Nutrition for power sports: Middle-distance running, track cycling, rowing, canoeing/kayaking, and swimming

Beyond Menstrual Dysfunction: Does Altered Endocrine Function Caused by Problematic Low Energy Availability Impair Health and Sports Performance in Female Athletes?

Low energy availability, particularly when problematic (i.e., prolonged and/or severe), has numerous negative consequences for health and sports performance as characterized in relative energy deficiency in sport. These consequences may be driven by disturbances in endocrine function, although scientific evidence clearly linking endocrine dysfunction to decreased sports performance and blunted or diminished training adaptations is limited. We describe how low energy availability-induced changes in sex hormones manifest as menstrual dysfunction and accompanying hormonal dysfunction in other endocrine axes that lead to adverse health outcomes, including negative bone health, impaired metabolic activity, undesired outcomes for body composition, altered immune response, problematic cardiovascular outcomes, iron deficiency, as well as impaired endurance performance and force production, all of which ultimately may influence athlete health and performance. Where identifiable menstrual dysfunction indicates hypothalamic-pituitary-ovarian axis dysfunction, concomitant disturbances in other hormonal axes and their impact on the athlete's health and sports performance must be recognized as well. Given that the margin between podium positions and "losing" in competitive sports can be very small, several important questions regarding low energy availability, endocrinology, and the mechanisms behind impaired training adaptations and sports performance have yet to be explored.

Perspectives on Concurrent Strength and Endurance Training in Healthy Adult Females: A Systematic Review

BACKGROUND

Both strength and endurance training are included in global exercise recommendations and are the main components of training programs for competitive sports. While an abundance of research has been published regarding concurrent strength and endurance training, only a small portion of this research has been conducted in females or has addressed their unique physiological circumstances (e.g., hormonal profiles related to menstrual cycle phase, menstrual dysfunction, and hormonal contraceptive use), which may influence training responses and adaptations.

OBJECTIVE

The aim was to complete a systematic review of the scientific literature regarding training adaptations following concurrent strength and endurance training in apparently healthy adult females.

METHODS

A systematic electronic search for articles was performed in July 2021 and again in December 2022 using PubMed and Medline. This review followed, where applicable, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the included studies was assessed using a modified Downs and Black checklist. Inclusion criteria were (1) fully published peer-reviewed publications; (2) study published in English; (3) participants were healthy normal weight or overweight females of reproductive age (mean age between > 18 and < 50) or presented as a group (n > 5) in studies including both females and males and where female results were reported separately; (4) participants were randomly assigned to intervention groups, when warranted, and the study included measures of maximal strength and endurance performance; and (5) the duration of the intervention was ≥ 8 weeks to ensure a meaningful training duration.

RESULTS

Fourteen studies met the inclusion criteria (seven combined strength training with running, four with cycling, and three with rowing or cross-country skiing). These studies indicated that concurrent strength and endurance training generally increases parameters associated with strength and endurance performance in female participants, while several other health benefits such as, e.g., improved body composition and blood lipid profile were reported in individual studies. The presence of an "interference effect" in females could not be assessed from the included studies as this was not the focus of any included research and single-mode training groups were not always included alongside concurrent training groups. Importantly, the influence of concurrent training on fast-force production was limited, while the unique circumstances affecting females were not considered/reported in most studies. Overall study quality was low to moderate.

CONCLUSION

Concurrent strength and endurance training appears to be beneficial in increasing strength and endurance capacity in females; however, multiple research paradigms must be explored to better understand the influence of concurrent training modalities in females. Future research should explore the influence of concurrent strength and endurance training on fast-force production, the possible presence of an "interference effect" in athletic populations, and the influence of unique circumstances, such as hormone profile, on training responses and adaptations.

Direct and indirect impact of low energy availability on sports performance

Low energy availability (LEA) occurs inadvertently and purposefully in many athletes across numerous sports; and well planned, supervised periods with moderate LEA can improve body composition and power to weight ratio possibly enhancing performance in some sports. LEA however has the potential to have negative effects on a multitude of physiological and psychological systems in female and male athletes. Systems such as the endocrine, cardiovascular, metabolism, reproductive, immune, mental perception, and motivation as well as behaviors can all be impacted by severe (serious and/or prolonged or chronic) LEA. Such widely diverse effects can influence the health status, training adaptation, and performance outcomes of athletes leading to both direct changes (e.g., decreased strength and endurance) as well as indirect changes (e.g., reduced training response, increased risk of injury) in performance. To date, performance implications have not been well examined relative to LEA. Therefore, the intent of this narrative review is to characterize the effects of short-, medium-, and long-term exposure to LEA on direct and indirect sports performance outcomes. In doing so we have focused both on laboratory settings as well as descriptive athletic case-study-type experiential evidence.

Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs

The 2023 International Olympic Committee (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) notes that exposure to low energy availability (LEA) exists on a continuum between adaptable and problematic LEA, with a range of potential effects on both health and performance. However, there is variability in the outcomes of LEA exposure between and among individuals as well as the specific manifestations of REDs. We outline a framework for a 'systems biology' examination of the effect of LEA on individual body systems, with the eventual goal of creating an integrated map of body system interactions. We provide a template that systematically identifies characteristics of LEA exposure (eg, magnitude, duration, origin) and a variety of moderating factors (eg, medical history, diet and training characteristics) that could exacerbate or attenuate the type and severity of impairments to health and performance faced by an individual athlete. The REDs Physiological Model may assist the diagnosis of underlying causes of problems associated with LEA, with a personalised and nuanced treatment plan promoting compliance and treatment efficacy. It could also be used in the strategic prevention of REDs by drawing attention to scenarios of LEA in which impairments of health and performance are most likely, based on knowledge of the characteristics of the LEA exposure or moderating factors that may increase the risk of harmful outcomes. We challenge researchers and practitioners to create a unifying and dynamic physiological model for each body system that can be continuously updated and mapped as knowledge is gained.

Caffeine and sport

Caffeine is a trimethylxanthine found in coffee and several other foods and beverages. Its stimulatory effects make it an interesting strategy to boost performance for athletic populations. Scientific evidence supports its efficacy to improve high-intensity endurance exercise, explosive and high-intensity efforts, resistance exercise, team sports and combat sports, though individual variation in the ergogenic response to caffeine exists. Supplementation can be taken in many forms including dissolved in water, via capsules, coffee, energy drinks and caffeinated gum; ingestion via capsules, dissolved in water or in caffeinated gum appear to be most effective. Variability in the exercise response following caffeine supplementation may be explained by genetic factors or habitual caffeine consumption. Caffeine is an excellent supplement for athletes looking to improve their exercise performance, though some consideration of side-effects and impact on sleep are warranted.

Do Triathletes Periodize Their Diet and Do Their Mineral Content, Body Composition and Aerobic Capacity Change during Training and Competition Periods?

The triathlon is a demanding endurance multisport, which may strongly affect the nutritional status of athletes. The aim of this study was to find whether there are any differences in energy value and nutrient intake, body mass and body composition, aerobic performance and hair mineral status between training and competition periods and to assess whether there is a link between hair mineral content and physical capacity and nutrition. This observational study covered 20 triathletes aged 32 ± 7 years. The results of our study indicated performance improvement during the competition period (longer time to exhaustion (p = 0.025) and lower maximal oxygen uptake at the ventilatory threshold (%VO_{2max_VT}; p = 0.047)). However, no differences were recorded in nutrition and body composition between two training vs. competition periods. There was a significant depletion in hair iron content during the competition period (p = 0.010). Furthermore, there were significant relationships between hair calcium content and absolute maximal oxygen uptake and %VO_{2max_VT} during the training period. It is necessary to introduce nutritional education in the group of triathletes focused on exercise-oriented nutritional periodization following the requirements of the training and competition periods, thus preventing the risk of nutrient deficiencies.

