Changes in foot volume, body composition, and hydration status in male and female 24-hour ultra-mountain bikers

Ultra-Cycling- Past, Present, Future: A Narrative Review

BACKGROUND

Ultra-endurance events are gaining popularity in multiple exercise disciplines, including cycling. With increasing numbers of ultra-cycling events, aspects influencing participation and performance are of interest to the cycling community.

MAIN BODY

The aim of this narrative review was, therefore, to assess the types of races offered, the characteristics of the cyclists, the fluid and energy balance during the race, the body mass changes after the race, and the parameters that may enhance performance based on existing literature. A literature search was conducted in PubMed, Scopus, and Google Scholar using the search terms 'ultracycling', 'ultra cycling', 'ultra-cycling', 'ultra-endurance biking', 'ultra-bikers' and 'prolonged cycling'. The search yielded 948 results, of which 111 were relevant for this review. The studies were classified according to their research focus and the results were summarized. The results demonstrated changes in physiological parameters, immunological and oxidative processes, as well as in fluid and energy balance. While the individual race with the most published studies was the Race Across America, most races were conducted in Europe, and a trend for an increase in European participants in international races was observed. Performance seems to be affected by characteristics such as age and sex but not by anthropometric parameters such as skin fold thickness. The optimum age for the top performance was around 40 years. Most participants in ultra-cycling events were male, but the number of female athletes has been increasing over the past years. Female athletes are understudied due to their later entry and less prominent participation in ultra-cycling races. A post-race energy deficit after ultra-cycling events was observed.

CONCLUSION

Future studies need to investigate the causes for the observed optimum race age around 40 years of age as well as the optimum nutritional supply to close the observed energy gap under consideration of the individual race lengths and conditions. Another research gap to be filled by future studies is the development of strategies to tackle inflammatory processes during the race that may persist in the post-race period.

Ultra-Endurance Participation and Acute Kidney Injury: A Narrative Review

Increasingly popular, ultra-endurance participation exposes athletes to extremely high levels of functional and structural damage. Ultra-endurance athletes commonly develop acute kidney injury (AKI) and other pathologies harmful to kidney health. There is strong evidence that non-steroidal anti-inflammatory drugs, common amongst ultra-athletes, is linked to increased risk and severity of AKI and potentially ischaemic renal injury, i.e., acute tubular necrosis. Ultra-endurance participation also increases the risk of exertional rhabdomyolysis, exercise-associated hyponatremia, and gastrointestinal symptoms, interlinked pathologies all with potential to increase the risk of AKI. Hydration and fuelling both also play a role with the development of multiple pathologies and ultimately AKI, highlighting the need for individualised nutritional and hydration plans to promote athlete health. Faster athletes, supplementing nitrates, and being female also increase the risk of developing AKI in this setting. Serum creatinine criteria do not provide the best indicator for AKI for ultra-athletes therefore further investigations are needed to assess the practicality and accuracy of new renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL). The potential of recurring episodes of AKI provide need for further research to assess the longitudinal renal health impact of ultra-participation to provide appropriate advice to athletes, coaches, medical staff, and event organisers.

Tolvaptan Reduces Extracellular Fluid per Amount of Body Fluid Reduction Less Markedly than Conventional Diuretics

Objective Tolvaptan, a vasopressin V2 receptor antagonist, is a water diuretic, removing electrolyte-free water from the kidneys and affecting the water balance between the intracellular and extracellular fluid. We previously reported that tolvaptan efficiently reduced the intracellular fluid volume, suggesting its utility for treating cellular edema. Furthermore, tolvaptan is known for its low incidence of worsening the renal function, with conventional diuretics use associated with worsening of the renal function Methods In this retrospective observational study, five chronic kidney disease (CKD) patients with fluid retention were assessed by the bioelectrical impedance (BIA) method twice (before and after tolvaptan therapy). Tolvaptan was used with conventional diuretics. The post/pre ratio of extracellular water (ECW)/total body water (TBW) in the tolvaptan group was compared with that in 18 CKD patients undergoing body fluid reduction with conventional diuretics alone (conventional diuretics groups), taking the reduced amount of body fluid into consideration. Results Removing body fluid, either by tolvaptan or by conventional diuretics alone, decreased the ECW/TBW ratio. Of note, the reduction in extracellular fluid was milder in the tolvaptan group than in the conventional diuretics group. Conclusion Tolvaptan reduces the extracellular fluid per amount of body fluid reduction less markedly than conventional diuretics.

