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Roger R, Kinch R, Morris M, Grebenik P. Changes in submaximal and maximal measures of cardio-respiratory fitness resulting from 6-days of mountain walking. J Sports Sci 2022; 40:2353-2358. [PMID: 36581606 DOI: 10.1080/02640414.2022.2150387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Trekking is a popular activity associated with cardiovascular benefits. The aim of the present study was to investigate changes in the submaximal heart rate, oxygen uptake, oxygen pulse, and blood lactate concentration associated with a 6-day mountain walk. Over a 12-year period, 134 male (age 21.0 ± 1.4 years) and 124 female undergraduates (age 20.8 ± 1.6 years) participated. Three days before the trek submaximal and maximal laboratory measures were made on participants walking on a motorized treadmill using a breath-by-breath system to measure oxygen uptake (VO2) during exercise. Oxygen uptake and heart rate were recorded during steady-state exercise at treadmill gradients 0, 4, 8, 12, and 16%. Measurements were made, at the same time of day, two days after the trek. There were significant improvements in both the walking economy and the relative exercise intensity (%VO2max) at submaximal treadmill gradients 0-16%. Post-trek, heart rate was lower while oxygen pulse was higher, at each treadmill gradient. There was a significant increase in the maximal oxygen uptake for men (+2.7%) and women (+2.9%). The results of the present study suggest that improvements in cardiorespiratory fitness are associated with a 6-day mountain walk with no sex difference in the exercise response. .
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Affiliation(s)
- Ramsbottom Roger
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Rhodri Kinch
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Martyn Morris
- School of Life Sciences, Coventry University, Coventry, UK
| | - Peter Grebenik
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Energy Deficiency During Cold Weather Mountain Training in NSW SEAL Qualification Students. Int J Sport Nutr Exerc Metab 2019; 29:315-321. [DOI: 10.1123/ijsnem.2018-0041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Procter E, Brugger H, Burtscher M. Accidental hypothermia in recreational activities in the mountains: A narrative review. Scand J Med Sci Sports 2018; 28:2464-2472. [PMID: 30203539 DOI: 10.1111/sms.13294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 01/16/2023]
Abstract
The popularity of recreational activities in the mountains worldwide has led to an increase in the total number of persons exposed to cold and extreme environments through recreation. There is little conclusive evidence about the risk of hypothermia for specific activities or populations, nor is it clear which activities are represented in the literature. This is a non-systematic review of accidental hypothermia in different recreational activities in the mountains, with a specific focus on outdoor or winter activities that potentially involve cold exposure. Cases of hypothermia have been reported in the literature in mountaineering, trekking, hiking, skiing, activities performed in the backcountry, ultra-endurance events, and databases from search and rescue services that include various types of recreation. Of these activities, hypothermia as a primary illness occurs most commonly during mountaineering in the highest elevation areas in the world and during recreation practiced in more northern or remote areas. Hypothermia in skiers, snowboarders, and glacier-based activities is most often associated with accidents occurring off-piste or in the backcountry (crevasse, avalanche). Organizers of outdoor events also have a role in reducing the incidence of hypothermia through medical screening and other preparedness measures. More complete collection and reporting of data on mild hypothermia and temperature measurement would improve our understanding of the incidence of hypothermia in outdoor recreation in future.