Nutritional Habits of Professional Cyclists during Pre-Season

The first aim of the present study was to assess the dietary intake of professional cyclists during pre-season. The second aim was to assess the dietary habits of this population during a complete season. Fifteen elite male (age: 23.2 ± 5.4 years) and twenty-three elite female (age: 20.1 ± 7.0 years) cyclists volunteered to participate in the study. Dietary nutrient intake during pre-season was assessed using a 72 h dietary recall interview, and a 136-item food frequency questionnaire was used to assess dietary habits during the year. Protein intake exceeded the PRI’s recommendation of 0.83 g/kg/day for all cycling groups. Fat exceeded RI recommendations in females in both road (43.3%) and CXO (39.8%) cycling groups, whilst males were found to follow recommendations for fat intake. CHO intake was below recommendations in all groups. Intake of all vitamins exceeded recommendations, with the exception of B9 in female road cyclists (77.8% RDA) and vitamin D in all groups. With regards to mineral intake, consumption exceeded RDA/AI recommendations in all groups except for iodine in male XCO cyclists (61.6%), female road cyclists (61.6%), and female XCO cyclists (58%) and potassium in female road cyclists (74.6%). Males consumed greater amounts of eggs and non-processed foods than females. Road cyclists consumed greater amounts of fish and seafood and had a lower intake of coffee and tea than XCO cyclists. Better knowledge of food guidelines in terms of serving and food variety is important for professional cyclists at may impact health and performance.

High Energetic Demand of Elite Rowing - Implications for Training and Nutrition

Purpose: Elite rowers have large body dimensions, a high metabolic capacity, and they realize high training loads. These factors suggest a high total energy requirement (TER), due to high exercise energy expenditure (EEE) and additional energetic needs. We aimed to study EEE and intensity related substrate utilization (SU) of elite rowers during rowing (EEE_ROW) and other (EEE_NON-ROW) training.

Methods: We obtained indirect calorimetry data during incremental (N = 174) and ramp test (N = 42) ergometer rowing in 14 elite open-class male rowers (body mass 91.8 kg, 95% CI [87.7, 95.9]). Then we calculated EEE_ROW and SU within a three-intensity-zone model. To estimate EEE_NON-ROW, appropriate estimates of metabolic equivalents of task were applied. Based on these data, EEE, SU, and TER were approximated for prototypical high-volume, high-intensity, and tapering training weeks. Data are arithmetic mean and 95% confidence interval (95% CI).

Results: EEE_ROW for zone 1 to 3 ranged from 15.6 kcal·min⁻¹, 95% CI [14.8, 16.3] to 49.8 kcal·min⁻¹, 95% CI [48.1, 51.6], with carbohydrate utilization contributing from 46.4%, 95% CI [42.0, 50.8] to 100.0%, 95% CI [100.0, 100.0]. During a high-volume, a high-intensity, or a taper week, TER was estimated to 6,775 kcal·day⁻¹, 95% CI [6,651, 6,898], 5,772 kcal·day⁻¹, 95% CI [5,644, 5,900], or 4,626 kcal∙day⁻¹, 95% CI [4,481, 4,771], respectively.

Conclusion: EEE in elite open-class male rowers is remarkably high already during zone 1 training and carbohydrates are dominantly utilized, indicating relatively high metabolic stress even during low intensity rowing training. In high-volume training weeks, TER is presumably at the upper end of the sustainable total energy expenditure. Periodized nutrition seems warranted for rowers to avoid low energy availability, which might negatively impact performance, training, and health.

Plant-based food patterns to stimulate muscle protein synthesis and support muscle mass in humans: a narrative review

The interest in a diet with a higher proportion of plant-based foods to animal-based foods is a global food pattern trend. However, there are concerns regarding adopting plants as the main dietary protein source to support muscle protein synthesis and muscle mass. These concerns are centred on three issues: lower protein bioavailability due to antinutritional compounds in plants, lower per-serve scores of protein at similar energy intake, and amino acid scores of plants being lower than optimal. We aimed here to synthesize and discuss evidence around plant protein in human nutrition focusing on the capacity of these proteins to stimulate muscle protein synthesis as a key part of gaining or maintaining muscle mass. In this review, we address the issues of plant protein quality and provide evidence for how plant proteins can be made more effective to stimulate muscle protein synthesis and support muscle mass in partial or total replacement of consumption of products of animal origin. Novelty: ● Plant proteins are known, in general, to have lower protein quality scores than animal proteins, and this may have important implications, especially for those aiming to increase their skeletal muscle mass through exercise. ● A plant-based diet has been postulated to have lower protein quality limiting MPS responses and potentially compromising exercise-induced gains in muscle mass. ● Current evidence shows that plant proteins can stimulate MPS, as can whole foods, especially when combining food groups, increasing portion sizes, and optimizing amino acid bioavailability through processing or common preparation methods.

Nutritional intakes of highly trained adolescent swimmers before, during, and after a national lockdown in the COVID-19 pandemic

Strict lockdown measures were introduced in response to the COVID-19 pandemic, which caused mass disruption to adolescent swimmers’ daily routines. To measure how lockdown impacted nutritional practices in this cohort, three-day photograph food diaries were analysed at three time points: before (January), during (April), and after (September) the first UK lockdown. Thirteen swimmers (aged 15 ± 1 years) from a high-performance swimming club submitted satisfactory food diaries at all time points. During lockdown, lower amounts of energy (45.3 ± 9.8 vs. 31.1 ± 7.7 kcal∙kg BM∙day^-1, p<0.001), carbohydrate (5.4 ± 1.2 vs. 3.5 ± 1.1 g∙kg BM∙day^-1, p<0.001), protein (2.3 ± 0.4 vs. 1.7 ± 0.4 g∙kg BM∙day^-1, p = 0.002), and fat (1.6 ± 0.4 vs. 1.1 ± 0.3 g∙kg BM∙day^-1, p = 0.011) were reported. After lockdown, no nutritional differences were found in comparison compared to before lockdown (energy: 44.0 ± 12.1 kcal∙kg BM∙day^-1; carbohydrate: 5.4 ± 1.4 g∙kg BM∙day^-1; protein: 2.1 ± 0.6 g∙kg BM∙day^-1; fat: 1.5 ± 0.6 g ∙kg BM∙day^-1, all p>0.05), despite fewer training hours being completed (15.0 ± 1.4 vs. 19.1 ± 2.2 h∙week^-1, p<0.001). These findings highlight the ability of adolescent swimmers to alter their nutrition based on their changing training circumstances when receiving sport nutrition support. However, some individuals displayed signs of suboptimal nutrition during lockdown that were not corrected once training resumed. This warrants future research to develop interactive education workshops that maintain focus and motivation towards optimal nutrition practices in isolated periods away from training.

Is RED-S in athletes just another face of malnutrition?

BACKGROUND & AIMS

Relative energy deficiency syndrome in sport (RED-S) can impair the function of several body systems, resulting in short and long-term threats to athletes' health and performance. Research showed that these health and performance problems are often unrecognized, and the treatment is not adequate. The retrospective study presented in this paper aims to determine the prevalence of RED-S-related symptoms in a sample of Slovenian competitive athletes from various sports.

METHODS

We performed retrospective research based on a database of 150 athletes, aged from 14 to 34, who had nutritional assessments as a part of their medical examination. Data were collected, refined and statistical analysis was performed. 77 women and 73 men were included; 113 were classified as young athletes (14-21 years) and 37 as elite athletes (more than 21 years).

RESULTS

The majority (87%) of the athletes demonstrated at least one health-related symptom described by the RED-S-model; only 9% female and 18% male did not have any symptoms of RED-S. The number of different body systems with the compromised function was significantly higher (p < 0.001) in female athletes (2.9 ± 0.2) in comparison to male athletes (1.6 ± 0.1). For other health-related symptoms, there are statistically significant differences between young and elite athletes (p = 0.03), between female and male athletes (p = 0.02) and between young and elite female athletes (p = 0.01). When comparing groups by the number of all RED-S related symptoms, female athletes were more affected (p = 0.02). According to the RED-S CAT tool, the majority of athletes (64%) were classified in the yellow group, 7% of athletes have severe health and performance problems and fulfil criteria for the red group, and only 29% were classified in the green group.

CONCLUSIONS

A high prevalence of RED-S-related symptoms in our sample competitive athletes indicates the high prevalence of nutrition-related medical problems in young and elite athletes. Therefore, it is necessary to incorporate nutritional risk screenings as a part of regular medical examinations of athletes. In addition, appropriate treatments for competitive athletes should be readily accessible, even for young athletes. It seems that the youth athlete population is the most endangered for developing malnutrition-related health problems. At the same time, we urgently need a more specific and simple nutritional screening tool that will allow us to identify athletes at nutritional risk or athletes who have RED-S.

