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Fuchs CJ, Trommelen J, Weijzen MEG, Smeets JSJ, van Kranenburg J, Verdijk LB, van Loon LJC. Becoming a World Champion Powerlifter at 71 Years of Age: It Is Never Too Late to Start Exercising. Int J Sport Nutr Exerc Metab 2024; 34:223-231. [PMID: 38458181 DOI: 10.1123/ijsnem.2023-0230] [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: 10/26/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 03/10/2024]
Abstract
This case study assessed body composition, muscle strength, cardiorespiratory fitness, and metabolic health of the present female world champion powerlifter in the 70+ age category who started resistance exercise training at 63 years of age with no prior experience with structured exercise training. Measures of body composition (magnetic resonance imaging, computed tomography, and dual-energy X-ray absorptiometry scanning, leg volume); strength (one-repetition maximum leg press and extension, maximum voluntary contraction, and handgrip strength); physical function (short physical performance battery); cardiorespiratory fitness (peak oxygen consumption); and metabolic health (oral glucose tolerance test) were assessed. In addition, a muscle biopsy was collected to assess muscle fiber type distribution and cross-sectional area (CSA). Where possible, data were compared with previously (un)published sex- and age-matched data using z scores. Skeletal muscle mass index was calculated by dividing limb muscle mass by height squared. Data from the control groups are expressed as mean ± 95% confidence interval. Our participant (age: 71 years; body mass: 64.5 kg; body mass index: 27.6 kg/m2) reported a good bone mineral density of 1.09 g/cm2 (T score between -1 and +1) and very low values of abdominal and organ body fat (i.e., between 20% and 70% lower compared with a reference group of postmenopausal women). In addition, she showed a 33% greater skeletal muscle mass index when compared with healthy, older female control subjects (7.9 vs. 5.9 [5.7-6.2] kg/m2; n = 61) as well as 37% greater muscle quadriceps CSA (63.8 vs. 46.6 [44.5-48.7] cm2; n = 48) and 46% greater Type II muscle fiber CSA (4,536 vs. 3,097 [2,707-3,488] μm2; n = 19). Absolute leg press muscle strength was 36% greater (190 vs. 140 [132-147] kg; n = 30) and handgrip strength was 33% greater (33 vs. 25 [23-26] kg; n = 48) when compared with healthy, age-matched controls. In conclusion, even for resistance exercise naïve individuals, starting exercise at an advanced age can lead to improvements in body composition and muscle strength allowing older adults to reduce the risk for developing metabolic syndrome, live independently, and even compete at a world class level.
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Affiliation(s)
- Cas J Fuchs
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Jorn Trommelen
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Michelle E G Weijzen
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Joey S J Smeets
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Janneau van Kranenburg
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Lex B Verdijk
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Luc J C van Loon
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
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Flood TR, Clausen E, Kuikman MA, Smith E, McKay AKA, Burke LM, Elliott-Sale KJ. Auditing the representation of hormonal contraceptives in studies assessing exercise performance in women. J Sports Sci 2024; 42:825-839. [PMID: 38896557 DOI: 10.1080/02640414.2024.2368762] [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: 12/19/2023] [Accepted: 06/09/2024] [Indexed: 06/21/2024]
Abstract
Hormonal contraceptive (HC) users have a different ovarian hormonal profile compared to eumenorrheic women. Due to the prevalence of HC use amongst sportswomen, there has been increased research efforts to understand their impact on exercise performance. The aim was to audit this research. Studies identified were assessed for HC type, athlete calibre, performance outcome, study design, and quality of methodological control regarding ovarian hormonal profiles. Sixty-eight different HCs were reported across 61 studies. Monophasic combined oral contraceptive (OCP) pills represented 60% of HCs, followed by other pills [34%, phasic-combined, progestogen-only, and un-specified], phasic and long acting reversible contraceptives [5%, vaginal ring, patch, implant, injection, intrauterine system] and unspecified HCs (1%). Eleven percent of participants using HCs were classified as highly trained or elite/international with no participants being classed as world class. Whilst the number of studies involving HCs has increased two-fold over the past decade, the number of studies ranked as gold standard has not increased (HC; 2003-57%, 2011-55%, 2022-43%. OCP; 2003-14%, 2011-17%, 2022-12%). Future research assessing HCs and exercise performance should adopt high-quality research designs and include a broader range of HCs in highly trained to world-class populations to increase the reach and impact of research in this area.
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Affiliation(s)
- Tessa R Flood
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Emma Clausen
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Megan A Kuikman
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ella Smith
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
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Rodriguez LA, Liu Y, Soedirdjo SDH, Thakur B, Dhaher YY. Oral Contraception Use and Musculotendinous Injury in Young Female Patients: A Database Study. Med Sci Sports Exerc 2024; 56:511-519. [PMID: 37890119 PMCID: PMC10922414 DOI: 10.1249/mss.0000000000003334] [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] [Indexed: 10/29/2023]
Abstract
PURPOSE The purpose of this study is to characterize the effect of sex and the influence of oral contraception usage on musculotendinous injury (MTI). Current literature suggests a disparity in the incidence of MTI between males and females. This may be attributed to inherent biological differences between the sexes, such as in the sex hormonal milieu. There is a lack of information associating sex hormone milieu and MTI. METHODS We searched the PearlDiver database (a for-fee healthcare database) for males, females taking oral contraceptives (OC), and eumenorrheic females not taking any form of hormonal contraceptives (non-OC) 18-39 yr old. The three populations were matched by age and body mass index. We queried the database for lower-extremity skeletal MTI diagnoses in these groups. RESULTS Each group contained 42,267 patients with orthopedic injuries. There were a total of 1476 (3.49%) skeletal MTI in the male group, 1078 (2.55%) in non-OC females, and 231 (0.55%) in OC females. Both the non-OC and the OC groups had a significantly smaller proportion of MTI than males ( P < 0.0001), and therefore these groups were less likely (adjusted odds ratios, 0.72 and 0.15, respectively) to experience MTI when controlled for potential covariates. CONCLUSIONS In this study, we show that females are less likely to develop MTI to total injuries, when compared with males, with OC using females being least likely followed by non-OC females. These results are consistent with other epidemiological studies; however, overall results in the literature are variable. This study adds to the emerging body of literature on sex hormone-influenced musculoskeletal injury but, more specifically, MTI, which have not been rigorously investigated.
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Affiliation(s)
- Luis A. Rodriguez
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX
- Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX
| | - Yida Liu
- Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX
| | | | - Bhaskar Thakur
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX
| | - Yasin Y. Dhaher
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX
- Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX
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Mckee JR, Girard O, Peiffer JJ, Hiscock DJ, De Marco K, Scott BR. Repeated-Sprint Training With Blood-Flow Restriction Improves Repeated-Sprint Ability Similarly to Unrestricted Training at Reduced External Loads. Int J Sports Physiol Perform 2024; 19:257-264. [PMID: 38154016 DOI: 10.1123/ijspp.2023-0321] [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: 08/17/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 12/30/2023]
Abstract
PURPOSE This study examined performance and physiological adaptations following 3 weeks of repeated-sprint training (RST) with blood-flow restriction (BFR) or without (non-BFR). METHODS Twenty-six semiprofessional and amateur adult male team-sport players were assessed for repeated-sprint ability, anaerobic capacity, leg lean mass, neuromuscular function, and maximal aerobic capacity before and after RST. Participants completed 9 cycling RST sessions (3 sets of 5-7 × 5-s sprints, 25-s passive recovery, 3-min rest) over a 3-week period with BFR or non-BFR. RESULTS During RST sessions, the BFR group demonstrated lower mean power output compared with non-BFR (-14.5%; g = 1.48; P = .001). Significant improvements (P < .05) in mean and peak power output during repeated-sprint ability (+4.1%; g = 0.42, and + 2.2%; g = 0.25, respectively) and anaerobic capacity (+4.8%; g = 0.47, and + 4.7%; g = 0.32, respectively) tests, leg lean mass (+2.0%; g = 0.16), and peak aerobic power (+3.3%; g = 0.25) were observed from pretesting to posttesting without any between-groups differences. No significant changes (P > .05) were observed for maximal isometric voluntary contraction and maximal aerobic capacity. Peak rate of force development decreased (P = .003) in both groups following RST (-14.6%; g = 0.65), without any between-groups differences. CONCLUSIONS Repeated-sprint ability, anaerobic capacity, leg lean mass, and peak aerobic power improved following 3 weeks of RST; however, the addition of BFR did not further enhance adaptations. Interestingly, comparable improvements were achieved between groups despite lower external loads experienced during RST sessions with BFR.
