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Henningsen K, Henry R, Gaskell SK, Alcock R, Mika A, Rauch C, Cheuvront SN, Blazy P, Kenefick R, Costa RJS. Exertional heat stress promotes the presence of bacterial DNA in plasma: A counterbalanced randomised controlled trial. J Sci Med Sport 2024; 27:610-617. [PMID: 38906729 DOI: 10.1016/j.jsams.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES The primary aim was to explore the impact of exertional-heat stress (EHS) promoted exercise-associated bacteraemia. A secondary aim was to examine if an amino acid beverage (AAB) intervention may mitigate exercise-associated bacteraemia. DESIGN Counterbalanced randomised control trial. METHODS Twenty endurance trained male participants completed two randomised EHS trials. On one occasion, participants consumed a 237 mL AAB twice daily for 7 days prior, immediately before and every 20 min during EHS (2 h running at 60 % V̇O2max in 35 °C). On the other occasion, a water volume control (CON) equivalent was consumed. Whole blood samples were collected pre- and immediately post-EHS, and were analysed for plasma DNA concentration by fluorometer quantification after microbial extraction, and bacterial relative abundance by next generation 16s rRNA gene sequencing. RESULTS Increased concentration of microbial DNA in plasma pre- to post-EHS was observed on CON (pre-EHS 0.014 ng/μL, post-EHS 0.039 ng/μL) (p < 0.001) and AAB (pre-EHS 0.015 ng/μL, post-EHS 0.031 ng/μL) (p < 0.001). The magnitude of change from pre- to post-exercise on AAB was 40 % lower, but no significant difference was observed versus CON (p = 0.455). Predominant bacterial groups identified included: phyla-Proteobacteria (88.0 %), family-Burkholderiaceae (59.1 %), and genus-Curvibacter (58.6 %). No significant variation in absolute and relative change in α-diversity and relative abundance for phyla, family, and genus bacterial groups was observed in AAB versus CON. CONCLUSIONS The increased presence of microbial-bacterial DNA in systemic circulation in response to EHS appears positive in all participants. An amino acid beverage supplementation period prior to and consumption during EHS did not provide significant attenuation of EHS-associated bacteraemia.
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Scrivin R, Slater G, Mika A, Rauch C, Young P, Martinez I, Costa RJS. The impact of 48 h high carbohydrate diets with high and low FODMAP content on gastrointestinal status and symptoms in response to endurance exercise, and subsequent endurance performance. Appl Physiol Nutr Metab 2024; 49:773-791. [PMID: 38359412 DOI: 10.1139/apnm-2023-0508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
This study investigated the effects of a high carbohydrate diet, with varied fermentable oligo-, di-, and mono-saccharide and polyol (FODMAP) content, before endurance exercise on gastrointestinal integrity, motility, and symptoms; and subsequent exercise performance. Twelve endurance athletes were provided with a 48 h high carbohydrate (mean ± SD: 12.1 ± 1.8 g kg day-1) diet on two separate occasions, composed of high (54.8 ± 10.5 g day-1) and low FODMAP (3.0 ± 0.2 g day-1) content. Thereafter, participants completed a 2 h steady-state running exercise at 60% of V ˙ O 2 max (22.9 ± 1.2 °C, 46.4 ± 7.9% RH), followed by a 1 h distance performance test. Pre-exercise and every 20 min during steady-state exercise, 100 mL maltodextrin (10% w/v) solution was consumed. A 150 mL lactulose (20 g) solution was consumed 30 min into the distance performance test to determine orocecal transit time (OCTT) during exercise. Blood was collected pre- and post exercise to determine gastrointestinal integrity biomarkers (i.e., I-FABP, sCD14, and CRP). Breath hydrogen (H2) and gastrointestinal symptoms (GIS) were determined pre-exercise, every 15 min, during and throughout recovery. No differences in gastrointestinal integrity biomarkers, OCTT, or distance completed were observed between trials. Pre-exercise total-GIS (1.3 ± 2.9 vs. 4.3 ± 4.4), gut discomfort (9.9 ± 8.1 vs. 15.8 ± 9.0), and upper-GIS (2.8 ± 2.6 vs. 5.7 ± 4.8) during exercise were less severe on high carbohydrate low FODMAP (HC-LFOD) versus high carbohydrate high FODMAP (HC-HFOD) (p < 0.05). Gut discomfort (3.4 ± 4.4 vs. 0.2 ± 0.6) and total-GIS (4.9 ± 6.8 vs. 0.2 ± 0.6) were higher during recovery on HC-LFOD versus HC-HFOD (p < 0.05). The FODMAP content of a 48 h high carbohydrate diet does not impact gastrointestinal integrity or motility in response to endurance exercise. However, a high FODMAP content exacerbates GIS before and during exercise, but this does not impact performance outcomes.
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Affiliation(s)
- Rachel Scrivin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- Faculty of Health, Education and Environment, Toi Ohomai Institute of Technology, Tauranga, New Zealand
| | - Gary Slater
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Alice Mika
- Faculty of Medicine Nursing & Health Sciences, Department of Nutrition Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - Christopher Rauch
- Faculty of Medicine Nursing & Health Sciences, Department of Nutrition Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - Pascale Young
- Faculty of Medicine Nursing & Health Sciences, Department of Nutrition Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - Isabel Martinez
- Faculty of Medicine Nursing & Health Sciences, Department of Nutrition Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - Ricardo J S Costa
- Faculty of Medicine Nursing & Health Sciences, Department of Nutrition Dietetics and Food, Monash University, Melbourne, VIC, Australia
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Willems MET, Bray PW, Bassett HM, Spurr TJ, West AT. Effects of CurraNZ, a New Zealand Blackcurrant Extract during 1 Hour of Treadmill Running in Female and Male Marathon des Sables Athletes in Hot Conditions: Two Case Studies. J Funct Morphol Kinesiol 2024; 9:76. [PMID: 38651434 PMCID: PMC11036262 DOI: 10.3390/jfmk9020076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Four weeks before competition in the 2023 Marathon des Sables, a 6-stage, ~250 km running event in the Sahara Desert, we examined the effects of a 7-day intake of New Zealand blackcurrant extract (210 mg anthocyanins per day) on 1 h treadmill running-induced physiological and metabolic responses in the heat (~34 °C, relative humidity: ~30%) in non-acclimatized amateur female and male athletes (age: 23, 38 yrs, BMI: 24.2, 28.4 kg·m-2, body fat%: 29.2, 18.8%, V˙O2max: 50.1, 52.1 mL·kg-1·min-1). During the 1 h run at 50%V˙O2max (speed female: 7.3, male: 7.5 km·h-1), indirect calorimetry was used, and heart rate was recorded at 15 min intervals with core temperature monitoring (0.05 Hz). The 1 h runs took place 3 h after a light breakfast and 2 h after intake of the final dose of New Zealand blackcurrant extract with water allowed ad libitum during the run. The New Zealand blackcurrant extract had no effects on the female athlete. The respiratory exchange ratio (RER) of the female athlete in the non-supplement control condition was 0.77 ± 0.01, indicating an existing ~77% contribution of fat oxidation to the energy requirements. In the male athlete, during 1 h of running, fat oxidation was higher by 21% (p < 0.01), carbohydrate oxidation was 31% lower (p = 0.05), RER was 0.03 units lower (p = 0.04), and core temperature was 0.4 °C lower (p < 0.01) with no differences for heart rate, minute ventilation, oxygen uptake, and carbon dioxide production for the New Zealand blackcurrant condition compared to the non-supplement control condition. Seven-day intake of New Zealand blackcurrant extract (210 mg anthocyanins per day) provided beneficial physiological and metabolic responses during exertional heat stress by 1 h of indoor (~34 °C) treadmill running in a male Marathon des Sables athlete 4 weeks before competition. Future work is required to address whether New Zealand blackcurrant provides a nutritional ergogenic effect for Marathon des Sables athletes during long-duration running in the heat combined with personalized nutrition.
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Affiliation(s)
- Mark E. T. Willems
- Institute of Applied Sciences, University of Chichester, College Lane, Chichester PO19 6PE, UK; (P.W.B.); (H.M.B.); (T.J.S.); (A.T.W.)
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Gaskell SK, Henningsen K, Young P, Gill P, Muir J, Henry R, Costa RJS. The Impact of a 24-h Low and High Fermentable Oligo- Di- Mono-Saccharides and Polyol (FODMAP) Diet on Plasma Bacterial Profile in Response to Exertional-Heat Stress. Nutrients 2023; 15:3376. [PMID: 37571312 PMCID: PMC10420669 DOI: 10.3390/nu15153376] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Exertional-heat stress (EHS) compromises intestinal epithelial integrity, potentially leading to the translocation of pathogenic agents into circulation. This study aimed to explore the impact of EHS on the systemic circulatory bacterial profile and to determine the impact of a short-term low (LFOD) and high (HFOD) fermentable oligo- di- mono-saccharide and polyol dietary intervention before EHS on this profile. Using a double-blind randomized cross-over design, thirteen endurance runners (n = 8 males, n = 5 females), with a history of exercise-associated gastrointestinal symptoms (Ex-GIS), consumed a 24 h LFOD and HFOD before 2 h running at 60% V.O2max in 35.6 °C. Blood and fecal samples were collected pre-EHS to determine plasma microbial DNA concentration, and sample bacteria and short chain fatty acid (SCFA) profiles by fluorometer quantification, 16S rRNA amplicon gene sequencing, and gas chromatography, respectively. Blood samples were also collected post-EHS to determine changes in plasma bacteria. EHS increased plasma microbial DNA similarly in both FODMAP trials (0.019 ng·μL-1 to 0.082 ng·μL-1) (p < 0.01). Similar pre- to post-EHS increases in plasma Proteobacteria (+1.6%) and Firmicutes (+0.6%) phyla relative abundance were observed in both FODMAP trials. This included increases in several Proteobacteria genus (Delftia and Serratia) groups. LFOD presented higher fecal Firmicutes (74%) and lower Bacteroidota (10%) relative abundance pre-EHS, as a result of an increase in Ruminococcaceae and Lachnospiraceae family and respective genus groups, compared with HFOD (64% and 25%, respectively). Pre-EHS plasma total SCFA (p = 0.040) and acetate (p = 0.036) concentrations were higher for HFOD (188 and 178 μmol·L-1, respectively) vs. LFOD (163 and 153 μmol·L-1, respectively). Pre-EHS total fecal SCFA concentration (119 and 74 μmol·g-1; p < 0.001), including acetate (74 and 45 μmol·g-1; p = 0.001), butyrate (22 and 13 μmol·g-1; p = 0.002), and propionate (20 and 13 μmol·g-1; p = 0.011), were higher on HFOD vs LFOD, respectively. EHS causes the translocation of whole bacteria into systemic circulation and alterations to the plasma bacterial profile, but the FODMAP content of a 24 h diet beforehand does not alter this outcome.
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Affiliation(s)
- Stephanie K. Gaskell
- Department of Nutrition Dietetics & Food, Monash University, Notting Hill, VIC 3168, Australia; (S.K.G.); (K.H.); (P.Y.)
| | - Kayla Henningsen
- Department of Nutrition Dietetics & Food, Monash University, Notting Hill, VIC 3168, Australia; (S.K.G.); (K.H.); (P.Y.)
| | - Pascale Young
- Department of Nutrition Dietetics & Food, Monash University, Notting Hill, VIC 3168, Australia; (S.K.G.); (K.H.); (P.Y.)
| | - Paul Gill
- Department of Gastroenterology, Monash University, Melbourne, VIC 3004, Australia; (P.G.); (J.M.)
| | - Jane Muir
- Department of Gastroenterology, Monash University, Melbourne, VIC 3004, Australia; (P.G.); (J.M.)
| | - Rebekah Henry
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia;
- Department of Civil Engineering, Monash University, Clayton, VIC 3168, Australia
| | - Ricardo J. S. Costa
- Department of Nutrition Dietetics & Food, Monash University, Notting Hill, VIC 3168, Australia; (S.K.G.); (K.H.); (P.Y.)
