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McKnight K, Omotosho O, Jassim S, Cotter A. Exercise and endometriosis-is there a promising future? A narrative review. Ir J Med Sci 2024:10.1007/s11845-024-03733-2. [PMID: 38916808 DOI: 10.1007/s11845-024-03733-2] [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: 10/28/2023] [Accepted: 06/04/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Endometriosis is the leading cause of chronic pelvic pain in women of reproductive age with debilitating effects on quality of life, yet no cure exists. Exercise yields the potential in providing women with a non-invasive, non-pharmacological method of symptom control. AIM(S) Present up-to-date knowledge regarding how exercise may contribute to the management of endometriosis-related symptoms. OBJECTIVE(S) Discuss: 1. The pathophysiology surrounding exercise and endometriosis. 2. The role of exercise in endometriosis symptom control. RATIONALE Scientific literature has alluded to exercise being a favourable factor in the management of endometriosis-related symptoms. Moreover, current clinical guidelines for endometriosis fail to reflect the aforementioned benefits of exercise. SEARCH STRATEGY A search strategy using the terms 'endometriosis', 'endometriomas', 'exercise', and 'physical activity' was devised. Pubmed, Medline, Cochrane reviews, and Embase were reviewed. INCLUSION CRITERIA Interventional studies, within-subjects studies, randomised-control trials, systematic reviews, meta-analysis, cohort studies, publication since 2000. EXCLUSION CRITERIA Non-English publications, non-human studies. RESULTS Numerous studies have suggested positive effects for endometriosis patients who performed exercise exclusively or in conjunction with other therapies. Improvements in pain levels, quality of life, anxiety, and depression were noted. DISCUSSION Current research outlines promise regarding the potential benefit of exercise prescribing in patients with endometriosis as well as a synergy between exercise and hormonal therapies for the management of endometriosis-related symptoms. However, the current paucity of high-quality robust studies investigating these aspects of endometriosis management is an apparent obstacle to progression in this area. CONCLUSION For clinicians to incorporate exercise in managing endometriosis, clear recommendations regarding advice and benefits are needed.
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Affiliation(s)
- Kathryn McKnight
- Univerisity Hospital Galway, Galway, Ireland.
- School of Medicine, University of Limerick, Limerick, Ireland.
| | | | | | - Amanda Cotter
- Univerisity Hospital Galway, Galway, Ireland
- University Maternity Hospital Limerick (UMHL), Limerick, Ireland
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la Torre ME, Monda A, Messina A, de Stefano MI, Monda V, Moscatelli F, Tafuri F, Saraiello E, Latino F, Monda M, Messina G, Polito R, Tafuri D. The Potential Role of Nutrition in Overtraining Syndrome: A Narrative Review. Nutrients 2023; 15:4916. [PMID: 38068774 PMCID: PMC10708264 DOI: 10.3390/nu15234916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/13/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Competition between athletes and an increase in sporting knowledge have greatly influenced training methods while increasing the number of them more and more. As a result, the number of athletes who have increased the number and intensity of their workouts while decreasing recovery times is rising. Positive overtraining could be considered a natural and fundamental process when the result is adaptation and improved performance; however, in the absence of adequate recovery, negative overtraining could occur, causing fatigue, maladaptation, and inertia. One of the earliest forms of fatigue is overreaching. It is considered to be an accumulation of training that leads to reduced sports performance, requiring days or weeks to recover. Overreaching, if followed by adequate recovery, can lead to an increase in athletic performance. Nonetheless, if overreaching becomes extreme, combined with additional stressors, it could lead to overtraining syndrome (OTS). OTS, caused by systemic inflammation, leads to central nervous system (CNS) effects, including depressed mood, further inflammation, central fatigue, and ultimately neurohormonal changes. There are therefore not only physiological, biochemical, and immunological but also psychological symptoms or markers that must be considered, independently or together, being intrinsically linked with overtraining, to fully understand OTS. However, to date, there are very few published studies that have analyzed how nutrition in its specific food aspects, if compromised during OTS, can be both etiology and consequence of the syndrome. To date, OTS has not yet been fully studied, and the topic needs further research. The purpose of this narrative review is therefore to study how a correct diet and nutrition can influence OTS in all its aspects, from prevention to treatment.
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Affiliation(s)
- Maria Ester la Torre
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.l.T.); (M.I.d.S.); (G.M.)
| | - Antonietta Monda
- Department of Experimental Medicine, Section of Human Physiology, Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.M.)
| | - Antonietta Messina
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Maria Ida de Stefano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.l.T.); (M.I.d.S.); (G.M.)
| | - Vincenzo Monda
- Department of Economics, Law, Cybersecurity, and Sports Sciences, University of Naples “Parthenope”, 80131 Naples, Italy; (V.M.); (E.S.); (D.T.)
| | - Fiorenzo Moscatelli
- Department of Human Sciences, Telematic University Pegaso, 80100 Naples, Italy; (F.M.); (F.L.)
| | - Francesco Tafuri
- Heracle Lab Research in Educational Neuroscience, Niccolò Cusano University, 00166 Roma, Italy;
| | - Emma Saraiello
- Department of Economics, Law, Cybersecurity, and Sports Sciences, University of Naples “Parthenope”, 80131 Naples, Italy; (V.M.); (E.S.); (D.T.)
| | - Francesca Latino
- Department of Human Sciences, Telematic University Pegaso, 80100 Naples, Italy; (F.M.); (F.L.)
| | - Marcellino Monda
- Department of Experimental Medicine, Section of Human Physiology, Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.M.)
