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Doré A, Jacq R, Bas AC. Athletes' medical preventive behaviors: the case of oral health and ultraendurance trail runners. BMC Oral Health 2024; 24:777. [PMID: 38992671 PMCID: PMC11242021 DOI: 10.1186/s12903-024-04492-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/17/2024] [Indexed: 07/13/2024] Open
Abstract
Ultra-endurance runners are particularly exposed to caries risk factors due to the continuous intake of sugars in liquid or sticky forms during long-distance exercise. The risk of caries increases due to a failure to perform oral hygiene during races. Ultra-endurance runners had good oral health status despite these particularities. Our hypothesis is that high compliance with preventive oral health recommendations (toothbrushing and preventive or regular dental visits) counterbalance the risks associated with their exposure to caries. We aimed to gain a better understanding of preventive dental behaviors in ultra-endurance runners. We then studied the determinants of two major recommendations: (1) visiting a dentist for preventive check-ups and (2) visiting a dentist during the year. 37% of the total sample reported patterns of both preventive dental visits and recent visits. Early visits (ORa = 4.8***), good oral health (ORa = 8.8**) and tooth brushing (ORa = 2.2**) were associated with preventive dental visits, but there was no significant influence of snacking or weekly work hours. The ultra-endurance race frequency was associated with early dental visits despite equal needs. Most risk-control behaviors were associated with each other, indicating that they are all-or-nothing behaviors. Individual prevention strategies implemented at the dental office may not be as effective as they predominantly target individuals who are already aware of and interested in preventive care. Instead, developing targeted primary prevention strategies that are accessible at race venues, such as stands, villages, or food supply points, could be more effective.
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Affiliation(s)
- Amélie Doré
- U1018, Inserm, Centre de recherche en Épidémiologie et Santé des Populations, University of Paris Saclay, UVSQ, Villejuif, France
| | - Romain Jacq
- Dental Department, UFR Santé, University of Rouen Normandy, 22 boulevard Gambetta, Rouen Cedex, 76183, France
| | - Anne-Charlotte Bas
- U1018, Inserm, Centre de recherche en Épidémiologie et Santé des Populations, University of Paris Saclay, UVSQ, Villejuif, France.
- Dental Department, UFR Santé, University of Rouen Normandy, 22 boulevard Gambetta, Rouen Cedex, 76183, France.
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Henningsen K, Martinez I, Costa RJS. Exertional Stress-induced Pathogenic Luminal Content Translocation - Friend or Foe? Int J Sports Med 2024; 45:559-571. [PMID: 38286406 DOI: 10.1055/a-2235-1629] [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: 01/31/2024]
Abstract
The incidence of perturbed gastrointestinal integrity, as well as resulting systemic immune responses and gastrointestinal symptoms, otherwise known as exercised-induced gastrointestinal syndrome (EIGS), is common among individuals who partake in prolonged exercise. EIGS may cause the translocation of pathogenic material, including whole bacteria and bacterial endotoxins, from the lumen into circulation, which may progress into clinical consequences such as sepsis, and potentially subsequent fatality. However, further investigation is warranted to assess the possibility of food allergen and/or digestive enzyme luminal to circulatory translocation in response to exercise, and the clinical consequences. Findings from this narrative literature review demonstrate evidence that whole bacteria and bacterial endotoxins translocation from the gastrointestinal lumen to systemic circulation occurs in response to exercise stress, with a greater propensity of translocation occurring with accompanying heat exposure. It has also been demonstrated that food allergens can translocate from the lumen to systemic circulation in response to exercise stress and initiate anaphylaxis. To date, no research investigating the effect of exercise on the translocation of digestive enzymes from the lumen into systemic circulation exists. It is evident that EIGS and consequential pathogenic translocation presents life-threatening clinical implications, warranting the development and implementation of effective management strategies in at-risk populations.
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Affiliation(s)
- Kayla Henningsen
- Nutrition Dietetics & Food, Monash University Faculty of Medicine Nursing and Health Sciences, Notting Hill, Australia
| | - Isabel Martinez
- Nutrition Dietetics & Food, Monash University Faculty of Medicine Nursing and Health Sciences, Notting Hill, Australia
| | - Ricardo J S Costa
- Nutrition Dietetics & Food, Monash University Faculty of Medicine Nursing and Health Sciences, Notting Hill, Australia
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Wang Z, Wang J. The effects of high-intensity interval training versus moderate-intensity continuous training on athletes' aerobic endurance performance parameters. Eur J Appl Physiol 2024:10.1007/s00421-024-05532-0. [PMID: 38904772 DOI: 10.1007/s00421-024-05532-0] [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: 01/09/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE To systematically evaluate and meta-analyze the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on athletes of aerobic endurance performance parameters. METHODS PubMed, Web of Science, EBSCO, Embase, and Cochrane databases were searched. The assessment of quality was conducted employing The Cochrane Risk of Bias Assessment Tool, while heterogeneity examination and subgroup analysis were performed. Moreover, regression and sensitivity analyses were executed. RESULTS There was no significant difference between the effects of HIIT and MICT on the enhancement of athletes' running economy (RE) (P > 0.05); 1-3 weeks and 4-9 weeks of HIIT were more effective in improving athletes' maximum oxygen uptake (VO2max) (P < 0.05), and 10 weeks and above were not significant (P > 0.05); 1-3 weeks of HIIT was more effective in improving athletes' anaerobic threshold (AT) (P < 0.05), and 4-10 weeks was not significant (P > 0.05); 3 weeks of high-intensity interval training (HIIT) did not significantly enhance athletes' minute ventilation (VE) (P > 0.05), whereas a duration of 6-10 weeks yielded superior results (P < 0.05); 8 weeks of moderate-intensity continuous training (MICT) did not significantly enhance athletes' hemoglobin (Hb) level (P > 0.05), whereas a duration of 2-3 weeks yielded superior results (P < 0.05). CONCLUSIONS (1) HIIT and MICT have similar effects on enhancing athletes' RE. (2) 6-9 weeks' HIIT was more effective in improving athletes' VO2max and VE, and 3 weeks' HIIT was more effective in improving athletes' AT. (3) Within 3 weeks, MICT was more effective in improving the Hb level of athletes. REGISTRATION NUMBER ON PROSPERO CRD42024499039.
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Affiliation(s)
- Ziyi Wang
- College of Human Sport Science, Beijing Sport University, No.48, Shangdi Rd, Beijing, 100084, China
| | - Jun Wang
- College of Human Sport Science, Beijing Sport University, No.48, Shangdi Rd, Beijing, 100084, China.
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Scheer V, Chandi H, Valero E, Steinach M. Polar Thigh and Other Medical Observations During the Longest Solo Unsupported One-Way Polar Ski Expedition in Antarctica. Wilderness Environ Med 2024:10806032241253817. [PMID: 38853425 DOI: 10.1177/10806032241253817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Antarctic expeditions are exceptional challenges for the human body, and medical issues such as nutritional deficiencies, polar anemia, cold injuries, and even death have been reported. We prospectively investigated medical issues encountered by a 33-year-old female adventurer completing the longest solo unsupported one-way polar ski expedition in Antarctica, covering 1484.53 km in 70 days and 16 h from Hercules Inlet to the Ross Ice Shelf, in temperatures estimated from -12 to -50°C and wind speeds of up to 60 mi/h. The adventurer developed a debilitating overuse musculoskeletal neck injury due to poor environmental conditions (ie, poor visibility, wind, and soft snow) while pulling a heavy sled and continuously holding the neck in a flexed position for checking directions on a mounted compass. The adventurer further developed a cold injury on the left calf (polar thigh) that gradually worsened and became ulcerated and more painful throughout the expedition. Potential risk factors included cold ambient temperatures, exposure to windy conditions, and clothing. After the expedition, this injury was treated with a skin graft. Important changes in body mass were observed (ie, reduction of body mass by 26.7% after the expedition) as well as general fatigue, muscle soreness, and sleep deterioration. This case study contributes to the body of knowledge of medical issues during Antarctic expeditions and provides the first scientific account of an adventurer with polar thigh. Further research into this condition is recommended.
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Affiliation(s)
- Volker Scheer
- Ultra Sports Science Foundation, Pierre-Benite, France
| | - Harpreet Chandi
- Royal Air Force Halton, British Armed Forces, Ayelsbury, United Kingdom
| | | | - Mathias Steinach
- Charité Universitätsmedizin Berlin and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments, Berlin, Germany
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Ryan T, Daly E, Ryan L. Carbohydrate beliefs and practices of ultra-endurance runners in Ireland for gastrointestinal symptom management. Front Nutr 2024; 11:1408101. [PMID: 38883858 PMCID: PMC11176419 DOI: 10.3389/fnut.2024.1408101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/13/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose This study aimed to investigate the carbohydrate beliefs and practices of ultra-endurance runners in Ireland to gain an understanding of their gastrointestinal symptom (GIS) management strategies. Methodology An adapted version of a previously developed and validated questionnaire was distributed online to ultra-endurance runners, recognized as those who completed a single bout of exercise lasting 4 or more hours. The questionnaire asked about carbohydrate awareness and sourcing, and dietary practices, particularly in relation to GIS management. Results A total of n = 68 individuals completed the adapted questionnaire. Of these, n = 1 was excluded due to their reporting of an ulcerative colitis diagnosis. The remaining participants included 46 men and 21 women. Personal previous experience was the main source directing participants' nutrition practices (n = 30), while only 3 participants quoted sourcing information from qualified professionals. Forty-two participants experienced GIS, usually equally around training and competition times. Many participants had not previously implemented any specific dietary or non-dietary strategies to alleviate exercise-induced GIS. Supplementing with nitrates (n = 9) and probiotics (n = 4) were the most common dietary practices to alleviate GIS, while other practices (n = 14) and portion control (n = 13) were the most reported non-dietary practices. Discussion Similar to previous studies, these findings suggest that GISs are prevalent in the ultra-endurance running community, occurring regardless of whether during training or an event. Similarly, this research highlights the vast range of GISs experienced by this population. However, the absence of both dietary and non-dietary-related practices used for GIS management alludes to a current deficit in the availability of nutrition information specific to this problem. Further research is required to understand the mechanisms behind ultra-endurance-associated GISs and its various management strategies as well as best practices for communicating these to the target audience to reduce individuals' risks of developing long-term, chronic health complications.
