Skeletal muscle adaptation: training twice every second day vs. training once daily

An Opinion on the Interpretation of Bone Turnover Markers Following Acute Exercise or Nutrition Intervention and Considerations for Applied Research

It is important for athlete and public health that we continue to develop our understanding of the effects of exercise and nutrition on bone health. Bone turnover markers (BTMs) offer an opportunity to accelerate the progression of bone research by revealing a bone response to exercise and nutrition stimuli far more rapidly than current bone imaging techniques. However, the association between short-term change in the concentration of BTMs and long-term bone health remains ambiguous. Several other limitations also complicate the translation of acute BTM data to applied practice. Importantly, several incongruencies exist between the effects of exercise and nutrition stimuli on short-term change in BTM concentration compared with long-term bone structural outcomes to similar stimuli. There are many potential explanations for these inconsistencies, including that short-term study designs fail to encompass a full remodeling cycle. The current article presents the opinion that data from relatively acute studies measuring BTMs may not be able to reliably inform applied practice aiming to optimize bone health. There are important factors to consider when interpreting or translating BTM data and these are discussed.

Reliability of Anaerobic Contributions during a Single Exhaustive Knee-extensor Exercise

The total anaerobic contribution (AC[La-]+PCr) is a valid and reliable methodology. However, the active muscle mass plays an important role in the AC[La-]+PCr determination, which might influence its reliability. Thus, this study aimed to investigate the effects of two exhaustive intensities on the reliability of the AC[La-]+PCr during a one-legged knee extension (1L-KE) exercise. Thirteen physically active males were submitted to a graded exercise to determine the peak power output (PPO) in the 1L-KE. Then, two constant-load exercises were conducted to task failure at 100% (TTF100) and 110% (TTF110) of PPO, and the exercises were repeated on a third day. The blood lactate accumulation and the oxygen uptake after exercise were used to estimate the anaerobic lactic and alactic contributions, respectively. Higher values of AC[La-]+PCr were found after the TTF100 compared to TTF110 (p=0.042). In addition, no significant differences (p=0.432), low systematic error (80.9 mL), and a significant ICC (0.71; p=0.004) were found for AC[La-]+PCr in the TTF100. However, an elevated coefficient of variation was found (13.7%). In conclusion, we suggest the use of the exhaustive efforts performed at 100% of the PPO with the 1L-KE model, but its elevated individual variability must be carefully considered in future studies.

The effect of pre-exercise protein intake on substrate metabolism, energy expenditure, and energy intake: a dose-response study

BACKGROUND

Pre-exercise protein consumption does not seem to influence substrate metabolism during exercise compared to fasted exercise, however it is unclear if the protein dose impacts on this effect.

METHODS

In a randomized, double-blinded within-subject design trial, healthy, active males and females (n = 15, 25 ± 5 yrs, O2peak: 47.5 ± 8.8 ml/kg/min) completed 1 h of cycling exercise at 60% peak power output 30 min after having consumed either 0, 20, or 40 g of whey protein. Indirect calorimetry was used to measure substrate oxidation during exercise and baseline and post-exercise resting energy expenditure. Blood samples were taken throughout the trials to measure metabolic responses. Free-living food intake post-trial was collected using food diaries.

RESULTS

Fat oxidation rates during exercise did not differ between the three conditions (p = 0.19) with small effect sizes between conditions (Cohen's dz: 0 vs. 20 g = 0.22, 0 vs. 40 g = 0.47, 20 vs. 40 g = 0.27). Serum insulin was higher in the protein groups vs. 0 g (p < 0.05), whereas non-esterified fatty acids were higher in the 0 g compared to 20 and 40 g (p < 0.05). Glucose was significantly lower after 15 min of exercise in 20 and 40 g vs. 0 g (p = 0.01). Resting energy expenditure was elevated post-exercise (p < 0.001), without an interaction for protein dose (p = 0.90). Post-trial free-living energy intake was not different between conditions (p = 0.31), but 24-h energy intake was significantly higher in 40 vs. 0 g (p = 0.04).

CONCLUSION

Protein doses up to 40 g do not seem to impair fat oxidation rates during exercise compared to fasted exercise and could be considered as a nutritional strategy for exercising individuals who struggle to include fasted exercise in their training.

Physical performance during energy deficiency in humans: An evolutionary perspective

Energy deficiency profoundly disrupts normal endocrinology, metabolism, and physiology, resulting in an orchestrated response for energy preservation. As such, despite energy deficit is typically thought as positive for weight-loss and treatment of cardiometabolic diseases during the current obesity pandemic, in the context of contemporary sports and exercise nutrition, chronic energy deficiency is associated to negative health and athletic performance consequences. However, the evidence of energy deficit negatively affecting physical capacity and sports performance is unclear. While severe energy deficiency can negatively affect physical capacity, humans can also improve aerobic fitness and strength while facing significant energy deficit. Many athletes, also, compete at an elite and world-class level despite showing clear signs of energy deficiency. Maintenance of high physical capacity despite the suppression of energetically demanding physiological traits seems paradoxical when an evolutionary viewpoint is not considered. Humans have evolved facing intermittent periods of food scarcity in their natural habitat and are able to thrive in it. In the current perspective it is argued that when facing limited energy availability, maintenance of locomotion and physical capacity are of high priority given that they are essential for food procurement for survival in the habitat where humans evolved. When energetic resources are limited, energy may be allocated to tasks essential for survival (e.g. locomotion) while minimising energy allocation to traits that are not (e.g. growth and reproduction). The current perspective provides a model of energy allocation during energy scarcity supported by observation of physiological and metabolic responses that are congruent with this paradigm.

The effect of acute manipulation of carbohydrate availability on high intensity running performance, running economy, critical speed, and substrate metabolism in trained Male runners

Completing selected training sessions with reduced glycogen availability is associated with greater signalling and improved muscle oxidative capacity, although it may impact the overall quality of the session. We examined the effects of low carbohydrate availability on high intensity exercise performance, running economy, critical speed, and substrate metabolism. On two occasions, nine male runners (V̇O2peak 60.3 ± 3.3 mL.kg-1.min-1) completed a glycogen depletion protocol involving 90-min at 75%vV̇O2peak followed by 10 × 1-min at 110% vV̇O2peak. This was followed either by high (HIGH) or low (LOW) carbohydrate intake (>6 g.kg-1.day-1 and <50 g.day-1, respectively) until completion of a performance protocol on day 2 consisting of a series of time-trials (TT) (50m to 3000m) and physiological assessments. There were no differences between LOW and HIGH for any TT distance (mean TT performance times for LOW and HIGH were: 3000m TT 651.7 ± 52.8s and 646.4 ± 52.5s, 1500 m TT 304.0 ± 20.2s and 304.2 ± 22.1s, 400 m TT 67.64 ± 4.2s and 67.3 ± 3.8s, 50 m TT 7.27 ± 0.44s and 7.25 ± 0.45s, respectively, P > 0.05), though some athletes performed better in LOW (n = 5). While fat oxidation in LOW was significantly greater than HIGH (Δ0.32 ± 0.14 g.min-1; P < 0.001 at 14 km.h-1 and Δ0.34 ± 0.12 g.min-1 at 16 km.h-1; P < 0.01), running economy did not differ between trials (P > 0.05). Acute manipulation of carbohydrate availability showed immediate effects on substrate metabolism evidenced by greater fat oxidation without changes in RE. Acute low carbohydrate availability did not affect high intensity running performance across a range of distances.Highlights Acute manipulation of muscle glycogen availability using an exercise and dietary manipulation protocol did not affect subsequent high intensity running performance across a range of running distances.Reduced muscle glycogen resulted in a marked increase in fat oxidation in low glycogen condition but no changes in running economy or critical speed.Individual factors should be considered when prescribing high intensity sessions with restricted carbohydrate availability.

The fourth dimension: physiological resilience as an independent determinant of endurance exercise performance

Endurance exercise performance is known to be closely associated with the three physiological pillars of maximal O2 uptake (V ̇ O 2 max $\dot{V}_{{\rm O}_{2}{\rm max}}$ ), economy or efficiency during submaximal exercise, and the fractional utilisation ofV ̇ O 2 max $\dot{V}_{{\rm O}_{2}{\rm max}}$ (linked to metabolic/lactate threshold phenomena). However, while 'start line' values of these variables are collectively useful in predicting performance in endurance events such as the marathon, it is not widely appreciated that these variables are not static but are prone to significant deterioration as fatiguing endurance exercise proceeds. For example, the 'critical power' (CP), which is a composite of the highest achievable steady-state oxidative metabolic rate and efficiency (O2 cost per watt), may fall by an average of 10% following 2 h of heavy intensity cycle exercise. Even more striking is that the extent of this deterioration displays appreciable inter-individual variability, with changes in CP ranging from <1% to ∼32%. The mechanistic basis for such differences in fatigue resistance or 'physiological resilience' are not resolved. However, resilience may be important in explaining superlative endurance performance and it has implications for the physiological evaluation of athletes and the design of interventions to enhance performance. This article presents new information concerning the dynamic plasticity of the three 'traditional' physiological variables and argues that physiological resilience should be considered as an additional component, or fourth dimension, in models of endurance exercise performance.

