Overtraining following intensified training with normal muscle glycogen

A Narrative Review on Adipose Tissue and Overtraining: Shedding Light on the Interplay among Adipokines, Exercise and Overtraining

Lifestyle factors, particularly physical inactivity, are closely linked to the onset of numerous metabolic diseases. Adipose tissue (AT) has been extensively studied for various metabolic diseases such as obesity, type 2 diabetes, and immune system dysregulation due to its role in energy metabolism and regulation of inflammation. Physical activity is increasingly recognized as a powerful non-pharmacological tool for the treatment of various disorders, as it helps to improve metabolic, immune, and inflammatory functions. However, chronic excessive training has been associated with increased inflammatory markers and oxidative stress, so much so that excessive training overload, combined with inadequate recovery, can lead to the development of overtraining syndrome (OTS). OTS negatively impacts an athlete's performance capabilities and significantly affects both physical health and mental well-being. However, diagnosing OTS remains challenging as the contributing factors, signs/symptoms, and underlying maladaptive mechanisms are individualized, sport-specific, and unclear. Therefore, identifying potential biomarkers that could assist in preventing and/or diagnosing OTS is an important objective. In this review, we focus on the possibility that the endocrine functions of AT may have significant implications in the etiopathogenesis of OTS. During physical exercise, AT responds dynamically, undergoing remodeling of endocrine functions that influence the production of adipokines involved in regulating major energy and inflammatory processes. In this scenario, we will discuss exercise about its effects on AT activity and metabolism and its relevance to the prevention and/or development of OTS. Furthermore, we will highlight adipokines as potential markers for diagnosing OTS.

A Simple Model for Diagnosis of Maladaptations to Exercise Training

Background

The concept of overreaching and super compensation is widely in use by athletes and coaches seeking to maximize performance and adaptations to exercise training. The physiological aspects of acute fatigue, overreaching and non-functional overreaching are, however, not well understood, and well-defined negative physiological outcomes are missing. Instead, the concept relies heavily on performance outcomes for differentiating between the states. Recent advancements in the field of integrated exercise physiology have associated maladaptations in muscular oxidative function to high loads of exercise training.

Method

Eleven female and male subjects that exercised regularly but did not engage in high-intensity interval training (HIIT) were recruited to a 4-week long training intervention where the responses to different training loads were studied. Highly monitored HIIT sessions were performed on a cycle ergometer in a progressive fashion with the intent to accomplish a training overload. Throughout the intervention, physiological and psychological responses to HIIT were assessed, and the results were used to construct a diagnostic model that could indicate maladaptations during excessive training loads.

Results

We here use mitochondrial function as an early marker of excessive training loads and show the dynamic responses of several physiological and psychological measurements during different training loads. During HIIT, a loss of mitochondrial function was associated with reduced glycolytic, glucoregulatory and heart rate responses and increased ratings of perceived exertion in relation to several physiological measurements. The profile of mood states was highly affected after excessive training loads, whereas performance staled rather than decreased. By implementing five of the most affected and relevant measured parameters in a diagnostic model, we could successfully, and in all the subjects, identify the training loads that lead to maladaptations.

Conclusions

As mitochondrial parameters cannot be assessed without donating a muscle biopsy, this test can be used by coaches and exercise physiologists to monitor adaptation to exercise training for improving performance and optimizing the health benefits of exercise.

Clinical trial registry numberNCT04753021. Retrospectively registered 2021-02-12.

Overtraining Syndrome as a Complex Systems Phenomenon

The phenomenon of reduced athletic performance following sustained, intense training (Overtraining Syndrome, and OTS) was first recognized more than 90 years ago. Although hundreds of scientific publications have focused on OTS, a definitive diagnosis, reliable biomarkers, and effective treatments remain unknown. The present review considers existing models of OTS, acknowledges the individualized and sport-specific nature of signs/symptoms, describes potential interacting predisposing factors, and proposes that OTS will be most effectively characterized and evaluated via the underlying complex biological systems. Complex systems in nature are not aptly characterized or successfully analyzed using the classic scientific method (i.e., simplifying complex problems into single variables in a search for cause-and-effect) because they result from myriad (often non-linear) concomitant interactions of multiple determinants. Thus, this review 1) proposes that OTS be viewed from the perspectives of complex systems and network physiology, 2) advocates for and recommends that techniques such as trans-omic analyses and machine learning be widely employed, and 3) proposes evidence-based areas for future OTS investigations, including concomitant multi-domain analyses incorporating brain neural networks, dysfunction of hypothalamic-pituitary-adrenal responses to training stress, the intestinal microbiota, immune factors, and low energy availability. Such an inclusive and modern approach will measurably help in prevention and management of OTS.

Energy availability during training camp is associated with signs of overreaching and changes in performance in young female cross-country skiers

Study aim: The aim of this study was to evaluate if young female skiers meet their energy and macronutrient requirements, and how energy availability (EA) and macronutrient intake affects their performance during an intensive training camp.

Material and methods: 19 female cross-country skiers (age 16.7 ± 0.7) filled in 48-hour food and training logs during a 5-day training camp. Fasting concentrations of hemoglobin, leptin, triiodothyronine (T3), insulin, insulin-like growth factor 1 (IGF-1), and glucose were measured before (PRE) and after (POST) the camp. Blood lactate (LA), heart rate (HR) and rating of perceived exertion (RPE) from a submaximal treadmill running test, jump height from counter movement jump (CMJ), and power from a reactive jump test (RJ) were also measured PRE and POST.

Results: Mean EA was 40.3 ± 17.3 kcal · kgFFM–1 · d–1. 58% of the participants had suboptimal EA, 37% had low EA, and 53% had suboptimal carbohydrate intake. HR, HR/RPE ratio, LA/RPE ratio, CMJ, hemoglobin, leptin, T3, and insulin decreased from PRE to POST. RPE and glucose increased from PRE to POST. EA during the camp correlated with changes in LA (r = 0.54, p = 0.018), LA/RPE (r = 0.65, p = 0.003), and RJ (r = 0.47, p = 0.043).

Conclusions: Many athletes had difficulties in meeting their energy and carbohydrate requirements during a training camp. Furthermore, sufficient EA may help to avoid overreaching and to maintain performance during an intensive training period.

Overtraining Syndrome (OTS) and Relative Energy Deficiency in Sport (RED-S): Shared Pathways, Symptoms and Complexities

The symptom similarities between training-overload (with or without an Overtraining Syndrome (OTS) diagnosis) and Relative Energy Deficiency in Sport (RED-S) are significant, with both initiating from a hypothalamic-pituitary origin, that can be influenced by low carbohydrate (CHO) and energy availability (EA). In this narrative review we wish to showcase that many of the negative outcomes of training-overload (with, or without an OTS diagnosis) may be primarily due to misdiagnosed under-fueling, or RED-S, via low EA and/or low CHO availability. Accordingly, we undertook an analysis of training-overload/OTS type studies that have also collected and analyzed for energy intake (EI), CHO, exercise energy expenditure (EEE) and/or EA. Eighteen of the 21 studies (86%) that met our criteria showed indications of an EA decrease or difference between two cohorts within a given study (n = 14 studies) or CHO availability decrease (n = 4 studies) during the training-overload/OTS period, resulting in both training-overload/OTS and RED-S symptom outcomes compared to control conditions. Furthermore, we demonstrate significantly similar symptom overlaps across much of the OTS (n = 57 studies) and RED-S/Female Athlete Triad (n = 88 studies) literature. It is important to note that the prevention of under-recovery is multi-factorial, but many aspects are based around EA and CHO availability. Herein we have demonstrated that OTS and RED-S have many shared pathways, symptoms, and diagnostic complexities. Substantial attention is required to increase the knowledge and awareness of RED-S, and to enhance the diagnostic accuracy of both OTS and RED-S, to allow clinicians to more accurately exclude LEA/RED-S from OTS diagnoses.

