcurrant extract altered exercise-induced substrate oxidation in a male amateur ultra-endurance runner covering a half-marathon distance in 2 h. More studies are required to address whether intake of New Zealand blackcurrant extract provides a nutritional ergogenic effect for ultra-endurance athletes to enhance exercise performance.

Effects of Mediterranean Diet Combined with CrossFit Training on Trained Adults’ Performance and Body Composition

CrossFit is a high-intensity training discipline increasingly practiced in recent years. Specific nutritional approaches are usually recommended to maximize performance and improve body composition in high-intensity training regimens; notwithstanding, to date there are no targeted nutritional recommendations for CrossFit athletes. The Mediterranean Diet (MD) is a diet approach with a well-designed proportion of macronutrients, using only available/seasonal food of the Mediterranean area, whose health benefits are well demonstrated. No studies have evaluated this dietary strategy among CrossFit athletes and practitioners; for this reason, we tested the effects of 8 weeks of MD on CrossFit athletes’ performance and body composition. Participants were assigned to two groups: a diet group (DG) in which participants performed CrossFit training plus MD, and a control group (CG) in which participants partook in the CrossFit training, continuing their habitual diet. Participants were tested before and after the 8 weeks of intervention. At the end of the study, no significant difference was noted in participants’ body composition, whereas improvements in anaerobic power, explosive strength of the lower limbs, and CrossFit-specific performance were observed only in the DG. Our results suggest that adopting a MD in CrossFit athletes/practitioners could be a useful strategy to improve specific strength, endurance, and anaerobic capacity while maintaining overall body composition.

Nutritional Ergogenic Aids in Combat Sports: A Systematic Review and Meta-Analysis

Nutritional ergogenic aids (NEAs) are substances included within the group of sports supplements. Although they are widely consumed by athletes, evidence-based analysis is required to support training outcomes or competitive performance in specific disciplines. Combat sports have a predominant use of anaerobic metabolism as a source of energy, reaching peak exertion or sustained effort for very short periods of time. In this context, the use of certain NEAs could help athletes to improve their performance in those specific combat skills (i.e., the number of attacks, throws and hits; jump height; and grip strength, among others) as well as in general physical aspects (time to exhaustion [TTE], power, fatigue perception, heart rate, use of anaerobic metabolism, etc.). Medline/PubMed, Scopus and EBSCO were searched from their inception to May 2022 for randomised controlled trials (RCTs). Out of 677 articles found, 55 met the predefined inclusion criteria. Among all the studied NEAs, caffeine (5–10 mg/kg) showed strong evidence for its use in combat sports to enhance the use of glycolytic pathways for energy production during high-intensity actions due to a greater production of and tolerance to blood lactate levels. In this regard, abilities including the number of attacks, reaction time, handgrip strength, power and TTE, among others, were improved. Buffering supplements such as sodium bicarbonate, sodium citrate and beta-alanine may have a promising role in high and intermittent exertion during combat, but more studies are needed in grappling combat sports to confirm their efficacy during sustained isometric exertion. Other NEAs, including creatine, beetroot juice or glycerol, need further investigation to strengthen the evidence for performance enhancement in combat sports. Caffeine is the only NEA that has shown strong evidence for performance enhancement in combat sports.

Caffeine Combined With Sodium Bicarbonate Improves Pacing and Overall Performance During a High-Intensity Time Trial