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Young P, Russo I, Gill P, Muir J, Henry R, Davidson Z, Costa RJS. Reliability of pathophysiological markers reflective of exercise-induced gastrointestinal syndrome (EIGS) in response to 2-h high-intensity interval exercise: A comprehensive methodological efficacy exploration. Front Physiol 2023; 14:1063335. [PMID: 36895638 PMCID: PMC9989174 DOI: 10.3389/fphys.2023.1063335] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
The study aimed to determine the test-retest reliability of exercise-induced gastrointestinal syndrome (EIGS) biomarkers, and assess the association of pre-exercise short chain fatty acid (SCFA) concentration with these biomarkers in response to prolonged strenuous exercise. Thirty-four participants completed 2 h of high-intensity interval training (HIIT) on two separate occasions with at least 5-days washout. Blood samples were collected pre- and post-exercise, and analysed for biomarkers associated with EIGS [i.e., cortisol, intestinal fatty-acid binding protein (I-FABP), sCD14, lipopolysaccharide binding protein (LBP), leukocyte counts, in-vitro neutrophil function, and systemic inflammatory cytokine profile]. Fecal samples were collected pre-exercise on both occasions. In plasma and fecal samples, bacterial DNA concentration was determined by fluorometer quantification, microbial taxonomy by 16S rRNA amplicon sequencing, and SCFA concentration by gas-chromatography. In response to exercise, 2 h of HIIT modestly perturbed biomarkers indicative of EIGS, including inducing bacteremia (i.e., quantity and diversity). Reliability analysis using comparative tests, Cohen's d, two-tailed correlation, and intraclass correlation coefficient (ICC) of resting biomarkers presented good-to-excellent for IL-1ra (r = 0.710, ICC = 0.92), IL-10 (r = 0.665, ICC = 0.73), cortisol (r = 0.870, ICC = 0.87), and LBP (r = 0.813, ICC = 0.76); moderate for total (r = 0.839, ICC = 0.44) and per cell (r = 0.749, ICC = 0.54) bacterially-stimulated elastase release, IL-1β (r = 0.625, ICC = 0.64), TNF-α (r = 0.523, ICC = 0.56), I-FABP (r = 0.411, ICC = 0.21), and sCD14 (r = 0.409, ICC = 0.38), plus fecal bacterial α-diversity; and poor for leukocyte (r = 0.327, ICC = 0.33) and neutrophil (r = 0.352, ICC = 0.32) counts. In addition, a medium negative correlation was observed between plasma butyrate and I-FABP (r = -0.390). The current data suggest a suite of biomarkers should be used to determine the incidence and severity of EIGS. Moreover, determination of plasma and/or fecal SCFA may provide some insight into the mechanistic aspects of EIGS instigation and magnitude in response to exercise.
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Affiliation(s)
- Pascale Young
- Department of Nutrition Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Isabella Russo
- Department of Nutrition Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Paul Gill
- Department of Gastroenterology, Monash University, Melbourne, VIC, Australia
| | - Jane Muir
- Department of Gastroenterology, Monash University, Melbourne, VIC, Australia
| | - Rebekah Henry
- Department of Civil Engineering, Monash University, Clayton, VIC, Australia
| | - Zoe Davidson
- Department of Nutrition Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Ricardo J S Costa
- Department of Nutrition Dietetics and Food, Monash University, Notting Hill, VIC, Australia
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Gaskell SK, Burgell R, Wiklendt L, Dinning PG, Costa RJS. Impact of exercise duration on gastrointestinal function and symptoms. J Appl Physiol (1985) 2023; 134:160-171. [PMID: 36476157 DOI: 10.1152/japplphysiol.00393.2022] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The study aimed to determine the impact of exercise duration on gastrointestinal functional responses and gastrointestinal symptoms (GISs) in response to differing exercise durations. Endurance runners (n = 16) completed three trials on separate occasions, randomized to 1 h (1-H), 2 h (2-H), and 3 h (3-H) of running at 60% V̇o2max in temperate ambient temperature. Orocecal transit time (OCTT) was determined by lactulose challenge, with concomitant breath hydrogen (H2) determination. Gastric slow wave activity was recorded using cutaneous electrogastrography (cEGG) before and after exertion. GIS was determined using a modified visual analog scale (mVAS). OCTT response was classified as very slow on all trials (∼93-101 min) with no trial difference observed (P = 0.895). Bradygastria increased postexercise on all trials (means ± SD: 1-H: 10.9 ± 11.7%, 2-H: 6.2 ± 9.8%, and 3-H: 13.2 ± 21.4%; P < 0.05). A reduction in the normal gastric slow wave activity (2-4 cycles/min) was observed postexercise on 1-H only (-10.8 ± 17.6%; P = 0.039). GIS incidence and gut discomfort was higher on 2-H (81% and 12 counts) and 3-H (81% and 18 counts), compared with 1-H (69% and 6 counts) (P = 0.038 and P = 0.006, respectively). Severity of gut discomfort, total-GIS, upper-GIS, and lower-GIS increased during exercise on all trials (P < 0.05). Steady-state exercise in temperate ambient conditions for 1 h, 2 h, and 3 h instigates perturbations in gastric slow wave activity compared with rest and hampers OCTT, potentially explaining the incidence and severity on exercise-associated GIS.NEW & NOTEWORTHY Exercise stress per se appears to instigate perturbations to gastric myoelectrical activity, resulting in an increase in bradygastria frequency, inferring a reduction in gastric motility. The perturbations to gastrointestinal functional responses instigated by exercise per se, likely contribute to the high incidence and severity level of exercise-associated gastrointestinal symptoms. Cutaneous electrogastrography is not commonly used in exercise gastroenterology research, however, may be a useful aid in providing an overall depiction of gastrointestinal function. Particularly relating to gastrointestinal motility and concerning gastroparesis.
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Affiliation(s)
- Stephanie K Gaskell
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Rebecca Burgell
- Medicine, Nursing and Health Sciences, Monash University, Prahan, Victoria, Australia.,Department of Gastroenterology, Alfred Health, Prahan, Victoria, Australia
| | - Lukasz Wiklendt
- Department of Surgery, College of Medicine and Public Health, The Flinders University, Bedford Park, South Australia, Australia
| | - Phil G Dinning
- Department of Surgery, College of Medicine and Public Health, The Flinders University, Bedford Park, South Australia, Australia.,Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Ricardo J S Costa
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
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7
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Assessment of Exercise-Associated Gastrointestinal Perturbations in Research and Practical Settings: Methodological Concerns and Recommendations for Best Practice. Int J Sport Nutr Exerc Metab 2022; 32:387-418. [PMID: 35963615 DOI: 10.1123/ijsnem.2022-0048] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/26/2022] [Accepted: 07/07/2022] [Indexed: 12/14/2022]
Abstract
Strenuous exercise is synonymous with disturbing gastrointestinal integrity and function, subsequently prompting systemic immune responses and exercise-associated gastrointestinal symptoms, a condition established as "exercise-induced gastrointestinal syndrome." When exercise stress and aligned exacerbation factors (i.e., extrinsic and intrinsic) are of substantial magnitude, these exercise-associated gastrointestinal perturbations can cause performance decrements and health implications of clinical significance. This potentially explains the exponential growth in exploratory, mechanistic, and interventional research in exercise gastroenterology to understand, accurately measure and interpret, and prevent or attenuate the performance debilitating and health consequences of exercise-induced gastrointestinal syndrome. Considering the recent advancement in exercise gastroenterology research, it has been highlighted that published literature in the area is consistently affected by substantial experimental limitations that may affect the accuracy of translating study outcomes into practical application/s and/or design of future research. This perspective methodological review attempts to highlight these concerns and provides guidance to improve the validity, reliability, and robustness of the next generation of exercise gastroenterology research. These methodological concerns include participant screening and description, exertional and exertional heat stress load, dietary control, hydration status, food and fluid provisions, circadian variation, biological sex differences, comprehensive assessment of established markers of exercise-induced gastrointestinal syndrome, validity of gastrointestinal symptoms assessment tool, and data reporting and presentation. Standardized experimental procedures are needed for the accurate interpretation of research findings, avoiding misinterpreted (e.g., pathological relevance of response magnitude) and overstated conclusions (e.g., clinical and practical relevance of intervention research outcomes), which will support more accurate translation into safe practice guidelines.
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Søberg S, Löfgren J, Philipsen FE, Jensen M, Hansen AE, Ahrens E, Nystrup KB, Nielsen RD, Sølling C, Wedell-Neergaard AS, Berntsen M, Loft A, Kjær A, Gerhart-Hines Z, Johannesen HH, Pedersen BK, Karstoft K, Scheele C. Altered brown fat thermoregulation and enhanced cold-induced thermogenesis in young, healthy, winter-swimming men. CELL REPORTS MEDICINE 2021; 2:100408. [PMID: 34755128 PMCID: PMC8561167 DOI: 10.1016/j.xcrm.2021.100408] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 07/13/2021] [Accepted: 09/17/2021] [Indexed: 12/18/2022]
Abstract
The Scandinavian winter-swimming culture combines brief dips in cold water with hot sauna sessions, with conceivable effects on body temperature. We study thermogenic brown adipose tissue (BAT) in experienced winter-swimming men performing this activity 2–3 times per week. Our data suggest a lower thermal comfort state in the winter swimmers compared with controls, with a lower core temperature and absence of BAT activity. In response to cold, we observe greater increases in cold-induced thermogenesis and supraclavicular skin temperature in the winter swimmers, whereas BAT glucose uptake and muscle activity increase similarly to those of the controls. All subjects demonstrate nocturnal reduction in supraclavicular skin temperature, whereas a distinct peak occurs at 4:30–5:30 a.m. in the winter swimmers. Our data leverage understanding of BAT in adult human thermoregulation, suggest both heat and cold acclimation in winter swimmers, and propose winter swimming as a potential strategy for increasing energy expenditure. Winter swimmers have a lower core temperature at a thermal comfort state than controls Winter swimmers had no BAT glucose uptake at a thermal comfort state Winter swimmers have higher cold-induced thermogenesis than control subjects Human supraclavicular skin temperature varies with a diurnal rhythm
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Affiliation(s)
- Susanna Søberg
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Johan Löfgren
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Frederik E Philipsen
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Michal Jensen
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - Adam E Hansen
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Esben Ahrens
- Department of Neurophysiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Kristin B Nystrup
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Rune D Nielsen
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Christine Sølling
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Anne-Sophie Wedell-Neergaard
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - Marianne Berntsen
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Annika Loft
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Andreas Kjær
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Zachary Gerhart-Hines
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Helle H Johannesen
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Bente K Pedersen
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - Kristian Karstoft
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark.,Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen 2400, Denmark
| | - Camilla Scheele
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
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Krumm B, Faiss R. Factors Confounding the Athlete Biological Passport: A Systematic Narrative Review. SPORTS MEDICINE - OPEN 2021; 7:65. [PMID: 34524567 PMCID: PMC8443715 DOI: 10.1186/s40798-021-00356-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Through longitudinal, individual and adaptive monitoring of blood biomarkers, the haematological module of the athlete biological passport (ABP) has become a valuable tool in anti-doping efforts. The composition of blood as a vector of oxygen in the human body varies in athletes with the influence of multiple intrinsic (genetic) or extrinsic (training or environmental conditions) factors. In this context, it is fundamental to establish a comprehensive understanding of the various causes that may affect blood variables and thereby alter a fair interpretation of ABP profiles. METHODS This literature review described the potential factors confounding the ABP to outline influencing factors altering haematological profiles acutely or chronically. RESULTS Our investigation confirmed that natural variations in ABP variables appear relatively small, likely-at least in part-because of strong human homeostasis. Furthermore, the significant effects on haematological variations of environmental conditions (e.g. exposure to heat or hypoxia) remain debatable. The current ABP paradigm seems rather robust in view of the existing literature that aims to delineate adaptive individual limits. Nevertheless, its objective sensitivity may be further improved. CONCLUSIONS This narrative review contributes to disentangling the numerous confounding factors of the ABP to gather the available scientific evidence and help interpret individual athlete profiles.