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Affiliation(s)
- Emily Procter
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bozen/Bolzano, Italy
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Austrian Society for Alpine and Mountain Medicine, Innsbruck, Austria
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Waldron M, Waldron L, Lawlor C, Gray A, Highton J. Beetroot supplementation improves the physiological responses to incline walking. Eur J Appl Physiol 2018; 118:1131-1141. [PMID: 29546639 DOI: 10.1007/s00421-018-3843-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/08/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE We investigated the effects of an acute 24-h nitrate-rich beetroot juice supplement (BR) on the energy cost, exercise efficiency and blood pressure responses to intermittent walking at different gradients. METHODS In a double-blind, cross-over design, eight participants were provided with a total of 350 ml of nitrate-rich (~ 20.5 mmol nitrate) BR or placebo (PLA) across 24 h before completing intermittent walking at 3 km/h on treadmill at gradients of 1, 5, 10, 15 and 20%. RESULTS Resting mean arterial pressure (MAP) was ~ 4.1% lower after BR (93 vs. 89 mmHg; P = 0.001), as well as during exercise (102 vs. 99 mmHg; P = 0.011) and recovery (97 vs. 94 mmHg; P = 0.001). Exercising (1227 vs. 1129 ml/min P < 0.001) and end-stage (1404 vs. 1249 ml/min; P = 0.002) oxygen uptake ([Formula: see text]O2) was lower in BR compared to PLA, which was accompanied by an average reduction in phase II [Formula: see text]O2 amplitude (1067 vs. 940 ml/min; P = 0.025). Similarly, recovery [Formula: see text]O2 (509 vs. 458 ml/min; P = 0.001) was lower in BR. Whole blood potassium concentration increased from pre-post exercise in PLA (4.1 ± 0.3 vs. 4.5 ± 0.3 mmol/L; P = 0.013) but not BR (4.1 ± 0.31 vs. 4.3 ± 0.2 mmol/L; P = 0.188). CONCLUSIONS Energy cost of exercise, recovery of [Formula: see text]O2, MAP and blood markers were ameliorated after BR. Previously-reported mechanisms explain these findings, which are more noticeable during less-efficient walking at steep gradients (15-20%). These findings have practical implications for hill-walkers.
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Affiliation(s)
- Mark Waldron
- School of Sport, Health and Applied Science, St Mary's University, Waldegrave Road, Twickenham, London, TW1 4SX, UK. .,School of Science and Technology, University of New England, Armidale, NSW, 2350, Australia.
| | - Luke Waldron
- Medical Education Centre, Royal Cornwall Hospitals NHS Trust, Truro, TR1 3LJ, UK
| | - Craig Lawlor
- School of Science and Technology, University of New England, Armidale, NSW, 2350, Australia
| | - Adrian Gray
- School of Science and Technology, University of New England, Armidale, NSW, 2350, Australia
| | - Jamie Highton
- Department of Sports and Exercise Sciences, University of Chester, Parkgate Road, Chester, CH14BJ, UK
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MEDEX2015: Greater Sea-Level Fitness Is Associated with Lower Sense of Effort During Himalayan Trekking Without Worse Acute Mountain Sickness. High Alt Med Biol 2017; 18:152-162. [DOI: 10.1089/ham.2016.0088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Park SK, Yang DJ, Kang YH, Kim JH, Uhm YH, Lee YS. Effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force. J Phys Ther Sci 2015; 27:2891-3. [PMID: 26504319 PMCID: PMC4616120 DOI: 10.1589/jpts.27.2891] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 06/15/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of Nordic walking and
walking on spatiotemporal gait parameters and ground reaction force. [Subjects] The
subjects of this study were 30 young adult males, who were divided into a Nordic walking
group of 15 subjects and a walking group of 15 subjects. [Methods] To analyze the
spatiotemporal parameters and ground reaction force during walking in the two groups, the
six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12
meters using the more comfortable walking method for them between Nordic walking and
walking. After they walked 12 meters more than 10 times, their most natural walking
patterns were chosen three times and analyzed. To determine the pole for Nordic walking,
each subject’s height was multiplied by 0.68. We then measured the spatiotemporal gait
parameters and ground reaction force. [Results] Compared with the walking group, the
Nordic walking group showed an increase in cadence, stride length, and step length, and a
decrease in stride time, step time, and vertical ground reaction force. [Conclusion] The
results of this study indicate that Nordic walking increases the stride and can be
considered as helping patients with diseases affecting their gait. This demonstrates that
Nordic walking is more effective in improving functional capabilities by promoting
effective energy use and reducing the lower limb load, because the weight of the upper and
lower limbs is dispersed during Nordic walking.