Background: No study has demonstrated the effects of sodium bicarbonate plus caffeine (NaHCO₃ + CAF) on power output (PO) distribution (e.g., pacing), physiological parameters and energy system contribution during a 4-km cycling time trial (TT). Thus, we aimed to investigate the effects of NaHCO₃ + CAF on pacing, physiological parameters, and energy system contribution during a 4-km cycling TT. Methods: Using a double-blind and counterbalanced design, 10 cyclists performed three ingestion protocols (NaHCO₃ + CAF, NaHCO₃ and placebo) followed by a 4-km cycling TT. Results: 100 min after substance ingestion, the magnitude of change in blood pH and bicarbonate concentration [HCO₃^-] for NaHCO₃ + CAF (+0.04 ± 0.03 and +5.9 ± 1.6 mmol·L^-1, respectively, P < .05) and NaHCO₃ (+0.02 ± 0.03 and +4.1 ± 2.0 mmol·L^-1, respectively, P < .05) was more pronounced than in placebo (-0.01 ± 0.02 and 0.4 ± 0.9 mmol·L^-1, respectively). The increase in plasma lactate concentration was more pronounced in NaHCO₃ + CAF than in NaHCO₃ and placebo (P < .05). Mean ventilation and carbon dioxide production were higher in NaHCO₃ + CAF compared to NaHCO₃ and placebo (P < .05). The PO and anaerobic power output were increased at the beginning of the 4-km TT (P < .05) in NaHCO₃ + CAF compared to the other two conditions, resulting in an improved overall performance (P < .05). Conclusion: NaHCO₃ + CAF results in a higher PO and increased anaerobic contribution and respiratory parameters during a 4-km cycling TT.

The effect of endurance, resistance training, and supplements on mitochondria and bioenergetics of muscle cells

Bioenergetics is the study of energy flow between biological systems and the surroundings and is measured quantitatively. Energy flow can be affected by many variables, including lifestyle and exercise, where exercise comes in different types; endurance and resistance training play significant roles in enhancing bioenergetics and promoting health. In addition, a supplementary diet supports recovery and energy production. This review aims to study the effect of endurance training, resistance training, and supplement intake on the muscle cell's bioenergetics. As a conclusion of the information presented in this mini-review, it was found that resistance, endurance training, and supplements can increase mitochondrial biogenesis, fat oxidation, myofibril synthesis, and increase VO₂ max.

Research Progress of Mitochondrial Mechanism in NLRP3 Inflammasome Activation and Exercise Regulation of NLRP3 Inflammasome

NLRP3 is an important pattern recognition receptor in the innate immune system, and its activation induces a large number of pro-inflammatory cytokines, IL-1β and IL-18 which are involved in the development of various diseases. In recent years, it has been suggested that mitochondria are the platform for NLRP3 inflammasome activation. Additionally, exercise is considered as an important intervention strategy to mediate the innate immune responses. Generally, chronic moderate-intensity endurance training, resistance training and high-intensity interval training inhibit NLRP3 inflammasome activation in response to various pathological factors. In contrast, acute exercise activates NLRP3 inflammasome. However, the mechanisms by which exercise regulates NLRP3 inflammasome activation are largely unclear. Therefore, the mechanism of NLRP3 inflammasome activation is discussed mainly from the perspective of mitochondria in this review. Moreover, the effect and potential mechanism of exercise on NLRP3 inflammasome are explored, hoping to provide new target for relevant research.

Effects of Tryptophan Supplementation and Exercise on the Fate of Kynurenine Metabolites in Mice and Humans

The kynurenine pathway of tryptophan (TRP) degradation (KP) generates metabolites with effects on metabolism, immunity, and mental health. Endurance exercise training can change KP metabolites by changing the levels of KP enzymes in skeletal muscle. This leads to a metabolite pattern that favors energy expenditure and an anti-inflammatory immune cell profile and reduces neurotoxic metabolites. Here, we aimed to understand if TRP supplementation in untrained vs. trained subjects affects KP metabolite levels and biological effects. Our data show that chronic TRP supplementation in mice increases all KP metabolites in circulation, and that exercise reduces the neurotoxic branch of the pathway. However, in addition to increasing wheel running, we did not observe other effects of TRP supplementation on training adaptations, energy metabolism or behavior in mice. A similar increase in KP metabolites was seen in trained vs. untrained human volunteers that took a TRP drink while performing a bout of aerobic exercise. With this acute TRP administration, TRP and KYN were higher in the trained vs. the untrained group. Considering the many biological effects of the KP, which can lead to beneficial or deleterious effects to health, our data encourage future studies of the crosstalk between TRP supplementation and physical exercise.