Periodised Carbohydrate Intake Does Not Affect Substrate Oxidation but May Contribute to Endurance Capacity

The aim of this study was to investigate whether periodising carbohydrate intake around specific training sessions will enhance endurance training adaptations.Seventeen healthy recreationally endurance-trained males (n = 5) and females (n = 12) (27.5 ± 5.4 years) participated in a four-week training intervention. Participants were divided into two groups: FASTED (stayed fasted between evening high-intensity interval training session and low-intensity training session in the following morning) and FED (no restriction in food intake). Pre- and post-testing included peak oxygen uptake (VO_2peak), anaerobic capacity, and 60 min submaximal running tests. Fasted venous blood samples were drawn for the determination of triglyceride and glucose concentrations.VO_2peak increased in both FASTED (4.4 ± 3.0%, p = 0.001) and FED (4.6 ± 4.2%, p = 0.017), whereas maximal running velocity increased only in the FASTED (3.5 ± 2.7%, p = 0.002). Lactate concentrations in the anaerobic test after intervention were greater in FASTED than FED (p = 0.025-0.041). Running time in the anaerobic test was improved in FASTED (from 64.1 ± 15.6-86.3 ± 23.2 s, p < 0.001) but not in FED (from 56.4 ± 15.2-66.9 ± 21.3 s, p = 0.099). Substrate oxidation did not change after intervention in either of the groups (p = 0.052-0.597). Heart rate was lower in the submaximal running test in FASTED (p < 0.001) but not in FED (p = 0.097).Training with periodised carbohydrate availability does not have any effect on substrate oxidation. However, it seems to enhance the capacity to perform high-intensity exercise.

Loss of hepatic phosphoenolpyruvate carboxykinase 1 dysregulates metabolic responses to acute exercise but enhances adaptations to exercise training in mice

Acute exercise increases liver gluconeogenesis to supply glucose to working muscles. Concurrently, elevated liver lipid breakdown fuels the high energetic cost of gluconeogenesis. This functional coupling between liver gluconeogenesis and lipid oxidation has been proposed to underlie the ability of regular exercise to enhance liver mitochondrial oxidative metabolism and decrease liver steatosis in individuals with nonalcoholic fatty liver disease. Herein we tested whether repeated bouts of increased hepatic gluconeogenesis are necessary for exercise training to lower liver lipids. Experiments used diet-induced obese mice lacking hepatic phosphoenolpyruvate carboxykinase 1 (KO) to inhibit gluconeogenesis and wild-type (WT) littermates. 2H/13C metabolic flux analysis quantified glucose and mitochondrial oxidative fluxes in untrained mice at rest and during acute exercise. Circulating and tissue metabolite levels were determined during sedentary conditions, acute exercise, and refeeding postexercise. Mice also underwent 6 wk of treadmill running protocols to define hepatic and extrahepatic adaptations to exercise training. Untrained KO mice were unable to maintain euglycemia during acute exercise resulting from an inability to increase gluconeogenesis. Liver triacylglycerides were elevated after acute exercise and circulating β-hydroxybutyrate was higher during postexercise refeeding in untrained KO mice. In contrast, exercise training prevented liver triacylglyceride accumulation in KO mice. This was accompanied by pronounced increases in indices of skeletal muscle mitochondrial oxidative metabolism in KO mice. Together, these results show that hepatic gluconeogenesis is dispensable for exercise training to reduce liver lipids. This may be due to responses in ketone body metabolism and/or metabolic adaptations in skeletal muscle to exercise.NEW & NOTEWORTHY Exercise training reduces hepatic steatosis partly through enhanced hepatic terminal oxidation. During acute exercise, hepatic gluconeogenesis is elevated to match the heightened rate of muscle glucose uptake and maintain glucose homeostasis. It has been postulated that the hepatic energetic stress induced by elevating gluconeogenesis during acute exercise is a key stimulus underlying the beneficial metabolic responses to exercise training. This study shows that hepatic gluconeogenesis is not necessary for exercise training to lower liver lipids.

Muscle Glycogen Assessment and Relationship with Body Hydration Status: A Narrative Review

Muscle glycogen is a crucial energy source for exercise, and assessment of muscle glycogen storage contributes to the adequate manipulation of muscle glycogen levels in athletes before and after training and competition. Muscle biopsy is the traditional and gold standard method for measuring muscle glycogen; alternatively, ¹³C magnetic resonance spectroscopy (MRS) has been developed as a reliable and non-invasive method. Furthermore, outcomes of ultrasound and bioimpedance methods have been reported to change in association with muscle glycogen conditions. The physiological mechanisms underlying this activity are assumed to involve a change in water content bound to glycogen; however, the relationship between body water and stored muscle glycogen is inconclusive. In this review, we discuss currently available muscle glycogen assessment methods, focusing on ¹³C MRS. In addition, we consider the involvement of muscle glycogen in changes in body water content and discuss the feasibility of ultrasound and bioimpedance outcomes as indicators of muscle glycogen levels. In relation to changes in body water content associated with muscle glycogen, this review broadens the discussion on changes in body weight and body components other than body water, including fat, during carbohydrate loading. From these discussions, we highlight practical issues regarding muscle glycogen assessment and manipulation in the sports field.

Effects of sustained swimming exercise on growth and body composition responses of Nile tilapia (Oreochromis niloticus), red drum (Sciaenops ocellatus), and hybrid striped bass (Morone chrysops × M. saxatilis)

Exercise has been shown to increase growth of many salmonid species. However, limited research has evaluated exercise on warmwater species. The present study was conducted to evaluate with tilapia, red drum (RD), and hybrid striped bass (HSB), the effects of swimming (exercising) in a constant slow current of approximately one body length/s (1bl/s) compared to not being forced to swim in a static culture system. Concurrent trials were conducted with 22 advanced juvenile male Nile tilapia (Wt₀ 97.9 ± 2.4 g), 38 juvenile red drum (Wt₀ 74.9 ± 4.4 g), and 20 juvenile HSB (Wt₀ 78.0 ± 3.2 g). Equal numbers of fish of each species were pit tagged and randomly assigned to two tanks, one operated static (control) and the other with current (exercised), which were all part of the same recirculating aquaculture system. Fish were fed to satiation twice daily a commercial diet and individually weighed every 2 weeks through 7 weeks. Significant (P ≤ 0.05) enhancements of weight gain were observed for exercised tilapia and RD vs static (control) treatments. Reduced growth was observed in exercised HSB, possibly due to consistently skittish feeding behavior. Hepatosomatic index was lower in all exercised fish, though not significantly so for RD and tilapia. Significant reductions also were detected in liver glycogen of exercised tilapia and RD. Results from this study indicate that continuous exercise beneficially affected aspects of tilapia and red drum growth and altered their body composition.

Six sessions of low-volume high-intensity interval exercise improves resting fat oxidation

It remains unclear whether a practical model of low-volume high-intensity interval exercise improves resting fat oxidation (FatOx) which is associated with metabolic health. We aimed to determine the effects of a short-term practical model of high-intensity interval training (HIIT) on resting FatOx in young, healthy males. Thirty healthy males were randomly assigned to either single (HIITsingle; n=13) or double HIIT (HIITdouble; n=17) group. The HIITsingle group trained once a day, 3 days/week for 2 weeks, whilst the HIITdouble group performed 6 sessions of high-intensity exercise over 5 days by exercising twice a day every second day. Both groups completed 6 high-intensity exercise sessions consisting of 10×60 s of cycling at peak power output, interspersed by 75 s cycling at 60 W. With 1% false discovery rate (FDR) significance threshold, resting respiratory exchange ratio similarly decreased in HIITsingle (pre=0.83±0.03 vs post=0.80±0.03) and HIITdouble group (pre=0.82±0.04 vs post=0.80±0.02) [(p=0.001; partial eta squared () =0.310, FDR-adjusted p value=0.005)]. Resting FatOx increased similarly in HIITsingle (pre=1.07±0.39 mg·kg-1 fat free mass (FFM)·min-1 vs post=1.44±0.36 mg·kg-1 FFM·min-1) and HIITdouble group (pre=1.35±0.45 mg·kg-1 FFM·min-1 vs post=1.52±0.29 mg·kg-1 FFM·min-1) [(p<0.001; =0.411, FDR-adjusted p value=0.005)]. Our results demonstrate that only six sessions of a practical model of low-volume high-intensity exercise improves resting FatOx in young, healthy males.

High intramuscular triglyceride turnover rates and the link to insulin sensitivity: influence of obesity, type 2 diabetes and physical activity

Large intramuscular triglyceride (IMTG) stores in sedentary, obese individuals have been linked to insulin resistance, yet well-trained athletes exhibit high IMTG levels whilst maintaining insulin sensitivity. Contrary to previous assumptions, it is now known that IMTG content per se does not result in insulin resistance. Rather, insulin resistance is caused, at least in part, by the presence of high concentrations of harmful lipid metabolites, such as diacylglycerols and ceramides in muscle. Several mechanistic differences between obese sedentary individuals and their highly trained counterparts have been identified, which determine the differential capacity for IMTG synthesis and breakdown in these populations. In this review, we first describe the most up-to-date mechanisms by which a low IMTG turnover rate (both breakdown and synthesis) leads to the accumulation of lipid metabolites and results in skeletal muscle insulin resistance. We then explore current and potential exercise and nutritional strategies that target IMTG turnover in sedentary obese individuals, to improve insulin sensitivity. Overall, improving IMTG turnover should be an important component of successful interventions that aim to prevent the development of insulin resistance in the ever-expanding sedentary, overweight and obese populations. Novelty: A description of the most up-to-date mechanisms regulating turnover of the IMTG pool. An exploration of current and potential exercise/nutritional strategies to target and enhance IMTG turnover in obese individuals. Overall, highlights the importance of improving IMTG turnover to prevent the development of insulin resistance.