Effects of Sodium Intake on Health and Performance in Endurance and Ultra-Endurance Sports

The majority of reviews on sports nutrition issues focus on macronutrients, often omitting or paying less attention to substances such as sodium. Through the literature, it is clear that there are no reviews that focus entirely on the effects of sodium and in particular on endurance sports. Sodium intake, both at high and low doses, has been found to be associated with health and performance issues in athletes. Besides, there have been theories that an electrolyte imbalance, specifically sodium, contributes to the development of muscle cramps (EAMC) and hyponatremia (EAH). For this reason, it is necessary to create this systematic review, in order to report extensively on the role of sodium consumption in the population and more specifically in endurance and ultra-endurance athletes, the relationship between the amount consumed and the occurrence of pathological disorders, the usefulness of simultaneous hydration and whether a disturbance of this substance leads to EAH and EAMC. As a method of data collection, this study focused on exploring literature from 2000–2021. The search was conducted through the research engines PubMed and Scopus. In order to reduce the health and performance effects in endurance athletes, simultaneous emphasis should be placed on both sodium and fluid intake.

What Is the Evidence That Dietary Macronutrient Composition Influences Exercise Performance? A Narrative Review

The introduction of the needle muscle biopsy technique in the 1960s allowed muscle tissue to be sampled from exercising humans for the first time. The finding that muscle glycogen content reached low levels at exhaustion suggested that the metabolic cause of fatigue during prolonged exercise had been discovered. A special pre-exercise diet that maximized pre-exercise muscle glycogen storage also increased time to fatigue during prolonged exercise. The logical conclusion was that the athlete's pre-exercise muscle glycogen content is the single most important acutely modifiable determinant of endurance capacity. Muscle biochemists proposed that skeletal muscle has an obligatory dependence on high rates of muscle glycogen/carbohydrate oxidation, especially during high intensity or prolonged exercise. Without this obligatory carbohydrate oxidation from muscle glycogen, optimum muscle metabolism cannot be sustained; fatigue develops and exercise performance is impaired. As plausible as this explanation may appear, it has never been proven. Here, I propose an alternate explanation. All the original studies overlooked one crucial finding, specifically that not only were muscle glycogen concentrations low at exhaustion in all trials, but hypoglycemia was also always present. Here, I provide the historical and modern evidence showing that the blood glucose concentration-reflecting the liver glycogen rather than the muscle glycogen content-is the homeostatically-regulated (protected) variable that drives the metabolic response to prolonged exercise. If this is so, nutritional interventions that enhance exercise performance, especially during prolonged exercise, will be those that assist the body in its efforts to maintain the blood glucose concentration within the normal range.

Nutrition in Cycling

Cycling is predominantly an endurance sport in which fuel utilization for energy production relies on the availability and delivery of oxygen to exercising muscle. Nutrition and training interventions to improve endurance performance are continually evolving, but ultimately, prescription should aim to generate improvements in cycling power and velocity while prioritizing athlete health and well-being. The wide range of cycling events and the different environments in which events take place pose a variety of nutrition-related challenges for cyclists. This review addresses some of these challenges and highlights recent advancements in nutrition for cycling performance.

The Dynamics of the Anaerobic Energy Contribution During a Simulated Mass-Start Competition While Roller-Ski Skating on a Treadmill

The purposes of this study were: 1) to investigate the anaerobic energy contribution during a simulated cross-country (XC) skiing mass-start competition while roller-ski skating on a treadmill; 2) to investigate the relationship between the recovery of the anaerobic energy reserves and performance; and 3) to compare the gross efficiency (GE) method and maximal accumulated oxygen deficit (MAOD) to determine the anaerobic contribution. Twelve male XC skiers performed two testing days while roller skiing on a treadmill. To collect submaximal data necessary for the GE and MAOD method, participants performed a resting metabolism measurement, followed by low-intensity warm up, 12 submaximal 4-min bouts, performed using three different skating sub-techniques (G2 on a 12% incline, G3 on 5% and G4 on 2%) on three submaximal intensities on day 1. On day 2, participants performed a 21-min simulated mass-start competition on varying terrain to determine the anaerobic energy contribution. The speed was fixed, but when participants were unable to keep up, a 30-s rest bout was included. Performance was established by the time to exhaustion (TTE) during a sprint at the end of the 21-min protocol. Skiers were ranked based on the number of rest bouts needed to finish the protocol and TTE. The highest GE of day 1 for each of the different inclines/sub-techniques was used to calculate the aerobic and anaerobic contribution during the simulated mass start using the GE method and two different MAOD approaches. About 85–90% of the required energy during the simulated mass-start competition (excluding downhill segments) came from the aerobic energy system and ~10–15% from the anaerobic energy systems. Moderate to large Spearman correlation coefficients were found between recovery of anaerobic energy reserves and performance rank (r_s = 0.58–0.71, p < 0.025). No significant difference in anaerobic work was found between methods/approaches (F_(1.2,8.5) = 3.2, p = 0.10), while clear individual differences existed. In conclusion, about 10–15% of the required energy during the periods of active propulsion of a 21-min simulated mass-start competition came from the anaerobic energy systems. Due to the intermittent nature of XC skiing, the recovery of anaerobic energy reserves seems highly important for performance. To assess the anaerobic contribution methods should not be used interchangeably.

Overtraining Syndrome (OTS) and Relative Energy Deficiency in Sport (RED-S): Shared Pathways, Symptoms and Complexities

The symptom similarities between training-overload (with or without an Overtraining Syndrome (OTS) diagnosis) and Relative Energy Deficiency in Sport (RED-S) are significant, with both initiating from a hypothalamic-pituitary origin, that can be influenced by low carbohydrate (CHO) and energy availability (EA). In this narrative review we wish to showcase that many of the negative outcomes of training-overload (with, or without an OTS diagnosis) may be primarily due to misdiagnosed under-fueling, or RED-S, via low EA and/or low CHO availability. Accordingly, we undertook an analysis of training-overload/OTS type studies that have also collected and analyzed for energy intake (EI), CHO, exercise energy expenditure (EEE) and/or EA. Eighteen of the 21 studies (86%) that met our criteria showed indications of an EA decrease or difference between two cohorts within a given study (n = 14 studies) or CHO availability decrease (n = 4 studies) during the training-overload/OTS period, resulting in both training-overload/OTS and RED-S symptom outcomes compared to control conditions. Furthermore, we demonstrate significantly similar symptom overlaps across much of the OTS (n = 57 studies) and RED-S/Female Athlete Triad (n = 88 studies) literature. It is important to note that the prevention of under-recovery is multi-factorial, but many aspects are based around EA and CHO availability. Herein we have demonstrated that OTS and RED-S have many shared pathways, symptoms, and diagnostic complexities. Substantial attention is required to increase the knowledge and awareness of RED-S, and to enhance the diagnostic accuracy of both OTS and RED-S, to allow clinicians to more accurately exclude LEA/RED-S from OTS diagnoses.

Body composition changes in physically active individuals consuming ketogenic diets: a systematic review

Background

To achieve ideal strength/power to mass ratio, athletes may attempt to lower body mass through reductions in fat mass (FM), while maintaining or increasing fat-free mass (FFM) by manipulating their training regimens and diets. Emerging evidence suggests that consumption of high-fat, ketogenic diets (KD) may be advantageous for reducing body mass and FM, while retaining FFM.

Methods

A systematic review of the literature was conducted using PubMed and Cochrane Library databases to compare the effects of KD versus control diets (CON) on body mass and composition in physically active populations. Randomized and non-randomized studies were included if participants were healthy (free of chronic disease), physically active men or women age ≥ 18 years consuming KD (< 50 g carbohydrate/d or serum or whole blood β-hydroxybutyrate (βhb) > 0.5 mmol/L) for ≥14 days.

Results

Thirteen studies (9 parallel and 4 crossover/longitudinal) that met the inclusion criteria were identified. Aggregated results from the 13 identified studies show body mass decreased 2.7 kg in KD and increased 0.3 kg in CON. FM decreased by 2.3 kg in KD and 0.3 kg in CON. FFM decreased by 0.3 kg in KD and increased 0.7 kg in CON. Estimated energy balance based on changes in body composition was − 339 kcal/d in KD and 5 kcal/d in CON. Risk of bias identified some concern of bias primarily due to studies which allowed participants to self-select diet intervention groups, as well as inability to blind participants to the study intervention, and/or longitudinal study design.

Conclusion

KD can promote mobilization of fat stores to reduce FM while retaining FFM. However, there is variance in results of FFM across studies and some risk-of-bias in the current literature that is discussed in this systematic review.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12970-021-00440-6.

