1
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Zuim AF, Edwards A, Ausiello D, Bhatta D, Edwards DA. Hypertonic Aerosols Hydrate Airways Longer and Reduce Acidification Risk with Nonpermeating Cation and Permeating Anion Salts. J Aerosol Med Pulm Drug Deliv 2024; 37:64-76. [PMID: 38354286 DOI: 10.1089/jamp.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background: Hyperosmolar aerosols appear to promote or suppress upper airway dysfunction caused by dehydration in a composition-dependent manner. We sought to explore this composition dependence experimentally, in an interventional human clinical study, and theoretically, by numerical analysis of upper airway ion and water transport. Methods: In a double-blinded, placebo-controlled clinical study, phonation threshold pressure (PTP) was measured prenasal and postnasal inhalation of hypertonic aerosols of NaCl, KCl, CaCl2, and MgCl2 in seven human subjects. Numerical analysis of water and solute exchanges in the upper airways following deposition of these same aerosols was performed using a mathematical model previously described in the literature. Results: PTP decreased by 9%-22% relative to baseline (p < 0.05) for all salts within the first 30 minutes postadministration, indicating effective laryngeal hydration. Only MgCl2 reduced PTP beyond 90 minutes (21% below baseline at 2 hours postadministration). By numerical analysis, we determined that, while airway water volume up to 15 minutes postdeposition is dictated by osmolarity, after 30 minutes, divalent cation salts, such as MgCl2, better retain airway surface liquid (ASL) volume by slow paracellular clearance of the divalent cation. Fall of CFTR chloride flux with rise in ASL height, a promoter of airway acidification, appears to be a signature of permeating cation (NaCl) and nonpermeating anion (mannitol) aerosol deposition. For hypertonic aerosols that lack permeating cation and include permeating anion (CaCl2 and MgCl2), this acid-trigger signature does not exist. Conclusions: Nonpermeating cation and permeating anion hypertonic aerosols appear to hydrate upper airways longer and, rather than provoke, may reduce laryngeal dysfunction such as cough and bronchoconstriction.
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Affiliation(s)
- Ana Flavia Zuim
- Steinberg School of Music, New York University, New York, New York, USA
| | - Aurélie Edwards
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Dennis Ausiello
- Center for Assessment Technology and Continuous Health (CATCH), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Deen Bhatta
- Sensory Cloud, Inc., Boston, Massachusetts, USA
| | - David A Edwards
- Sensory Cloud, Inc., Boston, Massachusetts, USA
- John Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
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2
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Paul LJ, Ericsson AC, Andrews FM, McAdams Z, Keowen ML, St Blanc MP, Banse HE. Field study examining the mucosal microbiome in equine glandular gastric disease. PLoS One 2023; 18:e0295697. [PMID: 38060520 PMCID: PMC10703338 DOI: 10.1371/journal.pone.0295697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
Equine glandular gastric disease (EGGD) is a common disease among athletic horses that can negatively impact health and performance. The pathophysiology of this EGGD remains poorly understood. Previous studies using controlled populations of horses identified differences in the gastric glandular mucosal microbiome associated with disease. The objective of this study was to compare the gastric microbiome in horses with EGGD and those without across multiple barns and differing management practices. We hypothesized that alterations in the microbiome of the gastric glandular mucosa are associated with EGGD. A secondary objective was to perform a risk factor analysis for EGGD using the diet and management data collected. Microbial populations of biopsies from normal pyloric mucosa of horses without EGGD (control biopsies), normal pyloric mucosa of horses with EGGD (normal biopsies) and areas of glandular mucosal disruption in horses with EGGD (lesion biopsies) were compared. Lesion biopsies had a different microbial community structure than control biopsies. Control biopsies had a higher read count for the phylum Actinomycetota compared to lesion biopsies. Control biopsies also had an enrichment of the genera Staphylococcus and Lawsonella and the species Streptococcus salivarius. Lesion biopsies had an enrichment of the genera Lactobacillus and Actinobacillus and the species Lactobacillus equigenerosi. These results demonstrate differences in the gastric glandular microbiome between sites of disrupted mucosa in horses with EGGD compared to pyloric mucosa of horses without EGGD. Risk factor analysis indicated that exercise duration per week was a risk factor for EGGD.
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Affiliation(s)
- Linda J. Paul
- Veterinary Clinical Sciences, Equine Health and Sports Performance, Louisiana State University, Baton Rouge, LA, United States of America
| | - Aaron C. Ericsson
- Metagenomics Center, Equine Gut Group, University of Missouri, Columbia, MO, United States of America
| | - Frank M. Andrews
- Veterinary Clinical Sciences, Equine Health and Sports Performance, Louisiana State University, Baton Rouge, LA, United States of America
| | - Zachary McAdams
- Metagenomics Center, Equine Gut Group, University of Missouri, Columbia, MO, United States of America
| | - Michael L. Keowen
- Veterinary Clinical Sciences, Equine Health and Sports Performance, Louisiana State University, Baton Rouge, LA, United States of America
| | - Michael P. St Blanc
- Veterinary Clinical Sciences, Equine Health and Sports Performance, Louisiana State University, Baton Rouge, LA, United States of America
| | - Heidi E. Banse
- Veterinary Clinical Sciences, Equine Health and Sports Performance, Louisiana State University, Baton Rouge, LA, United States of America
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3
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Akazawa N, Nakamura M, Eda N, Murakami H, Nakagata T, Nanri H, Park J, Hosomi K, Mizuguchi K, Kunisawa J, Miyachi M, Hoshikawa M. Gut microbiota alternation with training periodization and physical fitness in Japanese elite athletes. Front Sports Act Living 2023; 5:1219345. [PMID: 37521099 PMCID: PMC10382754 DOI: 10.3389/fspor.2023.1219345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction The gut microbiome plays a fundamental role in host homeostasis through regulating immune functions, enzyme activity, and hormone secretion. Exercise is associated with changes in gut microbiome composition and function. However, few studies have investigated the gut microbiome during training periodization. The present study aimed to investigate the relationship between training periodization and the gut microbiome in elite athletes. Methods In total, 84 elite athletes participated in the cross-sectional study; and gut microbiome was determined during their transition or preparation season period. Further, 10 short-track speed skate athletes participated in the longitudinal study, which assessed the gut microbiome and physical fitness such as aerobic capacity and anaerobic power in the general and specific preparation phase of training periodization. The gut microbiome was analyzed using 16S rRNA sequencing. Results The cross-sectional study revealed significant differences in Prevotella, Bifidobacterium, Parabacteroides, and Alistipes genera and in enterotype distribution between transition and preparation season phase periodization. In the longitudinal study, training phase periodization altered the level of Bacteroides, Blautia, and Bifidobacterium in the microbiome. Such changes in the microbiome were significantly correlated with alternations in aerobic capacity and tended to correlate with the anaerobic power. Discussion These findings suggest that periodization alters the gut microbiome abundance related to energy metabolism and trainability of physical fitness. Athlete's condition may thus be mediated to some extent by the microbiota in the intestinal environment.