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.l.T.); (M.I.d.S.); (G.M.)
| | - Rita Polito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.l.T.); (M.I.d.S.); (G.M.)
| | - Domenico Tafuri
- Department of Economics, Law, Cybersecurity, and Sports Sciences, University of Naples “Parthenope”, 80131 Naples, Italy; (V.M.); (E.S.); (D.T.)
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Noakes TD. What Is the Evidence That Dietary Macronutrient Composition Influences Exercise Performance? A Narrative Review. Nutrients 2022; 14:862. [PMID: 35215511 PMCID: PMC8875928 DOI: 10.3390/nu14040862] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 01/06/2023] Open
Abstract
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.
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Affiliation(s)
- Timothy David Noakes
- Department of Applied Design, Cape Peninsula University of Technology, Cape Town 8000, South Africa
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Hulton AT, Malone JJ, Campbell IT, MacLaren DPM. The effect of the menstrual cycle and hyperglycaemia on hormonal and metabolic responses during exercise. Eur J Appl Physiol 2021; 121:2993-3003. [PMID: 34235576 PMCID: PMC8505395 DOI: 10.1007/s00421-021-04754-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/18/2021] [Indexed: 11/28/2022]
Abstract
Purpose Variations in substrate metabolism have been identified in women during continuous steady-state aerobic exercise performed at the same relative intensity throughout discrete phases of the menstrual cycle, although some evidence exists that this is abolished when carbohydrate is ingested. This investigation examined the effects of a supraphysiologic exogenous glucose infusion protocol, administered during two phases of the menstrual cycle (follicular and luteal) in eumenorrheic women to identify differences between metabolic, hormonal and substrate oxidative responses. Methods During the experimental conditions, blood glucose was infused intravenously at rates to “clamp” blood glucose at 10 mM in seven healthy females (age 20 ± 1 y, mass 55.0 ± 4.1 kg, \documentclass[12pt]{minimal}
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\begin{document}$$\dot V{O_{2peak}}$$\end{document}V˙O2peak. During the rest period and throughout exercise, blood metabolites and hormones were collected at regular intervals, in addition to expired air for the measurement of substrate oxidation. Results Significant differences between ovarian hormones and menstrual phase were identified, with estrogen significantly higher during the luteal phase compared to the follicular phase (213.28 ± 30.70 pmol/l vs 103.86 ± 13.85 pmol/l; p = 0.016), and for progesterone (14.23 ± 4.88 vs 2.11 ± 0.36 nmol/l; p = 0.042). However, no further significance was identified in any of the hormonal, metabolite or substrate utilisation patterns between phases. Conclusion These data demonstrate that the infusion of a supraphysiological glucose dose curtails any likely metabolic influence employed by the fluctuation of ovarian hormones in eumenorrheic women during moderate exercise.
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Affiliation(s)
- A T Hulton
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK. .,Sport and Exercise Science, University of Surrey, Leggett Building, Guildford, GU2 7WG, UK.
| | - J J Malone
- School of Health Sciences, Liverpool Hope University, Liverpool, UK
| | - I T Campbell
- Dept of Anaesthesia, Wythenshawe Hospital, Manchester, UK
| | - D P M MacLaren
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Waldman HS, Heatherly AJ, Killen LG, Hollingsworth A, Koh Y, OʼNeal EK. A 3-Week, Low-Carbohydrate, High-Fat Diet Improves Multiple Serum Inflammatory Markers in Endurance-Trained Males. J Strength Cond Res 2020; 36:2502-2508. [PMID: 32826835 DOI: 10.1519/jsc.0000000000003761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Waldman, HS, Heatherly, AJ, Killen, LG, Hollingsworth, A, Koh, Y, and O'Neal, EK. A three-week, low-carbohydrate, high-fat diet improves multiple serum inflammatory markers in endurance-trained males. J Strength Cond Res XX(X): 000-000, 2020-This study examined the effects of a low-carbohydrate, high-fat diet (LCHF) on inflammatory marker responses in middle-aged endurance athletes. Eight male runners maintained their habitual mixed diet (HMD) in the first phase of the study before switching to a noncalorically restricted LCHF diet (∼70% of kcals from fat; carbohydrate <50 g) for 3 weeks. Subjects completed a 50-minute fixed pace treadmill running protocol in a hot environment, followed by a 5-km outdoor time trial. Fasting serum samples were collected immediately after exercise and heat stress restriction, and again 24 hours after the exercise/heat stressor. Thirty inflammation markers were assessed using the multiplex flow immunoassay technique. Seven markers (BAFF/TNFSF-13, sCD30/TNFRSF8, sCD163, Chitinase3-like1, gp130SIL-6Rβ, sTNFR-1, and sTNFR-2) reached statistical significance (p < 0.05) favoring LCHF before exercise, and sCD30/TNFRSF8 favored (p < 0.05) LCHF before (HMD = 459 ± 111; LCHF = 296 ± 100) and after (HMD = 385 ± 104; LCHF = 285 ± 104 pg·ml) exercise. Although the current dietary intervention was short in duration, LCHF seems to offer some protection against multiple chronic inflammation markers for physically active men between ages 30 and 50 years.