New Horizons in Carbohydrate Research and Application for Endurance Athletes

The importance of carbohydrate as a fuel source for exercise and athletic performance is well established. Equally well developed are dietary carbohydrate intake guidelines for endurance athletes seeking to optimize their performance. This narrative review provides a contemporary perspective on research into the role of, and application of, carbohydrate in the diet of endurance athletes. The review discusses how recommendations could become increasingly refined and what future research would further our understanding of how to optimize dietary carbohydrate intake to positively impact endurance performance. High carbohydrate availability for prolonged intense exercise and competition performance remains a priority. Recent advances have been made on the recommended type and quantity of carbohydrates to be ingested before, during and after intense exercise bouts. Whilst reducing carbohydrate availability around selected exercise bouts to augment metabolic adaptations to training is now widely recommended, a contemporary view of the so-called train-low approach based on the totality of the current evidence suggests limited utility for enhancing performance benefits from training. Nonetheless, such studies have focused importance on periodizing carbohydrate intake based on, among other factors, the goal and demand of training or competition. This calls for a much more personalized approach to carbohydrate recommendations that could be further supported through future research and technological innovation (e.g., continuous glucose monitoring). Despite more than a century of investigations into carbohydrate nutrition, exercise metabolism and endurance performance, there are numerous new important discoveries, both from an applied and mechanistic perspective, on the horizon.

Three weeks of a home-based "sleep low-train low" intervention improves functional threshold power in trained cyclists: A feasibility study

Background

“Sleep Low-Train Low” is a training-nutrition strategy intended to purposefully reduce muscle glycogen availability around specific exercise sessions, potentially amplifying the training stimulus via augmented cell signalling. The aim of this study was to assess the feasibility of a 3-week home-based “sleep low-train low” programme and its effects on cycling performance in trained athletes.

Methods

Fifty-five trained athletes (Functional Threshold Power [FTP]: 258 ± 52W) completed a home-based cycling training program consisting of evening high-intensity training (6 × 5 min at 105% FTP), followed by low-intensity training (1 hr at 75% FTP) the next morning, three times weekly for three consecutive weeks. Participant’s daily carbohydrate (CHO) intake (6 g·kg^-1·d^-1) was matched but timed differently to manipulate CHO availability around exercise: no CHO consumption post- HIT until post-LIT sessions [Sleep Low (SL), n = 28] or CHO consumption evenly distributed throughout the day [Control (CON), n = 27]. Sessions were monitored remotely via power data uploaded to an online training platform, with performance tests conducted pre-, post-intervention.

Results

LIT exercise intensity reduced by 3% across week 1, 3 and 2% in week 2 (P < 0.01) with elevated RPE in SL vs. CON (P < 0.01). SL enhanced FTP by +5.5% vs. +1.2% in CON (P < 0.01). Comparable increases in 5-min peak power output (PPO) were observed between groups (P < 0.01) with +2.3% and +2.7% in SL and CON, respectively (P = 0.77). SL 1-min PPO was unchanged (+0.8%) whilst CON improved by +3.9% (P = 0.0144).

Conclusion

Despite reduced relative training intensity, our data demonstrate short-term “sleep low-train low” intervention improves FTP compared with typically “normal” CHO availability during exercise. Importantly, training was completed unsupervised at home (during the COVID-19 pandemic), thus demonstrating the feasibility of completing a “sleep low-train low” protocol under non-laboratory conditions.

Micronutrients and athletic performance: A review

Optimising nutrition intake is a key component for supporting athletic performance and supporting adaption to training. Athletes often use micronutrient supplements in order to correct vitamin and mineral deficiencies, improve immune function, enhance recovery and or to optimise their performance. The aim of this review was to investigate the recent literature regarding micronutrients (specifically iron, vitamin C, vitamin E, vitamin D, calcium) and their effects on physical performance. Over the past ten years, several studies have investigated the impacts of these micronutrients on aspects of athletic performance, and several reviews have aimed to provide an overview of current use and effectiveness. Currently the balance of the literature suggests that micronutrient supplementation in well-nourished athletes does not enhance physical performance. Excessive intake of dietary supplements may impair the body's physiological responses to exercise that supports adaptation to training stress. In some cases, micronutrient supplementation is warranted, for example, with a diagnosed deficiency, when energy intake is compromised, or when training and competing at altitude, however these micronutrients should be prescribed by a medical professional. Athletes are encouraged to obtain adequate micronutrients from a wellbalanced and varied dietary intake.

Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective

Engaging in regular exercise results in a range of physiological adaptations offering benefits for exercise capacity and health, independent of age, gender or the presence of chronic diseases. Accumulating evidence shows that lack of time is a major impediment to exercise, causing physical inactivity worldwide. This issue has resulted in momentum for interval training models known to elicit higher enjoyment and induce adaptations similar to or greater than moderate-intensity continuous training, despite a lower total exercise volume. Although there is no universal definition, high-intensity interval exercise is characterized by repeated short bursts of intense activity, performed with a "near maximal" or "all-out" effort corresponding to ≥90% of maximal oxygen uptake or >75% of maximal power, with periods of rest or low-intensity exercise. Research has indicated that high-intensity interval training induces numerous physiological adaptations that improve exercise capacity (maximal oxygen uptake, aerobic endurance, anaerobic capacity etc.) and metabolic health in both clinical and healthy (athletes, active and inactive individuals without any apparent disease or disorder) populations. In this paper, a brief history of high-intensity interval training is presented, based on the novel findings of some selected studies on exercise capacity and health, starting from the early 1920s to date. Further, an overview of the mechanisms underlying the physiological adaptations in response to high-intensity interval training is provided.

Six high-intensity interval training sessions over 5 days increases maximal oxygen uptake, endurance capacity, and sub-maximal exercise fat oxidation as much as 6 high-intensity interval training sessions over 2 weeks

BACKGROUND

High-intensity interval training (HIIT) induces similar or even superior adaptations compared to continuous endurance training. Indeed, just 6 HIIT sessions over 2 weeks significantly improves maximal oxygen uptake (VO_2max), submaximal exercise fat oxidation, and endurance performance. Whether even faster adaptations can be achieved with HIIT is not known. Thus, we aimed to determine whether 2 sessions of HIIT per day, separated by 3 h, every other day for 5 days (double HIIT (HIIT-D), n = 15) could increase VO_2max, submaximal exercise fat oxidation, and endurance capacity as effectively as 6 sessions of HIIT over 2 weeks (single HIIT (HIIT-S), n = 13).

METHODS

Each training session consisted of 10 × 60 s of cycling at 100% of VO_2max interspersed with 75 s of low-intensity cycling at 60 watt (W). Pre- and post-training assessments included VO_2max, time to exhaustion at ∼80% of VO_2max, and 60-min cycling trials at ∼67% of VO_2max.

RESULTS

Similar increases (p < 0.05) in VO_2max (HIIT-D: 7.7% vs. HIIT-S: 6.0%, p > 0.05) and endurance capacity (HIIT-D: 80.1% vs. HIIT-S: 79.2%, p > 0.05) were observed. Submaximal exercise carbohydrate oxidation was reduced in the 2 groups after exercise training (HIIT-D: 9.2%, p = 0.014 vs. HIIT-S: 18.8%, p = 0.012) while submaximal exercise fat oxidation was significantly increased in HIIT-D (15.5%, p = 0.048) but not in HIIT-S (9.3%, p = 0.290).

CONCLUSION

Six HIIT sessions over 5 days was as effective in increasing VO_2max and endurance capacity and was more effective in improving submaximal exercise fat oxidation than 6 HIIT sessions over 2 weeks.

Fuelling the female athlete: Carbohydrate and protein recommendations

Optimal carbohydrate and protein intakes are vital for modulating training adaptation, recovery, and exercise performance. However, the research base underpinning contemporary sport nutrition guidelines has largely been conducted in male populations with a lack of consensus on whether the menstrual phase and associated changes in sex hormones allow broad application of these principles to female athletes. The present review will summarise our current understanding of carbohydrate and protein requirements in female athletes across the menstrual cycle and provide a critical analysis on how they compare to male athletes. On the basis of current evidence, we consider it premature to conclude that female athletes require sex specific guidelines in relation to CHO or protein requirements provided energy needs are met. However, there is a need for further research using sport-specific competition and training related exercise protocols that rigorously control for prior exercise, CHO/energy intake, contraceptive use and phase of menstrual cycle. Our overarching recommendation is to use current recommendations as a basis for adopting an individualised approach that takes into account athlete specific training and competition goals whilst also considering personal symptoms associated with the menstrual cycle.