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Affiliation(s)
- Nobuhiko Akazawa
- Department of Sports Research, Japan Institute of Sports Sciences, Tokyo, Japan
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Mariko Nakamura
- Department of Sports Sciences, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Nobuhiko Eda
- Department of Sports Research, Japan Institute of Sports Sciences, Tokyo, Japan
- Department of Fundamental Education, Dokkyo Medical University, Tochigi, Japan
| | - Haruka Murakami
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Takashi Nakagata
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Laboratory of Gut Microbiome for Health, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Hinako Nanri
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Laboratory of Gut Microbiome for Health, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Jonguk Park
- Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Koji Hosomi
- Laboratory of Vaccine Materials and Laboratory of Gut Environmental System, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Kenji Mizuguchi
- Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Institute for Protein Research, Osaka University, Osaka, Japan
| | - Jun Kunisawa
- Laboratory of Vaccine Materials and Laboratory of Gut Environmental System, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Masako Hoshikawa
- Department of Sports Research, Japan Institute of Sports Sciences, Tokyo, Japan
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4
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Zhang L, Zhang R, Li L. Effects of Probiotic Supplementation on Exercise and the Underlying Mechanisms. Foods 2023; 12:foods12091787. [PMID: 37174325 PMCID: PMC10178086 DOI: 10.3390/foods12091787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Long-term, high-intensity exercise can trigger stress response pathways in multiple organs, including the heart and lungs, gastrointestinal tract, skeletal muscle, and neuroendocrine system, thus affecting their material and energy metabolism, immunity, oxidative stress, and endocrine function, and reducing exercise function. As a natural, safe, and convenient nutritional supplement, probiotics have been a hot research topic in the field of biomedical health in recent years. Numerous studies have shown that probiotic supplementation improves the health of the body through the gut-brain axis and the gut-muscle axis, and probiotic supplementation may also improve the stress response and motor function of the body. This paper reviews the progress of research on the role of probiotic supplementation in material and energy metabolism, intestinal barrier function, immunity, oxidative stress, neuroendocrine function, and the health status of the body, as well as the underlying mechanisms.
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Affiliation(s)
- Li Zhang
- Department of Physical Education, China University of Mining and Technology, Beijing 100083, China
| | - Ruhao Zhang
- Department of Physical Education, China University of Mining and Technology, Beijing 100083, China
| | - Lu Li
- School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
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5
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Brill S, Schwellnus M, Sewry N, Janse Van Rensburg DC, Jansen Van Rensburg A, Jooste M, Leppan J, Boulter J, Seocharan I, Jordaan E. Pre-race self-reported medical conditions and allergies in 133 641 Comrades ultramarathon (90km) runners - SAFER XXIII. PHYSICIAN SPORTSMED 2023; 51:88-95. [PMID: 34751596 DOI: 10.1080/00913847.2021.2004080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To determine the prevalence of self-reported pre-race chronic medical conditions and allergies in ultramarathon race entrants and to explore if these are associated with an increased risk of race-day medical encounters (MEs). METHODS Data from two voluntary open-ended pre-race medical screening questions (Q1 - history of allergies; Q2 - history of chronic medical conditions/prescription medication use) were collected in 133641 Comrades Marathon race entrants (2014-2019). Race-day ME data collected prospectively over 6 years are reported as incidence (per 1000 starters) and incidence ratios (IR: 95%CI's). RESULTS Pre-race medical screening questions identified race entrants with a history of chronic medical conditions and/or prescription medication use (6.9%) and allergies (7.4%). The % entrants with risk factors for cardiovascular disease (CVD) was 30% and being older (>45 years) or male (27.5%) were the most frequent CVD risk factors. 0.3% of entrants reported existing CVD. The overall incidence of MEs was 20/1000 race starters. MEs were significantly higher in race entrants reporting a 'yes' to Q1 (allergies) (IR = 1.3; 1.1-1.5) (p = 0.014) or Q2 (chronic medical conditions and/or prescription medication use) (IR = 1.3; 1.1-1.5) (p = 0.0006). CONCLUSIONS Voluntary completion of two open-ended questions identified chronic medical conditions and/or prescription medication use in 6.9% and allergies in 7.4% of ultramarathon race entrants. This is lower than that reported for other races that implemented compulsory completion of a more comprehensive pre-screening questionnaire. Despite potential under-reporting, a pre-race self-reported history of chronic medical conditions and allergies was associated with a higher risk of race-day MEs.
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Affiliation(s)
- Stephan Brill
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Dina Christa Janse Van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Audrey Jansen Van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Marcel Jooste
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Jordan Leppan
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Ishen Seocharan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa.,Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
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6
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Paul LJ, Ericsson AC, Andrews FM, McAdams Z, Keowen ML, St Blanc MP, Banse HE. Dietary and management factors influence the equine gastric microbiome. J Am Vet Med Assoc 2022; 260:S111-S120. [DOI: 10.2460/javma.22.07.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
OBJECTIVE
The purpose of this study was to characterize the relationship of diet and management factors with the glandular gastric mucosal microbiome. We hypothesize that the gastric mucosal microbial community is influenced by diet and management factors. Our specific objective is to characterize the gastric mucosal microbiome in relation to these factors.
ANIMALS
57 client-owned horses in the southern Louisiana region with and without equine glandular gastric disease.
PROCEDURES
Diet and management data were collected via a questionnaire. Gastroscopy was used for evaluation of equine gastric ulcer syndrome and collection of glandular mucosal pinch biopsies. 16S rRNA amplicon sequencing was used for microbiome analysis. Similarity and diversity indices and sequence read counts of individual taxa were compared between diet and management factors.
RESULTS
Differences were detected in association with offering hay, type of hay, sweet feed, turnout, and stalling. Offering hay and stalling showed differences in similarity indices, whereas hay type, sweet feed, and turnout showed differences in similarity and diversity indices. Offering hay, hay type, and sweet feed were also associated with differences in individual sequence read counts.
CLINICAL RELEVANCE
This study provides preliminary characterization of the complex relationship between the glandular gastric microbiome and diet/management factors. The ideal microbiome to promote a healthy glandular gastric environment remains unknown.
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Affiliation(s)
- Linda J. Paul
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, LA
| | - Aaron C. Ericsson
- University of Missouri, Metagenomics Center, Equine Gut Group, Columbia, MO
| | - Frank M. Andrews
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, LA
| | - Zachary McAdams
- University of Missouri, Metagenomics Center, Equine Gut Group, Columbia, MO
| | - Michael L. Keowen
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, LA
| | - Michael P. St Blanc
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, LA
| | - Heidi E. Banse
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, LA
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7
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Brunelli L, De Vitis V, Ferrari R, Minuzzo M, Fiore W, Jäger R, Taverniti V, Guglielmetti S. In vitro assessment of the probiotic properties of an industrial preparation containing Lacticaseibacillus paracasei in the context of athlete health. Front Pharmacol 2022; 13:857987. [PMID: 36016576 PMCID: PMC9397523 DOI: 10.3389/fphar.2022.857987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Intense physical activity is often associated with undesirable physiological changes, including increased inflammation, transient immunodepression, increased susceptibility to infections, altered intestinal barrier integrity, and increased oxidative stress. Several trials suggested that probiotics supplementation may have beneficial effects on sport-associated gastro-intestinal and immune disorders. Recently, in a placebo-controlled human trial, the AminoAlta™ probiotic formulation (AApf) was demonstrated to increase the absorption of amino acids from pea protein, suggesting that the administration of AApf could overcome the compositional limitations of plant proteins. In this study, human cell line models were used to assess in vitro the potential capacity of AApf to protect from the physiological damages that an intense physical activity may cause. The obtained results revealed that the bacteria in the AApf have the ability to adhere to differentiated Caco-2 epithelial cell layer. In addition, the AApf was shown to reduce the activation of NF-κB in Caco-2 cells under inflammatory stimulation. Notably, this anti-inflammatory activity was enhanced in the presence of partially hydrolyzed plant proteins. The AApf also triggered the expression of cytokines by the THP-1 macrophage model in a dose-dependent manner. In particular, the expression of cytokines IL-1β, IL-6, and TNF-α was higher than that of the regulatory cytokine IL-10, resembling a cytokine profile characteristic of M1 phenotype, which typically intervene in counteracting bacterial and viral infections. Finally, AApf was shown to reduce transepithelial permeability and increase superoxide dismutase activity in the Caco-2 cell model. In conclusion, this study suggests that the AApf may potentially provide a spectrum of benefits useful to dampen the gastro-intestinal and immune detrimental consequences of an intense physical activity.