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Affiliation(s)
- Hunter S Waldman
- Department of Kinesiology, Human Performance Lab, University of North Alabama, Florence, Alabama
| | - Alexander J Heatherly
- Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, Tennessee
| | - Lauren G Killen
- Department of Kinesiology, Human Performance Lab, University of North Alabama, Florence, Alabama
| | | | - Yunsuk Koh
- Department of Health, Human Performance and Recreation, Baylor University, Waco, Texas
| | - Eric K OʼNeal
- Department of Kinesiology, Human Performance Lab, University of North Alabama, Florence, Alabama
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Liver-Metabolizing Genes and Their Relationship to the Performance of Elite Spanish Male Endurance Athletes; a Prospective Transversal Study. SPORTS MEDICINE-OPEN 2019; 5:50. [PMID: 31820125 PMCID: PMC6901632 DOI: 10.1186/s40798-019-0227-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/19/2019] [Indexed: 11/30/2022]
Abstract
Background The genetic profile that is needed to define an endurance athlete has been studied during recent years. The main objective of this work is to approach for the first time the study of genetic variants in liver-metabolizing genes and their role in endurance performance by comparing the allelic and genotypic frequencies in elite endurance athletes to the non-athlete population. Methods Genotypic and allelic frequencies were determined in 123 elite endurance athletes (75 professional road cyclists and 48 endurance elite runners) and 122 male non-athlete subjects (sedentary). Genotyping of cytochrome P450 family 2 subfamily D member 6 (CYP2D6 rs3892097), glutathione-S transferase mu isoform 1 (GSTM1), glutathione S-transferase pi (GSTP rs1695) and glutathione S-transferase theta (GSTT) genes was performed by polymerase chain reaction (PCR). The combination of the polymorphisms for the “optimal” polygenic profile has been quantified using the genotype score (GS). Results Statistical differences were found in the genetic distributions between elite endurance athletes and non-athletes in CYP2D6 (p < 0.001) and GSTT (p = 0.014) genes. The binary logistic regression model showed a favourable OR (odds ratio) of being an elite endurance runner against a professional road cyclist (OR: 2.403, 95% CI: 1.213–4.760 (p = 0.002)) in the polymorphisms studied. Conclusions Genotypic distribution of liver-metabolizing genes in elite endurance athletes is different to non-athlete subjects, with a favourable gene profile in elite endurance athletes in terms of detoxification capacity.
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Al-Dujaili EAS, Ashmore S, Tsang C. A Short Study Exploring the Effect of the Glycaemic Index of the Diet on Energy intake and Salivary Steroid Hormones. Nutrients 2019; 11:E260. [PMID: 30682835 PMCID: PMC6413178 DOI: 10.3390/nu11020260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/11/2019] [Accepted: 01/21/2019] [Indexed: 01/10/2023] Open
Abstract
Background: The glycaemic index or load (GI or GL) is a concept for ranking carbohydrate-rich foods based on the postprandial blood glucose response compared with a reference food (glucose). Due to the limited research investigating the effect of the GI or GL of the diet on salivary steroidal hormones, this explorative short study was conducted. Methods: 12 female participants consumed a low GI and a high GI diet for three days each, followed by a washout period between each intervention. Saliva was collected at baseline, and following the low or high GI diets. Cortisol and testosterone concentrations were measured by enzyme-linked immuno-sorbent assay (ELISA). Results: GI and GL were significantly different between the low and high GI diets (p < 0.001). There was a small but significant increase in salivary cortisol after the high GI diet (7.38 to 10.93 ng/mL, p = 0.036). No effect was observed after the low GI diet. Higher levels of testosterone were produced after the low GI diet (83.7 to 125.9 pg/mL, p = 0.002), and no effect was found after the high GI diet. The total intake of calories consumed on the low GI diet was significantly lower compared to the high GI diet (p = 0.019). Conclusions: A low GI diet was associated with a small but significant increase in salivary testosterone, while a high GI diet increased cortisol levels. Altering the GI of the diet may influence overall energy intake and the health and wellbeing of female volunteers.
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Affiliation(s)
- Emad A S Al-Dujaili
- Cardiovascular Science, Queen's Medical Research Institute, Edinburgh University, Edinburgh EH16 4TJ, UK.
- Dietetics, Nutrition & Biological Sciences, Queen Margret University, Edinburgh EH21 6UU, UK.
| | - Sophie Ashmore
- Dietetics, Nutrition & Biological Sciences, Queen Margret University, Edinburgh EH21 6UU, UK.
| | - Catherine Tsang
- Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk, Lancashire L39 4QP, UK.
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Xing J, Li J. Bradykinin Contributes to Sympathetic and Pressor Responses Evoked by Activation of Skeletal Muscle Afferents P2X in Heart Failure. Cell Physiol Biochem 2016; 39:2101-2109. [PMID: 27802438 DOI: 10.1159/000447906] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND/AIMS Published data suggest that purinergic P2X receptors of muscle afferent nerves contribute to the enhanced sympathetic nervous activity (SNA) and blood pressure (BP) responses during static exercise in heart failure (HF). In this study, we examined engagement of bradykinin (BK) in regulating responses of SNA and BP evoked by P2X stimulation in rats with HF. We further examined cellular mechanisms responsible for BK. We hypothesized that BK potentiates P2X currents of muscle dorsal root ganglion (DRG) neurons, and this effect is greater in HF due to upregulation of BK kinin B2 and P2X3 receptor. As a result, BK amplifies muscle afferents P2X-mediated SNA and BP responses. METHODS Renal SNA and BP responses were recorded in control rats and rats with HF. Western Blot analysis and patch-clamp methods were employed to examine the receptor expression and function of DRG neurons involved in the effects of BK. RESULTS BK injected into the arterial blood supply of the hindlimb muscles heightened the reflex SNA and BP responses induced by P2X activation with α,β-methylene ATP to a greater degree in HF rats. In addition, HF upregulated the protein expression of kinin B2 and P2X3 in DRG and the prior application of BK increased the magnitude of α,β-methylene ATP-induced currents in muscle DRG neurons from HF rats. CONCLUSION BK plays a facilitating role in modulating muscle afferent P2X-engaged reflex sympathetic and pressor responses. In HF, P2X responsivness is augmented due to increases in expression of kinin B2 and P2X3 receptors and P2X current activity.