The Use of Bovine Colostrum in Sport and Exercise

There has been a great deal of interest in bovine colostrum within sports nutrition over the last 25 years. Studies have investigated the effects on body composition, physical performance, recovery, gut damage and permeability, immune function, and illness risk. This narrative review considers available evidence in each of these areas. Although some studies have shown protection against performance decrements caused by periods of intensified training, there is limited evidence for effects on body composition and physical performance. There is stronger evidence for benefit on gut permeability and damage markers and on immune function and illness risk, especially during periods of intensified training. The balance of available evidence for gut permeability and illness risk is positive, but further research is required to fully determine all mechanisms responsible for these effects. Early suggestions that supplementation with bovine colostrum products could increase systemic IGF-1 levels are not supported by the balance of available evidence examining a range of doses over both short- and long-term periods. Nevertheless, dose–response studies would be valuable for determining the minimum efficacious dose, although this is complicated by variability in bioactivity between products, making any dose–response findings applicable only to the specific products used in such studies.

Analysis of Sport Supplement Consumption and Body Composition in Spanish Elite Rowers

The aim of this study was to analyze the anthropometric characteristics and sport supplement (SS) consumption patterns of heavyweight and lightweight international rowers. Methods: The 13 heavyweights (11 males) and seven lightweights (five males) of the Spanish National Rowing Team were recruited for the study. Body composition was measured by bio-impedance analysis, and the questionnaire used in this investigation was previously validated to assess SS consumption. According to anthropometrics parameters, it was reported that male heavyweight rowers were heavier (p < 0.001) and taller (p < 0.001), but no statistical differences were reported for % body fat (p = 0.104) or % lean body mass (p = 0.161). All rowers reported consumption of at least one SS. Based on the Australian Institute of Sport's classification, higher medical supplement consumption was observed when comparing heavyweight rowers to lightweight rowers (2.5 ± 1.1 vs. 1.7 ± 0.5, p = 0.040). There were no differences in the totals of group A (strong scientific evidence for sports scenarios, p = 0.069), group B (emerging scientific support, deserving of further research, p = 0.776), or group C (scientific evidence not supportive of benefit and/or security amongst athletes, p = 0.484). The six most consumed SSs were iron (85%), caffeine (85%), β-alanine (85%), energy bars (85%), vitamin supplements (80%), and isotonic drinks (80%), with no statistical differences between heavyweight and lightweight rowers (p > 0.05). These results suggest that the absence of differences in body composition (expressed as a percentage) do not represent anthropometric disadvantages for heavyweight rowers. In addition, SS consumption was similar between rowers, reporting only higher medical supplement consumption in heavyweight rowers.

Reasons for and Consequences of Low Energy Availability in Female and Male Athletes: Social Environment, Adaptations, and Prevention

Low energy availability (LEA) represents a state in which the body does not have enough energy left to support all physiological functions needed to maintain optimal health. When compared to the normal population, athletes are particularly at risk to experience LEA and the reasons for this are manifold. LEA may result from altered dietary behaviours that are caused by body dissatisfaction, the belief that a lower body weight will result in greater performance, or social pressure to look a certain way. Pressure can also be experienced from the coach, teammates, and in this day and age through social media platforms. While LEA has been extensively described in females and female athletes have started fighting against the pressure to be thin using their social media platforms, evidence shows that male athletes are at risk as well. Besides those obvious reasons for LEA, athletes engaging in sports with high energy expenditure (e.g. rowing or cycling) can unintentionally experience LEA; particularly, when the athletes' caloric intake is not matched with exercise intensity. Whether unintentional or not, LEA may have detrimental consequences on health and performance, because both short-term and long-term LEA induces a variety of maladaptations such as endocrine alterations, suppression of the reproductive axis, mental disorders, thyroid suppression, and altered metabolic responses. Therefore, the aim of this review is to increase the understanding of LEA, including the role of an athlete's social environment and the performance effects related to LEA.

Assessment of Dietary Intake and Nutritional Status in CrossFit-Trained Individuals: A Descriptive Study

CrossFit is a discipline with high training and nutritional requirements. To date, there is only scarce data evaluating nutrition among CrossFit training and they mostly focus on selected nutritional interventions. Therefore, the purpose of this descriptive study was the assessment of dietary intake and nutritional status in a selected group of CrossFit-trained participants. The study consisted of 62 CrossFit athletes (31 men and 31 women, aged 31.0 ± 5.2 and 30.0 ± 4.3 years, respectively). Body composition was analyzed by electrical bioimpedance. Dietary intake was assessed using a standardized 3-day food record. Body fat percentage for females and males was 20.3 ± 4.3% and 13.7 ± 3.3% respectively. The energy intake in the diet was lower (~1700 kcal in women and ~2300 kcal in men) than the recommended demand. Moreover, low consumption of carbohydrates was stated, as well as an inadequate intake of folate, vitamin E (in women), and minerals, such as Fe and Ca (in women). The energy, carbohydrate, iron, and calcium intake in the CrossFit participants' diet was too low in comparison to recommendations. It seems justified to educate athletes and coaches about nutritional habits, and individual energy and nutrients requirements.

Nutrition and Altitude: Strategies to Enhance Adaptation, Improve Performance and Maintain Health: A Narrative Review

Training at low to moderate altitudes (~ 1600-2400 m) is a common approach used by endurance athletes to provide a distinctive environmental stressor to augment training stimulus in the anticipation of increasing subsequent altitude- and sea-level-based performance. Despite some scientific progress being made on the impact of various nutrition-related changes in physiology and associated interventions at mountaineering altitudes (> 3000 m), the impact of nutrition and/or supplements on further optimization of these hypoxic adaptations at low-moderate altitudes is only an emerging topic. Within this narrative review we have highlighted six major themes involving nutrition: altered energy availability, iron, carbohydrate, hydration, antioxidant requirements and various performance supplements. Of these issues, emerging data suggest that particular attention be given to the potential risk for poor energy availability and increased iron requirements at the altitudes typical of elite athlete training (~ 1600-2400 m) to interfere with optimal adaptations. Furthermore, the safest way to address the possible increase in oxidative stress associated with altitude exposure is via the consumption of antioxidant-rich foods rather than high-dose antioxidant supplements. Meanwhile, many other important questions regarding nutrition and altitude training remain to be answered. At the elite level of sport where the differences between winning and losing are incredibly small, the strategic use of nutritional interventions to enhance the adaptations to altitude training provides an important consideration in the search for optimal performance.

Nutritional Strategies to Optimize Performanceand Recovery in Rowing Athletes

Rowing is a high-intensity sport requiring a high level of aerobic and anaerobic capacity. Although good nutrition is essential for successful performance in a rowing competition, its significance is not sufficiently established. This review aimed to provide nutritional strategies to optimize performance and recovery in rowing athletes based on a literature review. Following the guidelines given in the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), we performed web searches using online databases (Pubmed, Web of Science, Wiley Online Library, ACS Publications, and SciFinder). Typically, a rowing competition involves a 6–8-min high-intensity exercise on a 2000-m course. The energy required for the exercise is supplied by muscle-stored glycogens, which are derived from carbohydrates. Therefore, rowing athletes can plan their carbohydrate consumption based on the intensity, duration, and type of training they undergo. For effective and safe performance enhancement, rowing athletes can take supplements such as β-alanine, caffeine, β-hydroxy-β-methylbutyric acid (HMB), and beetroot juice (nitrate). An athlete may consume carbohydrate-rich foods or use a carbohydrate mouth rinse. Recovery nutrition is also very important to minimize the risk of injury or unexplained underperformance syndrome (UUPS) from overuse. It must take into account refueling (carbohydrate), rehydration (fluid), and repair (protein). As lightweight rowing athletes often attempt acute weight loss by limiting food and fluid intake to qualify for a competition, they require personalized nutritional strategies and plans based on factors such as their goals and environment. Training and competition performance can be maximized by including nutritional strategies in training plans.