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Affiliation(s)
| | | | | | | | | | - Ralf Jäger
- Increnovo LLC, Whitefish Bay, WI, United States
| | - Valentina Taverniti
- Division of Food Microbiology and Bioprocesses, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Simone Guglielmetti
- Division of Food Microbiology and Bioprocesses, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
- *Correspondence: Simone Guglielmetti,
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8
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Non-Cardiac Conditions that Mimic Cardiac Symptoms in Athletes. Clin Sports Med 2022; 41:389-404. [PMID: 35710268 DOI: 10.1016/j.csm.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
When considering the variety of complaints an athlete can present with, chest pain is arguably the most concerning given the potential for catastrophic outcomes. Luckily, these do not comprise the majority of cases, and indeed, are quite rare. The bulk of presentations of athletes with chest pain are due to musculoskeletal, gastrointestinal, and pulmonary causes. Each and every healthcare provider who works closely with athletes must have a thorough understanding of contributing conditions that present as chest pain. Here, we explore some of the more prevalent causes of non-cardiac chest pain, classic presentations, and management considerations.
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9
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The Athlete Gut Microbiome and its Relevance to Health and Performance: A Review. Sports Med 2022; 52:119-128. [PMID: 36396898 PMCID: PMC9734205 DOI: 10.1007/s40279-022-01785-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 11/19/2022]
Abstract
The human gut microbiome is a complex ecosystem of microorganisms that play an important role in human health, influencing functions such as vitamin uptake, digestion and immunomodulation. While research of the gut microbiome has expanded considerably over the past decade, some areas such as the relationship between exercise and the microbiome remain relatively under investigated. Despite this, multiple studies have shown a potential bidirectional relationship between exercise and the gut microbiome, with some studies demonstrating the possibility of influencing this relationship. This, in turn, could provide a useful route to influence athletic performance via microbiome manipulation, a valuable prospect for many elite athletes and their teams. The evidence supporting the potential benefits of pursuing this route and associated future perspectives are discussed in this review.
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10
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De Souza MJ, Strock NCA, Ricker EA, Koltun KJ, Barrack M, Joy E, Nattiv A, Hutchinson M, Misra M, Williams NI. The Path Towards Progress: A Critical Review to Advance the Science of the Female and Male Athlete Triad and Relative Energy Deficiency in Sport. Sports Med 2021; 52:13-23. [PMID: 34665451 DOI: 10.1007/s40279-021-01568-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2021] [Indexed: 12/01/2022]
Abstract
Energy status plays a key role in the health of athletes and exercising individuals. Energy deficiency/low energy availability (EA), referring to a state in which insufficient energy intake and/or excessive exercise energy expenditure has resulted in compensatory metabolic adaptations to conserve fuel, can affect numerous physiological systems in women and men. The Female Athlete Triad, Male Athlete Triad, and Relative Energy Deficiency in Sport (RED-S) models conceptualize the effects of energy deficiency in athletes, and each model has strengths and limitations. For instance, the Female Athlete Triad model depicts relationships between low EA, reproductive, and bone health, underpinning decades of experimental evidence, but may be perceived as limited in scope, while the more recent RED-S model proposes a wider range of potential health effects of low EA, though many model components require more robust scientific justification. This critical review summarizes current evidence regarding the effects of energy deficiency on athlete health by addressing the quality of the underlying science, the strengths and limitations of each model, and highlighting areas where future research is needed to advance the field. With the health and wellness of athletes and exercising individuals as the overarching priority, we conclude with specific steps that will help focus future research on the Female and Male Athlete Triad and RED-S, and encourage all researchers, clinicians, and practitioners to collaborate to support the common goal of promoting the highest quality science and evidence-based medicine in pursuit of the advancement of athletes' health, well-being, and performance.
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Affiliation(s)
- Mary Jane De Souza
- Department of Kinesiology and Physiology, Pennsylvania State University, University Park, PA, USA
| | - Nicole C A Strock
- Department of Kinesiology, Pennsylvania State University, University Park, PA, 16802, USA
| | - Emily A Ricker
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, USA
| | - Kristen J Koltun
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michelle Barrack
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, CA, USA
| | | | - Aurelia Nattiv
- Department of Sports Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Mark Hutchinson
- Department of Orthopedics and Sports Medicine, University of Illinois Chicago, Chicago, IL, USA
| | - Madhusmita Misra
- Division of Pediatric Endocrinology, Massachusetts General Hospital, Boston, MA, USA
| | - Nancy I Williams
- Department of Kinesiology, Pennsylvania State University, University Park, PA, 16802, USA.
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11
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Castanier C, Bougault V, Teulier C, Jaffré C, Schiano-Lomoriello S, Vibarel-Rebot N, Villemain A, Rieth N, Le-Scanff C, Buisson C, Collomp K. The Specificities of Elite Female Athletes: A Multidisciplinary Approach. Life (Basel) 2021; 11:622. [PMID: 34206866 PMCID: PMC8303304 DOI: 10.3390/life11070622] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/19/2022] Open
Abstract
Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18-40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.
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Affiliation(s)
- Carole Castanier
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | | | - Caroline Teulier
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | | | - Sandrine Schiano-Lomoriello
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Nancy Vibarel-Rebot
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Aude Villemain
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Nathalie Rieth
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Christine Le-Scanff
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Corinne Buisson
- Département des Analyses, AFLD, 92290 Chatenay-Malabry, France;
| | - Katia Collomp
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
- Département des Analyses, AFLD, 92290 Chatenay-Malabry, France;
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12
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Smith KA, Pugh JN, Duca FA, Close GL, Ormsbee MJ. Gastrointestinal pathophysiology during endurance exercise: endocrine, microbiome, and nutritional influences. Eur J Appl Physiol 2021; 121:2657-2674. [PMID: 34131799 DOI: 10.1007/s00421-021-04737-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/07/2021] [Indexed: 12/17/2022]
Abstract
Gastrointestinal symptoms are abundant among athletes engaging in endurance exercise, particularly when exercising in increased environmental temperatures, at higher intensities, or over extremely long distances. It is currently thought that prolonged ischemia, mechanical damage to the epithelial lining, and loss of epithelial barrier integrity are likely contributors of gastrointestinal (GI) distress during bouts of endurance exercise, but due to the many potential causes and sporadic nature of symptoms this phenomenon has proven difficult to study. In this review, we cover known factors that contribute to GI distress symptoms in athletes during exercise, while further attempting to identify novel avenues of future research to help elucidate mechanisms leading to symptomology. We explore the link between the intestinal microbiome, the integrity of the gut epithelia, and add detail on gut hormone and peptide secretion that could potentially contribute to GI distress symptoms in athletes. The influence of nutrition and dietary supplementation strategies are also detailed, where much research has opened up new ideas and potential mechanisms for understanding gut pathophysiology during exercise. The etiology of gastrointestinal symptoms during endurance exercise is multi-factorial with neuroendocrine, microbial, and nutritional factors likely contributing to specific, individualized symptoms. Recent work in previously unexplored areas of both microbiome and gut peptide secretion are pertinent areas for future work, and the numerous supplementation strategies explored to date have provided insight into physiological mechanisms that may be targetable to reduce the incidence and severity of gastrointestinal symptoms in athletes.
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Affiliation(s)
- Kyle A Smith
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Jamie N Pugh
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 5UA, UK
| | - Frank A Duca
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, USA
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 5UA, UK
| | - Michael J Ormsbee
- Department of Nutrition and Integrative Physiology, Institute of Sports Sciences and Medicine, Florida State University, 1104 Spirit Way, Tallahassee, FL, 32306, USA. .,Discipline of Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal, Durban, 4041, South Africa.