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Affiliation(s)
- James R Mckee
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
- Centre for Healthy Ageing, Murdoch University, Perth, WA, Australia
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia
| | - Jeremiah J Peiffer
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
- Centre for Healthy Ageing, Murdoch University, Perth, WA, Australia
| | - Daniel J Hiscock
- Sport Department, Wesley College, Perth, WA, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth,WA, Australia
| | - Kristen De Marco
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
- Centre for Healthy Ageing, Murdoch University, Perth, WA, Australia
| | - Brendan R Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
- Centre for Healthy Ageing, Murdoch University, Perth, WA, Australia
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Barrué-Belou S, Démaret MA, Wurtz A, Ducloux A, Fourchet F, Bothorel H. Absolute and Normalized Normative Torque Values of Knee Extensors and Flexors in Healthy Trained Subjects: Asymmetry Questions the Classical Use of Uninjured Limb as Reference. Arthrosc Sports Med Rehabil 2024; 6:100861. [PMID: 38288034 PMCID: PMC10823066 DOI: 10.1016/j.asmr.2023.100861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/08/2023] [Indexed: 01/31/2024] Open
Abstract
Purpose To provide normative values of maximal isometric torque of knee extensors and flexors measured at 80° of knee flexion and to characterize the results in healthy subjects practicing activities at risk of anterior cruciate ligament rupture. Methods Seventy-four trained volunteers (35 male and 39 female) aged 18 to 41 years were recruited. They alternately performed 3 maximal voluntary isometric contractions of knee extension and flexion. The maximal voluntary isometric contraction net torque was computed as the mean value of the peak torques recorded over the 3 trials. Results For women, the absolute torque for extensors was 143.5 ± 34.4 N⋅m (range, 87.7-253.1 N⋅m) and 66.8 ± 13.8 N⋅m (range, 37.5-93.1) for flexors. For men, the absolute torque for extensors was 199.8 ± 47.3 N⋅m (range, 99.3-311.5 N⋅m) and 89.8 ± 21.0 N⋅m (range, 51.8-137.2 N⋅m) for flexors. For women, the body mass normalized torque for extensors was 2.20 ± 0.51 N⋅m.kg-1 (range, 1.22-3.74 N⋅m.kg-1) and 1.04 ± 0.26 N⋅m.kg-1 (range, 0.41-1.50 N⋅m.kg-1) for flexors. For men, the normalized torque for extensors was 2.74 ± 0.58 N⋅m.kg-1 (range, 1.51-4.08 N⋅m.kg-1) and 1.24 ± 0.30 N⋅m.kg-1 (range, 0.64-2.05 N⋅m.kg-1) for flexors. Conclusions This study provides absolute and normalized normative values of maximal isometric torque measured at 80° of knee flexion for extensors and flexors in a series of healthy trained subjects practicing activities at risk of anterior cruciate ligament rupture. The considerable level of interlimb asymmetry and the weak association between dominance and strength observed in uninjured subjects call into question the classical use of contralateral side as reference for injured patients. Clinical Relevance Patients with anterior cruciate ligament (ACL) injuries are the most represented subjects using isokinetic dynamometers in many sport medicine and rehabilitation departments. Clinicians need reference values to compare patients with ACL injuries with comparable healthy subjects. This study may provide this information.
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Affiliation(s)
- Simon Barrué-Belou
- Physiotherapy Department and Motion Analysis Lab, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
- Sports University Clinic, Toulouse University Hospital, Toulouse, France
| | - Marc-Antoine Démaret
- Sports University Clinic, Toulouse University Hospital, Toulouse, France
- Swiss Olympic Medical Center Cressy Santé - University Hospitals of Geneva, Geneva, Switzerland
| | - Alexis Wurtz
- Physiotherapy Department and Motion Analysis Lab, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
| | - Alicia Ducloux
- Physiotherapy Department and Motion Analysis Lab, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
- Research Department, La Tour Hospital, Meyrin, Switzerland
| | - François Fourchet
- Physiotherapy Department and Motion Analysis Lab, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
| | - Hugo Bothorel
- Research Department, La Tour Hospital, Meyrin, Switzerland
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Notbohm HL, Umlauff L, Bloch W, Schumann M. Comparison of the cytokine responses to acute strength exercise between oral contraceptive users and naturally cycling women. Eur J Appl Physiol 2024; 124:257-267. [PMID: 37453973 PMCID: PMC10786951 DOI: 10.1007/s00421-023-05275-4] [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: 03/30/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Cytokines are released as part of an inflammatory reaction in response to strength exercise to initiate muscle repair and morphological adaptations. Whether hormonal fluctuations induced by the menstrual cycle or oral contraceptives affect inflammatory responses to strength exercise remains unknown. Therefore, we aimed to compare the response of cytokines after acute strength exercise in naturally menstruating women and oral contraceptive users. METHODS Naturally menstruating women (MC, n = 13, 24 ± 4 years, weekly strength training: 4.3 ± 1.7 h) and women using a monophasic combined pill (> 9 months) (OC, n = 8, 22 ± 3 years, weekly strength training: 4.5 ± 1.9 h) were recruited. A one-repetition-maximum (1RM) test and strength exercise in the squat (4 × 10 repetitions, 70%1RM) was performed in the early follicular phase or pill free interval. Concentrations of oestradiol, IL-1β, IL-1ra, IL-6, IL-8, and IL-10 were assessed before (pre), directly after (post) and 24 h after (post24) strength exercise. RESULTS IL-1ra increased from pre to post (+ 51.1 ± 59.4%, p = 0.189) and statistically decreased from post to post24 (- 20.5 ± 13.5%, p = 0.011) only in OC. Additionally, IL-1β statistically decreased from post to post24 (- 39.6 ± 23.0%, p = 0.044) only in OC. There was an interaction effect for IL-1β (p = 0.038) and concentrations were statistically decreased at post24 in OC compared to MC (p = 0.05). IL-8 increased across both groups from post to post24 (+ 66.6 ± 96.3%, p = 0.004). CONCLUSION We showed a differential regulation of IL-1β and IL-1ra between OC users in the pill-free interval and naturally cycling women 24 h after strength exercise, while there was no effect on other cytokines. Whether this is associated with previously shown compromised morphological adaptations remains to be investigated.
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Affiliation(s)
- Hannah L Notbohm
- Department of Molecular and Cellular Sports Medicine, German Sport University, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Lisa Umlauff
- Department of Molecular and Cellular Sports Medicine, German Sport University, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, German Sport University, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Moritz Schumann
- Department of Molecular and Cellular Sports Medicine, German Sport University, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
- Division of Training and Movement Science, University of Potsdam, Potsdam, Germany.
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Nolan D, McNulty KL, Manninen M, Egan B. The Effect of Hormonal Contraceptive Use on Skeletal Muscle Hypertrophy, Power and Strength Adaptations to Resistance Exercise Training: A Systematic Review and Multilevel Meta-analysis. Sports Med 2024; 54:105-125. [PMID: 37755666 PMCID: PMC10798924 DOI: 10.1007/s40279-023-01911-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Resistance exercise training is widely used by general and athletic populations to increase skeletal muscle hypertrophy, power and strength. Endogenous sex hormones influence various bodily functions, including possibly exercise performance, and may influence adaptive changes in response to exercise training. Hormonal contraceptive (HC) use modulates the profile of endogenous sex hormones, and therefore, there is increasing interest in the impact, if any, of HC use on adaptive responses to resistance exercise training. OBJECTIVE Our aim is to provide a quantitative synthesis of the effect of HC use on skeletal muscle hypertrophy, power and strength adaptations in response to resistance exercise training. METHODS A systematic review with meta-analysis was conducted on experimental studies which directly compared skeletal muscle hypertrophy, power and strength adaptations following resistance exercise training in hormonal contraceptive users and non-users conducted before July 2023. The search using the online databases PUBMED, SPORTDiscus, Web of Science, Embase and other supplementary search strategies yielded 4669 articles, with 8 articles (54 effects and 325 participants) meeting the inclusion criteria. The methodological quality of the included studies was assessed using the "Tool for the assessment of study quality and reporting in exercise". RESULTS All included studies investigated the influence of oral contraceptive pills (OCP), with no study including participants using other forms of HC. The articles were analysed using a meta-analytic multilevel maximum likelihood estimator model. The results indicate that OCP use does not have a significant effect on hypertrophy [0.01, 95% confidence interval (CI) [- 0.11, 0.13], t = 0.14, p = 0.90), power (- 0.04, 95% CI [- 0.93, 0.84], t = - 0.29, p = 0.80) or strength (0.10, 95% CI [- 0.08, 0.28], t = 1.48, p = 0.20). DISCUSSION Based on the present analysis, there is no evidence-based rationale to advocate for or against the use of OCPs in females partaking in resistance exercise training to increase hypertrophy, power and/or strength. Rather, an individualised approach considering an individual's response to OCPs, their reasons for use and menstrual cycle history may be more appropriate. REGISTRATION The review protocol was registered on PROSPERO (ID number and hyperlink: CRD42022365677).
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Affiliation(s)
- David Nolan
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Kelly L McNulty
- Sport, Health & Exercise (SHE) Research Group, Department of Sport and Health Sciences, Technological University of the Shannon, Athlone, Co. Westmeath, Ireland
- UPMC Sports Medicine and UPMC Institute for Health, UPMC, Pittsburgh, Ireland
| | - Mika Manninen
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, Ireland.