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Affiliation(s)
- Bastien Krumm
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Raphael Faiss
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.
- Center of Research and Expertise in Anti-Doping Sciences - REDs, University of Lausanne, Lausanne, Switzerland.
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Gaskell SK, Rauch CE, Costa RJS. Gastrointestinal Assessment and Therapeutic Intervention for the Management of Exercise-Associated Gastrointestinal Symptoms: A Case Series Translational and Professional Practice Approach. Front Physiol 2021; 12:719142. [PMID: 34557109 PMCID: PMC8452991 DOI: 10.3389/fphys.2021.719142] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/05/2021] [Indexed: 12/31/2022] Open
Abstract
This translational research case series describes the implementation of a gastrointestinal assessment protocol during exercise (GastroAxEx) to inform individualised therapeutic intervention of endurance athletes affected by exercise-induced gastrointestinal syndrome (EIGS) and associated gastrointestinal symptoms (GIS). A four-phase approach was applied. Phase 1: Clinical assessment and exploring background history of exercise-associated gastrointestinal symptoms. Phase 2: Individual tailored GastroAxEx laboratory simulation designed to mirror exercise stress, highlighted in phase 1, that promotes EIGS and GIS during exercise. Phase 3: Individually programmed therapeutic intervention, based on the outcomes of Phase 2. Phase 4: Monitoring and readjustment of intervention based on outcomes from field testing under training and race conditions. Nine endurance athletes presenting with EIGS, and two control athletes not presenting with EIGS, completed Phase 2. Two athletes experienced significant thermoregulatory strain (peak core temperature attained > 40°C) during the GastroAxEx. Plasma cortisol increased substantially pre- to post-exercise in n = 6/7 (Δ > 500 nmol/L). Plasma I-FABP concentration increased substantially pre- to post-exercise in n = 2/8 (Δ > 1,000 pg/ml). No substantial change was observed in pre- to post-exercise for systemic endotoxin and inflammatory profiles in all athletes. Breath H2 responses showed that orocecal transit time (OCTT) was delayed in n = 5/9 (90-150 min post-exercise) athletes, with the remaining athletes (n = 4/9) showing no H2 turning point by 180 min post-exercise. Severe GIS during exercise was experienced in n = 5/9 athletes, of which n = 2/9 had to dramatically reduce work output or cease exercise. Based on each athlete's identified proposed causal factors of EIGS and GIS during exercise (i.e., n = 9/9 neuroendocrine-gastrointestinal pathway of EIGS), an individualised gastrointestinal therapeutic intervention was programmed and advised, adjusted from a standard EIGS prevention and management template that included established strategies with evidence of attenuating EIGS primary causal pathways, exacerbation factors, and GIS during exercise. All participants reported qualitative data on their progress, which included their previously presenting GIS during exercise, such as nausea and vomiting, either being eliminated or diminished resulting in work output improving (i.e., completing competition and/or not slowing down during training or competition as a result of GIS during exercise). These outcomes suggest GIS during exercise in endurance athletes are predominantly related to gastrointestinal functional and feeding tolerance issues, and not necessarily gastrointestinal integrity and/or systemic issues. GastroAxEx allows for informed identification of potential causal pathway(s) and exacerbation factor(s) of EIGS and GIS during exercise at an individual level, providing a valuable informed individualised therapeutic intervention approach.
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Affiliation(s)
| | | | - Ricardo J. S. Costa
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
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11
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Patrick RP, Johnson TL. Sauna use as a lifestyle practice to extend healthspan. Exp Gerontol 2021; 154:111509. [PMID: 34363927 DOI: 10.1016/j.exger.2021.111509] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
Sauna use, sometimes referred to as "sauna bathing," is characterized by short-term passive exposure to high temperatures, typically ranging from 45 °C to 100 °C (113 °F to 212 °F), depending on modality. This exposure elicits mild hyperthermia, inducing a thermoregulatory response involving neuroendocrine, cardiovascular, and cytoprotective mechanisms that work in a synergistic fashion in an attempt to maintain homeostasis. Repeated sauna use acclimates the body to heat and optimizes the body's response to future exposures, likely due to the biological phenomenon known as hormesis. In recent decades, sauna bathing has emerged as a probable means to extend healthspan, based on compelling data from observational, interventional, and mechanistic studies. Of particular interest are the findings from large, prospective, population-based cohort studies of health outcomes among sauna users that identified strong dose-dependent links between sauna use and reduced morbidity and mortality. This review presents an overview of sauna practices; elucidates the body's physiological response to heat stress and the molecular mechanisms that drive the response; enumerates the myriad health benefits associated with sauna use; and describes sauna use concerns.
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Affiliation(s)
| | - Teresa L Johnson
- TLJ Communications, LLC, 36 Creek Harbour Blvd., Freeport, FL 32439, USA.
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12
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Pokora I, Sadowska-Krępa E, Wolowski Ł, Wyderka P, Michnik A, Drzazga Z. The Effect of Medium-Term Sauna-Based Heat Acclimation (MPHA) on Thermophysiological and Plasma Volume Responses to Exercise Performed under Temperate Conditions in Elite Cross-Country Skiers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6906. [PMID: 34199101 PMCID: PMC8297353 DOI: 10.3390/ijerph18136906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/04/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
The influence of a series of ten sauna baths (MPHA) on thermophysiological and selected hematological responses in 14 elite cross-country skiers to a submaximal endurance exercise test performed under thermoneutral environmental conditions was studied. Thermal and physiological variables were measured before and after the exercise test, whereas selected hematological indices were studied before, immediately after, and during recovery after a run, before (T1) and after sauna baths (T2). MPHA did not influence the baseline internal, body, and skin temperatures. There was a decrease in the resting heart rate (HR: p = 0.001) and physiological strain (PSI: p = 0.052) after MPHA and a significant effect of MPHA on systolic blood pressure (p = 0.03), hematological indices, and an exercise effect but no combined effect of treatments and exercise on the tested variables. A positive correlation was reported between PSI and total protein (%ΔTP) in T2 and a negative between plasma volume (%ΔPV) and mean red cellular volume (%ΔMCV) in T1 and T2 in response to exercise and a positive one during recovery. This may suggest that MPHA has a weak influence on body temperatures but causes a moderate decrease in PSI and modifications of plasma volume restoration in response to exercise under temperate conditions in elite athletes.
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Affiliation(s)
- Ilona Pokora
- Department of Physiological-Medical Sciences, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland;
| | - Ewa Sadowska-Krępa
- Department of Physiological-Medical Sciences, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland;
| | - Łukasz Wolowski
- Doctoral Studies, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (Ł.W.); (P.W.)
| | - Piotr Wyderka
- Doctoral Studies, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (Ł.W.); (P.W.)
| | - Anna Michnik
- The Silesian Centre for Education and Interdisciplinary Research, Faculty of Science and Technology, University of Silesia in Katowice, 75 Pułku Piechoty 1A, 41-500 Chorzow, Poland; (A.M.); (Z.D.)
| | - Zofia Drzazga
- The Silesian Centre for Education and Interdisciplinary Research, Faculty of Science and Technology, University of Silesia in Katowice, 75 Pułku Piechoty 1A, 41-500 Chorzow, Poland; (A.M.); (Z.D.)
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13
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Riera F, Monjo R, Coudevylle GR, Meric H, Hue O. Face Cooling During Swimming Training in Tropical Condition. Front Psychol 2021; 12:622184. [PMID: 33967888 PMCID: PMC8102736 DOI: 10.3389/fpsyg.2021.622184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/25/2021] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to test the effect of face cooling with cold water (1.2 ± 0.7°C) vs. face cooling with neutral water (28.0 ± 3.0°C) during high-intensity swimming training on both the core temperature (Tco) and thermal perceptions in internationally ranked long-distance swimmers (5 men’s and 3 women’s) during 2 randomized swimming sessions. After a standardized warm-up of 1,200 m, the athletes performed a standardized training session that consisted of 2,000 m (5 × 400 m; start every 5’15”) at a best velocity then 600 m of aerobic work. Heart rate (HR) was continuously monitored during 5 × 400 m, whereas Tco, thermal comfort (TC), and thermal sensation (TS) were measured before and after each 400 m. Before and after each 400 m, the swimmers were asked to flow 200 mL of cold water (1.2°C) or neutral (22°C) water packaged in standardized bottles on their face. The swimmers were asked don’t drink during exercise. The velocity was significantly different between cold water and neutral water (p < 0.004 – 71.58 m.min–1 ± 2.32 and 70.52 m.min–1 ± 1.73, respectively). The Tco was increased by ±0.5°C at race pace, under both face cooling conditions with no significant difference. No significant changes were noted in mean HR (i.e., 115 ± 9 and 114 ± 15 bpm for NW and CW, respectively). TC was higher with Cold Cooling than Neutral Cooling and TS was lower with Cold cooling compared with Neutral cooling. The changes in perceptual parameters caused by face cooling with cold water reflect the psychological impact on the physical parameters. The mean velocity was less important with face cooling whereas the heat rate and Tco were the same in the both conditions. The mechanism leading to these results seems to involve brain integration of signals from physiological and psychological sources.
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Affiliation(s)
- Florence Riera
- Laboratory ACTES, UPRES-EA 3596, University of the French West Indies, Point-à-Pitre, France.,Laboratory IMAGE, UMR ESPACE DEV 228, University of Perpignan Via Domitia, Perpignan, France
| | - Roland Monjo
- Laboratory ACTES, UPRES-EA 3596, University of the French West Indies, Point-à-Pitre, France
| | - Guillaume R Coudevylle
- Laboratory ACTES, UPRES-EA 3596, University of the French West Indies, Point-à-Pitre, France
| | - Henri Meric
- Laboratory IMAGE, UMR ESPACE DEV 228, University of Perpignan Via Domitia, Perpignan, France
| | - Olivier Hue
- Laboratory ACTES, UPRES-EA 3596, University of the French West Indies, Point-à-Pitre, France
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14
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Russo I, Della Gatta PA, Garnham A, Porter J, Burke LM, Costa RJS. Assessing Overall Exercise Recovery Processes Using Carbohydrate and Carbohydrate-Protein Containing Recovery Beverages. Front Physiol 2021; 12:628863. [PMID: 33613323 PMCID: PMC7890126 DOI: 10.3389/fphys.2021.628863] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/12/2021] [Indexed: 12/31/2022] Open
Abstract
We compared the impact of two different, but commonly consumed, beverages on integrative markers of exercise recovery following a 2 h high intensity interval exercise (i.e., running 70-80% V̇O2 max intervals and interspersed with plyometric jumps). Participants (n = 11 males, n = 6 females) consumed a chocolate flavored dairy milk beverage (CM: 1.2 g carbohydrate/kg BM and 0.4 g protein/kg BM) or a carbohydrate-electrolyte beverage (CEB: isovolumetric with 0.76 g carbohydrate/kg BM) after exercise, in a randomized-crossover design. The recovery beverages were provided in three equal boluses over a 30 min period commencing 1 h post-exercise. Muscle biopsies were performed at 0 h and 2 h in recovery. Venous blood samples, nude BM and total body water were collected before and at 0, 2, and 4 h recovery. Gastrointestinal symptoms and breath hydrogen (H2) were collected before exercise and every 30 min during recovery. The following morning, participants returned for performance assessment. In recovery, breath H2 reached clinical relevance of >10 ppm following consumption of both beverages, in adjunct with high incidence of gastrointestinal symptoms (70%), but modest severity. Blood glucose response was greater on CEB vs. CM (P < 0.01). Insulin response was greater on CM compared with CEB (P < 0.01). Escherichia coli lipopolysaccharide stimulated neutrophil function reduced on both beverages (49%). p-GSK-3β/total-GSK-3β was greater on CM compared with CEB (P = 0.037); however, neither beverage achieved net muscle glycogen re-storage. Phosphorylation of mTOR was greater on CM than CEB (P < 0.001). Fluid retention was lower (P = 0.038) on CEB (74.3%) compared with CM (82.1%). Physiological and performance outcomes on the following day did not differ between trials. Interconnected recovery optimization markers appear to respond differently to the nutrient composition of recovery nutrition, albeit subtly and with individual variation. The present findings expand on recovery nutrition strategies to target functionality and patency of the gastrointestinal tract as a prerequisite to assimilation of recovery nutrition, as well as restoration of immunocompetency.