Functional Overreaching in Endurance Athletes: A Necessity or Cause for Concern?

There are variable responses to short-term periods of increased training load in endurance athletes, whereby some athletes improve without deleterious effects on performance, while others show diminished exercise performance for a period of days to months. The time course of the decrement in performance and subsequent restoration, or super compensation, has been used to distinguish between the different stages of the fitness-fatigue adaptive continuum termed functional overreaching (FOR), non-functional overreaching (NFOR) or overtraining syndrome. The short-term transient training-induced decrements in performance elicited by increases in training load (i.e. FOR) are thought be a sufficient and necessary component of a training program and are often deliberately induced in training to promote meaningful physiological adaptations and performance super-compensation. Despite the supposition that deliberately inducing FOR in athletes may be necessary to achieve performance super-compensation, FOR has been associated with various negative cardiovascular, hormonal and metabolic consequences. Furthermore, recent studies have demonstrated dampened training and performance adaptations in FOR athletes compared to non-overreached athletes who completed the same training program or the same relative increase in training load. However, this is not always the case and a number of studies have also demonstrated substantial performance super-compensation in athletes who were classified as being FOR. It is possible that there are a number of contextual factors that may influence the metabolic consequences associated with FOR and classifying this training-induced state of fatigue based purely on a decrement in performance may be an oversimplification. Here, the most recent research on FOR in endurance athletes will be critically evaluated to determine (1) if there is sufficient evidence to indicate that inducing a state of FOR is necessary and required to induce a performance super-compensation; (2) the metabolic consequences that are associated with FOR; (3) strategies that may prevent the negative consequences of overreaching.

Monitoring training and recovery responses with heart rate measures during standardized warm-up in elite badminton players

Purpose

To investigate short-term training and recovery-related effects on heart rate during a standardized submaximal running test.

Methods

Ten elite badminton players (7 females and 3 males) were monitored during a 12-week training period in preparation for the World Championships. Exercise heart rate (HRex) and perceived exertion were measured in response to a 5-min submaximal shuttle-run test during the morning session warm-up. This test was repeatedly performed on Mondays after 1–2 days of pronounced recovery (‘recovered’ state; reference condition) and on Fridays following 4 consecutive days of training (‘strained’ state). In addition, the serum concentration of creatine kinase and urea, perceived recovery–stress states, and jump performance were assessed before warm-up.

Results

Creatine kinase increased in the strained compared to the recovered state and the perceived recovery–stress ratings decreased and increased, respectively (range of average effects sizes: |d| = 0.93–2.90). The overall HRex was 173 bpm and the observed within-player variability (i.e., standard deviation as a coefficient of variation [CV]) was 1.3% (90% confidence interval: 1.2% to 1.5%). A linear reduction of -1.4% (-3.0% to 0.3%) was observed in HRex over the 12-week observational period. HRex was -1.5% lower (-2.2% to -0.9%) in the strained compared to the recovered state, and the standard deviation (as a CV) representing interindividual variability in this response was 0.7% (-0.6% to 1.2%).

Conclusions

Our findings suggest that HRex measured during a standardized warm-up can be sensitive to short-term accumulation of training load, with HRex decreasing on average in response to consecutive days of training within repeated preparatory weekly microcycles. From a practical perspective, it seems advisable to determine intra-individual recovery–strain responses by repeated testing, as HRex responses may vary substantially between and within players.

Exercise Time and Intensity: How Much Is Too Much?

The growing prevalence and popularity of interval training necessitate additional guidelines in regard to maximal levels of time and intensity.

PURPOSE

To correlate salivary hormones and time in varying heart-rate (HR) zones. The hypothesis was that chronic exercise durations >9% of total exercise time in the >90% maximum HR zone would lead to decreased variation in salivary cortisol concentration after exercise in a 2-bout high-intensity protocol compared with less or more time in this zone.

METHODS

A total of 35 healthy adults who regularly exercised for an average of 8 hours per week recorded their HR during every training session for 3 weeks. Later, they completed an experimental day composed of two 30-minute high-intensity interval sessions separated by 4 hours of nonactive recovery. The authors collected saliva samples before, immediately following, and 30 minutes after each exercise session to assess changes in cortisol concentrations.

RESULTS

There was a correlation between weekly time training at an intensity >90% maximum HR and the variables associated with overtraining. Salivary cortisol concentration fluctuated less in the participants who exercised in this extreme zone for >40 minutes per week (P < .001).

CONCLUSION

Based on the current study data, for individuals who regularly exercise, 4% to 9% total training time above 90% maximum HR is the ideal duration to maximize fitness and minimize symptoms related to overreaching.

Ketone ester supplementation blunts overreaching symptoms during endurance training overload

KEY POINTS

Overload training is required for sustained performance gain in athletes (functional overreaching). However, excess overload may result in a catabolic state which causes performance decrements for weeks (non-functional overreaching) up to months (overtraining). Blood ketone bodies can attenuate training- or fasting-induced catabolic events. Therefore, we investigated whether increasing blood ketone levels by oral ketone ester (KE) intake can protect against endurance training-induced overreaching. We show for the first time that KE intake following exercise markedly blunts the development of physiological symptoms indicating overreaching, and at the same time significantly enhances endurance exercise performance. We provide preliminary data to indicate that growth differentiation factor 15 (GDF15) may be a relevant hormonal marker to diagnose the development of overtraining. Collectively, our data indicate that ketone ester intake is a potent nutritional strategy to prevent the development of non-functional overreaching and to stimulate endurance exercise performance.

ABSTRACT

It is well known that elevated blood ketones attenuate net muscle protein breakdown, as well as negate catabolic events, during energy deficit. Therefore, we hypothesized that oral ketones can blunt endurance training-induced overreaching. Fit male subjects participated in two daily training sessions (3 weeks, 6 days/week) while receiving either a ketone ester (KE, n = 9) or a control drink (CON, n = 9) following each session. Sustainable training load in week 3 as well as power output in the final 30 min of a 2-h standardized endurance session were 15% higher in KE than in CON (both P < 0.05). KE inhibited the training-induced increase in nocturnal adrenaline (P < 0.01) and noradrenaline (P < 0.01) excretion, as well as blunted the decrease in resting (CON: -6 ± 2 bpm; KE: +2 ± 3 bpm, P < 0.05), submaximal (CON: -15 ± 3 bpm; KE: -7 ± 2 bpm, P < 0.05) and maximal (CON: -17 ± 2 bpm; KE: -10 ± 2 bpm, P < 0.01) heart rate. Energy balance during the training period spontaneously turned negative in CON (-2135 kJ/day), but not in KE (+198 kJ/day). The training consistently increased growth differentiation factor 15 (GDF15), but ∼2-fold more in CON than in KE (P < 0.05). In addition, delta GDF15 correlated with the training-induced drop in maximal heart rate (r = 0.60, P < 0.001) and decrease in osteocalcin (r = 0.61, P < 0.01). Other measurements such as blood ACTH, cortisol, IL-6, leptin, ghrelin and lymphocyte count, and muscle glycogen content did not differentiate KE from CON. In conclusion, KE during strenuous endurance training attenuates the development of overreaching. We also identify GDF15 as a possible marker of overtraining.