- Florida Institute of Human and Machine Cognition, Pensacola, FL, USA.
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Hunter SK, S Angadi S, Bhargava A, Harper J, Hirschberg AL, D Levine B, L Moreau K, J Nokoff N, Stachenfeld NS, Bermon S. The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine. Med Sci Sports Exerc 2023; 55:2328-2360. [PMID: 37772882 DOI: 10.1249/mss.0000000000003300] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
ABSTRACT Biological sex is a primary determinant of athletic performance because of fundamental sex differences in anatomy and physiology dictated by sex chromosomes and sex hormones. Adult men are typically stronger, more powerful, and faster than women of similar age and training status. Thus, for athletic events and sports relying on endurance, muscle strength, speed, and power, males typically outperform females by 10%-30% depending on the requirements of the event. These sex differences in performance emerge with the onset of puberty and coincide with the increase in endogenous sex steroid hormones, in particular testosterone in males, which increases 30-fold by adulthood, but remains low in females. The primary goal of this consensus statement is to provide the latest scientific knowledge and mechanisms for the sex differences in athletic performance. This review highlights the differences in anatomy and physiology between males and females that are primary determinants of the sex differences in athletic performance and in response to exercise training, and the role of sex steroid hormones (particularly testosterone and estradiol). We also identify historical and nonphysiological factors that influence the sex differences in performance. Finally, we identify gaps in the knowledge of sex differences in athletic performance and the underlying mechanisms, providing substantial opportunities for high-impact studies. A major step toward closing the knowledge gap is to include more and equitable numbers of women to that of men in mechanistic studies that determine any of the sex differences in response to an acute bout of exercise, exercise training, and athletic performance.
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Affiliation(s)
- Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, and Athletic and Human Performance Center, Marquette University, Milwaukee, WI
| | | | - Aditi Bhargava
- Department of Obstetrics and Gynecology, Center for Reproductive Sciences, University of California, San Francisco, CA
| | - Joanna Harper
- Loughborough University, Loughborough, UNITED KINGDOM
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet, and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, SWEDEN
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and the Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Kerrie L Moreau
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, CO
| | - Natalie J Nokoff
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Nina S Stachenfeld
- The John B. Pierce Laboratory and Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
| | - Stéphane Bermon
- Health and Science Department, World Athletics, Monaco and the LAMHESS, University Côte d'Azur, Nice, FRANCE
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Plotkin DL, Rodas MA, Vigotsky AD, McIntosh MC, Breeze E, Ubrik R, Robitzsch C, Agyin-Birikorang A, Mattingly ML, Michel JM, Kontos NJ, Lennon S, Frugé AD, Wilburn CM, Weimar WH, Bashir A, Beyers RJ, Henselmans M, Contreras BM, Roberts MD. Hip thrust and back squat training elicit similar gluteus muscle hypertrophy and transfer similarly to the deadlift. Front Physiol 2023; 14:1279170. [PMID: 37877099 PMCID: PMC10593473 DOI: 10.3389/fphys.2023.1279170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/27/2023] [Indexed: 10/26/2023] Open
Abstract
We examined how set-volume equated resistance training using either the back squat (SQ) or hip thrust (HT) affected hypertrophy and various strength outcomes. Untrained college-aged participants were randomized into HT (n = 18) or SQ (n = 16) groups. Surface electromyograms (sEMG) from the right gluteus maximus and medius muscles were obtained during the first training session. Participants completed 9 weeks of supervised training (15-17 sessions), before and after which gluteus and leg muscle cross-sectional area (mCSA) was assessed via magnetic resonance imaging. Strength was also assessed prior to and after the training intervention via three-repetition maximum (3RM) testing and an isometric wall push test. Gluteus mCSA increases were similar across both groups. Specifically, estimates [(-) favors HT (+) favors SQ] modestly favored the HT versus SQ for lower [effect ±SE, -1.6 ± 2.1 cm2; CI95% (-6.1, 2.0)], mid [-0.5 ± 1.7 cm2; CI95% (-4.0, 2.6)], and upper [-0.5 ± 2.6 cm2; CI95% (-5.8, 4.1)] gluteal mCSAs but with appreciable variance. Gluteus medius + minimus [-1.8 ± 1.5 cm2; CI95% (-4.6, 1.4)] and hamstrings [0.1 ± 0.6 cm2; CI95% (-0.9, 1.4)] mCSA demonstrated little to no growth with small differences between groups. mCSA changes were greater in SQ for the quadriceps [3.6 ± 1.5 cm2; CI95% (0.7, 6.4)] and adductors [2.5 ± 0.7 cm2; CI95% (1.2, 3.9)]. Squat 3RM increases favored SQ [14 ± 2 kg; CI95% (9, 18),] and hip thrust 3RM favored HT [-26 ± 5 kg; CI95% (-34, -16)]. 3RM deadlift [0 ± 2 kg; CI95% (-4, 3)] and wall push strength [-7 ± 12N; CI95% (-32, 17)] similarly improved. All measured gluteal sites showed greater mean sEMG amplitudes during the first bout hip thrust versus squat set, but this did not consistently predict gluteal hypertrophy outcomes. Squat and hip thrust training elicited similar gluteal hypertrophy, greater thigh hypertrophy in SQ, strength increases that favored exercise allocation, and similar deadlift and wall push strength increases.
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Affiliation(s)
| | | | - Andrew D. Vigotsky
- Departments of Biomedical Engineering and Statistics, Evanston, IL, United States
- Department of Neuroscience, Northwestern University, Chicago, IL, United States
| | | | - Emma Breeze
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Rachel Ubrik
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Cole Robitzsch
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | | | | | - J. Max Michel
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | | | - Sarah Lennon
- College of Nursing, Auburn University, Auburn, AL, United States
| | - Andrew D. Frugé
- College of Nursing, Auburn University, Auburn, AL, United States
| | | | - Wendi H. Weimar
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Adil Bashir
- MRI Research Center, Auburn University, Auburn, AL, United States
| | - Ronald J. Beyers
- MRI Research Center, Auburn University, Auburn, AL, United States
| | - Menno Henselmans
- International Scientific Research Foundation for Fitness and Nutrition, Amsterdam, Netherlands
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10
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Roberts MD, McCarthy JJ, Hornberger TA, Phillips SM, Mackey AL, Nader GA, Boppart MD, Kavazis AN, Reidy PT, Ogasawara R, Libardi CA, Ugrinowitsch C, Booth FW, Esser KA. Mechanisms of mechanical overload-induced skeletal muscle hypertrophy: current understanding and future directions. Physiol Rev 2023; 103:2679-2757. [PMID: 37382939 PMCID: PMC10625844 DOI: 10.1152/physrev.00039.2022] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
Mechanisms underlying mechanical overload-induced skeletal muscle hypertrophy have been extensively researched since the landmark report by Morpurgo (1897) of "work-induced hypertrophy" in dogs that were treadmill trained. Much of the preclinical rodent and human resistance training research to date supports that involved mechanisms include enhanced mammalian/mechanistic target of rapamycin complex 1 (mTORC1) signaling, an expansion in translational capacity through ribosome biogenesis, increased satellite cell abundance and myonuclear accretion, and postexercise elevations in muscle protein synthesis rates. However, several lines of past and emerging evidence suggest that additional mechanisms that feed into or are independent of these processes are also involved. This review first provides a historical account of how mechanistic research into skeletal muscle hypertrophy has progressed. A comprehensive list of mechanisms associated with skeletal muscle hypertrophy is then outlined, and areas of disagreement involving these mechanisms are presented. Finally, future research directions involving many of the discussed mechanisms are proposed.
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Affiliation(s)
- Michael D Roberts
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - John J McCarthy
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - Troy A Hornberger
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gustavo A Nader
- Department of Kinesiology and Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Marni D Boppart
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | - Andreas N Kavazis
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Paul T Reidy
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, Ohio, United States
| | - Riki Ogasawara
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Cleiton A Libardi
- MUSCULAB-Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Frank W Booth
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States
| | - Karyn A Esser
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, Florida, United States
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11
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White L, Losciale JM, Squier K, Guy S, Scott A, Prior JC, Whittaker JL. Combined hormonal contraceptive use is not protective against musculoskeletal conditions or injuries: a systematic review with data from 5 million females. Br J Sports Med 2023; 57:1195-1202. [PMID: 37225254 DOI: 10.1136/bjsports-2022-106519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Assess the association between combined hormonal contraceptives (CHC) use and musculoskeletal tissue pathophysiology, injuries or conditions. DESIGN Systematic review with semiquantitative analyses and certainty of evidence assessment, guided by the Grading of Recommendations Assessment, Development and Evaluation approach. DATA SOURCES MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to April 2022. ELIGIBILITY Intervention and cohort studies that assessed the association between new or ongoing use of CHC and an outcome of musculoskeletal tissue pathophysiology, injury or condition in postpubertal premenopausal females. RESULTS Across 50 included studies, we assessed the effect of CHC use on 30 unique musculoskeletal outcomes (75% bone related). Serious risk of bias was judged present in 82% of studies, with 52% adequately adjusting for confounding. Meta-analyses were not possible due to poor outcome reporting, and heterogeneity in estimate statistics and comparison conditions. Based on semiquantitative synthesis, there is low certainty evidence that CHC use was associated with elevated future fracture risk (risk ratio 1.02-1.20) and total knee arthroplasty (risk ratio 1.00-1.36). There is very low certainty evidence of unclear relationships between CHC use and a wide range of bone turnover and bone health outcomes. Evidence about the effect of CHC use on musculoskeletal tissues beyond bone, and the influence of CHC use in adolescence versus adulthood, is limited. CONCLUSION Given a paucity of high certainty evidence that CHC use is protective against musculoskeletal pathophysiology, injury or conditions, it is premature and inappropriate to advocate, or prescribe CHC for these purposes. PROSPERO REGISTRATION NUMBER This review was registered on PROSPERO CRD42021224582 on 8 January 2021.