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Affiliation(s)
- Isabella Russo
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
| | - Paul A. Della Gatta
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Andrew Garnham
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
| | - Judi Porter
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Louise M. Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Ricardo J. S. Costa
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
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15
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Willingham BD, Ragland TJ, Ormsbee MJ. Betaine Supplementation May Improve Heat Tolerance: Potential Mechanisms in Humans. Nutrients 2020; 12:nu12102939. [PMID: 32992781 PMCID: PMC7599524 DOI: 10.3390/nu12102939] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 11/16/2022] Open
Abstract
Betaine has been demonstrated to increase tolerance to hypertonic and thermal stressors. At the cellular level, intracellular betaine functions similar to molecular chaperones, thereby reducing the need for inducible heat shock protein expression. In addition to stabilizing protein conformations, betaine has been demonstrated to reduce oxidative damage. For the enterocyte, during periods of reduced perfusion as well as greater oxidative, thermal, and hypertonic stress (i.e., prolonged exercise in hot-humid conditions), betaine results in greater villi length and evidence for greater membrane integrity. Collectively, this reduces exercise-induced gut permeability, protecting against bacterial translocation and endotoxemia. At the systemic level, chronic betaine intake has been shown to reduce core temperature, all-cause mortality, markers of inflammation, and change blood chemistry in several animal models when exposed to heat stress. Despite convincing research in cell culture and animal models, only one published study exists exploring betaine's thermoregulatory function in humans. If the same premise holds true for humans, chronic betaine consumption may increase heat tolerance and provide another avenue of supplementation for those who find that heat stress is a major factor in their work, or training for exercise and sport. Yet, this remains speculative until data demonstrate such effects in humans.
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Affiliation(s)
- Brandon D. Willingham
- Institute of Sports Sciences and Medicine, Department of Nutrition, Food, and Exercise Science, Florida State University, Tallahassee, FL 32306, USA; (B.D.W.); (T.J.R.)
| | - Tristan J. Ragland
- Institute of Sports Sciences and Medicine, Department of Nutrition, Food, and Exercise Science, Florida State University, Tallahassee, FL 32306, USA; (B.D.W.); (T.J.R.)
| | - Michael J. Ormsbee
- Institute of Sports Sciences and Medicine, Department of Nutrition, Food, and Exercise Science, Florida State University, Tallahassee, FL 32306, USA; (B.D.W.); (T.J.R.)
- Department of Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal, Westville, Durban 4041, South Africa
- Correspondence:
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16
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Gibson OR, James CA, Mee JA, Willmott AG, Turner G, Hayes M, Maxwell NS. Heat alleviation strategies for athletic performance: A review and practitioner guidelines. Temperature (Austin) 2019; 7:3-36. [PMID: 32166103 PMCID: PMC7053966 DOI: 10.1080/23328940.2019.1666624] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/06/2019] [Accepted: 09/08/2019] [Indexed: 12/19/2022] Open
Abstract
International competition inevitably presents logistical challenges for athletes. Events such as the Tokyo 2020 Olympic Games require further consideration given historical climate data suggest athletes will experience significant heat stress. Given the expected climate, athletes face major challenges to health and performance. With this in mind, heat alleviation strategies should be a fundamental consideration. This review provides a focused perspective of the relevant literature describing how practitioners can structure male and female athlete preparations for performance in hot, humid conditions. Whilst scientific literature commonly describes experimental work, with a primary focus on maximizing magnitudes of adaptive responses, this may sacrifice ecological validity, particularly for athletes whom must balance logistical considerations aligned with integrating environmental preparation around training, tapering and travel plans. Additionally, opportunities for sophisticated interventions may not be possible in the constrained environment of the athlete village or event arenas. This review therefore takes knowledge gained from robust experimental work, interprets it and provides direction on how practitioners/coaches can optimize their athletes' heat alleviation strategies. This review identifies two distinct heat alleviation themes that should be considered to form an individualized strategy for the athlete to enhance thermoregulatory/performance physiology. First, chronic heat alleviation techniques are outlined, these describe interventions such as heat acclimation, which are implemented pre, during and post-training to prepare for the increased heat stress. Second, acute heat alleviation techniques that are implemented immediately prior to, and sometimes during the event are discussed. Abbreviations: CWI: Cold water immersion; HA: Heat acclimation; HR: Heart rate; HSP: Heat shock protein; HWI: Hot water immersion; LTHA: Long-term heat acclimation; MTHA: Medium-term heat acclimation; ODHA: Once-daily heat acclimation; RH: Relative humidity; RPE: Rating of perceived exertion; STHA: Short-term heat acclimation; TCORE: Core temperature; TDHA: Twice-daily heat acclimation; TS: Thermal sensation; TSKIN: Skin temperature; V̇O2max: Maximal oxygen uptake; WGBT: Wet bulb globe temperature.
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Affiliation(s)
- Oliver R. Gibson
- Centre for Human Performance, Exercise and Rehabilitation (CHPER), Division of Sport, Health and Exercise Sciences, Brunel University London, Uxbridge, UK
| | - Carl A. James
- Institut Sukan Negara (National Sports Institute), Kuala Lumpur, Malaysia
| | - Jessica A. Mee
- School of Sport and Exercise Sciences, University of Worcester, Worcester, UK
| | - Ashley G.B. Willmott
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Gareth Turner
- Bisham Abbey National High-Performance Centre, English Institute of Sport, EIS Performance Centre, Marlow, UK
| | - Mark Hayes
- Environmental Extremes Laboratory, School of Sport and Service Management, University of Brighton, Eastbourne, UK
| | - Neil S. Maxwell
- Environmental Extremes Laboratory, School of Sport and Service Management, University of Brighton, Eastbourne, UK
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17
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Kissling LS, Akerman AP, Cotter JD. Heat-induced hypervolemia: Does the mode of acclimation matter and what are the implications for performance at Tokyo 2020? Temperature (Austin) 2019; 7:129-148. [PMID: 33015241 DOI: 10.1080/23328940.2019.1653736] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Tokyo 2020 will likely be the most heat stressful Olympics to date, so preparation to mitigate the effects of humid heat will be essential for performance in several of the 33 sports. One key consideration is heat acclimation (HA); the repeated exposure to heat to elicit physiological and psychophysical adaptations that improve tolerance and exercise performance in the heat. Heat can be imposed in various ways, including exercise in the heat, hot water immersion, or passive exposure to hot air (e.g., sauna). The physical requirements of each sport will determine the impact that the heat has on performance, and the adaptations required from HA to mitigate these effects. This review focuses on one key adaptation, plasma volume expansion (PVE), and how the mode of HA may affect the kinetics of adaptation. PVE constitutes a primary HA-mediated adaptation and contributes to functional adaptations (e.g., lower heart rate and increased heat loss capacity), which may be particularly important in athletes of "sub-elite" cardiorespiratory fitness (e.g., team sports), alongside athletes of prolonged endurance events. This review: i) highlights the ability of exercise in the heat, hot-water immersion, and passive hot air to expand PV, providing the first quantitative assessment of the efficacy of different heating modes; ii) discusses how this may apply to athletes at Tokyo 2020; and iii) provides recommendations regarding the protocol of HA and the prospect for achieving PVE (and the related outcomes).
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Affiliation(s)
- Lorenz S Kissling
- The School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Ashley P Akerman
- The School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.,Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - James D Cotter
- The School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
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18
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Hermand E, Chabert C, Hue O. Ultra-endurance events in tropical environments and countermeasures to optimize performances and health. Int J Hyperthermia 2019; 36:753-760. [PMID: 31429600 DOI: 10.1080/02656736.2019.1635718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Physical performance in a tropical environment, combining high heat and humidity, is a difficult physiological challenge that requires specific preparation. The elevated humidity of a tropical climate impairs the thermoregulatory mechanisms by limiting the rate of sweat evaporation. Hence, a proper management of whole-body temperature is required to complete an ultra-endurance event in such an environment. In these long-duration events, which can last from 8 to 20 h, held in hot and humid settings, performance is tightly linked to the ability in maintaining an optimal hydration status. Indeed, the rate of withdrawal in these longer races was associated with lower water intake, and the majority of finishers exhibited alterations in electrolyte balance (e.g., sodium). Hence, this work reviews the effects on performance of high heat and humidity in two representative ultra-endurance sports, ultramarathons and long-distance triathlons, and several countermeasures to counteract the impact of these harsh environmental stresses and maintain a high level of performance, such as hydration, cooling strategies and heat acclimation.
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Affiliation(s)
- E Hermand
- Laboratory « Adaptations au Climat Tropical, Exercice et Santé » (EA 3596 ACTES), French West Indies University , Pointe-à-Pitre , France.,Laboratory « Handicap, Activité, Vieillissement, Autonomie, Environnement » (EA 6310 HAVAE), University of Limoges , Limoges , France
| | - C Chabert
- Laboratory « Adaptations au Climat Tropical, Exercice et Santé » (EA 3596 ACTES), French West Indies University , Pointe-à-Pitre , France
| | - O Hue
- Laboratory « Adaptations au Climat Tropical, Exercice et Santé » (EA 3596 ACTES), French West Indies University , Pointe-à-Pitre , France
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19
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Gastrointestinal Complaints and Correlations with Self-Reported Macronutrient Intake in Independent Groups of (Ultra)Marathon Runners Competing at Different Distances. Sports (Basel) 2019; 7:sports7060140. [PMID: 31181655 PMCID: PMC6628076 DOI: 10.3390/sports7060140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/28/2019] [Accepted: 06/04/2019] [Indexed: 01/18/2023] Open
Abstract
This study investigated the differences in gastrointestinal (GI) and exercise related complaints between groups of runners competing at different distances using web-based questionnaires. Total (severe) complaints were reported by 89.3% (49.7%) of the runners during the race vs. 70.6% (29.4%) after the race. Significant differences between groups were described for marathon (n = 98) and 60 km (n = 43) runners. During competition, runners reported the urge to urinate (47.7%), muscle cramps (43.6%) and belching (43.6%). The prevalence of bloating, flatulence, side ache and dizziness differed between distances (p < 0.02). There were small to moderate negative correlations between food and fluid intake and GI complaints. After competition (12 h), 70.6% of participants reported complaints, with muscle cramps (47.6%), flatulence (19.0%) and bloating (12.7%) being the most prevalent. Prevalence of belching, nausea, stomach cramps and muscle cramps differed between race distances (p < 0.04). There were small to high positive correlations between complaints during and after competition (p < 0.05). In conclusion, runners of all distances reported a high prevalence of GI and other exercise related complaints. There were some small differences in reporting type and severity of complaints between distances. Results showed small to strong correlations between complaints during and after competition and with nutrient intake, without a clear similar pattern for all distances.