Actual Nutrition and Dietary Supplementation in Lithuanian Elite Athletes

Background and objectives: Health is partly determined by the state of one's nutrition; it stimulates the body's functional and metabolic adaptations to physical strain and helps one prevent sports injuries and get in shape in terms of body composition. This study aims to investigate the actual nutrition and dietary supplements taken by elite Lithuanian athletes and to identify the relationship between the dietary intake, dietary supplementation and body composition of elite athletes. Materials and Methods: The research subjects were 76.7% of Lithuanian elite athletes (N = 247). The actual diet was investigated using the 24 h recall dietary survey method. Dietary supplementation was studied applying the questionnaire method. Measurements of body composition were performed using the BIA (bioelectrical impedance analysis) tetra-polar electrodes and measuring resistivity with 8-12 tangent electrodes at different frequencies of signal: 5, 50 and 250 kHz. Results: Results indicate that among the athletes, 62% use too few carbohydrates and 77% use too much fat. Although the 3.5% increase in lean body mass (95% CI: -0.107, 7.070) helps gain an increased protein intake with food (p = 0.057), 38% of athletes consume too little protein with food. The athletes mostly use carbohydrates (86%), vitamins (81%), protein supplements (70%), and multivitamins (62%). We did not determine the impact (p > 0.05) of individual or complex supplement use on the lean body mass (%) or fat mass (%) values of athletes. Conclusions: Athletes consume insufficient carbohydrates, vitamin D, calcium, polyunsaturated fatty acids, omega-3 and omega-6 fatty acids and too much fat, saturated fatty acids, cholesterol, and they use proteins irrationally. Sport nutritionists should also focus on the risk of malnutrition for female athletes. Nutritional supplements partially offset macronutrient and micronutrient deficiency. Nevertheless, the effect of food supplements on the body composition of athletes is too small compared to the normal diet. Athletes ought to prioritize the formation of eating habits and only then use supplements.

The Effect of Sodium Bicarbonate Supplementation on the Decline in Gross Efficiency During a 2000-m Cycling Time Trial

BACKGROUND

Gross efficiency (GE) declines during high-intensity exercise. Increasing extracellular buffer capacity might diminish the decline in GE and thereby improve performance.

PURPOSE

To examine if sodium bicarbonate (NaHCO3) supplementation diminishes the decline in GE during a 2000-m cycling time trial.

METHODS

Sixteen male cyclists and 16 female cyclists completed 4 testing sessions including a maximal incremental test, a familiarization trial, and two 2000-m GE tests. The 2000-m GE tests were performed after ingestion of either NaHCO3 supplements (0.3 g/kg body mass) or placebo supplements (amylum solani, magnesium stearate, and sunflower oil capsules). The GE tests were conducted using a double-blind, randomized, crossover design. Power output, gas exchange, and time to complete the 2000-m time trials were recorded. Capillary blood samples were analyzed for blood bicarbonate, pH, and lactate concentration. Data were analyzed using magnitude-based inference.

RESULTS

The decrement in GE found after the 2000-m time trial was possibly smaller in the male and female groups after NaHCO3 than with placebo ingestion, with the effect in both groups combined being unclear. The effect on performance was likely trivial for males (placebo 164.2 [5.0] s, NaHCO3 164.3 [5.0] s; Δ0.1; ±0.6%), unclear for females (placebo 178.6 [4.8] s, NaHCO3 178.0 [4.3] s; Δ-0.3; ±0.5%), and very likely trivial when effects were combined. Blood bicarbonate, pH, and lactate concentration were substantially elevated from rest to pretest after NaHCO3 ingestion.

CONCLUSIONS

NaHCO3 supplementation results in an unclear effect on the decrease in GE during high-intensity exercise and in a very likely trivial effect on performance.

Validation of the Athlete's Plate Nutrition Educational Tool: Phase I

Nutrition education visual tools are designed to help the general population translate science into practice. The purpose of this study was to validate the Athlete's Plate (AP) to ensure that it meets the current sport nutrition recommendations for athletes. Twelve registered dietitians (RDs; 10 female and 2 male) volunteered for the study. Each registered dietitian was asked to create three real and virtual plates at three different times corresponding to breakfast, lunch, and dinner, and the three different AP training loads, easy (E), moderate (M), and hard (H), divided into two weight categories (male 75 kg and female 60 kg). Data of the real and virtual plates were evaluated using Computrition software (v. 18.1; Computrition, Chatsworth, CA). Statistical analyses were conducted by SPSS (version 23.0; IBM, Armonk, NY) to compare the difference between each training load category (E, M, and H) and the recommendations. No statistically significant differences were found among the created plates and the recommendations for energy, carbohydrates, fat, and fiber for E, M, and H. Protein relative to body mass (BM) was higher than recommended for E (1.9 ± 0.3 g·kg-1 BM·day-1, p = .003), M (2.3 ± 0.3 g·kg-1 BM·day-1, p < .001), and H (2.9+0.5 g·kg-1 BM·day-1, p < .001). No differences were found for the macronutrient distribution by gender when correcting for kilograms of body mass. The authors conclude that the AP meets the nutrition recommendations for athletes at different training intensities for energy, carbohydrates, fat, and fiber, but exceeds the recommendations for protein. Further research should consider this protein discrepancy and develop an AP model that meets, besides health and performance goals, contemporary guidelines for sustainability.

The Effect of Beta-Alanine versus Alkaline Agent Supplementation Combined with Branched-Chain Amino Acids and Creatine Malate in Highly-Trained Sprinters and Endurance Athletes: A Randomized Double-Blind Crossover Study

The study aimed to verify the effect of intra- (beta-alanine—BA) versus extra- (alkaline agents—ALK) cellular buffering agent supplementation, combined with customarily used branched-chain amino acids (BCAAs) and creatine malate (TCM) treatment in natural training conditions. Thirty-one elite athletes (11 sprinters and 20 endurance athletes) participated in the study. Eight-week randomized double-blind, crossover, combined supplementation with BA-ALKpla_BCAA&TCM and ALK-BApla_BCAA&TCM was implemented. In the course of the experiment, body composition, aerobic capacity, and selected blood markers were assayed. After BA-ALKpla_BCAA&TCM supplementation, total fat-free mass increased in sprinters (p = 0.009). No other differences were found in body composition, respiratory parameters, aerobic capacity, blood lactate concentration, and hematological indices after BA-ALKpla_BCAA&TCM/ALK-BApla_BCAA&TCM supplementation. The maximum post-exercise blood ammonia (NH₃) concentration decreased in both groups after BA-ALKpla_BCAA&TCM supplementation (endurance, p = 0.002; sprint, p < 0.0001). Also, lower NH₃ concentrations were observed in endurance athletes in the post-exercise recovery period. The results of our study indicate that combined BCAA, TCM, and BA supplementation is more effective than combined BCAA, TCM and ALK supplementation for an increase in fat-free mass and exercise adaptation, but not for aerobic capacity improvement. Besides, it seems that specific exercise stimuli and the training status are key factors affecting exercise performance, even in athletes using efficient supplementation.

Towards a Sustainable Nutrition Paradigm in Physique Sport: A Narrative Review

Physique athletes strive for low body fat with high lean mass and have higher body image and eating disorder rates than the general population, and even other weightlifting populations. Whether athletes with a background or tendency to develop these issues are drawn to the sport, or whether it drives these higher incidences, is unknown. However, the biological drive of cyclical energy restriction may contribute to binge-eating behavior. Additionally, requisite monitoring, manipulation, comparison, and judgement of one's physique may contribute to body image concerns. Contest preparation necessitates manipulating body composition through energy restriction and increased expenditure, requiring dietary restraint and nutrition, exercise, and physique assessment. Thus, competitors are at mental health risk due to (1) pre-existing or predispositions to develop body image or eating disorders; (2) biological effects of energy restriction on eating psychology; and (3) dietary restraint attitudes and resultant physique, exercise, and nutrition monitoring behavior. In our narrative review we cover each factor, concluding with tentative best-practice recommendations, including dietary flexibility, slower weight loss, structured monitoring, gradual returns to offseason energy intakes, internal eating cues, appropriate offseason body compositions, and support from nutrition and mental health professionals. A mental health focus is a needed paradigm shift in bodybuilding nutrition practice and research.

The benefits of nutritional counselling for improving sport performance

BACKGROUND

It is well known that the synergy between physical activity and healthy eating habits is an important combination for the achievement of different objectives. However, recent studies in the literature focused mainly on the effect of this synergy on weight loss or different non communicable diseases. In this study, we aimed to investigate the effect of healthy eating, based on the Mediterranean diet, on physical performance of kickboxers and runners.