Effects of 10 weeks of military training on neuromuscular function in non-overreached and overreached conscripts

The purpose of the study was to examine how military training influences neuromuscular function in non-overreached and overreached conscripts. A total of 24 male conscripts participated in the study (8 weeks basic training + 2 weeks specialized training). All measurements were conducted during weeks 1, 5, 8 and 10. After the training period, non-overreached (NOR, n = 16) and overreached (OR, n = 8) groups were compared. Isometric maximal forces (bench press, elbow flexion and knee extension), single twitch (plantar flexors), H-reflex, M-wave (Hmax/Mmax) and V-wave (V/Mmax) (soleus) were measured. In knee extension, force production increased in NOR by 22.5 ± 20.5% (p < 0.01) between weeks 1 and 8, which was not observed in OR (-1.1 ± 18.2%, p > 0.05). In OR, plantarflexion twitch contraction time increased between weeks 5 and 10 by 82.2 ± 34.4% (p < 0.01), which was not observed in NOR. No changes were observed in the H-reflex and V-wave responses in either of the groups. In conclusion, short term overreaching can also reduce the performance of the neuromuscular system, however, it seems to be more muscle than neural based. To avoid overreaching, more individualized periodization should be used during basic training. To enhance neuromuscular performance, maximal and explosive strength training should also be added into the basic training program.

Blood Biomarkers in Sports Medicine and Performance and the Future of Metabolomics

The field of sports medicine and performance has undergone an important transformation in the past years where the scientific approach is becoming increasingly more important for teams and athletes. Physical and physiological fitness, nutrition, fatigue and recovery, as well as injury prevention are key elements of the scientific monitoring of athletes nowadays. Many different methods are used nowadays as part of the scientific monitoring and testing of the competitive athlete. Among them, physiological and metabolic testing, biomechanical and movement assessments, GPS-based tracking systems, heart rate monitors, power meters, and training software are an integrative part of the scientific monitor program of many teams and athletes.Blood biomarkers through traditional blood analysis have been used for over three decades (mainly in Europe) to monitor athletic performance. In the same manner that different cells in the body respond to the stress of an infection or a disease, cells in athletes respond to the stress of competition and training. Nowadays, the area of blood biomarkers is an emerging field in the US offering important level of possibilities to monitor athletes. The field of metabolomics can offer a significantly higher level of blood biomarkers for sports medicine and performance monitoring.

DIAGNOSIS OF OVERTRAINING SYNDROME

ABSTRACT Overtraining syndrome (OTS) is a condition associated with diminished sports performance due to an increase in the volume and/or intensity of physical activity without adequate rest, and/or due to an inadequate diet. The condition often involves hormonal, nutritional, emotional, muscle, immune and neurological imbalances. Epidemiology varies considerably, affecting both sexes in different age groups. Diagnosis is still a challenge, as the syndrome resembles different diseases. The lack of specific symptoms requires a meticulous investigation in all athletes, which is often multidisciplinary. OTS can have an important repercussion on sports performance and on the quality of life of athletes. Methods: This is a mapping of scientific literature along the lines of the Systemic Review. The databases investigated were: MEDLINE and Latin American and Caribbean Health Sciences Literature – LILACS and EMBASE, in addition to printed documents. Studies describing OTS were included, prioritizing articles that report the efficacy of the different diagnostic methods, be they clinical, laboratory, or imaging. Results: We found 83 articles, of which 30 were selected. Conclusion: The only symptom present in all the different forms of manifestation of OTS is loss of performance. However, some tests assessing oxidative stress levels seem promising, even though they are not specific. Revision article.

Decrement in Professional Cyclists' Performance After a Grand Tour

PURPOSE

To analyze professional cyclists' performance declines after, and the exercise demands during, a Grand Tour.

METHODS

Seven professional cyclists performed 2 incremental exercise tests, 1 wk before and the day after the Vuelta España. During the race the exercise demands were analyzed on the basis of heart rate (HR). Three intensity zones were established according to reference HR values corresponding to the ventilatory- (VT) and respiratory-compensation (RCT) thresholds determined during the prerace test. In addition, exercise demands for the last weeks of the Vuelta were recalculated using the reference HR determined during the postrace test for the 3rd week and averaging the change observed in the VT and RCT per stage for the 2nd week. The reference HR for the beginning of the 2nd week was estimated.

RESULTS

A significant (P-value range, .044-.000) decrement in oxygen uptake, power output, and HR at maximal exercise, VT, and RCT was found after the race. Based on the prerace test, the mean time spent daily above the RCT was 13.8 ± 10.2 min. This time decreased -1.2 min·day^-1 across the race. When the exercise intensity was corrected according to the postrace test, the time above RCT (34.1 ± 9.9 min) increased 1.0 min·day^-1.

CONCLUSION

These data indicate that completing a Grand Tour may result in a significant decrement in maximal and submaximal endurance performance capacity. This may modify reference values used to analyze exercise demands. As a consequence, the high-intensity exercise performed by cyclists may be underestimated.

Diagnosis and prevention of overtraining syndrome: an opinion on education strategies

Overtraining syndrome is a condition of maladapted physiology in the setting of excessive exercise without adequate rest. The exact etiology and pathogenesis are unknown and being investigated. Symptoms are multisystem in nature and often representative of underlying hormonal, immunologic, neurologic, and psychologic disturbances. Unfortunately, systematic review of the literature does not clearly direct diagnosis, management, or prevention. However, given the severity of symptoms and impairment to quality of life, prevention of overtraining syndrome should be considered by all who interact with endurance athletes. This article will provide suggestions for management of at-risk athletes despite absence of validated diagnostic tests and preventative measures.

Sports Ultrasound: Applications Beyond the Musculoskeletal System

BACKGROUND

Traditionally, ultrasound has been used to evaluate musculoskeletal injuries in athletes; however, ultrasound applications extend well beyond musculoskeletal conditions, many of which are pertinent to athletes.

EVIDENCE ACQUISITION

Articles were identified in PubMed using the search terms ultrasound, echocardiogram, preparticipation physical examination, glycogen, focused assessment with sonography of trauma, optic nerve, and vocal cord dysfunction. No date restrictions were placed on the literature search.

STUDY DESIGN

Clinical review.

LEVEL OF EVIDENCE

Level 4.

RESULTS

Several potential applications of nonmusculoskeletal ultrasound in sports medicine are presented, including extended Focused Assessment with Sonography for Trauma (eFAST), limited echocardiographic screening during preparticipation physical examinations, assessment of muscle glycogen stores, optic nerve sheath diameter measurements in athletes with increased intracranial pressure, and assessment of vocal cord dysfunction in athletes.

CONCLUSION

Ultrasound can potentially be used to assist athletes with monitoring their muscle glycogen stores and the diagnosis of multiple nonmusculoskeletal conditions within sports medicine.

Effects of Methane-Rich Saline on the Capability of One-Time Exhaustive Exercise in Male SD Rats

Purpose

To explore the effects of methane-rich saline (CH₄ saline) on the capability of one-time exhaustive exercise in male SD rats.

Methods

Thirty rats were equally divided into to three groups at random: control group (C), placebo group (P) and methane saline group (M). Rats in M group underwent intraperitoneal injection of CH₄ saline, and the other two groups simultaneously underwent intraperitoneal injection of normal saline. Then, the exercise capability of rats was tested through one-time exhaustive treadmill exercise except C group. Exercise time and body weight were recorded before and after one-time exhaustive exercise. After exhaustive exercise, the blood and gastrocnemius samples were collected from all rats to detect biochemical parameters in different methods.