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Affiliation(s)
- Lynita White
- Tall Tree Physiotherapy and Health Centre, Vancouver, British Columbia, Canada
| | - Justin M Losciale
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kipling Squier
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Guy
- City Sport + Physiotherapy Clinic, Vancouver, British Columbia, Canada
| | - Alex Scott
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jerilynn C Prior
- Centre for Menstrual Cycle and Ovulation Research, The University of British Columbia, Vancouver, British Columbia, Canada
- Women's Health Research Institute, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jackie L Whittaker
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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12
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Römer C, Zessin E, Czupajllo J, Fischer T, Wolfarth B, Lerchbaumer MH. Effect of Physical Parameters and Training Load on Patellar Tendon Stiffness in Professional Athletes. Diagnostics (Basel) 2023; 13:2541. [PMID: 37568903 PMCID: PMC10417388 DOI: 10.3390/diagnostics13152541] [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: 06/30/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Injuries of the patellar tendon commonly occur as a result of mechanical loading of the tendon during physical activity. Shear wave elastography (SWE) is an established technique for assessing tendon stiffness, and has good interindividual reliability. The aim of this study was to investigate the impacts of physical parameters and different sports on patellar tendon stiffness in professional athletes using SWE. METHODS Standardized patellar tendon SWE was performed in a relaxed supine position with a small roll under the knee (20° flexion) in 60 healthy professional athletes (30 female, 30 male). Multiple linear regression was performed for patellar tendon stiffness including gender, age, body mass index (BMI), and type of sport. RESULTS Patellar tendon stiffness showed no significant difference between female (3.320 m/s) and male (3.416 m/s) professional athletes. Mean age (female: 20.53 years; male: 19.80 years) and BMI (female: 23.24 kg/m2; male: 23.52 kg/m2) were comparable. Female professional athletes with oral contraceptive (OC) intake showed higher patellar tendon stiffness than athletes without OC intake (3.723 versus 3.017; p = 0.053), but not significantly. CONCLUSION In professional athletes, there are no significant differences in patellar tendon stiffness according to gender, age, BMI and type of sport (handball, volleyball, soccer, sprint, hammer throw). Oral contraceptives may not have an impact on patellar tendon stiffness in female athletes. Further studies are necessary.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Enrico Zessin
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
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13
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Plotkin DL, Rodas MA, Vigotsky AD, McIntosh MC, Breeze E, Ubrik R, Robitzsch C, Agyin-Birikorang A, Mattingly ML, Michel JM, Kontos NJ, Frugé AD, Wilburn CM, Weimar WH, Bashir A, Beyers RJ, Henselmans M, Contreras BM, Roberts MD. Hip thrust and back squat training elicit similar gluteus muscle hypertrophy and transfer similarly to the deadlift. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.21.545949. [PMID: 37461495 PMCID: PMC10349977 DOI: 10.1101/2023.06.21.545949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
Purpose We examined how set-volume equated resistance training using either the back squat (SQ) or hip thrust (HT) affected hypertrophy and various strength outcomes. Methods Untrained college-aged participants were randomized into HT or SQ groups. Surface electromyograms (sEMG) from the right gluteus maximus and medius muscles were obtained during the first training session. Participants completed nine weeks of supervised training (15-17 sessions), before and after which we assessed muscle cross-sectional area (mCSA) via magnetic resonance imaging and strength via three-repetition maximum (3RM) testing and an isometric wall push test. Results Glutei mCSA growth was similar across both groups. Estimates [(-) favors HT; (+) favors SQ] modestly favored the HT compared to SQ for lower [effect ± SE, -1.6 ± 2.1 cm2], mid [-0.5± 1.7 cm2], and upper [-0.5 ± 2.6 cm2], but with appreciable variance. Gluteus medius+minimus [-1.8 ± 1.5 cm2] and hamstrings [0.1 ± 0.6 cm2] mCSA demonstrated little to no growth with small differences between groups. Thigh mCSA changes were greater in SQ for the quadriceps [3.6 ± 1.5 cm2] and adductors [2.5 ± 0.7 cm2]. Squat 3RM increases favored SQ [14 ± 2.5 kg] and hip thrust 3RM favored HT [-26 ± 5 kg]. 3RM deadlift [0 ± 2 kg] and wall push strength [-7 ± 13 N] similarly improved. All measured gluteal sites showed greater mean sEMG amplitudes during the first bout hip thrust versus squat set, but this did not consistently predict gluteal hypertrophy outcomes. Conclusion Nine weeks of squat versus hip thrust training elicited similar gluteal hypertrophy, greater thigh hypertrophy in SQ, strength increases that favored exercise allocation, and similar strength transfers to the deadlift and wall push.
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Affiliation(s)
| | | | - Andrew D. Vigotsky
- Departments of Biomedical Engineering and Statistics, Evanston, IL, USA
- Department of Neuroscience, Northwestern University, Chicago, IL, USA
| | | | - Emma Breeze
- School of Kinesiology, Auburn University, Auburn, AL, USA
| | - Rachel Ubrik
- School of Kinesiology, Auburn University, Auburn, AL, USA
| | - Cole Robitzsch
- School of Kinesiology, Auburn University, Auburn, AL, USA
| | | | | | - J. Max Michel
- School of Kinesiology, Auburn University, Auburn, AL, USA
| | | | | | | | | | - Adil Bashir
- MRI Research Center, Auburn University, Auburn AL, USA
| | | | - Menno Henselmans
- International Scientific Research Foundation for Fitness and Nutrition, Amsterdam, Netherlands
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14
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Lanng SK, Oxfeldt M, Pedersen SS, Johansen FT, Risikesan J, Lejel T, Bertram HC, Hansen M. Influence of protein source (cricket, pea, whey) on amino acid bioavailability and activation of the mTORC1 signaling pathway after resistance exercise in healthy young males. Eur J Nutr 2023; 62:1295-1308. [PMID: 36536114 DOI: 10.1007/s00394-022-03071-y] [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: 03/15/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE New dietary proteins are currently introduced to replace traditional animal protein sources. However, not much is known about their bioaccessibility and ability to stimulate muscle protein synthesis compared to the traditional protein sources. We aimed to compare effects of ingesting a protein bolus (0.25 g/kg fat free mass) of either cricket (insect), pea, or whey protein on circulating amino acid levels and activation of the mTORC1 signaling pathway in the skeletal muscle at rest and after exercise. METHODS In a randomized parallel controlled trial, young males (n = 50) performed a one-legged resistance exercise followed by ingestion of one of the three protein sources. Blood samples were collected before and in the following 4 h after exercise. Muscle biopsies were obtained at baseline and after 3 h from the non-exercised and exercised leg. RESULTS Analysis of blood serum showed a significantly higher concentration of amino acids after ingestion of whey protein compared to cricket and pea protein. No difference between protein sources in activation of the mTORC1 signaling pathway was observed either at rest or after exercise. CONCLUSION Amino acid blood concentration after protein ingestion was higher for whey than pea and cricket protein, whereas activation of mTORC1 signaling pathway at rest and after exercise did not differ between protein sources. TRIAL REGISTRATION NUMBER Clinicaltrials.org ID NCT04633694.
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Affiliation(s)
- Sofie Kaas Lanng
- Department of Food Science, Aarhus University, 8200, Aarhus N, Denmark
- CiFOOD, Centre for Innovative Food Research, Aarhus University, 8200, Aarhus N, Denmark
| | - Mikkel Oxfeldt
- Department of Public Health, Aarhus University, 8000, Aarhus C, Denmark
| | | | | | - Jeyanthini Risikesan
- Department of Clinical Medicine, Diabetes and Hormones Diseases, Aarhus University Hospital, 8200, Aarhus N, Denmark
| | - Trine Lejel
- Department of Clinical Medicine, Regional Hospital Horsens, 8700, Horsens, Denmark
| | - Hanne Christine Bertram
- Department of Food Science, Aarhus University, 8200, Aarhus N, Denmark.
