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McGuire A, Warrington G, Walsh A, Byrne T, Doyle L. Measurement of energy availability in highly trained male endurance athletes and examination of its associations with bone health and endocrine function. Eur J Nutr 2024:10.1007/s00394-024-03433-8. [PMID: 38953963 DOI: 10.1007/s00394-024-03433-8] [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: 08/23/2023] [Accepted: 05/17/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Despite the introduction of Relative Energy Deficiency in Sport (RED-s) in 2014, there is evidence to suggest that male endurance athletes still present with a high prevalence of low energy availability (LEA). Previous findings suggest that energy availability (EA) status is strongly correlated with impairments in endocrine function such as reduced leptin, triiodothyronine (T3), and insulin, and elevated bone loss. This study aimed to report the current EA status, endocrine function and bone health of highly trained Irish male endurance athletes. METHODS In this cross-sectional study, participants (n = 3 triathletes; n = 10 runners) completed a 7-day testing period during the competition season using lab-based measures, to ascertain EA status, hormone level and rates of bone metabolism. Serum blood samples were obtained to assess hormone levels and markers of bone metabolism. RESULTS Mean EA was < 30 kcal/kg lean body mass (LBM)/day in 76.9% of athletes. There was a strong association between LEA and low carbohydrate intake, and lower LBM. Mean levels of insulin, IGF-1 and leptin were significantly lower than their reference ranges. Elevated mean concentrations of β-CTX and a mean P1NP: β-CTX ratio < 100, indicated a state of bone resorption. CONCLUSION The EA level, carbohydrate intake, hormone status and bone metabolism status of highly trained male endurance athletes are a concern. Based on the findings of this study, more frequent assessment of EA across a season is recommended to monitor the status of male endurance athletes, in conjunction with nutritional education specific to EA and the associated risks.
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Affiliation(s)
- Amy McGuire
- Department of Sport and Early Childhood Studies, Technological University of the Shannon, Limerick, Ireland.
- ACTIVE Research Group, Technological University of the Shannon, Limerick, Ireland.
| | - Giles Warrington
- Department of Physical Education and Social Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Adam Walsh
- Department of Sport and Exercise Science, South East Technological University, Cork Road, Waterford, Ireland
| | - Thomas Byrne
- Department of Sport and Exercise Science, South East Technological University, Cork Road, Waterford, Ireland
| | - Lorna Doyle
- Department of Sport and Exercise Science, South East Technological University, Cork Road, Waterford, Ireland
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2
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Huang W, Chen M, Zhang H, Zhang Z, Yin C, Huang M, Shi B. Association between life's essential 8 and male biochemical androgen deficiency: evidence from NHANES 2013-2016. Front Endocrinol (Lausanne) 2024; 15:1369684. [PMID: 38978620 PMCID: PMC11228233 DOI: 10.3389/fendo.2024.1369684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/07/2024] [Indexed: 07/10/2024] Open
Abstract
Purpose To evaluate the association of Life's Essential 8 (LE8) and its subscales with male biochemical androgen deficiency (MBAD) and total testosterone based on the data from the national health and nutrition examination survey (NHANES) database. Methods Data of males aged 20 years or older from NHANES of 2013-2016 were extracted. LE8 score was calculated based on American Heart Association definitions. Total testosterone (TT) values were measured in NHANES using precise isotope dilution liquid chromatography. MBAD was defined as serum TT of <300 ng/dL. Univariate and multivariable analyses were conducted. Propensity score matching (PSM) and weighted regression after matching were added as sensitivity analyses. The generalized additive model, smooth curve fitting, and the recursive algorithm were used to determine the potential inflection points. Piecewise regression models with log-likelihood ratio test were used to quantify nonlinear effects. Results A total of 3094 participants who were males and aged 20 years or above were included. Out of them, 805 males were diagnosed with MBAD. After adjusting the confounders in the multivariable model, LE8 was independently associated with MBAD (OR 0.96, P < 0.001) and TT (β 2.7, P < 0.001). The association remained robust even after PSM. The non-linear relationship of LE8 behaviors score with MBAD and TT was revealed. Conclusion LE8 was an independent protective factor of MBAD and a feasible approach to promote male endocrine sexual function.
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Affiliation(s)
- Weisheng Huang
- Department of Urology, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, China
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Mutong Chen
- Department of Urology, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, China
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Haiyu Zhang
- Department of Urology, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, China
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Zhongfu Zhang
- Department of Urology, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, China
| | - Cong Yin
- Department of Urology, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, China
| | - Meiyang Huang
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Bentao Shi
- Department of Urology, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Shenzhen, China
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3
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Aerts A, Temmerman A, Vanhie A, Vanderschueren D, Antonio L. The Effect of Endurance Exercise on Semen Quality in Male Athletes: A Systematic Review. SPORTS MEDICINE - OPEN 2024; 10:72. [PMID: 38861008 PMCID: PMC11166609 DOI: 10.1186/s40798-024-00739-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/29/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Endurance exercise has the potential to affect reproductive function, with amenorrhea in female athletes. However, most studies focus on women. Evidence on the association between endurance exercise and male fertility is limited. OBJECTIVE To synthesise existing literature on exercise-induced alterations in semen parameters and to assess the clinical impact on male fertility. METHODS Studies reporting on the association between semen parameters and endurance exercise in healthy men were eligible. Men attending fertility clinics were excluded. We searched MEDLINE (PubMed), Embase, SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and International Clinical Trials Registry Platform (ICTRP) from their inception to May 28th 2022. JBI Critical Appraisal Tool was used to assess the potential risk of bias. RESULTS Thirteen studies met inclusion criteria, reporting on 280 subjects. Eight articles reported on endurance runners, three on cyclists and four on triathletes. Four studies did not find any statistically significant sperm alterations. Five reported significant changes in semen parameters, but these were not clinically relevant, as semen parameters remained well above World Health Organisation (WHO) thresholds. Four articles reported a decrease in semen quality with potential clinical consequences as they found a reduced number of sperm cells exhibiting normal morphology in cyclists and triathletes and a greater amount of DNA fragmentation in triathletes. CONCLUSION Endurance exercise can have a negative effect on semen quality, although rarely with a clinically relevant impact on male fertility. Evidence is however limited, with poor quality of the included studies. REGISTRATION PROSPERO International prospective register of systematic reviews (CRD42022336753).
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Affiliation(s)
- Alex Aerts
- Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Annelien Temmerman
- Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Arne Vanhie
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Vanderschueren
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Leen Antonio
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
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4
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Vardardottir B, Olafsdottir AS, Gudmundsdottir SL. A real-life snapshot: Evaluating exposures to low energy availability in male athletes from various sports. Physiol Rep 2024; 12:e16112. [PMID: 38923409 PMCID: PMC11194298 DOI: 10.14814/phy2.16112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Problematic low energy availability (LEA) is the underlying cause of relative energy deficiency in sport (REDs). Male specific etiology, as well as the duration and degree of LEA exposures resulting in REDs remain to be adequately described. The present study aimed to assess occurrences of LEA (energy availability [EA] <25 kcal/kg fat-free mass/day) in male athletes from various sports over 7 days. Associations between number of LEA days, physiological measures, and body image concerns were subsequently evaluated. The athletes recorded their weighed food intakes and training via photo-assisted mobile application. Body composition and resting metabolic rates were measured, and venous blood samples collected for assessments of hormonal and nutrition status. Participants also answered the Low Energy Availability in Males Questionnaire (LEAM-Q), Eating Disorder Examination-Questionnaire Short (EDE-QS), Exercise Addiction Inventory (EAI), and Muscle Dysmorphic Disorder Inventory (MDDI). Of 19 participants, 13 had 0-2, 6 had 3-5, and none had 6-7 LEA days. No associations were found between the number of LEA days with the physiological and body image outcomes, although those with greatest number of LEA days had highest EEE but relatively low dietary intakes. In conclusion, this group displayed considerable day-to-day EA fluctuations but no indication of problematic LEA.
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Affiliation(s)
- Birna Vardardottir
- Faculty of Health Promotion, Sport & Leisure StudiesUniversity of IcelandReykjavikIceland
| | - Anna S. Olafsdottir
- Faculty of Health Promotion, Sport & Leisure StudiesUniversity of IcelandReykjavikIceland
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Javadi M, Gholami Farashah MS, Roshangar L, Soleimani JR. Plasma-derived extracellular vesicles improve mice embryo development. Mol Biol Rep 2024; 51:621. [PMID: 38709430 DOI: 10.1007/s11033-024-09500-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/28/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND To investigate the effect of plasma-derived extracellular vesicles (EVs) or conventional medium in fertilization and early embryo development rate in mice. METHODS AND RESULTS MII oocytes (matured in vivo or in vitro conditions) were obtained from female mice. The extracellular vesicles were isolated by ultracentrifugation of plasma and were analyzed and measured for size and morphology by dynamic light scattering (DLS) and transmission electron microscopy (TEM). By western blotting analysis, the EVs proteins markers such as CD82 protein and heat shock protein 90 (HSP90) were investigated. Incorporating DiI-labeled EVs within the oocyte cytoplasm was visible at 23 h in oocyte cytoplasm. Also, the effective proteins in the early reproductive process were determined in isolated EVs by western blotting. These EVs had a positive effect on the fertilization rate (P < 0.05). The early embryo development (8 cell, morula and blastocyst stages) was higher in groups supplemented with EVs (P < 0.01). CONCLUSION Our findings showed that supplementing in vitro maturation media with EVs derived- plasma was beneficial for mice's embryo development.
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Affiliation(s)
- Maryam Javadi
- Department of Anatomical Sciences, Faculty of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran.
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Sadegh Gholami Farashah
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Leila Roshangar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jafar Rad Soleimani
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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6
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Õnnik L, Mooses M, Suvi S, Haile DW, Ojiambo R, Lane AR, Hackney AC. Influence of energy availability on metabolic hormonal profiles in east African female and male distance runners. J Sports Med Phys Fitness 2024; 64:490-495. [PMID: 38305005 DOI: 10.23736/s0022-4707.23.15253-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Energy availability (EA) and relative energy deficiency in sport (RED-S) are understudied in East African endurance athletes, both females (F) and males (M). This study assessed the metabolic hormonal profiles of such athletes relative to their EA status. METHODS Forty athletes (F=16, M=24) had their EA status, training, maximal oxygen uptake, and resting blood samples assessed using standard research practices. Subjects were stratified into two groups, high EA (HiEA) and low EA (LoEA) based on combined median value. RESULTS Cortisol (P=0.034) and insulin (P=0.044) were significantly elevated in the LoEA group, while growth hormone (P=0.045) was significantly suppressed; and, prolactin (P=0.078) trended towards suppression, respectively compared to the HiEA group. All other hormonal comparison were non-significant. CONCLUSIONS Metabolic hormonal profiles of female and male African distance runners are affected by their EA status. Aspects of these alterations agree in part with published findings based upon White populations, although some differences exist and need further investigation.