Results

It was found that the treadmill running time was significantly longer in rats treated with CH₄ saline. At the same time, CH₄ saline reduced the elevation of LD and UN in blood caused by one-time exhaustive exercise. The low level of blood glucose induced by exhaustive exercise was also normalized by CH₄ saline. Also CH₄ saline lowered the level of CK in plasma. Furthermore, this research indicated that CH₄ saline markedly increased the volume of T-AOC in plasma and alleviated the peak of TNF-α in both plasma and gastrocnemius. From H&E staining, CH₄ saline effectively improved exercise-induced structural damage in gastrocnemius.

Conclusions

CH₄ saline could enhance exercise capacity in male SD rats through increase of glucose aerobic oxidation, improvement of metabolic clearance and decrease of exhaustive exercise-induced gastrocnemius injury.

Impact of intensified training and carbohydrate supplementation on immunity and markers of overreaching in highly trained cyclists

Purpose

To determine effects of intensified training (IT) and carbohydrate supplementation on overreaching and immunity.

Methods

In a randomized, double-blind, crossover design, 13 male cyclists (age 25 ± 6 years, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}O_{2\hbox{max} }$$\end{document}V˙O2max 72 ± 5 ml/kg/min) completed two 8-day periods of IT. On one occasion, participants ingested 2 % carbohydrate (L-CHO) beverages before, during and after training sessions. On the second occasion, 6 % carbohydrate (H-CHO) solutions were ingested before, during and after training, with the addition of 20 g of protein in the post-exercise beverage. Blood samples were collected before and immediately after incremental exercise to fatigue on days 1 and 9.

Results

In both trials, IT resulted in decreased peak power (375 ± 37 vs. 391 ± 37 W, P < 0.001), maximal heart rate (179 ± 8 vs. 190 ± 10 bpm, P < 0.001) and haematocrit (39 ± 2 vs. 42 ± 2 %, P < 0.001), and increased plasma volume (P < 0.001). Resting plasma cortisol increased while plasma ACTH decreased following IT (P < 0.05), with no between-trial differences. Following IT, antigen-stimulated whole blood culture production of IL-1α was higher in L-CHO than H-CHO (0.70 (95 % CI 0.52–0.95) pg/ml versus 0.33 (0.24–0.45) pg/ml, P < 0.01), as was production of IL-1β (9.3 (95 % CI 7–10.4) pg/ml versus 6.0 (5.0–7.8) pg/ml, P < 0.05). Circulating total leukocytes (P < 0.05) and neutrophils (P < 0.01) at rest increased following IT, as did neutrophil:lymphocyte ratio and percentage CD4+ lymphocytes (P < 0.05), with no between-trial differences.

Conclusion

IT resulted in symptoms consistent with overreaching, although immunological changes were modest. Higher carbohydrate intake was not able to alleviate physiological/immunological disturbances.

The importance of the training-induced decrease in basal cortisol concentration in the improvement in muscular performance in humans

Acute exercise-induced changes in cortisol concentration (C) and training related adaptation within hypothalamic-pituitary-adrenal (HPA) axis has been widely examined, but their influence on muscle strength performance is at best uncertain. Twenty four young healthy men were randomly assigned to an endurance training group (ET, n=12) or to a non-exercising controls (CON, n=12). ET performed supervised endurance training on cycle ergometer for 20 weeks. Endurance training program improved exercise capacity (14 % increase in power output generated at peak oxygen uptake - VO(2peak)), muscle strength performance (increase in MVC - maximal voluntary contraction - by 9 % and in TTF 50 % MVC - time to fatigue at 50 % MVC - by 21 %) and led to a decrease in basal serum C concentration (P=0.006) and an increase in basal testosterone to cortisol (T/C) and free testosterone to cortisol (fT/C) ratios (P=0.01 and P=0.02, respectively). It was found that the decrease in C concentration (deltaC) was positively correlated to the increase in local muscular endurance (deltaTTF 50 % MVC). No significant hormonal changes were seen in CON group. It is concluded that greater decrease in cortisol concentration after the endurance training is accompanied by poorer improvement in skeletal muscle performance in previously untrained subjects.

An 8-year longitudinal study of overreaching in 114 elite female Chinese wrestlers

CONTEXT

Successful training involves structured overload but must avoid the combination of excessive overload and inadequate recovery.

OBJECTIVE

The aim of this study was to determine the incidence of functional overreaching (FOR), nonfunctional overreaching (NFOR), and overtraining syndrome in elite female wrestlers during their normal training and competition schedules and to explore the utility of blood markers for the early detection of overreaching. Classification of FOR, NFOR, and overtraining syndrome was based on the European Congress of Sports Medicine position statement.

DESIGN

Case series.

SETTING

China Institute of Sport Science.

PATIENTS OR OTHER PARTICIPANTS

Over an 8-year period, 114 wrestlers from the women's Asian wrestling team were monitored to help identify if and when they experienced FOR, NFOR, or overtraining syndrome.

MAIN OUTCOME MEASURE(S)

Creatine kinase, hemoglobin, testosterone, and cortisol were measured throughout the period to identify whether wrestlers were outside the reference intervals (constructed from normal recovery data) during periods of overreaching and not overreaching.

RESULTS

Among the 114 athletes, there were 13 (3.6%) instances of FOR, 23 (6.4%) instances of NFOR, and 2 (0.6%) instances of overtraining syndrome. The diagnostic sensitivity for FOR was 38%, 15%, 45%, and 18% for creatine kinase, hemoglobin, testosterone, and cortisol, respectively. The diagnostic sensitivity for NFOR was 29%, 33%, 26%, and 35% for creatine kinase, hemoglobin, testosterone, and cortisol, respectively. Specificity was 79%, 88%, 90%, and 82% for creatine kinase, hemoglobin, testosterone, and cortisol, respectively. Post hoc analysis showed no mean differences in creatine kinase (F = 0.5, P = .47), hemoglobin (F = 3.8, P = .052), testosterone (F = 0.2, P = .62), or cortisol (F = 0.04, P = .85) between monitoring periods when wrestlers were and were not diagnosed with FOR and NFOR.

CONCLUSIONS

Coaches and sports scientists should not use single blood variables as markers of overreaching in elite female wrestlers.

Validation of musculoskeletal ultrasound to assess and quantify muscle glycogen content. A novel approach

Glycogen storage is essential for exercise performance. The ability to assess muscle glycogen levels should be an important advantage for performance. However, skeletal muscle glycogen assessment has only been available and validated through muscle biopsy. We have developed a new methodology using high-frequency ultrasound to assess skeletal muscle glycogen content in a rapid, portable, and noninvasive way using MuscleSound (MuscleSound, LCC, Denver, CO) technology.

PURPOSE

To validate the utilization of high-frequency musculoskeletal ultrasound for muscle glycogen assessment and correlate it with histochemical glycogen quantification through muscle biopsy.

METHODS

Twenty-two male competitive cyclists (categories: Pro, 1-4; average height, 183.7 ± 4.9 cm; average weight, 76.8 ± 7.8 kg) performed a steady-state test on a cyclergometer for 90 minutes at a moderate to high exercise intensity, eliciting a carbohydrate oxidation of 2-3 g·min⁻¹ and a blood lactate concentration of 2 to 3 mM. Pre- and post-exercise glycogen content from rectus femoris muscle was measured using histochemical analysis through muscle biopsy and through high-frequency ultrasound scans using MuscleSound technology.

RESULTS

Correlations between muscle biopsy glycogen histochemical quantification (mmol·kg⁻¹) and high-frequency ultrasound methodology through MuscleSound technology were r = 0.93 (P < 0.0001) pre-exercise and r = 0.94 (P < 0.0001) post-exercise. The correlation between muscle biopsy glycogen quantification and high-frequency ultrasound methodology for the change in glycogen from pre- and post-exercise was r = 0.81 (P < 0.0001).