- CiFOOD, Centre for Innovative Food Research, Aarhus University, 8200, Aarhus N, Denmark.
| | - Mette Hansen
- Department of Public Health, Aarhus University, 8000, Aarhus C, Denmark
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15
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Dam TV, Dalgaard LB, Johansen FT, Bengtsen MB, Mose M, Lauritsen KM, Gravholt CH, Hansen M. Effects of transdermal estrogen therapy on satellite cell number and molecular markers for muscle hypertrophy in response to resistance training in early postmenopausal women. Eur J Appl Physiol 2023; 123:667-681. [PMID: 36585491 DOI: 10.1007/s00421-022-05093-0] [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: 10/06/2021] [Accepted: 03/31/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE To investigate the effects of resistance training with or without transdermal estrogen therapy (ET) on satellite cell (SC) number and molecular markers for muscle hypertrophy in early postmenopausal women. METHODS Using a double-blinded randomized controlled design, we allocated healthy, untrained postmenopausal women to perform 12 weeks of resistance training with placebo (PLC, n = 16) or ET (n = 15). Muscle biopsies obtained before and after the intervention, and two hours after the last training session were analyzed for fiber type, SC number and molecular markers for muscle hypertrophy and degradation (real-time PCR, western blotting). RESULTS The analysis of SCs per Type I fiber showed a time x treatment interaction caused by a 47% decrease in PLC, and a 26% increase after ET after the training period. Also, SCs per Type II fiber area was lower after the intervention driven by a 57% decrease in PLC. Most molecular markers changed similarly in the two groups. CONCLUSION A decline in SC per muscle fiber was observed after the 12-week training period in postmenopausal women, which was counteracted when combined with use of transdermal ET. CLINICAL TRIAL REGISTRATION NUMBER nct03020953.
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Affiliation(s)
- Tine Vrist Dam
- Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000, Aarhus C, Denmark
| | - Line Barner Dalgaard
- Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000, Aarhus C, Denmark
| | - Frank Ted Johansen
- Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000, Aarhus C, Denmark
| | - Mads Bisgaard Bengtsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Maike Mose
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Katrine Meyer Lauritsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Claus H Gravholt
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Hansen
- Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000, Aarhus C, Denmark.
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16
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Duggan JD, Keane K, Moody J, Byrne PJ, Malone S, Collins K, Ryan L. Strength and Conditioning Recommendations for Female Athletes: The Gaelic Footballer. Strength Cond J 2023. [DOI: 10.1519/ssc.0000000000000761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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17
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Römer C, Czupajllo J, Wolfarth B, Lerchbaumer MH, Legerlotz K. Effects of orally administered hormonal contraceptives on the musculoskeletal system of healthy premenopausal women—A systematic review. Health Sci Rep 2022; 5:e776. [PMID: 35957969 PMCID: PMC9364327 DOI: 10.1002/hsr2.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 07/12/2022] [Accepted: 07/17/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction The musculoskeletal system (MSK) is one of the extragonadal target tissues of sex hormones: osteoblasts and osteocytes express estrogen receptors, while in fibroblasts of the anterior cruciate ligament (ACL) and myocytes of the vastus lateralis muscle (MVL), estrogen and progesterone receptors can be detected by immunoassay. Indeed, upon binding of sex hormones to the extragonadal receptors, the MSK seems to respond to varying levels of sex hormones with structural adaptation. Hormonal contraceptives can affect the musculoskeletal system; however, there is a lack of high‐quality studies, and no recommendation for female athletes exists. Material and Methods This is a systematic review of publications on the effects of oral hormonal contraceptives on the biomechanical properties of tendons, muscles and ligaments, muscle strength, and soft tissue regeneration. A systematic database search was performed using MESH keywords and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) methodology in Pubmed and Cochrane to identify studies investigating the influence of oral hormonal contraceptives on muscles, tendons, and ligaments of healthy, adult, premenopausal women. The risk of bias in the studies included was assessed by two independent researchers using the ROBINS‐I Tool. Results Nine comparative studies were identified that met the inclusion criteria. Endpoints were muscle strength and biomechanical tissue properties. No significant influence of oral hormonal contraceptives on muscle strength was found, although general muscle growth and Type I fiber growth were found to be significantly increased in a dose‐dependent manner. There was a negative effect on regeneration of muscle strength after exercise. The stiffness of tendons remained unchanged, while their size adaptation to load increased. Conclusion The anabolic effect could be beneficial for specific sports, whereas reduced muscle regeneration could be disadvantageous for women exercising with high‐performance demands. The different effects on tendons and ligaments and the functional consequences of altered ligament and muscle stiffness, especially with regard to synthetic hormones, should be further investigated.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité—University Medicine Berlin Humboldt‐University of Berlin Berlin Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité—University Medicine Berlin Humboldt‐University of Berlin Berlin Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité—University Medicine Berlin Humboldt‐University of Berlin Berlin Germany
| | - Markus H. Lerchbaumer
- Department of Radiology Charité—University Medicine Berlin, Humboldt‐University of Berlin Berlin Germany
| | - Kirsten Legerlotz
- Movement Biomechanics, Institute of Sport Sciences Humboldt‐University of Berlin Berlin Germany
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18
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Abou Sawan S, Hodson N, Malowany JM, West DWD, Tinline-Goodfellow C, Brook MS, Smith K, Atherton PJ, Kumbhare D, Moore DR. Trained Integrated Postexercise Myofibrillar Protein Synthesis Rates Correlate with Hypertrophy in Young Males and Females. Med Sci Sports Exerc 2022; 54:953-964. [PMID: 35081094 DOI: 10.1249/mss.0000000000002878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Resistance training induces skeletal muscle hypertrophy via the summated effects of postexercise elevations in myofibrillar protein synthesis (MyoPS) that persist for up to 48 h, although research in females is currently lacking. MyoPS is regulated by mTOR translocation and colocalization; however, the effects of resistance training on these intracellular processes are unknown. We hypothesized that MyoPS would correlate with hypertrophy only after training in both sexes and would be associated with intracellular redistribution of mTOR. METHODS Recreationally active males and females (n = 10 each) underwent 8 wk of whole-body resistance exercise three times a week. Fasted muscle biopsies were obtained immediately before (REST) and 24 and 48 h after acute resistance exercise in the untrained (UT) and trained (T) states to determine integrated MyoPS over 48 h (D2O ingestion) and intracellular mTOR colocalization (immunofluorescence microscopy). RESULTS Training increased (P < 0.01) muscle strength (~20%-126%), muscle thickness (~8%-11%), and average fiber cross-sectional area (~15%-20%). MyoPS increased above REST in UT (P = 0.032) and T (P < 0.01), but to a greater extent in males (~23%; P = 0.023), and was positively (P < 0.01) associated with muscle thickness and fiber cross-sectional area at T only in both males and females. mTOR colocalization with the cell periphery increased (P < 0.01) in T, irrespective of sex or acute exercise. Training increased (P ≤ 0.043) total mTOR, LAMP2 (lysosomal marker), and their colocalization (P < 0.01), although their colocalization was greater in males at 24 and 48 h independent of training status (P < 0.01). CONCLUSIONS MyoPS during prolonged recovery from exercise is greater in males but related to muscle hypertrophy regardless of sex only in the trained state, which may be underpinned by altered mTOR localization.
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Affiliation(s)
- Sidney Abou Sawan
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, CANADA
| | - Nathan Hodson
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, CANADA
| | - Julia M Malowany
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, CANADA
| | | | | | - Matthew S Brook
- School of Life Sciences, University of Nottingham, Nottingham, UNITED KINGDOM
| | - Kenneth Smith
- School of Medicine, University of Nottingham, Derby Medical School, Derby, UNITED KINGDOM
| | - Philip J Atherton
- School of Medicine, University of Nottingham, Derby Medical School, Derby, UNITED KINGDOM
| | | | - Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, CANADA
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19
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Sung ES, Han A, Hinrichs T, Vorgerd M, Platen P. Effects of oral contraceptive use on muscle strength, muscle thickness, and fiber size and composition in young women undergoing 12 weeks of strength training: a cohort study. BMC Womens Health 2022; 22:150. [PMID: 35538569 PMCID: PMC9092708 DOI: 10.1186/s12905-022-01740-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background It is suspected that hormonal fluctuations during menstruation may cause different responses to strength training in women who use oral contraceptives (OC) versus those who do not. However, previous studies that investigated the existence of such differences produced conflicting results. In this study, we hypothesized that OC use has no effect on muscle strength and hypertrophy among women undergoing strength training. Thus, we compared the differences in muscle strength and thickness among women who used OCs and those who did not. Methods We investigated the influence of OC use on muscle strength (Fmax), muscle thickness (Mtk), type 1-to-type 2 muscle fiber (NO) ratio, muscle fiber thickness (MFT), and nuclear-to-fiber (N/F) ratio. Seventy-four healthy young women (including 34 who used OCs and 40 who did not) underwent 12 weeks of submaximal strength training, after which Fmax was evaluated using a leg-press machine with a combined force and load cell, while Mtk was measured using real-time ultrasonography. Moreover, the NO ratio, MFT, and N/F ratio were evaluated using muscle needle biopsies. Results Participants in the non-OC and OC groups experienced increases in Fmax (+ 23.30 ± 10.82 kg and + 28.02 ± 11.50 kg respectively, p = 0.073), Mtk (+ 0.48 ± 0.47 cm2 and + 0.50 ± 0.44 cm2 respectively, p = 0.888), Fmax/Mtk (+ 2.78 ± 1.93 kg/cm2 and + 3.32 ± 2.37 kg/cm2 respectively, p = 0.285), NO ratio (type 2 fibers: + 1.86 ± 6.49% and − 4.17 ± 9.48% respectively, p = 0.169), MFT (type 2 fibers: + 7.15 ± 7.50 µm and + 4.07 ± 9.30 µm respectively, p = 0.435), and N/F ratio (+ 0.61 ± 1.02 and + 0.15 ± 0.97 respectively, p = 0.866) after training. There were no significant differences between the non-OC and OC groups in any of these parameters (p > 0.05). Conclusions The effects of 12 weeks of strength training on Fmax, muscle thickness, muscle fiber size, and composition were similar in young women irrespective of their OC use.
