Gender Differences in Chronic Hormonal and Immunological Responses to CrossFit®

Do Men and Women Differ in Hematological Adaptations to 24 Weeks of Crossfit® Training?

Regular exercise can modulate the immune system functioning through changes in the number and function of leukocytes as well as in red blood cells and other typical blood markers. High intensity exercise promotes increases in cytotoxic activity, phagocytic capacity, chemotaxis and cell apoptosis. The aim of the study was to compare the chronic effects of a 24-week training program using CrossFit® methodology on hematological variables of men vs. women. Twenty-nine CrossFit® athletes (35.3 ± 10.4 years, 175.0 ± 9.2 cm, 79.5 ± 16.4 kg) participated in the study. The blood count, the lipid profile and glucose markers were measured every two months during the study period. The erythrocyte count and hemoglobin concentrations increased in months 4 and 6 in men and women, respectively. Hematocrit levels increased in men in months 2, 4 and 6, while in women only in month 6. Red cell distribution width increased in men in month 6 when compared to the value in month 2. Segmented neutrophils increased in men in month 6 and eosinophil levels increased in women in month 6. Differences between the two sexes were observed in monocytes levels at baseline, as well as in months 2, 4 and 6. Cross-Fit® training increased red cell count indicators in both sexes, which may be related to increased erythropoiesis. Some white blood cell counts were altered and these differed between sexes. The number of lymphocytes remained stable throughout the experiment.

Risk Factors for Injury in CrossFit®-A Retrospective Analysis

CrossFit^® is a physical activity program and sport which is based on functional movements performed at high intensity and with high variability of exercises. It develops all motor skills. The study included 424 athletes (266 men and 158 women) from twelve centers in Poland, actively practicing CrossFit^® between 18 and 60 years of age. A questionnaire consisting of 25 questions was used, which was divided into four subsections concerning the characteristics of the sample, training routine, injuries, and information about environment. In total, 48% of respondents participating in the study suffered at least one injury during their entire training history. The injuries suffered most often involved shoulder joint and lumbar spine. Men were found to face a higher risk of injury than women, at 32.78% vs. 15.33% (p = 0.027). The shorter the training period, the smaller the number of injuries observed among the trainees. It was also noted that the shorter the training period, the lower the number of injuries that occurred (p = 0.041). An increase in the number of training sessions per week did not increase the incidence of injuries (p > 0.05). Performing isometric exercises during warm-up reduced the likelihood of injury during CrossFit^® training itself (p = 0.012). Training despite of concomitant acute pain had a significant adverse effect on the incidence of injuries (p = 0.002). The most common risk factors for injury in the CrossFit^® training process include, in particular: gender, training experience, and length of training sessions. Proper warm-up including isometric exercises and training conducted without accompanying pain symptoms reduces the risk of injury.

Joint and muscle injuries in men and women CrossFit® training participants

OBJECTIVE

Verify the incidence and rate of joint and muscle injuries with the practice of CrossFit® and the potential risk factors for injuries in men and women.

METHODS

A total of 184 CrossFit® participants (97 men and 87 women). A questionnaire was conducted based on characterization, training routine, injuries, and additional information. The incidence refers to the number of new cases of injury in the sample during the CrossFit® training. The injury rate was calculated by estimating the number of weekly training hours and converted into the number of injuries per 1000 training hours.

RESULTS

Among the participants, 38.6% reported some type of injury, being joint injuries (83.1%) and/or muscle injuries (45.1%). The injury rate was 3.4/1000 h, with men having a higher rate. The location of the joint injuries was shoulders, wrists, and elbows, in addition to the lumbar spine in women. As for muscle injuries, the deltoid, upper back muscles, and quadriceps femoris were the most reported in men and deltoid, trapezius, upper back muscles, and gastrocnemius in women.

CONCLUSIONS

A better understanding of the anatomical distribution of the injuries may help coaches prescribe the most adequate workout that may reduce the likelihood of injuries occurring in CrossFit® training participants. It was demonstrated that gender, experience, weekly frequency, and previous injuries are important factors, and professionals must be concerned with the assessment of the participants and with an individualized progression in order to avoid risks.

