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Zieff G, Cornwall J, Blue MN, Smith-Ryan AE, Stoner L. Ultrasound-based measurement of central adiposity: Key considerations and guidelines. Obes Rev 2024; 25:e13716. [PMID: 38418428 DOI: 10.1111/obr.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 12/05/2023] [Accepted: 01/12/2024] [Indexed: 03/01/2024]
Abstract
Central adiposity, which is visceral and subcutaneous adiposity in the abdominal region, is a known risk factor for developing chronic cardiometabolic diseases. Central adiposity can be measured relatively inexpensively using ultrasound. Ultrasound has been shown to be precise and reliable, with measurement accuracy comparable to computed tomography and magnetic resonance. Despite the advantages conferred by ultrasound, widespread adoption has been hindered by lack of reliable standard operating procedures. To consolidate the literature and bring clarity to the use of ultrasound-derived measures of central adiposity, this review outlines (i) the [patho]physiological importance of central adiposity to cardiometabolic disease risk; (ii) an overview of the history and main technical aspects of ultrasound methodology; (iii) key measurement considerations, including transducer selection, subject preparation, image acquisition, image analysis, and operator training; and (iv) guidelines for standardized ultrasound protocols for measuring central adiposity.
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Affiliation(s)
- Gabriel Zieff
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Malia N Blue
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Cabre HE, Ladan AN, Moore SR, Joniak KE, Blue MNM, Pietrosimone BG, Hackney AC, Smith-Ryan AE. Effects of Hormonal Contraception and the Menstrual Cycle on Fatigability and Recovery From an Anaerobic Exercise Test. J Strength Cond Res 2024:00124278-990000000-00426. [PMID: 38598545 DOI: 10.1519/jsc.0000000000004764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
ABSTRACT Cabre, HE, Ladan, AN, Moore, SR, Joniak, KE, Blue, MNM, Pietrosimone, BG, Hackney, AC, and Smith-Ryan, AE. Effects of hormonal contraception and the menstrual cycle on fatigability and recovery from an anaerobic exercise test. J Strength Cond Res XX(X): 000-000, 2024-This study sought to evaluate the effects of oral contraceptive (OC) and hormonal intrauterine device (H-IUD) use, compared with a eumenorrheic (EUM) cycle, on fatigability and recovery between hormone the phases. Peak power (PP), average power (AP), fatigue index (FI), blood lactate, vessel diameter, and blood flow (BF) were measured from a repeated sprint cycle test (10 × 6 seconds) in 60, healthy, active women (mean ± SD; age: 26.5 ± 7.0 years, BMI: 22.5 ± 3.7 kg·m-2) who used monophasic OC (≥6 months; n = 21), had a H-IUD (≥6 months; n = 20), or had regular naturally occurring menstrual cycle (≥3 months) or had a nonhormonal IUD (EUM; n = 19). Subjects were randomly assigned to begin in either the low-hormone phase (LHP) or high-hormone phase (HHP) and were tested once in each phase. Separate univariate analyses of covariances assessed the change from HHP to LHP between the groups, covaried for progesterone, with significance set at p ≤ 0.05. All groups demonstrated similar changes in PP, AP, FI, blood lactate, vessel diameter, and BF between the phases (p > 0.05). Although not significant, AP was higher in LHP for OC (Δ -248.2 ± 1,301.4 W) and EUM (Δ -19.5 ± 977.7 W) and higher in HHP for H-IUD (Δ 369.3 ± 1,123.0 W). Oral contraceptive group exhibited a higher FI (Δ 2.0%) and reduced blood lactate clearance (Δ 2.5%) in HHP. In recreationally active women, hormonal contraception and hormone phases may minimally impact fatigue and recovery. Individual elite female athletes may benefit from understanding hormonal contraception type as performance and recovery may slightly vary across the cycle.
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Affiliation(s)
- Hannah E Cabre
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Alex N Ladan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sam R Moore
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Kelly E Joniak
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Malia N M Blue
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Brian G Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Moore SR, Cabre HE, Smith-Ryan AE. Body composition, physical activity, and menopause symptoms: how do they relate? Menopause 2024; 31:336-341. [PMID: 38442308 DOI: 10.1097/gme.0000000000002334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVE This study characterized the impact of physical activity (light, moderate, and vigorous [VIG] active minutes per day) and body composition (percent body fat [%BF] and fat-free mass index) on total menopausal symptoms (TMSs) in 72 premenopausal, perimenopausal (PERI), or postmenopausal women. METHODS Activity minutes were collected from wearable fitness trackers. Body composition was evaluated using a whole-body dual-energy x-ray absorptiometry scan. TMSs were quantified using The North American Menopause Society Questionnaire. RESULTS Significant associations were observed between TMSs and %BF ( r = 0.464, P < 0.001) and VIG ( r = -0.245, P = 0.038). %BF and VIG were significant predictors for TMSs across groups ( R2 = 0.146 and R2 = 0.092, respectively), but only %BF maintained for PERI ( R2 = 0.421, P < 0.001). CONCLUSIONS %BF predicted nearly half of the variance in PERI TMSs, whereas VIG predicted 9% of the sample variance, demonstrating an important influence of body fat accumulation and intense physical activity in the menopause transition. High-intensity exercise interventions to alleviate body composition changes may also reduce menopausal-related symptoms for PERI women.
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Muntis FR, Crandell JL, Evenson KR, Maahs DM, Seid M, Shaikh SR, Smith-Ryan AE, Mayer-Davis E. Pre-exercise protein intake is associated with reduced time in hypoglycaemia among adolescents with type 1 diabetes. Diabetes Obes Metab 2024; 26:1366-1375. [PMID: 38221862 PMCID: PMC10922329 DOI: 10.1111/dom.15438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/03/2023] [Accepted: 12/15/2023] [Indexed: 01/16/2024]
Abstract
AIM Secondary analyses were conducted from a randomized trial of an adaptive behavioural intervention to assess the relationship between protein intake (g and g/kg) consumed within 4 h before moderate-to-vigorous physical activity (MVPA) bouts and glycaemia during and following MVPA bouts among adolescents with type 1 diabetes (T1D). MATERIALS AND METHODS Adolescents (n = 112) with T1D, 14.5 (13.8, 15.7) years of age and 36.6% overweight/obese, provided measures of glycaemia using continuous glucose monitoring [percentage of time above range (>180 mg/dl), time in range (70-180 mg/dl), time below range (TBR; <70 mg/dl)], self-reported physical activity (previous day physical activity recalls), and 24 h dietary recall data at baseline and 6 months post-intervention. Mixed effects regression models adjusted for design (randomization assignment, study site), demographic, clinical, anthropometric, dietary, physical activity and timing covariates estimated the association between pre-exercise protein intake on percentage of time above range, time in range and TBR during and following MVPA. RESULTS Pre-exercise protein intakes of 10-19.9 g and >20 g were associated with an absolute reduction of -4.41% (p = .04) and -4.83% (p = .02) TBR during physical activity compared with those who did not consume protein before MVPA. Similarly, relative protein intakes of 0.125-0.249 g/kg and ≥0.25 g/kg were associated with -5.38% (p = .01) and -4.32% (p = .03) absolute reductions in TBR during physical activity. We did not observe a significant association between protein intake and measures of glycaemia following bouts of MVPA. CONCLUSIONS Among adolescents with T1D, a dose of ≥10 g or ≥0.125 g/kg of protein within 4 h before MVPA may promote reduced time in hypoglycaemia during, but not following, physical activity.
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Affiliation(s)
- Franklin R Muntis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jamie L Crandell
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David M Maahs
- Division of Endocrinology, Department of Pediatrics, School of Medicine, Stanford University, Stanford, California, USA
- Stanford Diabetes Research Center, Stanford, California, USA
| | - Michael Seid
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Saame R Shaikh
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Abbie E Smith-Ryan
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth Mayer-Davis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Cabre HE, Greenwalt CE, Gould LM, Smith-Ryan AE. The effects of L-Citrulline and Glutathione on Endurance performance in young adult trained males. J Int Soc Sports Nutr 2023; 20:2206386. [PMID: 37125500 PMCID: PMC10134954 DOI: 10.1080/15502783.2023.2206386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/19/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Citrulline may amplify the effects of L-arginine and nitric oxide concentration, which may augment vasodilation and blood flow, thereby enhancing aerobic exercise performance. The purpose of this randomized, double-blind, placebo-controlled crossover study was to investigate effects of L-citrulline + Glutathione on aerobic exercise performance and blood flow in well-trained men. METHODS Twenty-five males (Mean ± SD; Age: 22.2 ± 2.4 yrs; Height: 177.0 ± 4.8 cm; Weight: 75.3 ± 6.9 kg) were randomly assigned to the L-citrulline + Glutathione (Setria Performance Blend: SPB; L-citrulline [2 g] + glutathione [200 mg], 6 capsules) or placebo (PL; 3.1 g cellulose, 6 capsules) group. Participants performed a maximal oxygen consumption treadmill test to determine peak velocity (PV) and returned after eight days of ingesting either PL or SPB. Three timed treadmill runs to exhaustion (TTE) were performed at 90%, 100%, and 110% PV. Brachial artery blood flow and vessel diameter were assessed using ultrasound at 1-hr prior to exercise (1hrPrEX), after each exercise bout, immediately post-exercise (immediate PEX), and 30 minutes post exercise (30minPEX) at visits 2 and 4. Blood analytes were assessed via venous blood draws at visit 1, visit 3, and 1hrPEX, immediate PEX, and 30minPEX at visits 2 and 4. After a 14-day washout, participants repeated the same procedures, ingesting the opposite treatment. Separate repeated measures ANOVAs were performed for TTE, vessel diameter, blood flow, and blood analytes. RESULTS Blood flow was significantly augmented 30minPEX (p = 0.04) with SPB in comparison with PL. L-citrulline and L-arginine plasma concentrations were significantly elevated immediately PEX (p = 0.001) and 30-minPEX (p = 0.001) following SPB in comparison to PL. CONCLUSION Acute ingestion of SPB after eight days may enhance blood flow, L-citrulline, and L-arginine plasma concentrations after high-intensity exercise, which may enhance performance. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/ct2/show/nct04090138], identifier [NCT04090138].