Creatine Supplementation: An Update

ABSTRACT

Creatine is a popular and widely used ergogenic dietary supplement among athletes, for which studies have consistently shown increased lean muscle mass and exercise capacity when used with short-duration, high-intensity exercise. In addition to strength gains, research has shown that creatine supplementation may provide additional benefits including enhanced postexercise recovery, injury prevention, rehabilitation, as well as a number of potential neurologic benefits that may be relevant to sports. Studies show that short- and long-term supplementation is safe and well tolerated in healthy individuals and in a number of patient populations.

Creatine for Exercise and Sports Performance, with Recovery Considerations for Healthy Populations

Creatine is one of the most studied and popular ergogenic aids for athletes and recreational weightlifters seeking to improve sport and exercise performance, augment exercise training adaptations, and mitigate recovery time. Studies consistently reveal that creatine supplementation exerts positive ergogenic effects on single and multiple bouts of short-duration, high-intensity exercise activities, in addition to potentiating exercise training adaptations. In this respect, supplementation consistently demonstrates the ability to enlarge the pool of intracellular creatine, leading to an amplification of the cell's ability to resynthesize adenosine triphosphate. This intracellular expansion is associated with several performance outcomes, including increases in maximal strength (low-speed strength), maximal work output, power production (high-speed strength), sprint performance, and fat-free mass. Additionally, creatine supplementation may speed up recovery time between bouts of intense exercise by mitigating muscle damage and promoting the faster recovery of lost force-production potential. Conversely, contradictory findings exist in the literature regarding the potential ergogenic benefits of creatine during intermittent and continuous endurance-type exercise, as well as in those athletic tasks where an increase in body mass may hinder enhanced performance. The purpose of this review was to summarize the existing literature surrounding the efficacy of creatine supplementation on exercise and sports performance, along with recovery factors in healthy populations.

Pre-Exercise Carbohydrate or Protein Ingestion Influences Substrate Oxidation but Not Performance or Hunger Compared with Cycling in the Fasted State

Nutritional intake can influence exercise metabolism and performance, but there is a lack of research comparing protein-rich pre-exercise meals with endurance exercise performed both in the fasted state and following a carbohydrate-rich breakfast. The purpose of this study was to determine the effects of three pre-exercise nutrition strategies on metabolism and exercise capacity during cycling. On three occasions, seventeen trained male cyclists (VO_2peak 62.2 ± 5.8 mL·kg⁻¹·min⁻¹, 31.2 ± 12.4 years, 74.8 ± 9.6 kg) performed twenty minutes of submaximal cycling (4 × 5 min stages at 60%, 80%, and 100% of ventilatory threshold (VT), and 20% of the difference between power at the VT and peak power), followed by 3 × 3 min intervals at 80% peak aerobic power and 3 × 3 min intervals at maximal effort, 30 min after consuming a carbohydrate-rich meal (CARB; 1 g/kg CHO), a protein-rich meal (PROTEIN; 0.45 g/kg protein + 0.24 g/kg fat), or water (FASTED), in a randomized and counter-balanced order. Fat oxidation was lower for CARB compared with FASTED at and below the VT, and compared with PROTEIN at 60% VT. There were no differences between trials for average power during high-intensity intervals (367 ± 51 W, p = 0.516). Oxidative stress (F₂-Isoprostanes), perceived exertion, and hunger were not different between trials. Overall, exercising in the overnight-fasted state increased fat oxidation during submaximal exercise compared with exercise following a CHO-rich breakfast, and pre-exercise protein ingestion allowed similarly high levels of fat oxidation. There were no differences in perceived exertion, hunger, or performance, and we provide novel data showing no influence of pre-exercise nutrition ingestion on exercise-induced oxidative stress.