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Affiliation(s)
| | | | | | | | - Robert Ojiambo
- Moi University, Eldoret, Kenya
- University of Global Health Equity, Butaro, Rwanda
| | - Amy R Lane
- University of North Carolina, Chapel Hill, NC, USA
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Nikjou R, Ajri-Khameslou M, Jegargoosheh S, Momeni P, Nemati-Vakilabad R. The severity of andropause symptoms and its relationship with social well-being among retired male nurses: a preliminary cross-sectional study. BMC Geriatr 2024; 24:184. [PMID: 38395767 PMCID: PMC10893613 DOI: 10.1186/s12877-024-04805-9] [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] [Received: 04/25/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Andropause is a syndrome that occurs due to decreased androgen levels in men. Various aspects of health, such as social well-being, can affect andropause status during men's retirement. This study aimed to determine the severity of andropause symptoms and its relationship with social well-being among retired male nurses. METHODS This preliminary cross-sectional study was conducted on 284 retired male nurses in Ardabil (northwest of Iran). The participants were selected through the census sampling method. Data were collected using a demographic information form, the Male Andropause Symptoms Self-Assessment Questionnaire (MASSQ), and the Social Well-Being Scale (SWBS). Data were analyzed using SPSS software (version 22.0). RESULTS The study found that the overall mean scores of the severity of andropause symptoms and social well-being among retired male nurses were 57.24 ± 12.62 (range = 35-91) and 94.54 ± 12.77 (range = 75-123), respectively. The highest and lowest mean scores between dimensions of social well-being were related to social contribution (20.26 ± 2.47) and social acceptance (15.26 ± 2.77), respectively. Multiple linear regression analysis revealed that subscales of social well-being, age, marital status, and spouse's menopause were predictors of the severity of andropause symptoms among retired male nurses. The selected predictors accounted for 53.1% of the total variance in severity of andropause symptoms (F = 36.613, p < 0.001). CONCLUSION The results showed a moderate to severe prevalence of andropause among retired male nurses and a significant association between andropause and social well-being. The study suggests further research to examine sexual orientation and other factors that may affect andropause in retired male nurses.
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Affiliation(s)
- Roya Nikjou
- Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Ajri-Khameslou
- Department of Intensive Care Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Shiva Jegargoosheh
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Parisa Momeni
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Reza Nemati-Vakilabad
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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8
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Di Luigi L, Antinozzi C, Duranti G, Dimauro I, Sgrò P. Sex-Chromosome-Related Dimorphism in Steroidogenic Enzymes and Androgen Receptor in Response to Testosterone Treatment: An In Vitro Study on Human Primary Skeletal Muscle Cells. Int J Mol Sci 2023; 24:17382. [PMID: 38139211 PMCID: PMC10743853 DOI: 10.3390/ijms242417382] [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] [Received: 11/06/2023] [Revised: 12/09/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
Gender-related methodology in biomedical sciences receives considerable attention, with numerous studies highlighting biological differences between cisgender males and females. These differences influence the clinical symptoms of various diseases and impact therapeutic approaches. In this in vitro study, we investigate the potential role of sex-chromosome-related dimorphism on steroidogenic enzymes, androgen receptor (AR) expression, and cellular translocation in primary human skeletal muscle cells before and after exposure to testosterone. We analyzed 46XY and 46XX cells for 17β-hydroxysteroid dehydrogenase (17β-HSD), 5α-reductase (5α-R2), aromatase (Cyp-19), and AR gene expression. We also compared AR expression and intracellular translocation after increasing exposure to testosterone. At baseline, we observed higher mRNA expression for 5α-R2 and AR in 46XY cells and higher Cyp-19 mRNA expression in 46XX cells. Following testosterone exposure, we observed an increase in AR expression and translocation in 46XX cells, even at the lowest dose of 0.5 nM, while significant changes in 46XY cells were observed only from 10 nM. Our in vitro results demonstrate that the diverse sex chromosome assets reflect important differences in muscle steroidogenesis. They support the concept that chromosomal disparities between males and females, even in vitro, lead to pivotal variations in cellular physiology and response. This understanding represents a crucial starting point in gender medicine, ensuring a precise approach in clinical practice, sports, and exercise settings and facilitating the translation of in vitro data to in vivo applicability.
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Affiliation(s)
- Luigi Di Luigi
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; (L.D.L.); (P.S.)
| | - Cristina Antinozzi
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; (L.D.L.); (P.S.)
| | - Guglielmo Duranti
- Unit of Biochemistry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy;
| | - Paolo Sgrò
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; (L.D.L.); (P.S.)
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Saliba T, De Leucio A, Simoni P. Idiopathic parietal bone thinning mimicking a bone lesion. Ghana Med J 2023; 57:321-323. [PMID: 38957854 PMCID: PMC11215221 DOI: 10.4314/gmj.v57i4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Abstract
Idiopathic focal unilateral skull thinning is a rare finding. An explanation, such as trauma or disease, can often be found. However, in some cases, no explanation is forthcoming, and thus, we must look further into their history for a possible cause. The case of a nine-year-old boy with a crescent-shaped unilateral parietal bone thinning and a history of ventouse-assisted birth is presented. The lesion matches a ventouse's typical location, shape, and size. Thus, with the support of one other reported similar case, we hypothesise this may be the origin. We present the case of a crescent-shaped lesion matching the imprint of a ventouse in a child with a concordant history. This finding is put in the context of similar reports in the literature, and we believe that this report provides further evidence of this obscure phenomenon. Funding None declared.
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Affiliation(s)
- Thomas Saliba
- Hopital Universitaire des Enfants Reine Fabiola (HUDERF), Brussels, Belgium
| | | | - Paolo Simoni
- Hopital Universitaire des Enfants Reine Fabiola (HUDERF), Brussels, Belgium
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10
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Bezuglov E, Ahmetov II, Lazarev A, Mskhalaya G, Talibov O, Ustinov V, Shoshorina M, Bogachko E, Azimi V, Morgans R, Hackney AC. The relationship of testosterone levels with sprint performance in young professional track and field athletes. Physiol Behav 2023; 271:114344. [PMID: 37689381 DOI: 10.1016/j.physbeh.2023.114344] [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] [Received: 07/09/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
Evidence suggests that higher testosterone levels may provide an athletic advantage. Therefore, it is of practical interest to examine the association between testosterone levels and power- and strength-related traits in young professional track and field athletes, and to consider the factors that determine testosterone levels. The study involved 68 young professional athletes (45 females, 17.3 ± 2.6 years; 23 males, 18.2 ± 1.9 years). Testosterone levels were assessed via liquid chromatography-mass spectrometry. All subjects performed two 20 m and two 30 m sprint trials, and countermovement jump without arm-swing. A bioimpedance analysis of body composition was carried out and biological maturity was examined using the Khamis-Roche method. The average testosterone levels were 26.4 ± 9.6 nmol/l and 1.5 ± 0.7 nmol/l in males and females, respectively. In female athletes, testosterone levels did not correlate with any of traits. Males with the highest testosterone levels were significantly faster in the 20 m (p = 0.033) and 30 m (p = 0.014) sprint trials compared to males with lower testosterone levels. Testosterone levels in males were positively associated with fat mass (p = 0.027), and degree of biological maturation (p = 0.003). In conclusion, we found a positive relationship between testosterone levels and sprint performance in young male athletes.
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Affiliation(s)
- Eduard Bezuglov
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia; Sirius University of Science and Technology, Sochi, Russia; Academy of Talents, Moscow, Russia
| | - Ildus I Ahmetov
- Department of Physical Education, Plekhanov Russian University of Economics, Moscow, Russia; Laboratory of Molecular Genetics, Kazan State Medical University, Kazan, Russia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Artemii Lazarev
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA
| | - George Mskhalaya
- Department of Internal Medicine, European Medical Center, Moscow, Russia
| | - Oleg Talibov
- Sirius University of Science and Technology, Sochi, Russia; Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Vjacheslav Ustinov
- International Medical Center for Processing and Cryostorage of Biomaterials, Moscow, Russia
| | - Maria Shoshorina
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Elizaveta Bogachko
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Violetta Azimi
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ryland Morgans
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
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11
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Dolan E, Koehler K, Areta J, Longman DP, Pontzer H. Energy constraint and compensation: Insights from endurance athletes. Comp Biochem Physiol A Mol Integr Physiol 2023; 285:111500. [PMID: 37557979 DOI: 10.1016/j.cbpa.2023.111500] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023]
Abstract
The Constrained Model of Total Energy Expenditure predicts that increased physical activity may not influence total energy expenditure, but instead, induces compensatory energetic savings in other processes. Much remains unknown, however, about concepts of energy expenditure, constraint and compensation in different populations, and it is unclear whether this model applies to endurance athletes, who expend very large amounts of energy during training and competition. Furthermore, it is well-established that some endurance athletes consciously or unconsciously fail to meet their energy requirements via adequate food intake, thus exacerbating the extent of energetic stress that they experience. Within this review we A) Describe unique characteristics of endurance athletes that render them a useful model to investigate energy constraints and compensations, B) Consider the factors that may combine to constrain activity and total energy expenditure, and C) Describe compensations that occur when activity energy expenditure is high and unmet by adequate energy intake. Our main conclusions are as follows: A) Higher activity levels, as observed in endurance athletes, may indeed increase total energy expenditure, albeit to a lesser degree than may be predicted by an additive model, given that some compensation is likely to occur; B) That while a range of factors may combine to constrain sustained high activity levels, the ability to ingest, digest, absorb and deliver sufficient calories from food to the working muscle is likely the primary determinant in most situations and C) That energetic compensation that occurs in the face of high activity expenditure may be primarily driven by low energy availability i.e., the amount of energy available for all biological processes after the demands of exercise have been met, and not by activity expenditure per se.
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Affiliation(s)
- Eimear Dolan
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil.
| | - Karsten Koehler
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Jose Areta
- Research Institute of Sport and Exercise Sciences, School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK. https://twitter.com/jlAreta
| | - Daniel P Longman
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. https://twitter.com/danny_longman
| | - Herman Pontzer
- Global Health Institute, Duke University, Durham, NC, USA. https://twitter.com/HermanPontzer
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12
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Vardardottir B, Olafsdottir AS, Gudmundsdottir SL. Body dissatisfaction, disordered eating and exercise behaviours: associations with symptoms of REDs in male and female athletes. BMJ Open Sport Exerc Med 2023; 9:e001731. [PMID: 38348179 PMCID: PMC10860738 DOI: 10.1136/bmjsem-2023-001731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 02/15/2024] Open
Abstract
Objectives Disordered eating and compulsive exercise behaviours are common among athletes and can increase the risk of relative energy deficiency in sport (REDs). Contrarily, the prevalence of muscle dysmorphia and its relationship with REDs are unknown. This cross-sectional study aimed to evaluate associations of all three with REDs symptoms. Methods Elite and subelite Icelandic athletes (n=83, 67.5% females) answered the Low Energy Availability in Females/Males Questionnaires (LEAF-Q/LEAM-Q), Eating Disorder Examination-Questionnaire Short (EDE-QS), Exercise Addiction Inventory (EAI) and Muscle Dysmorphic Disorder Inventory (MDDI). Body composition was assessed via dual-energy X-ray absorptiometry; resting metabolic rate via indirect calorimetry; and blood samples were drawn for analysis of nutrition and hormonal status. Females were compared based on LEAF-Q total score (≥8 (at risk) vs <8). Simple linear regression was applied to evaluate associations of (a) testosterone with other objective measures and LEAM-Q scores in males; and (b) LEAF-Q/LEAM-Q scores with EDE-QS, EAI and MDDI scores. Results In total, 8.4% of participants scored above cut-off on EDE-QS, 19.3% on EAI and 13.3% on MDDI. Females with LEAF-Q total score ≥8 had higher median scores on EDE-QS, EAI and MDDI compared with those scoring <8. Testosterone was positively associated with iron and inversely with total iron-binding capacity but was not associated with scoring on any of the administered questionnaires. Conclusion Drive for muscularity and aesthetic physique may play a role in the complex presentation of REDs. Screening for muscle dysmorphia, in addition to disordered eating and compulsive exercise, could therefore facilitate early detection of REDs.