Performance effects of periodized carbohydrate restriction in endurance trained athletes - a systematic review and meta-analysis

Endurance athletes typically consume carbohydrate-rich diets to allow for optimal performance during competitions and intense training. However, acute exercise studies have revealed that training or recovery with low muscle glycogen stimulates factors of importance for mitochondrial biogenesis in addition to favourable metabolic adaptations in trained athletes. Compromised training quality and particularly lower intensities in peak intervals seem to be a major drawback from dietary interventions with chronic carbohydrate (CHO) restriction. Therefore, the concept of undertaking only selected training sessions with restricted CHO availability (periodized CHO restriction) has been proposed for endurance athletes. However, the overall performance effect of this concept has not been systematically reviewed in highly adapted endurance-trained athletes. We therefore conducted a meta-analysis of training studies that fulfilled the following criteria: a) inclusion of females and males demonstrating a VO₂max ≥ 55 and 60 ml · kg^− 1 · min^− 1, respectively; b) total intervention and training periods ≥ 1 week, c) use of interventions including training and/or recovery with periodized carbohydrate restriction at least three times per week, and d) measurements of endurance performance before and after the training period. The literature search resulted in 407 papers of which nine studies fulfilled the inclusion criteria. The subsequent meta-analysis demonstrated no overall effect of CHO periodization on endurance performance compared to control endurance training with normal (high) CHO availability (standardized mean difference = 0.17 [− 0.15, 0.49]; P = 0.29). Based on the available literature, we therefore conclude that periodized CHO restriction does not per se enhance performance in endurance-trained athletes. The review discusses different approaches to CHO periodization across studies with a focus on identifying potential physiological benefits.

25 Years of Session Rating of Perceived Exertion: Historical Perspective and Development

The session rating of perceived exertion (sRPE) method was developed 25 years ago as a modification of the Borg concept of rating of perceived exertion (RPE), designed to estimate the intensity of an entire training session. It appears to be well accepted as a marker of the internal training load. Early studies demonstrated that sRPE correlated well with objective measures of internal training load, such as the percentage of heart rate reserve and blood lactate concentration. It has been shown to be useful in a wide variety of exercise activities ranging from aerobic to resistance to games. It has also been shown to be useful in populations ranging from patients to elite athletes. The sRPE is a reasonable measure of the average RPE acquired across an exercise session. Originally designed to be acquired ∼30 minutes after a training bout to prevent the terminal elements of an exercise session from unduly influencing the rating, sRPE has been shown to be temporally robust across periods ranging from 1 minute to 14 days following an exercise session. Within the training impulse concept, sRPE, or other indices derived from sRPE, has been shown to be able to account for both positive and negative training outcomes and has contributed to our understanding of how training is periodized to optimize training outcomes and to understand maladaptations such as overtraining syndrome. The sRPE as a method of monitoring training has the advantage of extreme simplicity. While it is not ideal for the precise recording of the details of the external training load, it has large advantages relative to evaluating the internal training load.

Low-carbohydrate diets: Effects on metabolism and exercise - A comprehensive literature review

BACKGROUND & AIMS

Low-carbohydrate diets (LCD) have gained substantial attention in recent years for their potential in health promotion and treatment of diseases, but they remain controversial in nutrition guidelines and exercise performance. Herein, through a literature review, we discuss the current evidence base by considering management of LCD and potential coupling of these dietary regiments with physical exercise.

METHODS

We performed a comprehensive literature review with no date limits as a means of including seminal to current studies.

RESULTS

Reduction of CHO intake decreases muscle glycogen, yielding greater fat oxidation and associated metabolic benefits. LCD may promote fat mass loss and regulation of biochemical parameters, such as lipid and glycemic biomarkers. The therapeutic potential of LCD towards noncommunicable diseases, particularly obesity and its comorbidities, is therefore reasonable as a dietary candidate in this context. Potential benefits to this approach are linked to enhancement of mitochondrial gene expression and mitochondrial biogenesis. As such, LCD may be a feasible tool in a 'periodized nutrition' for athletes and within clinical scenarios. Long-term observational follow-up studies have demonstrated increased mortality and cardiovascular implications of LCD. However, harmful associations may depend on the food source (e.g., animal-based vs. plant-based foods).

CONCLUSION

LCD may decrease body mass, waist circumference, and improve fat and carbohydrate metabolism. When combined with exercise, LCD seems to be an effective strategy in regulating metabolic factors of cardiovascular diseases. Conversely, LCD may be associated with higher mortality and metabolic dysregulations if it contains large amounts of animal-based foods, particularly saturated fat.

What Should I Eat before Exercise? Pre-Exercise Nutrition and the Response to Endurance Exercise: Current Prospective and Future Directions

The primary variables influencing the adaptive response to a bout of endurance training are exercise duration and exercise intensity. However, altering the availability of nutrients before and during exercise can also impact the training response by modulating the exercise stimulus and/or the physiological and molecular responses to the exercise-induced perturbations. The purpose of this review is to highlight the current knowledge of the influence of pre-exercise nutrition ingestion on the metabolic, physiological, and performance responses to endurance training and suggest directions for future research. Acutely, carbohydrate ingestion reduces fat oxidation, but there is little evidence showing enhanced fat burning capacity following long-term fasted-state training. Performance is improved following pre-exercise carbohydrate ingestion for longer but not shorter duration exercise, while training-induced performance improvements following nutrition strategies that modulate carbohydrate availability vary based on the type of nutrition protocol used. Contrasting findings related to the influence of acute carbohydrate ingestion on mitochondrial signaling may be related to the amount of carbohydrate consumed and the intensity of exercise. This review can help to guide athletes, coaches, and nutritionists in personalizing pre-exercise nutrition strategies, and for designing research studies to further elucidate the role of nutrition in endurance training adaptations.

Carbohydrate supplementation: a critical review of recent innovations

PURPOSE

To critically examine the research on novel supplements and strategies designed to enhance carbohydrate delivery and/or availability.

METHODS

Narrative review.

RESULTS

Available data would suggest that there are varying levels of effectiveness based on the supplement/supplementation strategy in question and mechanism of action. Novel carbohydrate supplements including multiple transportable carbohydrate (MTC), modified carbohydrate (MC), and hydrogels (HGEL) have been generally effective at modifying gastric emptying and/or intestinal absorption. Moreover, these effects often correlate with altered fuel utilization patterns and/or glycogen storage. Nevertheless, performance effects differ widely based on supplement and study design. MTC consistently enhances performance, but the magnitude of the effect is yet to be fully elucidated. MC and HGEL seem unlikely to be beneficial when compared to supplementation strategies that align with current sport nutrition recommendations. Combining carbohydrate with other ergogenic substances may, in some cases, result in additive or synergistic effects on metabolism and/or performance; however, data are often lacking and results vary based on the quantity, timing, and inter-individual responses to different treatments. Altering dietary carbohydrate intake likely influences absorption, oxidation, and and/or storage of acutely ingested carbohydrate, but how this affects the ergogenicity of carbohydrate is still mostly unknown.

CONCLUSIONS

In conclusion, novel carbohydrate supplements and strategies alter carbohydrate delivery through various mechanisms. However, more research is needed to determine if/when interventions are ergogenic based on different contexts, populations, and applications.

Supplement with whey protein hydrolysate in contrast to carbohydrate supports mitochondrial adaptations in trained runners

Background

Protein supplementation has been suggested to augment endurance training adaptations by increasing mixed muscle and myofibrillar protein synthesis and lean body mass. However, a potential beneficial effect on mitochondrial adaptations is yet to be clarified.

The aim of the present study was to investigate the effect of consuming whey protein hydrolysate before and whey protein hydrolysate plus carbohydrate (PRO-CHO) after each exercise session during a six-week training period compared to similarly timed intake of isocaloric CHO supplements on biomarkers of mitochondrial biogenesis, VO_2max and performance in trained runners.

Methods

Twenty-four trained runners (VO_2max 60.7 ± 3.7 ml O₂ kg^− 1 min¹) completed a six-week block randomized controlled intervention period, consisting of progressive running training. Subjects were randomly assigned to either PRO-CHO or CHO and matched in pairs for gender, age, VO_2max, training and performance status. The PRO-CHO group ingested a protein beverage (0.3 g kg^− 1) before and protein-carbohydrate beverage (0.3 g protein kg^− 1 and 1 g carbohydrate kg^− 1) after each exercise session. The CHO group ingested an energy matched carbohydrate beverage. Resting muscle biopsies obtained pre and post intervention were analyzed for mitochondrial specific enzyme activity and mitochondrial protein content. Subjects completed a 6 K time trial (6 K TT) and a VO_2max test pre, midway (only 6 K TT) and post intervention.

Results

Following six weeks of endurance training Cytochrome C (Cyt C) protein content was significantly higher in the PRO-CHO group compared to the CHO group (p < 0.05), with several other mitochondrial proteins (Succinate dehydrogenase (SDHA), Cytochrome C oxidase (COX-IV), Voltage-dependent anion channel (VDAC), Heat shock protein 60 (HSP60), and Prohibitin (PHB1)) following a similar, but non-significant pattern (p = 0.07–0.14). β-hydroxyacyl-CoA dehydrogenase (HAD) activity was significantly lower after training in the CHO group (p < 0.01), but not in the PRO-CHO group (p = 0.24). VO_2max and 6 K TT was significantly improved after training with no significant difference between groups.

