Acute Effects of Carbohydrate Supplementation on Intermittent Sports Performance

Comparison of Australian Football League Women's athletes match day energy and nutrient intake to recommendations

AIMS

This cross-sectional observational study quantified Australian Football League Women's athletes' match volume, and compared match-day dietary intakes against recommendations.

METHODS

Self-report, direct observation, and fluid measurements determined dietary intake (n = 17, 25 ± 4.5 years, 22.8 ± 1.8 kg/m2) on five home match days (early or late starting). Global positioning system software captured match volume. Linear mixed effects models evaluated differences in early versus late match volume and nutrient intakes. Data are presented as mean ± standard deviation.

RESULTS

Athletes covered 6712 ± 622 m during matches, with similar numbers of very high-intensity running efforts over equal distances in early and late matches (early vs. late efforts [no.]: 8.5 ± 4.9 vs. 9.5 ± 5.5; distance [m]: 203 ± 127 vs. 212 ± 113). Across all match days, 71% (n = 12) of athletes met their predicted daily energy requirements. However, 82% (n = 14) failed to meet minimum daily carbohydrate recommendations; intake was lower on early compared with late match days (4.7 g/day vs. 5.4 g/kg/day, p = 0.027). On average, no athletes met carbohydrate recommendations in the 2 h prior to a match and only 24% (n = 4) met recommendations during matches. All athletes met post-match carbohydrate and protein requirements.

CONCLUSION

Athletes cover large distances during games with frequent bursts of high-intensity running. However, they do not adjust their intake to meet the energy demands of competition, with inadequate fuelling prior to and during matches. These findings emphasise the need for greater athlete education and dietary support to maximise strategic fuelling to optimise athletic performance.

Supplement Consumption by Elite Soccer Players: Differences by Competitive Level, Playing Position, and Sex

Soccer is a sport practiced all over the world and whose practice begins in young athletes. Currently, the consumption of nutritional supplements is essential to achieve the maximum performance of players. The aim of this study was to describe the consumption of sports supplements (CSS) by elite soccer players and its association with their competitive level, playing position, and sex. A comparative descriptive and non-experimental study was performed during the 2021-2022 competitive season. A total of 70 elite players completed one online questionnaire about their CSS. We found that sports drinks (55.7%), sports bars (50.0%), whey protein (48.6%), caffeine (47.1%), and creatine (60.0%) were the most consumed supplements by the total sample. Relative to the categories, the CSS was higher in the senior teams for both men and women. Regarding playing positions, caffeine was more consumed by midfielders and forwards (p = 0.013). Finally, in relation to sex, significant differences were found in the consumption of sports confectionery (p = 0.036), whey protein (p = 0.002), β-alanine (p = 0.013), and melatonin (p = 0.016). Soccer club SS questionnaires gather data to understand patterns, assess effectiveness and risks, and aid research. In conclusion, differences were found in the CSS according to competitive level, sex, and playing position.

Acute Effects of 30 g Cyclodextrin Intake during CrossFit® Training on Performance and Fatigue

The main objective of this study was to investigate the influence of carbohydrate intake (cyclodextrin) on performance during the performance of two consecutive workouts of the day (WODs) lasting 20 min each. Twenty-one male CrossFit (CF) athletes (29.5 ± 4.3 years; 72.81 ± 12.85 kg; 1.74 ± 0.06 m; 3.41 ± 1.21 years of experiences) participated in a crossover, randomized, and double-blind study. The effect of supplementation with 30 g of cyclodextrin (SG) (Cluster Dextrin®) or placebo (PG) (Bolero Advanced Hydration®) was evaluated on the performance of two specific WOD. Additionally, the effect on handgrip maximum strength, countermovement jump (CMJ), Wingate test, and 1 RM bench press test was evaluated. The effect on blood glucose and lactate was also evaluated. No differences were found in time, height, and power (W/Kg) in CMJ. However, there was a percentage improvement in CMJ jump power (W) (p < 0.05) between the groups, assuming an improvement in performance due to the intervention. Moreover, both conditions experimented differences in execution speed between sets (p < 0.05) in pre-WOD, and differences in post-WOD only in the placebo group, as well as decreases in this variable per repetition across the set (p < 0.01) in both conditions. However, no differences were found in the rest of the variables. Supplementation with 30 g of cyclodextrin did not have any metabolic or performance effects in CF tests. Although some differences between groups were observed in CMJ and power tests for bench press, the data are not conclusive and further research is needed in this regard.

14. Children and Adolescents: Standards of Care in Diabetes-2024

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

Effects of dietary supplements on athletic performance in elite soccer players: a systematic review

Dietary supplements are widely used among athletes, and soccer players are no exception. Nevertheless, evidence supporting the use of dietary supplements aiming to enhance performance in soccer is somewhat contradictory, scarce, or even nonexistent. Thus, the present study aimed to systematically review and synthesize the effects of dietary supplements on athletic performance (e.g. distance covered, sprinting, jump performance) in elite soccer players. Studies enrolling highly trained, elite, and world-class soccer players using dietary supplements were searched in MEDLINE/PubMed, Web of Science, Scopus, and EBSCO databases in June 2022. In total, 1043 studies were identified, and 18 met the eligibility criteria. The studies evaluated the impacts on athletic performance of several dietary supplements, including caffeine, creatine, protein, beverages with carbohydrates and electrolytes, tart cherry juice, nitrate-rich beetroot juice, sodium bicarbonate with minerals, yohimbine, and a proprietary nutraceutical blend. Caffeine supplementation in doses between 3 and 6 mg/kg of body mass may improve jump height and sprint ability, particularly in female players, but individual response to caffeine must be considered. Creatine may improve sprint, agility, and in female players, jump performance. Protein supplementation can improve sprint and jump performance between matches, especially if protein ingested from food is not up to recommendations. Beverages containing carbohydrates and electrolytes can be used as part of the strategies to achieve carbohydrate intake during training and match-days but used alone do not benefit athletic performance. Tart cherry juice might be useful for maintaining athletic performance after matches that produce higher force loss and exercise-induced muscle damage, although polyphenols from the diet might attenuate the effects of tart cherry supplementation. Nitrate-rich beetroot concentrate can attenuate performance decrease in the days following matches. Further investigation with sodium bicarbonate alone is necessary, as supplementation protocols with elite players included other substances. Finally, the available data does not support yohimbine supplementation or the use of Resurgex Plus® to improve athletic performance in elite soccer players. Still, more well-designed research with elite soccer players is needed to improve support and advice regarding the use of dietary supplements for athletic performance enhancement.

Carbohydrate Nutrition and Skill Performance in Soccer

In soccer, players must perform a variety of sport-specific skills usually during or immediately after running, often at sprint speed. The quality of the skill performed is likely influenced by the volume of work done in attacking and defending over the duration of the match. Even the most highly skilful players succumb to the impact of fatigue both physical and mental, which may result in underperforming skills at key moments in a match. Fitness is the platform on which skill is performed during team sport. With the onset of fatigue, tired players find it ever more difficult to successfully perform basic skills. Therefore, it is not surprising that teams spend a large proportion of their training time on fitness. While acknowledging the central role of fitness in team sport, the importance of team tactics, underpinned by spatial awareness, must not be neglected. It is well established that a high-carbohydrate diet before a match and, as a supplement during match play, helps delay the onset of fatigue. There is some evidence that players ingesting carbohydrate can maintain sport-relevant skills for the duration of exercise more successfully compared with when ingesting placebo or water. However, most of the assessments of sport-specific skills have been performed in a controlled, non-contested environment. Although these methods may be judged as not ecologically valid, they do rule out the confounding influences of competition on skill performance. The aim of this brief review is to explore whether carbohydrate ingestion, while delaying fatigue during match play, may also help retain sport soccer-specific skill performance.