Analysis of the Impact of a Multi-Strain Probiotic on Body Composition and Cardiorespiratory Fitness in Long-Distance Runners

Use of probiotic supplements, the benefits of which have not been proven in sportspeople, is becoming more widespread among runners. The aim of this study was to evaluate the effect of a multi-strain probiotic on body composition, cardiorespiratory fitness and inflammation in the body. The randomised, double-blind study included 66 long-distance runners. The intervention factor was a multi-strain probiotic or placebo. At the initial and final stages of the study, evaluation of body composition and cardiorespiratory fitness was performed and the presence of inflammation determined. In the group of men using the probiotic, an increase in lean body mass (p = 0.019) and skeletal muscle mass (p = 0.022) was demonstrated, while in the group of women taking the probiotic, a decrease in the content of total body fat (p = 0.600) and visceral fat (p = 0.247) was observed. Maximum oxygen consumption (VO_2max) increased in women (p = 0.140) and men (p = 0.017) using the probiotic. Concentration of tumour necrosis factor-alpha decreased in women (p = 0.003) and men (p = 0.001) using the probiotic and in women (p = 0.074) and men (p = 0.016) using the placebo. Probiotic therapy had a positive effect on selected parameters of body composition and cardiorespiratory fitness of study participants and showed a tendency to reduce inflammation.

Tolvaptan Efficiently Reduces Intracellular Fluid: Working Toward a Potential Treatment Option for Cellular Edema

Objective Tolvaptan is a class of diuretics that reduce body water through aquaresis. One of the most prominent characteristics of these agents is that worsening of the renal function is less likely to occur. We investigated the underlying mechanism concerning the change in the intracellular fluid (ICF) when the body fluid is reduced. Methods In this retrospective observational study, five overhydrated chronic kidney disease (CKD) patients with edema or pleural effusion treated with tolvaptan were assessed by the bioelectrical impedance method twice: once before and once after tolvaptan therapy. The changes in the ICF rate were compared with those in 11 hemodialysis patients undergoing body fluid reduction by hemodialysis. Results Removal of the body fluid either by tolvaptan or by hemodialysis increased the post/pre-ratio of ICW/total body water (TBW). Tolvaptan reduced the ICF more efficiently than hemodialysis. Conclusion Tolvaptan treatment lessens body fluid by the efficient reduction of the ICF.

Pacing and Changes in Body Composition in 48 h Ultra-Endurance Running-A Case Study

Pacing has been investigated in elite and master runners competing in marathon and ultra-marathon races up to 100 km and 100 miles, but not in longer ultra-marathons. In this case study, a 54-year-old master ultra-marathoner—intending to achieve as many kilometers as possible in a 48 h run—was examined. The changes in running speed during the race and selected anthropometric characteristics using bioelectrical impedance analysis (i.e., body mass and body water), during and after the race, were analyzed. The runner achieved a total distance of 230 km and running speed decreased non-linearly during the race. Body mass decreased, while percent body water increased, non-linearly, across the race. There was no statistically significant relationship between the decrease in body mass and the increase in percent body water. Considering the popularity of ultra-endurance running races, the findings of the present study offered valuable insight in the pacing and changes of body mass and body water during a 48 h run, and this information can be used by ultra-endurance runners and practitioners working with them.

Reported Hydration Beliefs and Behaviors without Effect on Plasma Sodium in Endurance Athletes

Purpose: Little information is available on the association of hydration beliefs and behaviors in endurance athletes and exercise-associated hyponatremia (EAH). The aim of the present study was to determine hydration beliefs and behaviors in endurance athletes.

Method: A 100 and 38 recreational athletes [107 mountain bikers (MTBers) and 31 runners] competing in seven different endurance and ultra-endurance races completed pre- and post-race questionnaires, and a subgroup of 113 (82%) participants (82 MTBers and 31 runners) also provided their blood samples.