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20
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Coudevylle GR, Sinnapah S, Robin N, Collado A, Hue O. Conventional and Alternative Strategies to Cope With the Subtropical Climate of Tokyo 2020: Impacts on Psychological Factors of Performance. Front Psychol 2019; 10:1279. [PMID: 31214085 PMCID: PMC6558207 DOI: 10.3389/fpsyg.2019.01279] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 05/15/2019] [Indexed: 12/01/2022] Open
Abstract
The thermal discomfort caused by a hot or hot-wet climate can have negative effects on human performance. The 2020 Summer Olympic and Paralympic Games will take place in Tokyo’s hot and humid summer period, possibly exposing athletes to severe environmental stressors. In addition to technical, tactical, physical and nutritional preparation, Olympians and Paralympians need an optimal psychological state to turn in their best performances, especially in terms of emotional control, concentration and motivation. Yet, the tropical climate can have many negative effects on these factors. Better understanding of the negative effects of this climate and the strategies to manage them might be crucial for competitors, coaches and their teams in Japan. At the psychological level, cooling interventions before, during and/or immediately after exercise were mainly studied on perceptual responses. However, the effects of these interventions on other psychological components such as cognitive abilities or psychological states and the use of psychological techniques have been little explored, especially in hot-wet climate. Thus, this article proposes to take stock of the knowledge on the conventional and alternative strategies that help athletes to psychologically cope with the subtropical climate of Tokyo.
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Affiliation(s)
- Guillaume R Coudevylle
- Laboratory ACTES (UPRES-EA 3596), University of the French West Indies, Pointe-à-Pitre, France
| | - Stéphane Sinnapah
- Laboratory ACTES (UPRES-EA 3596), University of the French West Indies, Pointe-à-Pitre, France
| | - Nicolas Robin
- Laboratory ACTES (UPRES-EA 3596), University of the French West Indies, Pointe-à-Pitre, France
| | - Aurélie Collado
- Laboratory ACTES (UPRES-EA 3596), University of the French West Indies, Pointe-à-Pitre, France
| | - Olivier Hue
- Laboratory ACTES (UPRES-EA 3596), University of the French West Indies, Pointe-à-Pitre, France
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21
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Kirby NV, Lucas SJE, Lucas RAI. Nine-, but Not Four-Days Heat Acclimation Improves Self-Paced Endurance Performance in Females. Front Physiol 2019; 10:539. [PMID: 31156449 PMCID: PMC6532023 DOI: 10.3389/fphys.2019.00539] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/16/2019] [Indexed: 11/13/2022] Open
Abstract
Although emerging as a cost and time efficient way to prepare for competition in the heat, recent evidence indicates that "short-term" heat acclimation (<7 days) may not be sufficient for females to adapt to repeated heat stress. Furthermore, self-paced performance following either short-term, or longer (>7 days) heat acclimation has not been examined in a female cohort. Therefore, the aim of this study was to investigate self-paced endurance performance in hot conditions following 4- and 9-days of a high-intensity isothermic heat acclimation protocol in a female cohort. Eight female endurance athletes (mean ± SD, age 27 ± 5 years, mass 61 ± 5 kg, VO2peak 47 ± 6 ml⋅kg⋅min-1) performed 15-min self-paced cycling time trials in hot conditions (35°C, 30%RH) before (HTT1), and after 4-days (HTT2), and 9-days (HTT3) isothermic heat acclimation (HA, with power output manipulated to increase and maintain rectal temperature (T rec) at ∼38.5°C for 90-min cycling in 40°C, 30%RH) with permissive dehydration. There were no significant changes in distance cycled (p = 0.47), mean power output (p = 0.55) or cycling speed (p = 0.44) following 4-days HA (i.e., from HTT1 to HTT2). Distance cycled (+3.2%, p = 0.01; +1.8%, p = 0.04), mean power output (+8.1%, p = 0.01; +4.8%, p = 0.05) and cycling speed (+3.0%, p = 0.01; +1.6%, p = 0.05) were significantly greater in HTT3 than in HTT1 and HTT2, respectively. There was an increase in the number of active sweat glands per cm2 in HTT3 as compared to HTT1 (+32%; p = 0.02) and HTT2 (+22%; p < 0.01), whereas thermal sensation immediately before HTT3 decreased ("Slightly Warm," p = 0.03) compared to ratings taken before HTT1 ("Warm") in 35°C, 30%RH. Four-days HA was insufficient to improve performance in the heat in females as observed following 9-days HA.
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Affiliation(s)
- Nathalie V. Kirby
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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22
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Costa RJS, Gaskell SK, McCubbin AJ, Snipe RMJ. Exertional-heat stress-associated gastrointestinal perturbations during Olympic sports: Management strategies for athletes preparing and competing in the 2020 Tokyo Olympic Games. Temperature (Austin) 2019; 7:58-88. [PMID: 32166105 PMCID: PMC7053925 DOI: 10.1080/23328940.2019.1597676] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/05/2019] [Accepted: 03/14/2019] [Indexed: 12/15/2022] Open
Abstract
Exercise-induced gastrointestinal syndrome (EIGS) is a common characteristic of exercise. The causes appear to be multifactorial in origin, but stem primarily from splanchnic hypoperfusion and increased sympathetic drive. These primary causes can lead to secondary outcomes that include increased intestinal epithelial injury and gastrointestinal hyperpermeability, systemic endotoxemia, and responsive cytokinemia, and impaired gastrointestinal function (i.e. transit, digestion, and absorption). Impaired gastrointestinal integrity and functional responses may predispose individuals, engaged in strenuous exercise, to gastrointestinal symptoms (GIS), and health complications of clinical significance, both of which may have exercise performance implications. There is a growing body of evidence indicating heat exposure during exercise (i.e. exertional-heat stress) can substantially exacerbate these gastrointestinal perturbations, proportionally to the magnitude of exertional-heat stress, which is of major concern for athletes preparing for and competing in the upcoming 2020 Tokyo Olympic Games. To date, various hydration and nutritional strategies have been explored to prevent or ameliorate exertional-heat stress associated gastrointestinal perturbations. The aims of the current review are to comprehensively explore the impact of exertional-heat stress on markers of EIGS, examine the evidence for the prevention and (or) management of EIGS in relation to exertional-heat stress, and establish best-practice nutritional recommendations for counteracting EIGS and associated GIS in athletes preparing for and competing in Tokyo 2020.
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Affiliation(s)
- Ricardo J S Costa
- Monash University, Department of Nutrition Dietetics and Food, Notting Hill, Victoria, Australia
| | - Stephanie K Gaskell
- Monash University, Department of Nutrition Dietetics and Food, Notting Hill, Victoria, Australia
| | - Alan J McCubbin
- Monash University, Department of Nutrition Dietetics and Food, Notting Hill, Victoria, Australia
| | - Rhiannon M J Snipe
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Science, Burwood, Victoria, Australia
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23
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Costa RJS, Camões-Costa V, Snipe RMJ, Dixon D, Russo I, Huschtscha Z. Impact of exercise-induced hypohydration on gastrointestinal integrity, function, symptoms, and systemic endotoxin and inflammatory profile. J Appl Physiol (1985) 2019; 126:1281-1291. [DOI: 10.1152/japplphysiol.01032.2018] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
It is commonly believed that gastrointestinal issues during exercise are exacerbated by hypohydration. This study aimed to determine the effect of exercise-induced hypohydration on gastrointestinal integrity, function, symptoms, and systemic endotoxin and inflammatory profiles. In a randomized crossover design, male endurance runners ( n = 11) performed 2 h of running at 70% of maximum oxygen uptake in 25°C ambient temperature with water provision [euhydration (EuH)] and total water restriction [hypohydration (HypoH)] during running, which accounted for 0.6 ± 0.6% and 3.1 ± 0.7% body mass loss, respectively. Blood and fecal samples were collected before and after exercise. Breath samples (H2 determination) were collected and gastrointestinal symptoms (GIS) recorded before, during, and after exercise. HypoH resulted in a higher, yet insignificant, ∆ preexercise to postexercise plasma cortisol concentration (+286 nmol/l vs. +176 nmol/l; P = 0.098) but significantly higher intestinal fatty acid-binding protein (I-FABP) (+539 pg/ml vs. +371 pg/ml; P = 0.047) concentration compared with EuH. A greater breath H2 response ( P = 0.026) was observed on HypoH (1,188 ppm/3 h, peak +12 ppm) vs. EuH (579 ppm/3 h, peak +6 ppm). Despite greater GIS incidence on HypoH (82%) vs. EuH (64%), GIS severity scores were not significant between trials. Exercise-induced leukocytosis (overall pre- to postexercise: 5.9 × 109/l to 12.1 × 109/l) was similar on both trials. Depressed in vitro neutrophil function was observed during recovery on HypoH (−36%) but not on EUH (+6%). A pre- to postexercise increase ( P < 0.05) was observed for circulating cytokine concentrations but not endotoxin values. Hypohydration during 2 h of running modestly perturbs gastrointestinal integrity and function and increases GIS incidence but does not affect systemic endotoxemia and cytokinemia. NEW & NOTEWORTHY Despite anecdotal beliefs that exercise-induced hypohydration exacerbates perturbations to gastrointestinal status, the present study reports only modest perturbations in gastrointestinal integrity, function, and symptoms compared with euhydration maintenance. Exercise-induced hypohydration does not exacerbate systemic endotoxemia and cytokinemia compared with euhydration maintenance. Programmed water intake to maintain euhydration results in gastrointestinal symptom severity similar to exercise-induced hypohydration. Maintaining euhydration during exertional stress prevents the exercise-associated depression in bacterially stimulated neutrophil function.
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Affiliation(s)
- Ricardo J. S. Costa
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Vera Camões-Costa
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
- The Health & Aging Research Group, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Rhiannon M. J. Snipe
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - David Dixon
- Writtle University College, Chelmsford, United Kingdom
| | - Isabella Russo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Zoya Huschtscha
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
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24
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Abstract
Ultramarathon running events and participation numbers have increased progressively over the past three decades. Besides the exertion of prolonged running with or without a loaded pack, such events are often associated with challenging topography, environmental conditions, acute transient lifestyle discomforts, and/or event-related health complications. These factors create a scenario for greater nutritional needs, while predisposing ultramarathon runners to multiple nutritional intake barriers. The current review aims to explore the physiological and nutritional demands of ultramarathon running and provide general guidance on nutritional requirements for ultramarathon training and competition, including aspects of race nutrition logistics. Research outcomes suggest that daily dietary carbohydrates (up to 12 g·kg-1·day-1) and multiple-transportable carbohydrate intake (∼90 g·hr-1 for running distances ≥3 hr) during exercise support endurance training adaptations and enhance real-time endurance performance. Whether these intake rates are tolerable during ultramarathon competition is questionable from a practical and gastrointestinal perspective. Dietary protocols, such as glycogen manipulation or low-carbohydrate high-fat diets, are currently popular among ultramarathon runners. Despite the latter dietary manipulation showing increased total fat oxidation rates during submaximal exercise, the role in enhancing ultramarathon running performance is currently not supported. Ultramarathon runners may develop varying degrees of both hypohydration and hyperhydration (with accompanying exercise-associated hyponatremia), dependent on event duration, and environmental conditions. To avoid these two extremes, euhydration can generally be maintained through "drinking to thirst." A well practiced and individualized nutrition strategy is required to optimize training and competition performance in ultramarathon running events, whether they are single stage or multistage.