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Affiliation(s)
- Birna Vardardottir
- Faculty of Health Promotion, Sport and Leisure Studies, University of Iceland, Reykjavik, Iceland
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13
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Mountjoy M, Ackerman KE, Bailey DM, Burke LM, Constantini N, Hackney AC, Heikura IA, Melin A, Pensgaard AM, Stellingwerff T, Sundgot-Borgen JK, Torstveit MK, Jacobsen AU, Verhagen E, Budgett R, Engebretsen L, Erdener U. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med 2023; 57:1073-1097. [PMID: 37752011 DOI: 10.1136/bjsports-2023-106994] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2023] [Indexed: 09/28/2023]
Abstract
Relative Energy Deficiency in Sport (REDs) was first introduced in 2014 by the International Olympic Committee's expert writing panel, identifying a syndrome of deleterious health and performance outcomes experienced by female and male athletes exposed to low energy availability (LEA; inadequate energy intake in relation to exercise energy expenditure). Since the 2018 REDs consensus, there have been >170 original research publications advancing the field of REDs science, including emerging data demonstrating the growing role of low carbohydrate availability, further evidence of the interplay between mental health and REDs and more data elucidating the impact of LEA in males. Our knowledge of REDs signs and symptoms has resulted in updated Health and Performance Conceptual Models and the development of a novel Physiological Model. This Physiological Model is designed to demonstrate the complexity of either problematic or adaptable LEA exposure, coupled with individual moderating factors, leading to changes in health and performance outcomes. Guidelines for safe and effective body composition assessment to help prevent REDs are also outlined. A new REDs Clinical Assessment Tool-Version 2 is introduced to facilitate the detection and clinical diagnosis of REDs based on accumulated severity and risk stratification, with associated training and competition recommendations. Prevention and treatment principles of REDs are presented to encourage best practices for sports organisations and clinicians. Finally, methodological best practices for REDs research are outlined to stimulate future high-quality research to address important knowledge gaps.
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Affiliation(s)
- Margo Mountjoy
- Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
- Games Group, International Olympic Committee, Lausanne, Switzerland
| | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Naama Constantini
- Sports Medicine Center, Shaare Zedek Medical Center, The Hebrew University, Jerusalem, Israel
| | - Anthony C Hackney
- Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ida Aliisa Heikura
- Canada Sport Institute Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Anna Melin
- Department of Sport Science - Swedish Olympic Committee Research Fellow, Linnaeus University, Kalmar, Sweden
| | - Anne Marte Pensgaard
- Department of Sport and Social Sciences, Norwegian School of Sports Sciences, Oslo, Norway
| | - Trent Stellingwerff
- Canada Sport Institute Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | | | | | | | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Science, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Uğur Erdener
- Department of Ophthalmology, Hacettepe University, Ankara, Turkey
- World Archery, Lausanne, Switzerland
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14
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Cupka M, Sedliak M. Hungry runners - low energy availability in male endurance athletes and its impact on performance and testosterone: mini-review. Eur J Transl Myol 2023. [PMID: 37052052 PMCID: PMC10388605 DOI: 10.4081/ejtm.2023.11104] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/17/2023] [Indexed: 04/14/2023] Open
Abstract
Low Energy Availability (LEA) arises from the inability to cover energy needs and requirements of training or normal physiological functions. This value differs from the energy balance, which takes into account the total daily energy intake compared to all the energy expended, regardless of the amount of fat-free mass. Insufficient energy consumption affects recovery, adaptation processes, increases the risk of injury or illness, so all of this can negatively affect performance. This mini-review is written on research articles in Pubmed database related to LEA in endurance-trained men and its impact on performance and testosterone. This article also clarifies the prevalence of LEA in male endurance athletes and its correlation to Relative Energy Deficiency in Sports (RED-S). LEA occurs in male endurance athletes and correlates with decreased testosterone levels, decreased bone density and also Resting Metabolic Rate. In endurance-trained men, there is great potential for the negative consequences of low energy availability. It can also be said that there are possibilities for primary screening, so we recommend regular check-ups of blood markers, body structure and keeping not only training but also dietary records, which can increase awareness of an adequate energy balance.
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Affiliation(s)
- Martin Cupka
- Comenius University in Bratislava, Faculty of Physical Education and Sport, Department of Biological and Medical Sciences, Bratislava.
| | - Milan Sedliak
- Comenius University in Bratislava, Faculty of Physical Education and Sport, Department of Biological and Medical Sciences, Bratislava.
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15
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Berryman CE, McClung HL, Sepowitz JJ, Gaffney‐Stomberg E, Ferrando AA, McClung JP, Pasiakos SM. Testosterone status following short-term, severe energy deficit is associated with fat-free mass loss in U.S. Marines. Physiol Rep 2022; 10:e15461. [PMID: 36117330 PMCID: PMC9483439 DOI: 10.14814/phy2.15461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023] Open
Abstract
The objective of this study was to determine metabolic and physiological differences between males with low testosterone (LT) versus those with normal testosterone (NT) following a period of severe energy deficit. In this secondary analysis, 68 male US Marines (mean ± SD, 24.6 ± 2.4 y) were dichotomized by testosterone concentration (< or ≥ 10.5 nmol/L as determined from a single blood sample collected between 0600-0630 after an 8-10 h overnight fast by automated immunoassay) following 7 days of near complete starvation (~300 kcal consumed/d, ~85% energy deficit) during Survival, Evasion, Resistance, and Escape (SERE) training. Dietary intake was assessed before (PRE) SERE. Body composition (dual-energy x-ray absorptiometry and peripheral quantitative computed tomography) and whole-body protein turnover (15 N alanine) were assessed before (PRE) and after (POST) SERE. Mean testosterone concentrations decreased PRE (17.5 ± 4.7 nmol/L) to POST (9.8 ± 4.0 nmol/L, p < 0.0001). When volunteers were dichotomized by POST testosterone concentrations [NT (n = 24) 14.1 ± 3.4 vs. LT (n = 44): 7.5 ± 1.8 nmol/L, p < 0.0001], PRE BMI, total fat mass, trunk fat mass, and testosterone were greater and the diet quality score and total carbohydrate intake were lower in NT compared to LT (p ≤ 0.05). LT lost more fat-free mass and less fat mass, particularly in the trunk region, compared to NT following SERE (p-interaction≤0.044). Whole-body protein synthesis, net balance, and flux decreased and whole-body protein breakdown increased from PRE to POST in both groups (p-time ≤0.025). Following short-term, severe energy deficit, Marines who exhibited low testosterone had greater fat-free mass loss than those who maintained normal testosterone concentrations. Altering body composition and dietary strategies prior to physical training that elicits severe energy deficit may provide an opportunity to attenuate post-training decrements in testosterone and its associated effects (e.g., loss of lean mass, performance declines, fatigue).
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Affiliation(s)
- Claire E. Berryman
- Military Nutrition DivisionUS Army Research Institute of Environmental MedicineNatickMassachusettsUSA
- Oak Ridge Institute for Science and EducationBelcampMarylandUSA
- Department of Nutrition and Integrative PhysiologyFlorida State UniversityTallahasseeFloridaUSA
| | - Holly L. McClung
- Military Nutrition DivisionUS Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - John J. Sepowitz
- Military Nutrition DivisionUS Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Erin Gaffney‐Stomberg
- Military Performance DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Arny A. Ferrando
- Department of Geriatrics, The Center for Translational Research in Aging & LongevityDonald W. Reynolds Institute of Aging, University of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - James P. McClung
- Military Nutrition DivisionUS Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Stefan M. Pasiakos
- Military Performance DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
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16
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Abstract
Relative Energy Deficiency in Sport (RED-S) refers to a condition in which energy imbalance leads to impaired physiological function of multiple organ systems and expands on the diagnosis previously known as the Female Athlete Triad. Researchers attribute the medical complications of RED-S to low energy availability, in which energy availability is defined as dietary energy intake minus exercise energy expenditure divided by fat-free mass. This article reviews the history of this diagnosis, the changing terminology, and the reasons for the expansion. Accepted definitions of each part of the energy availability equation are considered and the difficulties that exist using these equations in practice or comparatively in the literature are assessed. The review analyzes the broad spectrum of health consequences of RED-S, especially as it relates to hypoestrogenemia and menstrual function, gives guidance to those caring for athletes on the identification and management of RED-S, and sheds lights on the important role of coaches, athletic trainers, and families in recognizing this diagnosis and in helping getting patients to care.
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17
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Markers of Low Energy Availability in Overreached Athletes: A Systematic Review and Meta-analysis. Sports Med 2022; 52:2925-2941. [PMID: 35819582 DOI: 10.1007/s40279-022-01723-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Overreaching is the transient reduction in performance that occurs following training overload and is driven by an imbalance between stress and recovery. Low energy availability (LEA) may drive underperformance by compounding training stress; however, this has yet to be investigated systematically. OBJECTIVE The aim of this study was to quantify changes in markers of LEA in athletes who demonstrated underperformance, and exercise performance in athletes with markers of LEA. METHODS Studies using a ≥ 2-week training block with maintained or increased training loads that measured exercise performance and markers of LEA were identified using a systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Changes from pre- to post-training were analyzed for (1) markers of LEA in underperforming athletes and (2) performance in athletes with ≥ 2 markers of LEA. RESULTS From 56 identified studies, 14 separate groups of athletes demonstrated underperformance, with 50% also displaying ≥ 2 markers of LEA post-training. Eleven groups demonstrated ≥ 2 markers of LEA independent of underperformance and 37 had no performance reduction or ≥ 2 markers of LEA. In underperforming athletes, fat mass (d = - 0.29, 95% confidence interval [CI] - 0.54 to - 0.04; p = 0.02), resting metabolic rate (d = - 0.63, 95% CI - 1.22 to - 0.05; p = 0.03), and leptin (d = - 0.72, 95% CI - 1.08 to - 0.35; p < 0.0001) were decreased, whereas body mass (d = - 0.04, 95% CI - 0.21 to 0.14; p = 0.70), cortisol (d = - 0.06, 95% CI - 0.35 to 0.23; p = 0.68), insulin (d = - 0.12, 95% CI - 0.43 to 0.19; p = 0.46), and testosterone (d = - 0.31, 95% CI - 0.69 to 0.08; p = 0.12) were unaltered. In athletes with ≥ 2 LEA markers, performance was unaffected (d = 0.09, 95% CI - 0.30 to 0.49; p = 0.6), and the high heterogeneity in performance outcomes (I2 = 84.86%) could not be explained by the performance tests used or the length of the training block. CONCLUSION Underperforming athletes may present with markers of LEA, but overreaching is also observed in the absence of LEA. The lack of a specific effect and high variability of outcomes with LEA on performance suggests that LEA is not obligatory for underperformance.