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Affiliation(s)
- Jihong Xing
- Jilin University First Hospital, Norman Bethune College of Medicine, Changchun, China
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Horsburgh S, Todryk S, Toms C, Moran CN, Ansley L. Exercise-conditioned plasma attenuates nuclear concentrations of DNA methyltransferase 3B in human peripheral blood mononuclear cells. Physiol Rep 2015; 3:3/12/e12621. [PMID: 26660547 PMCID: PMC4760429 DOI: 10.14814/phy2.12621] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
DNA methylation is modifiable by acute and chronic exercise. DNA methyltransferases (DNMT) catalyze this process; however, there is a lack of literature concerning the specific mechanisms by which exercise‐induced modifications occur. Interleukin 6 (IL‐6) stimulation of various cell lines has been shown to augment DNMT expression and nuclear translocation, which suggests a possible pathway by which exercise is able to elicit changes in epigenetic enzymes. The present study sought to elucidate the response of the de novo methyltransferases DNMT3A and DNMT3B to circulatory factors found in plasma isolated from whole blood before and after 120‐min of treadmill running at an intensity of 60% of individual velocity at V˙O2max (vV˙O2max) interspersed with 30‐sec sprints at 90% of vV˙O2max every 10‐min. Peripheral blood mononuclear cells (PBMCs) isolated from a resting participant were incubated with plasma isolated from exercising participants (n = 10) or recombinant IL‐6 (rIL‐6), followed by nuclear protein extraction and quantification of DNMT3A and DNMT3B concentrations. Nuclear concentrations of DNMT3B significantly decreased following the experimental protocol (P = 0.03), with no change observed in DNMT3A (P = 0.514).Various concentrations of rIL‐6 caused an elevation in both DNMT3A and DNMT3B nuclear concentration compared with the blank control. The conflicting results between exercising and rIL‐6 conditions suggests that IL‐6 does regulate DNMT nuclear transport, however, other plasma mediators may also exert significant influence on the nuclear concentrations of these enzymes.
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Affiliation(s)
- Steven Horsburgh
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, England
| | - Stephen Todryk
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, England
| | - Christopher Toms
- Research Department, British College of Osteopathic Medicine, London, England
| | - Colin N Moran
- Health and Exercise Sciences Research Group, University of Stirling, Stirling, Scotland
| | - Les Ansley
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, England
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Cuddy JS, Reinert AR, Hailes WS, Slivka DR, Ruby BC. Accelerometry and salivary cortisol response during Air Force Special Tactics Officer selection. EXTREME PHYSIOLOGY & MEDICINE 2013; 2:28. [PMID: 24229454 PMCID: PMC3849553 DOI: 10.1186/2046-7648-2-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 08/06/2013] [Indexed: 12/05/2022]
Abstract
Background Special Tactics Officer (STO) selection is conducted to select officers to enter the combat controller training pipeline. The aims were to determine physical activity patterns, estimate energy expenditure, and identify whether return and/or unsuccessful candidates demonstrated differences in cortisol responses compared to non-selected and/or first-time attendees. Methods Participants completed the STO selection, consisting of 5 days of physical and mental challenges. Participants were equipped with ActiCals®, and saliva samples were collected throughout the STO selection. Results Average activity counts were 684 ± 200 counts∙min−1, with no group differences. Estimated energy expenditure was 4,105 ± 451 kcal∙day−1. Cortisol was elevated following extended physical training but returned to baseline during rest. Return candidates had significantly lower cortisol responses compared to first-timers, 0.43 ± 0.06 μg∙dl−1 versus 0.76 ± 0.18 μg∙dl−1, respectively, p < 0.05. Conclusions An individual's salivary cortisol response to the stresses incurred during the STO selection has the potential to be incorporated into the entire picture of a candidate's performance and ability to handle stress.
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Markworth JF, Vella L, Lingard BS, Tull DL, Rupasinghe TW, Sinclair AJ, Maddipati KR, Cameron-Smith D. Human inflammatory and resolving lipid mediator responses to resistance exercise and ibuprofen treatment. Am J Physiol Regul Integr Comp Physiol 2013; 305:R1281-96. [PMID: 24089379 DOI: 10.1152/ajpregu.00128.2013] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Classical proinflammatory eicosanoids, and more recently discovered lipid mediators with anti-inflammatory and proresolving bioactivity, exert a complex role in the initiation, control, and resolution of inflammation. Using a targeted lipidomics approach, we investigated circulating lipid mediator responses to resistance exercise and treatment with the NSAID ibuprofen. Human subjects undertook a single bout of unaccustomed resistance exercise (80% of one repetition maximum) following oral ingestion of ibuprofen (400 mg) or placebo control. Venous blood was collected during early recovery (0-3 h and 24 h postexercise), and serum lipid mediator composition was analyzed by LC-MS-based targeted lipidomics. Postexercise recovery was characterized by elevated levels of cyclooxygenase (COX)-1 and 2-derived prostanoids (TXB2, PGE2, PGD2, PGF2α, and PGI2), lipooxygenase (5-LOX, 12-LOX, and 15-LOX)-derived hydroxyeicosatetraenoic acids (HETEs), and leukotrienes (e.g., LTB4), and epoxygenase (CYP)-derived epoxy/dihydroxy eicosatrienoic acids (EpETrEs/DiHETrEs). Additionally, we detected elevated levels of bioactive lipid mediators with anti-inflammatory and proresolving properties, including arachidonic acid-derived lipoxins (LXA4 and LXB4), and the EPA (E-series) and DHA (D-series)-derived resolvins (RvD1 and RvE1), and protectins (PD1 isomer 10S, 17S-diHDoHE). Ibuprofen treatment blocked exercise-induced increases in COX-1 and COX-2-derived prostanoids but also resulted in off-target reductions in leukotriene biosynthesis, and a diminished proresolving lipid mediator response. CYP pathway product metabolism was also altered by ibuprofen treatment, as indicated by elevated postexercise serum 5,6-DiHETrE and 8,9-DiHETrE only in those receiving ibuprofen. These findings characterize the blood inflammatory lipid mediator response to unaccustomed resistance exercise in humans and show that acute proinflammatory signals are mechanistically linked to the induction of a biological active inflammatory resolution program, regulated by proresolving lipid mediators during postexercise recovery.