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Affiliation(s)
- Tansy Ryan
- Department of Sport, Exercise and Nutrition, School of Science and Computing, Atlantic Technological University, Galway, Ireland
| | - Ed Daly
- Department of Sport, Exercise and Nutrition, School of Science and Computing, Atlantic Technological University, Galway, Ireland
| | - Lisa Ryan
- Department of Sport, Exercise and Nutrition, School of Science and Computing, Atlantic Technological University, Galway, Ireland
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Tao Z, Sun X, Sun J, Zhu E. Dose-response relationship between 15 weeks of running and aerobic fitness: a retrospective analysis based on the fun running program. BMC Public Health 2024; 24:1019. [PMID: 38609934 PMCID: PMC11010386 DOI: 10.1186/s12889-024-18484-z] [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: 10/30/2023] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Students' physical fitness, particularly aerobic fitness, has seriously declined during the COVID-19 epidemic. However, in the post-epidemic era, there are few studies on the methods of improving aerobic fitness. Understanding the dose-response relationship between physical activity and aerobic fitness is crucial for developing effective exercise prescriptions. METHOD This retrospective study reviewed the Fun Running program at Wannan Medical College in China. We conducted a pre-post study design to analyze the impact of 15 weeks of Fun Running training on aerobic fitness. Middle and long-distance running pace (MLDR-P) was used as the primary indicator of aerobic fitness. A paired sample T-test was used to analyze the differences between the two MLDR-Ps. Pearson's correlation was used to examine the correlation between variables. Multiple linear regression was used to determine the extent to which Fun Running components explain the variance in MLDR-P. RESULTS A total of 3244 college students participated in this study. 15 weeks of Fun Running training can significantly improve the MLDR-P in both females (P < 0.001, ES = 0.68) and males (P < 0.001, ES = 0.72). The MLDR-P was significantly correlated with Fun Running (R2 = 0.95, p < 0.05, for females; R2 = 0.96, p < 0.05, for males). The component that had the greatest impact on MLDR-P was pace (β = 1.39, for females; β = 1.09, for males), followed by distance (β = 0.49, for females; β = 0.15, for males), and last frequency (β = -0.03, for all). CONCLUSION This study fills the gap in research on the dose-response relationship between running and aerobic fitness among college students in the post-epidemic era. The results show that 15 weeks of Fun Running training can significantly improve aerobic fitness. Examination of the dose-response relationship between Fun Running and MLDR-P provides practitioners with valuable insights into prescribing aerobic fitness training, allowing them to develop more effective training programs. Future research should focus on how to implement a hierarchical Fun Running program effectively.
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Affiliation(s)
- Zhixuan Tao
- Department of Public Foundation, Wannan Medical College, 241000, Wuhu, China
| | - Xugui Sun
- Department of Public Foundation, Wannan Medical College, 241000, Wuhu, China
| | - Jun Sun
- Department of Public Foundation, Wannan Medical College, 241000, Wuhu, China.
| | - Ergang Zhu
- Department of Public Foundation, Wannan Medical College, 241000, Wuhu, China.
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Ayaz A, Zaman W, Radák Z, Gu Y. Harmony in Motion: Unraveling the Nexus of Sports, Plant-Based Nutrition, and Antioxidants for Peak Performance. Antioxidants (Basel) 2024; 13:437. [PMID: 38671884 PMCID: PMC11047508 DOI: 10.3390/antiox13040437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
The intricate interplay between plant-based nutrition, antioxidants, and their impact on athletic performance forms the cornerstone of this comprehensive review. Emphasizing the pivotal importance of dietary choices in the realm of sports, this paper sets the stage for an in-depth exploration of how stress and physical performance are interconnected through the lens of nutrition. The increasing interest among athletes in plant-based diets presents an opportunity with benefits for health, performance, and recovery. It is essential to investigate the connection between sports, plants, and antioxidants. Highlighting the impact of nutrition on recovery and well-being, this review emphasizes how antioxidants can help mitigate oxidative stress. Furthermore, it discusses the growing popularity of plant-based diets among athletes. It elaborates on the importance of antioxidants in combating radicals addressing stress levels while promoting cellular health. By identifying rich foods, it emphasizes the role of a balanced diet in ensuring sufficient intake of these beneficial compounds. Examining stress within the context of sports activities, this review provides insights into its mechanisms and its impact on athletic performance as well as recovery processes. This study explores the impact of plant-based diets on athletes including their types, potential advantages and challenges. It also addresses the drawbacks of relying on plant-based diets, concerns related to antioxidant supplementation and identifies areas where further research is needed. Furthermore, the review suggests directions for research and potential innovations in sports nutrition. Ultimately it brings together the aspects of sports, plant-based nutrition, and antioxidants to provide a perspective for athletes, researchers and practitioners. By consolidating existing knowledge, it offers insights that can pave the way for advancements in the ever-evolving field of sports nutrition.
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Affiliation(s)
- Asma Ayaz
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
| | - Wajid Zaman
- Department of Life Sciences, Yeungnam University, Gyeongsan 38541, Republic of Korea;
| | - Zsolt Radák
- Research Institute of Sport Science, University of Physical Education, 1123 Budapest, Hungary;
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
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Choi J, Lee SR, Choi EK, Lee KY, Ahn HJ, Kwon S, Han KD, Oh S, Lip GYH. Effect of physical activity on incident atrial fibrillation in individuals with varying duration of diabetes: a nationwide population study. Cardiovasc Diabetol 2024; 23:115. [PMID: 38555442 PMCID: PMC10981812 DOI: 10.1186/s12933-024-02194-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/10/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Diabetes mellitus (DM) duration affects incident atrial fibrillation (AF) risk; the effect of physical activity on mitigating AF risk related to varying DM duration remains unknown. We assessed the effect of physical activity on incident AF in patients with DM with respect to known DM duration. METHODS Patients with type 2 DM who underwent the Korean National Health Insurance Service health examination in 2015-2016 were grouped by DM duration: new onset and < 5, 5-9, and ≥ 10 years. Physical activity was classified into four levels: 0, < 500, 500-999, 1,000-1,499, and ≥ 1,500 metabolic equivalent task (MET)-min/week, with the primary outcome being new-onset AF. RESULTS The study enrolled 2,392,486 patients (aged 59.3 ± 12.0 years, 39.8% female) with an average follow-up of 3.9 ± 0.8 years and mean DM duration of 5.3 ± 5.1 years. Greater physical activity was associated with a lower AF risk. Lowering of incident AF risk varied with different amounts of physical activity in relation to known DM duration. Among patients with new-onset DM, DM duration < 5 years and 5-9 years and 1,000-1,499 MET-min/week exhibited the lowest AF risk. Physical activity ≥ 1,500 MET-min/week was associated with the lowest incident AF risk in patients with DM duration ≥ 10 years (by 15%), followed DM duration of 5-9 years (12%) and < 5 years (9%) (p-for-interaction = 0.002). CONCLUSIONS Longer DM duration was associated with a high risk of incident AF, while increased physical activity generally reduced AF risk. Engaging in > 1,500 MET-min/week was associated with the greatest AF risk reduction in patients with longer DM duration, highlighting the potential benefits of higher activity levels for AF prevention.
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Affiliation(s)
- JungMin Choi
- Division of cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - So-Ryoung Lee
- Division of cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Eue-Keun Choi
- Division of cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Kyung-Yeon Lee
- Division of cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyo-Jeong Ahn
- Division of cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soonil Kwon
- Division of cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Do Han
- Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Seil Oh
- Division of cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Gregory Y H Lip
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Liverpool Center for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Chest & Heart Hospital, Liverpool, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Parent C, Mauvieux B, Lespagnol E, Hingrand C, Vauthier JC, Noirez P, Hurdiel R, Martinet Q, Delaunay PL, Besnard S, Heyman J, Gabel V, Baron P, Gamelin FX, Maboudou P, Rabasa-Lhoret R, Jouffroy R, Heyman E. Glycaemic Effects of a 156-km Ultra-trail Race in Athletes: An Observational Field Study. Sports Med 2024:10.1007/s40279-024-02013-4. [PMID: 38555307 DOI: 10.1007/s40279-024-02013-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Ultra-trail running races pose appreciable physiological challenges, particularly for glucose metabolism. Previous studies that yielded divergent results only measured glycaemia at isolated times. OBJECTIVES We aimed to explore the impact of an ultra-endurance race on continuously measured glycaemia and to understand potential physiological mechanisms, as well as the consequences for performance and behavioural alertness. METHODS Fifty-five athletes (78% men, 43.7 ± 9.6 years) ran a 156-km ultra-trail race (six 26-km laps, total elevation 6000 m). Participants wore a masked continuous glucose monitoring sensor from the day before the race until 10 days post-race. Blood was taken at rest, during refuelling stops after each lap, and after 24-h recovery. Running intensity (% heart rate reserve), performance (lap times), psychological stress, and behavioural alertness were explored. Linear mixed models and logistic regressions were carried out. RESULTS No higher risk of hypo- or hyperglycaemia was observed during the exercise phases of the race (i.e. excluding stops for scientific measurements and refuelling) compared with resting values. Laps comprising a greater proportion of time spent at maximal aerobic intensity were nevertheless associated with more time > 180 mg/dL (P = 0.021). A major risk of hyperglycaemia appeared during the 48-h post-race period compared with pre-race (P < 0.05), with 31.9% of the participants spending time with values > 180 mg/dL during recovery versus 5.5% during resting. Changes in circulating insulin, cortisol, and free fatty acids followed profiles comparable with those usually observed during traditional aerobic exercise. However, creatine phosphokinase, and to a lesser extent lactate dehydrogenase, increased exponentially during the race (P < 0.001) and remained high at 24-h post-race (P < 0.001; respectively 43.6 and 1.8 times higher vs. resting). Glycaemic metrics did not influence physical performance or behavioural alertness. CONCLUSION Ultra-endurance athletes were exposed to hyperglycaemia during the 48-h post-race period, possibly linked to muscle damage and inflammation. Strategies to mitigate muscle damage or subsequent inflammation before or after ultra-trail races could limit recovery hyperglycaemia and hence its related adverse health consequences. TRIAL REGISTRATION NUMBER NCT05538442 2022-09-21 retrospectively registered.