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Affiliation(s)
- Seung Kyu Park
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Dae Jung Yang
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Yang Hun Kang
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Je Ho Kim
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Yo Han Uhm
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Yong Seon Lee
- Department of Physical Therapy, Mokpo Won-Kwang Oriental Hospital, Republic of Korea
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Stuempfle KJ, Nindl BC, Kamimori GH. Stress Hormone Responses to an Ultraendurance Race in the Cold. Wilderness Environ Med 2010; 21:22-7. [DOI: 10.1016/j.wem.2009.12.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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8
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Kramer PA. The effect on energy expenditure of walking on gradients or carrying burdens. Am J Hum Biol 2010; 22:497-507. [DOI: 10.1002/ajhb.21027] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Young AJ, Castellani JW. Exertional fatigue and cold exposure: mechanisms of hiker's hypothermia. Appl Physiol Nutr Metab 2007; 32:793-8. [PMID: 17622297 DOI: 10.1139/h07-041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Participants in prolonged, physically demanding activities in cold weather are at risk of a condition known as “hiker's hypothermia”. During exposure to cold weather, the increased gradient favoring body heat loss to the environment must be balanced by physiological responses, clothing, and behavioral strategies that conserve body heat stores, or else body temperature will decline. The primary human physiological responses elicited by cold exposure are shivering and peripheral vasoconstriction. Shivering increases thermogenesis and replaces body heat losses, while peripheral vasoconstriction improves thermal insulation of the body and retards the rate of heat loss. A body of scientific literature supports the concept that prolonged and (or) repeated cold exposure, fatigue induced by sustained physical exertion, or both together can impair shivering and vasoconstrictor response to cold. The mechanisms accounting for this thermoregulatory impairment are not clear, but the possibility that changes in blood glucose availability or sympathetic responsiveness to cold due to exertion and fatigue merit further research.
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Affiliation(s)
- Andrew J Young
- US Army Research Institute of Environmental Medicine, Kansas St., Natick, MA 01760-5007, USA.
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Hoyt RW, Opstad PK, Haugen AH, DeLany JP, Cymerman A, Friedl KE. Negative energy balance in male and female rangers: effects of 7 d of sustained exercise and food deprivation. Am J Clin Nutr 2006; 83:1068-75. [PMID: 16685048 DOI: 10.1093/ajcn/83.5.1068] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A challenging 7-d ranger field exercise (FEX) by cadets in the Norwegian Military Academy provided a venue in which to study the effects of negative energy balance. OBJECTIVE We quantified total energy expenditure (TEE), food intake, and changes in body composition in male and female cadets. DESIGN TEE (measured by doubly labeled water), food intake, activity patterns (measured by accelerometry), and body composition (measured by dual-energy X-ray absorptiometry) were measured in 16 cadets (10 men and 6 women aged 21-27 y). RESULTS The physically active (approximately 23 h/d) and semistarved (0.2-2.2 MJ/d) cadets lost weight (x +/- SD: men, -7.7 +/- 1.1 kg; women, -5.9 +/- 1.1 kg; P < 0.05). Absolute TEE differed by sex (men, 26.6 +/- 2.0 MJ/d; women, 21.9 +/- 2.0 MJ/d; P < 0.05) but body weight-specific TEE did not (men, 343 +/- 26 kJ . kg(-1) . d(-1); women, 354 +/- 18 kJ . kg(-1) . d(-1); NS). Fat-free mass (FFM) loss differed significantly by sex (men, -4.0 +/- 1.2 kg; women, -2.5 +/- 1.1 kg; P < 0.05), but percentage FFM loss did not (men, -6.3 +/- 1.9%; women, -5.6 +/- 2.4%). In contrast, absolute FM loss did not differ significantly by sex (men, -3.45 +/- 0.72 kg; women, -3.42 +/- 0.22 kg), but fat oxidation (men, 5.2 +/- 1.0 mg . min(-1) . kg FFM(-1); women, 7.3 +/- 0.5 mg . min(-1) . kg FFM(-1)) and the relative contribution of FM to TEE (men, 74 +/- 14%; women, 89 +/- 6%) were significantly greater in women than in men (P < 0.05). CONCLUSION Female cadets maintained a significantly more fat-predominant fuel metabolism than did male cadets in response to sustained exercise and semistarvation.
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Affiliation(s)
- Reed W Hoyt
- US Army Research Institute of Environmental Medicine, Natick, MA 01760-5007, USA.