Flavonoid Containing Polyphenol Consumption and Recovery from Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis

BACKGROUND

Flavonoid polyphenols are bioactive phytochemicals found in fruits and teas among other sources. It has been postulated that foods and supplements containing flavonoid polyphenols may enhance recovery from exercise-induced muscle damage (EIMD) through upregulation of cell signalling stress response pathways, particularly the nuclear factor erythroid 2-related factor 2 (NRF2) pathway.

OBJECTIVES

This study aims to investigate the ability of polyphenol treatments containing flavonoids to enhance recovery of skeletal muscle strength, soreness and creatine kinase post EIMD.

METHODS

Medline (Pubmed), Embase and SPORTdiscus were searched from inception to August 2020 for randomised placebo-controlled trials which assessed the impact of 6 or more days of flavonoid containing polyphenol ingestion on skeletal muscle recovery in the 96-h period following a single bout of EIMD. A total of 2983 studies were screened in duplicate resulting in 26 studies included for analysis. All meta-analyses were undertaken using a random-effects model.

RESULTS

The pooled results of these meta-analyses show flavonoid polyphenol treatments can enhance recovery of muscle strength by 7.14% (95% CI [5.50-8.78], P < 0.00001) and reduce muscle soreness by 4.12% (95% CI [- 5.82 to - 2.41] P = 0.00001), no change in the recovery of creatine kinase concentrations was observed.

CONCLUSION

These results indicate that ingestion of polyphenol treatments which contain flavonoids has significant potential to improve recovery of muscular strength and reduce muscle soreness in the 4-day period post EIMD. However, the characterisation of polyphenol dosage and composition of study treatments should be prioritised in future research to facilitate the development of specific guidelines for the inclusion of flavonoid-rich foods in the diet of athletes and active individuals.

The Effects of High Mineral Alkaline Water Consumed Over Three Consecutive Days on Reaction Time Following Anaerobic Exercise - A Randomized Placebo-Controlled Crossover Pilot Study

Drinking alkaline water after intense anaerobic exercise may enhance both cognitive and physical performance. This study aimed to investigate the effect of high mineral alkaline water consumed over three consecutive days on reaction time after anaerobic exercise in twelve healthy young males (aged 21.1 ± 1.3 years) with a valid sports medical examination. Participants were excluded when they took any medications or performance-enhancing supplements for the period of at least four weeks before the study commenced. Participants were randomly divided into two groups in this double-blind, placebo-controlled crossover pilot study. They ingested either alkaline water (AW) or regular table water ( RTW) for three consecutive days before anaerobic exercise. The anaerobic exercise consisted of two 2-min high-intensity step-tests with a passive rest interval of 3 minutes between the two bouts of exercise. Performance in the step-test (W), reaction time for visual and auditory signals, the rate of perceived exertion (RPE), urine specific gravity, and lactate concentration were analysed. No effect of AW was found on reaction time and the other variables except anaerobic performance. An-aerobic performance was significantly higher after ingestion of AW in both step-tests (p < 0.05). The ingestion of AW for three consecutive days before anaerobic exercise seems to positively affect anaerobic performance.

Effect of Physical Training on Exercise-Induced Inflammation and Performance in Mice

Acute exercise increases the amount of circulating inflammatory cells and cytokines to maintain physiological homeostasis. However, it remains unclear how physical training regulates exercise-induced inflammation and performance. Here, we demonstrate that acute high intensity exercise promotes an inflammatory profile characterized by increased blood IL-6 levels, neutrophil migratory capacity, and leukocyte recruitment to skeletal muscle vessels. Moreover, we found that physical training amplified leukocyte-endothelial cell interaction induced by acute exercise in skeletal muscle vessels and diminished exercise-induced inflammation in skeletal muscle tissue. Furthermore, we verified that disruption of the gp-91 subunit of NADPH-oxidase inhibited exercise-induced leukocyte recruitment on skeletal muscle after training with enhanced exercise time until fatigue. In conclusion, the training was related to physical improvement and immune adaptations. Moreover, reactive oxygen species (ROS) could be related to mechanisms to limit aerobic performance and its absence decreases the inflammatory response elicited by exercise after training.