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Affiliation(s)
- Eun-Sook Sung
- Department of Physical Education, Korea University, Seoul, Republic of Korea.,Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr-University Bochum, Gesundheitscampus Nord, Haus 10, 44801, Bochum, Germany
| | - Ahreum Han
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr-University Bochum, Gesundheitscampus Nord, Haus 10, 44801, Bochum, Germany
| | - Timo Hinrichs
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr-University Bochum, Gesundheitscampus Nord, Haus 10, 44801, Bochum, Germany.,Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Matthias Vorgerd
- Department of Neurology, Kliniken Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr-University Bochum, Gesundheitscampus Nord, Haus 10, 44801, Bochum, Germany.
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Kissow J, Jacobsen KJ, Gunnarsson TP, Jessen S, Hostrup M. Effects of Follicular and Luteal Phase-Based Menstrual Cycle Resistance Training on Muscle Strength and Mass. Sports Med 2022; 52:2813-2819. [PMID: 35471634 DOI: 10.1007/s40279-022-01679-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2022] [Indexed: 11/30/2022]
Abstract
There is an increasing interest in female athletic performance-especially concerning the impact of the female menstrual cycle on training response. Indeed, fluctuations in female sex hormones, estrogen and progesterone, during the menstrual cycle regulate protein metabolism and recovery processes in skeletal muscle and may thus impact exercise training-related outcomes. Studies demonstrate that anaerobic capacity and muscle strength are greatest during the follicular phase of the menstrual cycle, when estrogen levels peak. In addition, studies indicate that resistance training conducted in the follicular phase of the menstrual cycle (follicular phase-based resistance training) may be superior to luteal phase-based training in terms of enhancing muscle strength and mass. This raises the possibility that the physiological capabilities of skeletal muscle to adapt to exercise training are dependent on the menstrual cycle and can be important for female athletes in optimizing their training. In this paper, we critically review the current state of the art concerning the impact of menstrual cycle phase-based resistance training and highlight why follicular phase-based resistance training possibly is superior to luteal phase-based training in enhancing resistance training outcomes. Finally, we identify directions for further research.
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Affiliation(s)
- Julie Kissow
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark
| | - Kamine J Jacobsen
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark
| | - Thomas P Gunnarsson
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark
| | - Søren Jessen
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark
| | - Morten Hostrup
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh Building 2nd floor, Universitetsparken 13, 2100, Copenhagen, Denmark.
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21
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Oxfeldt M, Dalgaard LB, Farup J, Hansen M. Sex Hormones and Satellite Cell Regulation in Women. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:9065923. [PMID: 38655160 PMCID: PMC11022763 DOI: 10.1155/2022/9065923] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/17/2022] [Accepted: 03/02/2022] [Indexed: 04/26/2024]
Abstract
Recent years have seen growing scholarly interest in female physiology in general. Moreover, particular attention has been devoted to how concentrations of female sex hormones vary during the menstrual cycle and menopausal transition and how hormonal contraception and hormonal therapy influence skeletal muscle tissue. While much effort has been paid to macro outcomes, such as muscle function or mass, rather less attention has been paid to mechanistic work that may help explain the underlying mechanism through which sex hormones regulate skeletal muscle tissue. Evidence from animal studies shows a strong relationship between the female sex hormone estrogen and satellite cells (SCs), a population of muscle stem cells involved in skeletal muscle regulation. A few human studies investigating this relationship have been published only recently. Thus, the purpose of this study was to bring an updated review on female sex hormones and their role in SC regulation. First, we describe how SCs regulate skeletal muscle maintenance and repair and introduce sex hormone signaling within the muscle. Second, we present evidence from animal studies elucidating how estrogen deficiency and supplementation influence SCs. Third, we present results from investigations from human trials including women whose concentrations of female hormones differ due to menopause, hormone therapy, hormonal contraceptives, and the menstrual cycle. Finally, we discuss research and methodological recommendations for future studies aiming at elucidating the link between female sex hormones and SCs with respect to aging and training.
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Affiliation(s)
- Mikkel Oxfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Jean Farup
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Hansen
- Department of Public Health, Aarhus University, Aarhus, Denmark
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22
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Active Women Across the Lifespan: Nutritional Ingredients to Support Health and Wellness. Sports Med 2022; 52:101-117. [PMID: 36173598 PMCID: PMC9521557 DOI: 10.1007/s40279-022-01755-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
Women are the largest consumers of dietary supplements. Dietary supplements can play a role in health and performance, particularly for women. Growing evidence and innovations support the unique physiological and nutrient timing needs for women. Despite the need for more nutrition and exercise-specific research in women, initial data and known physiological differences between sexes related to the brain, respiration, bone, and muscle support new product development and evidence-based education for active women regarding the use of dietary supplements. In this narrative review, we discuss hormonal and metabolic considerations with the potential to impact nutritional recommendations for active women. We propose four potential areas of opportunity for ingredients to help support the health and well-being of active women, including: (1) body composition, (2) energy/fatigue, (3) mental health, and (4) physical health.
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23
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Šarabon N, Kozinc Ž, Perman M. Establishing Reference Values for Isometric Knee Extension and Flexion Strength. Front Physiol 2021; 12:767941. [PMID: 34721087 PMCID: PMC8554160 DOI: 10.3389/fphys.2021.767941] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/24/2021] [Indexed: 01/23/2023] Open
Abstract
Single-joint isometric and isokinetic knee strength assessment plays an important role in strength and conditioning, physical therapy, and rehabilitation. The literature, however, lacks absolute reference values. We systematically reviewed the available studies that assessed isometric knee strength. Two scientific databases (PubMed and PEDro) were searched for the papers that are published from the inception of the field to the end of 2019. We included studies that involved participants of both genders and different age groups, regardless of the study design, that involved isometric knee extension and/or flexion measurement. The extracted data were converted to body-mass-normalized values. Moreover, the data were grouped according to the knee angle condition (extended, mid-range, and flexed). A meta-analysis was performed on 13,893 participants from 411 studies. In adult healthy males, the pooled 95% confidence intervals (CI) for knee extension were 1.34–2.23Nm/kg for extended knee angle, 2.92–3.45Nm/kg for mid-range knee angle, and 2.50–3.06Nm/kg for flexed knee angle, while the CIs for flexion were 0.85–1.20, 1.15–1.62, and 0.96–1.54Nm/kg, respectively. Adult females consistently showed lower strength than adult male subgroups (e.g., the CIs for knee extension were 1.01–1.50, 2.08–2.74, and 2.04–2.71Nm/kg for extended, mid-range, and flexed knee angle condition). Older adults consistently showed lower values than adults (e.g., pooled CIs for mid-range knee angle were 1.74–2.16Nm/kg (male) and 1.40–1.64Nm/kg (female) for extension, and 0.69–0.89Nm/kg (male) and 0.46–0.81Nm/kg (female) for flexion). Reliable normative for athletes could not be calculated due to limited number of studies for individual sports.
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Affiliation(s)
- Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia.,Human Health Department, InnoRenew CoE, Izola, Slovenia.,Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., Ljubljana, Slovenia
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Mihael Perman
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Koper, Slovenia.,Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia
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24
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Randell RK, Clifford T, Drust B, Moss SL, Unnithan VB, De Ste Croix MBA, Datson N, Martin D, Mayho H, Carter JM, Rollo I. Physiological Characteristics of Female Soccer Players and Health and Performance Considerations: A Narrative Review. Sports Med 2021; 51:1377-1399. [PMID: 33844195 PMCID: PMC8222040 DOI: 10.1007/s40279-021-01458-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 12/18/2022]
Abstract
Female soccer has seen a substantial rise in participation, as well as increased financial support from governing bodies over the last decade. Thus, there is an onus on researchers and medical departments to develop a better understanding of the physical characteristics and demands, and the health and performance needs of female soccer players. In this review, we discuss the current research, as well as the knowledge gaps, of six major topics: physical demands, talent identification, body composition, injury risk and prevention, health and nutrition. Data on female talent identification are scarce, and future studies need to elucidate the influence of relative age and maturation selection across age groups. Regarding the physical demands, more research is needed on the pattern of high-intensity sprinting during matches and the contribution of soccer-specific movements. Injuries are not uncommon in female soccer players, but targeting intrinsically modifiable factors with injury prevention programmes can reduce injury rates. The anthropometric and physical characteristics of female players are heterogeneous and setting specific targets should be discouraged in youth and sub-elite players. Menstrual cycle phase may influence performance and injury risk; however, there are few studies in soccer players. Nutrition plays a critical role in health and performance and ensuring adequate energy intake remains a priority. Despite recent progress, there is considerably less research in female than male soccer players. Many gaps in our understanding of how best to develop and manage the health and performance of female soccer players remain.