Effects of Training Loads on Stress Tolerance and Mucosal Immunity in High-Intensity Functional Fitness Athletes

Purpose: This study aimed to analyze the effects of training load on stress tolerance (ST) and secretory immunoglobulin A (SIgA) in male and female high-intensity functional fitness (HIFF) athletes during two different 10 and consecutive weekly training volume loads [higher (week 1) and lower volume (week 2)]. Methods: 14 athletes [7 males: 29.3 (±5.8) years; 86.3 (±8.2) kg and 176.8 (±3.8) cm and 7 females: 32.7 (±4.4) years; 60.0 (±6.7) kg and 162.5 (±5.9) cm] participated. The ST, assessed by Daily Analysis of Life Demand in Athletes questionnaire (DALDA) and Saliva sampling were performed in four time-points (pre (T1) and post (T2) week 1; pre (T3) and post (T4) week 2). Results: Female athletes showed a decrease in ST (symptoms of stress) from 15 T1 to T3 [F_(3,36) = 7.184, p˂ 0.001, ηp² = 0.374], without difference in male athletes (p > .05). There is a significant difference of SIgA concentration [F_(3.36) = 3.551; p = .024; ηp² = 0.228], with a significant decrease in female athletes group in T2 compared to T1 (p = .013) and T4 (p = .023). In addition, the different training volume loads did not impact mucosal immunity in male athletes (p > .05). Conclusion: The current findings suggest that higher HIFF volume results in decreased ST and SIgA concentration in female 20 athletes and a subsequent decrease in training volume loads contributed to restoring these variables.

Weighted vests in CrossFit increase physiological stress during walking and running without changes in spatiotemporal gait parameters

This study quantified the physiological and biomechanical effects of the 20 lb (9.07 kg, males) and 14 lb (6.35 kg, females) weighted vest used in CrossFit, and whether they were predisposed to injury. Twenty subjects (10 males, 10 females) undertook walking (0%, 5% and 10% gradient) and running trials in two randomised study visits (weighted vest/no weighted vest). Physiological demand during walking was increased with the vest at 10% but not 5% or 0% with no change in gait variables. In the running trial, the weighted vest increased oxygen uptake (males; females) (+0.22L/min, p < 0.01; +0.07 L/min, p < 0.05), heart rate (+11bpm, p < 0.01; +11bpm, p < 0.05), carbohydrate oxidation (+0.6 g/min, p < 0.001; +0.2 g/min, p < 0.01), and energy expenditure (+3.8 kJ/min, p < 0.001; +1.5 kJ/min, p < 0.05) whilst blood lactate was increased only in males (+0.6 mmol/L, p < 0.05). There was no change in stride length or frequency. Weighted vest training increases physiological stress and carbohydrate oxidation without affecting measured gait parameters. Practitioner summary: We examined the effect of weighted vest training prescribed in CrossFit (20 lb/9.07 kg, males and 14 lb/6.35 kg, females) in a randomised controlled trial. We found that physiological stress is increased in both sexes, although three-fold greater in males, but with no change in biomechanical gait that predisposes to lower-limb injury.

Comparison of Physiological Responses and Training Load between Different CrossFit® Workouts with Equalized Volume in Men and Women

The purpose of the present study was to compare the heart rate (HR), blood lactate and training load between different CrossFit^® workouts, with equalized total work volumes in men and women. The study included 23 individuals (13 men and 10 women) experienced in CrossFit^® training, who performed two workouts with different training types (as many reps as possible (AMRAP) and ‘for time’) but an equalized volume. Measurements of lactate, HR and rating of perceived exertion (RPE) were performed. The results show that there was no HR interaction between workout time and sex (p = 0.822; η² = 0.006) and between workout type and sex (p = 0.064, η² = 0.803). The HR significantly differed during each workout type (p < 0.001, η² = 0.621), but not between the two workout types (p = 0.552, η² = 0.017). Lactate showed no difference between the workout types (p = 0.474, η² = 0.768), although the training load was higher (p = 0.033, η² = 0.199) in women when they performed AMRAP. Altogether, the HR was not significantly different between training types or sex, while RPE, lactate and training load showed statistically significant differences depending on the group (women or men) or workout type (AMRAP or ‘for time’).