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Affiliation(s)
- Hannah E. Cabre
- University of North Carolina at Chapel Hill, Applied Physiology Laboratory, Department of Exercise and Sport Science, Chapel Hill, NC
- University of North Carolina at Chapel Hill, Human Movement Science Curriculum, Department of Allied Health Science, Chapel Hill, NC
| | - Casey E. Greenwalt
- University of North Carolina at Chapel Hill, Applied Physiology Laboratory, Department of Exercise and Sport Science, Chapel Hill, NC
| | - Lacey M. Gould
- University of North Carolina at Chapel Hill, Applied Physiology Laboratory, Department of Exercise and Sport Science, Chapel Hill, NC
| | - Abbie E. Smith-Ryan
- University of North Carolina at Chapel Hill, Applied Physiology Laboratory, Department of Exercise and Sport Science, Chapel Hill, NC
- University of North Carolina at Chapel Hill, Human Movement Science Curriculum, Department of Allied Health Science, Chapel Hill, NC
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Sims ST, Kerksick CM, Smith-Ryan AE, Janse de Jonge XAK, Hirsch KR, Arent SM, Hewlings SJ, Kleiner SM, Bustillo E, Tartar JL, Starratt VG, Kreider RB, Greenwalt C, Rentería LI, Ormsbee MJ, VanDusseldorp TA, Campbell BI, Kalman DS, Antonio J. International society of sports nutrition position stand: nutritional concerns of the female athlete. J Int Soc Sports Nutr 2023; 20:2204066. [PMID: 37221858 DOI: 10.1080/15502783.2023.2204066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Based on a comprehensive review and critical analysis of the literature regarding the nutritional concerns of female athletes, conducted by experts in the field and selected members of the International Society of Sports Nutrition (ISSN), the following conclusions represent the official Position of the Society: 1. Female athletes have unique and unpredictable hormone profiles, which influence their physiology and nutritional needs across their lifespan. To understand how perturbations in these hormones affect the individual, we recommend that female athletes of reproductive age should track their hormonal status (natural, hormone driven) against training and recovery to determine their individual patterns and needs and peri and post-menopausal athletes should track against training and recovery metrics to determine the individuals' unique patterns. 2. The primary nutritional consideration for all athletes, and in particular, female athletes, should be achieving adequate energy intake to meet their energy requirements and to achieve an optimal energy availability (EA); with a focus on the timing of meals in relation to exercise to improve training adaptations, performance, and athlete health. 3. Significant sex differences and sex hormone influences on carbohydrate and lipid metabolism are apparent, therefore we recommend first ensuring athletes meet their carbohydrate needs across all phases of the menstrual cycle. Secondly, tailoring carbohydrate intake to hormonal status with an emphasis on greater carbohydrate intake and availability during the active pill weeks of oral contraceptive users and during the luteal phase of the menstrual cycle where there is a greater effect of sex hormone suppression on gluconogenesis output during exercise. 4. Based upon the limited research available, we recommend that pre-menopausal, eumenorrheic, and oral contraceptives using female athletes should aim to consume a source of high-quality protein as close to beginning and/or after completion of exercise as possible to reduce exercise-induced amino acid oxidative losses and initiate muscle protein remodeling and repair at a dose of 0.32-0.38 g·kg-1. For eumenorrheic women, ingestion during the luteal phase should aim for the upper end of the range due to the catabolic actions of progesterone and greater need for amino acids. 5. Close to the beginning and/or after completion of exercise, peri- and post-menopausal athletes should aim for a bolus of high EAA-containing (~10 g) intact protein sources or supplements to overcome anabolic resistance. 6. Daily protein intake should fall within the mid- to upper ranges of current sport nutrition guidelines (1.4-2.2 g·kg-1·day-1) for women at all stages of menstrual function (pre-, peri-, post-menopausal, and contraceptive users) with protein doses evenly distributed, every 3-4 h, across the day. Eumenorrheic athletes in the luteal phase and peri/post-menopausal athletes, regardless of sport, should aim for the upper end of the range. 7. Female sex hormones affect fluid dynamics and electrolyte handling. A greater predisposition to hyponatremia occurs in times of elevated progesterone, and in menopausal women, who are slower to excrete water. Additionally, females have less absolute and relative fluid available to lose via sweating than males, making the physiological consequences of fluid loss more severe, particularly in the luteal phase. 8. Evidence for sex-specific supplementation is lacking due to the paucity of female-specific research and any differential effects in females. Caffeine, iron, and creatine have the most evidence for use in females. Both iron and creatine are highly efficacious for female athletes. Creatine supplementation of 3 to 5 g per day is recommended for the mechanistic support of creatine supplementation with regard to muscle protein kinetics, growth factors, satellite cells, myogenic transcription factors, glycogen and calcium regulation, oxidative stress, and inflammation. Post-menopausal females benefit from bone health, mental health, and skeletal muscle size and function when consuming higher doses of creatine (0.3 g·kg-1·d-1). 9. To foster and promote high-quality research investigations involving female athletes, researchers are first encouraged to stop excluding females unless the primary endpoints are directly influenced by sex-specific mechanisms. In all investigative scenarios, researchers across the globe are encouraged to inquire and report upon more detailed information surrounding the athlete's hormonal status, including menstrual status (days since menses, length of period, duration of cycle, etc.) and/or hormonal contraceptive details and/or menopausal status.
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Affiliation(s)
- Stacy T Sims
- SPRINZ Auckland University of Technology, Auckland, New Zealand
| | - Chad M Kerksick
- Exercise & Sport Nutrition Lab, Department of Kinesiology and Sport Management, Saint Charles, TX, USA
| | - Abbie E Smith-Ryan
- Institute of Sports Sciences and Medicine, Florida State University, Nutrition and Integrative Physiology, Tallahassee, FL, USA
| | | | - Katie R Hirsch
- Jacksonville University, Department of Health and Exercise Sciences, Jacksonville, FL, USA
| | - Shawn M Arent
- Jacksonville University, Department of Health and Exercise Sciences, Jacksonville, FL, USA
| | - Susan Joyce Hewlings
- University of South Florida, Performance and Physique Enhancement Laboratory,Tampa, FL, USA
| | - Susan M Kleiner
- Dr. Kiran C Patel College of Osteopathic Medicine, Nova Southeastern University, Nutrition Department, Davie, FL, USA
| | - Erik Bustillo
- Nova Southeastern University, Exercise and Sport Science, Fight Science Lab, Davie, FL, USA
| | - Jaime L Tartar
- College of Science, Technology, and Health, Lindenwood University, Exercise and Performance Nutrition Laboratory, St Charles, MO, USA
| | - Valerie G Starratt
- College of Science, Technology, and Health, Lindenwood University, Exercise and Performance Nutrition Laboratory, St Charles, MO, USA
| | - Richard B Kreider
- University of North Carolina Chapel Hill, Department of Exercise and Sport Science, Chapel Hill, NC, USA
| | - Casey Greenwalt
- Macquarie University, Department of Health Sciences, Macquarie Park, NSW, Australia
| | - Liliana I Rentería
- Macquarie University, Department of Health Sciences, Macquarie Park, NSW, Australia
| | - Michael J Ormsbee
- Macquarie University, Department of Health Sciences, Macquarie Park, NSW, Australia
| | - Trisha A VanDusseldorp
- University of South, Department of Exercise Science, Arnold School of Public Health, Carolina, Columbia, USA
- Nutrasource, Guelph, Ontario, Canada
| | | | | | - Jose Antonio
- Nova Southeastern University, Department of Psychology and Neuroscience, Fort Lauderdale, FL, USA
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Greenwalt CE, Angeles E, Vukovich MD, Smith-Ryan AE, Bach CW, Sims ST, Zeleny T, Holmes KE, Presby DM, Schiltz KJ, Dupuit M, Renteria LI, Ormsbee MJ. Pre-sleep feeding, sleep quality, and markers of recovery in division I NCAA female soccer players. J Int Soc Sports Nutr 2023; 20:2236055. [PMID: 37470428 PMCID: PMC10360998 DOI: 10.1080/15502783.2023.2236055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/01/2023] [Indexed: 07/21/2023] Open
Abstract
Pre-sleep nutrition habits in elite female athletes have yet to be evaluated. A retrospective analysis was performed with 14 NCAA Division I female soccer players who wore a WHOOP, Inc. band - a wearable device that quantifies recovery by measuring sleep, activity, and heart rate metrics through actigraphy and photoplethysmography, respectively - 24 h a day for an entire competitive season to measure sleep and recovery. Pre-sleep food consumption data were collected via surveys every 3 days. Average pre-sleep nutritional intake (mean ± sd: kcals 330 ± 284; cho 46.2 ± 40.5 g; pro 7.6 ± 7.3 g; fat 12 ± 10.5 g) was recorded. Macronutrients and kcals were grouped into high and low categories based upon the 50th percentile of the mean to compare the impact of a high versus low pre-sleep intake on sleep and recovery variables. Sleep duration (p = 0.10, 0.69, 0.16, 0.17) and sleep disturbances (p = 0.42, 0.65, 0.81, 0.81) were not affected by high versus low kcal, PRO, fat, CHO intake, respectively. Recovery (p = 0.81, 0.06, 0.81, 0.92), RHR (p = 0.84, 0.64, 0.26, 0.66), or HRV (p = 0.84, 0.70, 0.76, 0.93) were also not affected by high versus low kcal, PRO, fat, or CHO consumption, respectively. Consuming a small meal before bed may have no impact on sleep or recovery.