Continuous Monitoring of Interstitial Fluid Glucose Responses to Endurance Exercise with Different Levels of Carbohydrate Intake

We compared the 24 h changes in interstitial fluid glucose concentration (IGC) following a simulated soccer match between subjects consuming a high-carbohydrate (HCHO; 8 g/kg BW/day) diet and those consuming a moderate-carbohydrate (MCHO; 4 g/kg BW/day) diet. Eight active healthy males participated in two different trials. The subjects were provided with the prescribed diets from days 1 to 3. On day 3, the subjects performed 90 min (2 bouts × 45 min) of exercise simulating a soccer match. The IGC of the upper arm was continuously monitored from days 1 to 4. No significant difference in the IGC was observed between trials during exercise. The total area under the curve (t-AUC) value during exercise did not significantly differ between the HCHO (9719 ± 305 mg/dL·90 min) and MCHO (9991 ± 140 mg/dL·90 min). Serum total ketone body and beta-hydroxybutyrate concentrations were significantly higher in the MCHO than in the HCHO after a second bout of exercise. No significant differences in the IGC were observed between trials at any time point during the night after exercise (0:00-7:00). In addition, t-AUC value during the night did not significantly differ between the HCHO (32,378 ± 873 mg/dL·420 min) and MCHO (31,749 ± 633 mg/dL·420 min). In conclusion, two days of consuming different carbohydrate intake levels did not significantly affect the IGC during a 90 min simulated soccer match. Moreover, the IGC during the night following the exercise did not significantly differ between the two trials despite the different carbohydrate intake levels (8 vs. 4 g/kg BW/day).

Core Body Temperatures in Intermittent Sports: A Systematic Review

BACKGROUND

Hyperthermia (and associated health and performance implications) can be a significant problem for athletes and teams involved in intermittent sports. Quantifying the highest thermal strain (i.e. peak core body temperature [peak Tc]) from a range of intermittent sports would enhance our understanding of the thermal requirements of sport and assist in making informed decisions about training or match-day interventions to reduce thermally induced harm and/or performance decline.

OBJECTIVE

The objective of this systematic review was to synthesise and characterise the available thermal strain data collected in competition from intermittent sport athletes.

METHODS

A systematic literature search was performed on Web of Science, MEDLINE, and SPORTDiscus to identify studies up to 17 April 2023. Electronic databases were searched using a text mining method to provide a partially automated and systematic search strategy retrieving terms related to core body temperature measurement and intermittent sport. Records were eligible if they included core body temperature measurement during competition, without experimental intervention that may influence thermal strain (e.g. cooling), in healthy, adult, intermittent sport athletes at any level. Due to the lack of an available tool that specifically includes potential sources of bias for physiological responses in descriptive studies, a methodological evaluation checklist was developed and used to document important methodological considerations. Data were not meta-analysed given the methodological heterogeneity between studies and therefore were presented descriptively in tabular and graphical format.

RESULTS

A total of 34 studies were selected for review; 27 were observational, 5 were experimental (2 parallel group and 3 repeated measures randomised controlled trials), and 2 were quasi-experimental (1 parallel group and 1 repeated measures non-randomised controlled trial). Across all included studies, 386 participants (plus participant numbers not reported in two studies) were recruited after accounting for shared data between studies. A total of 4 studies (~ 12%) found no evidence of hyperthermia, 24 (~ 71%) found evidence of 'modest' hyperthermia (peak Tc between 38.5 and 39.5 °C), and 6 (~ 18%) found evidence of 'marked' hyperthermia (peak Tc of 39.5 °C or greater) during intermittent sports competition.

CONCLUSIONS

Practitioners and coaches supporting intermittent sport athletes are justified to seek interventions aimed at mitigating the high heat strain observed in competition. More research is required to determine the most effective interventions for this population that are practically viable in intermittent sports settings (often constrained by many competing demands). Greater statistical power and homogeneity among studies are required to quantify the independent effects of wet bulb globe temperature, competition duration, sport and level of competition on peak Tc, all of which are likely to be key modulators of the thermal strain experienced by competing athletes.

REGISTRATION

This systematic review was registered on the Open Science Framework ( https://osf.io/vfb4s ; https://doi.org/10.17605/OSF.IO/EZYFA , 4 January 2021).

Dietary Habits of Elite Soccer Players: Variations According to Competitive Level, Playing Position and Sex

Soccer is a sport practiced worldwide by both men and women, where nutrition plays a fundamental role in the performance of soccer players, providing them with the nutrients necessary for energy, muscle recovery and injury prevention. The aim of this study is to describe the dietary habits in elite soccer players and their association with their competitive level, playing position and sex. A descriptive and non-experimental comparative study was conducted during the 2021-2022 competitive season. A total of 105 players belonging to a Spanish elite soccer team completed a food frequency questionnaire (FCFQ). It was observed that male players presented a higher consumption of carbohydrate-rich foods (p < 0.05), fermented foods (p = 0.014), frozen foods (p = 0.049) and red meat (p = 0.012) compared to female players, with the exception of lean meats, which were higher in females (p = 0.012). Furthermore, the U16-15 categories stand out for consuming carbohydrate-rich foods such as pasta (p = 0.000), bread (p = 0.004) and sweets (p = 0.046), as well as frozen foods (p = 0.002). Finally, alcohol consumption is higher in the senior categories (42.9%), where men are more likely to drink mixed drinks (6.2%), and beer and wine by women (10.7%). Practically no differences were found between the playing positions. In conclusion, differences were found in FCFQ according to competitive level and sex.

Effects of carbohydrate drinks ingestion on executive function in athletes: a systematic review and meta-analysis

Background

Carbohydrates are often used as boosters for endurance and high-intensity exercise. However, it is unclear whether carbohydrate drinks intake before or during exercise can affect specific domains of cognitive function, such as Executive Function (EF).

Methods

Following the guidance of PRISMA 2020, we searched six major databases including PubMed, WOS, SPORTDiscus, Cochrane, Embase, and Scopus. Outcomes were presented in the form of Reaction Time (RT), Accuracy (ACC), and Scores (Score) for performing EF tests. Effect sizes were calculated from the test results of EF and expressed as standardized mean differences (SMDs). After analyzing the overall results, we performed subgroup analyses based on the athletes' program characteristics.

Results

After retrieving a total of 5,355 articles, ten randomized controlled trials (RCTs) were identified and included in this review. The overall results showed that the intake of carbohydrate drinks before or during exercise did not have a significant effect on the reduction of EF after exercise (ACC (-0.05 [-0.27, 0.18]); RT (-0.18 [-0.45, 0.09]); Score (0.24 [-0.20, 0.68])). The subgroup analyses based on open skill sports and close skill sports also showed invalid results, but the results of RT ended up with different preference (ACC of open skill sports athletes (-0.10 [-0.34, 0.14]); RT of open skill athletes (-0.27 [-0.60, 0.07]); RT of close skill athletes (0.29 [-0.24, 0.82])).

Conclusion

The intake of 6-12% of single or mixed carbohydrates before or during exercise was not significantly effective in reducing the decline in EF after exercise. Our findings may have been influenced by the type of intervention, dose, mode of administration, or individual variability of the included subjects.

A brief body scan mindfulness practice has no positive effect on the recovery of heart rate variability and cognitive tasks in female professional basketball players

Introduction

In this study, we examined the acute effects of a short video-based body scan mindfulness practice on the heart rate variability (HRV) and cognitive performance of professional female basketball players after the first half of a simulated basketball game.

Methods

In this crossover randomized controlled trial, nine professional athletes completed a physical loading protocol on two separate days. The protocol consisted of a 10-min Yo-Yo Intermittent Recovery Test Level 1 in the first quarter, followed by a 10-min basketball game in the second quarter. Immediately afterward, they were asked to engage in a 10-min mindfulness practice or watch a 10-min nature-based documentary as a type of mental intervention. Their HRV, Rating of Perceived Exertion (RPE), National Aeronautics and Space Administration Task Load Index 2 (NASA TLX-2), and Go/No-Go test scores were recorded immediately before and after the physical loading and after the mental intervention.

Results

The physical demand, effort, and frustration level subscales of the NASA TLX-2 and the RPE scores were found to be significantly higher after the physical loading, and they returned to the baseline level after both types of mental intervention. The Go/No-Go test scores did not differ depending on the measurement time. All time- and frequency-domain heart rate variability parameters, except the low-to-high frequency ratio, were found to be significantly high immediately after the physical loading protocol. However, these parameters returned to their initial levels after both types of mental intervention.