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18
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Klasson CL, Sadhir S, Pontzer H. Daily physical activity is negatively associated with thyroid hormone levels, inflammation, and immune system markers among men and women in the NHANES dataset. PLoS One 2022; 17:e0270221. [PMID: 35793317 PMCID: PMC9258892 DOI: 10.1371/journal.pone.0270221] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/06/2022] [Indexed: 12/18/2022] Open
Abstract
The acute effects of exercise on metabolic energy expenditure and inflammation are well studied, but the long-term effects of regular daily physical activity on metabolic and endocrine effects are less clear. Further, prior studies investigating the impact of daily physical activity in large cohorts have generally relied on self-reported activity. Here, we used the U.S. National Health and Nutrition Examination Survey (NHANES) to investigate the relationship between daily physical activity and both thyroid and immune activity. Daily physical activity was assessed through accelerometry or accelerometry-validated survey responses. Thyroid activity was assessed from circulating levels of thyroid stimulating hormone (TSH) and thyroxine (T4). Immune function was assessed from circulating cytokines (C-reactive protein [CRP], immunoglobulin E [IgE], fibrinogen) and blood cell counts. In general linear models including body mass index, age, gender, activity and TSH as factors, active adults had a lower levels of T4 and reduced slope of the TSH:T4 relationship. Similarly, greater physical activity was associated with lower CRP and fibrinogen levels (but not IgE) and lower white blood cell, basophil, monocyte, neutrophil, and eosinophil (but not lymphocyte) counts. Daily physical activity was also associated with lower prevalence of clinically elevated CRP, WBC, and lymphocytes in a dose-response manner. These results underscore the long-term impact of daily physical activity on both systemic metabolic activity (thyroid) and on specific physiological tasks (immune). The regulatory effects of physical activity on other bodily systems are clinically relevant and should be incorporated into public health strategies promoting exercise.
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Affiliation(s)
- Christopher L. Klasson
- Trinity College, Duke University, Durham, North Carolina, United States of America
- * E-mail: (CLK); (HP)
| | - Srishti Sadhir
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States of America
| | - Herman Pontzer
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- * E-mail: (CLK); (HP)
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19
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Andrzejewski M, Konefał M, Podgórski T, Pluta B, Chmura P, Chmura J, Marynowicz J, Melka K, Brazaitis M, Kryściak J. How training loads in the preparation and competitive period affect the biochemical indicators of training stress in youth soccer players? PeerJ 2022; 10:e13367. [PMID: 35539014 PMCID: PMC9080429 DOI: 10.7717/peerj.13367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/11/2022] [Indexed: 01/13/2023] Open
Abstract
Background Physical fitness optimization and injury risk-reducing require extensive monitoring of training loads and athletes' fatigue status. This study aimed to investigate the effect of a 6-month training program on the training-related stress indicators (creatine kinase - CK; cortisol - COR; serotonin - SER; brain-derived neurotrophic factor - BDNF) in youth soccer players. Methods Eighteen players (17.8 ± 0.9 years old, body height 181.6 ± 6.9 cm, training experience 9.7 ± 1.7 years) were blood-tested four times: at the start of the preparation period (T0), immediately following the preparation period (T1), mid-competitive period (T2), and at the end of the competitive period (T3). CK activity as well as concentrations of serum COR, SER and BDNF were determined. Training loads were recorded using a session rating of perceived exertion (sRPE). Results Statistical analyzes revealed significant effects for all biochemical parameters in relation to their time measurements (T0, T1, T2, T3). The statistical analyzes of sRPE and differences of biochemical parameters in their subsequent measurements (T0-T1, T1-T2, T2-T3) also demonstrated significant effects observed for all variables: sRPE (HKW = 13.189 (df = 2); p = 0.00), COR (HKW = 9.261 (df = 2); p = 0.01), CK (HKW = 12.492 (df = 2); p = 0.00), SER (HKW = 7.781 (df = 2); p = 0.02) and BDNF (HKW = 15.160 (df = 2); p < 0.001). Discussion In conclusion, it should be stated that the most demanding training loads applied in the preparation period (highest sRPE values) resulted in a significant increase in all analyzed biochemical training stress indicators. The reduction in the training loads during a competitive period and the addition of recovery training sessions resulted in a systematic decrease in the values of the measured biochemical indicators. The results of the study showed that both subjective and objective markers, including training loads, are useful in monitoring training stress in youth soccer players.
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Affiliation(s)
- Marcin Andrzejewski
- Department of Methodology of Recreation, Poznań University of Physical Education, Poznań, Poland
| | - Marek Konefał
- Department of Biological and Motor Sport Bases, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Tomasz Podgórski
- Department of Physiology and Biochemistry, Poznań University of Physical Education, Poznań, Poland
| | - Beata Pluta
- Department of Methodology of Recreation, Poznań University of Physical Education, Poznań, Poland
| | - Paweł Chmura
- Department of Team Games, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Jan Chmura
- Department of Biological and Motor Sport Bases, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Jakub Marynowicz
- Department of Theory and Methodology of Team Sport Games, Poznań University of Physical Education, Poznań, Poland
| | - Kamil Melka
- Institute of Mathematics, University of Wrocław, Wrocław, Poland
| | - Marius Brazaitis
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Jakub Kryściak
- Department of Physiology and Biochemistry, Poznań University of Physical Education, Poznań, Poland
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20
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Popp KL, Cooke LM, Bouxsein ML, Hughes JM. Impact of Low Energy Availability on Skeletal Health in Physically Active Adults. Calcif Tissue Int 2022; 110:605-614. [PMID: 35171303 DOI: 10.1007/s00223-022-00957-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/04/2022] [Indexed: 12/13/2022]
Abstract
For decades researchers reported that pre-menopausal women who engage in extensive endurance exercise and have menstrual dysfunction can develop low bone mineral density (BMD) or osteoporosis. More recently, low energy availability has been recognized as the initiating factor for low BMD in these women. Furthermore, the relationship between low energy availability and poor skeletal health is not exclusive to women engaging in endurance exercise. Rather, both males and females commonly experience endocrine dysfunction resulting from low energy availability and high exercise levels that degrades skeletal health. Consequences to skeletal health can range from short-term changes in bone metabolism and increased risk of bone stress injuries to long-term consequences of low BMD, such as osteoporosis and related fragility fractures. The degree to which low energy availability degrades skeletal health may be dependent on the length and extent of the energy deficit. However, the complex relationships between under-fueling, short- and long-term skeletal consequences and the factors that mediate these relationships are not well described. In this review, we discuss the consequences of low energy availability on sex hormones and skeletal health in two highly-active populations-athletes and military trainees-and provide a summary of existing knowledge gaps for future study.
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Affiliation(s)
- Kristin L Popp
- United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
- Massachusetts General Hospital, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, 02215, USA.
| | - Laura M Cooke
- Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Mary L Bouxsein
- United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
- Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02215, USA
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Julie M Hughes
- United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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21
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Lundy B, Torstveit MK, Stenqvist TB, Burke LM, Garthe I, Slater GJ, Ritz C, Melin AK. Screening for Low Energy Availability in Male Athletes: Attempted Validation of LEAM-Q. Nutrients 2022; 14:nu14091873. [PMID: 35565840 PMCID: PMC9101736 DOI: 10.3390/nu14091873] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 02/06/2023] Open
Abstract
A questionnaire-based screening tool for male athletes at risk of low energy availability (LEA) could facilitate both research and clinical practice. The present options rely on proxies for LEA such screening tools for disordered eating, exercise dependence, or those validated in female athlete populations. in which the female-specific sections are excluded. To overcome these limitations and support progress in understanding LEA in males, centres in Australia, Norway, Denmark, and Sweden collaborated to develop a screening tool (LEAM-Q) based on clinical investigations of elite and sub-elite male athletes from multiple countries and ethnicities, and a variety of endurance and weight-sensitive sports. A bank of questions was developed from previously validated questionnaires and expert opinion on various clinical markers of LEA in athletic or eating disorder populations, dizziness, thermoregulation, gastrointestinal symptoms, injury, illness, wellbeing, recovery, sleep and sex drive. The validation process covered reliability, content validity, a multivariate analysis of associations between variable responses and clinical markers, and Receiver Operating Characteristics (ROC) curve analysis of variables, with the inclusion threshold being set at 60% sensitivity. Comparison of the scores of the retained questionnaire variables between subjects classified as cases or controls based on clinical markers of LEA revealed an internal consistency and reliability of 0.71. Scores for sleep and thermoregulation were not associated with any clinical marker and were excluded from any further analysis. Of the remaining variables, dizziness, illness, fatigue, and sex drive had sufficient sensitivity to be retained in the questionnaire, but only low sex drive was able to distinguish between LEA cases and controls and was associated with perturbations in key clinical markers and questionnaire responses. In summary, in this large and international cohort, low sex drive was the most effective self-reported symptom in identifying male athletes requiring further clinical assessment for LEA.
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Affiliation(s)
- Bronwen Lundy
- Rowing Australia, Canberra, ACT 2600, Australia;
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
| | - Monica K. Torstveit
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, 4630 Kristiansand, Norway; (M.K.T.); (T.B.S.)
| | - Thomas B. Stenqvist
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, 4630 Kristiansand, Norway; (M.K.T.); (T.B.S.)
| | - Louise M. Burke
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
- Correspondence:
| | - Ina Garthe
- Norwegian Olympic Sports Centre, Department of Sports Nutrition, 0806 Oslo, Norway;
| | - Gary J. Slater
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia;
| | - Christian Ritz
- National Institute of Public Health—SDU, 1455 Copenhagen, Denmark;
| | - Anna K. Melin
- Department of Sport Science, Faculty of Social Sciences, Linnaeus University, 351 95 Vaxjo, Sweden;
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22
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Nutrition and Physical Activity During British Army Officer Cadet Training: Part 1-Energy Balance and Energy Availability. Int J Sport Nutr Exerc Metab 2022; 32:195-203. [PMID: 35393372 DOI: 10.1123/ijsnem.2021-0190] [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: 06/23/2021] [Revised: 01/07/2022] [Accepted: 02/25/2022] [Indexed: 11/18/2022]
Abstract
Military training is characterized by high daily energy expenditures which are difficult to match with energy intake, potentially resulting in negative energy balance (EB) and low energy availability (EA). The aim of this study was to quantify EB and EA during British Army Officer Cadet training. Thirteen (seven women) Officer Cadets (mean ± SD: age 24 ± 3 years) volunteered to participate. EB and EA were estimated from energy intake (weighing of food and food diaries) and energy expenditure (doubly labeled water) measured in three periods of training: 9 days on-camp (CAMP), a 5-day field exercise (FEX), and a 9-day mixture of both CAMP and field-based training (MIX). Variables were compared by condition and gender with a repeated-measures analysis of variance. Negative EB was greatest during FEX (-2,197 ± 455 kcal/day) compared with CAMP (-692 ± 506 kcal/day; p < .001) and MIX (-1,280 ± 309 kcal/day; p < .001). EA was greatest in CAMP (23 ± 10 kcal·kg free-fat mass [FFM]-1·day-1) compared with FEX (1 ± 16 kcal·kg FFM-1·day-1; p = .002) and MIX (10 ± 7 kcal·kg FFM-1·day-1; p = .003), with no apparent difference between FEX and MIX (p = .071). Irrespective of condition, there were no apparent differences between gender in EB (p = .375) or EA (p = .385). These data can be used to inform evidenced-based strategies to manage EA and EB during military training, and enhance the health and performance of military personnel.