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Affiliation(s)
- James F Markworth
- School of Exercise and Nutrition Science, Deakin University, Melbourne, Victoria, Australia
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12
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Gunzer W, Konrad M, Pail E. Exercise-induced immunodepression in endurance athletes and nutritional intervention with carbohydrate, protein and fat-what is possible, what is not? Nutrients 2012; 4:1187-1212. [PMID: 23112908 PMCID: PMC3475230 DOI: 10.3390/nu4091187] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 08/23/2012] [Accepted: 08/24/2012] [Indexed: 01/08/2023] Open
Abstract
Heavily exercising endurance athletes experience extreme physiologic stress, which is associated with temporary immunodepression and higher risk of infection, particularly upper respiratory tract infections (URTI). The aim of this review is to provide a critical up-to-date review of existing evidence on the immunomodulatory potential of selected macronutrients and to evaluate their efficacy. The results of 66 placebo-controlled and/or crossover trials were compared and analysed. Among macronutrients, the most effective approach to maintain immune function in athletes is to consume ≥6% carbohydrate during prolonged exercise. Because inadequate nutrition affects almost all aspects of the immune system, a well-balanced diet is also important. Evidence of beneficial effects from other macronutrients is scarce and results are often inconsistent. Using a single nutrient may not be as effective as a mixture of several nutritional supplements. Due to limited research evidence, with the exception of carbohydrate, no explicit recommendations to reduce post-exercise URTI symptoms with single macronutrients can be derived.
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Affiliation(s)
| | - Manuela Konrad
- Author to whom correspondence should be addressed; ; Tel.: +43-316-5453-6762; Fax: +43-316-5453-6741
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Yeo WK, Carey AL, Burke L, Spriet LL, Hawley JA. Fat adaptation in well-trained athletes: effects on cell metabolism. Appl Physiol Nutr Metab 2011; 36:12-22. [PMID: 21326374 DOI: 10.1139/h10-089] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The performance of prolonged (>90 min), continuous, endurance exercise is limited by endogenous carbohydrate (CHO) stores. Accordingly, for many decades, sports nutritionists and exercise physiologists have proposed a number of diet-training strategies that have the potential to increase fatty acid availability and rates of lipid oxidation and thereby attenuate the rate of glycogen utilization during exercise. Because the acute ingestion of exogenous substrates (primarily CHO) during exercise has little effect on the rates of muscle glycogenolysis, recent studies have focused on short-term (<1-2 weeks) diet-training interventions that increase endogenous substrate stores (i.e., muscle glycogen and lipids) and alter patterns of substrate utilization during exercise. One such strategy is "fat adaptation", an intervention in which well-trained endurance athletes consume a high-fat, low-CHO diet for up to 2 weeks while undertaking their normal training and then immediately follow this by CHO restoration (consuming a high-CHO diet and tapering for 1-3 days before a major endurance event). Compared with an isoenergetic CHO diet for the same intervention period, this "dietary periodization" protocol increases the rate of whole-body and muscle fat oxidation while attenuating the rate of muscle glycogenolysis during submaximal exercise. Of note is that these metabolic perturbations favouring the oxidation of fat persist even in the face of restored endogenous CHO stores and increased exogenous CHO availability. Here we review the current knowledge of some of the potential mechanisms by which skeletal muscle sustains high rates of fat oxidation in the face of high exogenous and endogenous CHO availability.
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Affiliation(s)
- Wee Kian Yeo
- Health Innovations Research Institute, School of Medical Sciences, RMIT University, P.O. Box 71, Bundoora, Victoria 3083, Australia
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Wang J, Song H, Tang X, Yang Y, Vieira VJ, Niu Y, Ma Y. Effect of exercise training intensity on murine T-regulatory cells and vaccination response. Scand J Med Sci Sports 2011; 22:643-52. [PMID: 21410542 DOI: 10.1111/j.1600-0838.2010.01288.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
To understand the underlying mechanism(s) for the effect of exercise at different intensities on T cell and DNA vaccination responses, we treated mice in a training protocol with regular moderate-intensity exercise (MIE) or prolonged, exhaustive high-intensity exercise (HIE). After 6 weeks of training, splenocytes were isolated to evaluate cytokine expression and T-regulatory (Treg) cell proportion by RT-PCR and FACS, respectively. Another set of mice that completed the same training protocol were used to determine DNA vaccination responses. These mice were immunized three times with HBV DNA vaccine at 2-week intervals and euthanized on day 14 after the last immunization. Serum and splenocytes were isolated to determine humoral and cell-mediated immunity (CMI). Results showed that HIE increased anti-inflammatory cytokine expression and CD4(+) CD25(+) Treg cell proportion. Further, HIE decreased IFN-γ expression, T-lymphocyte proliferation, and antigen-specic cytotoxic response in HBV DNA vaccine-immunized mice. MIE did not change anti-inflammatory cytokine expression or CD4(+) CD25(+) Treg cell proportion but increased pro-inflammatory cytokine expression and augmented antigen-specific CMI. Thus, MIE lower the risk of cancer and infectious illness through enhancing the pro-inflammatory responses. By contrast, HIE might increase the risk of common infections, such as upper respiratory tract infection, due to an up-regulation of CD4(+) CD25(+) Treg cells and anti-inflammatory responses.