Discussion

Completing the tests involved in the study protocol successfully induced physical fatigue, as evidenced by consistent measurement tools, but the one-time and short-term mindfulness practice had no additional benefits for the recovery of heart rate variability, cognitive tasks, or subjective assessment methods, such as RPE and NASA TLX-2, in basketball players with no previous experience of mindfulness practice.

An Intense Bout of Acute Aerobic Exercise, but Not a Carbohydrate Supplement, Improves Cognitive Task Performance in a Sample of Black, Indigenous, and People of Color (BIPOC) Student Athletes

BACKGROUND

There are contradictory findings in the literature on whether an acute bout of aerobic exercise leads to a post-exercise improvement in cognitive function (CF). Moreover, participants used in the published literature are not representative of the racial make-up of sport or tactical populations.

METHODS

A randomized crossover design was incorporated, with participants randomly consuming water or a carbohydrate sports drink within the first 3 min of a graded maximal exercise test (GMET) conducted in a laboratory. Twelve self-identified African American participants, (seven males, five females, age = 21.42 ± 2.38 years, height = 174.94 ± 12.55 cm, mass = 82.45 ± 33.09 kg) completed both testing days. Participants completed the CF tests immediately pre- and post-GMET. CF was assessed with the Stroop color and word task (SCWT) and concentration task grid (CTG). Participants completed the GMET when they reported a score of 20 on the Borg ratings of perceived exertion scale.

RESULTS

Time to complete the SCWT incongruent task (p < 0.001) and CTG performance (p < 0.001) significantly improved post-GMET in both conditions. VO_2max was positively correlated with pre- and post-GMET SCWT performance.

CONCLUSIONS

The findings of our study suggest that an acute bout of maximal exercise significantly improves CF. Additionally, cardiorespiratory fitness is positively associated with CF in our sample of student athletes from a historically Black college and university.

Wearable Microfluidic Sweat Chip for Detection of Sweat Glucose and pH in Long-Distance Running Exercise

Traditional exercise training monitoring is based on invasive blood testing methods. As sweat can reveal abundant blood-related physiological information about health, wearable sweat sensors have received significant research attention and become increasingly popular in the field of exercise training monitoring. However, most of these sensors are used to measure physical indicators such as heart rate, blood pressure, respiration, etc., demanding a versatile sensor that can detect relevant biochemical indicators in body fluids. In this work, we proposed a wearable microfluidic sweat chip combined with smartphone image processing to realize non-invasive in situ analysis of epidermal sweat for sports practitioners. The polydimethylsiloxane (PDMS) based chip was modified with nonionic surfactants to ensure good hydrophilicity for the automatic collection of sweat. Besides, a simple, reliable, and low-cost paper-based sensor was prepared for high-performance sensing of glucose concentration and pH in sweat. Under optimized conditions, this proposed chip can detect glucose with low concentrations from 0.05 mM to 0.40 mM, with a pH range of 4.0 to 6.5 for human sweat. The ability of this microfluidic chip for human sweat analysis was demonstrated by dynamically tracking the changes in glucose concentration and pH in long-distance running subjects.

Hydrolyzed whey protein enriched with glutamine dipeptide attenuates skeletal muscle damage and improves physical exhaustion test performance in triathletes

Purpose

To investigate the effects of hydrolyzed whey protein enriched with glutamine dipeptide on the percentage of oxygen consumption, second ventilatory threshold, duration and total distance covered, and skeletal muscle damage during an exhaustion test in elite triathletes.

Methods

The study was a randomized, double-blinded, placebo-controlled, crossover trial. Nine male triathletes performed a progressive incremental test on a treadmill ergometer (1.4 km h^-1·3 min^-1) 30 min after ingesting either 50 g of maltodextrin plus four tablets of 700 mg hydrolyzed whey protein enriched with 175 mg of glutamine dipeptide diluted in 250 ml of water (MGln) or four tablets of 700 mg maltodextrin plus 50 g maltodextrin diluted in 250 ml of water (M). Each athlete was submitted to the two dietary treatments and two corresponding exhaustive physical tests with an interval of one week between the interventions. The effects of the two treatments were then compared within the same athlete. Maximal oxygen consumption, percentage of maximal oxygen consumption, second ventilatory threshold, and duration and total distance covered were measured during the exhaustion test. Blood was collected before and immediately after the test for the determination of plasma lactate dehydrogenase (LDH) and creatine kinase (CK) activities and lactate concentration (also measured 6, 10, and 15 min after the test). Plasma cytokines (IL-6, IL-1β, TNF-α, IL-8, IL-10, and IL-1ra) and C-reactive protein levels were also measured.

Results

A single dose of MGln increased the percentage of maximal oxygen consumption, second ventilatory threshold duration, and total distance covered during the exhaustion test and augmented plasma lactate levels 6 and 15 min after the test. MGln also decreased plasma LDH and CK activities indicating muscle damage protection. Plasma cytokine and C-reactive protein levels did not change across the study periods.

Conclusion

Conditions including overnight fasting and a single dose of MGln supplementation resulted in exercising at a higher percentage of maximal oxygen consumption, a higher second ventilatory threshold, blood lactate levels, and reductions in plasma markers of muscle damage during an exhaustion test in elite triathletes. These findings support oral glutamine supplementation's efficacy in triathletes, but further studies require.

14. Children and Adolescents: Standards of Care in Diabetes-2023

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

The Role of Muscle Glycogen Content and Localization in High-Intensity Exercise Performance: A Placebo-Controlled Trial

PURPOSE

We investigated the coupling between muscle glycogen content and localization and high-intensity exercise performance using a randomized, placebo-controlled, parallel-group design with emphasis on single-fiber subcellular glycogen concentrations and sarcoplasmic reticulum Ca 2+ kinetics.

METHODS

Eighteen well-trained participants performed high-intensity intermittent glycogen-depleting exercise, followed by randomization to a high- (CHO; ~1 g CHO·kg -1 ·h -1 ; n = 9) or low-carbohydrate placebo diet (PLA, <0.1 g CHO·kg -1 ·h -1 ; n = 9) for a 5-h recovery period. At baseline, after exercise, and after the carbohydrate manipulation assessments of repeated sprint ability (5 × 6-s maximal cycling sprints with 24 s of rest), neuromuscular function and ratings of perceived exertion during standardized high-intensity cycling (~90% Wmax ) were performed, while muscle and blood samples were collected.

RESULTS

The exercise and carbohydrate manipulations led to distinct muscle glycogen concentrations in CHO and PLA at the whole-muscle (291 ± 78 vs 175 ± 100 mmol·kg -1 dry weight (dw), P = 0.020) and subcellular level in each of three local regions ( P = 0.001-0.046). This was coupled with near-depleted glycogen concentrations in single fibers of both main fiber types in PLA, especially in the intramyofibrillar region (within the myofibrils). Furthermore, increased ratings of perceived exertion and impaired repeated sprint ability (~8% loss, P < 0.001) were present in PLA, with the latter correlating moderately to very strongly ( r = 0.47-0.71, P = 0.001-0.049) with whole-muscle glycogen and subcellular glycogen fractions. Finally, sarcoplasmic reticulum Ca 2+ uptake, but not release, was superior in CHO, whereas neuromuscular function, including prolonged low-frequency force depression, was unaffected by dietary manipulation.

CONCLUSIONS

Together, these results support an important role of muscle glycogen availability for high-intensity exercise performance, which may be mediated by reductions in single-fiber levels, particularly in distinct subcellular regions, despite only moderately lowered whole-muscle glycogen concentrations.