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Affiliation(s)
- Casey E Greenwalt
- Florida State University, Institute of Sports Science and Medicine, Nutrition and Integrative Physiology Department, Tallahassee, FL, USA
| | - Elisa Angeles
- Florida State University, Institute of Sports Science and Medicine, Nutrition and Integrative Physiology Department, Tallahassee, FL, USA
| | - Matthew D Vukovich
- College of Education and Human Sciences, South Dakota State University, Brookings, SD, USA
| | - Abbie E Smith-Ryan
- University of North Carolina at Chapel Hill, Applied Physiology Laboratory, Department of Exercise and Sport Science, Chapel Hill, NC, USA
| | - Chris W Bach
- Department of Athletics, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Tucker Zeleny
- Department of Athletics, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - David M Presby
- WHOOP, Inc, Department of Data Science and Research, Boston, MA, USA
| | - Katie J Schiltz
- Florida State University, Institute of Sports Science and Medicine, Nutrition and Integrative Physiology Department, Tallahassee, FL, USA
| | - Marine Dupuit
- Florida State University, Institute of Sports Science and Medicine, Nutrition and Integrative Physiology Department, Tallahassee, FL, USA
- Clermont Auvergne University, Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France
| | - Liliana I Renteria
- Florida State University, Institute of Sports Science and Medicine, Nutrition and Integrative Physiology Department, Tallahassee, FL, USA
| | - Michael J Ormsbee
- Florida State University, Institute of Sports Science and Medicine, Nutrition and Integrative Physiology Department, Tallahassee, FL, USA
- University of KwaZulu-Natal, School of Health Sciences, Discipline of Biokinetics, Exercise and Leisure Sciences, Durban, South Africa
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Jagim AR, Harty PS, Tinsley GM, Kerksick CM, Gonzalez AM, Kreider RB, Arent SM, Jager R, Smith-Ryan AE, Stout JR, Campbell BI, VanDusseldorp T, Antonio J. International society of sports nutrition position stand: energy drinks and energy shots. J Int Soc Sports Nutr 2023; 20:2171314. [PMID: 36862943 PMCID: PMC9987737 DOI: 10.1080/15502783.2023.2171314] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 03/04/2023] Open
Abstract
Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of energy drink (ED) or energy shot (ES) consumption on acute exercise performance, metabolism, and cognition, along with synergistic exercise-related performance outcomes and training adaptations. The following 13 points constitute the consensus of the Society and have been approved by the Research Committee of the Society: Energy drinks (ED) commonly contain caffeine, taurine, ginseng, guarana, carnitine, choline, B vitamins (vitamins B1, B2, B3, B5, B6, B9, and B12), vitamin C, vitamin A (beta carotene), vitamin D, electrolytes (sodium, potassium, magnesium, and calcium), sugars (nutritive and non-nutritive sweeteners), tyrosine, and L-theanine, with prevalence for each ingredient ranging from 1.3 to 100%. Energy drinks can enhance acute aerobic exercise performance, largely influenced by the amount of caffeine (> 200 mg or >3 mg∙kg bodyweight [BW-1]) in the beverage. Although ED and ES contain several nutrients that are purported to affect mental and/or physical performance, the primary ergogenic nutrients in most ED and ES based on scientific evidence appear to be caffeine and/or the carbohydrate provision. The ergogenic value of caffeine on mental and physical performance has been well-established, but the potential additive benefits of other nutrients contained in ED and ES remains to be determined. Consuming ED and ES 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance with doses >3 mg∙kg BW-1. Consuming ED and ES containing at least 3 mg∙kg BW-1 caffeine is most likely to benefit maximal lower-body power production. Consuming ED and ES can improve endurance, repeat sprint performance, and sport-specific tasks in the context of team sports. Many ED and ES contain numerous ingredients that either have not been studied or evaluated in combination with other nutrients contained in the ED or ES. For this reason, these products need to be studied to demonstrate efficacy of single- and multi-nutrient formulations for physical and cognitive performance as well as for safety. Limited evidence is available to suggest that consumption of low-calorie ED and ES during training and/or weight loss trials may provide ergogenic benefit and/or promote additional weight control, potentially through enhanced training capacity. However, ingestion of higher calorie ED may promote weight gain if the energy intake from consumption of ED is not carefully considered as part of the total daily energy intake. Individuals should consider the impact of regular coingestion of high glycemic index carbohydrates from ED and ES on metabolic health, blood glucose, and insulin levels. Adolescents (aged 12 through 18) should exercise caution and seek parental guidance when considering the consumption of ED and ES, particularly in excessive amounts (e.g. > 400 mg), as limited evidence is available regarding the safety of these products among this population. Additionally, ED and ES are not recommended for children (aged 2-12), those who are pregnant, trying to become pregnant, or breastfeeding and those who are sensitive to caffeine. Diabetics and individuals with preexisting cardiovascular, metabolic, hepatorenal, and/or neurologic disease who are taking medications that may be affected by high glycemic load foods, caffeine, and/or other stimulants should exercise caution and consult with their physician prior to consuming ED. The decision to consume ED or ES should be based upon the beverage's content of carbohydrate, caffeine, and other nutrients and a thorough understanding of the potential side effects. Indiscriminate use of ED or ES, especially if multiple servings per day are consumed or when consumed with other caffeinated beverages and/or foods, may lead to adverse effects. The purpose of this review is to provide an update to the position stand of the International Society of Sports Nutrition (ISSN) integrating current literature on ED and ES in exercise, sport, and medicine. The effects of consuming these beverages on acute exercise performance, metabolism, markers of clinical health, and cognition are addressed, as well as more chronic effects when evaluating ED/ES use with exercise-related training adaptions.
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Affiliation(s)
- Andrew R. Jagim
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI, USA
- Exercise & Sport Science, University of Wisconsin – La Crosse, La Crosse, WI, USA
| | - Patrick S. Harty
- Exercise & Performance Nutrition Laboratory, Lindenwood University, St. Charles, MO, USA
| | - Grant M. Tinsley
- Energy Balance and Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Chad M. Kerksick
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI, USA
- Exercise & Performance Nutrition Laboratory, Lindenwood University, St. Charles, MO, USA
| | - Adam M. Gonzalez
- Department of Allied Health and Kinesiology, Hofstra University, Hempstead, NY, USA
| | - Richard B. Kreider
- Exercise & Sport Nutrition Lab, Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX, USA
| | - Shawn M Arent
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Abbie E. Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Jeffrey R. Stout
- School of Kinesiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA
| | - Bill I. Campbell
- Performance & Physique Enhancement Laboratory, University of South Florida, Tampa, FL, USA
| | - Trisha VanDusseldorp
- Bonafede Health, LLC, JDS Therapeutics, Harrison, NY, USA
- Department of Health and Exercise Sciences, Jacksonville University, Jacksonville, FL, USA
| | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL, USA
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9
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Muntis FR, Mayer-Davis EJ, Shaikh SR, Crandell J, Evenson KR, Smith-Ryan AE. Post-Exercise Protein Intake May Reduce Time in Hypoglycemia Following Moderate-Intensity Continuous Exercise among Adults with Type 1 Diabetes. Nutrients 2023; 15:4268. [PMID: 37836552 PMCID: PMC10574378 DOI: 10.3390/nu15194268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Little is known about the role of post-exercise protein intake on post-exercise glycemia. Secondary analyses were conducted to evaluate the role of post-exercise protein intake on post-exercise glycemia using data from an exercise pilot study. Adults with T1D (n = 11), with an average age of 33.0 ± 11.4 years and BMI of 25.1 ± 3.4, participated in isoenergetic sessions of high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT). Participants completed food records on the days of exercise and provided continuous glucose monitoring data throughout the study, from which time in range (TIR, 70-180 mg/dL), time above range (TAR, >180 mg/dL), and time below range (TBR, <70 mg/dL) were calculated from exercise cessation until the following morning. Mixed effects regression models, adjusted for carbohydrate intake, diabetes duration, and lean mass, assessed the relationship between post-exercise protein intake on TIR, TAR, and TBR following exercise. No association was observed between protein intake and TIR, TAR, or TBR (p-values ≥ 0.07); however, a borderline significant reduction of -1.9% (95% CI: -3.9%, 0.0%; p = 0.05) TBR per 20 g protein was observed following MICT in analyses stratified by exercise mode. Increasing post-exercise protein intake may be a promising strategy to mitigate the risk of hypoglycemia following MICT.
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Affiliation(s)
- Franklin R. Muntis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (F.R.M.); (S.R.S.)
| | - Elizabeth J. Mayer-Davis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (F.R.M.); (S.R.S.)