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23
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Shirley MK, Longman DP, Elliott-Sale KJ, Hackney AC, Sale C, Dolan E. A Life History Perspective on Athletes with Low Energy Availability. Sports Med 2022; 52:1223-1234. [PMID: 35113390 DOI: 10.1007/s40279-022-01643-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 12/19/2022]
Abstract
The energy costs of athletic training can be substantial, and deficits arising from costs unmet by adequate energy intake, leading to a state of low energy availability, may adversely impact athlete health and performance. Life history theory is a branch of evolutionary theory that recognizes that the way the body uses energy-and responds to low energy availability-is an evolved trait. Energy is a finite resource that must be distributed throughout the body to simultaneously fuel all biological processes. When energy availability is low, insufficient energy may be available to equally support all processes. As energy used for one function cannot be used for others, energetic "trade-offs" will arise. Biological processes offering the greatest immediate survival value will be protected, even if this results in energy being diverted away from others, potentially leading to their downregulation. Athletes with low energy availability provide a useful model for anthropologists investigating the biological trade-offs that occur when energy is scarce, while the broader conceptual framework provided by life history theory may be useful to sport and exercise researchers who investigate the influence of low energy availability on athlete health and performance. The goals of this review are: (1) to describe the core tenets of life history theory; (2) consider trade-offs that might occur in athletes with low energy availability in the context of four broad biological areas: reproduction, somatic maintenance, growth, and immunity; and (3) use this evolutionary perspective to consider potential directions for future research.
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Affiliation(s)
- Meghan K Shirley
- Division of GI, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Daniel P Longman
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Kirsty J Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Anthony C Hackney
- Department of Exercise and Sport Science, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Eimear Dolan
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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Oliveira-Junior G, Pinto RS, Shirley MK, Longman DP, Koehler K, Saunders B, Roschel H, Dolan E. The Skeletal Muscle Response to Energy Deficiency: A Life History Perspective. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2022. [DOI: 10.1007/s40750-021-00182-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Pankiv V, Yuzvenko T, Kobyliak N, Pankiv I. Correction of Androgen Deficiency in Men with Type 2 Diabetes. Rev Recent Clin Trials 2022; 17:34-39. [PMID: 34856912 DOI: 10.2174/1574887116666211202155304] [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: 03/27/2021] [Revised: 09/21/2021] [Accepted: 10/07/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND In men with low levels of testosterone in the blood, it is believed that the symptoms can be regarded as an association between testosterone deficiency syndrome and related comorbidities. AIM To investigate the effectiveness of testosterone therapy in patients with type 2 diabetes (T2D) and androgen deficiency. MATERIALS AND METHODS Testosterone replacement therapy was carried out in 26 men with T2D and clinically or laboratory-confirmed androgen deficiency. The age of the subjects ranged from 35 to 69 years old. Laboratory studies included determinations of the concentration of the hormones estradiol, luteinizing hormone (LH), and prostate-specific antigen (PSA). The observation period was 9 months. RESULTS The average level of total blood testosterone in the subjects before treatment was 9.4 mol/l and was likely lower than that of the control group (19.3 ± 1.6 nmol/l). The levels of total testosterone in the subjects ranged from 3.9 nmol/l to 10.7 nmol/l, and hormone levels measuring less than 8.0 nmol/l were observed in only 11 patients. After a course of testosterone replacement therapy, a stabilization in total testosterone levels at the level of reference values (as compared to the start of treatment) was observed in the blood of men with T2D after 9 months of observation and the administration of the fourth injection (16.83 ± 0.75 nmol/l). CONCLUSION The use of long-acting injectable testosterone undecanoate leads to normalization of total testosterone levels in the blood of men with T2D and androgen deficiency, and LH levels in these patients are unlikely to change.
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Affiliation(s)
- Volodymyr Pankiv
- Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Tetyana Yuzvenko
- Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Nazarii Kobyliak
- Department of Endocrinology, Bogomolets National Medical University, Kyiv, Ukraine
- Medical Laboratory CSD, Kyiv, Ukraine
| | - Ivan Pankiv
- Department of Clinical Immunology, Allergology and Endocrinology, Bukovinian State Medical University, Chernivtsi, Ukraine
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Aloisi A, Passavanti G, Paoli A, Rizzato A, Ceccarelli I, Fiorenzani P, Casini I. Age and training intensity differently affect male runners' endocrine and sexual parameters. CHINESE J PHYSIOL 2022; 65:37-45. [DOI: 10.4103/cjp.cjp_91_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Mahmud MR, Akter S, Tamanna SK, Mazumder L, Esti IZ, Banerjee S, Akter S, Hasan MR, Acharjee M, Hossain MS, Pirttilä AM. Impact of gut microbiome on skin health: gut-skin axis observed through the lenses of therapeutics and skin diseases. Gut Microbes 2022; 14:2096995. [PMID: 35866234 PMCID: PMC9311318 DOI: 10.1080/19490976.2022.2096995] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/10/2022] [Accepted: 06/27/2022] [Indexed: 02/08/2023] Open
Abstract
The human intestine hosts diverse microbial communities that play a significant role in maintaining gut-skin homeostasis. When the relationship between gut microbiome and the immune system is impaired, subsequent effects can be triggered on the skin, potentially promoting the development of skin diseases. The mechanisms through which the gut microbiome affects skin health are still unclear. Enhancing our understanding on the connection between skin and gut microbiome is needed to find novel ways to treat human skin disorders. In this review, we systematically evaluate current data regarding microbial ecology of healthy skin and gut, diet, pre- and probiotics, and antibiotics, on gut microbiome and their effects on skin health. We discuss potential mechanisms of the gut-skin axis and the link between the gut and skin-associated diseases, such as psoriasis, atopic dermatitis, acne vulgaris, rosacea, alopecia areata, and hidradenitis suppurativa. This review will increase our understanding of the impacts of gut microbiome on skin conditions to aid in finding new medications for skin-associated diseases.
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Affiliation(s)
- Md. Rayhan Mahmud
- Department of Production Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Sharmin Akter
- Department of Microbiology, Jagannath University, Dhaka, Bangladesh
| | | | - Lincon Mazumder
- Department of Microbiology, Jagannath University, Dhaka, Bangladesh
| | - Israt Zahan Esti
- Department of Microbiology, Jagannath University, Dhaka, Bangladesh
| | | | - Sumona Akter
- Department of Microbiology, Jagannath University, Dhaka, Bangladesh
| | | | - Mrityunjoy Acharjee
- Department of Bioscience, Graduate School of Science and Technology, Shizuoka University, Shizuoka, Japan
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Moore EM, Drenowatz C, Stodden DF, Pritchett K, Brodrick TC, Williams BT, Goins JM, Torres-McGehee TM. Examination of Athlete Triad Symptoms Among Endurance-Trained Male Athletes: A Field Study. Front Nutr 2021; 8:737777. [PMID: 34901104 PMCID: PMC8664375 DOI: 10.3389/fnut.2021.737777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Studies examining the physiological consequences associated with deficits in energy availability (EA) for male athletes are sparse. Purpose: To examine male athlete triad components; low energy availability (LEA) with or without an eating disorder risk (ED), reproductive hormone [testosterone (T)], and bone mineral density (BMD) in endurance-trained male athletes during different training periods. Methods: A cross-sectional design with 14 participants (age: 26.4 ± 4.2 years; weight: 70.6 ± 6.4 kg; height: 179.5 ± 4.3 cm; BMI: 21.9 ± 1.8 kg/m2) were recruited from the local community. Two separate training weeks [low (LV) and high (HV) training volumes] were used to collect the following: 7-day dietary and exercise logs, and blood concentration of T. Anthropometric measurements was taken prior to data collection. A one-time BMD measure (after the training weeks) and VO2max-HR regressions were utilized to calculate EEE. Results: Overall, EA presented as 27.6 ± 10.7 kcal/kgFFM·d-1 with 35% (n = 5) of participants demonstrating increased risk for ED. Examining male triad components, 64.3% presented with LEA (≤ 30 kcal/kgFFM·d-1) while participants presented with T (1780.6 ± 1672.6 ng/dl) and BMD (1.31 ±.09 g/cm2) within normal reference ranges. No differences were found across the 2 training weeks for EI, with slight differences for EA and EEE. Twenty-five participants (89.3%) under-ingested CHO across both weeks, with no differences between weeks. Conclusion: Majority of endurance-trained male athletes presented with one compromised component of the triad (LEA with or without ED risk); however, long-term negative effects on T and BMD were not demonstrated. Over 60% of the participants presented with an EA ≤ 30 kcal/kgFFM·d-1, along with almost 90% not meeting CHO needs. These results suggest male endurance-trained athletes may be at risk to negative health outcomes similar to mechanistic behaviors related to EA with or without ED in female athletes.
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Affiliation(s)
- Erin M Moore
- Kinesiology Department, University of Virginia, Charlottesville, VA, United States
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, Linz, University of Upper Austria, Upper Austria, Austria
| | - David F Stodden
- Physical Education, University of South Carolina, Columbia, SC, United States
| | - Kelly Pritchett
- Health Sciences, Central Washington University, Ellensburg, WA, United States
| | - Thaddus C Brodrick
- Exercise Science, Exercise Science Department, University of South Carolina, Columbia, SC, United States
| | - Brittany T Williams
- Exercise Science, Exercise Science Department, University of South Carolina, Columbia, SC, United States
| | - Justin M Goins
- Exercise Science, Exercise Science Department, University of South Carolina, Columbia, SC, United States
| | - Toni M Torres-McGehee
- Exercise Science, Exercise Science Department, University of South Carolina, Columbia, SC, United States
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Grossmann M, Wittert GA. Dysregulation of the Hypothalamic-Pituitary-Testicular Axis due to Energy Deficit. J Clin Endocrinol Metab 2021; 106:e4861-e4871. [PMID: 34264314 DOI: 10.1210/clinem/dgab517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Although gonadal axis dysregulation from energy deficit is well recognized in women, the effects of energy deficit on the male gonadal axis have received much less attention. EVIDENCE ACQUISITION To identify relevant articles, we conducted PubMed searches from inception to May 2021. EVIDENCE SYNTHESIS Case series and mechanistic studies demonstrate that energy deficit (both acutely over days or chronically over months) either from inadequate energy intake and/or excessive energy expenditure can lower serum testosterone concentration as a result of hypothalamic-pituitary-testicular (HPT) axis dysregulation in men. The extent to which this has clinical consequences that can be disentangled from the effects of nutritional insufficiency, concomitant endocrine dysregulation (eg, adrenal and thyroid axis), and coexisting comorbidities (eg, depression and substance abuse) is uncertain. HPT axis dysfunction is primarily the result of loss of GnRH pulsatility resulting from a failure of leptin to induce kisspeptin signaling. The roles of neuroendocrine consequences of depression, hypothalamic-pituitary-adrenal axis activation, proinflammatory cytokines, Ghrelin, and genetic susceptibility remain unclear. In contrast to hypogonadism from organic pathology of the HPT axis, energy deficit-associated HPT dysregulation is functional, and generally reversible by restoring energy balance. CONCLUSIONS The clinical management of such men should aim to restore adequate nutrition and achieve and maintain a healthy body weight. Psychosocial comorbidities must be identified and addressed. There is no evidence that testosterone treatment is beneficial. Many knowledge gaps regarding epidemiology, pathophysiology, and treatment remain and we highlight several areas that require future research.