CONCLUSION

These results demonstrate that skeletal muscle glycogen can be measured quickly and noninvasively through high-frequency ultrasound using MuscleSound technology.

Effect of 24 sessions of high-intensity aerobic interval training carried out at either high or moderate frequency, a randomized trial

Purpose

The training response of an intensified period of high-intensity exercise is not clear. Therefore, we compared the cardiovascular adaptations of completing 24 high-intensity aerobic interval training sessions carried out for either three or eight weeks, respectively.

Methods

Twenty-one healthy subjects (23.0±2.1 years, 10 females) completed 24 high-intensity training sessions throughout a time-period of either eight weeks (moderate frequency, MF) or three weeks (high frequency, HF) followed by a detraining period of nine weeks without any training. In both groups, maximal oxygen uptake (VO_2max) was evaluated before training, at the 9^th and 17^th session and four days after the final 24^th training session. In the detraining phase VO_2max was evaluated after 12 days and thereafter every second week for eight weeks. Left ventricular echocardiography, carbon monoxide lung diffusion transfer factor, brachial artery flow mediated dilatation and vastus lateralis citrate maximal synthase activity was tested before and after training.

Results

The cardiovascular adaptation after HF training was delayed compared to training with MF. Four days after ending training the HF group showed no improvement (+3.0%, p = 0.126), whereas the MF group reached their highest VO_2max with a 10.7% improvement (p<0.001: group difference p = 0.035). The HF group reached their highest VO_2max (6.1% increase, p = 0.026) twelve days into the detraining period, compared to a concomitant reduction to 7.9% of VO_2max (p<0.001) above baseline in the MF group (group difference p = 0.609).

Conclusion

Both HF and MF training of high-intensity aerobic exercise improves VO_2max. The cardiovascular adaptation following a HF programme of high-intensity exercise is however delayed compared to MF training.

Trial Registration

ClinicalTrials.gov NCT00733941.

Monitoring chronic physical stress using biomarkers, performance protocols and mathematical functions to identify physiological adaptations in rats

This study was undertaken to characterize the effects of monotonous training at lactate minimum (LM) intensity on aerobic and anaerobic performances; glycogen concentrations in the soleus muscle, the gastrocnemius muscle and the liver; and creatine kinase (CK), free fatty acids and glucose concentrations in rats. The rats were separated into trained ( n = 10), baseline ( n = 10) and sedentary ( n = 10) groups. The trained group was submitted to the following: 60 min/day, 6 day/week and intensity equivalent to LM during the 12-week training period. The training volume was reduced after four weeks according to a sigmoid function. The total CK (U/L) increased in the trained group after 12 weeks (742.0 ± 158.5) in comparison with the baseline (319.6 ± 40.2) and the sedentary (261.6 ± 42.2) groups. Free fatty acids and glycogen stores (liver, soleus muscle and gastrocnemius muscle) increased after 12 weeks of monotonous training but aerobic and anaerobic performances were unchanged in relation to the sedentary group. The monotonous training at LM increased the level of energy substrates, unchanged aerobic performance, reduced anaerobic capacity and increased the serum CK concentration; however, the rats did not achieve the predicted training volume.

A multidisciplinary approach to overreaching detection in endurance trained athletes

In sport, high training load required to reach peak performance pushes human adaptation to their limits. In that process, athletes may experience general fatigue, impaired performance, and may be identified as overreached (OR). When this state lasts for several months, an overtraining syndrome is diagnosed (OT). Until now, no variable per se can detect OR, a requirement to prevent the transition from OR to OT. It encouraged us to further investigate OR using a multivariate approach, including physiological, biomechanical, cognitive, and perceptive monitoring. Twenty-four highly trained triathletes were separated into an overload group and a normo-trained group (NT) during 3 wk of training. Given the decrement of their running performance, 11 triathletes were diagnosed as OR after this period. A discriminant analysis showed that the changes of eight parameters measured during a maximal incremental test could explain 98.2% of the OR state (lactatemia, heart rate, biomechanical parameters and effort perception). Variations in heart rate and lactatemia were the two most discriminating factors. When the multifactorial analysis was restricted to these variables, the classification score reached 89.5%. Catecholamines and creatine kinase concentrations at rest did not change significantly in both groups. Running pattern was preserved and cognitive performance decrement was observed only at exhaustion in OR subjects. This study showed that monitoring various variables is required to prevent the transition between NT and OR. It emphasized that an OR index, which combines heart rate and blood lactate concentration changes after a strenuous training period, could be helpful to routinely detect OR.

Overtraining syndrome: a practical guide

CONTEXT

Fatigue and underperformance are common in athletes. Understanding overtraining syndrome (OTS) is helpful in the evaluation, management, and education of athletes.

EVIDENCE ACQUISITION

Relevant articles in English were searched with OVID (1948-2011) and PubMed using the following keywords: overtraining syndrome, overtraining, overreaching, unexplained underperformance, staleness, pathophysiology, management, treatment, evaluation. Bibliographies were reviewed for additional resources.

RESULTS

OTS appears to be a maladapted response to excessive exercise without adequate rest, resulting in perturbations of multiple body systems (neurologic, endocrinologic, immunologic) coupled with mood changes. Many hypotheses of OTS pathogenesis are reviewed, and a clinical approach to athletes with possible OTS (including history, testing, and prevention) is presented.

CONCLUSIONS

OTS remains a clinical diagnosis with arbitrary definitions per the European College of Sports Science's position statement. History and, in most situations, limited serologies are helpful. However, much remains to be learned given that most past research has been on athletes with overreaching rather than OTS.

Effects of 21 days of intensified training on markers of overtraining

The purpose of this study was to impose a period of quantifiable intensified training to determine if commonly used diagnostic markers of overtraining parallel changes in physical performance and thus overtraining status. Eight trained male cyclists (24 ± 1 years, 71 ± 3 kg, VO2peak = 4.5 ± 0.1·L·min⁻¹) performed 21 days (3,211 km) of intensified training in the field where volume and intensity were increased over normal training. Salivary IgA, testosterone, and cortisol, 1-hour time trial performance, heart rate response, and profile of mood states (POMS) were collected and analyzed throughout the 21-day training period. The POMS category vigor declined from day 1 to day 4 and remained lower throughout (p < 0.05). There were no other statistical changes in overtraining parameters. However, individuals who demonstrated 2 or more symptoms of overtraining at any point throughout the 21 days were considered symptomatic and had a lower (p < 0.05) VO2peak (4.2 ± 0.1·vs. 4.7 ± 0.1 L·min⁻¹) and lower (p < 0.05) average workload during the initial 1-hour time trial (253 ± 5 vs. 288 ± 14 W). Interestingly, the 1-hour time trial power in these individuals with symptoms of overtraining did not decline (p > 0.05). These data demonstrate that markers of overtraining do not parallel a decrease in performance and should be interpreted with caution.

Influence of dietary carbohydrate intake on the free testosterone: cortisol ratio responses to short-term intensive exercise training

This study examined the effect of dietary carbohydrate (CHO) consumption on the free testosterone to cortisol (fTC) ratio during a short-term intense micro-cycle of exercise training. The fTC ratio is a proposed biomarker for overreaching-overtraining (i.e., training stress or imbalance) in athletes. The ratio was studied in two groups, control-CHO (approximately 60% of daily intake, n = 12) and low-CHO (approximately 30% of daily intake, n = 8), of male subjects who performed three consecutive days of intensive training (approximately 70-75% maximal oxygen consumption, 60 min per day) with a dietary intervention (on the day before and during training). Resting, pre-exercise blood samples were collected under standardized-controlled conditions before each day of training (Pre 1, 2, 3) and on a fourth day after the micro-cycle (Rest). Bloods were analyzed for free testosterone and cortisol via radioimmunoassay procedures. Subjects performed no additional physical activity other than prescribed training. Statistical analysis (ANCOVA) revealed the fTC ratio decreased significantly (p < 0.01) from pre-study resting measurement (Pre 1) to the final post-study resting measurement (Rest) in the low-CHO group (-43%), but no change occurred (p > 0.05) in the control-CHO group (-3%). Findings suggest if the fTC ratio is utilized as a marker of training stress or imbalance it is necessary for a moderately high diet of CHO to be consumed to maintain validity of any observed changes in the ratio value.