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13
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Tolentino Bento da Silva M, Palheta-Junior RC, Silva CMS, Cavalcante AKM, Quetz JDS, Havt A, de Lima JBM, Mecawi ADS, de Castro M, Antunes-Rodrigues J, de Oliveira RB, Magalhães PJC, Aguiar Dos Santos A. Role of cholecystokinin and oxytocin in slower gastric emptying induced by physical exercise in rats. Physiol Behav 2021; 233:113355. [PMID: 33571545 DOI: 10.1016/j.physbeh.2021.113355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 11/23/2022]
Abstract
Vigorous exercise can induce gastrointestinal disorders such decreased gastric emptying pace, while low-intensity exercise can accelerate gastric motility. However, the mechanisms of these effects are still unknown. We investigated the possible neurohumoral mechanisms involved in these phenomena. In sedentary (Sed) and acute exercise (Ex) groups of rats, we assessed the activation of c-Fos in NTS and DVMN and the plasma levels of CCK and OXT. Separate groups received pretreatment with the oxytocin antagonist atosiban (AT), the cholecystokinin antagonist devazepide (DVZ), or the TRPV1 receptor inhibitor capsazepine (CAPZ). AT, DVZ and CAPZ treatments prevented (p<0.05) slower gastric emptying induced by acute exercise. The gene expression of OXT decreased (P<0.05) while that of CCK increased (P<0.05) in the gastric fundus and pylorus of the Ex group, while the plasma levels of OXT rose (p<0.05) and of CCK declined (p<5.05). We also observed activation (p<0.05) of c-Fos-sensitive neurons in the NTS and DVMN of exercised rats. In conclusion, acute exercise slowed gastric emptying by the vagal afferent pathway, which involved activation of CCK1/OXT/TRPV1 sensitivity.
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Affiliation(s)
| | | | - Camila Meirelles Souza Silva
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Josiane da Silva Quetz
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Alexandre Havt
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - André de Souza Mecawi
- Department of Biophisics, Palista School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Margaret de Castro
- School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - José Antunes-Rodrigues
- School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Pedro Jorge Caldas Magalhães
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Armenio Aguiar Dos Santos
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
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14
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Liddle DG, Changstrom B, Senter C, Meirick P, Stern N, Putukian M, Shah S, Powell A, Dixit S, Eerkes K, Moran B, Barnes KP, Dal Molin C, Myers R, Waterbrook AL. Recommended Musculoskeletal and Sports Medicine Curriculum for Internal Medicine Residency Training. Curr Sports Med Rep 2021; 20:113-123. [PMID: 33560036 DOI: 10.1249/jsr.0000000000000811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
ABSTRACT Patients present to primary care physicians with musculoskeletal complaints more often than they do for upper respiratory infections, hypertension, or diabetes. Despite this, instruction in musculoskeletal medicine for internal medicine residents represents less than 1% of their total didactic and clinical education time. We recognize the immense breadth of knowledge and skill required to train residents in the practice of internal medicine. This curriculum guideline defines a recommended training strategy, and supplies relevant resources, to improve musculoskeletal education among internal medicine residents to optimize patient care. This curriculum guideline was created by internists who are sports medicine specialists. Sports medicine physicians promote overall health and well-being while providing expertise in acute and chronic musculoskeletal conditions, as well as how disease affects exercise and using exercise as medicine for people with chronic disease.
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Affiliation(s)
- David G Liddle
- Intermountain Sports Medicine, Intermountain Healthcare, Logan Regional Orthopedics and Sports Medicine, Logan, UT
| | - Bradley Changstrom
- Department of Medicine, Division of Internal Medicine, University of Colorado, Denver, CO
| | - Carlin Senter
- Department of Orthopaedic Surgery, Division of Sports Medicine, University of California San Francisco, San Francisco, CA
| | | | | | - Margot Putukian
- Princeton University, McCosh Health Center, University Health Services, Preinceton, NJ
| | - Selina Shah
- Center for Sports Medicine, Walnut Creek, CA
| | - Amy Powell
- Department of Orthopaedic Surgery and Department of Internal Medicine, Division of General Internal Medicine, University of Utah, Salt Lake City, UT
| | - Sameer Dixit
- Department of Primary Care Sports Medicine, Hospital for Special Surgery, New York, NY
| | - Kevin Eerkes
- NYU Langone Health, Department of Internal Medicine, New York University, New York, NY
| | - Byron Moran
- Department of Orthopaedic Surgery, Division of Sports Medicine, College of Medicine, University of South Florida, Tampa, FL
| | - Kenneth P Barnes
- Department of Orthopaedic Surgery, Division of Sports Medicine, Moses H. Cone Memorial Hospital, Greensboro, NC
| | - Claudia Dal Molin
- Department of Internal Medicine and Department of Orthopaedic Surgery, Division of Sports Medicine, University of Maryland, Baltimore, MD
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15
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Parnell JA, Wagner-Jones K, Madden RF, Erdman KA. Dietary restrictions in endurance runners to mitigate exercise-induced gastrointestinal symptoms. J Int Soc Sports Nutr 2020; 17:32. [PMID: 32522222 PMCID: PMC7288429 DOI: 10.1186/s12970-020-00361-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/04/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Endurance runners frequently experience exercise-induced gastrointestinal (GI) symptoms, negatively impacting their performance. Food choices pre-exercise have a significant impact on the gut's tolerance to running, yet little information is available as to which foods runners restrict prior to exercise. METHODS A questionnaire designed to assess dietary restrictions pre-racing and gastrointestinal symptoms was administered to 388 runners. Fisher's exact tests determined differences in gender, age, performance level, and distance with follow-up multivariable logistic regression modeling. RESULTS Runners regularly avoided meat (32%), milk products (31%), fish/seafood (28%), poultry (24%), and high-fiber foods (23%). Caffeinated beverages were commonly avoided in events 10 km or less (p < .001); whereas in females, increased running distance was a predictor of avoiding high-fiber foods (OR = 6.7; 95% CI = 1.6-28.5). Rates of food avoidance were elevated in younger and more competitive runners. Common GI symptoms included stomach pain/cramps (42%), intestinal pain/discomfort (23%), side ache/stitch (22%), urge to defecate (22%), and bloating (20%). The prevalence of GI symptoms was higher in younger athletes, especially females, which may explain their propensity to avoid foods. Lower recreational athletes were the least likely to report GI symptoms. Diarrhea incidence increased with running distance. CONCLUSIONS Identification of voluntary food restrictions in the pre-running meal highlights trends that can direct further research.
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Affiliation(s)
- Jill A. Parnell
- Department of Health and Physical Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, Alberta T3E 6K6 Canada
| | - Kim Wagner-Jones
- Helios Wellness Centres, Teaching, Research, Wellness Building, Suite 402, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Robyn F. Madden
- Faculty of Kinesiology, 2500 University Drive NW, University of Calgary, Calgary, Alberta T2N 1N4 Canada
| | - Kelly Anne Erdman
- University of Calgary, Sports Medicine Centre, 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada
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16
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Martínez-Sanz JM, Fernández Nuñez A, Sospedra I, Martínez-Rodríguez A, Domínguez R, González-Jurado JA, Sánchez-Oliver AJ. Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114082. [PMID: 32521666 PMCID: PMC7312487 DOI: 10.3390/ijerph17114082] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 01/16/2023]
Abstract
During the last few years, the numbers of competitors in endurance and ultra-endurance sports modalities have increased significantly. This type of competition is an extreme challenge for athletes. Therefore, they have an increased the risk of developing medical and nutritional problems. The aim of the work is to estimate the incidence of nutrition-related adverse outcomes in endurance and ultra-endurance sports, considering the variables that influence them. A critical review was carried out based on the PubMed database, by means of a search strategy based on keywords separated by Boolean connectors. For all the results obtained in a period from 2008 to 2019, a series of inclusion/exclusion criteria was applied to select only the studies that fitted the objective of the present study. Results and discussion: Of the 871 publications identified, 33 met the inclusion criteria. The adverse outcomes found included exercise-associated hyponatremia (EAH), heat stroke by exertion (EHS), gastrointestinal (GI) problems, dehydration, and hypothermia; the provision of misinformation to athletes about nutrient intake and hydration during competition was identified as the main cause. Conclusions: The main adverse outcomes in endurance and ultra-endurance sports modalities are EAH, GI inconveniences, and EHS. These problems can affect the performance and health status of the athlete during and post-competition. Several nutritional guidelines have been suggested that can prevent these adverse outcomes, and it is essential to individualize and adjust the nutritional intake and hydration status according to the characteristics of each competition.