- Department of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Saame R. Shaikh
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (F.R.M.); (S.R.S.)
| | - Jamie Crandell
- School of Nursing, University of North Carolina, Chapel Hill, NC 27599, USA;
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - Abbie E. Smith-Ryan
- Department of Exercise & Sports Science, University of North Carolina, Chapel Hill, NC 27599, USA;
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10
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Gordon AN, Moore SR, Patterson ND, Hostetter ME, Cabre HE, Hirsch KR, Hackney AC, Smith-Ryan AE. The Effects of Creatine Monohydrate Loading on Exercise Recovery in Active Women throughout the Menstrual Cycle. Nutrients 2023; 15:3567. [PMID: 37630756 PMCID: PMC10459976 DOI: 10.3390/nu15163567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Creatine supplementation improves anaerobic performance and recovery; however, to date, these outcomes have not been well explored in females. This study evaluated the effect of creatine monohydrate loading on exercise recovery, measured by heart rate variability (HRV) and repeated sprint performance, in women across the menstrual cycle. In this randomized, double-blind, cross-over study, 39 women (mean ± standard deviation: age: 24.6 ± 5.9 years, height: 172.5 ± 42.3 cm, weight: 65.1 ± 8.1 kg, BF: 27.4 ± 5.8%) were randomized to a creatine monohydrate (n = 19; 20 g per day in 4 × 5 g doses) or non-caloric PL group (n = 20). HRV was measured at rest and after participants completed a repeated sprint cycling test (10 × 6 s maximal sprints). Measurements were conducted before and after supplementation in the follicular/low hormone and luteal/high hormone phases. Creatine monohydrate supplementation did not influence HRV values, as no significant differences were seen in HRV values at rest or postexercise. For repeated sprint outcomes, there was a significant phase × supplement interaction (p = 0.048) for fatigue index, with the greatest improvement seen in high hormone in the creatine monohydrate group (-5.8 ± 19.0%) compared to changes in the PL group (0.1 ± 8.1%). Sprint performance and recovery were reduced by the high hormone for both groups. Though not statistically significant, the data suggests that creatine monohydrate could help counteract performance decrements caused by the high hormone. This data can help inform creatine monohydrate loading strategies for females, demonstrating potential benefits in the high hormone phase.
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Affiliation(s)
- Amanda N. Gordon
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.N.G.); (S.R.M.); (N.D.P.); (M.E.H.); (H.E.C.); (A.C.H.)
| | - Sam R. Moore
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.N.G.); (S.R.M.); (N.D.P.); (M.E.H.); (H.E.C.); (A.C.H.)
- Human Movement Science Curriculum, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Noah D. Patterson
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.N.G.); (S.R.M.); (N.D.P.); (M.E.H.); (H.E.C.); (A.C.H.)
| | - Maggie E. Hostetter
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.N.G.); (S.R.M.); (N.D.P.); (M.E.H.); (H.E.C.); (A.C.H.)
| | - Hannah E. Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.N.G.); (S.R.M.); (N.D.P.); (M.E.H.); (H.E.C.); (A.C.H.)
- Human Movement Science Curriculum, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Katie R. Hirsch
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - Anthony C. Hackney
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.N.G.); (S.R.M.); (N.D.P.); (M.E.H.); (H.E.C.); (A.C.H.)
| | - Abbie E. Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.N.G.); (S.R.M.); (N.D.P.); (M.E.H.); (H.E.C.); (A.C.H.)
- Human Movement Science Curriculum, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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11
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Smith-Ryan AE, Hirsch KR, Cabre HE, Gould LM, Gordon AN, Ferrando AA. Menopause Transition: A Cross-Sectional Evaluation on Muscle Size and Quality. Med Sci Sports Exerc 2023; 55:1258-1264. [PMID: 36878186 DOI: 10.1249/mss.0000000000003150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
INTRODUCTION The menopause transition yields significant physiological alterations. The purpose was to characterize lean soft tissue (LST), muscle size (muscle cross-sectional area (mCSA)), muscle quality (echo intensity (EI)), and strength across the menopause transition. A secondary aim was to evaluate whole-body protein turnover in a subsample of women. METHODS Seventy-two healthy women were enrolled in this cross-sectional study based on menopause stage (PRE: n = 24; PERI: n = 24; POST: n = 24). Whole-body LST was measured via dual-energy x-ray absorptiometry, and muscle characteristics (mCSA and EI) were measured via B-mode ultrasound of the vastus lateralis. Maximal voluntary contractions (N·m) of the knee extensors were evaluated. Physical activity (in minutes per day) was accounted for using the International Physical Activity Questionnaire. A subsample of women ( n = 27) ingested 2.0 g of 15 N-alanine to determine whole-body net protein balance (NB; in grams per kilogram of body mass per day). RESULTS Significant differences were evident in LST ( P = 0.022), leg LST ( P = 0.05), and EI ( P = 0.018) between menopause stages. Bonferroni post-hoc comparisons revealed greater LST in PRE versus PERI (mean difference (MD) ± SE, 3.8 ± 1.5 kg; P = 0.048) and POST (3.9 ± 1.5 lb; P = 0.049). Similarly, EI was significantly higher in PERI PRE (MD, 18.3 ± 7.1 a.u.; P = 0.036). There was no significant difference in mCSA ( P = 0.082) or in maximal voluntary contraction ( P = 0.167). NB was significantly different across groups ( P = 0.026); NB was greater in PRE compared with PERI (MD, 0.39 ± 0.17 g·kg -1 ; P = 0.090), and from PRE to POST (MD, 0.46 ± 0.17 g·kg -1 ; P = 0.042). Physical activity was not significantly different across groups but demonstrated a linear increase from PRE to POST. CONCLUSIONS The current findings suggest that LST, muscle quality, and protein balance may be negatively influenced by the menopause transition.
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Affiliation(s)
| | - Katie R Hirsch
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Amanda N Gordon
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Arny A Ferrando
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR
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12
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Hirsch KR, Cabre HE, Gould LM, Blue MNM, Smith-Ryan AE. Effects of Essential Amino Acids on High-Intensity Interval Training Performance, Fatigue Outcomes, and Workload Progression. J Am Nutr Assoc 2023; 42:411-417. [PMID: 35512775 DOI: 10.1080/07315724.2022.2060373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To explore the effects of essential amino acid (EAA) supplementation on high-intensity interval training (HIIT) fatigue, perceived exertion, and training progression in overweight and obese adults. A secondary aim was to explore potential sex-differences on these outcomes. METHODS Thirty-seven untrained adults (51% female; 36.2 ± 5.9 yrs; 35.5 ± 6.7% body fat) completed eight weeks of HIIT, 2d/wk on a cycle ergometer, either with EAA supplementation (HIIT + EAA; 3.6 g of EAA twice daily, 30 minutes pre and post HIIT) or without supplementation (HIIT). Heart rate (HR) and ratings of perceived exertion (RPE) were recorded throughout each session as indices of within training fatigue. Time to exhaustion (TTE) was recorded for the final interval of each session. Workload progression was determined by change in watts. Differences between groups (with and without EAA) were evaluated at 1wk, 4wks, and 8wks by repeated measure ANOVAs (α = 0.05). RESULTS There were no differences in TTE (p = 0.983) or workload progression (p = 0.655) with EAA supplementation at any time point. HR and RPE within HIIT sessions were not significantly different with EAA supplementation at any time point (p > 0.05). Results were similar when evaluating males and females separately, but in females, RPE was significantly lower with EAA supplementation at 4wks (Δ: 1.1-2.2; p = 0.016). CONCLUSION EAA supplementation did not extend TTE during exercise or enhance workload progression across eight weeks of HIIT in untrained, overweight and obese adults. However, EAA consumed 30 minutes before exercise may reduce perceived exertion during the first four weeks of training in women, which may have implications for overall exercise enjoyment and long-term adherence.
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Affiliation(s)
- Katie R Hirsch
- Center for Translational Research in Aging & Longevity, Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Hannah E Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Malia N M Blue
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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13
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Muntis FR, Smith-Ryan AE, Crandell J, Evenson KR, Maahs DM, Seid M, Shaikh SR, Mayer-Davis EJ. A High Protein Diet Is Associated with Improved Glycemic Control Following Exercise among Adolescents with Type 1 Diabetes. Nutrients 2023; 15:nu15081981. [PMID: 37111199 PMCID: PMC10143215 DOI: 10.3390/nu15081981] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Nutritional strategies are needed to aid people with type 1 diabetes (T1D) in managing glycemia following exercise. Secondary analyses were conducted from a randomized trial of an adaptive behavioral intervention to assess the relationship between post-exercise and daily protein (g/kg) intake on glycemia following moderate-to-vigorous physical activity (MVPA) among adolescents with T1D. Adolescents (n = 112) with T1D, 14.5 (13.8, 15.7) years of age, and 36.6% overweight or obese, provided measures of glycemia using continuous glucose monitoring (percent time above range [TAR, >180 mg/dL], time-in-range [TIR, 70-180 mg/dL], time-below-range [TBR, <70 mg/dL]), self-reported physical activity (previous day physical activity recalls), and 24 h dietary recall data at baseline and 6 months post-intervention. Mixed effects regression models adjusted for design (randomization assignment, study site), demographic, clinical, anthropometric, dietary, physical activity, and timing covariates estimated the association between post-exercise and daily protein intake on TAR, TIR, and TBR from the cessation of MVPA bouts until the following morning. Daily protein intakes of ≥1.2 g/kg/day were associated with 6.9% (p = 0.03) greater TIR and -8.0% (p = 0.02) less TAR following exercise, however, no association was observed between post-exercise protein intake and post-exercise glycemia. Following current sports nutrition guidelines for daily protein intake may promote improved glycemia following exercise among adolescents with T1D.