Quantifying training load: a comparison of subjective and objective methods

PURPOSE

To establish the relationship between a subjective (session rating of perceived exertion [RPE]) and 2 objective (training impulse [TRIMP]) and summatedheart- rate-zone (SHRZ) methods of quantifying training load and explain characteristics of the variance not accounted for in these relationships.

METHODS

Thirty-three participants trained ad libitum for 2 wk, and their heart rate (HR) and RPE were recorded to calculate training load. Subjects were divided into groups based on whether the regression equations over- (OVER), under- (UNDER), or accurately predicted (ACCURATE) the relationship between objective and subjective methods.

RESULTS

A correlation of r = .76 (95% CI: .56 to .88) occurred between TRIMP and session-RPE training load. OVER spent a greater percentage of training time in zone 4 of SHRZ (ie, 80% to 90% HRmax) than UNDER (46% +/- 8% vs 25% +/- 10% [mean +/- SD], P = .008). UNDER spent a greater percentage of training time in zone 1 of SHRZ (ie, 50% to 60% HRmax) than OVER (15%+/- 8% vs 3% +/- 3%, P = .005) and ACCURATE (5% +/- 3%, P = .020) and more time in zone 2 of SHRZ (ie, 60% to 70%HRmax) than OVER (17% +/- 6% vs 7% +/- 6%, P = .039). A correlation of r = .84 (.70 to .92) occurred between SHRZ and session-RPE training load. OVER spent proportionally more time in Zone 4 than UNDER (45% +/- 8% vs 25% +/- 10%, P = .018). UNDER had a lower training HR than ACCURATE (132 +/- 10 vs 148 +/- 12 beats/min, P = .048) and spent more time in zone 1 than OVER (15% +/- 8% vs 4% +/- 3%, P = .013) and ACCURATE (5% +/- 3%, P = .015).

CONCLUSIONS

The session-RPE method provides reasonably accurate assessments of training load compared with HR-based methods, but they deviate in accuracy when proportionally more time is spent training at low or high intensity.

Physiological Aspects of Soccer Refereeing Performance and Training

The role of the referee is far from minimal in the economy of soccer, as very often, particularly in professional soccer, a wrong judgment may have profound implications on the outcome of the game. In this regard, a better knowledge of soccer refereeing can obviously benefit the game. Recent studies have shown that during a competitive match, an elite soccer referee may cover 9-13 km attaining approximately 85-90% and approximately 70-80% of maximal heart rate and maximal oxygen uptake (VO2max), respectively. Of the total distance covered about 4-18% is covered at high intensity. Blood lactate concentration has been reported to be in the range of 4-5 mmol/L; however, during competitive matches, blood lactate concentrations as high as 14 mmol/L have been observed. This figure is similar to that extensively reported for soccer players, specifically paralleling that observed in midfield players. However, compared with players, referees are 15-20 years older, often have a non-professional status and cannot be substituted during the game. Furthermore, this important physical stress superimposes onto a high perceptual-cognitive workload throughout the entire game. In relation to fitness status, referees possess VO2max values somewhat lower than the players they officiate, with mean values in the range of 44-50 mL/kg/min. However, the methods used by the Federation Internationale de Football Association and the Union of European Football Associations to test referee fitness need to be changed as the current fitness tests do not relate to match performance. More task-specific tests such as the Yo-Yo Intermittent Recovery Test (YYIRT) have been devised and validated for use with referees. Given that aerobic performance is positively correlated with match performance, it is important that referees are trained to improve their ability to cover large distances during a match and also to repeat high-intensity efforts. A number of studies have shown large improvements in YYIRT performance following both short-term (12 weeks) and long-term (16 months) high-intensity interval training. Future research needs to focus on a number of important areas including the decision-making ability of referees when officiating under different conditions, such as high thermal strain, and the impact of age on both physical and mental performance.

Efeitos do aumento na sobrecarga de treinamento sobre parâmetros bioquímicos e hormonais em ratos

Para o treinamento ser bem sucedido deve ser suficientemente intenso para provocar a quebra da homeostase, a adaptação e, por fim, a supercompensação. Todavia, condições de estresse excessivo induzido pelo exercício físico podem provocar efeitos indesejáveis. Este trabalho tem como objetivo avaliar se o aumento na sobrecarga de treinamento altera parâmetros hormonais e bioquímicos similares ao overreaching. Os animais foram divididos em três grupos: SED (animais sedentários), MOD (animais que treinaram de forma moderada durante seis semanas) e grupo EXT (que treinaram de forma semelhante ao grupo MOD por quatro semanas, duas sessões diárias de treinamento na quinta semana e três sessões na sexta semana). Houve aumento da concentração plasmática de glutamato no grupo EXT (p < 0,05) em relação ao SED e da relação GLN/GLU em relação aos animais dos grupos SED e MOD (p < 0,05). Além disso, o grupo MOD apresentou aumento de glicogênio no músculo sóleo e fígado e de GH, enquanto a testosterona foi menor do que no grupo SED (p < 0,05). O grupo EXT apresentou comportamento semelhante ao grupo MOD com relação ao glicogênio hepático e muscular e a testosterona. Quanto ao GH, o grupo EXT apresentou concentração menor do que o grupo MOD (p < 0,05) e aumento de uréia (p < 0,05) em relação aos animais sedentários. Assim, concluímos que o protocolo do grupo EXT não foi capaz de induzir sinais de overreaching nos animais.

Relação da síndrome do excesso de treinamento com estresse, fadiga e serotonina

A grande exigência do esporte competitivo tem provocado sérias conseqüências em atletas envolvidos em treinamento de alto nível. Por sua vez, a mudança dos padrões estéticos tem levado indivíduos a buscarem, por meio do exercício físico, a redução da massa corporal, o aumento da massa muscular e do condicionamento aeróbio. É comum atletas e não atletas excederem os limites de suas capacidades físicas e psicológicas ocasionando o desenvolvimento da síndrome do excesso de treinamento (overtraining), a qual é definida como um distúrbio neuroendócrino (hipotálamo-hipofisário) que resulta do desequilíbrio entre a demanda do exercício e a possibilidade de assimilação de treinamento, acarretando alterações metabólicas, com conseqüências que abrangem não apenas o desempenho, mas também outros aspectos fisiológicos e emocionais. Altos índices de estresse físico, sócio-cultural e psíquico são fatores que colaboram com o seu aparecimento, bem como alterações neuroendócrinas provocadas por aspectos nutricionais, que levam a flutuações serotoninérgicas. Alterações nos níveis de serotonina cerebral podem ser associadas ao aparecimento do estado de fadiga física, que pode se estabelecer de forma crônica, constituindo-se um dos sintomas do quadro. Deficiências ou desequilíbrios em neurotransmissores e neuromoduladores também podem ser causados por severo ou longo estresse. O objetivo do presente artigo de revisão é fazer uma análise dos fatores que contribuem de forma sinérgica para o aparecimento da síndrome do excesso de treinamento.