Practical Nutrition Strategies to Support Basketball Performance during International Short-Term Tournaments: A Narrative Review

A short-term (e.g., 6 days) basketball tournament is a shorter version of international tournaments, and qualification in it enables participation in international tournaments such as the Olympics and World championships or preparation before major tournaments. Time for recovery between matches is shorter compared with major tournaments, resulting in an accentuated load on players, which can be repeated up to four times within the 6-day competition period. Therefore, nutritional strategies need to focus on faster and adequate recovery after each match as well as optimum fuelling and hydration before and during matches. Travelling can also create additional challenges when preparing and/or applying those nutritional strategies. There are some particular evidence-based sport foods and ergogenic aids that can improve intermittent activity and/or the execution of motor skills, which may facilitate basketball players' recovery and performance. The present review provides practical nutritional strategies to support short-term basketball tournaments based on players' physiological needs and current sport nutrition guidelines.

Effects of Polyphenol Consumption on Recovery in Team Sport Athletes of Both Sexes: A Systematic Review

Previous studies have shown that polyphenol consumption enhances recovery of the muscle after exercise-induced muscle damage (EIMD). However, EIMD markers have not been studied by sport type. The main aim of this research was to perform a systematic review to determine the efficacy of polyphenolic consumption in increasing muscle recovery for performing team sport skills. Eligible studies included, following PICOS structure, presented at least one of the following outcomes: maximal isometric voluntary contraction (MVIC); countermovement jump (CMJ); delayed onset muscle soreness (DOMS); 20 m sprint test; creatine kinase (CK); and C-reactive protein (hsCRP). A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed using the PEDro scale tool. The review showed a possibly positive impact of polyphenol consumption on recovery after EIMD in team sports athletes. No differences were found between sexes. Considering the limitations, there is moderate to very low certainty of polyphenol supplementation effects on recovery of team sport females and males. A dose of 60 mL/day, divided into two times per day, ingested for >7 days may present positive effects on muscle function and muscle soreness in team sport athletes. However, further investigation is required, specifically in females.

Fluid Balance and Carbohydrate Intake of Elite Female Soccer Players during Training and Competition

This study examined sweat rate, sweat sodium concentration [Na⁺], and ad-libitum carbohydrate and fluid intakes in elite female soccer players during training (n = 19) and a match (n = 8); eight completed both for comparisons. Body mass (kg) was obtained before and after exercise to calculate sweat rate. The sweat [Na⁺] was determined from absorbent patches on the thigh or back. Sweat rate, percentage body mass change, and sweat [Na⁺] for 19 players during training were 0.47 ± 0.19 L·h⁻¹, +0.19 ± 0.65%, and 28 ± 10 mmol·L⁻¹, respectively. Sweat rate was higher during a match (0.98 ± 0.34 L·h⁻¹) versus training (0.49 ± 0.26 L·h⁻¹, p = 0.007). Body mass losses were greater post-match (−1.12 ± 0.86%) than training (+0.29 ± 0.34%, p = 0.003). Sweat [Na⁺] was similar for training (29 ± 9 mmol·L⁻¹) and a match (35 ± 9 mmol·L⁻¹) (p = 0.215). There were no differences in match versus training carbohydrate intakes (2.0 ± 2.3 g·h⁻¹, 0.9 ± 1.5 g·h⁻¹, respectively, p = 0.219) or fluid intakes (0.71 ± 0.30 L·h⁻¹, 0.53 ± 0.21 L·h⁻¹, respectively, p = 0.114). In conclusion, female soccer players’ sweat rates were higher during a match than during training, and carbohydrate intakes were below recommendations for matches and training.

Validation of Internal and External Load Metrics in NCAA D1 Women's Beach Volleyball

ABSTRACT

Tometz, MJ, Jevas, SA, Esposito, PM, and Annaccone, AR. Validation of internal and external load metrics in NCAA D1 women's beach volleyball. J Strength Cond Res 36(8): 2223-2229, 2022-The purpose of this study was to determine the validity of internal and external load metrics in NCAA D1 women's beach volleyball. Subjects included 13 NCAA D1 women's beach volleyball players (age: 20.3 ± 1.4 years). A total of 578 data points were analyzed from 51 team training sessions, including practice, games, and sport-specific conditioning during the pre-season semester (15 weeks). Data points included Edward's training impulse (TRIMP) (228.0 ± 80.7 arbitrary units [AU]), session rating of perceived exertion (sRPE) Load (532.5 ± 232.8 [AU]), distance covered (DC) in meters (2,635.4 ± 884.3 [m]), and daily environmental condition variables {(temperature (76.5 ± 13.7 [°F]), relative humidity (72.5 ± 13.2 [%]), and wet-bulb globe temperature (52.9 ± 19.9 [°F])}. The subjects wore Polar Team Pro heart rate monitors with global positioning system during each session. Subjects completed an sRPE questionnaire after every session. Pearson product moment correlations yielded statistically significant relationships (p < 0.01) between TRIMP and sRPE Load (r = 0.81), TRIMP and DC (r = 0.78), and sRPE Load and DC (r = 0.82). A forward selection multiple regression yielded that sRPE Load could predict TRIMP with the equation: TRIMPTometz = 78.735 + (sRPE Load * 0.28) (p < 0.001). These findings support sRPE Load as a valid alternative to TRIMP when monitoring internal loads in NCAA D1 women's beach volleyball. Session rating of perceived exertion Load may be more practical and accessible for teams. Distance covered should be considered when periodizing and monitoring training loads because of its relationship with internal loads.

Assessment of Body Composition and Physical Performance of Young Soccer Players: Differences According to the Competitive Level

Soccer is a multifactorial sport, in which players are expected to possess well developed physical, psychological, technical, and tactical skills. Thus, the anthropometric and fitness measures play a determinant role and could vary according to the competitive level. Therefore, the present study aimed to verify differences in body composition and physical performance between two soccer team. 162 young soccer players (from the Under 12 to Under 15 age categories; age: 13.01 ± 1.15 years) of different competitive levels (elite—n = 98 and non-elite—n = 64) were recruited. Anthropometric characteristics (height, weight, lengths, widths, circumferences, and skinfold thicknesses (SK)), bioelectrical impedance, physical performance test as countermovement jump (CMJ), 15 m straight-line sprints, Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo), and 20 + 20 m repeated-sprint ability (RSA)) were carried out. In addition, Body mass index (BMI), body composition parameters (percentage of fat mass (%F), Fat mass (FM, kg), and Fat-free mass (FFM, kg)) and the areas of the upper arm, calf and thigh were calculated, and the Bioelectric Impedance Vector Analysis (BIVA) procedures were applied. In addition, a linear discriminant analysis was assessed to determine which factors better discriminate between an elite and non-elite football team. Many differences were observed in body composition between and within each football team’s category, especially in triceps SK (p < 0.05), %F (p < 0.05), and all performance tests (p < 0.01). The canonical correlation was 0.717 (F(7,128) = 19.37, p < 0.0001), and the coefficients that better discriminated between two teams were 15 m sprint (−2.39), RSA (1−26), suprailiac SK (−0.5) and CMJ (−0.45). Elite soccer team players present a better body composition and greater physical efficiency. In addition, BIVA outcome could be a relevant selection criterion to scout among younger soccer players.

School-based high-intensity interval training programs in children and adolescents: A systematic review and meta-analysis

PURPOSE

1) To investigate the effectiveness of school-based high-intensity interval training (HIIT) interventions in promoting health outcomes of children and adolescents compared with either a control group or other exercise modality; and 2) to explore the intervention characteristics and process outcomes of published school-based HIIT interventions.

METHODS

We searched Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from inception until 31 March 2021. Studies were eligible if 1) participants aged 5-17 years old; 2) a HIIT intervention within a school setting ≥ 2 weeks duration; 3) a control or comparative exercise group; 4) health-related, cognitive, physical activity, nutrition, or program evaluation outcomes; and 5) original research published in English. We conducted meta-analyses between HIIT and control groups for all outcomes with ≥ 4 studies and meta-regressions for all outcomes with ≥ 10 studies. We narratively synthesised results between HIIT and comparative exercise groups.

RESULTS

Fifty-four papers met eligibility criteria, encompassing 42 unique studies (35 randomised controlled trials; 36 with a high risk of bias). Meta-analyses indicated significant improvements in waist circumference (mean difference (MD) = -2.5cm), body fat percentage (MD = -1.7%), body mass index (standardised mean difference (SMD) = -1.0), cardiorespiratory fitness (SMD = +1.0), resting heart rate (MD = -5bpm), homeostatic model assessment-insulin resistance (MD = -0.7), and low-density lipoprotein cholesterol (SMD = -0.9) for HIIT compared to the control group. Our narrative synthesis indicated mixed findings between HIIT and other comparative exercise groups.