Conclusion

Intake of whey PRO hydrolysate before and whey PRO hydrolysate plus CHO after each exercise session during a six-week endurance training period may augment training effects on specific mitochondrial proteins compared to intake of iso-caloric CHO but does not alter VO_2max or 6 K TT performance.

Trial registration

clinicaltrials.gov, NCT03561337. Registered 6 June 2018 – Retrospectively registered.

Prevalence and Determinants of Fasted Training in Endurance Athletes: A Survey Analysis

Athletes may choose to perform exercise in the overnight-fasted state for a variety of reasons related to convenience, gut comfort, or augmenting the training response, but it is unclear how many endurance athletes use this strategy. We investigated the prevalence and determinants of exercise performed in the overnight-fasted state among endurance athletes using an online survey and examined differences based on sex, competitive level, and habitual dietary pattern. The survey was completed by 1,950 endurance athletes (51.0% female, mean age 40.9 ± 11.1 years). The use of fasted training was reported by 62.9% of athletes, with significant effects of sex (p < .001, Cramer’s V [φc] = 0.18, 90% CI [0.14, 0.22]), competitive level (p < .001, φc = 0.09, 90% CI [0.5, 0.13]), and habitual dietary pattern noted (p < .001, φc = 0.26, 90% CI [0.22, 0.29]). Males, nonprofessional athletes, and athletes following a low-carbohydrate, high-fat diet were most likely to perform fasted training. The most common reasons for doing so were related to utilizing fat as a fuel source (42.9%), gut comfort (35.5%), and time constraints/convenience (31.4%), whereas the most common reasons athletes avoided fasted training were that it does not help their training (47.0%), performance was worse during fasted training (34.7%), or greater hunger (34.6%). Overall, some athletes perform fasted training because they think it helps their training, whereas others avoid it because they think it is detrimental to their training goals, highlighting a need for future research. These findings offer insights into the beliefs and practices related to fasted-state endurance training.

Moderate-Intensity Exercise and High-Intensity Interval Training Affect Insulin Sensitivity Similarly in Obese Adults

OBJECTIVE

We compared the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on insulin sensitivity and other important metabolic adaptations in adults with obesity.

METHODS

Thirty-one inactive adults with obesity (age: 31 ± 6 years; body mass index: 33 ± 3 kg/m2) completed 12 weeks (4 sessions/week) of either HIIT (10 × 1-minute at 90%HRmax, 1-minute active recovery; n = 16) or MICT (45 minutes at 70%HRmax; n = 15). To assess the direct effects of exercise independent of weight/fat loss, participants were required to maintain body mass.

RESULTS

Training increased peak oxygen uptake by ~10% in both HIIT and MICT (P < 0.0001), and body weight/fat mass were unchanged. Peripheral insulin sensitivity (hyperinsulinemic-euglycemic clamp) was ~20% greater the day after the final exercise session compared to pretraining (P < 0.01), with no difference between HIIT and MICT. When trained participants abstained from exercise for 4 days, insulin sensitivity returned to pretraining levels in both groups. HIIT and MICT also induced similar increases in abundance of many skeletal muscle proteins involved in mitochondrial respiration and lipid and carbohydrate metabolism. Training-induced alterations in muscle lipid profile were also similar between groups.

CONCLUSION

Despite large differences in training intensity and exercise time, 12 weeks of HIIT and MICT induce similar acute improvements in peripheral insulin sensitivity the day after exercise, and similar longer term metabolic adaptations in skeletal muscle in adults with obesity. These findings support the notion that the insulin-sensitizing effects of both HIIT and MICT are mediated by factors stemming from the most recent exercise session(s) rather than adaptations that accrue with training.

Influence of Interval Training Frequency on Time-Trial Performance in Elite Endurance Athletes

PURPOSE

To determine the impact of interval training frequency in elite endurance athletes. It was hypothesized that two longer sessions would elicit greater performance improvements and physiological adaptation than four shorter sessions at the same intensity.

METHODS

Elite cross-country skiers and biathletes were randomly assigned to either a high-frequency group (HF group) (5 M, 1 F, age 22 (19-26), VO_2max 67.8 (65.5-70.2) mL/kg/min) doing four short interval sessions per week or a low-frequency group (LF group) (8 M, 1 F, age 22 (18-23), VO_2max 70.7 (67.0-73.9) mL/kg/min) doing two longer interval sessions. All interval sessions were performed at ~85% of maximum heart rate, and groups were matched for total weekly training volume. Pre- and post-intervention, athletes completed an 8 km rollerski time-trial, maximal oxygen uptake (VO_2max) test, and an incremental, submaximal exercise test.

RESULTS

The LF group had a statistically significant improved time-trial performance following the intervention (p = 0.04), with no statistically significant changes in the HF group. Similarly, percentage utilization of VO_2max at anaerobic threshold (p = 0.04) and exercise economy (p = 0.01) were statistically significantly improved following the intervention in the LF group only. No statistically significant changes in VO_2max were observed in either group.

CONCLUSIONS

Two longer interval sessions appear superior to four shorter sessions per week in promoting endurance adaptations and performance improvements in elite endurance athletes. Despite matched training volume and exercise intensity, the larger, more concentrated exercise stimulus in the LF group appears to induce more favorable adaptations. The longer time between training sessions in the LF group may also have allowed athletes to recover more effectively and better "absorb" the training. These findings are in line with the "best practice" observed by many of the world's best endurance athletes.

Perception of Carbohydrate Availability Augments High-Intensity Intermittent Exercise Capacity Under Sleep-Low, Train-Low Conditions

The authors tested the hypothesis that perception of carbohydrate (CHO) availability augments exercise capacity in conditions of reduced CHO availability. Nine males completed a sleep-low train model comprising evening glycogen-depleting cycling followed by an exhaustive cycling protocol the next morning in the fasted state (30 min steady state at 95% lactate threshold followed by 1-min intervals at 80% peak power output until exhaustion). After the evening depletion protocol and prior to sleeping, subjects consumed (a) a known CHO intake of 6 g/kg body mass (TRAIN HIGH) or (b) a perceived comparable CHO intake but 0 g/kg body mass (PERCEPTION) or a known train-low condition of 0 g/kg body mass (TRAIN LOW). The TRAIN HIGH and PERCEPTION trials were conducted double blind. During steady state, average blood glucose and CHO oxidation were significantly higher in TRAIN HIGH (4.01 ± 0.56 mmol/L; 2.17 ± 0.70 g/min) versus both PERCEPTION (3.30 ± 0.57 mmol/L; 1.69 ± 0.64 g/min, p < .05) and TRAIN LOW (3.41 ± 0.74 mmol/L; 1.61 ± 0.59 g/min, p < .05). Exercise capacity was significantly different between all pairwise comparisons (p < .05), where TRAIN LOW (8 ± 8 min) < PERCEPTION (12 ± 6 min) < TRAIN HIGH (22 ± 9 min). Data demonstrate that perception of CHO availability augments high-intensity intermittent exercise capacity under sleep-low, train-low conditions, though this perception does not restore exercise capacity to that of CHO consumption. Such data have methodological implications for future research designs and may also have practical applications for athletes who deliberately practice elements of training in CHO-restricted states.

Emerging Roles of Sympathetic Nerves and Inflammation in Perivascular Adipose Tissue

Perivascular adipose tissue (PVAT) is no longer recognised as simply a structural support for the vasculature, and we now know that PVAT releases vasoactive factors which modulate vascular function. Since the discovery of this function in 1991, PVAT research is rapidly growing and the importance of PVAT function in disease is becoming increasingly clear. Obesity is associated with a plethora of vascular conditions; therefore, the study of adipocytes and their effects on the vasculature is vital. PVAT contains an adrenergic system including nerves, adrenoceptors and transporters. In obesity, the autonomic nervous system is dysfunctional; therefore, sympathetic innervation of PVAT may be the key mechanistic link between increased adiposity and vascular disease. In addition, not all obese people develop vascular disease, but a common feature amongst those that do appears to be the inflammatory cell population in PVAT. This review will discuss what is known about sympathetic innervation of PVAT, and the links between nerve activation and inflammation in obesity. In addition, we will examine the therapeutic potential of exercise in sympathetic stimulation of adipose tissue.

Supplements and Nutritional Interventions to Augment High-Intensity Interval Training Physiological and Performance Adaptations-A Narrative Review

High-intensity interval training (HIIT) involves short bursts of intense activity interspersed by periods of low-intensity exercise or rest. HIIT is a viable alternative to traditional continuous moderate-intensity endurance training to enhance maximal oxygen uptake and endurance performance. Combining nutritional strategies with HIIT may result in more favorable outcomes. The purpose of this narrative review is to highlight key dietary interventions that may augment adaptations to HIIT, including creatine monohydrate, caffeine, nitrate, sodium bicarbonate, beta-alanine, protein, and essential amino acids, as well as manipulating carbohydrate availability. Nutrient timing and potential sex differences are also discussed. Overall, sodium bicarbonate and nitrates show promise for enhancing HIIT adaptations and performance. Beta-alanine has the potential to increase training volume and intensity and improve HIIT adaptations. Caffeine and creatine have potential benefits, however, longer-term studies are lacking. Presently, there is a lack of evidence supporting high protein diets to augment HIIT. Low carbohydrate training enhances the upregulation of mitochondrial enzymes, however, there does not seem to be a performance advantage, and a periodized approach may be warranted. Lastly, potential sex differences suggest the need for future research to examine sex-specific nutritional strategies in response to HIIT.