Does overtraining exist? An analysis of overreaching and overtraining research

Athletes experience minor fatigue and acute reductions in performance as a consequence of the normal training process. When the balance between training stress and recovery is disproportionate, it is thought that overreaching and possibly overtraining may develop. However, the majority of research that has been conducted in this area has investigated overreached and not overtrained athletes. Overreaching occurs as a result of intensified training and is often considered a normal outcome for elite athletes due to the relatively short time needed for recovery (approximately 2 weeks) and the possibility of a supercompensatory effect. As the time needed to recover from the overtraining syndrome is considered to be much longer (months to years), it may not be appropriate to compare the two states. It is presently not possible to discern acute fatigue and decreased performance experienced from isolated training sessions, from the states of overreaching and overtraining. This is partially the result of a lack of diagnostic tools, variability of results of research studies, a lack of well controlled studies and individual responses to training.The general lack of research in the area in combination with very few well controlled investigations means that it is very difficult to gain insight into the incidence, markers and possible causes of overtraining. There is currently no evidence aside from anecdotal information to suggest that overreaching precedes overtraining and that symptoms of overtraining are more severe than overreaching. It is indeed possible that the two states show different defining characteristics and the overtraining continuum may be an oversimplification. Critical analysis of relevant research suggests that overreaching and overtraining investigations should be interpreted with caution before recommendations for markers of overreaching and overtraining can be proposed. Systematically controlled and monitored studies are needed to determine if overtraining is distinguishable from overreaching, what the best indicators of these states are and the underlying mechanisms that cause fatigue and performance decrements. The available scientific and anecdotal evidence supports the existence of the overtraining syndrome; however, more research is required to state with certainty that the syndrome exists.

Physical activity and mental health: the association between exercise and mood

Physical activity is an important public health tool used in the treatment and prevention of various physical diseases, as well as in the treatment of some psychiatric diseases such as depressive and anxiety disorders. However, studies have shown that in addition to its beneficial effects, physical activity can also be associated with impaired mental health, being related to disturbances like "excessive exercise" and "overtraining syndrome". Although the number of reports of the effects of physical activity on mental health is steadily increasing, these studies have not yet identified the mechanisms involved in the benefits and dangers to mental health associated with exercise. This article reviews the information available regarding the relationship between physical activity and mental health, specifically addressing the association between exercise and mood.

Alterations of lipid profile in endurance over-trained subjects

BACKGROUND

We tested the hypothesis that endurance over-training could alter the favorable effects of well-tolerated training on lipid profile.

METHODS

At weeks 1, 6, 15, 26, 36, and 47 of the training program, blood was drawn to test lipid profile of 20 endurance-trained rowers. Diet and caloric intake were controlled.

RESULTS

Over-training was diagnosed in five subjects (loss of performance, asthenia, sleep disturbance...) at week 15 and lipid profile of well-trained and over-trained subjects were compared. Training improved cholesterolemic profile and lowered insulin resistance (HOMA-IR: -39 +/- 9%; p=0.02), and triglycerides concentration (-30 +/- 6%; p=0.05) in rowers who did not change to demonstrate over-training. Plasma LPL (+29 +/- 11%; p=0.01) and hepatic lipase (+5 +/- 3%; p=0.01) activities increased in this group suggesting higher TG utilization and turnover. After week 15 and regarding the well-trained condition for the five over-trained subjects, VLDL-TG (-13 +/- 7 %; p=0.03) and Apo-C(3) (-31 +/- 13%; p=0.01) concentrations decreased, while insulin resistance (+17 +/- 7%; p=0.03) and glycerol concentration (+17 +/- 3%; p=0.01) increased and hepatic lipase activity decreased (-14 +/- 4%; p=0.01).

CONCLUSION

Over-training was accompanied by alterations in the lipid profile, which appeared to be the consequence of over-training.

Effects of carbohydrate supplementation on performance and carbohydrate oxidation after intensified cycling training

To study the effects of carbohydrate (CHO) supplementation on performance changes and symptoms of overreaching, six male endurance cyclists completed 1 wk of normal (N), 8 days of intensified (ITP), and 2 wk of recovery training (R) on two occasions in a randomized crossover design. Subjects completed one trial with a 6% CHO solution provided before and during training and a 20% solution in the 1 h postexercise (H-CHO trial). On the other occasion, subjects consumed a 2% CHO solution at the same time points (L-CHO). A significant decline in time to fatigue at ∼63% maximal power output (H-CHO: 17 ± 3%; L-CHO: 26 ± 7%) and a significant increase in mood disturbance occurred in both trials after ITP. The decline in performance was significantly greater in the L-CHO trial. After ITP, a significant decrease in estimated muscle glycogen oxidation (H-CHO: N 49.3 ± 2.9 kcal/30 min, ITP 32.6 ± 3.4 kcal/30 min; L-CHO: N 49.1 ± 30 kcal/30 min, ITP 39.0 ± 5.6 kcal/30 min) and increase in fat oxidation (H-CHO: N 16.3 ± 2.4 kcal/30 min, ITP 27.8 ± 2.3 kcal/30 min; L-CHO: N 16.9 ± 2.6 kcal/30 min, ITP: 25.4 ± 3.5 kcal/30 min) occurred alongside significant increases in glycerol and free fatty acids and decreases in free triglycerides in both trials. An interaction effect was observed for submaximal plasma concentrations of cortisol and epinephrine, with significantly greater reductions in these stress hormones in L-CHO compared with H-CHO after ITP. These findings suggest that CHO supplementation can reduce the symptoms of overreaching but cannot prevent its development. Decreased endocrine responsiveness to exercise may be implicated in the decreased performance and increased mood disturbance characteristic of overreaching.

What makes an endurance athlete world-class? Not simply a physiological conundrum

Inter-individual variation in endurance performance capacity is a characteristic, not only of the general population, but also in trained athletes. The ability of sport scientists to predict which athletes amongst an elite group will become world-class is limited. We do not fully understand the interactions between biological factors, training, recovery and competitive performance. Assessment methods and interpretation of results do not take into account the facts that most research is not done on elite athletes and performances of world-class endurance athletes cannot be attributed to aerobic capacity alone. Many lines of evidence suggest that there is a limit to adaptation in aerobic capacity. Recent advances in molecular biology and genetics should be harnessed by exercise biologists in conjunction with previously used physiological, histological and biochemical techniques to study elite athletes and their responses to different training and recovery regimens. Technological advances should be harnessed to study world-class athletes to determine optimal training and competition strategies. In summary, it is likely that multiple factors are essential contributors to world-class endurance performance and that it is only by using a multidisciplinary approach that we will come closer to solving the conundrum: 'What makes an endurance athlete world class?'