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Affiliation(s)
- Cassandra Parent
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France
- Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada
- Department of Nutrition, Université de Montréal, Montréal, Québec, Canada
| | | | - Elodie Lespagnol
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France
| | | | - Jean-Charles Vauthier
- Département de Médecine Générale, Faculté de Médecine - Département du Grand Est de Recherche en Soins Primaires, Université de Lorraine, Nancy, France
- Laboratoire Interpsy (UR 4432), Université de Lorraine, Nancy, France
| | - Philippe Noirez
- Institute for Research in bioMedicine and Epidemiology of Sport (IRMES), Paris, France
- T3S, INSERM UMR-S 1124, University of Paris Cité, Paris, France
- Département des Sciences de l'activité Physique, Université du Québec à Montréal, Montreal, Canada
- PSMS, University of Reims Champagne Ardenne, Reims, France
| | - Rémy Hurdiel
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France
| | | | | | - Stéphane Besnard
- UR 7480 Vertex - Université de Caen, Caen, France
- CHU de Caen, Caen, France
| | - Joris Heyman
- CNRS, UMR 6118, Transferts d'eau et de Matière dans les Milieux Hétérogènes Complexes - Géosciences, Université Rennes, Rennes, France
| | | | - Pauline Baron
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France
| | - François-Xavier Gamelin
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France
| | - Patrice Maboudou
- Laboratoire de Biochimie et Biologie Moléculaire, CHU de Lille, Pôle de Biologie Pathologie Génétique, Lille, France
| | - Rémi Rabasa-Lhoret
- Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada
- Department of Nutrition, Université de Montréal, Montréal, Québec, Canada
| | - Romain Jouffroy
- Intensive Care Unit, Ambroise Paré Hospital, Assistance Publique - Hôpitaux de Paris, Boulogne Billancourt, France
- Centre de Recherche en Epidémiologie et Santé des Populations - U1018, INSERM - Paris Saclay University, Paris, France
- EA 7329 - Institut de Recherche Médicale et d'Épidémiologie du Sport - Institut National du Sport, de l'Expertise et de la Performance, Paris, France
| | - Elsa Heyman
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France.
- Institut Universitaire de France, Paris, France.
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Kali VR, Meda SS. Functional nutrition for the health of exercising individuals and elite sportspersons. Nutr Health 2024; 30:49-59. [PMID: 37583297 DOI: 10.1177/02601060231191865] [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: 08/17/2023]
Abstract
INTRODUCTION Elite sportspersons who are involved in high-intensity physical sports indulge in severe training and competition schedules, which exposes them to high levels of inflammatory and oxidative stress, hence it may hamper their health sometimes. Disturbance in the health of sportspersons also induces compromised performances. THE PREMISE FOR FUNCTIONAL NUTRITION Functional nutrition is essential for elite sportspersons training for securing both rest and recovery to have proper health and anticipated performance. Apart from serving the energy needs of the sportspersons, the nutrition strategies should provide them with certain metabolic advantages, which provide greater health and immunity, to ensure proper training and competition. The diet of the sportspersons needs to contain appropriate anti-inflammatory and antioxidative nutrients, to ensure to reduction and control of the physiological stress of tissues during high-intensity physical sports, especially during marathon running. Preserving anabolic valence among sportspersons for muscle myokine optimization is an essential aspect of sports nutrition, which secures health and provides excellent performance potential. Preservation and optimization of gut microbiome among sportspersons enhance immune health and performance, through proper gut integrity and enhanced metabolic cascades. As the genes are to be properly expressed for excellent manifestation in protein synthesis and other metabolic signaling, achieving genetic valance through proper nutrition ensures the health of the sportspersons. CONCLUSION Functional nutrition seems a very necessary and potent factor in the training and competition aspects of elite sportspersons since nutrition not only provides recovery but also ensures proper health for elite sportspersons.
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Stylemans D, Vandecruys M, Leunis S, Engelborghs S, Gargioli D, Monbaliu D, Cornelissen V, Van Craenenbroeck AH, De Smet S. Physical Exercise After Solid Organ Transplantation: A Cautionary Tale. Transpl Int 2024; 37:12448. [PMID: 38414660 PMCID: PMC10898592 DOI: 10.3389/ti.2024.12448] [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: 11/20/2023] [Accepted: 02/02/2024] [Indexed: 02/29/2024]
Abstract
An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the 'gift of life' are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.
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Affiliation(s)
- Dimitri Stylemans
- Department of Respiratory Diseases, Pulmonary Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Marieke Vandecruys
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sofie Leunis
- Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sofie Engelborghs
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Davide Gargioli
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Diethard Monbaliu
- Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
- Transplantoux Foundation, Leuven, Belgium
| | - Véronique Cornelissen
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Amaryllis H. Van Craenenbroeck
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Nephrology and Kidney Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Stefan De Smet
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
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Pannone E, Abbott R. What is known about the health effects of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultraendurance running: a scoping review. BMJ Open Sport Exerc Med 2024; 10:e001846. [PMID: 38318269 PMCID: PMC10840051 DOI: 10.1136/bmjsem-2023-001846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
This systematic scoping review aimed to understand the extent and scope of evidence on the health risks of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultraendurance running. NSAIDs are commonly consumed by runners to combat pain and inflammation; however, the health risks of consuming these drugs during marathon and ultrarunning events are currently not fully understood. Four databases (Cochrane Library, PubMed, MEDLINE and SPORTDiscus) were searched to identify articles focusing on running events of 26.2 miles or further, and they must have reported on the health risks of NSAID use. There was no restriction on the study design or the date of publication. Thirty studies were ultimately included: 4 randomised controlled trials, 1 cross-sectional study, 11 retrospective reviews, 4 case reports, 1 non-randomised control trial, and 9 prospective observational studies. The literature showed that potential health concerns of NSAID use could be split into five categories: electrolyte balance and hyponatraemia; acute kidney injury (AKI); gastrointestinal disturbances; oxidative stress, inflammation and muscle damage; other medical concerns. None of these sections had clear statistically significant links with NSAID use in ultraendurance running. However, potential links were shown, especially in AKI and electrolyte balance. This review suggests there is very limited evidence to show that NSAIDs have a negative impact on the health of ultrarunning athletes. Indications from a few non-randomised studies of a possible effect on kidney function need exploring with more high-quality research.
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Affiliation(s)
- Eve Pannone
- Medical School, University of Exeter, Exeter, UK
| | - Rebecca Abbott
- Medical School, University of Exeter, Exeter, UK
- Evidence Synthesis Team, NIHR Applied Research Collaboration South West (PenARC), University of Exeter, Exeter, UK
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13
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Thuany M, Viljoen C, Gomes TN, Knechtle B, Scheer V. Mental Health in Ultra-Endurance Runners: A Systematic Review. Sports Med 2023; 53:1891-1904. [PMID: 37535248 DOI: 10.1007/s40279-023-01890-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Among ultra-endurance runners (UER), the mental, behavioral, and physical demands of training/competition can result in maladaptive outcomes. Mental health issues are common in athletes and can impact psychology, physical health, and performance. OBJECTIVE To synthesize information regarding the incidence/prevalence and factors associated with mental health issues among UER. METHODS Systematic searches were performed in PubMed, SPORTDiscus, Scopus, Cochrane databases, CINAHL, Web of Science, and Medline Ovid using key terms related to UER (e.g., trail running, road running) and psychological issues (e.g., exercise addiction, depression). Inclusion criteria included original articles published in peer-reviewed journals in English, using qualitative or quantitative approaches. We considered papers reporting incidence/prevalence and associated factors with mental health outcomes in UER of both sexes, all ages, and levels of competition (e.g., elite, nonprofessional runners). The Joanna Briggs Institute Analytical Cross-Sectional Studies critical appraisal tool was used for quality assessment. RESULTS A total of 282 studies were identified, and 11 studies were included in the final selection. A total of 3670 UER were included in the studies. The prevalence of mental health issues among UER ranged between 32.0% and 62.5% for eating disorders, from 11.5% to 18.2% for exercise addiction, 18.6% for depressive symptoms, and 24.5% for sleep disturbance. Exercise addiction was not related to weekly volume, but a strong relationship with exercise in an unstructured space, age, and body mass index was shown. CONCLUSION Mental health issues among UER are common, especially eating disorders, exercise addiction, sleep disturbances, and depressive symptoms. Further high-quality studies are needed to examine underlying factors and find preventative strategies to protect UER. REGISTRATION The protocol of this systematic review was registered at the PROSPERO-CRD42022338743.
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Affiliation(s)
- Mabliny Thuany
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.
| | - Carel Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Thayse Natacha Gomes
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Physical Education, Federal University of Sergipe, São Cristóvão, Brazil
| | - Beat Knechtle
- Medbase St. Gallen am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Volker Scheer
- Ultra Sports Science Foundation, Pierre-Bénite, France
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14
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Koutserimpas C, Kotzias D, Chronopoulos E, Naoum S, Raptis K, Karamitros A, Dretakis K, Piagkou M. Suggestion of a Novel Classification Based on the Anatomical Region and Type of Bilateral Fatigue Femoral Fractures. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1572. [PMID: 37763691 PMCID: PMC10534755 DOI: 10.3390/medicina59091572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
Purpose: Bilateral fatigue femoral fractures (BFFF) represent an extremely rare clinical entity. The present study introduces a novel classification, in order to categorize the BFFFs and provide a thorough review of all these, so far in the literature, reported cases. Methods: The BFFF were classified taking into account the anatomical region of the femoral fracture; (fh): femoral head, (sc): sub-capital, (pt): peri-trochanteric, (st): sub-trochanteric, (s): shaft, (d): distal femur and the fracture type (complete or incomplete); type I: bilateral incomplete fractures, type II: unilateral incomplete fracture, and type III: bilateral complete fractures. Type III was further subdivided into type IIIA: bilateral non-displaced fractures, type IIIB: unilateral displaced fracture, and type IIIC: bilateral displaced fractures. Furthermore, a meticulous review of the PubMed and MEDLINE databases was conducted to locate all articles reporting these injuries. Results: A total of 38 patients (86.8% males), with a mean age of 25.3 years, suffering BFFFs were identified from the literature search. The mean time interval from symptoms' onset to diagnosis was 54 days. According to the proposed classification, 2.6% of the fractures were categorized as type I (h), 36.8% as type I (sc), 2.6% as type I(st/s), 7.9% as type I (s), 2.6% as type I (d), 5.4% as type II (fh), 26.3% as type II (sc), 2.6% as type IIIA (st), 2.6% as type IIIA (d), 5.4% as type IIIB (sc), 2.6% as type IIIB (d) and 2.6% as type IIIC (sc). Surgery was performed in 52.6%, while non-operative treatment was followed in 47.4% of the population. Regarding the fracture type, 75% of type I fractures were conservatively treated, while 91.7% and 66.6% of type II and III fractures were surgically treated. For patients treated conservatively, the mean time from diagnosis to return to previous status was 260 days, while for patients treated surgically, 343 days. Conclusions: BFFFs, although rare, may pose a diagnostic and therapeutic challenge. The present classification offers valuable information and may act as a guide for the management of these patients.