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Affiliation(s)
- Franklin R Muntis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Abbie E Smith-Ryan
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
- Department of Exercise & Sports Science, University of North Carolina, Chapel Hill, NC 27519, USA
| | - Jamie Crandell
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - David M Maahs
- Division of Endocrinology, Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA 94305, USA
- Stanford Diabetes Research Center, Stanford, CA 94304, USA
| | - Michael Seid
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA
| | - Saame R Shaikh
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC 27514, USA
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14
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Blue MNM, Tinsley GM, Hirsch KR, Ryan ED, Ng BK, Smith-Ryan AE. Validity of total body water measured by multi-frequency bioelectrical impedance devices in a multi-ethnic sample. Clin Nutr ESPEN 2023; 54:187-193. [PMID: 36963862 DOI: 10.1016/j.clnesp.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS Total body water (TBW) is the largest component of fat free mass and therefore is commonly used in multi-compartment body composition models and as a stand-alone method to assess body composition. Previous literature has not validated bioelectrical impedance spectroscopy device estimates of TBW in racial and ethnic minority populations; previous studies have focused on bioelectrical impedance analysis devices that rely on proprietary algorithms and participant characteristics for accuracy. The purpose of this study was to assess the validity of two bioelectrical impedance spectroscopy devices for measures of TBW compared to a deuterium dilution criterion in a multi-ethnic sample. METHODS 109 individuals (55% female, Age: 26.6 ± 6.9 yrs, BMI: 25.3 ± 4.0 kg/m2) identifying as Asian, African American/Black, Caucasian/White, Hispanic, and Multi-racial were enrolled. After a 12 h fast, participants provided a saliva sample for the criterion baseline TBW measure and completed two bioelectrical impedance device (BIS, IB) measurements of TBW. Participants then ingested deuterium oxide (D2O). After an equilibration period, participants provided a second saliva sample for analysis of TBW. RESULTS For the total multi-ethnic sample, BIS estimates demonstrated good to fairly good agreement (Total error [TE] = 2.56 L, R2 = 0.951) and IB estimates were excellent to very good (TE = 1.95 L, R2 = 0.975). Validity results did not vary meaningfully between race and ethnicity. CONCLUSIONS The results suggest the BIS and IB devices evaluated can produce valid TBW estimates compared to D2O in a multi-ethnic sample. TBW estimates from the IB may have better agreement with D2O compared to the BIS when using the default settings.
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Affiliation(s)
- Malia N M Blue
- Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, 27599, USA.
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Katie R Hirsch
- Department of Exercise Science, University of South Carolina, Columbia, SC, 29208, USA
| | - Eric D Ryan
- Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Bennett K Ng
- Emerging Growth and Incubation Group, Intel Corporation, Santa Clara, CA, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, 27599, USA; Department of Nutrition, The University of North Carolina, Chapel Hill, NC, 27599, USA
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15
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Anderson KC, Hirsch KR, Peterjohn AM, Blue MNM, Pihoker AA, Ward DS, Ondrak KS, Smith-Ryan AE. Characterization and prevalence of obesity among normal weight college students. Int J Adolesc Med Health 2023; 35:81-88. [PMID: 33155992 DOI: 10.1515/ijamh-2020-0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/06/2020] [Indexed: 11/15/2022]
Abstract
Normal weight obesity (NWO) describes individuals who have a normal weight body mass index (BMI), but have an unhealthy amount of body fat. Based on the life-long habits that develop during college, exploring NWO among a college-aged population may be essential in identifying and preventing obesity that develops in early adulthood. This study aimed to characterize NWO among young adults with normal weight BMI. 94 college students (Mean ± SD: Age: 19.6 ± 1.5 yrs; BMI: 21.9 ± 1.8 kg/m2) enrolled during the Fall semester (Aug-Oct) were assessed for body composition by dual energy X-ray absorptiometry to determine body fat percentage, fat mass, lean mass and trunk fat; lifestyle habits were characterized from validated questionnaires. Mean arterial pressure and metabolic biomarkers [total cholesterol, high density lipoproteins, non-high density lipoproteins, and glucose] were evaluated for cardiometabolic health. NWO was defined using data from the National Health and Nutrition Examination Survey (NHANES) for body fat percentage. Data was analyzed by group (NWO vs NWL) and sex. with independent t-tests to investigate continuous data, and chi-square test of independence for categorical data. Rates of NWO for the total sample were 13.8%. Males (n=30) had a higher rate of NWO (26.7%) compared to females (n=64; 7.8%). NWO individuals had higher fat mass (p=0.024), trunk fat (p<0.001), and larger waist to hip ratio (p<0.001) than normal weight lean. NWO also engaged in less vigorous physical activity (p=0.043). The occurrence of NWO among otherwise healthy college students is evident. Identification of these individuals may be an effective component for obesity prevention and treatment. Determining feasible methods to measure body fat in this population is essential, as BMI may mask obesity in a young adult population.
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Affiliation(s)
- Kara C Anderson
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Katie R Hirsch
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Austin M Peterjohn
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Malia N M Blue
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Alexis A Pihoker
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Dianne S Ward
- Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kristin S Ondrak
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
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Moore SR, Gordon AN, Cabre HE, Hackney AC, Smith-Ryan AE. A Randomized Controlled Trial of Changes in Fluid Distribution across Menstrual Phases with Creatine Supplementation. Nutrients 2023; 15:nu15020429. [PMID: 36678300 PMCID: PMC9865497 DOI: 10.3390/nu15020429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
This study examined the effects of creatine (Cr) loading on body mass (BM) and fluid markers of total body water (TBW), extra-cellular fluid (ECF), and intra-cellular fluid (ICF) across the menstrual cycle (MC). Thirty moderately active females, either naturally-menstruating (NM) or using hormonal contraceptives (HC), were randomized to Cr (Cr; 4 × 5 g/day of creatine monohydrate for 5 days; n = 15) or a non-caloric placebo (PL; n = 15) using a double-blind, placebo-controlled design, with a menstrual phase crossover. BM, TBW, ECF, and ICF were measured at pre- and post-supplementation in randomized order of follicular phase (FP; NM: MC days 0−8, HC: inactive pill days) or luteal phase (LP; NM: ≤15 days from next projected cycle start date, HC: active pill days) using bioelectrical impedance spectroscopy. Acute hydration status and salivary estrogen were used as covariates. Change in BM was not different between groups across MC ([PL-Cr] Δ 0.40 ± 0.50 kg; p = 0.427) or between MC phase across groups ([FP-LP] Δ 0.31 ± 0.48 kg; p = 0.528). TBW (p = 0.802), ECF (p = 0.373), and ICF (p = 0.795) were not different between supplement groups at pre-supplementation/FP time points. There were no significant differences between the NM and HC subjects at any time point, for any outcome (p > 0.05). Following LP supplementation, significant changes were observed in TBW (Cr: Δ 0.83 ± 0.38 L, PL: Δ −0.62 ± 0.38 L; p = 0.021), ECF (Cr: Δ 0.46 ± 0.15 L, PL: Δ −0.19 ± 0.15 L; p = 0.013), and ICF (Cr: Δ 0.74 ± 0.23 L, PL: Δ −0.02 ± 0.23 L; p = 0.041). These data demonstrate an increase in all fluid compartments in the LP following Cr loading, without observed alterations in body weight for females.
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Affiliation(s)
- Sam R. Moore
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Human Movement Science Curriculum, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Amanda N. Gordon
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Hannah E. Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Human Movement Science Curriculum, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Anthony C. Hackney
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Abbie E. Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Human Movement Science Curriculum, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Correspondence: ; Tel.: +1-919-962-2574
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Wohlgemuth KJ, Gerstner GR, Giuliani-Dewig HK, Mota JA, Smith-Ryan AE, Ryan ED. The Time Course of Health, Fitness, and Occupational Performance Changes in Recruits Across a Fire Academy. Med Sci Sports Exerc 2023; 55:1087-1096. [PMID: 36728567 DOI: 10.1249/mss.0000000000003119] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE The purpose of this study was to examine the time course of health, fitness, and occupational performance changes in firefighter recruits across a fire academy. METHODS Nineteen recruits (24.9 ± 4.3 yrs; 26.7 ± 3.1 kg·m-2) had their body composition, balance, vertical jump (VJ) performance, cardiorespiratory fitness (CRF), upper and lower body strength, hamstrings-to-quadriceps (H:Q) ratio, lower back endurance, and weighted stair climb (SC) performance assessed at the beginning (week 1 [W1]), midpoint (week 15 [W15]), and end (week 30 [W30]) of a fire academy. RESULTS The fire academy improved body composition, balance, CRF, leg extension strength, and SC performance from W1 to W15 (P ≤ 0.042) which then plateaued at W30 (P ≥ 0.314). Leg flexion strength and the H:Q ratio decreased from W1 to W15 (P ≤ 0.035) and plateaued at W30 (P ≥ 0.947). Upper body strength was similar at W1 and W15 (P ≥ 0.999), but decreased at W30 (P ≤ 0.033). However, no significant changes occurred across the academy for VJ performance or lower back endurance (P ≥ 0.090). CONCLUSIONS These findings highlight the positive effect of the academy on body composition, CRF, balance, SC performance, and leg extension strength. However, the decreases in upper body and leg flexion strength, the H:Q ratio, and lack of changes in VJ performance and low back endurance may highlight key areas of need to maximize injury prevention and performance enhancement efforts in the academy. Further, the varied time course of changes may help fire departments identify opportunities to modify exercise programming across their academies.