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25
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Heathcote SL, Hassmén P, Zhou S, Stevens CJ. Passive Heating: Reviewing Practical Heat Acclimation Strategies for Endurance Athletes. Front Physiol 2018; 9:1851. [PMID: 30618849 PMCID: PMC6306444 DOI: 10.3389/fphys.2018.01851] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 12/07/2018] [Indexed: 11/13/2022] Open
Abstract
Heat acclimation protocols—both active and passive—have been employed by athletes in an effort to attenuate the detrimental effects of heat stress on physical capacities and sports performance. Active strategies have been extensively reviewed, but have various practical and economic limitations. The purpose of this review was therefore to provide an overview of the passive strategies that have received less attention, yet may be more practical or economically viable; recommendations for athletes are also provided. With a systematic search of the relevant databases ending in June 2018, 16 articles on passive heat acclimation that met the inclusion criteria were included in the review. The review highlighted that passive heat acclimation strategies can successfully induce heat adaptations, evident by reports of improved exercise performance, thermoregulatory, cardiovascular, and perceptual responses accompanying such interventions. Based on the review it is apparent that the use of sauna, hot-water immersion and environmental chambers may be used to provide heat stress under passive conditions, for the purpose of acclimation. To maximize the thermoregulatory-adaptive responses, exercise bouts should be employed prior to passive heat stress, rather than passive heating alone, with a minimal delay between exercise and the application of heat stress. Heating bouts should have a minimum duration of 30 min per session and be employed on consecutive days, when possible, with a minimum of 6–7 exposures to induce adaptation. This review identified that information regarding the magnitude of performance changes that can occur, as well as the perceptual responses to passive heating protocols is limited. Future research should investigate the use of passive heat exposures before and/or after repeated heat training sessions, to assess if a further boost to heat adaptation can be achieved with this strategy.
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Affiliation(s)
- Storme L Heathcote
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia.,Centre for Athlete Development, Experience & Performance, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Peter Hassmén
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
| | - Shi Zhou
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
| | - Christopher J Stevens
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia.,Centre for Athlete Development, Experience & Performance, Southern Cross University, Coffs Harbour, NSW, Australia
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26
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Alcock R, McCubbin A, Camões-Costa V, Costa RJS. Case Study: Providing Nutritional Support to an Ultraendurance Runner in Preparation for a Self-Sufficient Multistage Ultramarathon: Rationed Versus Full Energy Provisions. Wilderness Environ Med 2018; 29:508-520. [PMID: 30249353 DOI: 10.1016/j.wem.2018.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/14/2018] [Accepted: 06/13/2018] [Indexed: 01/24/2023]
Abstract
To assess the impact of rationed versus full estimated energy provisions on markers of physiological strain in response to a simulated 250 km multistage ultramarathon (MSUM), on two separate occasions, the ultraendurance runner performed a laboratory simulated MSUM, with rationed (RP: 3303±75 kcal⋅day-1) and full (FP: 7156±359 kcal⋅day-1) provisions. Total daily energy expenditure was determined using dual-method indirect calorimetry. Resting metabolic rate, iDXA, and body water were measured at baseline, day 3, and post-MSUM. Blood, urine, and feces were collected, and mood state was measured, d 1 to 5 (before and after running) to determine various physiological strain indices. Heart rate, RPE, thermal comfort, gastrointestinal symptoms, and non-protein oxidation rates were measured every 30 min during running. Data were analyzed using single-subject design analysis and interpreted using Cohen's effect size. Energy expenditure was lower on RP (6943±145 kcal⋅day-1) than FP (7486±143 kcal⋅day-1) (Cohen's δ=-3.1). More pronounced exertional strain (RPE δ=1.2, thermal conform δ=0.6, rectal temperature δ=1.0, and plasma cortisol concentration δ=1.7) was observed on RP as the MSUM progressed. Total carbohydrate and fat oxidation during running decreased (0.76 vs. 1.82 g⋅min-1; δ=-3.9) and increased (0.91 vs. 0.54 g⋅min-1; δ=3.7), respectively, more profoundly on RP as the MSUM progressed. Gastrointestinal symptoms were modestly lower in RP (δ=-0.26). Exercise-induced leukocytosis, cytokinaemia, and neutrophil responses were higher on RP. Iron status markers were trivial. Higher mood disturbance and fatigue were reported on RP. The ultraendurance runner presented greater physiological and psychophysiological disturbances, in response to a laboratory simulated MSUM, on rationed energy provisions, despite the lighter pack-weight.
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Affiliation(s)
- Rebekah Alcock
- Sports Nutrition, Australian Institute of Sport, Australian Sports Commission, Bruce, Australia (Ms Alcock)
| | - Alan McCubbin
- Department of Nutrition, Dietetics & Food, Monash University, Victoria, Australia (Mr McCubbin and Drs Camões-Costa and Costa)
| | - Vera Camões-Costa
- Department of Nutrition, Dietetics & Food, Monash University, Victoria, Australia (Mr McCubbin and Drs Camões-Costa and Costa); Health & Aging Research Group, Swinburne University of Technology, Victoria, Australia (Dr Camões-Costa)
| | - Ricardo J S Costa
- Department of Nutrition, Dietetics & Food, Monash University, Victoria, Australia (Mr McCubbin and Drs Camões-Costa and Costa).
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27
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Wardenaar FC, Hoogervorst D, Versteegen JJ, van der Burg N, Lambrechtse KJ, Bongers CCWG. Real-Time Observations of Food and Fluid Timing During a 120 km Ultramarathon. Front Nutr 2018; 5:32. [PMID: 29780808 PMCID: PMC5946582 DOI: 10.3389/fnut.2018.00032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/18/2018] [Indexed: 11/16/2022] Open
Abstract
The aim of the present case study was to use real-time observations to investigate ultramarathon runners' timing of food and fluid intake per 15 km and per hour, and total bodyweight loss due to dehydration. The study included 5 male ultramarathon runners observed during a 120 km race. The research team members followed on a bicycle and continuously observed their dietary intake using action cameras. Hourly carbohydrate intake ranged between 22.1 and 62.6 g/h, and fluid intake varied between 260 and 603 mL/h. These numbers remained relatively stable over the course of the ultra-endurance marathon. Runners consumed food and fluid on average 3–6 times per 15 km. Runners achieved a higher total carbohydrate consumption in the second half of the race (p = 0.043), but no higher fluid intake (p = 0.08). Energy gels contributed the most to the total average carbohydrate intake (40.2 ± 25.7%). Post-race weight was 3.6 ± 2.3% (range 0.3–5.7%) lower than pre-race weight, revealing a non-significant (p = 0.08) but practical relevant difference. In conclusion, runners were able to maintain a constant timing of food and fluid intake during competition but adjusted their food choices in the second half of the race. The large variation in fluid and carbohydrate intake indicate that recommendations need to be individualized to further optimize personal intakes.
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Affiliation(s)
- Floris C Wardenaar
- School of Nutrition and Health Promotion, College of Health, Arizona State University, Phoenix, AZ, United States
| | - Daan Hoogervorst
- Sports and Exercise Nutrition, Institute for Sports and Exercise, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Joline J Versteegen
- Sports and Exercise Nutrition, Institute for Sports and Exercise, HAN University of Applied Sciences, Nijmegen, Netherlands.,Global Nutrition Development, FrieslandCampina, Amersfoort, Netherlands
| | - Nancy van der Burg
- Sports and Exercise Nutrition, Institute for Sports and Exercise, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Karin J Lambrechtse
- Sports and Exercise Nutrition, Institute for Sports and Exercise, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Coen C W G Bongers
- Sports and Exercise Nutrition, Institute for Sports and Exercise, HAN University of Applied Sciences, Nijmegen, Netherlands.,Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
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28
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Minuzzi LG, Teixeira AM, Carvalho HM, Costa RJD, Rama L. DAILY HEMATOLOGIC ASSESSMENT DURING A 230-KM MULTISTAGE ULTRAMARATHON. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182403171999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
ABSTRACT Introduction: The popularity of ultra-endurance events is increasing worldwide. However, information about hematological parameters during repeated bouts of long-duration running, such as stages during a multi-stage ultramarathon (MSUM) is scarce. Objective: The purpose of the study was to monitor daily hematologic assessment in a 230-km multistage ultramarathon (MSUM) in hot environmental conditions. Methods: Eleven male and three female (n = 14) ultra-endurance runners entered this MSUM, which was conducted over five stages, covering a total distance of 230 km in hot ambient conditions. Peripheral blood samples were collected before and after each stage to determine leukocyte and erythrocytes parameters. Results: Multilevel modelling considering all measurement points showed an increase for whole blood leukocyte and granulocyte counts at five stages of the MSUM and for monocytes until Stage 3 of the race. For erythrocyte parameters, decreases across stages were observed in hemoglobin concentration and hematocrit responses when computing/considering all measurement points. Conclusions: The results indicate that MSUM in a hot environment leads to a greater impact on leukocyte population responses and platelet variation in the initial stages of the race. We suggest that athletes may have a decrease in immune function in the early stages of the MSUM, probably with some transient risk of infectious. Nevertheless, a physiological adaptation to physical exertion and heat mitigates these changes in the subsequent stages of MSUM. Level of Evidence III; Case-control study.
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29
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Snipe RM, Khoo A, Kitic CM, Gibson PR, Costa RJ. Carbohydrate and protein intake during exertional heat stress ameliorates intestinal epithelial injury and small intestine permeability. Appl Physiol Nutr Metab 2017; 42:1283-1292. [DOI: 10.1139/apnm-2017-0361] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Exertional heat stress (EHS) disturbs the integrity of the gastrointestinal tract leading to endotoxaemia and cytokinaemia, which have symptomatic and health implications. This study aimed to determine the effects of carbohydrate and protein intake during EHS on gastrointestinal integrity, symptoms, and systemic responses. Eleven (male, n = 6; female, n = 5) endurance runners completed 2 h of running at 60% maximal oxygen uptake in 35 °C ambient temperature on 3 occasions in randomised order, consuming water (WATER), 15 g glucose (GLUC), or energy-matched whey protein hydrolysate (WPH) before and every 20 min during EHS. Rectal temperature and gastrointestinal symptoms were recorded every 10 min during EHS. Blood was collected pre- and post-EHS, and during recovery to determine plasma concentrations of intestinal fatty-acid binding protein (I-FABP) as a marker of intestinal epithelial injury, cortisol, endotoxin, and inflammatory cytokines. Urinary lactulose/l-rhamnose ratio was used to measure small intestine permeability. Compared with WATER, GLUC, and WPH ameliorated EHS associated intestinal epithelial injury (I-FABP: 897 ± 478 pg·mL−1 vs. 123 ± 197 pg·mL−1 and 82 ± 156 pg·mL−1, respectively, p < 0.001) and small intestine permeability (lactulose/l-rhamnose ratio: 0.034 ± 0.014 vs. 0.017 ± 0.005 and 0.008 ± 0.002, respectively, p = 0.001). Endotoxaemia was observed post-EHS in all trials (10.2 pg·mL−1, p = 0.001). Post-EHS anti-endotoxin antibodies were higher (p < 0.01) and cortisol and interleukin-6 lower (p < 0.05) on GLUC than WATER only. Total and upper gastrointestinal symptoms were greater on WPH, compared with GLUC and WATER (p < 0.05), in response to EHS. In conclusion, carbohydrate and protein intake during EHS ameliorates intestinal injury and permeability. Carbohydrate also supports endotoxin clearance and reduces stress markers, while protein appears to increase gastrointestinal symptoms, suggesting that carbohydrate is a more appropriate option.