Evaluating the Clinical Utility of Daily Heart Rate Variability Assessment for Classifying Meaningful Change in Testosterone-to-Cortisol Ratio: A Preliminary Study

The study purpose was to determine the relationship of resting heart rate variability (HRV) and testosterone to cortisol (T:C) ratio, along with the diagnostic ability of HRV to assess changes in T:C ratio during a 9-week high-intensity functional training intervention. Eight recreationally-active men (n = 4, age 24.25 ± 1.75 yrs, height 181.25 ± 3.86 cm, weight 79.68 ± 11.66 kg) and women (n = 4, age 26 ± 3.6 yrs, height 164.25 ± 3.3, weight 73.4 ± 8.42) completed daily HRV measurements (HRVdaily) using photoplethysmography via a commercially-available smartphone application along with weekly saliva samples. Saliva samples were analyzed for concentrations of testosterone (T) and cortisol (C) via enzyme-linked immunosorbent assays. Upon study completion 72 data points were available, due to participant compliance and inadequate saliva sample, 67 matched pairs of HRV and T:C ratio were analyzed. A statistically significant negative relationship (n = 67, r = -.315, p < 0.05) was found between HRVdaily and saliva T:C ratio concentrations within aggregate data. Individual participant relationships showed considerable variability (r = -0.101 - 0.665, p = 0.103 to 0.829 The model which best explained the data resulted in AIC = 130.247 with factors HRVdaily (β = -0.218, 95%CI = -0.391, -0.044, t = -2.46, p < 0.05), Sex (β = 0.450, 95%CI = -0.214, 1.114, t = 1.113, p = 0.242), and Group (β = -0.394, 95%CI = -1.089, 0.302, t = -1.11, p = 0.311). Diagnostically, HRVdaily demonstrates excellent sensitivity (95%), but poor specificity (5%) for detecting meaningful changes in T:C ratio. Assessment of HRVdaily may be a clinically valid proxy measure for monitoring hormonal changes throughout a training intervention.

Acute leucocyte, muscle damage, and stress marker responses to high-intensity functional training

BACKGROUND

High-intensity functional training (HIFT) has become more popular, and the number of practitioners has increased; however, it remains unclear whether perturbations in the immune parameters occur, even after one single bout. Our aim was to examine acute leucocyte, muscle damage, and stress marker responses following a single 'Cindy' workout session, and compare the results between novice and experienced participants.

MATERIAL AND METHODS

Twenty-three HIFT practitioners (age 31.0 ± 1.0 years) completed the 'Cindy' workout. They were categorized as novice (3-8 months of experience; n = 10) and experienced (≥18 months; n = 13). White blood cell (WBC) count, plasma creatine kinase (CK) activity, blood cortisol level, and lactate concentration were measured. Blood analysis was performed before (pre-ex), immediately after (post-ex), 30 min after (post-30 min), and 24 h after (post-24 h) a single 'Cindy' workout session.

RESULTS

WBC count was higher post-ex (6.8 to 11.8x103/μL) and returned to baseline values within post-30 min (p<0.01). Neutrophil (3.3 to 4.5x103/μL) and lymphocyte levels (2.8 to 5.9x103/μL) were higher post-ex and returned to baseline values after post-24 h, yet lymphocytopoenia (2.2x103/μL) was observed at post-30 min (p<0.01). CK increased post-ex (174.9 to 226.7 U.L-1) and remained elevated post-24 h. Cortisol (14.7 to 17.0 μg/dL) and lactate (1.9 to 13.5 mmol.l-1) responses increased post-ex, but only the lactate level was reduced at post-30 min (p<0.01). The experienced participants had higher WBC, lymphocyte, and cortisol concentrations post-ex than the novice ones (p<0.01).