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Affiliation(s)
- José Miguel Martínez-Sanz
- Departamento de Enfermería, Grupo de Investigación en Alimentación y Nutrición (ALINUT), Facultad de Ciencias de la Salud, Universidad de Alicante, 03690 Alicante, Spain; (J.M.M.-S.); (I.S.)
| | - Ana Fernández Nuñez
- Facultad de Ciencias de la Salud, Universidad de Alicante, 03690 Alicante, Spain;
| | - Isabel Sospedra
- Departamento de Enfermería, Grupo de Investigación en Alimentación y Nutrición (ALINUT), Facultad de Ciencias de la Salud, Universidad de Alicante, 03690 Alicante, Spain; (J.M.M.-S.); (I.S.)
| | - Alejandro Martínez-Rodríguez
- Analytical Chemistry, Nutrition and Food Sciences Department, Sciences Faculty, University of Alicante, 03690 Alicante, Spain;
| | - Raúl Domínguez
- Facultad de Ciencias de la Salud de la Universidad Isabel I, 09003 Burgos, Spain;
| | - José Antonio González-Jurado
- Facultad del Deporte, Universidad Pablo Olavide de Sevilla, 41013 Sevilla, Spain
- Correspondence: ; Tel.: +34-651-517-571
| | - Antonio J. Sánchez-Oliver
- Departamento de Motricidad Humana y Rendimiento Deportivo, Universidad de Sevilla, 41004 Sevilla, Spain;
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17
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Axling U, Önning G, Combs MA, Bogale A, Högström M, Svensson M. The Effect of Lactobacillus plantarum 299v on Iron Status and Physical Performance in Female Iron-Deficient Athletes: A Randomized Controlled Trial. Nutrients 2020; 12:E1279. [PMID: 32365981 PMCID: PMC7282001 DOI: 10.3390/nu12051279] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 02/07/2023] Open
Abstract
Iron is an essential micronutrient for oxygen transport and mitochondrial metabolism and is critical for physical performance. Compromised iron stores are more commonly found among athletes, and females are especially at risk. Iron deficiency is generally treated using oral iron supplements. However, only a small proportion of ingested iron is absorbed, necessitating higher intakes, which may result in adverse side effects, reduced compliance, and inefficient repletion of iron stores. The probiotic strain Lactobacillus plantarum 299v (Lp299v) significantly increases intestinal iron absorption in meal studies. The present study was conducted to explore the effects of 20 mg of iron with or without Lp299v on iron status, mood state, and physical performance. Fifty-three healthy non-anemic female athletes with low iron stores (ferritin < 30 μg/L) were randomized, and 39 completed the study. Intake of Lp299v with iron for four weeks increased ferritin levels more than iron alone (13.6 vs. 8.2 µg/L), but the difference between the groups was not significant (p = 0.056). The mean reticulocyte hemoglobin content increased after intake of Lp299v compared to control (1.5 vs. 0.82 pg) after 12 weeks, but the difference between the group was not significant (p = 0.083). The Profile of Mood States (POMS) questionnaire showed increased vigor with Lp299v vs. iron alone after 12 weeks (3.5 vs. 0.1, p = 0.015). No conclusive effects on physical performance were observed. In conclusion, Lp299v, together with 20 mg of iron, could result in a more substantial and rapid improvement in iron status and improved vigor compared to 20 mg of iron alone. A larger clinical trial is needed to further explore these findings as well as the impact of Lp299v on physical performance.
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Affiliation(s)
| | - Gunilla Önning
- Probi AB, 223 70 Lund, Sweden;
- Biomedical Nutrition, Pure and Applied Biochemistry, Center for Applied Life Sciences, Lund University, 221 00 Lund, Sweden
| | - Maile A. Combs
- Nutrition and Scientific Affairs Department, The Nature’s Bounty Co., Ronkonkoma, NY 11779, USA; (M.A.C.); (A.B.)
| | - Alemtsehay Bogale
- Nutrition and Scientific Affairs Department, The Nature’s Bounty Co., Ronkonkoma, NY 11779, USA; (M.A.C.); (A.B.)
| | - Magnus Högström
- Sports Medicine Umeå AB and Orthopedics, Department of Surgical and Perioperative Sciences, Umeå University, 901 87 Umeå, Sweden;
| | - Michael Svensson
- Section of Sports Medicine, Department of Community Medicine and Rehabilitation, Umeå University, 901 87 Umeå, Sweden
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18
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Pruna R, Lizarraga A. Nutrición y deporte. Nuevos enfoques conceptuales en la actualidad. Med Clin (Barc) 2019; 153:281-283. [DOI: 10.1016/j.medcli.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 11/27/2022]
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19
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Affiliation(s)
- Nailah Coleman
- Department of Pediatrics, The George Washington University, Washington, DC; The Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, DC
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20
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Williams NI, Koltun KJ, Strock NCA, De Souza MJ. Female Athlete Triad and Relative Energy Deficiency in Sport: A Focus on Scientific Rigor. Exerc Sport Sci Rev 2019; 47:197-205. [DOI: 10.1249/jes.0000000000000200] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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21
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Lira CABD, Viana RB, Mesquista KP, Santos DDAT, Campos MH, Andrade MS, Vancini RL. Frequency and intensity of gastrointestinal symptoms in exercisers individuals at rest and during physical exercise: an internet-based survey. Intest Res 2019; 17:537-545. [PMID: 31060114 PMCID: PMC6821937 DOI: 10.5217/ir.2018.00162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/01/2019] [Indexed: 12/04/2022] Open
Abstract
Background/Aims Despite the evidence of a modest to high prevalence of gastrointestinal (GI) symptoms in recreational runners and endurance athletes, the frequency and intensity of GI symptoms in exercisers, but nonathletes, individuals from different modalities have been less investigated. Therefore, the present study aimed to assess the prevalence of GI symptoms in individuals that practice moderate or vigorous physical exercise, at rest and during physical exercise training session. Methods The sample consisted of 142 exercisers individuals (64 women and 78 men with mean age of 32.9 ± 10.7 years). Out of the 142 participants, 71 reported to perform moderate physical exercise and 71 reported to perform vigorous physical exercise. Participants were assessed by an internet-based questionnaire designed to assess the frequency and intensity (at rest and during physical exercise training session) of 18 GI symptoms. Results The GI symptoms most frequently reported by the respondents (during rest and physical exercise training session, respectively) were flatulence (90.8% and 69.7%), abdominal noise (77.5% and 41.5%), and eructation (73.9% and 52.1%). Overall, the frequency and intensity of symptoms were higher (P< 0.050) during rest than physical exercise training session for who perform moderate and vigorous physical exercise. Conclusions It can be concluded that GI symptoms in exercisers, but nonathletes, individuals are more prevalent during rest than during physical exercise training session, suggesting that moderate and vigorous physical exercise may act as a regulator of the GI tract.