Higher dietary carbohydrate content during intensified running training results in better maintenance of performance and mood state

The aim of this study was to determine whether consumption of a diet containing 8.5 g carbohydrate (CHO) x kg(-1) x day(-1) (high CHO; HCHO) compared with 5.4 g CHO x kg(-1) x day(-1) (control; Con) during a period of intensified training (IT) would result in better maintenance of physical performance and mood state. In a randomized cross-over design, seven trained runners [maximal O(2) uptake (Vo(2 max)) 64.7 +/- 2.6 ml x kg(-1) x min(-1)] performed two 11-day trials consuming either the Con or the HCHO diet. The last week of both trials consisted of IT. Performance was measured with a preloaded 8-km all-out run on the treadmill and 16-km all-out runs outdoors. Substrate utilization was measured using indirect calorimetry and continuous [U-(13)C]glucose infusion during 30 min of running at 58 and 77% Vo(2 max). Time to complete 8 km was negatively affected by the IT: time significantly increased by 61 +/- 23 and 155 +/- 38 s in the HCHO and Con trials, respectively. The 16-km times were significantly increased (by 8.2 +/- 2.1%) during the Con trial only. The Daily Analysis of Life Demands of Athletes questionnaire showed significant deterioration in mood states in both trials, whereas deterioration in global mood scores, as assessed with the Profile of Mood States, was more pronounced in the Con trial. Scores for fatigue were significantly higher in the Con compared with the HCHO trial. CHO oxidation decreased significantly from 1.7 +/- 0.2 to 1.2 +/- 0.2 g/min over the course of the Con trial, which was completely accounted for by a decrease in muscle glycogen oxidation. These findings indicate that an increase in dietary CHO content from 5.4 to 8.5 g CHO x kg(-1)x day(-1) (41 vs. 65% total energy intake, respectively) allowed better maintenance of physical performance and mood state over the course of training, thereby reducing the symptoms of overreaching.

Heart rate monitoring: applications and limitations

Over the last 20 years, heart rate monitors (HRMs) have become a widely used training aid for a variety of sports. The development of new HRMs has also evolved rapidly during the last two decades. In addition to heart rate (HR) responses to exercise, research has recently focused more on heart rate variability (HRV). Increased HRV has been associated with lower mortality rate and is affected by both age and sex. During graded exercise, the majority of studies show that HRV decreases progressively up to moderate intensities, after which it stabilises. There is abundant evidence from cross-sectional studies that trained individuals have higher HRV than untrained individuals. The results from longitudinal studies are equivocal, with some showing increased HRV after training but an equal number of studies showing no differences. The duration of the training programmes might be one of the factors responsible for the versatility of the results.HRMs are mainly used to determine the exercise intensity of a training session or race. Compared with other indications of exercise intensity, HR is easy to monitor, is relatively cheap and can be used in most situations. In addition, HR and HRV could potentially play a role in the prevention and detection of overtraining. The effects of overreaching on submaximal HR are controversial, with some studies showing decreased rates and others no difference. Maximal HR appears to be decreased in almost all 'overreaching' studies. So far, only few studies have investigated HRV changes after a period of intensified training and no firm conclusions can be drawn from these results. The relationship between HR and oxygen uptake (VO(2)) has been used to predict maximal oxygen uptake (VO(2max)). This method relies upon several assumptions and it has been shown that the results can deviate up to 20% from the true value. The HR-VO(2) relationship is also used to estimate energy expenditure during field conditions. There appears to be general consensus that this method provides a satisfactory estimate of energy expenditure on a group level, but is not very accurate for individual estimations. The relationship between HR and other parameters used to predict and monitor an individual's training status can be influenced by numerous factors. There appears to be a small day-to-day variability in HR and a steady increase during exercise has been observed in most studies. Furthermore, factors such as dehydration and ambient temperature can have a profound effect on the HR-VO(2) relationship.

Biochemical aspects of overtraining in endurance sports : the metabolism alteration process syndrome

Recent studies have shown that endurance overtraining could result from successive and cumulative alterations in metabolism, which become chronic during training. The onset of this process is a biochemical alteration in carbohydrate (saccharide) metabolism. During endurance exercises, the amount of saccharide chains from two blood glycoproteins (alpha(2)-macroglobulin and alpha(1)-acid glycoprotein) was found to have decreased, i.e. concentrations of these proteins remained unchanged but their quality changed. These saccharide chains were probably used for burning liver glycogen stores during exercise. This step was followed by alterations in lipid metabolism. The most relevant aspect of this step was that the mean chain length of blood fatty acids decreased, i.e. the same amount of fatty acids were found within the blood, but overtrained individuals presented shorter fatty acids than well-trained individuals. This suggests that alterations appeared in the liver synthesis of long-chain fatty acids or that higher peroxidation of blood lipoparticles occurred. For the final step of this overtraining process, it was found that these dysfunctions in carbohydrate/lipid metabolism led to the higher use of amino acids, which probably resulted from protein catabolism. The evolution of three protein concentrations (alpha(1)-acid glycoprotein, alpha(2)-macroglobulin and IgG(3)) correlated with this amino acid concentration increase, suggesting a specific catabolism of these proteins. At this time only, overtraining was clinically diagnosed through conventional symptoms. Therefore, this process described successive alterations in exercise metabolism that shifted from the main energetic stores of exercise (carbohydrates and lipids) towards molecular pools (proteins) normally not substantially used for the energetic supply of skeletal muscles. Now, a general biochemical model of the overtraining process may be proposed which includes most of the previously identified metabolic hypotheses.

Sleep Efficiency and Overreaching in Swimmers

Context:

Overreaching can be beneficial, but there is a risk of overtraining.

Objective:

To investigate the difference in sleep efficiency between overreached and nonover-reached swimmers.

Design:

Repeated-measures, between-subjects. Swimmers were determined to be overreaching if 2 or more of their consecutive weekly swim times increased by 5% or more from baseline.

Participants:

9 competitive high school and university sprinter swimmers.

Intervention:

24-h wrist actigraph.

Main Outcome Measure:

Sleep efficiency as measured by the actigraph.

Results:

There was a significant difference in sleep efficiency on night 1 between the overreached and nonoverreached swimmers (P = .008), as well as in their times after averaging over all 5 trials and adjusting for baseline (P = .016). By the fourth swim trial, the overreached swimmers had significantly slower swim times than those of the nonoverreached swimmers (P = .001).

Conclusions:

Sleep efficiency shows potential as an objective, noninvasive predictor and monitor of overreaching in swimmers.

Biochemical aspects of overtraining in endurance sports: a review

Top-level performances in endurance sports require several years of hard training loads. A major objective of this endurance training is to reach the most elevated metabolic adaptations the athlete will be able to support. As a consequence, overtraining is a recurrent problem that highly-trained athletes may experience during their career. Many studies have revealed that overtraining could be highlighted by various biochemical markers but a principal discrepancy in the diagnosis of overtraining stems from the fact that none of these markers may be considered as universal. In endurance sports, the metabolic aspects of training fatigue appear to be the most relevant parameters that may characterise overtraining when recovery is not sufficient, or when dietary habits do not allow an optimal replenishment of substrate stores. From the skeletal muscle functions to the overall energetic substrate availability during exercise, six metabolic schemes have been studied in relation to overtraining, each one related to a central parameter, i.e. carbohydrates, branched-chain amino acids, glutamine, polyunsaturated fatty acids, leptin, and proteins. We summarise the current knowledge on these metabolic hypotheses regarding the occurrence of overtraining in endurance sports.

Time course of performance changes and fatigue markers during intensified training in trained cyclists

To study the cumulative effects of exercise stress and subsequent recovery on performance changes and fatigue indicators, the training of eight endurance cyclists was systematically controlled and monitored for a 6-wk period. Subjects completed 2 wk of normal (N), intensified (ITP), and recovery training. A significant decline in maximal power output (N = 338 +/- 17 W, ITP = 319 +/- 17 W) and a significant increase in time to complete a simulated time trial (N = 59.4 +/- 1.9 min, ITP = 65.3 +/- 2.6 min) occurred after ITP in conjunction with a 29% increase in global mood disturbance. The decline in performance was associated with a 9.3% reduction in maximal heart rate, a 5% reduction in maximal oxygen uptake, and an 8.6% increase in perception of effort. Despite the large reductions in performance, no changes were observed in substrate utilization, cycling efficiency, and lactate, plasma urea, ammonia, and catecholamine concentrations. These findings indicate that a state of overreaching can already be induced after 7 days of intensified training with limited recovery.