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Affiliation(s)
- Mathis Grossmann
- Department of Medicine (Austin Health), The University of Melbourne, Victoria, Australia
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
| | - Gary A Wittert
- Freemasons Centre for Male Health and Well-being, University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Woodville, South Australia, Australia
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Prevalence of Surrogate Markers of Relative Energy Deficiency in Male Norwegian Olympic-Level Athletes. Int J Sport Nutr Exerc Metab 2021; 31:497-506. [PMID: 34489365 DOI: 10.1123/ijsnem.2020-0368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/10/2021] [Accepted: 08/04/2021] [Indexed: 11/18/2022]
Abstract
The syndrome of Relative Energy Deficiency in Sport (RED-S) includes wide-ranging effects on physiological and psychological functioning, performance, and general health. However, RED-S is understudied among male athletes at the highest performance levels. This cross-sectional study aimed to investigate surrogate RED-S markers prevalence in Norwegian male Olympic-level athletes. Athletes (n = 44) aged 24.7 ± 3.8 years, body mass 81.3 ± 15.9 kg, body fat 13.7% ± 5.8%, and training volume 76.1 ± 22.9 hr/month were included. Assessed parameters included resting metabolic rate (RMR), body composition, and bone mineral density by dual-energy X-ray absorptiometry and venous blood variables (testosterone, free triiodothyronine, cortisol, and lipids). Seven athletes (16%) grouped by the presence of low RMR (RMRratio < 0.90) (0.81 ± 0.07 vs. 1.04 ± 0.09, p < .001, effect size 2.6), also showed lower testosterone (12.9 ± 5.3 vs. 19.0 ± 5.3 nmol/L, p = .020) than in normal RMR group. In low RMRratio individuals, prevalence of other RED-S markers (-subclinical-low testosterone, low free triiodothyronine, high cortisol, and elevated low-density lipoprotein) was (N/number of markers): 2/0, 2/1, 2/2, 1/3. Low bone mineral density (z-score < -1) was found in 16% of the athletes, all with normal RMR. Subclinical low testosterone and free triiodothyronine levels were found in nine (25%) and two (5%) athletes, respectively. Subclinical high cortisol was found in 23% of athletes while 34% had elevated low-density lipoprotein cholesterol levels. Seven of 12 athletes with two or more RED-S markers had normal RMR. In conclusion, this study found that multiple RED-S markers also exist in male Olympic-level athletes. This highlights the importance of regular screening of male elite athletes, to ensure early detection and treatment of RED-S.
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La Vignera S, Izzo G, Emerenziani GP, Cannarella R, Condorelli RA, Calogero AE, Aversa A. Male hypogonadism: therapeutic choices and pharmacological management. MINERVA ENDOCRINOL 2021; 45:189-203. [PMID: 33000619 DOI: 10.23736/s0391-1977.20.03195-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Male hypogonadism, defined as an inadequate testosterone production, recognizes a testicular (primary hypogonadism) or a hypothalamic-pituitary dysfunction (central hypogonadism), although combined forms can also occur. Moreover, it has been known that intensive exercise training might be a cause of functional hypogonadism. Many therapeutic choices are currently available, depending on the timing of hypogonadism onset and fertility issue. The aim of this review was to comprehensively supply therapeutic options and schemes currently available for male hypogonadism, including pharmacological management of primary and central forms. Evidence on testosterone formulations, human chorionic gonadotropin, selective estrogen receptor modulators and aromatase inhibitors will be provided.
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Affiliation(s)
- Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy -
| | - Giulia Izzo
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| | - Gian Pietro Emerenziani
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
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Saidi K, Abderrahman AB, Hackney AC, Bideau B, Zouita S, Granacher U, Zouhal H. Hematology, Hormones, Inflammation, and Muscle Damage in Elite and Professional Soccer Players: A Systematic Review with Implications for Exercise. Sports Med 2021; 51:2607-2627. [PMID: 34347283 DOI: 10.1007/s40279-021-01522-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Knowledge of the long-term effects of soccer training on hematological, hormonal, inflammatory, and muscle damage markers and physical performance may help to better design strength and conditioning programs for performance development and injury prevention for the individual player and the team. OBJECTIVES The aim of this systematic review was to summarize and discuss evidence on the long-term effects of soccer training on selected hematological, hormonal, inflammatory, and muscle damage markers and physical performance in elite and professional soccer players. A second goal was to investigate associations between selected physiological markers and measures of performance. METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic literature search was conducted in four electronic databases (PubMed, ISI Web of Knowledge, Web of Science, and SPORTDiscus) from inception until August 2020 to identify articles related to soccer training effects. To be included in this systematic review, studies had to examine male elite (national level) and/or professional (international level) soccer players aged > 17 years and a soccer training period > 4 weeks, and report outcomes related to hematological, hormonal, inflammatory, muscle damage, and performance markers. RESULTS The search syntax initially identified 2420 records. After screening titles, abstracts, and full texts, 20 eligible studies were included in this systematic review, with training durations lasting between 4 and 18 weeks in 15 studies, around 6 months in four studies, and around 1 year in one study. Effects of long-term soccer training revealed parameter-specific increases or decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance. Two studies showed a moderate increase in hematological markers such as hemoglobin (effect size [ES] = 0.67-0.93). Parameter-specific changes were noted for hormonal markers in the form of increases for total testosterone (ES = 0.20-0.67) and free testosterone (FT) (ES = 0.20-0.65) and decreases for cortisol (ES = - 0.28 to - 1.31). Finally, moderate to very large increases were found for muscle damage markers such as creatine kinase (ES = 0.94-6.80) and physical performance such as countermovement jump (CMJ) height (ES = 0.50-1.11) and squat jump (SJ) height (ES = 0.65-1.28). After long-term periods of soccer training, significant positive correlations were found between percentage change (Δ%) in FT and Δ% in CMJ height (r = 0.94; p = 0.04) and between Δ% in total testosterone/cortisol (TT/C) ratio and Δ% in SJ (r = 0.89; p = 0.03). CONCLUSIONS Findings suggest that long-term soccer training induces increases/decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance in male elite and professional soccer players. These fluctuations can be explained by different contextual factors (e.g., training load, duration of training, psychological factors, mood state). Interestingly, the observed changes in hormonal parameters (FT and TT/C) were related to vertical jump performance changes (e.g., CMJ and SJ). Anabolic hormones and TT/C can possibly be used as a tool to identify physical performance alteration after long-term soccer training.
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Affiliation(s)
- Karim Saidi
- M2S (Laboratoire Mouvement, Sport, Santé)-EA 1274, University Rennes, 35000, Rennes, France.,Higher Institute of Sport and Physical Education of Ksar-Said, Tunis, Tunisia
| | | | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
| | - Benoit Bideau
- M2S (Laboratoire Mouvement, Sport, Santé)-EA 1274, University Rennes, 35000, Rennes, France
| | - Sghaeir Zouita
- Higher Institute of Sport and Physical Education of Ksar-Said, Tunis, Tunisia
| | - Urs Granacher
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany.
| | - Hassane Zouhal
- M2S (Laboratoire Mouvement, Sport, Santé)-EA 1274, University Rennes, 35000, Rennes, France.
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Lane AR, Hackney AC, Smith-Ryan AE, Kucera K, Register-Mihalik JK, Ondrak K. Energy Availability and RED-S Risk Factors in Competitive, Non-elite Male Endurance Athletes. TRANSLATIONAL MEDICINE AND EXERCISE PRESCRIPTION 2021; 1:25-32. [PMID: 34296227 PMCID: PMC8294781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Relative Energy Deficiency in Sport (RED-S) is predicated on the assumption that low energy availability (EA) induces deficiencies-dysfunction in multiple physiologic systems. However, research on RED-S and EA in male athletes is limited in comparison to women. The aim of this study is to investigate EA and the risk factors for RED-S, and their potential associations in non-elite male endurance athletes. Laboratory assessments for resting metabolic rate (RMR), bone mineral density (BMD), blood hormonal biomarkers and maximal aerobic capacity were conducted on 60 competitive, recreationally trained male endurance athletes (age=43.4±11.6 years [mean±SD], training=10.9±2.7 h/wk, 7.1±8.8 years). Participants provided 7-days of training logs and 4-days of diet records. Diet and training records were used to calculate EA. Correlations were used to examine associations between EA and RMR, BMD, stress fractures and reproductive, metabolic and bone biomarkers. Mean EA was 28.7±13.4 kcal/kg fat free mass (FFM), which categorized our sample as low EA (based upon published criterion, < 30 kcal/kg FFM) and at a high risk for RED-S. Hormonal and bone biomarkers were in normal clinical ranges, even though EA was low. The only interesting significant association was EA being negatively associated with total body BMD (r = -0.360, P =0.005), opposite of expectations. On average our subjects displayed a state of low EA based upon the criterion which has been primarily developed from female-based research. Nonetheless, our participants displayed no major hormonal or bone health disturbances found in athletes diagnosed with RED-S. A value of < 30 kcal/kg FFM to diagnose low EA may not be appropriate for non-elite endurance trained men.