CONCLUSIONS

A single HIFT session elicited significant acute perturbations in WBC count, stress markers, and muscle tissue, which is like other similar regimens. Importantly, the experienced participants showed greater lymphocyte and cortisol responses than the novice ones.

CrossFit® Training Strategies from the Perspective of Concurrent Training: A Systematic Review

In the basic principles of CrossFit®, the goal is to improve fitness, related to the simultaneous development of strength and endurance. This is also the main idea of concurrent training, which has been researched since the 1980s. This article aimed to analyze the acute and chronic effects of CrossFit® and to assess the relevance of using the concurrent training methodology. The findings show that CrossFit® is an intense form of exercise that affects the function of the endocrine, immune, and central nervous systems. It also has potential in the development of strength and endurance parameters. These conclusions were compared with relevant concurrent training studies. Although the CrossFit® interventions (workouts of the day) have much in common with concurrent training, methodological recommendations can only be partially transferred. The approach for training and athlete development must be based on the originality of this sport.

Understanding the effects of beetroot juice intake on CrossFit performance by assessing hormonal, metabolic and mechanical response: a randomized, double-blind, crossover design

BACKGROUND

Acute beetroot juice (BJ) intake has shown to enhance aerobic and anaerobic performance. However, no studies have evaluated the effects of BJ intake on CrossFit (CF) performance by linking hormonal, metabolic, and mechanical responses. The purpose of this study was to determine the causal physiological association between hormonal, metabolic and mechanical responses, and CF workouts performance after acute BJ intake.

METHODS

Twelve well-trained male practitioners undertook a CF workout after drinking 140 mL of BJ (~ 12.8 mmol NO3-) or placebo. The two experimental conditions (BJ or placebo) were administered using a randomized, double-blind, crossover design. The CF workout consisted of repeating the same exercise routine twice: Wall ball (WB) shots plus full back squat (FBS) with 3-min rest (1st routine) or without rest (2nd routine) between the two exercises. A 3-min rest was established between the two exercise routines.

RESULTS

An interaction effect was observed in the number of repetitions performed (p = 0.04). The Bonferroni test determined a higher number of repetitions after BJ than placebo intake when a 3-min rest between WB and FBS (1st routine) was established (p = 0.007). An interaction effect was detected in cortisol response (p = 0.04). Cortisol showed a higher increase after BJ compared to placebo intake (76% vs. 36%, respectively). No interaction effect was observed in the testosterone and testosterone/cortisol ratio (p > 0.05). A significant interaction effect was found in oxygen saturation (p = 0.01). A greater oxygen saturation drop was observed in BJ compared to placebo (p <  0.05). An interaction effect was verified in muscular fatigue (p = 0.03) with a higher muscular fatigue being observed with BJ than placebo (p = 0.02).

CONCLUSIONS

BJ intake improved anaerobic performance only after the recovery time between exercises. This increase in performance in the first routine probably generated greater hypoxia in the muscle mass involved, possibly conditioning post-exercise performance. This was observed with a fall in oxygen saturation and in muscle fatigue measured at the end of the CF workout. The greatest perceived changes in cortisol levels after BJ intake could be attributed to the nitrate-nitrite-nitric oxide pathway.

Acute and Chronic Catabolic Responses to

Given the wide variety of conditioning program trainings employed, the present study compared the catabolic effects induced by CrossFit^® and resistance training in moderately trained subjects. Twenty males joined either the CrossFit^® group (n = 10; 30 min/day of “workout of the day”) or the resistance training (RT) group (n = 10; 30 min/day of resistance exercises) thrice a week, for 8 weeks. Salivary levels of cortisol, interleukin 1-beta (IL-1β), and uric acid were assessed via enzyme-linked immunosorbent assays before (PRE) and 30-min after (POST) SESSION 1 and SESSION 24. Variables’ percentual changes were computed as (POST-PRE)/PRE*100 in each session (Δ%). CrossFit^® acutely increased cortisol levels in both sessions, with a significant decrease in Δ%cortisol from SESSION 1 to 24. In the RT group, cortisol values decreased in both sessions, only acutely. A significant decrease in IL-1β levels was registered acutely in both groups, in both sessions, whereas Δ%IL-1β was not different between the two groups. While uric acid levels increased in both groups acutely, a chronic downregulation of Δ%uric acid, from SESSION 1 to 24, was appreciated for the RT group only. Overall, CrossFit^® appeared to induce more intense effects than the RT program as to the investigated catabolic responses.