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Affiliation(s)
- Claudio Andre Barbosa de Lira
- Human and Exercise Physiology Sector, Human Movement Assessment Laboratory, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Ricardo Borges Viana
- Human and Exercise Physiology Sector, Human Movement Assessment Laboratory, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | | | - Douglas de Assis Teles Santos
- Human and Exercise Physiology Sector, Human Movement Assessment Laboratory, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil.,Collegiate of Physical Education, Bahia State University, Teixeira de Freitas, Brazil
| | - Mário Hebling Campos
- Human and Exercise Physiology Sector, Human Movement Assessment Laboratory, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | | | - Rodrigo Luiz Vancini
- Center of Physical Education and Sports, Federal University of Espírito Santo, Vitória, Brazil
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22
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Parnell JA, Lafave H, Wagner-Jones K, Madden RF, Erdman KA. Development of a questionnaire to assess dietary restrictions runners use to mitigate gastrointestinal symptoms. J Int Soc Sports Nutr 2019; 16:11. [PMID: 30819184 PMCID: PMC6396487 DOI: 10.1186/s12970-019-0278-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/17/2019] [Indexed: 11/12/2022] Open
Abstract
Background Exercise induced gastrointestinal (GI) symptoms can plague athletes, especially runners. Sport nutrition recommendations are nutrient rather than foods focused and do not adequately address strategies to reduce GI symptoms. The objective was to develop a valid and reliable questionnaire to evaluate pre-training and pre-racing voluntary food restrictions/choices, reasons for avoiding foods, and gastrointestinal symptoms in endurance runners. Methods Validity testing occurred through four Registered Dietitians, three of whom possess Master’s degrees, and a dietetic trainee who provided initial feedback. Additionally, one Registered Dietitian is a Board Certified Specialist in Sports Dietetics (CSSD), and another has an International Olympic Committee Diploma in Sports Nutrition. The second version was sent out to nine different experts who rated each question using a Likert scale and provided additional comments. For reliability testing, the questionnaire was administered to 39 participants in a test re-test format. Kappa statistics and the prevalence-adjusted bias-adjusted kappa (PABAK) were used to assess the reliability. Results All questions had an average Likert scale rating of 4/5 or greater. All test re-test results falling under basic information exhibited substantial agreement (kappa ≥0.61). All medical questions including food allergies and intolerances had moderate (kappa ≥0.41) or higher agreement. Responses were less consistent for food avoidances while training (5/28 outcomes) versus racing (0/28 outcomes) with a kappa below 0.41. All reasons for avoiding foods were deemed reliable. Regarding symptoms, side stitch while training and gas while racing were the only flagged categories. Conclusions Overall, the questionnaire is a valid and reliable tool to evaluate voluntary dietary restrictions among endurance runners. Future studies can use the questionnaire to assess dietary strategies runners employ to reduce GI distress and optimize performance. Electronic supplementary material The online version of this article (10.1186/s12970-019-0278-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jill A Parnell
- Department of Health and Physical Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, Alberta, T3E 6K6, Canada.
| | - Hailey Lafave
- Department of Biology, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, Alberta, T3E 6K6, Canada
| | - Kim Wagner-Jones
- Helios Wellness Centres, Teaching, Research, Wellness Building, Suite 402, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Robyn F Madden
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Kelly Anne Erdman
- Sport Medicine Centre, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
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23
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Kraljević Pavelić S, Simović Medica J, Gumbarević D, Filošević A, Pržulj N, Pavelić K. Critical Review on Zeolite Clinoptilolite Safety and Medical Applications in vivo. Front Pharmacol 2018; 9:1350. [PMID: 30538633 PMCID: PMC6277462 DOI: 10.3389/fphar.2018.01350] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/02/2018] [Indexed: 12/15/2022] Open
Abstract
Unique and outstanding physical and chemical properties of zeolite materials make them extremely useful in a variety of applications including agronomy, ecology, manufacturing, and industrial processes. Recently, a more specific application of one naturally occurring zeolite material, clinoptilolite, has been widely studied in veterinary and human medicine. Due to a number of positive effects on health, including detoxification properties, the usage of clinoptilolite-based products in vivo has increased enormously. However, concerns have been raised in the public about the safety of clinoptilolite materials for in vivo applications. Here, we review the scientific literature on the health effects and safety in medical applications of different clinoptilolite-based materials and propose some comprehensive, scientifically-based hypotheses on possible biological mechanisms underlying the observed effects on the health and body homeostasis. We focus on the safety of the clinoptilolite material and the positive medical effects related to detoxification, immune response, and the general health status.
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Affiliation(s)
- Sandra Kraljević Pavelić
- Department of Biotechnology, Centre for High-Throughput Technologies, University of Rijeka, Rijeka, Croatia
| | | | - Darko Gumbarević
- Department of Biotechnology, Centre for High-Throughput Technologies, University of Rijeka, Rijeka, Croatia
| | - Ana Filošević
- Department of Biotechnology, Centre for High-Throughput Technologies, University of Rijeka, Rijeka, Croatia
| | - Nataša Pržulj
- Computer Science Department, University College London, London, United Kingdom
| | - Krešimir Pavelić
- Department of Biotechnology, Centre for High-Throughput Technologies, University of Rijeka, Rijeka, Croatia.,Juraj Dobrila University of Pula, Pula, Croatia
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24
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Robinson N, Saugy J, Schütz F, Faiss R, Baume N, Giraud S, Saugy M. Worldwide distribution of blood values in elite track and field athletes: Biomarkers of altered erythropoiesis. Drug Test Anal 2018; 11:567-577. [DOI: 10.1002/dta.2526] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 10/08/2018] [Accepted: 10/14/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Neil Robinson
- Swiss Laboratory for Doping Analyses (LAD), University Centre of Legal Medicine, Lausanne and GenevaCentre Hospitalier Universitaire Vaudois and University of Lausanne Switzerland
| | - Jonas Saugy
- Centre of Research and Expertise in anti‐Doping sciences ‐ REDsUniversity of Lausanne Switzerland
| | - Frédéric Schütz
- Bioinformatics Core Facility; SIB Swiss Institute of Bioinformatics Lausanne Switzerland
- Centre for Integrative GenomicsUniversity of Lausanne Switzerland
| | - Raphael Faiss
- Centre of Research and Expertise in anti‐Doping sciences ‐ REDsUniversity of Lausanne Switzerland
| | - Norbert Baume
- Swiss Laboratory for Doping Analyses (LAD), University Centre of Legal Medicine, Lausanne and GenevaCentre Hospitalier Universitaire Vaudois and University of Lausanne Switzerland
| | - Sylvain Giraud
- Swiss Laboratory for Doping Analyses (LAD), University Centre of Legal Medicine, Lausanne and GenevaCentre Hospitalier Universitaire Vaudois and University of Lausanne Switzerland
| | - Martial Saugy
- Swiss Laboratory for Doping Analyses (LAD), University Centre of Legal Medicine, Lausanne and GenevaCentre Hospitalier Universitaire Vaudois and University of Lausanne Switzerland
- Centre of Research and Expertise in anti‐Doping sciences ‐ REDsUniversity of Lausanne Switzerland
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Schwabe K, Schwellnus M, Swanevelder S, Jordaan E, Derman W, Bosch A. Leisure athletes at risk of medical complications: outcomes of pre-participation screening among 15,778 endurance runners - SAFER VII. PHYSICIAN SPORTSMED 2018; 46:405-413. [PMID: 30052116 DOI: 10.1080/00913847.2018.1505569] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE International guidelines for pre-participation screening of masters/leisure athletes to identify those that require medical assessment exist, but have not been implemented in mass-community based sports events. We determined the prevalence of runners who, according to these guidelines, would require a medical assessment before participating in a distance running event. METHODS Participants of the 2012 Two Oceans races (21.1 and 56 km) in South Africa (n = 15,778) completed an online pre-race medical screening questionnaire using European pre-participation screening guidelines. We determined the prevalence of runners that would require a pre-race medical assessment, based on risk factors, symptoms, and disease. RESULTS The pre-participation "self assessment of risk" screening identified 4,941 runners (31.3%; 95% CI 30.6-32.0) that would need to undergo a full pre-participation medical assessment prior to running, if the current pre-participation screening guidelines are applied. Although musculoskeletal complaints and prescription medication use were the main triggers for a medical assessment, 16.8% (n = 2657) runners should undergo medical evaluation for suspected cardiac disease based on the questionnaire results: 3.4% (n = 538) reporting existing CVD (very high risk) and 13.4% (n = 2119) reporting multiple CVD risk factors (high risk). Other possible risk factors were reported as follows: history of chronic diseases (respiratory = 13.1%, gastro-intestinal = 4.3%, nervous system = 3.8%, metabolic/endocrine = 3.5%, allergies = 13.9%); chronic prescription medication = 14.8%, used medication before or during races = 15.6%; past history of collapse during a race = 1.4%. CONCLUSIONS Current guidelines identified that > 30% runners would require a full medical assessment before race participation - mainly linked to runners reporting musculoskeletal conditions. We suggest a revision of guidelines and propose that pre-race screening should be considered to identify runners with a "very high," "high," and "intermediate risk" for medical complications during exercise. Pre-race screening and educational intervention could be implemented to reduce medical complications during exercise.