Blood-flow-restricted exercise: Strategies for enhancing muscle adaptation and performance in the endurance-trained athlete

NEW FINDINGS

What is the topic of this review? Blood-flow-restricted (BFR) exercise represents a potential approach to augment the adaptive response to training and improve performance in endurance-trained individuals. What advances does it highlight? When combined with low-load resistance exercise, low- and moderate-intensity endurance exercise and sprint interval exercise, BFR can provide an augmented acute stimulus for angiogenesis and mitochondrial biogenesis. These augmented acute responses can translate into enhanced capillary supply and mitochondrial function, and subsequent endurance-type performance, although this might depend on the nature of the exercise stimulus. There is a requirement to clarify whether BFR training interventions can be used by high-performance endurance athletes within their structured training programme.

ABSTRACT

A key objective of the training programme for an endurance athlete is to optimize the underlying physiological determinants of performance. Training-induced adaptations are governed by physiological and metabolic stressors, which initiate transcriptional and translational signalling cascades to increase the abundance and/or function of proteins to improve physiological function. One important consideration is that training adaptations are reduced as training status increases, which is reflected at the molecular level as a blunting of the acute signalling response to exercise. This review examines blood-flow-restricted (BFR) exercise as a strategy for augmenting exercise-induced stressors and subsequent molecular signalling responses to enhance the physiological characteristics of the endurance athlete. Focus is placed on the processes of capillary growth and mitochondrial biogenesis. Recent evidence supports that BFR exercise presents an intensified training stimulus beyond that of performing the same exercise alone. We suggest that this has the potential to induce enhanced physiological adaptations, including increases in capillary supply and mitochondrial function, which can contribute to an improvement in performance of endurance exercise. There is, however, a lack of consensus regarding the potency of BFR training, which is invariably attributable to the different modes, intensities and durations of exercise and BFR methods. Further studies are needed to confirm its potential in the endurance-trained athlete.

The effect of citrus flavonoid extract supplementation on anaerobic capacity in moderately trained athletes: a randomized controlled trial

BACKGROUND

Nutritional supplementation is commonly used by athletes to improve their exercise performance. Previous studies demonstrated that citrus flavonoid extract (CFE) supplementation may be an effective strategy to improve exercise performance in male athletes. Yet, no conclusive research has been performed to investigate the effect of chronic CFE supplementation on high-intensity exercise performance under anaerobic conditions. Therefore, the aim of the study was to assess whether CFE supplementation in daily dosages of 400 and 500 mg for a period of 4 and 8 weeks improves anaerobic exercise capacity.

METHODS

A randomized, double-blind, placebo controlled, parallel clinical study was conducted in 92 moderately trained healthy men and women. Subjects were randomized to receive 400 mg of CFE (n = 30), 500 mg of CFE (n = 31) or placebo (n = 31) daily, for 8 consecutive weeks. The Wingate anaerobic test was used to assess anaerobic exercise capacity and power output at baseline, after 4 weeks and after 8 weeks.

RESULTS

After 4 weeks supplementation, average power output significantly increased in the 400 mg group (Estimated difference [ED] = 38.2 W [18.0, 58.3]; p < 0.001; effect size [ES] = 0.27) and in the 500 mg group (ED = 21.2 W [0.91, 41.4]; p = 0.041; ES = 0.15) compared to placebo. The 5 s peak power output was also increased in the 400 mg group (ED = 53.6 [9.96, 97.2]; p = 0.017; ES = 0.25) after 4 weeks compared to placebo. After 8 weeks of supplementation, average power output was significantly improved in the group receiving 400 mg of CFE (ED = 31.6 [8.33, 54.8]; p = 0.008; ES = 0.22) compared to placebo.