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Affiliation(s)
- Christos Koutserimpas
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece; (D.K.); (S.N.); (K.R.); (A.K.)
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- 2nd Department of Orthopaedics, “Hygeia” General Hospital of Athens, 15123 Athens, Greece;
| | - Dimitrios Kotzias
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece; (D.K.); (S.N.); (K.R.); (A.K.)
| | - Efstathios Chronopoulos
- Laboratory for Research of the Musculoskeletal System, School of Medicine, National and Kapodistrian University of Athens, 14561 Athens, Greece;
| | - Symeon Naoum
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece; (D.K.); (S.N.); (K.R.); (A.K.)
| | - Konstantinos Raptis
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece; (D.K.); (S.N.); (K.R.); (A.K.)
| | - Athanasios Karamitros
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece; (D.K.); (S.N.); (K.R.); (A.K.)
| | - Konstantinos Dretakis
- 2nd Department of Orthopaedics, “Hygeia” General Hospital of Athens, 15123 Athens, Greece;
| | - Maria Piagkou
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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15
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Fariod M, Olher RR, Sousa CV, Scheer V, Cuk I, Nikolaidis PT, Thuany M, Weiss K, Knechtle B. Pacing Variation in Multistage Ultramarathons: Internet-Based Cross-Sectional Study. JMIR Form Res 2023; 7:e46650. [PMID: 37610796 PMCID: PMC10483293 DOI: 10.2196/46650] [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: 02/20/2023] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Ultramarathon running is the most popular ultraendurance competition in terms of the number of races and runners competing annually worldwide; however, no study has compared pacing and performance over a long period. OBJECTIVE This study analyzes the pacing of successful finishers and nonfinishers in multistage ultramarathons worldwide. METHODS A total of 4079 athletes (men=3288; women=791) competing in 99 multistage ultramarathon events from 1983 to 2021 were analyzed, including the number of participants, age, gender, rank, and running speed of successful finishers. RESULTS The results showed a significant increase in the number of events (n=338) and a significant increase in the number of finishers and nonfinishers (n=5575) in the ultramarathons worldwide during this period. The general linear models (GLMs) of pacing variation showed nonsignificant effects for gender (F1,36.2=2.5; P=.127; ηp2=0.063) and age group (F10,10=0.6; P=.798; ηp2=0.367), but it showed a significant interaction (gender × age) effect (F10,2689=2.3; P=.008; ηp2=0.009). Post hoc analyses showed that men have a higher pacing variation than women in the under 30 years (U30), U35, U45, and U50 groups. Additionally, the fastest women's age group (U35) had the lowest pacing variation. The GLM of pacing variation by gender and event distance showed significant effects for both gender (F1,3=18.5; P<.001; ηp2=0.007) and distance (F2,3=20.1; P<.001; ηp2=0.015). Post hoc analyses showed a growing pacing variation with increasing race distance for both men and women. In addition, men had a higher variation in long events. Furthermore, there was a significant main effect for both genders (F1,3=33.7; P<.001; ηp2=0.012) and rank (F1,3=136.6; P<.001; ηp2=0.048) on performance, with men being faster than women. Pacing varied greatly due to gender (F1,3=4.0; P=.047; ηp2=0.001), with a lower (ie, more even) pacing variation for male athletes in the top 3 finishers. Male nonfinishers showed a higher performance than female nonfinishers (F1,1340=25.6; P<.001), and no difference was identified for pacing variation (F1,789=1.5; P=.228) based on gender. In addition, a weak but significant correlation (r=-0.130; P<.001) was identified between the average running speed and pacing variation for both female and male nonfinishers. CONCLUSIONS In summary, multistage ultramarathon competitions showed an increasing number of competitors and a higher performance challenge. Men have a higher pacing (ie, less even) variation than women, especially observed in longer events. A higher pacing variation was associated with lower performance for men, women, and nonfinishers.
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Affiliation(s)
- Mielad Fariod
- Department of Orthopedic, Traumatology and Reconstructive Surgery, Klinikum Frankfurt-Höchst, Frankfurt, Germany
| | - Rafael Reis Olher
- Department of Physical Education, University Center of Central Plateau Apparecido dos Santos, Brasilia, Brazil
| | - Caio Victor Sousa
- Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, United States
| | - Volker Scheer
- Ultra Sports Science Foundation, Pierre-Benite, France
| | - Ivan Cuk
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade,
| | | | | | - Katja Weiss
- Institute of Primary Care, University Hospital Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Medbase St Gallen Am Vadianplatz, St Gallen, Switzerland
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16
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Rojas-Valverde D, Bonilla DA, Gómez-Miranda LM, Calleja-Núñez JJ, Arias N, Martínez-Guardado I. Examining the Interaction between Exercise, Gut Microbiota, and Neurodegeneration: Future Research Directions. Biomedicines 2023; 11:2267. [PMID: 37626763 PMCID: PMC10452292 DOI: 10.3390/biomedicines11082267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Physical activity has been demonstrated to have a significant impact on gut microbial diversity and function. Emerging research has revealed certain aspects of the complex interactions between the gut, exercise, microbiota, and neurodegenerative diseases, suggesting that changes in gut microbial diversity and metabolic function may have an impact on the onset and progression of neurological conditions. This study aimed to review the current literature from several databases until 1 June 2023 (PubMed/MEDLINE, Web of Science, and Google Scholar) on the interplay between the gut, physical exercise, microbiota, and neurodegeneration. We summarized the roles of exercise and gut microbiota on neurodegeneration and identified the ways in which these are all connected. The gut-brain axis is a complex and multifaceted network that has gained considerable attention in recent years. Research indicates that gut microbiota plays vital roles in metabolic shifts during physiological or pathophysiological conditions in neurodegenerative diseases; therefore, they are closely related to maintaining overall health and well-being. Similarly, exercise has shown positive effects on brain health and cognitive function, which may reduce/delay the onset of severe neurological disorders. Exercise has been associated with various neurochemical changes, including alterations in cortisol levels, increased production of endorphins, endocannabinoids like anandamide, as well as higher levels of serotonin and dopamine. These changes have been linked to mood improvements, enhanced sleep quality, better motor control, and cognitive enhancements resulting from exercise-induced effects. However, further clinical research is necessary to evaluate changes in bacteria taxa along with age- and sex-based differences.
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Affiliation(s)
- Daniel Rojas-Valverde
- Nucleus of Studies for High Performance and Health (CIDISAD-NARS), School of Human Movement Sciences and Quality of Life (CIEMHCAVI), National University, Heredia 86-3000, Costa Rica
- Sports Injury Clinic (Rehab & Readapt), School of Human Movement Sciences and Quality of Life (CIEMHCAVI), National University, Heredia 86-3000, Costa Rica
| | - Diego A. Bonilla
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia;
- Research Group in Biochemistry and Molecular Biology, Faculty of Sciences and Education, Universidad Distrital Francisco José de Caldas, Bogotá 110311, Colombia
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería 230002, Colombia
- Sport Genomics Research Group, Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Luis M. Gómez-Miranda
- Sports Faculty, Autonomous University of Baja California, Tijuana 22615, Mexico; (L.M.G.-M.); (J.J.C.-N.)
| | - Juan J. Calleja-Núñez
- Sports Faculty, Autonomous University of Baja California, Tijuana 22615, Mexico; (L.M.G.-M.); (J.J.C.-N.)
| | - Natalia Arias
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, C/del Hostal, 28248 Madrid, Spain;
| | - Ismael Martínez-Guardado
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, C/del Hostal, 28248 Madrid, Spain;
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Kelly CPMG. Is There Evidence for the Development of Sex-Specific Guidelines for Ultramarathon Coaches and Athletes? A Systematic Review. SPORTS MEDICINE - OPEN 2023; 9:6. [PMID: 36695958 PMCID: PMC9877268 DOI: 10.1186/s40798-022-00533-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/13/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND There is evidence of sex differences in the physiology of endurance exercise, yet most of the advice and guidelines on training, racing, nutrition, and recovery for ultramarathons are based on research that has largely excluded female athletes. The objective was therefore to review the current knowledge of sex differences in ultramarathon runners and determine if sufficient evidence exists for providing separate guidelines for males and females. METHODS This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three databases were searched for studies investigating differences in elite and recreational male and female ultramarathon runners. Studies were included if they compared males and females and looked at outcomes relating to the performance or health of ultramarathon runners. The quality of the included studies was determined using the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach. RESULTS The search strategy identified 45 studies that met the inclusion criteria. Most studies were observational in design, with only three papers based on randomised controlled trials. The overall quality of the evidence was low. Sex differences in the predictors of ultramarathon performance; physiological responses to training, racing, and recovery; chronic and acute health issues; and pacing strategies were found. There were areas with contradictory findings, and very few studies examined specific interventions. CONCLUSION The results from this review suggest that the development of sex-specific guidelines for ultramarathon coaches and athletes could have a significant effect on the performance and health of female runners. At present, there is insufficient high-quality evidence on which to formulate these guidelines, and further research is required.