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Affiliation(s)
- Karen Schwabe
- a Division of Exercise Science & Sports Medicine, Department of Human Biology, Faculty of Health Sciences , University of Cape Town , Cape Town , South Africa
| | - Martin Schwellnus
- b Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences , University of Pretoria , Pretoria , South Africa.,c International Olympic Committee (IOC) Research Centre , Pretoria , South Africa.,d Faculty of Health Sciences , University of Cape Town , Cape Town , South Africa
| | - Sonja Swanevelder
- e Biostatistics Unit , South African Medical Research Council , Cape Town , South Africa
| | - Esme Jordaan
- e Biostatistics Unit , South African Medical Research Council , Cape Town , South Africa.,f Statistics and Population Studies Department , University of the Western Cape , Cape Town , South Africa
| | - Wayne Derman
- c International Olympic Committee (IOC) Research Centre , Pretoria , South Africa.,g Institute for Sport and Exercise Medicine, Faculty of Medicine & Health Sciences , University of Stellenbosch , Stellenbosch , South Africa
| | - Andrew Bosch
- a Division of Exercise Science & Sports Medicine, Department of Human Biology, Faculty of Health Sciences , University of Cape Town , Cape Town , South Africa
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Rodríguez de Santiago E, Aguilera Castro L, García García de Paredes A, Ferre Aracil C, Martín de Argila de Prados C. Upper gastrointestinal bleeding secondary to vigorous physical exercise. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2018. [DOI: 10.1016/j.rgmxen.2017.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Exercise can have significant effects on gastrointestinal diseases. Regular, moderate exercise can impart beneficial effects for the intestinal microbiome, irritable bowel syndrome symptoms, and inflammatory bowel disease. High-intensity training or prolonged endurance training, on the other hand, can have negative effects on these same entities. Female athletes report a higher prevalence of irritable bowel syndrome and celiac disease, and furthermore, have gastrointestinal symptoms modulated by the menstrual cycle. Management of gastrointestinal problems in the athletic population is widespread and includes training adjustments, dietary measures, and medicine management of symptoms.
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Affiliation(s)
- Barry Kent Diduch
- Department of Sports Medicine, James Madison University, 261 Bluestone Drive MSC 2301, Harrisonburg, VA 24401, USA.
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König TT, Muensterer OJ. Physical Fitness and Locomotor Skills in Children With Esophageal Atresia-A Case Control Pilot Study. Front Pediatr 2018; 6:337. [PMID: 30460218 PMCID: PMC6232263 DOI: 10.3389/fped.2018.00337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/18/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with esophageal atresia (EA) often experience physical limitations. With increasing survival over the past decades, the focus in care shifted toward improving the long-term quality of life. We performed validated testing fitness and motor skills in children born with EA. Methods: Patients with EA were evaluated using the standardized Kinderturntest Plus/ Deutscher Motorik Test after caregiver's written consent. Test scores range from 1 to 5 (compared to an age- and gender matched standard population). Caregivers completed an online-questionnaire on patient history. Results: Seventeen patients (median age 7 [3-12] years) were included. Comorbidities were prematurity (54%), birth weight <1,500 g (23%), congenital heart disease (46%), developmental delay (38%), skeletal deformity (23%), and anorectal malformation (15%). The mean test score was significantly lower in children with EA (2.19) compared to a control group matched for age, gender, body weight, and -height, (2.75, p = 0.04), and the general population (3, p = 0.00). Distribution of patient scores was below the 41st performance percentile for gender and age in 54-63%. Caregivers identified notable deficits of strength and endurance. All but one patient complained about discomfort during physical exercise, most commonly respiratory distress (46%) and gastroesophageal reflux symptoms (31%). Notably, 93% of subjects participated in regular school physical education classes, and 86% participated regularly in additional organized sporting activities. Conclusions: Children after EA repair have decreased physical fitness and impaired locomotor function compared to the general population on a standardized test. Physical discomfort is frequent during exertion. To avoid demotivation, locomotor skill should be promoted at each individual's comfortable level. The study was registered at www.researchregistry.com (No. 3707).
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Affiliation(s)
- Tatjana T König
- Department of Pediatric Surgery, Universitätsmedizin Mainz, Mainz, Germany
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Upper gastrointestinal bleeding secondary to vigorous physical exercise. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2017; 83:350-351. [PMID: 28347530 DOI: 10.1016/j.rgmx.2016.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/09/2016] [Accepted: 12/16/2016] [Indexed: 11/23/2022]
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Granger DN, Holm L, Kvietys P. The Gastrointestinal Circulation: Physiology and Pathophysiology. Compr Physiol 2016; 5:1541-83. [PMID: 26140727 DOI: 10.1002/cphy.c150007] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The gastrointestinal (GI) circulation receives a large fraction of cardiac output and this increases following ingestion of a meal. While blood flow regulation is not the intense phenomenon noted in other vascular beds, the combined responses of blood flow, and capillary oxygen exchange help ensure a level of tissue oxygenation that is commensurate with organ metabolism and function. This is evidenced in the vascular responses of the stomach to increased acid production and in intestine during periods of enhanced nutrient absorption. Complimenting the metabolic vasoregulation is a strong myogenic response that contributes to basal vascular tone and to the responses elicited by changes in intravascular pressure. The GI circulation also contributes to a mucosal defense mechanism that protects against excessive damage to the epithelial lining following ingestion of toxins and/or noxious agents. Profound reductions in GI blood flow are evidenced in certain physiological (strenuous exercise) and pathological (hemorrhage) conditions, while some disease states (e.g., chronic portal hypertension) are associated with a hyperdynamic circulation. The sacrificial nature of GI blood flow is essential for ensuring adequate perfusion of vital organs during periods of whole body stress. The restoration of blood flow (reperfusion) to GI organs following ischemia elicits an exaggerated tissue injury response that reflects the potential of this organ system to generate reactive oxygen species and to mount an inflammatory response. Human and animal studies of inflammatory bowel disease have also revealed a contribution of the vasculature to the initiation and perpetuation of the tissue inflammation and associated injury response.
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Affiliation(s)
- D Neil Granger
- Department of Molecular and Cellular Physiology, LSU Health Science Center-Shreveport, Shreveport, Louisiana, USA
| | - Lena Holm
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Peter Kvietys
- Department of Physiological Sciences, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Pattullo KM, Kidney BA, Taylor SM, Jackson ML. Reticulocytosis in nonanemic dogs: increasing prevalence and potential etiologies. Vet Clin Pathol 2014; 44:26-36. [PMID: 25488123 DOI: 10.1111/vcp.12215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND An increasing prevalence of reticulocytosis in the absence of anemia (RAA) in dogs has been suspected in recent years. OBJECTIVES The objectives were to determine whether prevalence of RAA in our canine population has been increasing over the last years, and to identify potential predisposing factors. METHODS The annual prevalence of RAA in adult dogs was determined between 2000 and 2012. Clinical histories and CBC data were analyzed for all dogs, as well as owner response to a questionnaire including information on nutrition and supplements was conducted for dogs with RAA identified between 2011 and 2012. In addition, serum iron concentration (Fe), total iron-binding capacity (TIBC), and percent transferrin saturation (%TS) were determined in 14 dogs with RAA and compared with 8 healthy control dogs. RESULTS Reticulocytosis in the absence of anemia was identified in 1035 dogs, with the prevalence increasing since 2006. Dogs with RAA evaluated after 2006 (n = 853) had significantly lower MCV and were more likely to have microcytosis than those prior to 2006 (n = 182). Increased incidence of osteoarthritis was observed in dogs evaluated after 2006, including the dogs studied between 2011 and 2012 (n = 31), and administration of nonsteroidal anti-inflammatory drugs, omega-3 fatty acids, and glucosamine was more common in the latter. Significantly lower mean Fe and %TS, and higher TIBC were found in dogs with RAA compared to unaffected dogs. CONCLUSIONS Prevalence of RAA has increased in recent years in our canine population. More ubiquitous use of anti-inflammatory medications and nutraceuticals, associated with increased diagnosis of osteoarthritis should be considered as contributing factors.