METHODS

Forty athletes were recruited from the University Sports Center of Bergamo. Twenty participants practiced kickboxing, an High Energy Expenditure Rate sport, whereas twenty subjects practiced half marathon, a typical High Energy Expenditure Volume sport. Kickboxers and runners were randomly divided into two sub-groups of ten subjects each: one was the control group (CG) and one the nutritional counselling group (NCG), in which subjects were instructed to follow a nutritional counselling.

RESULTS

At the baseline, runners started with greater VO2max and lower resting metabolic rate compared to kickboxers. After three months of controlled diet and training, kickboxers in NCG improved their results in Counter Movement Jump (CMJ) Test (P=0.015) and squat (P=0.012). Moreover, athletes had a decrease in body fat percentage (P=0.008). Runners in NCG, had a significant VO2max (P=0.007) increase and a reduction in body fat percentage (P=0.002). They also showed an increase of squat (P=0.012) and CMJ test (P=0.024).

CONCLUSIONS

Significant benefits were achieved in all groups of athletes, but results were maximized by training plus nutritional counselling.

Contemporary Nutrition Interventions to Optimize Performance in Middle-Distance Runners

Middle-distance runners utilize the full continuum of energy systems throughout training, and given the infinite competition tactical scenarios, this event group is highly complex from a performance intervention point of view. However, this complexity results in numerous potential periodized nutrition interventions to optimize middle-distance training adaptation and competition performance. Middle-distance race intensity is extreme, with 800- to 5,000-m races being at ∼95% to 130% of VO₂max. Accordingly, elite middle-distance runners have primarily Type IIa/IIx fiber morphology and rely almost exclusively on carbohydrate (primarily muscle glycogen) metabolic pathways for producing adenosine triphosphate. Consequently, the principle nutritional interventions that should be emphasized are those that optimize muscle glycogen contents to support high glycolytic flux (resulting in very high lactate values, of >20 mmol/L in some athletes) with appropriate buffering capabilities, while optimizing power to weight ratios, all in a macro- and microperiodized manner. From youth to elite level, middle-distance athletes have arduous racing schedules (10-25 races/year), coupled with excessive global travel, which can take a physical and emotional toll. Accordingly, proactive and integrated nutrition planning can have a profound recovery effect over a long race season, as well as optimizing recovery during rounds of championship racing. Finally, with evidence-based implementation and an appropriate risk/reward assessment, several ergogenic aids may have an adaptive and/or performance-enhancing effect in the middle-distance athlete. Given that elite middle-distance athletes undertake ∼400 to 800 training sessions with 10-25 races/year, there are countless opportunities to implement various periodized acute and chronic nutrition-based interventions to optimize performance.

The Multimodal Nature of High-Intensity Functional Training: Potential Applications to Improve Sport Performance

Training for sports performance requires the development of multiple fitness components within the same program. In this context, training strategies that have the potential to concomitantly enhance metabolic and musculoskeletal fitness are of great value for athletes and coaches. The purpose of this manuscript is to review the current studies on high-intensity functional training (HIFT) and to assess how HIFT could be utilized in order to improve sport-specific performance. Studies on untrained and recreationally-active participants have led to positive results on aerobic power and anaerobic capacity, and muscular endurance, while results on muscular strength and power are less clear. Still, HIFT sessions can elicit high levels of metabolic stress and resistance training exercises are prescribed with parameters that can lead to improvements in muscular endurance, hypertrophy, strength, and power. As similar training interventions have been shown to be effective in the athletic population, it is possible that HIFT could be a time-efficient training intervention that can positively impact athletes’ performances. While the potential for improvements in fitness and performance with HIFT is promising, there is a clear need for controlled studies that employ this training strategy in athletes in order to assess its effectiveness in this population.

Effects of an increase in intensity during tapering on 1500-m running performance

We examined the effect of completing the final interval training session during a taper at either (i) race pace (RP) or (ii) faster than RP on 1500-m running performance and neuromuscular performance. Ten trained runners (age, 21.7 ± 3.0 years; height, 182.9 ± 7.0 cm; body mass, 73.4 ± 6.8 kg; and personal best 1500-m time, 4:17.5 ± 0:26.9 min) completed 2 conditions consisting of 7 days of regular training and a 7-day taper, separated by 3 weeks of training. In 1 condition, the taper was prescribed using prediction models based on the practices of elite British middle-distance runners, with the intensity of the final interval session being equal to 1500-m RP. The taper was repeated in the high-intensity (HI) condition, with the exception that the final interval session was completed at 115% of 1500-m RP. A 1500-m treadmill time trial and measures of maximal voluntary contraction (MVC) and rate of force development (RFD) were completed before and after regular training and tapering. Performance was most likely improved after RP (mean ± 90% confidence limits, 10.1 ± 1.6 s), and possibly beneficial after HI (4.2 ± 12.0 s). Both MVC force (p = 0.002) and RFD (p = 0.02) were improved after tapering, without differences between conditions. An RP taper based on the practices of elite middle-distance runners is recommended to improve performance in young, subelite runners. The effect of this strategy with an increase in interval intensity is highly variable and should be implemented with caution.

The effect of two β-alanine dosing strategies on 30-minute rowing performance: a randomized, controlled trial

Background

β-alanine (βA) supplementation has been shown to increase intramuscular carnosine content and subsequent high-intensity performance in events lasting < 4 minutes (min), which may be dependent on total, as opposed to daily, dose. The ergogenic effect of βA has also been demonstrated for 2000-m rowing performance prompting interest in whether βA may be beneficial for sustained aerobic exercise. This study therefore investigated the effect of two βA dosing strategies on 30-min rowing and subsequent sprint performance.

Methods

Following University Ethics approval, twenty-seven healthy, male rowers (age: 24 ± 2 years; body-height: 1.81 ± 0.02 m; body-mass: 82.3 ± 2.5 kg; body-fat: 14.2 ± 1.0%) were randomised in a double-blind manner to 4 weeks of: i) βA (2.4 g·d^− 1, βA1); ii) matched total βA (4.8 g on alternate days, βA2); or iii) cornflour placebo (2.4 g·d^− 1, PL). Participants completed a laboratory 30-min rowing time-trial, followed by 3x30-seconds (s) maximal sprint efforts at days 0, 14 and 28 (T1-T3). Total distance (m), average power (W), relative average power (W·kg^− 1), cardio-respiratory measures and perceived exertion were assessed for each 10-min split. Blood lactate ([La-]_b mmol·L^− 1) was monitored pre-post time-trial and following maximal sprint efforts. A 3-way repeated measures ANOVA was employed for main analyses, with Bonferonni post-hoc assessment (P ≤ 0.05).

Results

Total 30-min time-trial distance significantly increased from T1-T3 within βA1 only (7397 ± 195 m to 7580 ± 171 m, P = 0.002, ƞp² = 0.196), including absolute average power (194.8 ± 18.3 W to 204.2 ± 15.5 W, P = 0.04, ƞp² = 0.115) and relative average power output (2.28 ± 0.15 W·kg^− 1 to 2.41 ± 0.12 W·kg^− 1, P = 0.031, ƞp² = 0.122). These findings were potentially explained by within-group significance for the same variables for the first 10 min split (P ≤ 0.01), and for distance covered (P = 0.01) in the second 10-min split. However, no condition x time interactions were observed. No significant effects were found for sprint variables (P > 0.05) with comparable values at T3 for mean distance (βA1: 163.9 ± 3.8 m; βA2: 161.2 ± 3.5 m; PL: 162.7 ± 3.6 m), average power (βA1: 352.7 ± 14.5 W; βA2: 342.2 ± 13.5 W; PL: 348.2 ± 13.9 W) and lactate (βA1: 10.0 ± 0.9 mmol·L^− 1; βA2: 9.2 ± 1.1 mmol·L^− 1; PL: 8.7 ± 0.9 mmol·L^− 1).

Conclusions

Whilst daily βA may confer individual benefits, these results demonstrate limited impact of βA (irrespective of dosing strategy) on 30-min rowing or subsequent sprint performance. Further investigation of βA dosage > 2.4 g·d^− 1 and/or chronic intervention periods (> 4–8 weeks) may be warranted based on within-group observations.

Ergogenic Effects of β-Alanine Supplementation on Different Sports Modalities: Strong Evidence or Only Incipient Findings?