CONCLUSION

School-based HIIT is effective for improving several health outcomes. Future research should address the paucity of information on physical activity and nutrition outcomes and focus on the integration and long-term effectiveness of HIIT interventions within school settings.

TRIAL REGISTRATION NUMBER

PROSPERO CRD42018117567.

Acute caffeine supplementation and live match-play performance in team-sports: A systematic review (2000-2021)

Caffeine is a psycho-active stimulant that can improve physical and cognitive performance. We systematically reviewed the evidence on the effects of acute caffeine ingestion on physiological parameters, physical and technical-skill performance during high-performance team-sport match-play. Following PRISMA guidelines, studies were identified using scientific databases (PubMed, Web-of-Science, Scopus, and SPORTDiscus) in February 2021. Of 281 results, 13 studies met inclusion, totalling 213 participants. Included studies adopted the randomised double-blinded cross-over design, involving caffeine and control conditions. In studies reporting physiological variables, responses to caffeine included higher peak (n=6/ 8 [n/ total studies measuring the variable]) and mean (n=7/ 9) heart rates, increased blood glucose (n=2/ 2) and lactate (n=2/ 2) concentrations. Improvements in physical performance were widely documented with caffeine, including greater distance coverage (n=7/ 7), high-speed distance coverage (n=5/ 7) and impact frequencies (n=6/ 8). From three studies that assessed technical-skills, it appears caffeine may benefit gross-skill performance, but have no effect, or negatively confound finer technical-skill outcomes. There is compelling evidence that ingesting moderate caffeine doses (~3 to 6 mg·kg-1) ~60 minutes before exercise may improve physical performance in team-sports, whereas evidence is presently too scarce to draw confident conclusions regarding sport-specific skill performance.

Energy Requirements and Nutritional Strategies for Male Soccer Players: A Review and Suggestions for Practice

Soccer is a high intensity intermittent sport, featuring critical events completed at high/maximal intensity which is superimposed onto an aerobic base of lower intensity activities and rest. Due to these varying energic demands and the duration of competition the need for optimal nutritional strategies to offset and delay fatigue are paramount. Over the last 50 years, several investigations have been reported on aspects of soccer be they nutrition-focused or those concerning the demands of the sport. Emanating from these scientific papers, observations have been made on the likely factors which result in the fatigue during match-play. Factors such as muscle glycogen depletion and hypoglycaemia are discussed. Studies on the energy demands of soccer have employed a variety of methodologies which are briefly reviewed and vary between the use of heart rate telemetry to the use of global positioning systems (GPS). Moving on from observations of the energy demands of the sport leads to the major focus of this review which highlights key nutritional strategies to support the preparation and recovery of male soccer players to enhance performance, or at least to enable players to perform adequately. This review examines relevant methodologies in assessing training and competitive energy costs as well as the concomitant energy intakes demanded for successful performance outcomes. In order to bring an applied aspect to the overall findings from areas discussed, some practical ideas of feeding strategies are presented.

Ergo-Nutritional Intervention in Basketball: A Systematic Review

Using nutritional supplements is a widespread strategy among basketball players to ensure the appropriate provision of energy and nutrients to avoid certain complaints. Particularly in basketball, there is no consensus on the type, quantity or form of use in which these supplements should be administered. Therefore, the main aim of this systematic review is to highlight the ergo-nutritional aids that may be effective in basketball. A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA®) guidelines in the Medline/PubMed and Web of Science, Cochrane Library, and Scopus databases until 31 December 2021; no year restriction was applied to the search strategy. There were no filters applied to the basketball players' level, gender, race, or age to increase the power of the analysis. The results of this systematic review have shown that the effective dose of caffeine to enhance anaerobic performance and the feeling of vigorousness and energy ranges from 3 to 6 mg·kg-1, showing more positive effects when is supplemented 60-75 min before exercise in the morning and in test-based task. On the other hand, vitamin E (ranging from 200 to 268 mg), vitamin D (10,000 IU) and EPA (2 g) may have a potential role in recovery and wellness. The primary limitation of this study is the scarcity of studies related to nutritional supplementation in basketball players. However, a major strength is that this is the first systematic review describing what ergo-nutritional aids may be specifically helpful for basketball. Despite the need for future studies, certain nutritional supplements may have promising advantages for basketball (long-term supplementation of nitrates for recovery), whereas others (β-alanine, sodium bicarbonate, and acute nitrate supplementation) might theoretically be regarded as not interesting for basketball, or even not recommended by the World Anti-Doping Agency (WADA) as bovine colostrum.

“Food First but Not Always Food Only”: Recommendations for Using Dietary Supplements in Sport

The term “food first” has been widely accepted as the preferred strategy within sport nutrition, although there is no agreed definition of this and often limited consideration of the implications. We propose that food first should mean “where practically possible, nutrient provision should come from whole foods and drinks rather than from isolated food components or dietary supplements.” There are many reasons to commend a food first strategy, including the risk of supplement contamination resulting in anti-doping violations. However, a few supplements can enhance health and/or performance, and therefore a food only approach could be inappropriate. We propose six reasons why a food only approach may not always be optimal for athletes: (a) some nutrients are difficult to obtain in sufficient quantities in the diet, or may require excessive energy intake and/or consumption of other nutrients; (b) some nutrients are abundant only in foods athletes do not eat/like; (c) the nutrient content of some foods with established ergogenic benefits is highly variable; (d) concentrated doses of some nutrients are required to correct deficiencies and/or promote immune tolerance; (e) some foods may be difficult to consume immediately before, during or immediately after exercise; and (f) tested supplements could help where there are concerns about food hygiene or contamination. In these situations, it is acceptable for the athlete to consider sports supplements providing that a comprehensive risk minimization strategy is implemented. As a consequence, it is important to stress that the correct terminology should be “food first but not always food only.”

14. Children and Adolescents: Standards of Medical Care in Diabetes-2022

The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

In-Season Nutrition Strategies and Recovery Modalities to Enhance Recovery for Basketball Players: A Narrative Review

Basketball players face multiple challenges to in-season recovery. The purpose of this article is to review the literature on recovery modalities and nutritional strategies for basketball players and practical applications that can be incorporated throughout the season at various levels of competition. Sleep, protein, carbohydrate, and fluids should be the foundational components emphasized throughout the season for home and away games to promote recovery. Travel, whether by air or bus, poses nutritional and sleep challenges, therefore teams should be strategic about packing snacks and fluid options while on the road. Practitioners should also plan for meals at hotels and during air travel for their players. Basketball players should aim for a minimum of 8 h of sleep per night and be encouraged to get extra sleep during congested schedules since back-to back games, high workloads, and travel may negatively influence night-time sleep. Regular sleep monitoring, education, and feedback may aid in optimizing sleep in basketball players. In addition, incorporating consistent training times may be beneficial to reduce bed and wake time variability. Hydrotherapy, compression garments, and massage may also provide an effective recovery modality to incorporate post-competition. Future research, however, is warranted to understand the influence these modalities have on enhancing recovery in basketball players. Overall, a strategic well-rounded approach, encompassing both nutrition and recovery modality strategies, should be carefully considered and implemented with teams to support basketball players' recovery for training and competition throughout the season.