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Affiliation(s)
- Kimberly M Pattullo
- Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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de Oliveira EP, Burini RC, Jeukendrup A. Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations. Sports Med 2014; 44 Suppl 1:S79-85. [PMID: 24791919 PMCID: PMC4008808 DOI: 10.1007/s40279-014-0153-2] [Citation(s) in RCA: 216] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Gastrointestinal problems are common, especially in endurance athletes, and often impair performance or subsequent recovery. Generally, studies suggest that 30-50% of athletes experience such complaints. Most gastrointestinal symptoms during exercise are mild and of no risk to health, but hemorrhagic gastritis, hematochezia, and ischemic bowel can present serious medical challenges. Three main causes of gastrointestinal symptoms have been identified, and these are either physiological, mechanical, or nutritional in nature. During intense exercise, and especially when hypohydrated, mesenteric blood flow is reduced; this is believed to be one of the main contributors to the development of gastrointestinal symptoms. Reduced splanchnic perfusion could result in compromised gut permeability in athletes. However, although evidence exists that this might occur, this has not yet been definitively linked to the prevalence of gastrointestinal symptoms. Nutritional training and appropriate nutrition choices can reduce the risk of gastrointestinal discomfort during exercise by ensuring rapid gastric emptying and the absorption of water and nutrients, and by maintaining adequate perfusion of the splanchnic vasculature. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates, and potentially the use of nutrients that stimulate the production of nitric oxide in the intestine and thereby improve splanchnic perfusion. However, at this stage, evidence for beneficial effects of such interventions is lacking, and more research needs to be conducted to obtain a better understanding of the etiology of the problems and to improve the recommendations to athletes.
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Affiliation(s)
- Erick Prado de Oliveira
- School of Medicine, Federal University of Uberlândia, Av. Pará, no 1720 Bloco 2U, Campus Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil,
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Hasselkvist A, Johansson A, Johansson AK. Association between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents. Acta Odontol Scand 2014; 72:1039-46. [PMID: 25183250 DOI: 10.3109/00016357.2014.946964] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The aim was to investigate the relationship between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents. MATERIALS AND METHODS A clinical dental examination and a questionnaire concerning lifestyle factors, including drinking habits, oral hygiene, dietary consumption, physical activity and screen-viewing habits were completed. Three hundred and ninety-two individuals completed the study (13-14 years, n = 195; 18-19 years, n = 197). The material was divided into high and low carbonated soft drink consumption groups, corresponding to approximately the highest and the lowest one-third of subjects in each age group. Differences between the groups were tested by the Mann-Whitney U-test and logistic regression. RESULTS Intake of certain dietary items, tooth brushing, sports activities, meal patterns, screen-viewing behaviors, BMI and parents born outside Sweden differed significantly between high and low consumers in one or both of the two age groups. Dental erosion (both age groups) and DMFT/DMFS (18-19 years group) were significantly higher in the high consumption groups. Logistic regression showed predictive variables for high consumption of carbonated soft drinks to be mainly gender (male), unhealthy dietary habits, lesser physical activity, higher BMI and longer time spent in front of TV/computer. CONCLUSION High soft drink consumption was related to poorer oral health and an unhealthier lifestyle.
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Affiliation(s)
- Agneta Hasselkvist
- Department of Clinical Dentistry-Cariology, Faculty of Medicine and Dentistry, University of Bergen , Bergen , Norway
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Selanne H, Ryba TV, Siekkinen K, Kyröläinen H, Kautiainen H, Hakonen H, Mikkelsson M, Kujala UM. The prevalence of musculoskeletal pain and use of painkillers among adolescent male ice hockey players in Finland. Health Psychol Behav Med 2014; 2:448-454. [PMID: 25750794 PMCID: PMC4345898 DOI: 10.1080/21642850.2014.884463] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 01/14/2014] [Indexed: 02/04/2023] Open
Abstract
Participating in competitive sport increases the risk for injuries and musculoskeletal pain among adolescent athletes. There is also evidence that the use of prescription drugs has increased among sport club athletes. The purpose of this study was to evaluate the use of painkillers among young male ice hockey players (IHP) in comparison to schoolboys (controls) and its relation to the prevalence of musculoskeletal pain and problems during activities and sleeping. Information was gathered through a questionnaire, completed by 121 IHP and compared to the responses of 618 age-matched controls. Results showed that monthly existing pain was at 82% for IHP, and 72% for controls, though IHP had statistically more musculoskeletal pain in their lower limbs (56% vs. 44%), lower back (54% vs. 35%), and buttocks (26% vs. 11%). There were no group differences in the neck, upper back, upper limb, or chest areas. The disability index was statistically similar for both groups, as musculoskeletal pain causing difficulties in daily activities and sleeping was reported by a minority of subjects. Despite this similarity, IHP used more painkillers than controls (18% vs. 10%). Further nuanced research is encouraged to compare athletes and non-athletes in relation to painkillers.
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Affiliation(s)
| | - Tatiana V Ryba
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark
| | | | - Heikki Kyröläinen
- Department of Biology of Physical Activity, University of Jyväskylä , Jyväskylä , Finland
| | | | | | | | - Urho M Kujala
- Department of Health Sciences, University of Jyväskylä , Jyväskylä , Finland
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Tesarz J, Gerhardt A, Schommer K, Treede RD, Eich W. Alterations in endogenous pain modulation in endurance athletes: an experimental study using quantitative sensory testing and the cold-pressor task. Pain 2013; 154:1022-9. [PMID: 23657118 DOI: 10.1016/j.pain.2013.03.014] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 02/26/2013] [Accepted: 03/07/2013] [Indexed: 11/28/2022]
Abstract
There is evidence for long-term alterations in pain tolerance among athletes compared with normally active controls. However, scientific data on pain thresholds in this population are inconsistent, and the underlying mechanisms for the differences remain unclear. Therefore, we assessed differences and similarities in pain perception and conditioned pain modulation (CPM) at rest in endurance athletes and normally active controls. The standardised quantitative sensory testing protocol (QST) of the 'German-Research-Network-on-Neuropathic-Pain' was used to obtain comprehensive profiles on somatosensory functions. The protocol consisted of thermal and mechanical detection as well as pain thresholds, vibration thresholds, and pain sensitivity to sharp and blunt mechanical stimuli. CPM (the diffuse-noxious-inhibitory-control-like effect) was measured using 2 tonic heat pain test stimuli (at the temperature exceeding a subjective pain rating of 50/100) separated by a 2-min cold-pressor task (CPM-TASK; conditioning stimulus). Pain ratings were measured with a numerical rating scale. Endurance capacity was validated by assessment of maximum oxygen uptake (VO2max). Participants included 25 pain-free male endurance athletes (VO2max>60mL/min∗kg) and 26 pain-free normally active controls (VO2max<45mL/min∗kg) matched based on age and body mass index. Athletes were significantly less sensitive to mechanical pain but showed higher sensitivity to vibration (P<0.05). In athletes, CPM was significantly less activated by the conditioning stimuli (P<0.05) when compared with normally active controls. Our data show that somatosensory processing in athletes differs in comparison with controls, and suggest that the endogenous pain inhibitory system may be less responsive. This finding may explain the paradoxical propensity of athletes to develop chronic widespread pain.
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Affiliation(s)
- Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, Medical Hospital, University of Heidelberg, Germany.
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Latunde-Dada GO. Iron metabolism in athletes - achieving a gold standard. Eur J Haematol 2012; 90:10-5. [DOI: 10.1111/ejh.12026] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2012] [Indexed: 01/01/2023]
Affiliation(s)
- Gladys O. Latunde-Dada
- Diabetes and Nutritional Sciences Division; School of Medicine; King's College London; London; UK
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Hayashi N, Yamaoka-Endo M, Someya N, Fukuba Y. Blood flow in non-muscle tissues and organs during exercise: Nature of splanchnic and ocular circulation. JOURNAL OF PHYSICAL FITNESS AND SPORTS MEDICINE 2012. [DOI: 10.7600/jpfsm.1.281] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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