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Affiliation(s)
- Amy R Lane
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Abbie E Smith-Ryan
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kristen Kucera
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Johna K Register-Mihalik
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kristin Ondrak
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
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Falqueto H, Júnior JLR, Silvério MNO, Farias JCH, Schoenfeld BJ, Manfredi LH. Can conditions of skeletal muscle loss be improved by combining exercise with anabolic-androgenic steroids? A systematic review and meta-analysis of testosterone-based interventions. Rev Endocr Metab Disord 2021; 22:161-178. [PMID: 33783694 DOI: 10.1007/s11154-021-09634-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 12/11/2022]
Abstract
Sarcopenia, cachexia, and atrophy due to inactivity and disease states are characterized by a loss of skeletal muscle mass, often accompanied by reduced levels of anabolic hormones (e.g. testosterone). These conditions are associated with an increase in mortality, hospitalization and worsening in quality of life. Both physical exercise (EX) and anabolic-androgenic steroid (AAS) administration can improve the prognosis of patients as they increase physical functionality. However, there is a gap in the literature as to the impact of these therapies on the gains in strength and muscle mass and their implications for patient safety. Accordingly, we performed a random-effects meta-analysis to elucidate the effects of AAS and/or EX interventions on lean body mass (LBM) and muscle strength in conditions involving muscle loss. A systematic search for relevant clinical trials was conducted in MEDLINE, EMBASE, SCOPUS, Web of Science, and SPORTDiscus. Comparisons included AAS vs. Control, EX vs. Control, AAS vs. EX, AAS + EX vs. AAS and AAS + EX vs. EX. A total of 1114 individuals were analyzed. AAS increased LBM (effect size [ES]: 0.46; 95% CI: 0.25, 0.68, P = 0.00) and muscle strength (ES: 0.31; 95% CI: 0.08, 0.53, P = 0.01) when compared to a control group. EX promoted an increase in muscular strength (ES: 0.89; 95% CI: 0.53, 1.25, P = 0.00), with no effect on LBM when compared to the control group (ES: 0.15; 95% CI: -0.07, 0.38, P = 0.17). AAS did not demonstrate statistically significant differences when compared to EX for LBM and muscle strength. The combination of EX + AAS promoted a greater increase in LBM and muscular strength when compared to AAS or EX in isolation. Qualitatively, AAS administration had relatively few side effects. Significant heterogeneity was found in some analyses, which may be explained by the use of different AAS types and EX protocols. Our findings suggest that AAS administration in cachectic and sarcopenic conditions may be a viable interventional strategy to enhance muscle function when exercise is not a possible approach. Moreover, combining AAS with exercise may enhance positive outcomes in this population.
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Affiliation(s)
- Hugo Falqueto
- Medical School, Federal University of Fronteira Sul, SC 484 - Km 02, Chapecó, Santa Catarina, Brazil
- Graduate Program in Biomedical Sciences, UFFS, Chapecó, Santa Catarina, Brazil
| | - Jorge L R Júnior
- Laboratory of Sport Biomechanics, Sports Department, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Mauro N O Silvério
- Medical School, Federal University of Fronteira Sul, SC 484 - Km 02, Chapecó, Santa Catarina, Brazil
| | - Juliano C H Farias
- Medical School, Federal University of Fronteira Sul, SC 484 - Km 02, Chapecó, Santa Catarina, Brazil
| | | | - Leandro H Manfredi
- Medical School, Federal University of Fronteira Sul, SC 484 - Km 02, Chapecó, Santa Catarina, Brazil.
- Graduate Program in Biomedical Sciences, UFFS, Chapecó, Santa Catarina, Brazil.
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Effects of Low Energy Availability on Bone Health in Endurance Athletes and High-Impact Exercise as A Potential Countermeasure: A Narrative Review. Sports Med 2021; 51:391-403. [PMID: 33346900 PMCID: PMC7900047 DOI: 10.1007/s40279-020-01396-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Endurance athletes expend large amounts of energy in prolonged high-intensity exercise and, due to the weight-sensitive nature of most endurance sports, often practice periods of dietary restriction. The Female Athlete Triad and Relative Energy Deficiency in Sport models consider endurance athletes at high-risk for suffering from low energy availability and associated health complications, including an increased chance of bone stress injury. Several studies have examined the effects of low energy availability on various parameters of bone structure and markers of bone (re)modelling; however, there are differences in findings and research methods and critical summaries are lacking. It is difficult for athletes to reduce energy expenditure or increase energy intake (to restore energy availability) in an environment where performance is a priority. Development of an alternative tool to help protect bone health would be beneficial. High-impact exercise can be highly osteogenic and energy efficient; however, at present, it is rarely utilized to promote bone health in endurance athletes. Therefore, with a view to reducing the prevalence of bone stress injury, the objectives of this review are to evaluate the effects of low energy availability on bone health in endurance athletes and explore whether a high-impact exercise intervention may help to prevent those effects from occurring.
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Friesen CR, Wilson M, Rollings N, Sudyka J, Giraudeau M, Whittington CM, Olsson M. Exercise training has morph-specific effects on telomere, body condition and growth dynamics in a color-polymorphic lizard. J Exp Biol 2021; 224:jeb.242164. [PMID: 33785504 DOI: 10.1242/jeb.242164] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/22/2021] [Indexed: 12/12/2022]
Abstract
Alternative reproductive tactics (ARTs) are correlated suites of sexually selected traits that are likely to impose differential physiological costs on different individuals. While moderate activity might be beneficial, animals living in the wild often work at the margins of their resources and performance limits. Individuals using ARTs may have divergent capacities for activity. When pushed beyond their respective capacities, they may experience condition loss, oxidative stress, and molecular damage that must be repaired with limited resources. We used the Australian painted dragon lizard that exhibits color polymorphism as a model to experimentally test the effect of exercise on body condition, growth, reactive oxygen species (ROS) and telomere dynamics - a potential marker of stress and aging and a correlate of longevity. For most males, ROS levels tended to be lower with greater exercise; however, males with yellow throat patches - or bibs - had higher ROS levels than non-bibbed males. At the highest level of exercise, bibbed males exhibited telomere loss, while non-bibbed males gained telomere length; the opposite pattern was observed in the no-exercise controls. Growth was positively related to food intake but negatively correlated with telomere length at the end of the experiment. Body condition was not related to food intake but was positively correlated with increases in telomere length. These results, along with our previous work, suggest that aggressive - territory holding - bibbed males suffer physiological costs that may reduce longevity compared with non-bibbed males with superior postcopulatory traits.
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Affiliation(s)
- Christopher R Friesen
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.,Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW 2522, Australia.,Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, NSW 2006, Australia
| | - Mark Wilson
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW 2522, Australia.,Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Nicky Rollings
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, NSW 2006, Australia
| | - Joanna Sudyka
- Institute of Environmental Sciences, Jagiellonian University, 30-060 Krakow, Poland
| | - Mathieu Giraudeau
- CREEC, UMR IRD 224-CNRS 5290-Université de Montpellier, F34394 Montpellier, France.,CREES Centre for Research on the Ecology and Evolution of Disease, 34394 Montpellier, France
| | - Camilla M Whittington
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, NSW 2006, Australia
| | - Mats Olsson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.,Department of Biological & Environmental Sciences, University of Gothenburg, 405 30 Gothenburg, Sweden
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Evaluation of the usefulness of saliva for mosaic loss of chromosome Y analysis. Sci Rep 2021; 11:3769. [PMID: 33580176 PMCID: PMC7881200 DOI: 10.1038/s41598-021-83308-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/27/2021] [Indexed: 11/30/2022] Open
Abstract
Mosaic loss of chromosome Y (mLOY) in leukocytes has attracted much attention as an emerging biomarker of aging and aging-related diseases. We evaluated the usefulness of saliva for mLOY analysis and showed that saliva-derived mLOY is significantly associated with aging and increased physical activity, but not with smoking. While these data support the robust association between saliva-derived mLOY and aging, caution is required when comparing data from saliva-derived and blood-derived mLOY.
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A Review of Nonpharmacological Strategies in the Treatment of Relative Energy Deficiency in Sport. Int J Sport Nutr Exerc Metab 2021; 31:268-275. [PMID: 33465762 DOI: 10.1123/ijsnem.2020-0211] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/08/2020] [Accepted: 11/18/2020] [Indexed: 11/18/2022]
Abstract
Relative energy deficiency in sport (RED-S) can result in negative health and performance outcomes in both male and female athletes. The underlying etiology of RED-S is low energy availability (LEA), which occurs when there is insufficient dietary energy intake to meet exercise energy expenditure, corrected for fat-free mass, leaving inadequate energy available to ensure homeostasis and adequate energy turnover (optimize normal bodily functions to positively impact health), but also optimizing recovery, training adaptations, and performance. As such, treatment of RED-S involves increasing energy intake and/or decreasing exercise energy expenditure to address the underlying LEA. Clinically, however, the time burden and methodological errors associated with the quantification of energy intake, exercise energy expenditure, and fat-free mass to assess energy availability in free-living conditions make it difficult for the practitioner to implement in everyday practice. Furthermore, interpretation is complicated by the lack of validated energy availability thresholds, which can result in compromised health and performance outcomes in male and female athletes across various stages of maturation, ethnic races, and different types of sports. This narrative review focuses on pragmatic nonpharmacological strategies in the treatment of RED-S, featuring factors such as low carbohydrate availability, within-day prolonged periods of LEA, insufficient intake of bone-building nutrients, lack of mechanical bone stress, and/or psychogenic stress. This includes the implementation of strategies that address exacerbating factors of LEA, as well as novel treatment methods and underlying mechanisms of action, while highlighting areas of further research.
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Lee S, Kuniko M, Han S, Oh T, Taguchi M. Association of Low Energy Availability and Suppressed Metabolic Status in Korean Male Collegiate Soccer Players: A Pilot Study. Am J Mens Health 2020; 14:1557988320982186. [PMID: 33356773 PMCID: PMC7768860 DOI: 10.1177/1557988320982186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Low energy availability (EA) can impair physiological function in athletes. The purpose of this study was to investigate EA status, metabolic status, and bone metabolism with biochemical analysis in Korean male soccer players. Twelve male athletes (18–20 years) completed the study. Body composition and bone mineral density were measured using dual energy X-ray absorptiometry (DXA), while VO2 max was determined by an incremental exercise test. Blood samples were taken for bone marker and hormone analyses. Resting energy expenditure (REE) was measured using the Douglas bag method and predicted using the DXA method. Food diaries and heart rates (HR) during training were recorded, and the Profile of Mood States 2 and Eating Attitude Test 26 were completed. Group differences between low EA (LEA <30 kcal/kg FFM/d, n = 5) and high EA (HEA ≥30 kcal/kg FFM/d, n = 7) were evaluated. The mean EA of the all participants was 31.9 ± 9.8 kcal/kg FFM/d with only two participants having an EA above 45 kcal/kg FFM/d. LEA showed suppressed REE (LEA: 26.0 ± 1.7 kcal/kg/d, HEA: 28.8 ± 1.4 kcal/kg/d, p = .011) with a lower REEratio (LEA: 0.91 ± 0.06, HEA: 1.01 ± 0.05, p = .008) as well as a lower insulin-like growth factor 1 (IGF-1) level (LEA: 248.6 ± 51.2 ng/mL, HEA: 318.9 ± 43.4 ng/mL, p = .028) compared to HEA. There were no group differences in bone markers or other hormone levels. Korean male athletes exhibited low EA status with suppressed metabolism, but there was limited evidence on the effect of EA on bone metabolism, endocrine system, and psychological parameters.
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Affiliation(s)
- Sihyung Lee
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Moto Kuniko
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Seungah Han
- Department of Sports and Leisure Studies, Yongin University, Yongin, Gyeonggi, Korea
| | - Taewoong Oh
- Department of Sports and Leisure Studies, Yongin University, Yongin, Gyeonggi, Korea
| | - Motoko Taguchi
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
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Abstract
Male infertility secondary to oligozoospermia is surprisingly common. Although a majority of cases are idiopathic, oligozoospermia can be caused by endocrine dysfunction, anatomic abnormalities, medications, or environmental exposures. The work-up includes excluding reversible factors such as hormonal deficiency, medication effects, and retrograde ejaculation and identifying any underlying genetic syndrome and treating reversible medical causes. If no reversible cause is found, appropriate referrals to urology and assisted reproductive technology should be initiated. Lastly, clinicians should be aware of and respond to the psychological and general health ramifications of a diagnosis of oligozoospermia as part of the comprehensive care of men and couples struggling with a diagnosis of infertility.