Increased carbohydrate availability effects energy and nutrient periodisation of professional male athletes from the Australian Football League

This research aimed to explore the effect of increased carbohydrate availability intervention on energy intake and distribution in professional Australian Football athletes. Six 24-h energy and macronutrient intakes were quantified (n = 19 males; age 24 ± 4 y, stature 187 ± 8 cm, mass 87 ± 9 kg) using photographic food diaries and Foodworks analyses. Energy expenditure was estimated for the same period using GeneActiv accelerometers. During 3 control days, athletes had ad libitum access to food, while the 3 intervention days increased carbohydrate availability, through greater prompting and access to carbohydrate foods. Daily energy intake was higher during intervention (185 ± 40 kJ/kg/d) compared with control (172 ± 31 kJ/kg/d; p < 0.05) but remained below estimated expenditure, and carbohydrate intake was also greater with intervention (5.0 ± 0.2 g/kg/d) than control (4.0 ± 0.2 g/kg/d; p < 0.05). Expenditure was highest during the morning, which coincided with lowest intake on all days, while the intervention was associated with greater carbohydrate intake in the morning (0.6 g/kg, p < 0.05) compared with control. Increasing availability of carbohydrate during high-load training generated a modest increase in carbohydrate and energy intake, and the intervention was most effective in improving carbohydrate intake during mornings. Novelty: Increased access and provision of carbohydrate foods increased carbohydrate consumption and energy intake on high training load days. Daily distribution of energy intake can be modified through actively promoting carbohydrate consumption.

Meta-Analysis of Carbohydrate Solution Intake during Prolonged Exercise in Adults: From the Last 45+ Years' Perspective

Carbohydrate (CHO) supplementation during prolonged exercise postpones fatigue. However, the optimum administration timing, dosage, type of CHO intake, and possible interaction of the ergogenic effect with athletes' cardiorespiratory fitness (CRF) are not clear. Ninety-six studies (from relevant databases based on predefined eligibility criteria) were selected for meta-analysis to investigate the acute effect of ≤20% CHO solutions on prolonged exercise performance. The between-subject standardized mean difference [SMD = ([mean post-value treatment group-mean post-value control group]/pooled variance)] was assessed. Overall, SMD [95% CI] of 0.43 [0.35, 0.51] was significant (p < 0.001). Subgroup analysis showed that SMD was reduced as the subjects' CRF level increased, with a 6-8% CHO solution composed of GL:FRU improving performance (exercise: 1-4 h); administration during the event led to a superior performance compared to administration before the exercise, with a 6-8% single-source CHO solution increasing performance in intermittent and 'stop and start' sports and an ~6% CHO solution appearing beneficial for 45-60 min exercises, but there were no significant differences between subjects' gender and age groups, varied CHO concentrations, doses, or types in the effect measurement. The evidence found was sound enough to support the hypothesis that CHO solutions, when ingested during endurance exercise, have ergogenic action and a possible crossover interaction with the subject's CRF.

Portuguese Football Federation consensus statement 2020: nutrition and performance in football

Nutrition is an undeniable part of promoting health and performance among football (soccer) players. Nevertheless, nutritional strategies adopted in elite football can vary significantly depending on culture, habit and practical constraints and might not always be supported by scientific evidence. Therefore, a group of 28 Portuguese experts on sports nutrition, sports science and sports medicine sought to discuss current practices in the elite football landscape and review the existing evidence on nutritional strategies to be applied when supporting football players. Starting from understanding football's physical and physiological demands, five different moments were identified: preparing to play, match-day, recovery after matches, between matches and during injury or rehabilitation periods. When applicable, specificities of nutritional support to young athletes and female players were also addressed. The result is a set of practical recommendations that gathered consensus among involved experts, highlighting carbohydrates periodisation, hydration and conscious use of dietary supplements.

"Fuel for the Damage Induced": Untargeted Metabolomics in Elite Rugby Union Match Play

The metabolic perturbations caused by competitive rugby are not well characterized. Our aim is to utilize untargeted metabolomics to develop appropriate interventions, based on the metabolic fluctuations that occur in response to this collision-based team sport. Seven members of an English Premiership rugby squad consented to provide blood, urine, and saliva samples daily, over a competitive week including gameday (GD), with physical demands and dietary intake also recorded. Sample collection, processing and statistical analysis were performed in accordance with best practice set out by the metabolomics standards initiative employing 700 MHz NMR spectroscopy. Univariate and multivariate statistical analysis were employed to reveal the acute energy needs of this high intensity sport are met via glycolysis, the TCA cycle and gluconeogenesis. The recovery period after cessation of match play and prior to training recommencing sees a re-entry to gluconeogenesis, coupled with markers of oxidative stress, structural protein degradation, and reduced fatty acid metabolism. This novel insight leads us to propose that effective recovery from muscle damaging collisions is dependent upon the availability of glucose. An adjustment in the periodisation of carbohydrate to increase GD+1 provision may prevent the oxidation of amino acids which may also be crucial to allay markers of structural tissue degradation. Should we expand the ‘Fuel for the work required’ paradigm in collision-based team sports to include ‘Fuel for the damage induced’?

Evaluation of Omega-3 Status in Professional Basketball Players

ABSTRACT

Davis, JK, Freese, EC, Wolfe, AS, Basham, SA, and Stein, KMW. Evaluation of omega-3 status in professional basketball players. J Strength Cond Res 35(7): 1794-1799, 2021-Omega-3 polyunsaturated fatty acids (PUFA) has been shown to promote muscle remodeling, improve immune status, decrease muscle soreness, and help maintain explosive power. Research that has assessed omega-3 blood concentrations with athletes has primarily focused on the college athlete. However, limited work has been conducted with the professional athlete. Therefore, the purpose of this study was to evaluate the omega-3 PUFA blood concentrations, dietary, and supplement intake of professional basketball players. Blood collection occurred during preseason medical screenings and analyzed for eicosapentaenoic acid, docosahexaenoic acid, the omega-3 Index (O3i), and various fatty acids using dried blood spot sampling. The mean O3i of 119 professional basketball players was 5.02 + 1.19% (range, 2.84-9.76%). Dietary intake of players showed that 31% of players reported consuming no fish in their diet per week, with 61% of players reported consuming less than 2 servings of fish per week. Only 12 of the 119 players reported supplementing with omega-3 PUFA, which varied widely for dosage and frequency of supplementation. A moderate correlation was shown for O3i and dietary fish consumption per week (r = 0.58; p < 0.01) and fish consumption per month (r = 0.57; p < 0.01). A large number of players reported consuming less than the recommend amount of dietary fish per week and very few players reported supplementing with omega-3 PUFA. The low intake of omega-3 PUFA likely contributed, in part, to the majority of players having an O3i of less than 8%.

Mechanisms of Physical Fatigue and its Applications in Nutritional Interventions

Physical fatigue during exercise can be defined as an impairment of physical performance. Multiple factors have been found contributing to physical fatigue, including neurotransmitter-mediated defense action, insufficient energy supply, and induction of oxidative stress. These mechanistic findings provide a sound theoretical rationale for nutritional intervention since most of these factors can be modulated by nutrient supplementation. In this review, we summarize the current evidence regarding the functional role of nutrients supplementation in managing physical performance and propose the issues that need to be addressed for better utilization of nutritional supplementation approach to improve physical performance.

A Syrup–Water Mixture Increases Performance in the Yo-Yo Intermittent Recovery Test after a Soccer-Specific Preload in the Hoff Test: A Double-Blind Crossover Study

Background: The positive effect of carbohydrates from commercial beverages on soccer-specific exercise has been clearly demonstrated. However, no study is available that uses a home-mixed beverage in a test where technical skills were required. Methods: Nine subjects participated voluntarily in this double-blind, randomized, placebo-controlled crossover study. On three testing days, the subjects performed six Hoff tests with a 3-min active break as a preload and then the Yo-Yo Intermittent Running Test Level 1 (Yo-Yo IR1) until exhaustion. On test days 2 and 3, the subjects received either a 69 g carbohydrate-containing drink (syrup–water mixture) or a carbohydrate-free drink (aromatic water). Beverages were given in several doses of 250 mL each: 30 min before and immediately before the exercise and after 18 and 39 min of exercise. The primary target parameters were the running performance in the Hoff test and Yo-Yo IR1, body mass and heart rate. Statistical differences between the variables of both conditions were analyzed using paired samples t-tests. Results: The maximum heart rate in Yo-Yo IR1 showed significant differences (syrup: 191.1 ± 6.2 bpm; placebo: 188.0 ± 6.89 bpm; t(6) = −2.556; p = 0.043; dz = 0.97). The running performance in Yo-Yo IR1 under the condition syrup significantly increased by 93.33 ± 84.85 m (0–240 m) on average (p = 0.011). Conclusions: The intake of a syrup–water mixture with a total of 69 g carbohydrates leads to an increase in high-intensive running performance after soccer specific loads. Therefore, the intake of carbohydrate solutions is recommended for intermittent loads and should be increasingly considered by coaches and players.