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Affiliation(s)
- Rhiannon M.J. Snipe
- Monash University, Department of Nutrition, Dietetics and Food, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia
| | - Anthony Khoo
- Monash University, Department of Nutrition, Dietetics and Food, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia
| | - Cecilia M. Kitic
- University of Tasmania, Sport Performance Optimisation Research Team, School of Health Sciences, Locked Bag 1322, Launceston, Tasmania 7250, Australia
| | - Peter R. Gibson
- Monash University, Department of Gastroenterology - The Alfred Hospital, 55 Commercial Road, Melbourne, 3004 Victoria, Australia
| | - Ricardo J.S. Costa
- Monash University, Department of Nutrition, Dietetics and Food, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia
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30
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Barrington JH, Chrismas BCR, Gibson OR, Tuttle J, Pegrum J, Govilkar S, Kabir C, Giannakakis N, Rayan F, Okasheh Z, Sanaullah A, Ng Man Sun S, Pearce O, Taylor L. Hypoxic Air Inhalation and Ischemia Interventions Both Elicit Preconditioning Which Attenuate Subsequent Cellular Stress In vivo Following Blood Flow Occlusion and Reperfusion. Front Physiol 2017; 8:560. [PMID: 28824456 PMCID: PMC5539087 DOI: 10.3389/fphys.2017.00560] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/18/2017] [Indexed: 12/17/2022] Open
Abstract
Ischemic preconditioning (IPC) is valid technique which elicits reductions in femoral blood flow occlusion mediated reperfusion stress (oxidative stress, Hsp gene transcripts) within the systemic blood circulation and/or skeletal muscle. It is unknown whether systemic hypoxia, evoked by hypoxic preconditioning (HPC) has efficacy in priming the heat shock protein (Hsp) system thus reducing reperfusion stress following blood flow occlusion, in the same manner as IPC. The comparison between IPC and HPC being relevant as a preconditioning strategy prior to orthopedic surgery. In an independent group design, 18 healthy men were exposed to 40 min of (1) passive whole-body HPC (FiO2 = 0.143; no ischemia. N = 6), (2) IPC (FiO2 = 0.209; four bouts of 5 min ischemia and 5 min reperfusion. n = 6), or (3) rest (FiO2 = 0.209; no ischemia. n = 6). The interventions were administered 1 h prior to 30 min of tourniquet derived femoral blood flow occlusion and were followed by 2 h subsequent reperfusion. Systemic blood samples were taken pre- and post-intervention. Systemic blood and gastrocnemius skeletal muscle samples were obtained pre-, 15 min post- (15PoT) and 120 min (120PoT) post-tourniquet deflation. To determine the cellular stress response gastrocnemius and leukocyte Hsp72 mRNA and Hsp32 mRNA gene transcripts were determined by RT-qPCR. The plasma oxidative stress response (protein carbonyl, reduced glutathione/oxidized glutathione ratio) was measured utilizing commercially available kits. In comparison to control, at 15PoT a significant difference in gastrocnemius Hsp72 mRNA was seen in HPC (−1.93-fold; p = 0.007) and IPC (−1.97-fold; p = 0.006). No significant differences were observed in gastrocnemius Hsp32 and Hsp72 mRNA, leukocyte Hsp72 and Hsp32 mRNA, or oxidative stress markers (p > 0.05) between HPC and IPC. HPC provided near identical amelioration of blood flow occlusion mediated gastrocnemius stress response (Hsp72 mRNA), compared to an established IPC protocol. This was seen independent of changes in systemic oxidative stress, which likely explains the absence of change in Hsp32 mRNA transcripts within leukocytes and the gastrocnemius. Both the established IPC and novel HPC interventions facilitate a priming of the skeletal muscle, but not leukocyte, Hsp system prior to femoral blood flow occlusion. This response demonstrates a localized tissue specific adaptation which may ameliorate reperfusion stress.
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Affiliation(s)
- James H Barrington
- Institute of Sport and Physical Activity Research, University of BedfordshireLuton, United Kingdom
| | - Bryna C R Chrismas
- Sport Science Program, College of Arts and Sciences, Qatar UniversityDoha, Qatar
| | - Oliver R Gibson
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Centre for Human Performance, Exercise and Rehabilitation, Brunel University LondonUxbridge, United Kingdom
| | - James Tuttle
- Institute of Sport and Physical Activity Research, University of BedfordshireLuton, United Kingdom
| | - J Pegrum
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - S Govilkar
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - Chindu Kabir
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - N Giannakakis
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - F Rayan
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - Z Okasheh
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - A Sanaullah
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - S Ng Man Sun
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - Oliver Pearce
- Milton Keynes University HospitalMilton Keynes, United Kingdom
| | - Lee Taylor
- ASPETAR, Athlete Health and Performance Research Centre, Qatar Orthopedic and Sports Medicine HospitalDoha, Qatar.,School of Sport, Exercise and Health Sciences. Loughborough UniversityLoughborough, United Kingdom
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31
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Miall A, Khoo A, Rauch C, Snipe RMJ, Camões-Costa VL, Gibson PR, Costa RJS. Two weeks of repetitive gut-challenge reduce exercise-associated gastrointestinal symptoms and malabsorption. Scand J Med Sci Sports 2017; 28:630-640. [DOI: 10.1111/sms.12912] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- A. Miall
- Department of Nutrition Dietetics & Food; Monash University; Notting Hill Vic. Australia
| | - A. Khoo
- Department of Nutrition Dietetics & Food; Monash University; Notting Hill Vic. Australia
| | - C. Rauch
- Department of Nutrition Dietetics & Food; Monash University; Notting Hill Vic. Australia
| | - R. M. J. Snipe
- Department of Nutrition Dietetics & Food; Monash University; Notting Hill Vic. Australia
| | - V. L. Camões-Costa
- Department of Nutrition Dietetics & Food; Monash University; Notting Hill Vic. Australia
| | - P. R. Gibson
- Department of Gastroenterology- The Alfred Hospital; Monash University; Melbourne Vic. Australia
| | - R. J. S. Costa
- Department of Nutrition Dietetics & Food; Monash University; Notting Hill Vic. Australia
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32
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Costa RJ, Miall A, Khoo A, Rauch C, Snipe R, Camões-Costa V, Gibson P. Gut-training: the impact of two weeks repetitive gut-challenge during exercise on gastrointestinal status, glucose availability, fuel kinetics, and running performance. Appl Physiol Nutr Metab 2017; 42:547-557. [DOI: 10.1139/apnm-2016-0453] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Due to gastrointestinal tract adaptability, the study aimed to determine the impact of gut-training protocol over 2 weeks on gastrointestinal status, blood glucose availability, fuel kinetics, and running performance. Endurance runners (n = 25) performed a gut-challenge trial (GC1), consisting of 2 h running exercise at 60% V̇O2maxwhilst consuming gel-discs containing 30 g carbohydrates (2:1 glucose/fructose, 10% w/v) every 20 min and a 1 h distance test. Participants were then randomly assigned to a carbohydrate gel-disc (CHO-S), carbohydrate food (CHO-F), or placebo (PLA) gut-training group for 2 weeks of repetitive gut-challenge intervention. Participants then repeated a second gut-challenge trial (GC2). Gastrointestinal symptoms reduced in GC2 on CHO-S (60%; p = 0.008) and CHO-F (63%; p = 0.046); reductions were greater than PLA (p < 0.05). H2peak was lower in GC2 on CHO-S (mean (CI): 6 (4–8) ppm) compared with CHO-F (9 (6–12) ppm) and PLA (12 (2–21) ppm) (trial × time: p < 0.001). Blood glucose concentration was higher in GC2 on CHO-S (7.2 (6.3–8.1) mmol·L−1) compared with CHO-F (6.1 (5.7–6.5) mmol·L−1) and PLA (6.2 (4.9–7.5) mmol·L−1) (trial × time: p = 0.015). No difference in oxidation rates, plasma I-FABP, and cortisol concentrations were observed between groups and trials. Distance test improved on CHO-S (5.2%) and CHO-F (4.3%) in GC2, but not on PLA (–2.1%) (trial × time: p = 0.009). Two weeks of gut-training with CHO-S and CHO-F improved gastrointestinal symptoms and running performance compared with PLA. CHO-S also reduced malabsorption and increased blood glucose availability during endurance running compared with PLA.
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Affiliation(s)
- Ricardo J.S. Costa
- Monash University, Department of Nutrition & Dietetics, Level 1, 264 Ferntree Gully road, Notting Hill, 3168 Victoria, Australia
| | - Atlanta Miall
- Monash University, Department of Nutrition & Dietetics, Level 1, 264 Ferntree Gully road, Notting Hill, 3168 Victoria, Australia
| | - Anthony Khoo
- Monash University, Department of Nutrition & Dietetics, Level 1, 264 Ferntree Gully road, Notting Hill, 3168 Victoria, Australia
| | - Christopher Rauch
- Monash University, Department of Nutrition & Dietetics, Level 1, 264 Ferntree Gully road, Notting Hill, 3168 Victoria, Australia
| | - Rhiannon Snipe
- Monash University, Department of Nutrition & Dietetics, Level 1, 264 Ferntree Gully road, Notting Hill, 3168 Victoria, Australia
| | - Vera Camões-Costa
- Monash University, Department of Nutrition & Dietetics, Level 1, 264 Ferntree Gully road, Notting Hill, 3168 Victoria, Australia
| | - Peter Gibson
- Monash University, Department of Gastroenterology-The Alfred Hospital, 55 Commercial road, Melbourne, 3004 Victoria, Australia
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Willmott AGB, Hayes M, Waldock KAM, Relf RL, Watkins ER, James CA, Gibson OR, Smeeton NJ, Richardson AJ, Watt PW, Maxwell NS. Short-term heat acclimation prior to a multi-day desert ultra-marathon improves physiological and psychological responses without compromising immune status. J Sports Sci 2016; 35:2249-2256. [PMID: 27935427 DOI: 10.1080/02640414.2016.1265142] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Multistage, ultra-endurance events in hot, humid conditions necessitate thermal adaptation, often achieved through short term heat acclimation (STHA), to improve performance by reducing thermoregulatory strain and perceptions of heat stress. This study investigated the physiological, perceptual and immunological responses to STHA prior to the Marathon des Sables. Eight athletes (age 42 ± 4 years and body mass 81.9 ± 15.0 kg) completed 4 days of controlled hyperthermia STHA (60 min·day‒1, 45°C and 30% relative humidity). Pre, during and post sessions, physiological and perceptual measures were recorded. Immunological measures were recorded pre-post sessions 1 and 4. STHA improved thermal comfort (P = 0.02), sensation (P = 0.03) and perceived exertion (P = 0.04). A dissociated relationship between perceptual fatigue and Tre was evident after STHA, with reductions in perceived Physical (P = 0.04) and General (P = 0.04) fatigue. Exercising Tre and HR did not change (P > 0.05) however, sweat rate increased 14% (P = 0.02). No changes were found in white blood cell counts or content (P > 0.05). Four days of STHA facilitates effective perceptual adaptations, without compromising immune status prior to an ultra-endurance race in heat stress. A greater physiological strain is required to confer optimal physiological adaptations.