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Affiliation(s)
- Rebecca K Randell
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK.
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Thomas Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Barry Drust
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Samantha L Moss
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
- Department of Sport and Exercise Sciences, University of Chester, Chester, UK
| | - Viswanath B Unnithan
- Institute of Clinical Exercise and Health Science, Division of Sport and Exercise, School of Health and Life Sciences, University of the West of Scotland, Hamilton, Scotland, UK
| | | | - Naomi Datson
- Institute of Sport, University of Chichester, Chichester, UK
| | - Daniel Martin
- School of Sport and Exercise Science, University of Lincoln, Lincoln, UK
| | - Hannah Mayho
- Sports Science Department, Manchester City Football Club, Manchester, UK
| | - James M Carter
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
| | - Ian Rollo
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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25
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Barakat M, Al-Qudah R, Akour A, Abu-Asal M, Thiab S, Dallal Bashi YH. Knowledge and beliefs about the use/abuse of oral contraceptive pills among males: A mixed-method explanatory sequential study in community pharmacy settings. PLoS One 2021; 16:e0251302. [PMID: 33961665 PMCID: PMC8104375 DOI: 10.1371/journal.pone.0251302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Oral contraceptive pills (OCPs) are considered one of the most important birth control methods globally. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists' observations. METHOD A mixed-method explanatory sequential study was conducted using an online self-administered survey, followed by semi-structured in-depth interviews for registered pharmacists, assistant pharmacists and pharmacy interns. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively. RESULTS A total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the participating pharmacists highlighted that males use OCPs mostly for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel). CONCLUSION This study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse. However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.
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Affiliation(s)
- Muna Barakat
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- * E-mail:
| | - Raja’a Al-Qudah
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Amal Akour
- Faculty of Pharmacy, Department of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Mona Abu-Asal
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Samar Thiab
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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26
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Wohlgemuth KJ, Arieta LR, Brewer GJ, Hoselton AL, Gould LM, Smith-Ryan AE. Sex differences and considerations for female specific nutritional strategies: a narrative review. J Int Soc Sports Nutr 2021; 18:27. [PMID: 33794937 PMCID: PMC8015182 DOI: 10.1186/s12970-021-00422-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/12/2021] [Indexed: 12/17/2022] Open
Abstract
Although there is a plethora of information available regarding the impact of nutrition on exercise performance, many recommendations are based on male needs due to the dominance of male participation in the nutrition and exercise science literature. Female participation in sport and exercise is prevalent, making it vital for guidelines to address the sex-specific nutritional needs. Female hormonal levels, such as estrogen and progesterone, fluctuate throughout the mensural cycle and lifecycle requiring more attention for effective nutritional considerations. Sex-specific nutritional recommendations and guidelines for the active female and female athlete have been lacking to date and warrant further consideration. This review provides a practical overview of key physiological and nutritional considerations for the active female. Available literature regarding sex-specific nutrition and dietary supplement guidelines for women has been synthesized, offering evidenced-based practical information that can be incorporated into the daily lives of women to improve performance, body composition, and overall health.
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Affiliation(s)
- Kealey J Wohlgemuth
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Luke R Arieta
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Gabrielle J Brewer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Andrew L Hoselton
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Lacey M Gould
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Nutrition, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA.
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Different Doses of Carbohydrate Mouth Rinse Have No Effect on Exercise Performance in Resistance Trained Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073463. [PMID: 33810470 PMCID: PMC8037125 DOI: 10.3390/ijerph18073463] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 01/19/2023]
Abstract
Carbohydrate (CHO) mouth rinse has been shown to enhance aerobic endurance performance. However, the effects of CHO mouth rinse on muscular strength and endurance are mixed and may be dependent on dosage of CHO. The primary purpose was to examine the effects of different dosages of CHO rinse on strength (bench press 1 repetition maximum [1-RM]) and muscular endurance (40% of 1-RM repetitions to failure) in female athletes. Sixteen resistance-trained females (age: 20 ± 1 years; height: 167 ± 3 cm; body mass: 67 ± 4 kg; BMI: 17 ± 2 kg/m2; resistance training experience: 2 ± 1 years) completed four conditions in random order. The four conditions consisted of a mouth rinse with 25 mL solutions containing either 6% of CHO (Low dose of CHO: LCHO), 12% CHO (Moderate dose of CHO: MCHO), 18% CHO (High dose of CHO: HCHO) or water (Placebo: PLA) for 10 s prior to a bench press strength and muscular endurance test. Maximal strength (1-RM), muscular endurance (reps and total volume), heart rate (HR), ratings of perceived exertion (RPE) and glucose (GLU) were recorded each condition. There were no significant differences in strength (p = 0.95) or muscular endurance (total repetitions: p = 0.06; total volume: p = 0.20) between conditions. Similarly, HR (p = 0.69), RPE (p = 0.09) and GLU (p = 0.92) did not differ between conditions. In conclusion, various doses of CHO mouth rinse (6%, 12% and 18%) have no effect on upper body muscular strength or muscular endurance in female athletes.
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28
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Bidirectional Interactions between the Menstrual Cycle, Exercise Training, and Macronutrient Intake in Women: A Review. Nutrients 2021; 13:nu13020438. [PMID: 33572821 PMCID: PMC7910908 DOI: 10.3390/nu13020438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/08/2023] Open
Abstract
Women have a number of specificities that differentiate them from men. In particular, the role of sex steroid hormones and the menstrual cycle (MC) significantly impact women’s physiology. The literature has shown nonlinear relationships between MC, exercise, and nutritional intake. Notably, these relationships are bidirectional and less straightforward than one would suppose. For example, the theoretical implications of the MC’s phases on exercise performance do not always translate into relevant practical effects. There is often a disconnect between internal measures (e.g., levels of hormone concentrations) and external performance. Furthermore, it is not entirely clear how nutritional intake varies across the MC’s phases and whether these variations impact on exercise performance. Therefore, a thorough review of the existing knowledge could help in framing these complex relationships and potentially contribute to the optimization of exercise prescription and nutritional intake according to the naturally occurring phases of the MC. Throughout this review, an emerging trend is the lack of generalizability and the need to individualize interventions, since the consequences of the MC’s phases and their relationships with exercise and nutritional intake seem to vary greatly from person to person. In this sense, average data are probably not relevant and could potentially be misleading.
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29
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Oxfeldt M, Dalgaard LB, Jørgensen EB, Johansen FT, Dalgaard EB, Ørtenblad N, Hansen M. Molecular markers of skeletal muscle hypertrophy following 10 wk of resistance training in oral contraceptive users and nonusers. J Appl Physiol (1985) 2020; 129:1355-1364. [PMID: 33054662 DOI: 10.1152/japplphysiol.00562.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The objective was to determine whether skeletal muscle molecular markers and SC number were influenced differently in users and nonusers of oral contraceptives (OCs) following 10 wk of resistance training. Thirty-eight young healthy untrained users (n = 20) and nonusers of OC (n = 18) completed a 10-wk supervised progressive resistance training program. Before and after the intervention, a muscle tissue sample was obtained from the vastus lateralis muscle for analysis of muscle fiber cross-sectional area (fCSA) and satellite cell (SC) and myonuclei number using immunohistochemistry, gene expression using PCR, protein expression, and myosin heavy chain composition. Following the training period, quadriceps fCSA (P < 0.05), SCs/type I fiber (P = 0.05), and MURF-1 mRNA (P < 0.01) were significantly increased with no difference between the groups. However, SCs/total fiber and SCs/type II fiber increased in OC users only, and SCs/type II fCSA tended (P = 0.055) to be greater in the OC users. Furthermore, in OC users there were a fiber type shift from myosin heavy chain (MHC) IIx to MHC IIa (P < 0.01), and expression of muscle regulatory factor 4 (MRF4) mRNA (P < 0.001) was significantly greater than in non-OC users. Use of second-generation OCs in young untrained women increased skeletal muscle MRF4 expression and SC number following 10 wk of resistance training compared with nonusers.NEW & NOTEWORTHY The effect of oral contraceptive use on the skeletal muscle regulatory pathways in response to resistance training has not been investigated previously. Here we present novel data, demonstrating that use of second-generation oral contraceptives in young untrained women increased skeletal muscle regulatory factor 4 expression and satellite cell number following 10 wk of resistance training compared with nonusers.