Primary, Secondary, and Tertiary Effects of Carbohydrate Ingestion During Exercise

The purpose of this current opinion paper is to describe the journey of ingested carbohydrate from 'mouth to mitochondria' culminating in energy production in skeletal muscles during exercise. This journey is conveniently described as primary, secondary, and tertiary events. The primary stage is detection of ingested carbohydrate by receptors in the oral cavity and on the tongue that activate reward and other centers in the brain leading to insulin secretion. After digestion, the secondary stage is the transport of monosaccharides from the small intestine into the systemic circulation. The passage of these monosaccharides is facilitated by the presence of various transport proteins. The intestinal mucosa has carbohydrate sensors that stimulate the release of two 'incretin' hormones (GIP and GLP-1) whose actions range from the secretion of insulin to appetite regulation. Most of the ingested carbohydrate is taken up by the liver resulting in a transient inhibition of hepatic glucose release in a dose-dependent manner. Nonetheless, the subsequent increased hepatic glucose (and lactate) output can increase exogenous carbohydrate oxidation rates by 40-50%. The recognition and successful distribution of carbohydrate to the brain and skeletal muscles to maintain carbohydrate oxidation as well as prevent hypoglycaemia underpins the mechanisms to improve exercise performance.

Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges

Obesity affects large numbers of patients with type 1 diabetes (T1D) across their lifetime, with rates ranging between 2.8% and 37.1%. Patients with T1D and obesity are characterized by the presence of insulin resistance, of high insulin requirements, have a greater cardiometabolic risk and an enhanced risk of developing chronic complications when compared to normal-weight persons with T1D. Dual treatment of obesity and T1D is challenging and no specific guidelines for improving outcomes of both glycemic control and weight management have been established for this population. Nevertheless, although evidence is scarce, a comprehensive approach based on a balanced hypocaloric diet, physical activity and cognitive behavioral therapy by a multidisciplinary team, expert in both obesity and diabetes, remains as the best clinical practice. However, weight loss responses with lifestyle changes alone are limited, so in the "roadmap" of the treatment of obesity in T1D, it will be helpful to include anti-obesity pharmacotherapy despite at present there is a lack of evidence since T1D patients have been excluded from anti-obesity drug clinical trials. In case of severe obesity, bariatric surgery has proven to be of benefit in obtaining a substantial and long-term weight loss and reduction in cardiovascular risk. The near future looks promising with the development of new and more effective anti-obesity treatments and strategies to improve insulin resistance and oxidative stress. Advances in precision medicine may help individualize and optimize the medical management and care of these patients. This review, by gathering current evidence, highlights the need of solid knowledge in all facets of the treatment of patients with obesity and T1D that can only be obtained through high quality well-designed studies.

13. Children and Adolescents: Standards of Medical Care in Diabetes-2021

The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc21-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc21-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

A Survey on Dietary Supplement Consumption in Amateur and Professional Rugby Players

Purpose: the aim of the present study was to analyse the pattern of dietary supplements (DS) consumption on federated rugby players, including the analysis of differences based on the sex and competitive level (professional vs. amateurs). Material and methods: 144 rugby players (83 male and 61 female), of whom 69 were professionals and 75 amateurs, were recruited for the study. All the participants filled out a specific questionnaire about DS consumption including questions related to the consumption of DS and their effects on sport performance and health status. Results: 65.3% of participants declared consuming at least one DS, with a higher prevalence in males than females (77.1% vs. 49.2%) and in professionals thanin amateur players (79.7% vs. 52.0%). The main reason for consumption was to enhance sport performance (62.3%) with differences only based on sex (74.3% males vs. 43.2% females). The most common purchase sites were the Internet (45.6%) and specialised stores (39.8%). As to the moment of ingestion, professionals did this most frequently during competition and training (56.4% vs. 28.2%), whereas amateur players did so only during competition (20.5% vs. 3.6%). Moreover, professional player intake most frequently in post-exercise (65.5% vs. 35.9%), whereas amateur during pre-exercise (30.8% vs. 5.5%). The DS most consumed included whey protein (44%), caffeine (42%), sports drinks (38%), energy bars (34%) and creatine monohydrate (31%), with a higher prevalence in male and professional players of whey protein and creatine monohydrate. Conclusions: The main reason for DS consumption is for enhancing sports performance). Professional players more frequently purchase them on the Internet and consume DS during training and competition period and in the post-exercise, whereas amateur players consume during competition and pre-exercise. Related to the main form of DS consumption, it is observed that a moderate consumption of DS could be considered ergogenic, such as whey protein, sport bar and creatine, while an absence of other DS could be considered ergogenic.

Carbohydrate and Glutamine Supplementation Attenuates the Increase in Rating of Perceived Exertion during Intense Exercise in Hypoxia Similar to 4200 m

The rating of perceived exertion (RPE) indicates the feeling of fatigue. However, hypoxia worsens the condition and can worsen RPE. We evaluated whether carbohydrate and glutamine supplementation alters RPE and physiological markers in running at 70% peak oxygen uptake until exhaustion in a simulated altitude of 4500 m. Nine volunteers underwent three running tests at 70% peak oxygen uptake until exhaustion: (1) hypoxia and placebo, (2) hypoxia and 8% maltodextrin, and (3) hypoxia after six days of glutamine supplementation (20 g/day) and 8% maltodextrin. The exercise and supplementation were randomized and double-blinded. Lactate, heart rate, haemoglobin O₂ saturation (SpO₂%), and RPE (6-20 scale) were analyzed at the 15th and 30th min. The level of significance was set at p ≤ 0.05. SpO₂% decreased at the 15th and 30th minutes compared to resting in placebo, carbohydrate, and glutamine supplementation. RPE increased at the 30th minute compared to the 15th minute in placebo and carbohydrate supplementation; however, there was no difference in the glutamine supplementation condition. Heart rate and lactate increased after the 15th and 30th minutes compared to resting, similar to the three conditions studied. We conclude that previous supplementation with glutamine and carbohydrate during intense exercise in hypoxia similar to 4500 m can attenuate the increase in RPE by the increase in glycemia and can be a useful strategy for people who exercise in these conditions.

Acute Effect of Brief Mindfulness-Based Intervention Coupled with Fluid Intake on Athletes' Cognitive Function

During the half time of intermittent team sports, substantial physiological changes relating to acid-base balance and glycemic response affect the second-half performance. Refuel and rehydrate strategy is therefore necessary to be investigated. This field experiment assessed the acute effect of a brief mindfulness-based intervention (MBI) coupled with fluid intake on players' cognitive function in a simulated soccer game. In a single-blinded, randomized, cross-over experiment, 14 male players received three treatments [Control: noncarbohydrate solution + traveling introduction audio; CHO: Carbohydrate (CHO)-electrolyte solution + traveling introduction audio; and CHO-M: CHO-electrolyte solution + MBI] during a simulated half-time break of a soccer game. Participants' mindfulness level, blood glucose and lactate, rating of perceived exertion, and cognitive function performance assessed by the Stroop effect task (ST), Corsi block-tapping test (CBT), and rapid visual information processing task (RVIPT) were immediately measured before, during, and after the trial. Repeated measure ANOVA was used for statistical analysis. The results revealed that: (1) in ST, the CHO_M group performed better than the Control group and marginally better than the CHO group; (2) in CBT, both the Control group and CHO-M group responded faster in the posttest than in the pretest; however, the performance of the CHO group remained the same; (3) the CHO group spent less time on missing numbers in post RVIPT compared with the other two groups. In conclusion, findings of this study provided a preliminary evidence of the positive effect of MBI coupled with CHO intake on athletes' cognitive function, with both positive and negative effect of CHO ingestion.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

A single dose of purple grape juice improves physical performance and antioxidant activity in runners: a randomized, crossover, double-blind, placebo study

PURPOSE

To investigate the effects of a single dose of juice on physical performance, oxidative stress, inflammation and muscle damage in runners.