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Affiliation(s)
| | | | | | - Jacob A Mota
- Department of Kinesiology and Sport Management. Texas Tech University, Lubbock, TX
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Cabre HE, Gordon AN, Patterson ND, Smith-Ryan AE. Evaluation of pre-workout and recovery formulations on body composition and performance after a 6-week high-intensity training program. Front Nutr 2022; 9:1016310. [DOI: 10.3389/fnut.2022.1016310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
IntroductionActivities such as high-intensity resistance training (HIRT) and high-intensity interval training (HIIT) may be more time-efficient modes to stimulate rapid changes in performance and body composition. There is little research evaluating the combined effects of HIRT and HIIT on body composition and strength, particularly when paired with nutritional supplementation.PurposeTo evaluate the chronic effects of pre- and post-workout supplementation on body composition and strength, and to understand sex-specific responses.Materials and methods64 untrained males (n = 23) and females (n = 41) (mean ± standard deviation; age: 33.2 ± 10.0 years; %fat: 31.6 ± 7.4%) were randomized to either (1) pre-post supplementation [SUP (n = 25); pre = multi-ingredient caffeine/HMB/vit D; post = whey protein/carbohydrates/glucosamine/vitamins], (2) placebo [PL (n = 24); non-caloric], or (3) control [CON (n = 15)]. All participants completed one repetition max (1RM) strength testing for leg press and bench press at baseline and week 6. Estimates of fat mass (FM) and lean mass (LM) were measured via dual energy x-ray absorptiometry. Participants in the SUP or PL group completed a 6-week supervised exercise intervention consisting of a full-body HIRT workout (3 × 6–8 reps) followed by a HIIT treadmill run (6 × 1 min run: 1 min rest) twice per week. Outcomes were evaluated by separate repeated measure ANOVAs (2 × 3).ResultsThere were no differences in FM between groups or sex (p = 0.133–0.851). LM increased from baseline to post-testing for all groups [Mean difference [MD(Post-Pre) ± Standard Error (SE) = 0.78 ± 0.12 kg; p < 0.001]. While not significant (p = 0.081), SUP gained more LM compared to PL [MD(SUP-PL) ± SE = 3.5 ± 3.3 kg] and CON [MD(SUP-CON) ± SE = 5.2 ± 3.8 kg]. LM increased over time for both males (0.84 ± 0.24 kg; p = 0.003) and females (0.73 ± 0.14 kg; p < 0.001). The SUP group resulted in a significant increase in 1RM leg press compared to the CON group (89.9 ± 30.8 kg; p = 0.015), with no significant differences compared to PL (p = 0.409). The SUP group had greater increases in 1RM bench press compared to the CON group (9.8 ± 1.8 kg; p < 0.001), with no significant differences compared to PL (p = 0.99). Both sexes increased upper- (5.5 ± 0.7 kg; p < 0.001) and lower-body strength (69.8 ± 4.5 kg p < 0.001) with training.ConclusionNutrient supplementation timing appears to augment body composition changes and strength compared to control. Pre-/post-nutrient timing may support greater increases in LM and lower- and upper-body strength in both men and women.Clinical trial registration[https://clinicaltrials.gov/ct2/show/NCT04230824?cond=NCT04230824&draw=2&rank=1], identifier [NCT04230824].
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Shekhar S, Tonleu JT, Okigbo CC, Leka H, Kim AE, Purse B, Zaccaro D, Soldin SJ, Hirsch KR, Smith-Ryan AE, Hall JE. RF10 | PMON215 Greater changes in metabolic hormones are associated with a smaller decrease in pulsatile LH secretion in response to short term moderate energy restriction in healthy, young women. J Endocr Soc 2022. [PMCID: PMC9625577 DOI: 10.1210/jendso/bvac150.1464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Energy restriction may result in hypothalamic amenorrhea by inhibiting GnRH secretion and downstream pulsatile LH secretion. Energy restriction also leads to adaptive changes in metabolic hormones. We sought to determine whether metabolic changes in response to energy restriction predict or mitigate inhibition of GnRH secretion. Methods Nineteen healthy women, (mean age ± SD; 23.36 ± 2.08 yrs) with regular ovulatory cycles and no evidence of energy restriction or excessive exercise, underwent two 5-day dietary interventions with identical exercise in the early follicular phase of two menstrual cycles. A neutral energy availability (NEA; 45 kCal/kg*LBM/d) was followed by a deficient energy availability (DEA; 20 kCal/kg*LBM/d) diet. On day five of each intervention, body composition was analyzed (BodPod®), and blood was sampled between 0800 —1600 hours for LH, TSH and GH, every 10 min, cortisol every 30 min, T3, reverse T3 (rT3) and T4 every 60 min, free T3 (FT3), free T4 (FT4) and TBG at 0800 h and 1600 h. We correlated means of pulsatile LH pulse frequency (LHPF) with integrated metabolic hormone changes across the day in the subset of women with reduced or unchanged LHPF after DEA (n=10) using linear regression. Results In ∼50% of healthy young women, LHPF decreased or was unchanged in response to short-term moderate energy deprivation. BMI and bodyweight declined after DEA in both groups while % fat mass was unchanged. TSH, T3, leptin, insulin declined, and T4 increased from NEA to DEA while glucose, cortisol and GH were unchanged. In subjects with reduced/unchanged LHPF, % delta T3 correlated inversely with delta LHPF (r=-0.727, p=0.017). Similarly, non-fasting delta TSH correlated inversely with % delta LHPF (r=-0.643, p=0.045), and % delta AUC TSH (r=-0.642, p=0.045) correlated inversely with DEA LHPF. Percent delta insulin (r= -0.722, p=0.018) and % delta insulin AUC (r= – 0.688, p=0.028) correlated inversely with delta LHPF. Percent delta insulin-glucose ratio (r=-0.772, p=0.009) and % change in AUC insulin-glucose ratio (r=-0.759, p=0.011) also correlated inversely with delta LHPF. This inverse relationship was preserved when insulin was normalized for caloric intake (n-insulin) was correlated with % delta LHPF (r=-0.722, p=0.018) and % delta AUC n-insulin correlated with delta LHPF (r= -0.631 and p= 0.050). Delta AUC leptin (r=-0.684, p=0.029) and % delta AUC leptin (r=-0.670, p=0.034) also correlated inversely with delta LHPF. Mean cortisol at NEA correlated inversely with LHPF during DEA (r=-0.816, p=0.007), implying that higher baseline cortisol levels may predict a greater relative fall in LHPF. Cortisol AUC in DEA also correlated inversely with LHPF in DEA (r=-0.722, p=0.028). Conclusion Our data suggest that greater changes in metabolic hormones may protect against the inhibitory effect of moderate energy deprivation on GnRH secretion in healthy young women with normal reproductive function. Presentation: Saturday, June 11, 2022 1:30 p.m. - 1:35 p.m., Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
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Hirsch KR, Smith-Ryan AE. Effect Of Acute Feeding On Raw Bioimpedance Values And Body Water Estimates In Healthy Adults. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000882420.31702.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Kviatkovsky SA, Sims ST, Greenwalt CE, Zeleny T, Vukovich MD, Smith-Ryan AE, Bach CW, Presby D, Holmes K, Ormsbee MJ. Characteristics Of Menstrual Cycle And Hormonal Contraceptive Use In Collegiate Female Athletes In The United States. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000875144.02023.cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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22
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Cabre HE, Moore SR, Smith-Ryan AE, Hackney AC. Relative energy deficiency in sport (RED-S): scientific, clinical, andpractical implications for the female athlete. Dtsch Z Sportmed 2022; 73:225-234. [DOI: 10.5960/dzsm.2022.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Problem: If athletes develop low energy availability (LEA), it can lead to a Relative Energy Deficiency in Sport (RED-S) syndrome which has severe health consequences if not treated. Methodology: A narrative review of the most recent and pertinent literature on the topic, with special emphasis on women. Results: In assessing the current literature, we have synthesized: i) the scientific implications of LEA and RED-S, ii) the clinical manifestations of the conditions currently available for detection, as well as iii) the practical implications for healthcare and support for female athletes and teams in planning intervention or prevention strategies (maintaining EA >45 kcal/kg FFM/day). Discussion: The ‘Female Athlete Triad” emerged in the 1990s as researchers understood more of the etiological adaptation of female athlete health to sports training. In the last 10 years, the scientific community has recognized that the ‘Triad’ approach was too narrow in focus, and the broader concept of RED-S emerged. Both the Triad and RED-S are consequences of a frequently prevalent LEA in athletes (<30 kcal/kg FFM/day). Developing LEA and RED-S compromises training adaptation, performance capacity, and health in athletes. For these reasons, it is critical that an athlete’s support team recognize the behaviors that may indicate RED-S evolution. In this way, we can assist female athletes in reaching their full potential in sports while protecting their health. Key Words: Energy Availability, Stress, Performance, Hormones, Menstrual Health
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Candow DG, Forbes SC, Roberts MD, Roy BD, Antonio J, Smith-Ryan AE, Rawson ES, Gualano B, Roschel H. Creatine O'Clock: Does Timing of Ingestion Really Influence Muscle Mass and Performance? Front Sports Act Living 2022; 4:893714. [PMID: 35669557 PMCID: PMC9163789 DOI: 10.3389/fspor.2022.893714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
It is well-established that creatine supplementation augments the gains in muscle mass and performance during periods of resistance training. However, whether the timing of creatine ingestion influences these physical and physiological adaptations is unclear. Muscle contractions increase blood flow and possibly creatine transport kinetics which has led some to speculate that creatine in close proximity to resistance training sessions may lead to superior improvements in muscle mass and performance. Furthermore, creatine co-ingested with carbohydrates or a mixture of carbohydrates and protein that alter insulin enhance creatine uptake. The purpose of this narrative review is to (i) discuss the purported mechanisms and variables that possibly justify creatine timing strategies, (ii) to critically evaluate research examining the strategic ingestion of creatine during a resistance training program, and (iii) provide future research directions pertaining to creatine timing.