Brisola, GMP and Zagatto, AM. Ergogenic effects of β-alanine supplementation on different sports modalities: strong evidence or only incipient findings? J Strength Cond Res 33(1): 253-282, 2019-β-Alanine supplementation is a popular nutritional ergogenic aid among the sports community. Due to its efficacy, already proven in the literature, to increase the intramuscular carnosine content (β-alanyl-L-histidine), whose main function is intramuscular buffering, β-alanine supplementation has become a nutritional strategy to improve performance, mainly in high-intensity efforts. However, although many studies present evidence of the efficacy of β-alanine supplementation in high-intensity efforts, discrepancies in outcomes are still present and the performance enhancing effects seem to be related to the specificities of each sport discipline, making it difficult for athletes/coaches to interpret the efficacy of β-alanine supplementation. Thus, this study carried out a review of the literature on this topic and summarized, analyzed, and critically discussed the findings with the objective of clarifying the current evidence found in the literature on different types of efforts and sport modalities. The present review revealed that inconsistencies are still found in aerobic parameters determined in incremental tests, except for physical working capacity at the neuromuscular fatigue threshold. Inconsistencies are also found for strength exercises and intermittent high-intensity efforts, whereas in supramaximal continuous mode intermittent exercise, the beneficial evidence is strong. In sports modalities, the evidence should be analyzed separately for each sporting modality. Thus, sports modalities that have strong evidence of the ergogenic effects of β-alanine supplementation are: cycling race of 4 km, rowing race of 2,000 m, swimming race of 100 and 200 m, combat modalities, and water polo. Finally, there is some evidence of slight additional effects on physical performance from cosupplementation with sodium bicarbonate.

Case Study: Body Composition Periodization in an Olympic-Level Female Middle-Distance Runner Over a 9-Year Career

This case study features an Olympic-level female middle-distance runner implementing a science-based approach to body composition periodization. Data are emerging to suggest that it is not sustainable from a health and/or performance perspective to be at peak body composition year-round, so body composition needs to be strategically periodized. Anthropometric (n = 44), hematological, other health measures, and 1,500-m race performances (n = 83) were periodically assessed throughout a 9-year career. General preparation phase (September to April) featured the athlete at ∼2–4% over ideal competition phase body weight (BW) and body fat (%), with optimal energy availability being prioritized. The competition body composition optimization phase (May to August) included creating an individualized time frame and caloric deficit with various feedback metrics (BW, performance, and hunger) to guide the process. There were significant seasonal fluctuations in anthropometric outcomes between phases (47.3 ± 0.8 vs. 48.3 ± 0.9 kg BW; 53.6 ± 7.8 vs. 61.6 ± 9.7 mm International Society for the Advancement of Kinanthropometry sum of 8 [So8] skinfolds; p < .01), and a significant correlation of decreasing So8 during the peak competition period over her career (r = −.838; p = .018). The range of body composition during the competition period was 46.0–48.0 kg BW and a So8 range was 42.0–55.9 mm. There were also significant positive correlations between slower 1,500-m race times and increasing So8 (r = .437; p < .01), estimated fat mass (r = .445; p < .01), and BW (r = .511; p < .0001). The athlete only had two career injuries. This case study demonstrates a body composition periodization approach that allowed for targeted peak yearly performances, which improved throughout her career, while maximizing training adaptation and long-term athlete health through optimal energy availability.

Pre-exercise β-hydroxy-β-methylbutyrate free-acid supplementation improves work capacity recovery: a randomized, double-blinded, placebo-controlled study

The purpose of this study was to investigate the effects of a single-dose of β-hydroxy-β-methylbutyrate free acid (HMB-FA) supplementation on muscle recovery after a high-intensity exercise bout. Twenty-three trained young males were randomly assigned to receive either a single-dose supplementation of 3 g of HMB-FA (n = 12; age, 22.8 ± 3.0 years) or placebo (PLA; n = 11; age, 22.9 ± 3.1 years). A muscle damage protocol was applied 60 min after supplementation, and consisted of 7 sets of 20 drop jumps from a 60-cm box with 2-min rest intervals between sets. Muscle swelling, countermovement jump (CMJ), maximal voluntary isometric torque (MVIT), and work capacity (WC) were measured before, immediately after, and 24, 48, and 72 h after the exercise protocol. Muscle swelling, CMJ, and MVIT changed similarly in both groups after the exercise protocol (p < 0.001), but returned to pre-exercise levels after 24 h in both groups. WC decreased similarly in both groups after the exercise protocol (p < 0.01). For HMB-FA, WC returned to pre-exercise level 24 h after exercise protocol. However, for PLA, WC did not return to pre-exercise level even 72 h after the exercise protocol. In summary, a single-dose of HMB-FA supplementation improved WC recovery after a high-intensity exercise bout. However, HMB-FA did not affect the time-course of muscle swelling, MVIT, and CMJ recovery.

Vegan diets: practical advice for athletes and exercisers

With the growth of social media as a platform to share information, veganism is becoming more visible, and could be becoming more accepted in sports and in the health and fitness industry. However, to date, there appears to be a lack of literature that discusses how to manage vegan diets for athletic purposes. This article attempted to review literature in order to provide recommendations for how to construct a vegan diet for athletes and exercisers. While little data could be found in the sports nutrition literature specifically, it was revealed elsewhere that veganism creates challenges that need to be accounted for when designing a nutritious diet. This included the sufficiency of energy and protein; the adequacy of vitamin B12, iron, zinc, calcium, iodine and vitamin D; and the lack of the long-chain n-3 fatty acids EPA and DHA in most plant-based sources. However, via the strategic management of food and appropriate supplementation, it is the contention of this article that a nutritive vegan diet can be designed to achieve the dietary needs of most athletes satisfactorily. Further, it was suggested here that creatine and β-alanine supplementation might be of particular use to vegan athletes, owing to vegetarian diets promoting lower muscle creatine and lower muscle carnosine levels in consumers. Empirical research is needed to examine the effects of vegan diets in athletic populations however, especially if this movement grows in popularity, to ensure that the health and performance of athletic vegans is optimised in accordance with developments in sports nutrition knowledge.

Metabolic Responses and Pacing Strategies during Successive Sprint Skiing Time Trials

PURPOSE

This study aimed to examine the metabolic responses and pacing strategies during the performance of successive sprint time trials (STTs) in cross-country skiing.

METHODS

Ten well-trained male cross-country skiers performed four self-paced 1300-m STTs on a treadmill, each separated by 45 min of recovery. The simulated sprint time trial (STT) course was divided into three flat (1°) sections (S1, S3, and S5) involving the double poling subtechnique interspersed with two uphill (7°) sections (S2 and S4) involving the diagonal stride subtechnique. Treadmill velocity and V˙O2 were monitored continuously, and gross efficiency was used to estimate the anaerobic energy supply.

RESULTS

The individual trial-to-trial variability in STTs performance time was 1.3%, where variations in O2 deficit and V˙O2 explained 69% (P < 0.05) and 11% (P > 0.05) of the variation in performance. The first and the last STTs were equally fast (228 ± 10 s) and ~1.3% faster than the second and the third STTs (P < 0.05). These two fastest STTs were associated with a 14% greater O2 deficit (P < 0.05), whereas the average V˙O2 was similar during all four STTs (86% ± 3% of V˙O2max). Positive pacing was used throughout all STTs, with significantly less time spent on the first than second course half. In addition, metabolic rates were substantially higher (~30%) for uphill than for flat skiing, indicating that pacing was regulated to the terrain.

CONCLUSIONS

The fastest STTs were characterized primarily by a greater anaerobic energy production, which also explained 69% of the individual variation in performance. Moreover, the skiers used positive pacing and a variable exercise intensity according to the course profile, yielding an irregular distribution of anaerobic energy production.

Systems biology of personalized nutrition

Personalized nutrition is fast becoming a reality due to a number of technological, scientific, and societal developments that complement and extend current public health nutrition recommendations. Personalized nutrition tailors dietary recommendations to specific biological requirements on the basis of a person's health status and goals. The biology underpinning these recommendations is complex, and thus any recommendations must account for multiple biological processes and subprocesses occurring in various tissues and must be formed with an appreciation for how these processes interact with dietary nutrients and environmental factors. Therefore, a systems biology-based approach that considers the most relevant interacting biological mechanisms is necessary to formulate the best recommendations to help people meet their wellness goals. Here, the concept of "systems flexibility" is introduced to personalized nutrition biology. Systems flexibility allows the real-time evaluation of metabolism and other processes that maintain homeostasis following an environmental challenge, thereby enabling the formulation of personalized recommendations. Examples in the area of macro- and micronutrients are reviewed. Genetic variations and performance goals are integrated into this systems approach to provide a strategy for a balanced evaluation and an introduction to personalized nutrition. Finally, modeling approaches that combine personalized diagnosis and nutritional intervention into practice are reviewed.