METHODS

Fourteen recreational male runners (39 ± 9 years, VO2peak = 55.9 ± 6.5 ml/kg/min) performed two running tests to exhaustion at 80% of VO2max after ingesting grape juice or a placebo drink (10 ml/kg/day) randomly. Blood samples were taken before and 2 h after supplementation and immediately after running to analyze total antioxidant capacity (TAC), malondialdehyde (MDA), alpha-1 acid glycoprotein (A1GPA), high-sensitivity C-reactive protein (hs-CRP), creatine kinase (CK) and lactate dehydrogenase (LDH).

RESULTS

The participants ran for an average of 59.2 ± 27.8 min until exhaustion in the placebo group and for 68.4 ± 29.7 min until exhaustion in the grape juice intake group, which was a significantly longer time (p = 0.008). This improvement in physical performance was accompanied by a 43.6% increase in TAC (p = 0.000) at the post-exercise timepoint compared to the level at baseline. MDA, A1GPA, hs-CRP, CK, and LDH did not exhibit changes. In contrast, no significant change in any variable was observed after consuming the placebo drink.

CONCLUSION

The single-dose intake of purple grape juice demonstrated an ergogenic effect in recreational runners by increasing run time to exhaustion and increasing antioxidant activity.

Nutrition and Exercise Performance in Adults With Type 1 Diabetes

The best nutritional practices for exercise and sports performance are largely activity specific. The presence of type 1 diabetes undeniably bestows additional factors to consider to manage exercise and ensure adequate nutrients and fuels are available for optimal performance. Whether participating in sports or physical activity on a recreational basis or striving to achieve a high level of athletic performance, individuals with type 1 diabetes must pay attention to their nutritional and dietary patterns, including intake of macronutrients, micronutrients, fluids and supplements, such as caffeine to maintain metabolic and glycemic balance. Performance aside, nutritional recommendations may also differ on an individual basis relative to exercise, glycemic management and body weight goals. Balancing all these dietary factors can be challenging for individuals with type 1 diabetes, and many related aspects have yet to be fully researched in this population.

Montmorency tart cherry juice does not reduce markers of muscle soreness, function and inflammation following professional male rugby League match-play

Rugby League (RL) match-play causes muscle damage, inflammation and symptoms of fatigue. To facilitate recovery, nutritional interventions are often employed, including Montmorency cherry juice (MC). We assessed the effects of MC on recovery following RL match-play in eleven male professional RL players who played in two matches (7-days apart) with MC or placebo (PLB) supplemented for 5-days pre-match, matchday and 2-days post-match. Blood was collected 48h pre-match, half-time, within 30-mins of full-time and 48h post-match to assess Interleukin concentrations (IL-6, -8 -10). Self-reported sleep, fatigue, mood, stress, and muscle-soreness were assessed 24h pre and 24 and 48h post-matches with muscle function assessed 48h pre and 48h post-match. No differences in distance covered (6334 ± 1944 Vs 6596 ± 1776m) and total collisions (28 ± 11 Vs 29 ± 13) were observed between both matches. There was a small albeit significant increase in IL-6, -8 and -10 concentrations pre to post-match in both PLB (IL-6: 0.83 ± 0.92 Vs 2.91 ± 1.40, IL-8: 2.16 ± 1.22 Vs 3.91 ± 1.61 and IL-10: 2.51 ± 2.14 Vs 0.61 ± 0.50 pg^.mL^-1) and MC groups (IL-6: 0.53 ± 0.53 Vs 2.24 ± 1.73, IL-8: 1.85 ± 0.96 Vs 3.46 ± 1.12 and IL-10: 0.48 ± 0.50 Vs 2.54 ± 2.10 pg^.mL^-1), although there were no significant differences between groups (P<0.05). Likewise, there was a small but significant increase in muscle soreness (P=0.01) and reduction in CMJ (P=0.003) with no significant differences between groups. No significant changes in sleep, fatigue or mood (P>0.05) were observed pre to post-match or between groups. These data suggest MC does not affect the modest changes observed in cytokine responses and markers of recovery from RL match-play.Keywords: Team Sport, Nutrition, Performance, Recovery.

Ingestion of Carbohydrate Prior to and during Maximal, Sprint Interval Cycling Has No Ergogenic Effect: A Randomized, Double-Blind, Placebo Controlled, Crossover Study

Carbohydrate (CHO) ingestion may improve intermittent sprint performance in repeated sprint efforts ≤15 s. Yet, evidence for its efficacy on sprint interval durations ~30 s is lacking. The purpose of this study was to investigate the effects of CHO ingestion on maximal sprint interval exercise. Fifteen (n = 15) recreational athletes (13/2 males/females, age 22 ± 2 years; height 176 ± 11 cm; mass 76.8 ± 11.3 kg) volunteered for this randomised, double-blind, placebo-controlled, crossover design. Participants completed two experimental trials (performed 10-days apart) involving the ingestion of an 8% CHO solution or a flavour and appearance-matched placebo (PLA) solution (5 mL/kg/bw), immediately before exercise, and preceding the second interval of four × 30 s bouts of repeated maximal sprint efforts (separated by 3.5 min of passive recovery). Peak and mean power (W) output progressively decreased during the repeated sprints (main effect of time, p < 0.0001), but there were no differences between CHO and PLA during any of the sprints (p > 0.05 for condition main effect and condition × time interaction). Physiological responses (blood lactate, heart rate, oxygen consumption, respiratory exchange ratio and RPE) were also unaltered by CHO ingestion. In conclusion, CHO ingestion does not enhance performance or modulate physiological responses during intermittent maximal, sprint cycling.

The influence of progressive-chronic and acute sodium bicarbonate supplementation on anaerobic power and specific performance in team sports: a randomized, double-blind, placebo-controlled crossover study

Background

The aims of this study were to verify the effect of progressive-chronic and acute sodium bicarbonate (SB) supplementation on the anaerobic capacity, blood acid-base balance, and discipline-specific performance in team sports disciplines.

Methods

Twenty-four trained male field hockey players completed a randomized, placebo-controlled, crossover trial of either progressive-chronic (increments from 0.05 up to 0.2 g/kg) or an acute one-off dose (0.2 g/kg) supplementation protocol. Before and after treatments, athletes completed an exercise protocol that comprised of a discipline-specific field performance test conducted between two separate Wingate anaerobic tests (WAnTs).

Results

Progressive-chronic SB supplementation improved anaerobic capacity in the first bout of WAnTs, as observed based on an increase in mean power (MP: 575 ± 71 vs. 602 ± 67 W, p = 0.005, ~ + 4.7%), peak power (PP: 749 ± 94 vs. 777 ± 96 W, p = 0.002, ~ + 3.7%), power carry threshold (P_CT) at 97%_PP (727 ± 91 vs. 753 ± 93 W, p = 0.002, ~ + 3.6%) and average power over P_CT (739 ± 94 vs. 765 ± 95 W, p = 0.001, ~ + 3.5%). Acute SB supplementation had no effect on anaerobic capacity. However, an improvement in time during discipline-specific field performance test was observed after progressive-chronic (919 ± 42 vs. 912 ± 27 s, p = 0.05; ~ - 0.8%) and acute (939 ± 26 vs. 914 ± 22 s, p = 0.006, ~ 2.7%) SB supplementation. Acute SB supplementation also improved post-exercise parameters of acid-base balance (based on blood pH, bicarbonate concentration and base excess) compared to no supplementation or placebo.

Conclusions

Our study indicates that both chronic and acute SB supplementation positively supports discipline-specific performance among field hockey athletes. Moreover, the chronic protocol supported anaerobic power indices before the inset of exercise-induced fatigue but had no significant impact afterwards. However, only the acute protocol significantly affected the buffering capacity, which can be used to determine athlete's performance during high-intensity sporting events. This study design therefore highlighted that future studies focusing on sodium bicarbonate supplementation in team sports should concentrate on the efficiency of chronic and acute supplementation in varying time frames.