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Affiliation(s)
- Jeremy T Choy
- Divisions of Endocrinology, Metabolism and Nutrition, University of Washington School of Medicine, Seattle, WA, US
- Men’s Health Clinic, University of Washington School of Medicine, Seattle, WA, US
| | - John K Amory
- General Internal Medicine; Department of Medicine, the Department of Urology, University of Washington School of Medicine, Seattle, WA, US
- Correspondence and Reprint Requests: John K. Amory MD, MPH, MSc, Professor of Medicine, University of Washington, Box 356429, 1959 NE Pacific St., Seattle, WA 98195. E-mail:
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Abstract
Care of young dancers requires a unique approach during a critical time of growth and development. Young dancers' well-being depends on factors including sleep, mental health, growth-associated musculoskeletal imbalances, and nutrition. Puberty is a particularly important time for young dancers. It coincides with an increased commitment to their art form and physical/psychosocial changes. It is imperative for practitioners to understand these various factors in order to optimize young dancers' health and allow them to safely train and perform.
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Affiliation(s)
- Bridget J Quinn
- Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children's Hospital, 319 Longwood Avenue, Boston, MA 02115, USA.
| | - Charles Scott
- Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children's Hospital, 319 Longwood Avenue, Boston, MA 02115, USA
| | - Andrea Stracciolini
- Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children's Hospital, 319 Longwood Avenue, Boston, MA 02115, USA
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Areta JL, Taylor HL, Koehler K. Low energy availability: history, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males. Eur J Appl Physiol 2020; 121:1-21. [PMID: 33095376 PMCID: PMC7815551 DOI: 10.1007/s00421-020-04516-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/23/2020] [Indexed: 12/21/2022]
Abstract
Energy availability (EA) is defined as the amount of dietary energy available to sustain physiological function after subtracting the energetic cost of exercise. Insufficient EA due to increased exercise, reduced energy intake, or a combination of both, is a potent disruptor of the endocrine milieu. As such, EA is conceived as a key etiological factor underlying a plethora of physiological dysregulations described in the female athlete triad, its male counterpart and the Relative Energy Deficiency in Sport models. Originally developed upon female-specific physiological responses, this concept has recently been extended to males, where experimental evidence is limited. The majority of data for all these models are from cross-sectional or observational studies where hypothesized chronic low energy availability (LEA) is linked to physiological maladaptation. However, the body of evidence determining causal effects of LEA on endocrine, and physiological function through prospective studies manipulating EA is comparatively small, with interventions typically lasting ≤ 5 days. Extending laboratory-based findings to the field requires recognition of the strengths and limitations of current knowledge. To aid this, this review will: (1) provide a brief historical overview of the origin of the concept in mammalian ecology through its evolution of algebraic calculations used in humans today, (2) Outline key differences from the ‘energy balance’ concept, (3) summarise and critically evaluate the effects of LEA on tissues/systems for which we now have evidence, namely: hormonal milieu, reproductive system endocrinology, bone metabolism and skeletal muscle; and finally (4) provide perspectives and suggestions for research upon identified knowledge gaps.
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Affiliation(s)
- José L Areta
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK.
| | - Harry L Taylor
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Karsten Koehler
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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Alves J, Toro V, Barrientos G, Bartolomé I, Muñoz D, Maynar M. Hormonal Changes in High-Level Aerobic Male Athletes during a Sports Season. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5833. [PMID: 32806586 PMCID: PMC7460198 DOI: 10.3390/ijerph17165833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 12/23/2022]
Abstract
The aim of this study was to determine the possible changes in plasma of several hormones such as Luteinizing Hormone, Testosterone, Cortisol and Insulin in endurance runners during the sports season. Twenty-one high-level male endurance runners (22 ± 3.2 years, 1.77 ± 0.05 m) participated in the study. Basal plasma hormones were measured at four moments during the season (initial, 3, 6 and 9 months), and were analyzed using ELISA (enzyme-linked immunosorbent assay). Testosterone and Luteinizing Hormone (LH) suffered very significant decreases (p < 0.01) at 3 months compared with the beginning and an increase (p < 0.05) at 6 and 9 months compared with 3 months. Insulin level was significantly lower (p < 0.05) at 3, 6 and 9 months compared with the initial test. Insulin and cortisol were associated inversely (r = 0.363; β = -0.577; p = 0.017) and positively (r = 0.202; β = 0.310; p = 0.043), respectively, with the amount of km per week performed by the runners. There was a significant association between km covered at a higher intensity than the anaerobic threshold and I (r = 0.580; β = -0.442; p = 0.000). Our findings indicate that testosterone, LH and insulin were more sensitive to changes in training volume and intensity than cortisol in high-level endurance runners. Basal testosterone and LH concentrations decrease in athletes who perform a high volume of aerobic km in situations of low energy availability.
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Affiliation(s)
- Javier Alves
- Department of Sport Science, Faculty of Education, Pontifical University of Salamanca, C/Henry Collet, 52–70, CP: 37007 Salamanca, Spain;
| | - Víctor Toro
- Department of Physiology, Faculty of Sports Science Faculty, University of Extremadura, University Avenue, s/n CP: 10003 Cáceres, Spain; (V.T.); (I.B.); (D.M.); (M.M.)
| | - Gema Barrientos
- Department of Sport Science, Faculty of Education, Pontifical University of Salamanca, C/Henry Collet, 52–70, CP: 37007 Salamanca, Spain;
| | - Ignacio Bartolomé
- Department of Physiology, Faculty of Sports Science Faculty, University of Extremadura, University Avenue, s/n CP: 10003 Cáceres, Spain; (V.T.); (I.B.); (D.M.); (M.M.)
| | - Diego Muñoz
- Department of Physiology, Faculty of Sports Science Faculty, University of Extremadura, University Avenue, s/n CP: 10003 Cáceres, Spain; (V.T.); (I.B.); (D.M.); (M.M.)
| | - Marcos Maynar
- Department of Physiology, Faculty of Sports Science Faculty, University of Extremadura, University Avenue, s/n CP: 10003 Cáceres, Spain; (V.T.); (I.B.); (D.M.); (M.M.)
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Saidi K, Ben Abderrahman A, Boullosa D, Dupont G, Hackney AC, Bideau B, Pavillon T, Granacher U, Zouhal H. The Interplay Between Plasma Hormonal Concentrations, Physical Fitness, Workload and Mood State Changes to Periods of Congested Match Play in Professional Soccer Players. Front Physiol 2020; 11:835. [PMID: 32792977 PMCID: PMC7385323 DOI: 10.3389/fphys.2020.00835] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
Background The regular assessment of hormonal and mood state parameters in professional soccer are proposed as good indicators during periods of intense training and/or competition to avoid overtraining. Objective The aim of this study was to analyze hormonal, psychological, workload and physical fitness parameters in elite soccer players in relation to changes in training and match exposure during a congested period of match play. Methods Sixteen elite soccer players from a team playing in the first Tunisian soccer league were evaluated three times (T1, T2, and T3) over 12 weeks. The non-congested period of match play was from T1 to T2, when the players played 6 games over 6 weeks. The congested period was from T2 to T3, when the players played 10 games over 6 weeks. From T1 to T3, players performed the Yo-Yo intermittent recovery test level 1 (YYIR1), the repeated shuttle sprint ability test (RSSA), the countermovement jump test (CMJ), and the squat jump test (SJ). Plasma Cortisol (C), Testosterone (T), and the T/C ratio were analyzed at T1, T2, and T3. Players had their mood dimensions (tension, depression, anger, vigor, fatigue, confusion, and a Total Mood Disturbance) assessed through the Profile of Mood State questionnaire (POMS). Training session rating of perceived exertion (sRPE) was also recorded on a daily basis in order to quantify internal training load and elements of monotony and strain. Results Significant performance declines (T1 < T2 < T3) were found for SJ performance (p = 0.04, effect size [ES] ES1–2 = 0.15−0.06, ES2–3 = 0.24) from T1 to T3. YYIR1 performance improved significantly from T1 to T2 and declined significantly from T2 to T3 (p = 0.001, ES1–2 = 0.24, ES2–3 = −2.54). Mean RSSA performance was significantly higher (p = 0.019, ES1–2 = −0.47, ES2–3 = 1.15) in T3 compared with T2 and T1. Best RSSA performance was significantly higher in T3 when compared with T2 and T1 (p = 0.006, ES2–3 = 0.47, ES1–2 = −0.56), but significantly lower in T2 when compared with to T1. T and T/C were significantly lower in T3 when compared with T2 and T1 (T: p = 0.03, ES3–2 = −0.51, ES3–1 = −0.51, T/C: p = 0.017, ES3–2 = −1.1, ES3–1 = −1.07). Significant decreases were found for the vigor scores in T3 when compared to T2 and T1 (p = 0.002, ES1–2 = 0.31, ES3–2 = −1.25). A significant increase was found in fatigue scores in T3 as compared to T1 and T2 (p = 0.002, ES1–2 = 0.43, ES2–3 = 0.81). A significant increase was found from T1 < T2 < T3 intension score (p = 0.002, ES1–2 = 1.1, ES2–3 = 0.2) and anger score (p = 0.03, ES1–2 = 0.47, ES2–3 = 0.33) over the study period. Total mood disturbance increased significantly (p = 0.02, ES1–2 = 0.91, ES2–3 = 1.1) from T1 to T3. Between T1-T2, significant relationships were observed between workload and changes in T (r = 0.66, p = 0.003), and T/C ratio (r = 0.62, p = 0.01). There were significant relationships between performance in RSSAbest and training load parameters (workload: r = 0.52, p = 0.03; monotony: r = 0.62, p = 0.01; strain: r = 0.62, p = 0.009). Between T2-T3, there was a significant relationship between Δ% of total mood disturbance and Δ% of YYIR1 (r = −0.54; p = 0.04), RSSAbest (r = 0.58, p = 0.01), SJ (r = −0,55, p = 0.01), T (r = 0.53; p = 0.03), and T/C (r = 0.5; p = 0.04). Conclusion An intensive period of congested match play significantly compromised elite soccer players’ physical and mental fitness. These changes were related to psychological but not hormonal parameters; even though significant alterations were detected for selected measures. Mood monitoring could be a simple and useful tool to determine the degree of preparedness for match play during a congested period in professional soccer.
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Affiliation(s)
- Karim Saidi
- Movement, Sport, Health and Sciences Laboratory (M2S), University of Rennes 2, Rennes, France.,Higher Institute of Sport and Physical Education of Ksar Said, University of Manouba, Tunis, Tunisia
| | | | - Daniel Boullosa
- Faculty of Health Sciences, University of Brasilia, Brasília, Brazil
| | | | - Anthony C Hackney
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Benoit Bideau
- Movement, Sport, Health and Sciences Laboratory (M2S), University of Rennes 2, Rennes, France
| | | | - Urs Granacher
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - Hassane Zouhal
- Movement, Sport, Health and Sciences Laboratory (M2S), University of Rennes 2, Rennes, France
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