Characterization of Hormonal, Metabolic, and Inflammatory Responses in CrossFit® Training: A Systematic Review

Background: CrossFit® training is a high-intensity functional training program that aims to increase physical functional performance through biochemical responses, i.e., hormonal, metabolic, and inflammatory responses. Most hormonal, metabolic, and inflammatory changes induced by CrossFit® training have been reported in isolated clinical studies. The purpose of this review was to systematically explore the existing literature on characterization of hormonal, metabolic, and inflammatory responses resulting from CrossFit® training. Methods: A systematic search of the literature was conducted in PubMed, Web of Science and Scopus from August 2019 to October 2019. Studies were selected through critical review of the content. Using specific keywords, 623 articles were found, of which 597 were excluded for ineligibility, and 25 were eligible. The papers were separated according to subject area: hormonal (n = 8), metabolic (n = 19), and inflammatory (n = 6) changes. All were published between 2015 and 2019. Results: This review reveals potential effects of CrossFit® training on hormonal, metabolic, and inflammatory responses. However, studies had low levels of evidence and reliability due to methodological limitations. Conclusion: In summary, the results showed a greater volume and intensity of workouts accentuate the responses, that are of paramount importance for improving understanding of the effects of CrossFit® training and serve as a basis for prescribing future exercise protocols.

Effects of Six Weeks of High-Intensity Functional Training on Physical Performance in Participants with Different Training Volumes and Frequencies

High-intensity functional training (HIFT) is characterized by presenting high volumes and training intensities with constantly varied exercises. The aim of this study was to analyze the internal training load and the effects of high-intensity functional training on physical performance in subjects with different training volumes and frequencies. A total of 31 volunteers involved in high-intensity functional training (14 men and 17 women) were divided according to their training volumes and frequencies (high training-volume and frequency-HTVF; (n = 17) (nine women and eight men; age: 31.0 ± 6.3 years; height: 168.8 ± 8.1 cm, body weight: 73.6 ± 11.9 kg; BMI: 25.96 kg/m²) and moderate training volume and frequency-MTVF; (n = 14) (eight women and six men; age: 26.6 ± 4.7 years; height: 167.2 ± 8.6 cm, body weight: 75.8 ± 18.0 kg; BMI: 27.33 kg/m²)). The internal training load was determined using the session-rating of perceived exertion method. The monotony index (MI) and training strain (TS) were used to determine training variability during the training weeks. Countermovement vertical jump height, 20-m sprinting and handgrip strength were assessed at baseline and after six weeks of training. There was a time effect for MI ((F_{(5, 145)} = 5.942; p = 0.0001)), TS ((F_{(5, 145)} = 5.734; p = 0.0001)), weekly internal training load ((F_{(4.006, 116.87)} = 4.188; p = 0.003)) and mean weekly internal training load ((F_{(4.006, 116.87)} = 4.188; p = 0.003)). There was no increase in performance in either group for countermovement vertical jump height ((F_(1,29) = 6.081; p = 0.050)), sprinting ((F_(1,29) = 1.014; p = 0.322)), right handgrip strength ((F_(1,29) = 2.522; p = 0.123)) or left handgrip strength ((F_(1,29) = 2.550; p = 0.121)). The current findings suggest that six weeks of high-intensity functional training was not able to increase performance in either group. Therefore, different volumes and frequencies do not seem to influence the increase in physical performance of HIFT practitioners.