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Affiliation(s)
- J Wang
- Key Laboratory of Cellular and Molecular Immunology, Henan University, Kaifeng, China.
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de Oliveira C, de Mattos ABM, Biz C, Oyama LM, Ribeiro EB, do Nascimento CMO. High-fat diet and glucocorticoid treatment cause hyperglycemia associated with adiponectin receptor alterations. Lipids Health Dis 2011; 10:11. [PMID: 21244702 PMCID: PMC3031255 DOI: 10.1186/1476-511x-10-11] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 01/18/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adiponectin is the most abundant plasma protein synthesized for the most part in adipose tissue, and it is an insulin-sensitive hormone, playing a central role in glucose and lipid metabolism. In addition, it increases fatty acid oxidation in the muscle and potentiates insulin inhibition of hepatic gluconeogenesis. Two adiponectin receptors have been identified: AdipoR1 is the major receptor expressed in skeletal muscle, whereas AdipoR2 is mainly expressed in liver. Consumption of high levels of dietary fat is thought to be a major factor in the promotion of obesity and insulin resistance. Excessive levels of cortisol are characterized by the symptoms of abdominal obesity, hypertension, glucose intolerance or diabetes and dyslipidemia; of note, all of these features are shared by the condition of insulin resistance. Although it has been shown that glucocorticoids inhibit adiponectin expression in vitro and in vivo, little is known about the regulation of adiponectin receptors. The link between glucocorticoids and insulin resistance may involve the adiponectin receptors and adrenalectomy might play a role not only in regulate expression and secretion of adiponectin, as well regulate the respective receptors in several tissues. RESULTS Feeding of a high-fat diet increased serum glucose levels and decreased adiponectin and adipoR2 mRNA expression in subcutaneous and retroperitoneal adipose tissues, respectively. Moreover, it increased both adipoR1 and adipoR2 mRNA levels in muscle and adipoR2 protein levels in liver. Adrenalectomy combined with the synthetic glucocorticoid dexamethasone treatment resulted in increased glucose and insulin levels, decreased serum adiponectin levels, reduced adiponectin mRNA in epididymal adipose tissue, reduction of adipoR2 mRNA by 7-fold in muscle and reduced adipoR1 and adipoR2 protein levels in muscle. Adrenalectomy alone increased adiponectin mRNA expression 3-fold in subcutaneous adipose tissue and reduced adipoR2 mRNA expression 2-fold in liver. CONCLUSION Hyperglycemia as a result of a high-fat diet is associated with an increase in the expression of the adiponectin receptors in muscle. An excess of glucocorticoids, rather than their absence, increase glucose and insulin and decrease adiponectin levels.
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Affiliation(s)
- Cristiane de Oliveira
- Disciplina de Fisiologia da Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, Brasil
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Pendergast DR, Meksawan K, Limprasertkul A, Fisher NM. Influence of exercise on nutritional requirements. Eur J Appl Physiol 2010; 111:379-90. [PMID: 21079991 DOI: 10.1007/s00421-010-1710-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2010] [Indexed: 01/05/2023]
Abstract
There is no consensus on the best diet for exercise, as many variables influence it. We propose an approach that is based on the total energy expenditure of exercise and the specific macro- and micronutrients used. di Prampero quantified the impact of intensity and duration on the energy cost of exercise. This can be used to determine the total energy needs and the balance of fats and carbohydrates (CHO). There are metabolic differences between sedentary and trained persons, thus the total energy intake to prevent overfeeding of sedentary persons and underfeeding athletes is important. During submaximal sustained exercise, fat oxidation (FO) plays an important role. This role is diminished and CHO's role increases as exercise intensity increases. At super-maximal exercise intensities, anaerobic glycolysis dominates. In the case of protein and micronutrients, specific recommendations are required. We propose that for submaximal exercise, the balance of CHO and fat favors fat for longer exercise and CHO for shorter exercise, while always maintaining the minimal requirements of each (CHO: 40% and fat: 30%). A case for higher protein (above 15%) as well as creatine supplementation for resistance exercise has been proposed. One may also consider increasing bicarbonate intake for exercise that relies on anaerobic glycolysis, whereas there appears to be little support for antioxidant supplementation. Insuring minimal levels of substrate will prevent exercise intolerance, while increasing some components may increase exercise tolerance.
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Affiliation(s)
- D R Pendergast
- Department of Physiology and Biophysics, 124 Sherman Hall, Center for Research and Education in Special Environments, University at Buffalo, 3435 Main Street, Buffalo, NY 14214, USA.