Effects of protein intake prior to carbohydrate-restricted endurance exercise: a randomized crossover trial

Background

Deliberately training with reduced carbohydrate availability, a paradigm coined training low, has shown to promote adaptations associated with improved aerobic capacity. In this context researchers have proposed that protein may be ingested prior to training as a means to enhance the protein balance during exercise without spoiling the effect of the low carbohydrate availability. Accordingly, this is being practiced by world class athletes. However, the effect of protein intake on muscle protein metabolism during training low has not been studied.

This study aimed to examine if protein intake prior to exercise with reduced carbohydrate stores benefits muscle protein metabolism in exercising and non-exercising muscles.

Methods

Nine well-trained subjects completed two trials in random order both of which included a high-intensity interval ergometer bike ride (day 1), a morning (day 2) steady state ride (90 min at 65% VO₂peak, 90ss), and a 4-h recovery period. An experimental beverage was consumed before 90ss and contained either 0.5 g whey protein hydrolysate [WPH]/ kg lean body mass or flavored water [PLA]. A stable isotope infusion (L-[ring-¹³C₆]-phenylalanine) combined with arterial-venous blood sampling, and plasma flow rate measurements were used to determine forearm protein turnover. Myofibrillar protein synthesis was determined from stable isotope incorporation into the vastus lateralis.

Results

Forearm protein net balance was not different from zero during 90ss exercise (nmol/100 ml/min, PLA: 0.5 ± 2.6; WPH: 1.8, ± 3.3) but negative during the 4 h recovery (nmol/100 ml/min, PLA: − 9.7 ± 4.6; WPH: − 8.7 ± 6.5); no interaction (P = 0.5) or main effect of beverage (P = 0.11) was observed. Vastus lateralis myofibrillar protein synthesis rates were increased during 90ss exercise (+ 0.02 ± 0.02%/h) and recovery (+ 0.02 ± 0.02%/h); no interaction (P = 0.3) or main effect of beverage (P = 0.3) was observed.

Conclusion

We conclude that protein ingestion prior to endurance exercise in the energy- and carbohydrate-restricted state does not increase myofibrillar protein synthesis or improve net protein balance in the exercising and non-exercising muscles, respectively, during and in the hours after exercise compared to ingestion of a non-caloric control.

Trial registration

clinicaltrials.gov, NCT01320449. Registered 10 May 2017 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03147001

Exercise twice-a-day potentiates markers of mitochondrial biogenesis in men

Endurance exercise begun with reduced muscle glycogen stores seems to potentiate skeletal muscle protein abundance and gene expression. However, it is unknown whether this greater signaling responses is due to performing two exercise sessions in close proximity-as a first exercise session is necessary to reduce the muscle glycogen stores. In the present study, we manipulated the recovery duration between a first muscle glycogen-depleting exercise and a second exercise session, such that the second exercise session started with reduced muscle glycogen in both approaches but was performed either 2 or 15 hours after the first exercise session (so-called "twice-a-day" and "once-daily" approaches, respectively). We found that exercise twice-a-day increased the nuclear abundance of transcription factor EB (TFEB) and nuclear factor of activated T cells (NFAT) and potentiated the transcription of peroxisome proliferator-activated receptor-ɣ coactivator 1-alpha (PGC-1α), peroxisome proliferator-activated receptor-alpha (PPARα), and peroxisome proliferator-activated receptor beta/delta (PPARβ/δ) genes, in comparison with the once-daily exercise. These results suggest that part of the elevated molecular signaling reported with previous "train-low" approaches might be attributed to performing two exercise sessions in close proximity. The twice-a-day approach might be an effective strategy to induce adaptations related to mitochondrial biogenesis and fat oxidation.

International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing

Background

In this Position Statement, the International Society of Sports Nutrition (ISSN) provides an objective and critical review of the literature pertinent to nutritional considerations for training and racing in single-stage ultra-marathon. Recommendations for Training. i) Ultra-marathon runners should aim to meet the caloric demands of training by following an individualized and periodized strategy, comprising a varied, food-first approach; ii) Athletes should plan and implement their nutrition strategy with sufficient time to permit adaptations that enhance fat oxidative capacity; iii) The evidence overwhelmingly supports the inclusion of a moderate-to-high carbohydrate diet (i.e., ~ 60% of energy intake, 5–8 g·kg^− 1·d^− 1) to mitigate the negative effects of chronic, training-induced glycogen depletion; iv) Limiting carbohydrate intake before selected low-intensity sessions, and/or moderating daily carbohydrate intake, may enhance mitochondrial function and fat oxidative capacity. Nevertheless, this approach may compromise performance during high-intensity efforts; v) Protein intakes of ~ 1.6 g·kg^− 1·d^− 1 are necessary to maintain lean mass and support recovery from training, but amounts up to 2.5 g.kg^− 1·d^− 1 may be warranted during demanding training when calorie requirements are greater; Recommendations for Racing. vi) To attenuate caloric deficits, runners should aim to consume 150–400 Kcal·h^− 1 (carbohydrate, 30–50 g·h^− 1; protein, 5–10 g·h^− 1) from a variety of calorie-dense foods. Consideration must be given to food palatability, individual tolerance, and the increased preference for savory foods in longer races; vii) Fluid volumes of 450–750 mL·h^− 1 (~ 150–250 mL every 20 min) are recommended during racing. To minimize the likelihood of hyponatraemia, electrolytes (mainly sodium) may be needed in concentrations greater than that provided by most commercial products (i.e., > 575 mg·L^− 1 sodium). Fluid and electrolyte requirements will be elevated when running in hot and/or humid conditions; viii) Evidence supports progressive gut-training and/or low-FODMAP diets (fermentable oligosaccharide, disaccharide, monosaccharide and polyol) to alleviate symptoms of gastrointestinal distress during racing; ix) The evidence in support of ketogenic diets and/or ketone esters to improve ultra-marathon performance is lacking, with further research warranted; x) Evidence supports the strategic use of caffeine to sustain performance in the latter stages of racing, particularly when sleep deprivation may compromise athlete safety.

Skeletal Muscle Glycogen Content at Rest and During Endurance Exercise in Humans: A Meta-Analysis

BACKGROUND

Skeletal muscle glycogen is an important energy source for muscle contraction and a key regulator of metabolic responses to exercise. Manipulation of muscle glycogen is therefore a strategy to improve performance in competitions and potentially adaptation to training. However, assessing muscle glycogen in the field is impractical, and there are no normative values for glycogen concentration at rest and during exercise.

OBJECTIVE

The objective of this study was to meta-analyse the effects of fitness, acute dietary carbohydrate (CHO) availability and other factors on muscle glycogen concentration at rest and during exercise of different durations and intensities.

DATA SOURCE AND STUDY SELECTION

PubMed was used to search for original articles in English published up until February 2018. Search terms included muscle glycogen and exercise, filtered for humans. The analysis incorporated 181 studies of continuous or intermittent cycling and running by healthy participants, with muscle glycogen at rest and during exercise determined by biochemical analysis of biopsies.

DATA ANALYSIS

Resting muscle glycogen was determined with a meta-regression mixed model that included fixed effects for fitness status [linear, as maximal oxygen uptake ([Formula: see text]O_2max) in mL·kg^-1·min^-1] and CHO availability (three levels: high, ≥ 6 g·kg^-1 of CHO per day for ≥ 3 days or ≥ 7 g·kg^-1 CHO per day for ≥ 2 days; low, glycogen depletion and low-CHO diet; and normal, neither high nor low, or not specified in study). Muscle glycogen during exercise was determined with a meta-regression mixed model that included fixed effects for fitness status, resting glycogen [linear, in mmol·kg^-1 of dry mass (DM)], exercise duration (five levels, with means of 5, 23, 53 and 116 min, and time to fatigue), and exercise intensity (linear, as percentage of [Formula: see text]O_2max); intensity, fitness and resting glycogen were interacted with duration, and there were also fixed effects for exercise modes, CHO ingestion, sex and muscle type. Random effects in both models accounted for between-study variance and within-study repeated measurement. Inferences about differences and changes in glycogen were based on acceptable uncertainty in standardised magnitudes, with thresholds for small, moderate, large and very large of 25, 75, 150 and 250 mmol·kg^-1 of DM, respectively.