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Affiliation(s)
- Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Scott C. Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB, Canada
- *Correspondence: Scott C. Forbes
| | | | - Brian D. Roy
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Abbie E. Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eric S. Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA, United States
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, Rheumatology Division, Faculty of Medicine FMUSP, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, Rheumatology Division, Faculty of Medicine FMUSP, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Gordon AN, Blue MN, Cabre HE, Gould LM, Smith-Ryan AE. Body composition of NCAA Division I football players pre and post COVID-19 stay-at-home advisory. J Sports Med Phys Fitness 2022; 62:1662-1667. [PMID: 35415995 DOI: 10.23736/s0022-4707.22.13465-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The COVID-19 pandemic forced collegiate athletes to train at home, without access to facilities. The purpose of this study was to evaluate the effect of the COVID-19 stay-at-home order on body composition of Division I football players, with a secondary aim to evaluate these changes between players with 'higher' (>25 kg/m2) and 'lower' (<25 kg/m2) fat-free mass index (kg/m2). METHODS Body composition of 29 NCAA Division I football players (Age=21.0±10 yr, Ht=186.7±5.6 cm, body mass=110.5±22.8 kg) were measured Spring season (February) and prior to pre-season (June). Whole body dual-energy x-ray absorptiometry scans were used to determine regional (arms, legs, trunk) and total body fat mass (FM), lean mass (LM), and fat-free mass (FFM). Fat-free mass index (FFMI) was calculated as [LM+Bone Mineral Content (BMC)]/Height2); participants were stratified by FFMI higher (n=16) and lower (n=13). RESULTS Total LM (Mean Difference ± Standard Error: 0.80 ± 1.65 kg, p=0.016) increased from pre- to post-COVID stay-at-home. No significant changes in total FM were seen. Players with lower FFMI showed a significant decrease in trunk FM (-0.55± 0.19 kg, p=0.016). Players with higher FFMI showed a significant increase in total LM (0.96±0.42 kg, p=0.038). CONCLUSIONS These results suggest no detrimental effect on body composition.
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Affiliation(s)
- Amanda N Gordon
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Malia N Blue
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hannah E Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA - .,Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Bailey RL, Dog TL, Smith-Ryan AE, Das SK, Baker FC, Madak-Erdogan Z, Hammond BR, Sesso HD, Eapen A, Mitmesser SH, Wong A, Nguyen H. Sex Differences Across the Life Course: A Focus On Unique Nutritional and Health Considerations among Women. J Nutr 2022; 152:1597-1610. [PMID: 35294009 PMCID: PMC9258555 DOI: 10.1093/jn/nxac059] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
In the United States, women, while having a longer life expectancy than men, experience a differential risk for chronic diseases and have unique nutritional needs based on physiological and hormonal changes across the life span. However, much of what is known about health is based on research conducted in men. Additional complexity in assessing nutritional needs within gender include the variations in genetics, body compositions, hormonal milieus, underlying chronic diseases, and medication usage, with this list expanding as we consider these variables across the life course. It is clear women experience nutrient shortfalls during key periods of their lives, which may differentially impact their health. Consequently, as we move into the era of precision nutrition, understanding these sex- and gender-based differences may help optimize recommendations and interventions chosen to support health and weight management. Recently, a scientific conference was convened with content experts to explore these topics from a life-course perspective at biological, physiological, and behavioral levels. This publication summarizes the presentations and discussions from the workshop and provides an overview of important nutrition and related lifestyle considerations across the life course. The landscape of addressing female-specific nutritional needs continues to grow; now more than ever, it is essential to increase our understanding of the physiological differences between men and women, and determine how these physiological considerations may aid in optimizing nutritional strategies to support certain personal goals related to health, quality of life, sleep, and exercise performance among women.
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Affiliation(s)
| | | | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Sai Krupa Das
- Jean-Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Zeynep Madak-Erdogan
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Billy R Hammond
- Behavioral and Brain Sciences Program, Department of Psychology, University of Georgia, Athens, GA, USA
| | - Howard D Sesso
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Alex Eapen
- R&D Scientific & Regulatory Affairs–North America, Cargill, Wayzata, MN, USA
| | | | - Andrea Wong
- Scientific & Regulatory Affairs, Council for Responsible Nutrition, Washington, DC, USA
| | - Haiuyen Nguyen
- Scientific & Regulatory Affairs, Council for Responsible Nutrition, Washington, DC, USA
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Gould LM, Gordon AN, Cabre HE, Hoyle AT, Ryan ED, Hackney AC, Smith-Ryan AE. Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism. Menopause 2022; 29:377-389. [PMID: 35231009 DOI: 10.1097/gme.0000000000001932] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate body composition, fat distribution, and metabolism at rest and during exercise in premenopausal, perimenopausal, and postmenopausal women. METHODS This cross-sectional study in 72 women ages 35 to 60 years evaluated body composition via a fourcompartment model, fat distribution using dual-energy x-ray absorptiometry-derived android to gynoid ratio, metabolic measures via indirect calorimetry, and lifestyle factors using surveys. One-way analyses of variance and one-way analyses of covariance covaried for age and hormone levels (estrogen and progesterone) were used to compare groups. RESULTS Body fat percent was significantly lower in premenopausal than perimenopausal women (mean difference ± standard error: - 10.29 ± 2.73%, P = 0.026) despite similarities in fat mass and fat-free mass between groups (P≥0.217). Android to gynoid ratio was significantly lower in premenopausal than perimenopausal women (MD ± SE: -0.16 ± 0.05 a.u., P = 0.031). Resting energy expenditure was similar between groups (P = 0.999). Fat oxidation during moderate intensity cycle ergometer exercise was significantly greater in premenopausal than postmenopausal women (MD ± SE: 0.09 ± 0.03 g/min, P = 0.045). The change in respiratory exchange ratio between rest and moderate intensity exercise was significantly lower in premenopausal women than peri- (MD ± SE: -0.05 ± 0.03 a.u., P = 0.035) and postmenopausal women (MD ± SE: -0.06 ± 0.03 a.u., P = 0.040). Premenopausal women reported significantly fewer menopause symptoms than peri- (MD ± SE: -6.58 ± 1.52 symptoms, P = 0.002) and postmenopausal participants (MD ± SE: -4.63 ± 1.52 symptoms, P = 0.044), while similarities between groups were observed for lifestyle factors including diet and physical activity (P>0.999). CONCLUSIONS Perimenopause may be the most opportune window for lifestyle intervention, as this group experienced the onset of unfavorable body composition and metabolic characteristics. VIDEO SUMMARY http://links.lww.com/MENO/A932.
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Affiliation(s)
- Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Amanda N Gordon
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Hannah E Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Funding/support: This research study was supported by a grant from the Center for Women's Health Research
| | - Andrew T Hoyle
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Eric D Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Funding/support: This research study was supported by a grant from the Center for Women's Health Research
| | - Anthony C Hackney
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Funding/support: This research study was supported by a grant from the Center for Women's Health Research
| | - Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Funding/support: This research study was supported by a grant from the Center for Women's Health Research
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Blue MNM, Hirsch KR, Brewer GJ, Cabre HE, Gould LM, Tinsley GM, Ng BK, Ryan ED, Padua D, Smith-Ryan AE. The validation of contemporary body composition methods in various races and ethnicities. Br J Nutr 2022; 128:1-11. [PMID: 35109945 DOI: 10.1017/s0007114522000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Few investigations have evaluated the validity of current body composition technology among racially and ethnically diverse populations. This study assessed the validity of common body composition methods in a multi-ethnic sample stratified by race and ethnicity. One hundred and ten individuals (55 % female, age: 26·5 (sd 6·9) years) identifying as Asian, African American/Black, Caucasian/White, Hispanic, Multi-racial and Native American were enrolled. Seven body composition models (dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), two bioelectrical impedance devices (BIS, IB) and three multi-compartment models) were evaluated against a four-compartment criterion model by assessing total error (TE) and standard error of the estimate. For the total sample, measures of % fat and fat-free mass (FFM) from multi-compartment models were all excellent to ideal (% fat: TE = 0·94-2·37 %; FFM: TE = 0·72-1·78 kg) compared with the criterion. % fat measures were very good to excellent for DXA, ADP and IB (TE = 2·52-2·89 %) and fairly good for BIS (TE = 4·12 %). For FFM, single device estimates were good (BIS; TE = 3·12 kg) to ideal (DXA, ADP, IB; TE = 1·21-2·15 kg). Results did not vary meaningfully between each race and ethnicity, except BIS was not valid for African American/Black, Caucasian/White and Multi-racial participants for % fat (TE = 4·3-4·9 %). The multi-compartment models evaluated can be utilised in a multi-ethnic sample and in each individual race and ethnicity to obtain highly valid results for % fat and FFM. Estimates from DXA, ADP and IB were also valid. The BIS may demonstrate greater TE for all racial and ethnic cohorts and results should be interpreted cautiously.