Result: More than half of the participants had some pre-race (59%), mid-race (58%), and post-race (55%) drinking plan. However, the participants simultaneously reported that temperature (66%), thirst (52%), and plan (37%) affected their drinking behavior during the race. More experienced (years of active sport: p = 0.002; number of completed races: p < 0.026) and trained (p = 0.024) athletes with better race performance (p = 0.026) showed a more profound knowledge of EAH, nevertheless, this did not influence their planned hydration, reported fluid intake, or post-race plasma sodium. Thirteen (12%) hyponatremic participants did not differ in their hydration beliefs, race behaviors, or reported fluid intake from those without post-race EAH. Compared to MTBers, runners more often reported knowledge of the volumes of drinks offered at fluid stations (p < 0.001) and information on how much to drink pre-race (p < 0.001), yet this was not associated with having a drinking plan (p > 0.05). MTBers with hydration information planned more than other MTBers (p = 0.004). In comparison with runners, more MTBers reported riding with their own fluids (p < 0.001) and planning to drink at fluid stations (p = 0.003). On the whole, hydration information was positively associated with hydration planning (n = 138) (p = 0.003); nevertheless, the actual reported fluid intake did not differ between the group with and without hydration information, or with and without a pre-race drinking plan (p > 0.05).

Conclusion: In summary, hydration beliefs and behaviors in the endurance athletes do not appear to affect the development of asymptomatic EAH.

Hydration assessment among marathoners using urine specific gravity and bioelectrical impedance analysis

The present study examined the relationship between urine specific gravity (Usg), body mass (BM) and bioelectrical impedance determined variables [total body water (TBW), per cent TBW and impedance values] before and after a marathon (n = 25 men; 10 women). A significant reduction in BM (pre: 71.2 ± 12.4 kg; post: 69.6 ± 12.0 kg; p < 0.001) and an increase in Usg (pre: 1.009 ± 0.007; post: 1.018 ± 0.009; p < 0.001) was observed post-race. TBW was not significantly decreased (pre: 42.7 ± 8.0 kg; post: 42.4 ± 7.7 kg) while per cent TBW significantly increased post-race (pre: 60.0 ± 3.9%; post: 60.8 ± 3.8%; p < 0.001). Impedance values were significantly greater post-race (pre: 3288 ± 482; post: 3416 ± 492 Ω; p < 0.001). There was no correlation between the change in Usg and the change in BM or any of the bioelectrical impedance determined variables. On average, BM, Usg and impedance values appear to express changes in hydration; however, the observed changes among these variables for a given individual appear to be inconsistent with one another.

Fluid retention, muscle damage, and altered body composition at the Ultraman triathlon

PURPOSE

The primary purpose of this investigation was to determine the effects of participation in a 3-day multistage ultraendurance triathlon (stage 1 = 10 km swim, 144.8 km bike; stage 2 = 275.4 km bike; stage 3 = 84.4 km run) on body mass and composition, hydration status, hormones, muscle damage, and blood glucose.

METHODS

Eighteen triathletes (mean ± SD; age 41 ± 7.5 years; height 175 ± 9 cm; weight 73.5 ± 9.8 kg; male n = 14, female n = 4) were assessed before and after each stage of the race. Body mass and composition were measured via bioelectrical impedance, hydration status via urine specific gravity, hormones and muscle damage via venous blood draw, and blood glucose via fingerstick.

RESULTS

Following the race, significant changes included reductions in body mass (qualified effect size: trivial), fat mass (moderate), and percent body fat (small); increases in percent total body water (moderate) and urine specific gravity (large); and unchanged absolute total body water and fat-free mass. There were also extremely large increases in creatine kinase, C-reactive protein, aldosterone and cortisol combined with reductions in testosterone (small) and the testosterone:cortisol ratio (moderate). There were associations between post-race aldosterone and total body water (r = -0.504) and changes in cortisol and fat-free mass (r = -0.536). Finally, blood glucose increased in a stepwise manner prior to each stage.

CONCLUSIONS

Participation in Ultraman Florida leads to fluid retention and dramatic alterations in body composition, muscle health, hormones, and metabolism.