CONCLUSION

These results demonstrate that CFE supplementation improved anaerobic capacity and peak power during high intensity exercise in moderately trained individuals. Further research is needed to identify the underlying mechanisms that are affected by CFE supplementation.

TRIAL REGISTRATION

ClinicalTrials.gov ( NCT03044444 ). Registered 7 February 2017.

A time and a place: A framework for caffeine periodization throughout the sporting year

Caffeine is a well-established ergogenic aid, with its performance-enhancing effects demonstrated across a variety of sports and exercise types. As a result of these ergogenic properties, caffeine is widely used by athletes at all levels around both competition and training. Caffeine exerts its performance benefits through a variety of mechanisms, each of which may be of increased importance at a given stage of training or competition. Additionally, regular caffeine use may diminish the performance-enhancing effects of a subsequent dose of caffeine. Recently, interest in the concept of nutritional periodization has grown. Here we propose a framework for the periodization of caffeine through the sporting year, balancing its training and competition performance-enhancing effects, along with the need to mitigate any negative effects of habituation. Furthermore, the regular use of caffeine within training may support the development of positive beliefs toward caffeine by athletes-potentially serving to enhance future performance through placebo and expectancy mechanisms-as well as allowing for the optimization of individual athlete caffeine strategies. Although future work is required to validate some of the suggestions made, the framework proposed here represents a starting point for athletes to maximize caffeine's performance benefits across the sporting year.

The Long History of Vitamin C: From Prevention of the Common Cold to Potential Aid in the Treatment of COVID-19

From Pauling's theories to the present, considerable understanding has been acquired of both the physiological role of vitamin C and of the impact of vitamin C supplementation on the health. Although it is well known that a balanced diet which satisfies the daily intake of vitamin C positively affects the immune system and reduces susceptibility to infections, available data do not support the theory that oral vitamin C supplements boost immunity. No current clinical recommendations support the possibility of significantly decreasing the risk of respiratory infections by using high-dose supplements of vitamin C in a well-nourished general population. Only in restricted subgroups (e.g., athletes or the military) and in subjects with a low plasma vitamin C concentration a supplementation may be justified. Furthermore, in categories at high risk of infection (i.e., the obese, diabetics, the elderly, etc.), a vitamin C supplementation can modulate inflammation, with potential positive effects on immune response to infections. The impact of an extra oral intake of vitamin C on the duration of a cold and the prevention or treatment of pneumonia is still questioned, while, based on critical illness studies, vitamin C infusion has recently been hypothesized as a treatment for COVID-19 hospitalized patients. In this review, we focused on the effects of vitamin C on immune function, summarizing the most relevant studies from the prevention and treatment of common respiratory diseases to the use of vitamin C in critical illness conditions, with the aim of clarifying its potential application during an acute SARS-CoV2 infection.

Nutritional Ergogenic Aids in Racquet Sports: A Systematic Review

A nutritional ergogenic aid (NEA) can help athletes optimize performance, but an evidence-based analysis is required in order to support training outcomes or competition performance in specific events. Racquet sports players are regularly exposed to a high-intensity workload throughout the tournament season. The activity during a match is characterized by variable durations (2–4 h) of repeated high-intensity bouts interspersed with standardized rest periods. Medline/PubMed, Scopus, and EBSCO were searched from their inception until February 2020 for randomized controlled trials (RCTs). Two independent reviewers extracted data, after which they assessed the risk of bias and the quality of trials. Out of 439 articles found, 21 met the predefined criteria: tennis (15 trials), badminton (three trials), paddle (one trial), and squash (two trials). Among all the studied NEAs, acute dosages of caffeine (3–6 mg/kg) 30–60 min before a match have been proven to improve specific skills and accuracy but may not contribute to improve perceived exertion. Currently, creatine, sodium bicarbonate, sodium citrate, beetroot juice, citrulline, and glycerol need more studies to strengthen the evidence regarding improved performance in racquet sports.