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TEIXEIRA VITORH, VALENTE HUGOF, CASAL SUSANAI, MARQUES AFRANKLIM, MOREIRA PEDROA. Antioxidants Do Not Prevent Postexercise Peroxidation and May Delay Muscle Recovery. Med Sci Sports Exerc 2009; 41:1752-60. [DOI: 10.1249/mss.0b013e31819fe8e3] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Kwon DK, Hwang KH, Kim YK, Lee KH, Song YJ. Effects of swimming exercise and soybean supplementation on the immune functions of rats fed a high-fat diet. Clin Exp Pharmacol Physiol 2008; 35:638-42. [PMID: 18177482 DOI: 10.1111/j.1440-1681.2007.04847.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
1. In the present study, the effects of swimming exercise and soybean supplementation on the immune functions of rats fed a high-fat diet were examined. 2. Thirty-four male rats were randomly divided into four groups: (i) HS, a high-fat diet sedentary group (n = 8); (ii) HE, a high-fat diet exercised group (n = 9); (iii) SS, a soybean diet sedentary group (n = 8); and (iv) SE, a soybean diet exercised group (n = 9). The high-fat diet was composed of 35% carbohydrate, 20% protein and 35% fat. For the soybean diet, 3% crude soybean extract was substituted for the protein, carbohydrate and fat according to the energy content of the diet. In the exercise groups, rats swam for 60 min/day, 5 days/week for 4 weeks. 3. The subpopulation of CD4(+) cells and the CD4(+)/CD8(+) ratio did not differ significantly between the high-fat diet and soybean diet groups. However, the subpopulation of CD8(+) cells in the spleens of SS rats was significantly higher than that in the spleens of HS rats (P < 0.05). In addition, splenic interferon-gamma secretion in the SE group, with or without conconavalin A stimulation, was significantly increased compared with the SS group (P < 0.05 and P < 0.01, respectively). 4. These results show that regular endurance exercise training with soybean supplementation ameliorates splenic T cell-mediated immunity.
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Affiliation(s)
- Dae Keun Kwon
- Laboratory Exercise Metabolism, Kyungpook National University Graduate School, Daegu, Korea
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Boullu-Ciocca S, Achard V, Tassistro V, Dutour A, Grino M. Postnatal programming of glucocorticoid metabolism in rats modulates high-fat diet-induced regulation of visceral adipose tissue glucocorticoid exposure and sensitivity and adiponectin and proinflammatory adipokines gene expression in adulthood. Diabetes 2008; 57:669-77. [PMID: 18057089 DOI: 10.2337/db07-1316] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Alterations of the perinatal environment, which lead to increased prevalence of the metabolic syndrome in adulthood, program an upregulation of systemic and/or adipose tissue glucocorticoid metabolism (11 beta-hydroxysteroid dehydrogenase type 1 [11 beta-HSD-1]-induced corticosterone reactivation). We hypothesized that postnatal programming could modulate high-fat diet-induced adipose tissue dysregulation in adulthood. RESEARCH DESIGN AND METHODS We compared the effects of chronic (since weaning) high- or low-fat diet in postnatally normofed (control) or overfed (programmed) rats. RESULTS Postnatal programming accentuated high-fat diet-induced overweight, insulin resistance, glucose intolerance, and decrease in circulating and epididymal adipose tissue adiponectin. Neither manipulation altered liver function. Postnatal programming or high-fat diet increased systemic corticosterone production, which was not further modified when both manipulations were associated. Postnatal programming suppressed high-fat diet-induced decrease in mesenteric adipose tissue (MAT) glucocorticoid sensitivity and triggered high-fat diet-induced increase in MAT glucocorticoid exposure, subsequent to enhanced MAT 11 beta-HSD-1 gene expression. MAT tumor necrosis factor (TNF)-alpha, TNF-receptor 1, interleukin (IL)-6, resistin, and plasminogen activator inhibitor-1 mRNAs were not changed by high-fat feeding in control rats and showed a large increase in programmed animals, with this effect further enhanced by high-fat diet for TNF-alpha and IL-6. CONCLUSIONS Our data show for the first time that postnatal manipulation programs high-fat diet-induced upregulation of MAT glucocorticoid exposure, sensitivity, and inflammatory status and therefore reveal the pivotal role of the environment during the perinatal period on the development of diet-induced adipose tissue dysregulation in adulthood. They also urge the need for clinical trials with specific 11 beta-HSD-1 inhibitors.
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Can non-invasive glucocorticoid measures be used as reliable indicators of stress in animals? Anim Welf 2006. [DOI: 10.1017/s0962728600030657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
AbstractRefinement techniques are being increasingly employed in all fields of animal research to try to ensure that the highest standards of welfare are upheld. This review concerns one of the main emerging techniques for the assessment of welfare itself, namely the non-invasive measurement of glucocorticoids (GCs) as indicators of stress. The paper is divided into three sections. The first discusses the relationship between GCs and stress. The second section considers whether factors other than stress are linked to rises in GCs, eg exercise, oestrus cycle and diet. The final part examines the reliability of the non-invasive techniques that measure GCs from samples of saliva and faeces. Although it is important to take into account some caveats associated with the methodologies employed, it is concluded, nevertheless, that these techniques can give accurate and reliable information regarding the welfare status of an individual or group of animals without the procedures themselves causing any kind of distress to the subjects.