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Affiliation(s)
- Ashley G B Willmott
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
| | - Mark Hayes
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
| | - Kirsty A M Waldock
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
| | - Rebecca L Relf
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
| | - Emily R Watkins
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
| | - Carl A James
- b National Sports Institute (Institut Sukan Negara) , National Sport Complex , Kuala Lumpur , Malaysia
| | - Oliver R Gibson
- c Centre for Human Performance, Exercise and Rehabilitation , Brunel University London , London , UK
| | - Nicholas J Smeeton
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
| | - Alan J Richardson
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
| | - Peter W Watt
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
| | - Neil S Maxwell
- a Environmental Extremes Laboratory, Centre for Sport and Exercise Science and Medicine (SESAME), Sport and Exercise Science Consultancy Unit (SESCU) , University of Brighton , Eastbourne , UK
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Mandatory Rest Stops Improve Athlete Safety during Event Medical Coverage for Ultramarathons. Prehosp Disaster Med 2016; 31:43-5. [PMID: 26750179 DOI: 10.1017/s1049023x15005555] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Provisions of medical direction and clinical services for ultramarathons require specific attention to heat illness. Heat stress can affect athlete performance negatively, and heat accumulation without acclimatization is associated with the development of exertional heat stroke (EHS). In order to potentially mitigate the risk of this safety concern, the Jungle Marathon (Para, Brazil) instituted mandatory rest periods during the first two days of this 7-day, staged, Brazilian ultramarathon. METHODS Race records were reviewed retrospectively to determine the number of runners that suffered an emergency medical complication related to heat stress and did not finish (DNF) the race. Review of records included three years before and three years after the institution of these mandatory rest periods. RESULTS A total of 326 runners competed in the Jungle Marathon during the 2008-2013 period of study. During the pre-intervention years, a total of 46 athletes (21%) DNF the full race with 25 (54.3%) cases attributed to heat-related factors. During the post-intervention years, a total of 26 athletes (24.3%) DNF the full race with four (15.4%) cases attributed to heat-related factors. CONCLUSION Mandatory rest stops during extreme running events in hot or tropical environments, like the Jungle Marathon, are likely to improve athlete safety and improve the heat acclimatization process.
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Willmott AGB, Gibson OR, Hayes M, Maxwell NS. The effects of single versus twice daily short term heat acclimation on heat strain and 3000m running performance in hot, humid conditions. J Therm Biol 2016; 56:59-67. [PMID: 26857978 DOI: 10.1016/j.jtherbio.2016.01.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/04/2016] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
Abstract
Endurance performances are impaired under conditions of elevated heat stress. Short term heat acclimation (STHA) over 4-6 days can evoke rapid adaptation, which mitigate decrements in performance and alleviate heat strain. This study investigated the efficacy of twice daily heat acclimation (TDHA) compared to single session per day heat acclimation (SDHA) and normothermic training, at inducing heat acclimation phenotype and its impact upon running performance in hot, humid conditions. Twenty one, moderately trained males were matched and assigned to three groups; SDHA (mean±SD) (peak oxygen consumption [V̇O2peak] 45.8±6.1mLkg(-1)min(-1), body mass 81.3±16.0kg, stature 182±3cm), TDHA (46.1±7.0mLkg(-1)min(-1), 80.1±11.9kg, 178±4cm) or control (CON) (47.1±3.5mLkg(-1)min(-1), 78.6±16.7kg, 178±4cm). Interventions consisted of 45min cycling at 50% V̇O2peak, once daily for 4d (SDHA) and twice daily for 2d (TDHA), in 35°C, 60% relative humidity (RH), and once daily for 4 days (CON) in 21°C, 40% RH. Participants completed a pre- and post-intervention 5km treadmill run trial in 30°C, 60% RH, where the first 2km were fixed at 40% V̇O2peak and the final 3km was self-paced. No statistically significant interaction effects occurred within- or between-groups over the 2-4 days intervention. While within-group differences were found in physiological and perceptual measures during the fixed intensity trial post-intervention, they did not statistically differ between-groups. Similarly, TDHA (-36±34s [+3.5%]) and SDHA (-26±28s [+2.8%]) groups improved 3km performances (p=0.35), but did not differ from CON (-6±44s [+0.6%]). This is the first study to investigate the effects of HA twice daily and compare it with traditional single session per day STHA. These STHA protocols may have the ability to induce partial adaptive responses to heat stress and possibly enhance performance in environmentally challenging conditions, however, future development is warranted to optimise the administration to provide a potent stimuli for heat adaptation in athletic and military personnel within a rapid regime.
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Affiliation(s)
- A G B Willmott
- Centre of Sport and Exercise Science and Medicine (SESAME), Environmental Extremes Laboratory, School of Sport and Service Management, University of Brighton, Eastbourne, UK.
| | - O R Gibson
- Centre of Sport and Exercise Science and Medicine (SESAME), Environmental Extremes Laboratory, School of Sport and Service Management, University of Brighton, Eastbourne, UK; Centre for Sports Medicine and Human Performance (CSMHP), Brunel University, London, UK
| | - M Hayes
- Centre of Sport and Exercise Science and Medicine (SESAME), Environmental Extremes Laboratory, School of Sport and Service Management, University of Brighton, Eastbourne, UK
| | - N S Maxwell
- Centre of Sport and Exercise Science and Medicine (SESAME), Environmental Extremes Laboratory, School of Sport and Service Management, University of Brighton, Eastbourne, UK
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Costa RJS, Snipe R, Camões-Costa V, Scheer V, Murray A. The Impact of Gastrointestinal Symptoms and Dermatological Injuries on Nutritional Intake and Hydration Status During Ultramarathon Events. SPORTS MEDICINE-OPEN 2016; 2:16. [PMID: 26767151 PMCID: PMC4701764 DOI: 10.1186/s40798-015-0041-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 12/21/2015] [Indexed: 12/05/2022]
Abstract
Background Debilitating gastrointestinal symptoms (GIS) and dermatological injuries (DI) are common during and after endurance events and have been linked to performance decrements, event withdrawal, and issues requiring medical attention. The study aimed to determine whether GIS and DI affect food and fluid intake, and nutritional and hydration status, of ultramarathon runners during multi-stage (MSUM) and 24-h continuous (24 h) ultramarathons. Methods Ad libitum food and fluid intakes of ultramarathon runners (MSUM n = 54; 24 h n = 22) were recorded throughout both events and analysed by dietary analysis software. Body mass and urinary ketones were determined, and blood samples were taken, before and immediately after running. A medical log was used to monitor symptoms and injuries throughout both events. Results GIS were reported by 85 and 73 % of ultramarathon runners throughout MSUM and 24 h, respectively. GIS during MSUM were associated with reduced total daily, during, and post-stage energy and macronutrient intakes (p < 0.05), whereas GIS during 24 h did not alter nutritional variables. Throughout the MSUM 89 % of ultramarathon runners reported DI. DI during MSUM were associated with reduced carbohydrate (p < 0.05) intake during running and protein intake post-stage (p < 0.05). DI during 24 h were low; thus, comparative analyses were not possible. Daily, during running, and post-stage energy, macronutrient and water intake variables were observed to be lower with severity of GIS and DI (p < 0.05) throughout the MSUM only. Conclusions GIS during the MSUM, but not the 24 h, compromised nutritional intake. DI presence and severity also compromised nutrient intake during running and recovery in the MSUM.
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Affiliation(s)
- Ricardo J S Costa
- Department of Nutrition & Dietetics, Monash University, Notting Hill, Victoria Australia
| | - Rhiannon Snipe
- Department of Nutrition & Dietetics, Monash University, Notting Hill, Victoria Australia
| | - Vera Camões-Costa
- Department of Nutrition & Dietetics, Monash University, Notting Hill, Victoria Australia
| | - Volker Scheer
- British Forces Germany Health Services, Paderborn, Germany
| | - Andrew Murray
- Centre of Sports & Exercise, Edinburgh University, Edinburgh, UK
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Perturbed energy balance and hydration status in ultra-endurance runners during a 24 h ultra-marathon. Br J Nutr 2014; 112:428-37. [PMID: 24818799 DOI: 10.1017/s0007114514000907] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The present study aimed to assess the adequacy of energy, macronutrients and water intakes of ultra-endurance runners (UER) competing in a 24 h ultra-marathon (distance range: 122-208 km). The ad libitum food and fluid intakes of the UER (n 25) were recorded throughout the competition and analysed using dietary analysis software. Body mass (BM), urinary ketone presence, plasma osmolality (POsmol) and volume change were determined at pre- and post-competition time points. Data were analysed using appropriate t tests, with significance set at P <0·05. The total energy intake and expenditure of the UER were 20 (sd 12) and 55 (sd 11) MJ, respectively (control (CON) (n 17): 12 (sd 1) and 14 (sd 5) MJ, respectively). The protein, carbohydrate and fat intakes of the UER were 1·1 (sd 0·4), 11·3 (sd 7·0) and 1·5 (sd 0·7) g/kg BM, respectively. The rate of carbohydrate intake during the competition was 37 (sd 24) g/h. The total water intake of the UER was 9·1 (sd 4·0) litres (CON: 2·1 (sd 1·0) litres), while the rate of water intake was 378 (sd 164) ml/h. Significant BM loss occurred at pre- to post-competition time points (P =0·001) in the UER (1·6 (sd 2·0) %). No significant changes in POsmol values were observed at pre- (285 (sd 11) mOsmol/kg) to post-competition (287 (sd 10) mOsmol/kg) time points in the UER and were lower than those recorded in the CON group (P <0·05). However, plasma volume (PV) increased at post-competition time points in the UER (10·2 (sd 9·7) %; P <0·001). Urinary ketones were evident in the post-competition samples of 90 % of the UER. Energy deficit was observed in all the UER, with only one UER achieving the benchmark recommendations for carbohydrate intake during endurance exercise. Despite the relatively low water intake rates recorded in the UER, hypohydration does not appear to be an issue, considering increases in PV values observed in the majority (80 %) of the UER. Population-specific dietary recommendations may be beneficial and warranted.
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Water and sodium intake habits and status of ultra-endurance runners during a multi-stage ultra-marathon conducted in a hot ambient environment: an observational field based study. Nutr J 2013; 12:13. [PMID: 23320854 PMCID: PMC3554439 DOI: 10.1186/1475-2891-12-13] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Accepted: 01/11/2013] [Indexed: 12/14/2022] Open
Abstract
Background Anecdotal evidence suggests ultra-runners may not be consuming sufficient water through foods and fluids to maintenance euhydration, and present sub-optimal sodium intakes, throughout multi-stage ultra-marathon (MSUM) competitions in the heat. Subsequently, the aims were primarily to assess water and sodium intake habits of recreational ultra-runners during a five stage 225 km semi self-sufficient MSUM conducted in a hot ambient environment (Tmax range: 32°C to 40°C); simultaneously to monitor serum sodium concentration, and hydration status using multiple hydration assessment techniques. Methods Total daily, pre-stage, during running, and post-stage water and sodium ingestion of ultra-endurance runners (UER, n = 74) and control (CON, n = 12) through foods and fluids were recorded on Stages 1 to 4 by trained dietetic researchers using dietary recall interview technique, and analysed through dietary analysis software. Body mass (BM), hydration status, and serum sodium concentration were determined pre- and post-Stages 1 to 5. Results Water (overall mean (SD): total daily 7.7 (1.5) L/day, during running 732 (183) ml/h) and sodium (total daily 3.9 (1.3) g/day, during running 270 (151) mg/L) ingestion did not differ between stages in UER (p < 0.001 vs. CON). Exercise-induced BM loss was 2.4 (1.2)% (p < 0.001). Pre- to post-stage BM gains were observed in 26% of UER along competition. Pre- and post-stage plasma osmolality remained within normal clinical reference range (280 to 303 mOsmol/kg) in the majority of UER (p > 0.05 vs. CON pre-stage). Asymptomatic hyponatraemia (<135 mmol/L) was evident pre- and post-stage in n = 8 UER, corresponding to 42% of sampled participants. Pre- and post-stage urine colour, urine osmolality and urine/plasma osmolality ratio increased (p < 0.001) as competition progressed in UER, with no change in CON. Plasma volume and extra-cellular water increased (p < 0.001) 22.8% and 9.2%, respectively, from pre-Stage 1 to 5 in UER, with no change in CON. Conclusion Water intake habits of ultra-runners during MSUM conducted in hot ambient conditions appear to be sufficient to maintain baseline euhydration levels. However, fluid over-consumption behaviours were evident along competition, irrespective of running speed and gender. Normonatraemia was observed in the majority of ultra-runners throughout MSUM, despite sodium ingestion under benchmark recommendations.
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