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Ainslie PN, Campbell IT, Lambert JP, MacLaren DPM, Reilly T. Physiological and Metabolic Aspects of Very Prolonged Exercise with Particular Reference to Hill Walking. Sports Med 2005; 35:619-47. [PMID: 16026174 DOI: 10.2165/00007256-200535070-00006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Hill walking is a popular recreational activity in the developed world, yet it has the potential to impose severe stress simultaneously upon several regulatory systems. Information regarding the physiological strain imposed by prolonged walking outdoors in adverse climatic conditions was reported almost four decades ago and recent research has extended some of this work. These data indicate that once the walker fatigues and starts to slow or stops walking altogether, the rate of heat production falls dramatically. This decrease alone predisposes to the development of hypothermia. These processes, in adverse weather conditions and/or during periods when the level of exertion is low (with low heat production), will be accelerated. Since the majority of walkers pursue this activity in groups, the less fit walkers may be more susceptible to fatigue when exercising at a higher relative intensity compared with their fitter counterparts. The best physiological offset for hypothermia is to maintain heat production by means of exercise, and so fatigue becomes a critical predisposing factor; it is as important to facilitate heat loss, especially during periods of high exertion, as it is to maintain heat production and preserve insulation. This can be partly achieved by clothing adjustments and consideration of the intensity of exercise. Failure to provide adequate energy intake during hill walking activities has been associated with decreased performance (particularly with respect to balance) and impaired thermoregulation. Such impairments may increase susceptibly to both fatigue and injury whilst pursuing this form of activity outdoors. The prolonged low to moderate intensity of activity experienced during a typical hill walk elicits marked changes in the metabolic and hormonal milieu. Available data suggest that during hill walking, even during periods of acute negative energy balance, blood glucose concentrations are maintained. The maintenance of blood glucose concentrations seems to reflect the presence of an alternative fuel source, a hormonally induced increase in fat mobilisation. Such enhancement of fat mobilisation should make it easier to maintain blood glucose by decreasing carbohydrate oxidation and promoting gluconeogenesis, thus sparing glucose utilisation by active muscle. During strenuous hill walking, older age walkers may be particularly prone to dehydration and decreased physical and mental performance, when compared with their younger counterparts. In summary, high rates of energy expenditure and hypohydration are likely to be closely linked to the activity. Periods of adverse weather, low energy intake, lowered fitness or increased age, can all increase the participants' susceptibility to injury, fatigue and hypothermia in the mountainous environment.
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Affiliation(s)
- Philip N Ainslie
- Department of Physiology and Biophysics, University of Calgary, Faculty of Medicine, Calgary, Canada.
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Ainslie PN, Campbell IT, Frayn KN, Humphreys SM, MacLaren DPM, Reilly T. Physiological, metabolic, and performance implications of a prolonged hill walk: influence of energy intake. J Appl Physiol (1985) 2003; 94:1075-83. [PMID: 12571136 DOI: 10.1152/japplphysiol.00683.2002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We aimed to examine the effects of different energy intakes on a range of responses that are relevant to the safety of hill walkers. In a balanced design, 16 men completed a strenuous self-paced mountainous hill walk over 21 km, under either a low-energy (2.6 MJ; 616 kcal) intake (LEI) or high-energy (12.7 MJ; 3,019 kcal) intake (HEI) condition. During the hill walk, rectal temperatures were measured continuously, and blood samples for the analysis of metabolites and hormones were drawn before breakfast and immediately after the walk. Subjects also completed a battery of performance tests that included muscular strength, reaction times, flexibility, balance, and kinesthetic differentiation tests. During the LEI, mean blood glucose concentrations leveled off at the low-middle range of normoglycemia, whereas, on the HEI, they were significantly elevated compared with the LEI. The maintained blood glucose concentrations, during the LEI, were probably mediated via the marked fat mobilization, reflected by a two- to fivefold increase in nonesterified fatty acids, 3-hydroxybutyrate, and glycerol concentrations. The LEI group showed significantly slower one- and two-finger reaction time, had an impaired ability to balance, and were compromised in their ability to maintain body temperature, when compared with the HEI group. The modestly impaired performance (particularly with respect to balance) and thermoregulation during the LEI condition may increase susceptibility to both fatigue and injury during the pursuit of recreational activity outdoors.