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Affiliation(s)
- Mikkel Oxfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | | | | | - Emil Barner Dalgaard
- Department of Clinical Medicine, Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mette Hansen
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Mercer D, Convit L, Condo D, Carr AJ, Hamilton DL, Slater G, Snipe RMJ. Protein Requirements of Pre-Menopausal Female Athletes: Systematic Literature Review. Nutrients 2020; 12:E3527. [PMID: 33207749 PMCID: PMC7696053 DOI: 10.3390/nu12113527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 12/23/2022] Open
Abstract
This systematic literature review aimed to determine the protein requirements of pre-menopausal (e.g., 18-45 years) female athletes and identify if the menstrual cycle phase and/or hormonal contraceptive use influence protein requirements. Four databases were searched for original research containing pre-menopausal female athletes that ingested protein alongside exercise. The Academy of Nutrition and Dietetics Quality Criteria Checklist was used to determine study quality. Fourteen studies, which included 204 recreationally active or competitive females, met the eligibility criteria for inclusion in this review, and all were assessed as positive quality. The estimated average requirement (EAR) for protein intake of pre-menopausal recreational and/or competitive female athletes is similar for those undertaking aerobic endurance (1.28-1.63 g/kg/day), resistance (1.49 g/kg/day) and intermittent exercise (1.41 g/kg/day) of ~60-90 min duration. The optimal acute protein intake and influence of menstrual cycle phase or hormonal contraceptive use on protein requirements could not be determined. However, pre- and post-exercise protein intakes of 0.32-0.38 g/kg have demonstrated beneficial physiological responses in recreational and competitive female athletes completing resistance and intermittent exercise. The protein requirements outlined in this review can be used for planning and assessing protein intakes of recreational and competitive pre-menopausal female athletes.
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Affiliation(s)
- Drew Mercer
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
| | - Lilia Convit
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
| | - Dominique Condo
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
| | - Amelia J. Carr
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
| | - D. Lee Hamilton
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Victoria, Australia;
| | - Gary Slater
- School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore 4558, Queensland, Australia;
| | - Rhiannon M. J. Snipe
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
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31
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Dalgaard LB, Jørgensen EB, Oxfeldt M, Dalgaard EB, Johansen FT, Karlsson M, Ringgaard S, Hansen M. Influence of Second Generation Oral Contraceptive Use on Adaptations to Resistance Training in Young Untrained Women. J Strength Cond Res 2020; 36:1801-1809. [PMID: 32694286 DOI: 10.1519/jsc.0000000000003735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dalgaard, LB, Jørgensen, EB, Oxfeldt, M, Dalgaard, EB, Johansen, FT, Karlsson, M, Ringgaard, S, and Hansen, M. Influence of second generation oral contraceptive use on adaptations to resistance training in young untrained women. J Strength Cond Res XX(X): 000-000, 2020-The study purpose was to determine effects of using second generation oral contraceptives (OC) on muscle adaptations to resistance training in young untrained women. Twenty users and 18 nonusers of OC completed a 10-week supervised progressive resistance training program. Before and after the intervention, muscle cross-sectional area (mCSA) of the quadriceps was measured using magnetic resonance imaging and muscle fiber CSA (fCSA) was determined by immunohistochemistry. In addition, body composition (DXA, fat mass/fat-free mass), maximal isometric muscle strength (dynamometry), 5 repetition maximum (5RM) leg press strength, counter movement jump (CMJ) height, and average power using a modified Wingate test were determined. Serum hormone analysis ensured OC compliance and 4-day food records documented dietary intake. After the training period, quadriceps mCSA (OC: 11.0 ± 6.0% vs. non-OC: 9.2 ± 5.0%, p = 0.001), type II fCSA (OC: 19.9 ± 7.9% vs. non-OC: 16.6 ± 7.2%, p = 0.05), muscle strength (knee extension, knee flexion and 5RM, p < 0.001), and functional power (CMJ, AP, p < 0.001) were significantly increased with no significant difference between the groups. However, a tendency toward a greater increase in fat-free mass (FFM) in the OC group was observed (OC: 3.7 ± 3.8% vs. non-OC: 2.7 ± 3.5%, p = 0.08). Collectively, use of second generation OCs in young untrained women did not significantly improve adaptations to 10 weeks of resistance training compared with nonusers. The trend toward greater gains in FFM in the OC group warrant future studies.
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Affiliation(s)
- Line B Dalgaard
- 1Department of Public Health, Aarhus University, Aarhus C, Denmark; 2Department of Clinical Medicine, Diagnostic Center, Silkeborg Regional Hospital, Silkeborg, Denmark; 3Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark; and 4The MR Research Center, Aarhus University, Aarhus N, Denmark
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Role of Menopausal Transition and Physical Activity in Loss of Lean and Muscle Mass: A Follow-Up Study in Middle-Aged Finnish Women. J Clin Med 2020; 9:jcm9051588. [PMID: 32456169 PMCID: PMC7290663 DOI: 10.3390/jcm9051588] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 12/13/2022] Open
Abstract
In midlife, women experience hormonal changes due to menopausal transition. A decrease especially in estradiol has been hypothesized to cause loss of muscle mass. This study investigated the effect of menopausal transition on changes in lean and muscle mass, from the total body to the muscle fiber level, among 47–55-year-old women. Data were used from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, where 234 women were followed from perimenopause to early postmenopause. Hormone levels (estradiol and follicle stimulating hormone), total and regional body composition (dual-energy X-ray absorptiometry (DXA) and computed tomography (CT) scans), physical activity level (self-reported and accelerometer-measured) and muscle fiber properties (muscle biopsy) were assessed at baseline and at early postmenopause. Significant decreases were seen in lean body mass (LBM), lean body mass index (LBMI), appendicular lean mass (ALM), appendicular lean mass index (ALMI), leg lean mass and thigh muscle cross-sectional area (CSA). Menopausal status was a significant predictor for all tested muscle mass variables, while physical activity was an additional significant contributor for LBM, ALM, ALMI, leg lean mass and relative muscle CSA. Menopausal transition was associated with loss of muscle mass at multiple anatomical levels, while physical activity was beneficial for the maintenance of skeletal muscle mass.
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Thompson B, Almarjawi A, Sculley D, Janse de Jonge X. The Effect of the Menstrual Cycle and Oral Contraceptives on Acute Responses and Chronic Adaptations to Resistance Training: A Systematic Review of the Literature. Sports Med 2020; 50:171-185. [PMID: 31677121 DOI: 10.1007/s40279-019-01219-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Resistance training is well known to increase strength and lean body mass, and plays a key role in many female athletic and recreational training programs. Most females train throughout their reproductive years when they are exposed to continuously changing female steroid hormone profiles due to the menstrual cycle or contraceptive use. Therefore, it is important to focus on how female hormones may affect resistance training responses. OBJECTIVE The aim of this systematic review is to identify and critically appraise current studies on the effect of the menstrual cycle and oral contraceptives on responses to resistance training. METHODS The electronic databases Embase, PubMed, SPORTDiscus and Web of Science were searched using a comprehensive list of relevant terms. Studies that investigated the effect of the menstrual cycle phase or oral contraceptive cycle on resistance training responses were included. Studies were also included if they compared resistance training responses between the natural menstrual cycle and oral contraceptive use, or if resistance training was adapted to the menstrual cycle phase or oral contraceptive phase. Studies were critically appraised with the McMasters Universities Critical Review Form for Quantitative Studies and relevant data were extracted. RESULTS Of 2007 articles found, 17 studies met the criteria and were included in this systematic review. The 17 included studies had a total of 418 participants with an age range of 18-38 years. One of the 17 studies found no significant differences in acute responses to a resistance training session over the natural menstrual cycle, while four studies did find changes. When assessing the differences in acute responses between the oral contraceptive and menstrual cycle groups, two studies reported oral contraceptives to have a positive influence, whilst four studies reported that oral contraceptive users had a delayed recovery, higher levels of markers of muscle damage, or both. For the responses to a resistance training program, three studies reported follicular phase-based training to be superior to luteal phase-based training or regular training, while one study reported no differences. In addition, one study reported no differences in strength development between oral contraceptive and menstrual cycle groups. One further study reported a greater increase in type I muscle fibre area and a trend toward a greater increase in muscle mass within low-androgenic oral contraceptive users compared with participants not taking hormonal contraceptives. Finally, one study investigated androgenicity of oral contraceptives and showed greater strength developments with high androgenic compared with anti-androgenic oral contraceptive use. CONCLUSIONS The reviewed articles reported conflicting findings, and were often limited by small participant numbers and methodological issues, but do appear to suggest female hormones may affect resistance training responses. The findings of this review highlight the need for further experimental studies on the effects of the menstrual cycle and oral contraceptives on acute and chronic responses to resistance training.
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Affiliation(s)
- Belinda Thompson
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia
| | - Ashley Almarjawi
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia
| | - Dean Sculley
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia
| | - Xanne Janse de Jonge
- School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, PO Box 127, Ourimbah, NSW, 2258, Australia.
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