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Affiliation(s)
- Claudia P M G Kelly
- College of Medicine and Health, The University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
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18
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Remilly M, Mauvieux B, Drigny J. Personality Traits Associated with the Risk of Exercise Dependence in Ultraendurance Athletes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1042. [PMID: 36673797 PMCID: PMC9858902 DOI: 10.3390/ijerph20021042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Exercise dependence (ED) is common in endurance athletes and can lead to physical and psychological distress with various health effects. We designed a prospective cross-sectional study to investigate the personality traits associated with ED among ultraendurance athletes. A total of 507 participants (41.6 (9.8) years, men: 73.7%) completed (1) a screening questionnaire about sociodemographic data, sporting habits, and healthcare data, (2) the Exercise Dependence Scale-Revised (EDS-R, 21 items scored from 1 (never) to 6 (always), 7 subscales), (3) the Big Five Inventory (BFI), and (4) 2 items of the SCOFF (Sick-Control-One Stone-Fat-Food) questionnaire regarding possible eating disorders. Based on the EDS-R scores, 37 (7.3%) participants were at risk for ED (scores ≥ 5/6 on ≥3 subscales), 366 (72.2%) were nondependent but symptomatic (scores ≥ 3/6 on ≥3 subscales), and 104 (20.5%) were asymptomatic. Participants with ED had a greater training volume and a higher prevalence of possible eating disorders. A higher level of neuroticism was associated with increased EDS-R scores (r = 0.294; p < 0.001), with significantly higher scores in the ED group (F = 14.50, p < 0.001). The association between neuroticism and ED was not moderated by the presence of eating disorders. These findings will help to screen ultraendurance athletes at risk for ED and optimize their care.
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Affiliation(s)
- Marion Remilly
- Normandie Univ, UNICAEN, CHU de Caen Normandie, Service de Médecine du Sport, 14000 Caen, France
| | - Benoit Mauvieux
- Normandie Univ, UNICAEN, INSERM, COMETE, GIP CYCERON, 14000 Caen, France
| | - Joffrey Drigny
- Normandie Univ, UNICAEN, CHU de Caen Normandie, Normandie University, Service de Médecine du Sport, Service de Médecine Physique et de Réadaptation, INSERM, COMETE, GIP CYCERON, 14000 Caen, France
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100 Long-Distance Triathlons in 100 Days: A Case Study on Ultraendurance, Biomarkers, and Physiological Outcomes. Int J Sports Physiol Perform 2023; 18:444-453. [PMID: 36898387 DOI: 10.1123/ijspp.2022-0327] [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: 08/24/2022] [Revised: 12/03/2022] [Accepted: 12/23/2022] [Indexed: 03/12/2023]
Abstract
The physical demands of a single long-distance triathlon (LDT) are sufficient to cause robust physiological perturbations. In this unique case study, an ultraendurance athlete completed 100 LDTs in 100 days (100LDT). PURPOSE This study aims to describe and analyze this single athlete's performance, physiological biomarkers, and sleep parameters throughout the 100LDT. METHODS An ultraendurance athlete completed an LDT (2.4-mile swim, 112-mile bike ride, and 26.2-mile marathon) each day for 100 consecutive days. Physical work, physiological biomarkers, and sleep parameters were recorded each night using a wrist-worn photoplethysmographic sensor. Clinical exercise tests were performed before and after the 100LDT. Time-series analysis assessed changes in biomarkers and sleep parameters across the 100LDT, and cross-correlations considered the associations between exercise performance and physiological metrics at varying time lags. RESULTS The swim and cycling performances varied across the 100LDT, while the run was relatively stable. Resting heart rate, heart-rate variability, oxygen saturation, sleep score, light sleep, sleep efficiency, and sleep duration were all best characterized by cubic models. Additional post hoc subanalyses suggest that the first half of the 100LDT most influenced these dynamics. CONCLUSIONS The 100LDT resulted in nonlinear alterations to physiological metrics. This world record was a unique event but allows valuable insights into the limits of human endurance performance.
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20
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Tidmas V, Brazier J, Bottoms L, Muniz D, Desai T, Hawkins J, Sridharan S, Farrington K. Ultra-Endurance Participation and Acute Kidney Injury: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16887. [PMID: 36554767 PMCID: PMC9779673 DOI: 10.3390/ijerph192416887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Increasingly popular, ultra-endurance participation exposes athletes to extremely high levels of functional and structural damage. Ultra-endurance athletes commonly develop acute kidney injury (AKI) and other pathologies harmful to kidney health. There is strong evidence that non-steroidal anti-inflammatory drugs, common amongst ultra-athletes, is linked to increased risk and severity of AKI and potentially ischaemic renal injury, i.e., acute tubular necrosis. Ultra-endurance participation also increases the risk of exertional rhabdomyolysis, exercise-associated hyponatremia, and gastrointestinal symptoms, interlinked pathologies all with potential to increase the risk of AKI. Hydration and fuelling both also play a role with the development of multiple pathologies and ultimately AKI, highlighting the need for individualised nutritional and hydration plans to promote athlete health. Faster athletes, supplementing nitrates, and being female also increase the risk of developing AKI in this setting. Serum creatinine criteria do not provide the best indicator for AKI for ultra-athletes therefore further investigations are needed to assess the practicality and accuracy of new renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL). The potential of recurring episodes of AKI provide need for further research to assess the longitudinal renal health impact of ultra-participation to provide appropriate advice to athletes, coaches, medical staff, and event organisers.
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Affiliation(s)
- Victoria Tidmas
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Jon Brazier
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Lindsay Bottoms
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Daniel Muniz
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Terun Desai
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Janine Hawkins
- Centre for Health Services and Clinical Research, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Sivakumar Sridharan
- Centre for Health Services and Clinical Research, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
- Renal Unit, Lister Hospital, East and North Herts Trust, Stevenage SG1 4AB, UK
| | - Ken Farrington
- Centre for Health Services and Clinical Research, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
- Renal Unit, Lister Hospital, East and North Herts Trust, Stevenage SG1 4AB, UK
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21
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Running for Your Life: Metabolic Effects of a 160.9/230 km Non-Stop Ultramarathon Race on Body Composition, Inflammation, Heart Function, and Nutritional Parameters. Metabolites 2022; 12:metabo12111138. [DOI: 10.3390/metabo12111138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Moderate endurance exercise leads to an improvement in cardiovascular performance, stress resilience, and blood function. However, the influence of chronic endurance exercise over several hours or days is still largely unclear. We examined the influence of a non-stop 160.9/230 km ultramarathon on body composition, stress/cardiac response, and nutrition parameters. Blood samples were drawn before (pre) and after the race (post) and analyzed for ghrelin, insulin, irisin, glucagon, cortisol, kynurenine, neopterin, and total antioxidant capacity. Additional measurements included heart function by echocardiography, nutrition questionnaires, and body impedance analyses. Of the 28 included ultra-runners (7f/21m), 16 participants dropped out during the race. The remaining 12 finishers (2f/10m) showed depletion of antioxidative capacities and increased inflammation/stress (neopterin/cortisol), while energy metabolism (insulin/glucagon/ghrelin) remained unchanged despite a high negative energy balance. Free fat mass, protein, and mineral content decreased and echocardiography revealed a lower stroke volume, left end diastolic volume, and ejection fraction post race. Optimizing nutrition (high-density protein-rich diet) during the race may attenuate the observed catabolic and inflammatory effects induced by ultramarathon running. As a rapidly growing discipline, new strategies for health prevention and extensive monitoring are needed to optimize the athletes’ performance.
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22
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Accelerometery-Based Load Symmetry in Track Running Kinematics concerning Body Location, Track Segment, and Distance in Amateur Runners. Symmetry (Basel) 2022. [DOI: 10.3390/sym14112332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Previous studies indicate that running at maximum speed on short or curved sections is slower than running on straight sections. This study aimed to analyse the external load symmetry in track running kinematics concerning body location (left vs. right, caudal vs. cephalic), track segment (straight vs. curved) and distance (150 m vs. 300 m). Methods: Twenty experienced athletes ran 150 m and 300 m on an official athletic track and were monitored by Magnetic, Angular Rate and Gravity sensors attached to six different body segments (thorax, lumbar, knees and malleolus). Player Load was quantified as a valid, effective and representative Accelerometery-based variable. Results: (1) Principal component analysis explained 62–93% of the total variance and clustered body locations relevance in curved (knees and malleolus) vs. straight (lumbar, knees, malleolus) running segments; (2) Player Load statistical differences by track segment (curved vs. straight) were found in all body locations; and (3) there were no differences in bilateral symmetries by distance or running segment. Conclusions: Track segment and body location directly impacted accelerometery-based load. Acceleration in straight segments was lower compared to that in curved segments in all the body locations (lumbar, knee and ankle), except in the thorax. Strength and conditioning programs should consider the singularity of curved sprinting (effects of centripetal–centrifugal force) for performance enhancement and injury prevention and focus on the knees and malleolus, as shown in the principal component analysis results.