RESULTS

The resting glycogen concentration in the vastus lateralis of males with normal CHO availability and [Formula: see text]O_2max (mean ± standard deviation, 53 ± 8 mL·kg^-1·min^-1) was 462 ± 132 mmol·kg^-1. High CHO availability was associated with a moderate increase in resting glycogen (102, ± 47 mmol·kg^-1; mean ± 90% confidence limits), whereas low availability was associated with a very large decrease (- 253, ± 30 mmol·kg^-1). An increase in [Formula: see text]O_2max of 10 mL·kg^-1·min^-1 had small effects with low and normal CHO availability (29, ± 44 and 67, ± 15 mmol·kg^-1, respectively) and a moderate effect with high CHO availability (80, ± 40 mmol·kg^-1). There were small clear increases in females and the gastrocnemius muscle. Clear modifying effects on glycogen utilisation during exercise were as follows: a 30% [Formula: see text]O_2max increase in intensity, small (41, ± 20 mmol·kg^-1) at 5 min and moderate (87-134 mmol·kg^-1) at all other timepoints; an increase in baseline glycogen of 200 mmol·kg^-1, small at 5-23 min (28-59 mmol·kg^-1), moderate at 116 min (104, ± 15 mmol·kg^-1) and moderate at fatigue (143, ± 33 mmol·kg^-1); an increase in [Formula: see text]O_2max of 10 mL·kg^-1·min^-1, mainly clear trivial effects; exercise mode (intermittent vs. continuous) and CHO ingestion, clear trivial effects. Small decreases in utilisation were observed in females (vs. males: - 30, ± 29 mmol·kg^-1), gastrocnemius muscle (vs. vastus lateralis: - 31, ± 46 mmol·kg^-1) and running (vs. cycling: - 70, ± 32 mmol·kg^-1).

CONCLUSION

Dietary CHO availability and fitness are important factors for resting muscle glycogen. Exercise intensity and baseline muscle glycogen are important factors determining glycogen use during exercise, especially with longer exercise duration. The meta-analysed effects may be useful normative values for prescription of endurance exercise.

Post-exercise carbohydrate and energy availability induce independent effects on skeletal muscle cell signalling and bone turnover: implications for training adaptation

KEY POINTS

Reduced carbohydrate (CHO) availability before and after exercise may augment endurance training-induced adaptations of human skeletal muscle, as mediated via modulation of cell signalling pathways. However, it is not known whether such responses are mediated by CHO restriction, energy restriction or a combination of both. In recovery from a twice per day training protocol where muscle glycogen concentration is maintained within 200-350 mmol kg^-1 dry weight (dw), we demonstrate that acute post-exercise CHO and energy restriction (i.e. < 24 h) does not potentiate potent cell signalling pathways that regulate hallmark adaptations associated with endurance training. In contrast, consuming CHO before, during and after an acute training session attenuated markers of bone resorption, effects that are independent of energy availability. Whilst the enhanced muscle adaptations associated with CHO restriction may be regulated by absolute muscle glycogen concentration, the acute within-day fluctuations in CHO availability inherent to twice per day training may have chronic implications for bone turnover.

ABSTRACT

We examined the effects of post-exercise carbohydrate (CHO) and energy availability (EA) on potent skeletal muscle cell signalling pathways (regulating mitochondrial biogenesis and lipid metabolism) and indicators of bone metabolism. In a repeated measures design, nine males completed a morning (AM) and afternoon (PM) high-intensity interval (HIT) (8 × 5 min at 85% V ̇ O 2 peak ) running protocol (interspersed by 3.5 h) under dietary conditions of (1) high CHO availability (HCHO: CHO ∼12 g kg^-1 , EA∼ 60 kcal kg^-1 fat free mass (FFM)), (2) reduced CHO but high fat availability (LCHF: CHO ∼3 (^-1 , EA∼ 60 kcal kg^-1 FFM) or (3), reduced CHO and reduced energy availability (LCAL: CHO ∼3 g kg^-1 , EA∼ 20 kcal kg^-1 FFM). Muscle glycogen was reduced to ∼200 mmol kg^-1  dw in all trials immediately post PM HIT (P < 0.01) and remained lower at 17 h (171, 194 and 316 mmol kg^-1  dw) post PM HIT in LCHF and LCAL (P < 0.001) compared to HCHO. Exercise induced comparable p38MAPK phosphorylation (P < 0.05) immediately post PM HIT and similar mRNA expression (all P < 0.05) of PGC-1α, p53 and CPT1 mRNA in HCHO, LCHF and LCAL. Post-exercise circulating βCTX was lower in HCHO (P < 0.05) compared to LCHF and LCAL whereas exercise-induced increases in IL-6 were larger in LCAL (P < 0.05) compared to LCHF and HCHO. In conditions where glycogen concentration is maintained within 200-350 mmol kg^-1  dw, we conclude post-exercise CHO and energy restriction (i.e. < 24 h) does not potentiate cell signalling pathways that regulate hallmark adaptations associated with endurance training. In contrast, consuming CHO before, during and after HIT running attenuates bone resorption, effects that are independent of energy availability and circulating IL-6.

Twice-a-day training improves mitochondrial efficiency, but not mitochondrial biogenesis, compared with once-daily training

Exercise training performed with lowered muscle glycogen stores can amplify adaptations related to oxidative metabolism, but it is not known if this is affected by the "train-low" strategy used (i.e., once-daily versus twice-a-day training). Fifteen healthy men performed 3 wk of an endurance exercise (100-min) followed by a high-intensity interval exercise 2 (twice-a-day group, n = 8) or 14 h (once-daily group, n = 7) later; therefore, the second training session always started with low muscle glycogen in both groups. Mitochondrial efficiency (state 4 respiration) was improved only for the twice-a-day group (group × training interaction, P < 0.05). However, muscle citrate synthase activity, mitochondria, and lipid area in intermyofibrillar and subsarcolemmal regions, and PGC1α, PPARα, and electron transport chain relative protein abundance were not altered with training in either group (P > 0.05). Markers of aerobic fitness (e.g., peak oxygen uptake) were increased, and plasma lactate, O₂ cost, and rating of perceived exertion during a 100-min exercise task were reduced in both groups, although the reduction in rating of perceived exertion was larger in the twice-a-day group (group × time × training interaction, P < 0.05). These findings suggest similar training adaptations with both training low approaches; however, improvements in mitochondrial efficiency and perceived effort seem to be more pronounced with twice-a-day training.NEW & NOTEWORTHY We assessed, for the first time, the differences between two "train-low" strategies (once-daily and twice-a-day) in terms of training-induced molecular, functional, and morphological adaptations. We found that both strategies had similar molecular and morphological adaptations; however, only the twice-a-day strategy increased mitochondrial efficiency and had a superior reduction in the rating of perceived exertion during a constant-load exercise compared with once-daily training. Our findings provide novel insights into skeletal muscle adaptations using the "train-low" strategy.

Nutrition and Supplement Update for the Endurance Athlete: Review and Recommendations

Background: Endurance events have experienced a significant increase in growth in the new millennium and are popular activities for participation globally. Sports nutrition recommendations for endurance exercise however remains a complex issue with often opposing views and advice by various health care professionals. Methods: A PubMed/Medline search on the topics of endurance, athletes, nutrition, and performance was undertaken and a review performed summarizing the current evidence concerning macronutrients, hydration, and supplements as it pertains to endurance athletes. Results: Carbohydrate and hydration recommendations have not drastically changed in years, while protein and fat intake have been traditionally underemphasized in endurance athletes. Several supplements are commercially available to athletes, of which, few may be of benefit for endurance activities, including nitrates, antioxidants, caffeine, and probiotics, and are reviewed here. The topic of “train low,” training in a low carbohydrate state is also discussed, and the post-exercise nutritional “recovery window” remains an important point to emphasize to endurance competitors. Conclusions: This review summarizes the key recommendations for macronutrients, hydration, and supplements for endurance athletes, and helps clinicians treating endurance athletes clear up misconceptions in sports nutrition research when counseling the endurance athlete.

Plasma free fatty acid concentration is closely tied to whole body peak fat oxidation rate during repeated exercise

Plasma free fatty acids (FFA) are a major contributor to whole body fat oxidation during exercise. However, the extent to which manipulating plasma FFA concentrations will influence whole body peak fat oxidation rate (PFO) during exercise remains elusive. In this study we aimed to increase plasma FFA concentrations through a combination of fasting and repeated exercise bouts. We hypothesized that an increase in plasma FFA concentration would increase PFO in a dose-dependent manner. Ten healthy young (31 ± 6 yr) (mean ± SD) well-trained (maximal oxygen uptake 65.9 ± 6.1 ml·min−1·kg−1) men performed four graded exercise tests (GXTs) on 1 day. The GXTs were interspersed by 4 h of bed rest. This was conducted either in a fasted state or with the consumption of a standardized carbohydrate-rich meal 3.5 h before each GXT. Fasting and previous GXTs resulted in a gradual increase in PFO from 0.63 ± 0.18 g/min after an overnight fast (10 h) to 0.93 ± 0.17 g/min after ∼22 h of fasting and three previous GXTs. This increase in PFO coincided with an increase in plasma FFA concentrations ( r2 = 0.73, P < 0.0001). Ingestion of a carbohydrate-rich meal 3.5 h before each GXT resulted in unaltered PFO. This was also reflected in unchanged plasma FFA, glucose, and insulin concentrations. In this study we show that plasma FFA availability is closely tied to whole body PFO and that the length of fasting combined with previous exercise are robust stimuli toward increasing plasma FFA concentration, highlighting the importance for preexercise standardization when conducting GXTs measuring substrate oxidation.