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Affiliation(s)
- Philip N Ainslie
- Department of Physiology and Biophysics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1.
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Ainslie PN, Campbell IT, Frayn KN, Humphreys SM, MacLaren DPM, Reilly T, Westerterp KR. Energy balance, metabolism, hydration, and performance during strenuous hill walking: the effect of age. J Appl Physiol (1985) 2002; 93:714-23. [PMID: 12133883 DOI: 10.1152/japplphysiol.01249.2001] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We aimed to examine the effect of age on energy balance, metabolism, hydration, and performance during 10 days of strenuous hill walking. Seventeen male subjects were divided into two groups according to their age. The nine subjects in group 1 constituted the younger group (age 24 +/- 3 yr), whereas eight older subjects were in group 2 (age 56 +/- 3 yr). Both groups completed 10 consecutive days of high-intensity hill walking. Mean (range) daily walking distances and ascent were 21 km (10-35 km) and 1,160 m (800-2,540 m), respectively. Energy intake was calculated from weighed food intake, and energy expenditure was measured by the doubly labeled water method. Blood and urine were sampled on alternative days to determine any changes in metabolism and hydration during the 10 days. Subjects also completed a battery of tests that included muscular strength (handgrip), jump performance, cognitive processing time, and flexibility. The younger group remained hydrated, whereas the older group became progressively dehydrated, indicated by a near twofold increase in urine osmolality concentration on day 11. This increased urine osmolality in the older group was highly correlated with impairment in vertical-jump performance (r = -0.86; P < 0.05) and decreased cognitive processing time (r = 0.79; P < 0.05). Despite energy expenditure of approximately 21 MJ/day, body mass was well maintained in both groups. Both groups displayed a marked increase in fat mobilization, reflected in significantly lowered prewalk insulin concentrations and elevated postwalk glycerol and nonesterified fatty acid concentrations. Despite the dehydration and impaired performance in the older group, blood glucose concentrations were well maintained in both groups, probably mediated via the increased mobilization of fat.
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Affiliation(s)
- P N Ainslie
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 2ET, United Kingdom.
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Ainslie PN, Abbas K, Campbell IT, Frayn KN, Harvie M, Keegan MA, MacLaren DPM, Macdonald IA, Paramesh K, Reilly T. Metabolic and appetite responses to prolonged walking under three isoenergetic diets. J Appl Physiol (1985) 2002; 92:2061-70. [PMID: 11960958 DOI: 10.1152/japplphysiol.01049.2001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The effects of three isoenergetic diets on metabolic and appetite responses to prolonged intermittent walking were investigated. Eight men undertook three 450-min walks at intensities varying between 25-30 and 50-55% of maximal O2 uptake. In a balanced design, the subjects were given breakfast, snacks, and lunch containing total carbohydrate (CHO), protein (P), and fat (F) in the following amounts (g/70 kg body mass): mixed diet, 302 CHO, 50 P, 84 F; high-CHO diet, 438 CHO, 46 P, 35 F; high-fat diet, 63 CHO, 44 P, 196 F. Substrate balance was calculated by indirect calorimetry over the 450-min exercise period. Blood samples were taken before exercise and every 45 min during the exercise period. The high-fat diet resulted in a negative total CHO balance (-140 +/- 1 g) and a lower negative fat balance (-110 +/- 33 g) than the other two diets (P < 0.05). Plasma glucagon, nonesterified fatty acids, glycerol, and 3-hydroxybutyrate were higher with the high-fat diet (P < 0.05 vs. high CHO), whereas plasma insulin was lower after high fat (P < 0.05 vs. mixed and high CHO). Subjective ratings of fatigue and appetite showed no differences between the three trials. Although diet influenced the degree of total CHO and fat oxidation, fat was the main source of energy in all trials.
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Affiliation(s)
- P N Ainslie
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, L3 2ET, United Kingdom.
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