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23
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Wołyniec W, Szwarc A, Kasprowicz K, Zorena K, Jaskulak M, Renke M, Naczyk M, Ratkowski W. Impact of hydration with beverages containing free sugars or xylitol on metabolic and acute kidney injury markers after physical exercise. Front Physiol 2022; 13:841056. [PMID: 36338481 PMCID: PMC9632281 DOI: 10.3389/fphys.2022.841056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
The proper fluid and carbohydrates intake is essential before and during physical exercise, and for this reason most athletes drink beverages containing a high amount of free sugars. Sweetened soft drinks are also commonly consumed by those not doing any sport, and this habit seems to be both unhealthy and also the cause of metabolic problems. Recently, several sweeteners have been proposed to replace sugars in popular beverages. To examine the impact of free sugars and the popular sweetener xylitol on metabolic profile and the markers of kidney function and injury after exercise the present study was conducted with semi-professional football players. All participants were healthy, with a mean age of 21.91 years. Their sports skills were on the level of the 4th-5th division of the league. The subjects took part in four football training sessions. During each session they drank a 7% solution of sugar (sucrose, fructose, glucose) or xylitol. The tolerability of these beverages and well-being during exercise was monitored. Before and after each training session, blood and urine were collected. The markers of kidney function and injury, uric acid, electrolytes, complete blood count, CRP, serum albumin, serum glucose and the lipid profile were analyzed. The main finding of this study was that the xylitol beverage is the least tolerated during exercise and 38.89% of participants experienced diarrhea after training and xylitol intake. Xylitol also led to unfavorable metabolic changes and a large increase in uric acid and creatinine levels. A mean increase of 1.8 mg/dl in the uric acid level was observed after xylitol intake. Increases in acute kidney injury markers were observed after all experiments, but changes in urine albumin and cystatin C were highest after xylitol. The other three beverages (containing “free sugars” - glucose, fructose and sucrose) had a similar impact on the variables studied, although the glucose solution seems to have some advantages over other beverages. The conclusion is that sweeteners are not a good alternative to sugars, especially during exercise. Pure water without sweeteners should be drunk by those who need to limit their calorie consumption. Clinical Trial Registration:ClinicalTrials.gov, (NCT04310514)
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Affiliation(s)
- Wojciech Wołyniec
- Division of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
- *Correspondence: Wojciech Wołyniec,
| | - Andrzej Szwarc
- Department of Sport Sciences, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Katarzyna Kasprowicz
- Faculty of Physical Education, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Katarzyna Zorena
- Division of Immunobiology and Environmental Microbiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marta Jaskulak
- Division of Immunobiology and Environmental Microbiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Renke
- Division of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - Marta Naczyk
- Laboratory of Nutritional Biochemistry, Department of Clinical Nutrition, Medical University of Gdańsk, Gdańsk, Poland
| | - Wojciech Ratkowski
- Department of Athletics, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
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24
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Tiller NB, Wheatley-Guy CM, Fermoyle CC, Robach P, Ziegler B, Gavet A, Schwartz JC, Taylor BJ, Constantini K, Murdock R, Johnson BD, Stewart GM. Sex-Specific Physiological Responses to Ultramarathon. Med Sci Sports Exerc 2022; 54:1647-1656. [PMID: 35653262 DOI: 10.1249/mss.0000000000002962] [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: 11/21/2022]
Abstract
PURPOSE Despite a growing body of literature on the physiological responses to ultramarathon, there is a paucity of data in females. This study assessed the female physiological response to ultramarathon and compared the frequency of perturbations to a group of race- and time-matched males. METHODS Data were collected from 53 contestants of an ultramarathon trail race at the Ultra-Trail du Mont-Blanc (UTMB®) in 2018/19. Before and within 2 h of the finish, participants underwent physiological assessments, including blood sampling for biomarkers (creatine kinase-MB isoenzyme [CK-MB], cardiac troponin I [cTnI], brain natriuretic peptide [BNP], and creatinine [Cr]), pulmonary function testing (spirometry, exhaled NO, diffusing capacities, and mouth pressures), and transthoracic ultrasound (lung comet tails, cardiac function). Data from eight female finishers (age = 36.6 ± 6.9 yr; finish time = 30:57 ± 11:36 h:min) were compared with a group of eight time-matched males (age = 40.3 ± 8.3 yr; finish time = 30:46 ± 10:32 h:min). RESULTS Females exhibited significant pre- to postrace increases in BNP (25.8 ± 14.6 vs 140.9 ± 102.7 pg·mL -1 ; P = 0.007) and CK-MB (3.3 ± 2.4 vs 74.6 ± 49.6 IU·L -1 ; P = 0.005), whereas males exhibited significant pre- to postrace increases in BNP (26.6 ± 17.5 vs 96.4 ± 51.9 pg·mL -1 ; P = 0.002), CK-MB (7.2 ± 3.9 vs 108.8 ± 37.4 IU·L -1 ; P = 0.002), and Cr (1.06 ± 0.19 vs 1.23 ± 0.24 mg·dL -1 ; P = 0.028). Lung function declined in both groups, but males exhibited additional reductions in lung diffusing capacities (DL CO = 34.4 ± 5.7 vs 29.2 ± 6.9 mL⋅min -1 ⋅mm Hg -1 , P = 0.004; DL NO = 179.1 ± 26.2 vs 152.8 ± 33.4 mL⋅min -1 ⋅mm Hg -1 , P = 0.002) and pulmonary capillary blood volumes (77.4 ± 16.7 vs 57.3 ± 16.1 mL; P = 0.002). Males, but not females, exhibited evidence of mild postrace pulmonary edema. Pooled effect sizes for within-group pre- to postrace changes, for all variables, were generally larger in males versus females ( d = 0.86 vs 0.63). CONCLUSIONS Ultramarathon negatively affects a range of physiological functions but generally evokes more frequent perturbations, with larger effect sizes, in males compared to females with similar race performances.
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Affiliation(s)
- Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | | | | | - Paul Robach
- Ecole Nationale des Sports de Montagne, Chamonix, FRANCE
| | - Briana Ziegler
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Alice Gavet
- Ecole Nationale des Sports de Montagne, Chamonix, FRANCE
| | - Jesse C Schwartz
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ
| | - Bryan J Taylor
- Department of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL
| | - Keren Constantini
- School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, ISRAEL
| | | | - Bruce D Johnson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
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25
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Effects of nutritional and hydration strategies during ultramarathon events between finishers and non-finishers: A systematic review protocol. PLoS One 2022; 17:e0272668. [PMID: 35984831 PMCID: PMC9390899 DOI: 10.1371/journal.pone.0272668] [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: 04/08/2022] [Accepted: 07/24/2022] [Indexed: 11/21/2022] Open
Abstract
Ultramarathon running is a sport that is growing in popularity. Competing in an ultramarathon event is physiologically taxing on the human body, and it should not be surprising that not all individuals who enroll for an event ultimately finish. While many factors can contribute to this phenomenon, it is likely that nutritional and hydration strategies play a large role between finishing and not finishing an ultramarathon. No published paper has systematically reviewed the effects of nutritional and hydration strategies during ultramarathon events between finishers and non-finishers. This paper details our intended protocol with the following steps that create the flow of the systematic review: 1) Determine the review question and Participant, Intervention, Comparator, Outcome, Study Design (PICOS) criteria; 2) Create inclusion and exclusion criteria; 3) Create and follow a search strategy; 4) Document sources that are included and excluded according to the pre-determined eligibility criteria; 5) Assess final sources for risk of bias; 6) Extract pertinent data from final full-text articles and synthesize the information; and 7) Disseminate findings of the systematic review.
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26
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Echocardiographic Assessment of Left Ventricular Function 10 Years after the Ultra-Endurance Running Event Eco-Trail de Paris® 2011. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148268. [PMID: 35886119 PMCID: PMC9318254 DOI: 10.3390/ijerph19148268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/02/2022] [Accepted: 07/03/2022] [Indexed: 11/16/2022]
Abstract
Background: Regular and moderate physical activity is beneficial for physical and mental health, resulting in an increase in life expectancy for both sexes. From a cardiovascular point of view, although the benefits of regular moderate physical exercise have been established, the long-term effects of repeated ultra-endurance running events are still unknown. Hypothesis: The aim of our study is to evaluate the 10-year evolution of the parameters of the left ventricular systolic and diastolic functions of amateur subjects regularly practising ultra-endurance running events using resting echocardiography. Study design: Cross-sectional study. Level of evidence: Level 3—non-randomized controlled cohort/follow-up study. Methods: The 66 participants who participated in the 2011 edition of the Eco-Trail de Paris® were contacted by e-mail. Demographic data, sports practice, and the results of an echocardiography scan carried out during the year 2021 evaluating left ventricular systolic and diastolic function variables were collected. Echographic variables from 2011 and 2021 were compared using the paired Student’s t-test. Results: Forty-six (70%) participants responded positively. Twenty (30%) participants could not be reached and were not analysed. Of the 46 respondents, 42 (91%) provided data from a trans-thoracic cardiac ultrasound performed in 2021. Over the past 10 years, the participants reported having completed an average of 4 ± 2 ultra-trails per year. No significant differences were observed between left ventricular diastolic and systolic echocardiographic parameters between the years 2011 and 2021. Conclusions: Among amateur participants, long-distance running is not associated with an alteration in the echocardiographic parameters of resting left ventricular systolic and diastolic function after 10 years of practice. Clinical relevance: Long-term long-distance running practice is not associated with left ventricular cardiac function alteration. These results suggest a potential adaptation role of the cardiovascular system to regular and moderate long-distance running practice.
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Mattioli AV, Nasi M, Pinti M, Palumbo C. Teaching Gender Differences at Medical School Could Improve the Safety and Efficacy of Personalized Physical Activity Prescription. Front Cardiovasc Med 2022; 9:919257. [PMID: 35811713 PMCID: PMC9260073 DOI: 10.3389/fcvm.2022.919257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/27/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Anna Vittoria Mattioli
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
- *Correspondence: Anna Vittoria Mattioli,
| | - Milena Nasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcello Pinti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Carla Palumbo
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Jouffroy R, Anglicheau D, Mansencal N, Toussaint JF, Antero J. Relationship between Exercise Intensity and IL-6 Increase during an 80 km Long-Distance Running Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116368. [PMID: 35681953 PMCID: PMC9179966 DOI: 10.3390/ijerph19116368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022]
Abstract
Background: IL-6 plasma concentration (IL-6PC) reflects the systemic inflammation related to exercise intensity level. This study aims to describe the IL-6PC kinetics during a long-distance running race. IL-6PC was measured in 20 male runners before (0 km), at each refreshment point (at 21 and 53 km, i.e., k21 and k53, respectively) and at the end of an 80 km long-distance run (k80). Methods: IL-6PC variations (absolute and relative values in each of the three sections (S)) were calculated over S1 (0_k21), S2 (k21_k53) and S3 (k53_k80) and compared with the exercise intensity (duration*race speed) within each section. Results: The mean IL-6PC increased during the run: 2.1 ± 0.6 ng.L−1 at 0 km, 21.0 ± 11.3 ng.L−1 at k21, 38.9 ± 13.0 ng.L−1 at k53 and 49.8 ± 11.9 ng.L−1 at k80. Exercise intensity increased between S1 (24.2 ± 0.5) and S2 (51.9 ± 3.2) (p = 0.04) but not between S2 and S3 (67.4 ± 4.5) (p = 0.69). IL-6PC variation was associated with exercise intensity within S1 (p = 0.03) and S2 (p = 2 × 10−3) and showed at least a trend within S3 (p = 0.06). Conclusions: IL-6PC increases that occur during the early stages of a long-distance run are associated with the running intensity, and then IL-6PC remain stable after the reduction in intensity related to the decrease in running speed.
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Affiliation(s)
- Romain Jouffroy
- Intensive Care Unit, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 92100 Boulogne-Billancourt, France
- IRMES—Institute for Research in Medicine and Epidemiology of Sport, INSEP, 75012 Paris, France; (J.F.T.); (J.A.)