Periodized Nutrition for Athletes

It is becoming increasingly clear that adaptations, initiated by exercise, can be amplified or reduced by nutrition. Various methods have been discussed to optimize training adaptations and some of these methods have been subject to extensive study. To date, most methods have focused on skeletal muscle, but it is important to note that training effects also include adaptations in other tissues (e.g., brain, vasculature), improvements in the absorptive capacity of the intestine, increases in tolerance to dehydration, and other effects that have received less attention in the literature. The purpose of this review is to define the concept of periodized nutrition (also referred to as nutritional training) and summarize the wide variety of methods available to athletes. The reader is referred to several other recent review articles that have discussed aspects of periodized nutrition in much more detail with primarily a focus on adaptations in the muscle. The purpose of this review is not to discuss the literature in great detail but to clearly define the concept and to give a complete overview of the methods available, with an emphasis on adaptations that are not in the muscle. Whilst there is good evidence for some methods, other proposed methods are mere theories that remain to be tested. 'Periodized nutrition' refers to the strategic combined use of exercise training and nutrition, or nutrition only, with the overall aim to obtain adaptations that support exercise performance. The term nutritional training is sometimes used to describe the same methods and these terms can be used interchangeably. In this review, an overview is given of some of the most common methods of periodized nutrition including 'training low' and 'training high', and training with low- and high-carbohydrate availability, respectively. 'Training low' in particular has received considerable attention and several variations of 'train low' have been proposed. 'Training-low' studies have generally shown beneficial effects in terms of signaling and transcription, but to date, few studies have been able to show any effects on performance. In addition to 'train low' and 'train high', methods have been developed to 'train the gut', train hypohydrated (to reduce the negative effects of dehydration), and train with various supplements that may increase the training adaptations longer term. Which of these methods should be used depends on the specific goals of the individual and there is no method (or diet) that will address all needs of an individual in all situations. Therefore, appropriate practical application lies in the optimal combination of different nutritional training methods. Some of these methods have already found their way into training practices of athletes, even though evidence for their efficacy is sometimes scarce at best. Many pragmatic questions remain unanswered and another goal of this review is to identify some of the remaining questions that may have great practical relevance and should be the focus of future research.

Total Energy Expenditure, Energy Intake, and Body Composition in Endurance Athletes Across the Training Season: A Systematic Review

BACKGROUND

Endurance athletes perform periodized training in order to prepare for main competitions and maximize performance. However, the coupling between alterations of total energy expenditure (TEE), energy intake, and body composition during different seasonal training phases is unclear. So far, no systematic review has assessed fluctuations in TEE, energy intake, and/or body composition in endurance athletes across the training season. The purpose of this study was to (1) systematically analyze TEE, energy intake, and body composition in highly trained athletes of various endurance disciplines and of both sexes and (2) analyze fluctuations in these parameters across the training season.

METHODS

An electronic database search was conducted on the SPORTDiscus and MEDLINE (January 1990-31 January 2015) databases using a combination of relevant keywords. Two independent reviewers identified potentially relevant studies. Where a consensus was not reached, a third reviewer was consulted. Original research articles that examined TEE, energy intake, and/or body composition in 18-40-year-old endurance athletes and reported the seasonal training phases of data assessment were included in the review. Articles were excluded if body composition was assessed by skinfold measurements, TEE was assessed by questionnaires, or data could not be split between the sexes. Two reviewers assessed the quality of studies independently. Data on subject characteristics, TEE, energy intake, and/or body composition were extracted from the included studies. Subjects were categorized according to their sex and endurance discipline and each study allocated a weight within categories based on the number of subjects assessed. Extracted data were used to calculate weighted means and standard deviations for parameters of TEE, energy intake, and/or body composition.

RESULTS

From 3589 citations, 321 articles were identified as potentially relevant, with 82 meeting all of the inclusion criteria. TEE of endurance athletes was significantly higher during the competition phase than during the preparation phase (p < 0.001) and significantly higher than energy intake in both phases (p < 0.001). During the competition phase, both body mass and fat-free mass were significantly higher compared to other seasonal training phases (p < 0.05).

CONCLUSIONS

Limitations of the present study included insufficient data being available for all seasonal training phases and thus low explanatory power of single parameters. Additionally, the classification of the different seasonal training phases has to be discussed. Male and female endurance athletes show important training seasonal fluctuations in TEE, energy intake, and body composition. Therefore, dietary intake recommendations should take into consideration other factors including the actual training load, TEE, and body composition goals of the athlete.

American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance

It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.

β-alanine supplementation to improve exercise capacity and performance: a systematic review and meta-analysis

OBJECTIVE

To conduct a systematic review and meta-analysis of the evidence on the effects of β-alanine supplementation on exercise capacity and performance.

DESIGN

This study was designed in accordance with PRISMA guidelines. A 3-level mixed effects model was employed to model effect sizes and account for dependencies within data.

DATA SOURCES

3 databases (PubMed, Google Scholar, Web of Science) were searched using a number of terms ('β-alanine' and 'Beta-alanine' combined with 'supplementation', 'exercise', 'training', 'athlete', 'performance' and 'carnosine').

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Inclusion/exclusion criteria limited articles to double-blinded, placebo-controlled studies investigating the effects of β-alanine supplementation on an exercise measure. All healthy participant populations were considered, while supplementation protocols were restricted to chronic ingestion. Cross-over designs were excluded due to the long washout period for skeletal muscle carnosine following supplementation. A single outcome measure was extracted for each exercise protocol and converted to effect sizes for meta-analyses.

RESULTS

40 individual studies employing 65 different exercise protocols and totalling 70 exercise measures in 1461 participants were included in the analyses. A significant overall effect size of 0.18 (95% CI 0.08 to 0.28) was shown. Meta-regression demonstrated that exercise duration significantly (p=0.004) moderated effect sizes. Subgroup analyses also identified the type of exercise as a significant (p=0.013) moderator of effect sizes within an exercise time frame of 0.5-10 min with greater effect sizes for exercise capacity (0.4998 (95% CI 0.246 to 0.753)) versus performance (0.1078 (95% CI -0.201 to 0.416)). There was no moderating effect of training status (p=0.559), intermittent or continuous exercise (p=0.436) or total amount of β-alanine ingested (p=0.438). Co-supplementation with sodium bicarbonate resulted in the largest effect size when compared with placebo (0.43 (95% CI 0.22 to 0.64)).

SUMMARY/CONCLUSIONS

β-alanine had a significant overall effect while subgroup analyses revealed a number of modifying factors. These data allow individuals to make informed decisions as to the likelihood of an ergogenic effect with β-alanine supplementation based on their chosen exercise modality.

Dietary Intake of Athletes Seeking Nutrition Advice at a Major International Competition

International travel and short-term residence overseas is now a common feature of an elite athlete's competition schedule, however, food choice away from home may be challenging and potentially impact on performance. Guidelines for dietary intake specific to competition exist for athletes, however, there is little evidence available to ascertain if athletes meet these recommendations during competition periods, particularly when food is provided in-house. During the Delhi 2010 Commonwealth Games, dietitians based in the dining hall recorded 24 h dietary recalls with all athletes who visited the nutrition kiosk. Analysis of dietary intake was conducted with FoodWorks (Xyris Pty Ltd., Brisbane, Australia). Overall, athletes reported consuming a median total daily energy intake of 8674 kJ (range 2384-18,009 kJ), with carbohydrate within the range of 1.0-9.0 g per kg of bodyweight (g/kg) (median = 3.8) and contributing to 50% total energy (TE) (range 14%-79%). Protein and fat intake ranged from 0.3-4.0 g/kg (median = 1.7) to 10-138 g (median = 67 g), and contributed to 21% TE (range 8%-48%) and 24% TE (range 8%-44%), respectively. Athletes reported consuming between 4 and 29 different food items (median = 15) in the previous 24 h period, with predominately discretionary, grains/cereals, meats, poultry, fish, eggs, and meat alternative items. This suggests that dairy, fruit, and vegetable intake may be suboptimal and intake of the micronutrients iron, zinc, calcium, and vitamins A and C may be of concern for a number of athletes.