Pre-Exercise Nutrition Habits and Beliefs of Endurance Athletes Vary by Sex, Competitive Level, and Diet

OBJECTIVE

The purpose of this study was to determine the self-reported beliefs and practices relating to pre-exercise nutrition intake among endurance athletes of varying ages and competitive levels and examine differences based on sex, competitive level, and habitual dietary pattern.

METHOD

An anonymous online survey was circulated internationally in English and completed by 1950 athletes of varying competitive levels (51.0% female, mean age 40.9 years [range 18:78]). Survey questions included training background, determinants of pre-exercise nutrition intake and composition, and timing relative to exercise.

RESULTS

Prior to morning exercise, 36.4%, 36.0%, and 27.6% of athletes consumed carbohydrate-containing food/drinks before almost every workout, some of the time, and never/rarely, respectively, with significant effects of sex (p < 0.001, Cramer's V (ϕ_c) = 0.15) and competitive level (p < 0.001, ϕ_c = 0.09). Nutritional intake before exercise varied based on workout duration for 47.6% of athletes, with significant effects of sex (ϕ_c = 0.15) and habitual diet (ϕ_c = 0.19), and based on workout intensity for 39.1% of athletes, with significant effects of sex (ϕ_c = 0.13) and habitual diet (ϕ_c = 0.17, all p < 0.001). Additionally, 89.0% of athletes reported using at least some type of dietary supplement (including caffeine from coffee/tea) within 1 hour before exercise.

CONCLUSIONS

Overall, nearly all factors measured relating to pre-exercise nutrition intake varied by sex, competitive level, habitual dietary pattern, and/or intensity/duration of the training session and suggest a large number of athletes may not be following current recommendations for optimizing endurance training adaptations.

Effects of diet interventions, dietary supplements, and performance-enhancing substances on the performance of CrossFit-trained individuals: A systematic review of clinical studies

CrossFit (CF) is characterized as a constantly varied, high-intensity, functional movement training program, performed with little or no rest between bouts, combining strength and endurance exercises, such as running, cycling, rowing, Olympic weightlifting, power weightlifting, and gymnastic-type exercises. Several nutritional strategies are used to improve sports performance of CF practitioners; however, most of them are empirical and lack scientific evidence. Thus, the aim of this review was to determine the effects of diet intervention, dietary supplements, and performance-enhancing substances on exercise-performance parameters of CF practitioners. MEDLINE/PubMed, Web of Science, LILACS, SciELO, and Scopus databases were searched using specific Medical Subject Headings and keywords for clinical studies that enrolled CF athletes in an intervention using diet, dietary supplements, or performance-enhancing substances. Athletic performance was considered as the primary outcome. No other filters were applied. Including grey literature search, 219 studies were identified; however only 14 studies met the eligibility criteria. Two studies evaluated the effects of caffeine supplementation on exercise performance; five studies evaluated high- or low-carbohydrate effects on performance and other parameters. One study verified the effects of multi-ingredient supplementation on CF-specific performance and body composition. One study compared the intake of protein supplements on performance and body composition. Two studies assessed the effect of green tea and (-)-epicatechin on performance and other parameters. One study evaluated the effects of nitrate supplementation on exercise performance. One study investigated the effect of betaine supplementation on body composition and muscle performance. Finally, one study examined the effects of sodium bicarbonate (SB) ingestion on exercise performance and aerobic capacity. Only SB supplementation improved CF performance. These outcomes may have been obtained due to methodological limitations such as small sample size, lack of control over influencing variables, short period of exercise intervention. Despite the popularity and growing evidence about CF, little is known about the relationship between performance-enhancing substances or dietary interventions and CF performance. Given the lack of scientific evidence, new studies with potential ergogenic supplements, a better methodological model, and practical application are required.