- INSERM U-1018, Centre de Recherche en Epidémiologie et Santé des Populations, Paris Saclay University, 94800 Paris, France;
- URP 7329, Université de Paris, 75012 Paris, France
- Correspondence: ; Tel.: +33-0-149-095-601; Fax: +33-0-149-095-892
| | - Dany Anglicheau
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, 75015 Paris, France;
- Paris Descartes, Sorbonne Paris Cité University, 75006 Paris, France
- Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - Nicolas Mansencal
- INSERM U-1018, Centre de Recherche en Epidémiologie et Santé des Populations, Paris Saclay University, 94800 Paris, France;
- Department of Cardiology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence des Cardiomyopathies et des Troubles du Rythme Cardiaque Héréditaires Ou Rares, Université de Versailles-Saint Quentin (UVSQ), 92100 Boulogne, France
| | - Jean François Toussaint
- IRMES—Institute for Research in Medicine and Epidemiology of Sport, INSEP, 75012 Paris, France; (J.F.T.); (J.A.)
- URP 7329, Université de Paris, 75012 Paris, France
- Centre d’Investigations en Médecine du Sport, Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), 75004 Paris, France
| | - Juliana Antero
- IRMES—Institute for Research in Medicine and Epidemiology of Sport, INSEP, 75012 Paris, France; (J.F.T.); (J.A.)
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Lecina M, Castellar-Otín C, López-Laval I, Carrasco Páez L, Pradas F. Acute Kidney Injury and Hyponatremia in Ultra-Trail Racing: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58050569. [PMID: 35629986 PMCID: PMC9146822 DOI: 10.3390/medicina58050569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/28/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022]
Abstract
Background and objectives: Ultra-trail races can cause episodes of acute kidney injury (AKI) and exercise-associated hyponatremia (EAH) in healthy subjects without previous renal pathology. This systematic review aims to review the incidence of these two syndromes together and separately taking into account the length and elevation of the ultra-trail race examined. Materials and Methods: A systematic review was conducted through electronic search in four electronic databases (PubMed, EBSCO, Web of Science and Alcorze). Results: A total of 1127 articles published between January 2006 and December 31, 2021 were included, 28 of which met the inclusion criteria. The studies were categorized according to the length and stages of the race in four categories: medium (42 to 69 km), long (70 to 99 km), extra (>100 km) and multi-stage if they included various stages. A total of 2950 runners (666 females and 2284 males) were extracted from 28 publications. The AKI incidence found was 42.04% (468 cases of 1113), and 195 of 2065 were diagnosed with EAH, accounting for 9.11%. The concurrence of both pathologies together reached 11.84% (27 individuals) from a total of 228 runners with AKI and EAH simultaneously analyzed. Sorted by race category, the AKI+EAH cases were distributed as follows: 18 of 27 in the extra (13.63% and n = 132), 4 in the large (5.79% and n = 69) and 5 in the medium category (18.15% and n = 27). Conclusions: According to these results, extra and medium races showed a similar incidence of AKI+EAH. These findings underline the importance of the duration and intensity of the race and may make them responsible for the etiology of these medical conditions. Due to their variable incidence, EAH and AKI are often underdiagnosed, leading to poorer prognosis, increased condition seriousness and hindered treatment. The results of this review urge participants, coaches and race organizers to take measures to improve the early diagnosis and urgent treatment of possible EAH and AKI cases.
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Affiliation(s)
- Miguel Lecina
- Faculty of Health and Sports Sciences, University of Zaragoza, 22002 Huesca, Spain;
| | - Carlos Castellar-Otín
- ENFYRED Research Group, Faculty of Health and Sports, University of Zaragoza, 22002 Huesca, Spain;
- Correspondence:
| | - Isaac López-Laval
- Department of Physiatry and Nursery, Section of Physical Education and Sports, Faculty of Health Sciences and Sport, University of Zaragoza, 22002 Huesca, Spain;
| | - Luis Carrasco Páez
- Department of Physical Education and Sport, University of Seville, 41013 Seville, Spain;
| | - Francisco Pradas
- ENFYRED Research Group, Faculty of Health and Sports, University of Zaragoza, 22002 Huesca, Spain;
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Hernando C, Hernando C, Panizo N, Collado-Boira E, Folch-Ayora A, Martínez-Navarro I, Hernando B. Renal Function Recovery Strategies Following Marathon in Amateur Runners. Front Physiol 2022; 13:812237. [PMID: 35295572 PMCID: PMC8918951 DOI: 10.3389/fphys.2022.812237] [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: 11/09/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Long distance races have a physiological impact on runners. Up to now, studies analyzing these physiological repercussions have been mainly focused on muscle and cardiac damage, as well as on its recovery. Therefore, a limited number of studies have been done to explore acute kidney failure and recovery after performing extreme exercises. Here, we monitored renal function in 76 marathon finishers (14 females) from the day before participating in a marathon until 192 h after crossing the finish line (FL). Renal function was evaluated by measuring serum creatinine (sCr) and the glomerular filtration rate (GFR). We randomly grouped our cohort into three intervention groups to compare three different strategies for marathon recovery: total rest (REST), continuous running at their ventilatory threshold 1 (VT1) intensity (RUN), and elliptical workout at their VT1 intensity (ELLIPTICAL). Interventions in the RUN and ELLIPTICAL groups were performed at 48, 96, and 144 h after marathon running. Seven blood samples (at the day before the marathon, at the FL, and at 24, 48, 96, 144, and 192 h post-marathon) and three urine samples (at the day before the marathon, at the finish line, and at 48 h post-marathon) were collected per participant. Both heart rate monitors and triaxial accelerometers were used to control the intensity effort during both the marathon race and the recovery period. Contrary to our expectations, the use of elliptical machines for marathon recovery delays renal function recovery. Specifically, the ELLIPTICAL group showed a significantly lower ∆GFR compared to both the RUN group (p = 4.5 × 10−4) and the REST group (p = 0.003). Hence, we encourage runners to carry out an active recovery based on light-intensity continuous running from 48 h after finishing the marathon. In addition, full resting seems to be a better strategy than performing elliptical workouts.
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Affiliation(s)
- Carlos Hernando
- Sport Service, Jaume I University, Castellon, Spain
- Department of Education and Specific Didactics, Jaume I University, Castellon, Spain
- *Correspondence: Carlos Hernando,
| | - Carla Hernando
- Department of Mathematics, Carlos III University of Madrid, Madrid, Spain
| | - Nayara Panizo
- Nephrology Service, University Clinical Hospital of Valencia, Valencia, Spain
| | | | - Ana Folch-Ayora
- Faculty of Health Sciences, Jaume I University, Castellon, Spain
| | - Ignacio Martínez-Navarro
- Department of Physical Education and Sport, University of Valencia, Valencia, Spain
- Sports Health Unit, Vithas-Nisa 9 de Octubre Hospital, Valencia, Spain
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Abstract
In recent years, there has been a significant expansion in female participation in endurance (road and trail) running. The often reported sex differences in maximal oxygen uptake (VO2max) are not the only differences between sexes during prolonged running. The aim of this narrative review was thus to discuss sex differences in running biomechanics, economy (both in fatigue and non-fatigue conditions), substrate utilization, muscle tissue characteristics (including ultrastructural muscle damage), neuromuscular fatigue, thermoregulation and pacing strategies. Although males and females do not differ in terms of running economy or endurance (i.e. percentage VO2max sustained), sex-specificities exist in running biomechanics (e.g. females have greater non-sagittal hip and knee joint motion compared to males) that can be partly explained by anatomical (e.g. wider pelvis, larger femur-tibia angle, shorter lower limb length relative to total height in females) differences. Compared to males, females also show greater proportional area of type I fibres, are more able to use fatty acids and preserve carbohydrates during prolonged exercise, demonstrate a more even pacing strategy and less fatigue following endurance running exercise. These differences confer an advantage to females in ultra-endurance performance, but other factors (e.g. lower O2 carrying capacity, greater body fat percentage) counterbalance these potential advantages, making females outperforming males a rare exception. The present literature review also highlights the lack of sex comparison in studies investigating running biomechanics in fatigue conditions and during the recovery process.
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Jouffroy R, Antero J, Toussaint JF. Comment on: "Potential long-term health problems associated with ultra-endurance running: a narrative review". Sports Med 2022; 52:955-956. [PMID: 35072939 DOI: 10.1007/s40279-022-01646-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Romain Jouffroy
- Intensive Care Unit, University Hospital Ambroise Paré, Boulogne Billancourt, France.
- Centre de recherche en Epidémiologie et Santé des Populations, U1018 INSERM, Université Paris Saclay, Paris, France.
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport, EA7329, INSEP, Université de Paris, Paris, France.
| | - Juliana Antero
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport, EA7329, INSEP, Université de Paris, Paris, France
| | - Jean-François Toussaint
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport, EA7329, INSEP, Université de Paris, Paris, France
- Centre d'Investigation en Médecine du Sport, Hôtel-Dieu, Assistance Publique, Hôpitaux de Paris, Paris, France
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Scheer V, Tiller NB, Doutreleau S, Khodaee M, Knechtle B, Pasternak A, Rojas-Valverde D. Authors' Response to: Comment on: "Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review". Sports Med 2022; 52:957-958. [PMID: 35072940 DOI: 10.1007/s40279-022-01647-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Volker Scheer
- Ultra Sports Science Foundation, 109 Boulevard de l'Europe, 69310, Pierre-Bénite, France.
| | - Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Centre, Torrance, CA, USA
| | - Stéphane Doutreleau
- Sports Medical Unit, HP2 Laboratory, University Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble, France
| | - Morteza Khodaee
- Department of Family Medicine and Orthopedics, Division of Sports Medicine, University of Colorado School of Medicine, Denver, CO, USA
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Andrew Pasternak
- Silver Sage Sports and Fitness Lab, Reno, NV, USA
- Department of Family and Community Medicine, University of Nevada Reno School of Medicine, Reno, NV, USA
| | - Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia, Costa Rica
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Atkins WC, Butts CL, Kelly MR, Troyanos C, Laursen RM, Duckett A, Emerson DM, Rosa-Caldwell ME, McDermott BP. Acute Kidney Injury Biomarkers and Hydration Outcomes at the Boston Marathon. Front Physiol 2022; 12:813554. [PMID: 35046841 PMCID: PMC8761943 DOI: 10.3389/fphys.2021.813554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of our field study was to investigate the effects of running the Boston Marathon on acute kidney injury (AKI) biomarkers. We hypothesized that biomarker values would be elevated immediately post-marathon but would resolve in the 24-h post-marathon. Secondarily, we sought to identify sex differences related to renal stress. Participants were 65 runners who completed the Boston Marathon (46 ± 9 years, 65.4 ± 10.8 kg). Urine samples were collected at three different time points (pre-marathon, post-marathon, and 24-h post-marathon). Blood samples were collected post-marathon and 24-h post-marathon. Urine specific gravity (USG) and AKI biomarkers were evaluated. Pre-marathon USG (1.012 ± 0.007) was significantly less than post-marathon (1.018 ± 0.008) and 24-h post-marathon (1.020 ± 0.009; P < 0.001). Male USG (1.024 ± 0.009) was significantly greater 24-h post-marathon than females (1.017 ± 0.008; P = 0.019). Urinary neutrophil gelatinase-associated lipocalin values were significantly greater over time (P < 0.001), and there was a main effect of sex with female urinary creatinine (UCr) greater than males at all three time points (P = 0.040). Post-marathonUCr (366.24 ± 295.16 mg/dl) was significantly greater than pre-marathon (206.65 ± 145.28.56 mg/dl; p < 0.001) and 24-h post-marathon was significantly lower than other time-points (93.90 ± 125.07 mg/dl; P < 0.001). FemaleUCr values were significantly greater than males 24-h post-marathon (P < 0.001). There was no difference in serum cystatin C (SCys) values post- or 24-h post-marathon (P = 0.178). Serum creatinine (SCr) significantly decreased between post-marathon and 24-h post-marathon, (P < 0.001). We can infer that the characteristics unique to the Boston Marathon may have attributed to prolonged elevations in AKI biomarkers. Sex differences were observed during the Boston Marathon warranting further investigation.
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Affiliation(s)
- Whitley C Atkins
- Exercise Science Research Center, College of Education and Health Professions, University of Arkansas, Fayetteville, AR, United States
| | - Cory L Butts
- Department of Exercise and Nutrition Sciences, Weber State University, Ogden, UT, United States
| | - Melani R Kelly
- Department of Exercise Science and Pre-Health Professions, Creighton University, Omaha, NE, United States
| | - Chris Troyanos
- Medical Coordinator for the Boston Marathon, Boston, MA, United States
| | - R Mark Laursen
- Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Andrew Duckett
- Athletic Training Department, Boston University, Boston, MA, United States
| | - Dawn M Emerson
- University of Kansas Medical Center, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, Kansas City, KS, United States
| | - Megan E Rosa-Caldwell
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Brendon P McDermott
- Exercise Science Research Center, College of Education and Health Professions, University of Arkansas, Fayetteville, AR, United States
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Rojas-Valverde D, Tomás-Carús P, Timón R, Batalha N, Sánchez-Ureña B, Gutiérrez-Vargas R, Olcina G. Short-Term Skin Temperature Responses to Endurance Exercise: A Systematic Review of Methods and Future Challenges in the Use of Infrared Thermography. Life (Basel) 2021; 11:1286. [PMID: 34947817 PMCID: PMC8704093 DOI: 10.3390/life11121286] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Body temperature is often assessed in the core and the skin. Infrared thermography has been used to measure skin temperature (Tsk) in sport research and clinical practice. This study aimed to explore the information reported to date on the use of infrared thermography to detect short-term Tsk responses to endurance exercise and to identify the methodological considerations and knowledge gaps, and propose future directions. METHOD A web search (PubMed, Science Direct, Google Scholar, and Web of Science) was conducted following systematic review guidelines, and 45 out of 2921 studies met the inclusion criteria (endurance sports, since 2000, English, full text available). RESULTS A total of 45 publications were extracted, in which most of the sample were runners (n = 457, 57.9%). Several differences between IRT imaging protocols and ROI selection could lead to potential heterogeneity of interpretations. These particularities in the methodology of the studies extracted are widely discussed in this systematic review. CONCLUSIONS More analyses should be made considering different sports, exercise stimuli and intensities, especially using follow-up designs. Study-derived data could clarify the underlying thermo physiological processes and assess whether Tsk could be used a reliable proxy to describe live thermal regulation in endurance athletes and reduce their risk of exertional heat illness/stroke. Also more in-depth analyses may elucidate the Tsk interactions with other tissues during exercise-related responses, such as inflammation, damage, or pain.
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Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional de Costa Rica, Heredia 86-3000, Costa Rica
- Clínica de Lesiones Deportivas (Rehab & Readapt), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional de Costa Rica, Heredia 86-3000, Costa Rica
| | - Pablo Tomás-Carús
- Comprehensive Health Research Center (CHRC), Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia-Universidade de Évora, 7000-727 Évora, Portugal
| | - Rafael Timón
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain
| | - Nuno Batalha
- Comprehensive Health Research Center (CHRC), Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia-Universidade de Évora, 7000-727 Évora, Portugal
| | - Braulio Sánchez-Ureña
- Programa de Ciencias del Ejercicio y la Salud (PROCESA), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional de Costa Rica, Heredia 86-3000, Costa Rica
| | - Randall Gutiérrez-Vargas
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional de Costa Rica, Heredia 86-3000, Costa Rica
| | - Guillermo Olcina
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain
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Rojas-Valverde D, Martínez-Guardado I, Sánchez-Ureña B, Timón R, Scheer V, Pino-Ortega J, Olcina G. Outpatient Assessment of Mechanical Load, Heat Strain and Dehydration as Causes of Transitional Acute Kidney Injury in Endurance Trail Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910217. [PMID: 34639516 PMCID: PMC8508486 DOI: 10.3390/ijerph181910217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/12/2021] [Accepted: 09/21/2021] [Indexed: 12/11/2022]
Abstract
Background: This study aimed to globally assess heat strain, dehydration, and mechanical load as acute kidney injury (AKI) indicators in amateur endurance trail athletes during a 35.3 km run. Methods: Thirty amateur experienced trail runners completed an endurance trail run (total positive ascend 1815 m). The following assessments were performed at four measurement time points (pre-, during, immediately post [-post0h], and after 24 h of the finish of the run [-post24h]): serum test (creatinine, blood ureic nitrogen, albumin, creatine kinase, blood ureic nitrogen: creatinine ratio, creatinine clearance, and glomerular filtration rate), mechanical load (impacts and Player Load), heat strain and dehydration (hematocrit, urine solids, body weight and urine specific gravity), pain and exertion perception (rate of perceived exertion, lumbar and bipodal, and one-leg squat pain), and urinalysis (pH, protein, glucose, erythrocytes, and urine specific gravity). Results: There were pre vs. post0h changes in all serum biomarkers (F = 5.4–34.45, p < 0.01). The change in these biomarkers correlated with an increase in mechanical load indicators (r = 0.47–59, p < 0.05). A total of 40% and 23.4% of participants presented proteinuria and hematuria, respectively. Pain and perceived exertion increased significantly due to effort made during the endurance trail running (F = 4.2–176.4, p < 0.01). Conclusions: Endurance trail running may lead to an increase in blood and urine indicators of transitional AKI. The difference in blood and urine markers was significantly related to the mechanical load during running, suggesting potential kidney overload and cumulative mechanical load.
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Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 86-3000, Costa Rica
- Clínica de Lesiones Deportivas (Rehab & Readapt), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional de Costa Rica, Heredia 86-3000, Costa Rica
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10003 Cáceres, Spain; (R.T.); (G.O.)
- Correspondence: (D.R.-V.); (I.M.-G.); Tel.: +506-88250219 (D.R.-V.)
| | - Ismael Martínez-Guardado
- Faculty of Life and Natural Sciences, University of Nebrija, 28015 Madrid, Spain
- Correspondence: (D.R.-V.); (I.M.-G.); Tel.: +506-88250219 (D.R.-V.)
| | - Braulio Sánchez-Ureña
- Programa de Ciencias del Ejercicio y la Salud, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia 86-3000, Costa Rica;
| | - Rafael Timón
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10003 Cáceres, Spain; (R.T.); (G.O.)
| | - Volker Scheer
- Ultra Sports Science Foundation, 69310 Pierre-Bénite, France;
| | - José Pino-Ortega
- Biovetmed & Sportsci Research Group, University of Murcia, 30720 San Javier, Spain;
| | - Guillermo Olcina
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10003 Cáceres, Spain; (R.T.); (G.O.)
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Analysis of sex-based differences in energy substrate utilization during moderate-intensity aerobic exercise. Eur J Appl Physiol 2021; 122:29-70. [PMID: 34550468 PMCID: PMC8748379 DOI: 10.1007/s00421-021-04802-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/24/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To explore sex-based differences in energy substrate utilization during moderate-intensity aerobic exercise; to identify the underpinning candidate physiological mechanisms. METHODS Three databases were searched from inception to August 2020. Pertinent studies quantifying the utilization of substrates during moderate aerobic exercise in healthy men and reproductive-age women were considered. Studies conducted on sedentary/recreationally active and athletic populations were included and analyzed separately. RESULTS Thirty-five studies entered the meta-analysis (21 in sedentary/recreationally active, 14 in athletic populations). Compared to women, the respiratory exchange ratio was significantly higher both in sedentary (mean difference, MD: + 0.03; p < 0.00001) and athletic men (MD: + 0.02; p < 0.0001). Greater carbohydrate oxidation was observed both in sedentary (standardized MD, SMD: 0.53; p = 0.006) and athletic men (SMD: 1.24; p < 0.00001). Regarding lipid substrates, sedentary men oxidized less fat than women (SMD: - 0.77; p = 0.0002), while no sex-based differences in fat oxidation were observed in athletes (SMD: 0.06; p = 0.77). Paucity of data prevented robust meta-analyses for protein sources. Sex hormones and different adrenergic activation were the most cited mechanisms to discuss sex-based differences. CONCLUSIONS Meta-analyses confirmed that men display greater reliance on carbohydrates while women rely more on lipids to sustain moderate aerobic exercise. The latter finding was not confirmed in athletes, a novel aspect of the present study. Mechanistically driven research is needed to further dissect the physiological underpinnings of sex differences in substrate utilization during aerobic exercise, especially for proteins, which are still less investigated than other substrates.
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