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Abstract
Studies in athletes have shown that carnitine supplementation may foster exercise performance. As reported in the majority of studies, an increase in maximal oxygen consumption and a lowering of the respiratory quotient indicate that dietary carnitine has the potential to stimulate lipid metabolism. Treatment with L-carnitine also has been shown to induce a significant postexercise decrease in plasma lactate, which is formed and used continuously under fully aerobic conditions. Data from preliminary studies have indicated that L-carnitine supplementation can attenuate the deleterious effects of hypoxic training and speed up recovery from exercise stress. Recent data have indicated that L-carnitine plays a decisive role in the prevention of cellular damage and favorably affects recovery from exercise stress. Uptake of L-carnitine by blood cells may induce at least three mechanisms: 1) stimulation of hematopoiesis, 2) a dose-dependent inhibition of collagen-induced platelet aggregation, and 3) the prevention of programmed cell death in immune cells. As recently shown, carnitine has direct effects in regulation of gene expression (i.e., carnitine-acyltransferases) and may also exert effects via modulating intracellular fatty acid concentration. Thus there is evidence for a beneficial effect of L-carnitine supplementation in training, competition, and recovery from strenuous exercise and in regenerative athletics.
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Affiliation(s)
- Heidrun Karlic
- Ludwig Boltzmann Institute for Leukemia Research and Hematology, Vienna, Austria.
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Meksawan K, Venkatraman JT, Awad AB, Pendergast DR. Effect of dietary fat intake and exercise on inflammatory mediators of the immune system in sedentary men and women. J Am Coll Nutr 2005; 23:331-40. [PMID: 15310737 DOI: 10.1080/07315724.2004.10719376] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Dietary fat intake and exercise affect the immune system. This study determined the changes in inflammatory components of the immune system in response to maximal exercise with three levels of dietary fat intake: 19%, 30%, and 50% of total calories. METHODS Five men and six women were randomly assigned to consume diets with 19% and 50% calories from fat for three weeks each, with a one-week washout. The habitual and washout diets were 30% calories from fat. At the beginning and the end of each diet, body composition and maximal exercise tests were performed. Blood samples were collected before and after exercise to determine the immunological parameters. RESULTS The subject's energy intake was balanced to expenditure on the 30% and 50% diets, but was in negative balance on the 19% diet. Exercise led to significant increases in the concentrations of leukocytes, neutrophils, lymphocytes, monocytes, plasma tumour necrosis factor (TNF)-alpha, plasma interleukin (IL)-2, plasma soluble vascular cell adhesion molecule (sVCAM)-1, and the production of IL-1beta and IL-6 by peripheral blood mononuclear (PBMN) cells stimulated with lipopolysaccharide (LPS), irrespective of diets (p < 0.05). The 19% fat diet resulted in increased plasma soluble intercellular adhesion molecule (sICAM)-1 after exercise. Leukotriene (LT) B4 concentration released by neutrophils stimulated with LPS was higher in the 50% fat diet, compared to the lower fat diets, and the sICAM-1 production of neutrophils stimulated with LPS was significantly increased after exercise only with 30% fat diet. CONCLUSION While a short, intense bout of exercise increased pro-inflammatory mediators of the immune system, decreasing fat intake to 19% on a caloric deficient diet caused a greater increase in plasma TNF-alpha, sVCAM-1 and sICAM-1 concentration than the 30% and 50% fat diets in male and female subjects. Increasing fat calories to 50% with caloric balance did not exacerbate pro-inflammatory mediators compared to a 30% fat diet.
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Affiliation(s)
- Kulwara Meksawan
- Department of Exercise and Nutrition Sciences, State University of New York at Buffalo, 14214, USA
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Abstract
Athletes are exposed to acute and chronic stress that may lead to suppression of the immune system and increased oxidative species generation. In addition, the tendency to consume fewer calories than expended and to avoid fats may further compromise the immune system and antioxidant mechanisms. The exercise stress is proportional to the intensity and duration of the exercise, relative to the maximal capacity of the athlete. Muscle glycogen depletion compromises exercise performance and it also increases the stress. Glycogen stores can be protected by increased fat oxidation (glycogen sparing). The diets of athletes should be balanced so that total caloric intake equals expenditure, and so that the carbohydrates and fats utilised in exercise are replenished. Many athletes do not meet these criteria and have compromised glycogen or fat stores, have deficits in essential fats, and do not take in sufficient micronutrients to support exercise performance, immune competence and antioxidant defence. Either overtraining or under nutrition may lead to an increased risk of infections. Exercise stress leads to a proportional increase in stress hormone levels and concomitant changes in several aspects of immunity, including the following: high cortisol; neutrophilia; lymphopenia; decreases in granulocyte oxidative burst, nasal mucociliary clearance, natural killer cell activity, lymphocyte proliferation, the delayed-type sensitivity response, the production of cytokines in response to mitogens, and nasal and salivary immunoglobulin A levels; blunted major histocompatibility complex II expression in macrophages; and increases in blood granulocyte and monocyte phagocytosis, and pro- and anti-inflammatory cytokines. In addition to providing fuel for exercise, glycolysis, glutaminlysis, fat oxidation and protein degradation participate in metabolism and synthesis of the immune components. Compromising, or overusing, any of these components may lead to immunosuppression. In some cases, supplementation with micronutrients may facilitate the immune system and compensate for deficits in essential nutrients. In summary, athletes should eat adequate calories and nutrients to balance expenditure of all nutrients. Dietary insufficiencies should be compensated for by supplementation with nutrients, with care not to over compensate. By following these rules, and regulating training to avoid overtraining, the immune system can be maintained to minimise the risk of upper respiratory tract infections.
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Affiliation(s)
- Jaya T Venkatraman
- Department of Physical Therapy, Exercise and Nutrition Sciences, School of Health Related Professions, University at Buffalo, Buffalo, New York 14214, USA.
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