NEW & NOTEWORTHY We show that peak fat oxidation is increased in close relationship with plasma free fatty acid availability after combined fasting and repeated incremental exercise tests in healthy highly trained men. Therefore it may be argued that whole body fat oxidation rate measured in most cases after an overnight fast indeed does not represent whole body maximal fat oxidation rate but a whole body peak fat oxidation rate within the context of the preexercise standardization obtained in the study design.

Graded reductions in preexercise muscle glycogen impair exercise capacity but do not augment skeletal muscle cell signaling: implications for CHO periodization

We examined the effects of graded muscle glycogen on exercise capacity and modulation of skeletal muscle signaling pathways associated with the regulation of mitochondrial biogenesis. In a repeated-measures design, eight men completed a sleep-low, train-low model comprising an evening glycogen-depleting cycling protocol followed by an exhaustive exercise capacity test [8 × 3 min at 80% peak power output (PPO), followed by 1-min efforts at 80% PPO until exhaustion] the subsequent morning. After glycogen-depleting exercise, subjects ingested a total of 0 g/kg (L-CHO), 3.6 g/kg (M-CHO), or 7.6 g/kg (H-CHO) of carbohydrate (CHO) during a 6-h period before sleeping, such that exercise was commenced the next morning with graded ( P < 0.05) muscle glycogen concentrations (means ± SD: L-CHO: 88 ± 43, M-CHO: 185 ± 62, H-CHO: 278 ± 47 mmol/kg dry wt). Despite differences ( P < 0.05) in exercise capacity at 80% PPO between trials (L-CHO: 18 ± 7, M-CHO: 36 ± 3, H-CHO: 44 ± 9 min), exercise induced comparable AMPKThr172 phosphorylation (~4-fold) and PGC-1α mRNA expression (~5-fold) after exercise and 3 h after exercise, respectively. In contrast, neither exercise nor CHO availability affected the phosphorylation of p38MAPKThr180/Tyr182 or CaMKIIThr268 or mRNA expression of p53, Tfam, CPT-1, CD36, or PDK4. Data demonstrate that when exercise is commenced with muscle glycogen < 300 mmol/kg dry wt, further graded reductions of 100 mmol/kg dry weight impair exercise capacity but do not augment skeletal muscle cell signaling.

NEW & NOTEWORTHY We provide novel data demonstrating that when exercise is commenced with muscle glycogen below 300 mmol/kg dry wt (as achieved with the sleep-low, train-low model) further graded reductions in preexercise muscle glycogen of 100 mmol/kg dry wt reduce exercise capacity at 80% peak power output by 20–50% but do not augment skeletal muscle cell signaling.

Dietary Fuels in Athletic Performance

Focusing on daily nutrition is important for athletes to perform and adapt optimally to exercise training. The major roles of an athlete's daily diet are to supply the substrates needed to cover the energy demands for exercise, to ensure quick recovery between exercise bouts, to optimize adaptations to exercise training, and to stay healthy. The major energy substrates for exercising skeletal muscles are carbohydrate and fat stores. Optimizing the timing and type of energy intake and the amount of dietary macronutrients is essential to ensure peak training and competition performance, and these strategies play important roles in modulating skeletal muscle adaptations to endurance and resistance training. In this review, recent advances in nutritional strategies designed to optimize exercise-induced adaptations in skeletal muscle are discussed, with an emphasis on mechanistic approaches, by describing the physiological mechanisms that provide the basis for different nutrition regimens.

Carbohydrate Availability and Physical Performance: Physiological Overview and Practical Recommendations

Strong evidence during the last few decades has highlighted the importance of nutrition for sport performance, the role of carbohydrates (CHO) being of special interest. Glycogen is currently not only considered an energy substrate but also a regulator of the signaling pathways that regulate exercise-induced adaptations. Thus, low or high CHO availabilities can result in both beneficial or negative results depending on the purpose. On the one hand, the depletion of glycogen levels is a limiting factor of performance during sessions in which high exercise intensities are required; therefore ensuring a high CHO availability before and during exercise is of major importance. A high CHO availability has also been positively related to the exercise-induced adaptations to resistance training. By contrast, a low CHO availability seems to promote endurance-exercise-induced adaptations such as mitochondrial biogenesis and enhanced lipolysis. In the present narrative review, we aim to provide a holistic overview of how CHO availability impacts physical performance as well as to provide practical recommendations on how training and nutrition might be combined to maximize performance. Attending to the existing evidence, no universal recommendations regarding CHO intake can be given to athletes as nutrition should be periodized according to training loads and objectives.

Carbohydrate Restriction in Type 1 Diabetes: A Realistic Therapy for Improved Glycaemic Control and Athletic Performance?

Around 80% of individuals with Type 1 diabetes (T1D) in the United States do not achieve glycaemic targets and the prevalence of comorbidities suggests that novel therapeutic strategies, including lifestyle modification, are needed. Current nutrition guidelines suggest a flexible approach to carbohydrate intake matched with intensive insulin therapy. These guidelines are designed to facilitate greater freedom around nutritional choices but they may lead to higher caloric intakes and potentially unhealthy eating patterns that are contributing to the high prevalence of obesity and metabolic syndrome in people with T1D. Low carbohydrate diets (LCD; <130 g/day) may represent a means to improve glycaemic control and metabolic health in people with T1D. Regular recreational exercise or achieving a high level of athletic performance is important for many living with T1D. Research conducted on people without T1D suggests that training with reduced carbohydrate availability (often termed "train low") enhances metabolic adaptation compared to training with normal or high carbohydrate availability. However, these "train low" practices have not been tested in athletes with T1D. This review aims to investigate the known pros and cons of LCDs as a potentially effective, achievable, and safe therapy to improve glycaemic control and metabolic health in people with T1D. Secondly, we discuss the potential for low, restricted, or periodised carbohydrate diets in athletes with T1D.

High-Intensity Exercise and Mitochondrial Biogenesis: Current Controversies and Future Research Directions

It is well established that different types of exercise can provide a powerful stimulus for mitochondrial biogenesis. However, there are conflicting findings in the literature, and a consensus has not been reached regarding the efficacy of high-intensity exercise to promote mitochondrial biogenesis in humans. The purpose of this review is to examine current controversies in the field and to highlight some important methodological issues that need to be addressed to resolve existing conflicts.

Relationship Between Various Training-Load Measures in Elite Cyclists During Training, Road Races, and Time Trials

Purpose: The relationship between various training-load (TL) measures in professional cycling is not well explored. This study investigated the relationship between mechanical energy spent (in kilojoules), session rating of perceived exertion (sRPE), Lucia training impulse (LuTRIMP), and training stress score (TSS) in training, races, and time trials (TT). Methods: For 4 consecutive years, field data were collected from 21 professional cyclists and categorized as being collected in training, racing, or TTs. Kilojoules (kJ) spent, sRPE, LuTRIMP, and TSS were calculated, and the correlations between the various TLs were made. Results: 11,655 sessions were collected, from which 7596 sessions had heart-rate data and 5445 sessions had an RPE score available. The r between the various TLs during training was almost perfect. The r between the various TLs during racing was almost perfect or very large. The r between the various TLs during TTs was almost perfect or very large. For all relationships between TSS and 1 of the other measurements of TL (kJ spent, sRPE, and LuTRIMP), a significant different slope was found. Conclusion: kJ spent, sRPE, LuTRIMP, and TSS all have a large or almost perfect relationship with each other during training, racing, and TTs, but during racing, both sRPE and LuTRIMP have a weaker relationship with kJ spent and TSS. Furthermore, the significant different slope of TSS vs the other measurements of TL during training and racing has the effect that TSS collected in training and road races differs by 120%, whereas the other measurements of TL (kJ spent, sRPE, and LuTRIMP) differ by only 73%, 67%, and 68%, respectively.

A Framework for Periodized Nutrition for Athletics

Over the last decade, in support of training periodization, there has been an emergence around the concept of nutritional periodization. Within athletics (track and field), the science and art of periodization is a cornerstone concept with recent commentaries emphasizing the underappreciated complexity associated with predictable performance on demand. Nevertheless, with varying levels of evidence, sport and event specific sequencing of various training units and sessions (long [macrocycle; months], medium [mesocycle; weeks], and short [microcycle; days and within-day duration]) is a routine approach to training periodization. Indeed, implementation of strategic temporal nutrition interventions (macro, meso, and micro) can support and enhance training prescription and adaptation, as well as acute event specific performance. However, a general framework on how, why, and when nutritional periodization could be implemented has not yet been established. It is beyond the scope of this review to highlight every potential nutritional periodization application. Instead, this review will focus on a generalized framework, with specific examples of macro-, meso-, and microperiodization for the macronutrients of carbohydrates, and, by extension, fat. More specifically, the authors establish the evidence and rationale for situations of acute high carbohydrate availability, as well as the evidence for more chronic manipulation of carbohydrates coupled with training. The topic of periodized nutrition has made considerable gains over the last decade but is ripe for further scientific progress and field application.