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Affiliation(s)
- Malia N M Blue
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Katie R Hirsch
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Hannah E Cabre
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Lacey M Gould
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Bennett K Ng
- Emerging Growth and Incubation Group, Intel Corporation, Santa Clara, CA, USA
| | - Eric D Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Darin Padua
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
- Department of Nutrition, The University of North Carolina, Chapel Hill, NC, USA
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Kleiner SM, Smith-Ryan AE, Forsythe CE. Nutrition. Sports Med 2021. [DOI: 10.1891/9780826182395.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gould LM, Cabre HE, Brewer GJ, Hirsch KR, Blue MNM, Smith-Ryan AE. Impact of Follicular Menstrual Phase on Body Composition Measures and Resting Metabolism. Med Sci Sports Exerc 2021; 53:2396-2404. [PMID: 34280938 DOI: 10.1249/mss.0000000000002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to identify the effects of early follicular (EF) and midfollicular (MF) menstrual phases on body composition, resting metabolic rate (RMR), and respiratory quotient (RQ) assessment accuracy to identify an optimal testing period. METHODS Body composition was obtained from a four-compartment (4C) criterion model (fat mass (FM), fat-free mass, body fat percent, and dual-energy x-ray absorptiometry (DXA; FM, lean mass (LM), trunk FM, and trunk LM) in 19 eumenorrheic females (mean ± SD: age, 21.3 ± 3.1 yr, body mass index, 23.6 ± 1.8 kg·m-2). RMR (kcal·d-1) and RQ (a.u.) were measured via indirect calorimetry for 25 min. Body composition, RMR, and RQ were measured during the EF and MF phases. Dependent-samples t-tests were used to compare outcomes between EF and MF. RESULTS 4C outcomes were similar between phases (P > 0.05). During EF, the following 4C components were significantly greater (P < 0.05): body volume (mean difference (MD) ± SD, 0.70 ± 1.05 L), extracellular fluid (MD ± SD, 0.27 ± 0.51 L), and body mass (MD ± SD, 0.56 ± 0.80 kg). DXA-measured LM, body fat percent, trunk LM, and trunk FM were similar (P > 0.05); however, DXA FM was significantly greater during EF (MD ± SD, 0.29 ± 0.40 kg; P = 0.005), yet within measurement error of the device. Although RMR was not significantly different between phases (MD ± SD, 6.0 ± 190.93 kcal·d-1; P > 0.05), RQ was significantly higher during EF (mean ± SD, 0.03 ± 0.06 a.u.; P = 0.029) compared with MF. CONCLUSIONS Body composition from 4C and DXA do not seem to be affected beyond measurement error as a result of compartmental changes from the menstrual cycle. During MF, women oxidized more fat as demonstrated by a lower RQ. Researchers should aim to be more inclusive and schedule testing for females within 11-12 d from the onset of menstruation.
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Affiliation(s)
- Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Gabrielle J Brewer
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Katie R Hirsch
- Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Malia N M Blue
- Human Biomechanics & Physiology Laboratory, Department of Exercise Science, High Point University, High Point, NC
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Blue MNM, Tinsley GM, Ryan ED, Smith-Ryan AE. Validity of Body-Composition Methods across Racial and Ethnic Populations. Adv Nutr 2021; 12:1854-1862. [PMID: 33684215 PMCID: PMC8528114 DOI: 10.1093/advances/nmab016] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/01/2020] [Accepted: 01/28/2021] [Indexed: 01/08/2023] Open
Abstract
Multi-compartment body-composition models that divide the body into its multiple constituents are the criterion method for measuring body fat percentage, fat mass, and fat-free mass. However, 2- and 3-compartment body-composition devices such as air displacement plethysmography (ADP), DXA, and bioelectrical impedance devices [bioelectrical impedance analysis (BIA)] are more commonly used. Accurate measures depend on several assumptions, including constant hydration, body proportion, fat-free body density, and population characteristics. Investigations evaluating body composition in racial and ethnic minorities have observed differences in the aforementioned components between cohorts. Consequently, for racial/ethnic minority populations, estimates of body composition may not be valid. The purpose of this review was to comprehensively examine the validity of common body-composition devices in multi-ethnic samples (samples including >1 race/ethnicity) and in African-American, Hispanic, Asian, and Native American populations. Based on the literature, DXA produces valid results in multi-ethnic samples and ADP is valid for Hispanic and African American males when utilizing race-specific equations. However, for DXA and ADP, there is a need for validity investigations that include larger, more racially diverse samples, specifically including Hispanic/Latinx, Asian, Native American adults, and African-American females. Technology has advanced significantly since initial validity studies were conducted; therefore, conclusions are based on outdated models and software. For BIA, body-composition measures may be valid in a multi-ethnic sample, but the literature demonstrates disparate results between races/ethnicities. For BIA and ADP, the majority of studies have utilized DXA or hydrostatic weighing as the criterion to determine validity; additional studies utilizing a multi-compartment model criterion are essential to evaluate accuracy. Validity studies evaluating more recent technology in larger, more racially/ethnically diverse samples may improve our ability to select the appropriate method to accurately assess body composition in each racial/ethnic population.
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Affiliation(s)
- Malia N M Blue
- Department of Exercise Science, High Point
University, High Point, NC,
USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech
University, Lubbock, TX, USA
| | - Eric D Ryan
- Department of Exercise and Sport Science, The University of
North Carolina, Chapel Hill, NC,
USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, The University of
North Carolina, Chapel Hill, NC,
USA
- Department of Nutrition, The University of North
Carolina, Chapel Hill, NC, USA
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Cabre HE, Greenwalt CE, Gould LM, Hirsch KR, Blue MNM, Smith-Ryan AE. Exploring the "Athlete's Paradox": Division I Cross-Country Runners Demonstrate Similar Muscle Characteristics to Recreationally Trained Young Adults. J Strength Cond Res 2021; 35:3213-3217. [PMID: 34474434 DOI: 10.1519/jsc.0000000000004127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Cabre, HE, Greenwalt, CE, Gould, LM, Hirsch, KR, Blue, MNM, and Smith-Ryan, AE. Exploring the "Athlete's Paradox": Division I cross-country runners demonstrate similar muscle characteristics to recreationally trained young adults. J Strength Cond Res XX(X): 000-000, 2021-Endurance training can influence body composition and muscle characteristics. Endurance athletes have demonstrated elevated intramuscular fat (IMF), yet individuals with greater body fat also demonstrate elevated IMF. The purpose of this study was to examine differences in muscle characteristics (echo intensity [EI] and muscle cross-sectional area [mCSA]) and body composition between Division I collegiate athletes and college-age adults matched for percent fat (%fat). Thirty cross-country athletes (XC) and 30 normal-weight (NW) recreationally active college students (male athletes: n = 30; female athletes: n = 30; mean ± SD: age: 19.2 ± 1.1 years; body mass: 61.7 ± 8.7 kg; %fat: 18.0 ± 5.2%) underwent a panoramic ultrasound scan of the vastus lateralis to evaluate EI and mCSA. A full-body dual-energy x-ray absorptiometry scan was used to assess fat mass (FM), lean mass (LM), and %fat. Independent t-tests were used to evaluate mCSA, EI, and body composition. Significance level was set at ≤ 0.05. There were no significant differences between the XC and NW cohorts in mCSA (mean difference [MD; XC - NW], -1.30 ± -0.40 cm3; p = 0.340) or EI (MD: 3.97 ± 2.66 a.u.; p = 0.478). Body composition was not different between the groups: FM (MD: -0.14 ± -0.54 kg; p = 0.848), LM (-3.07 ± 1.25 kg; p = 0.268), or bone mineral content (-0.21 ± 0.03 kg; p = 0.120). There were also no significant differences for any outcome variables when stratified by male athletes (p = 0.097-0.468) or female athletes (p = 0.055-0.700). These results suggest that XC athletes may have similar muscle characteristics to NW individuals when matched for %fat. Understanding and tracking muscle characteristics in XC athletes may be important for performance, injury prevention, and the transition to retirement.
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Affiliation(s)
- Hannah E Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina; Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, North Carolina; Institute of Sport Science Medicine, Department of Nutrition, Food, and Exercise Science, Florida State University, Tallahassee, Florida; Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Human Biomechanics and Applied Physiology Lab, Department of Exercise Science, High Point University, One University Parkway, High Point, North Carolina
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Brown AF, Alfiero CJ, Brooks SJ, Kviatkovsky SA, Smith-Ryan AE, Ormsbee MJ. Prevalence of Normal Weight Obesity and Health Risk Factors for the Female Collegiate Dancer. J Strength Cond Res 2021; 35:2321-2326. [PMID: 34398079 DOI: 10.1519/jsc.0000000000004064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Brown, AF, Alfiero, CJ, Brooks, SJ, Kviatkovsky, SA, Smith-Ryan, AE, and Ormsbee, MJ. Prevalence of normal weight obesity and health risk factors for the female collegiate dancer. J Strength Cond Res 35(8): 2321-2326, 2021-The purpose of this study was to investigate the prevalence of normal weight obesity (NWO) and evaluate the relationship between NWO and health risk factors in a collegiate dancer population. Reanalysis of data of female dancers (N = 42) from 2 larger studies was used to assess prevalence and health risk factors of NWO. Dancers completed a dual-energy x-ray absorptiometry scan to assess fat mass (FM), lean mass (LM), and visceral adipose tissue (VAT) and a 3-day food record. Normal weight obesity was defined as a body mass index (BMI) of 18.5-24.9 kg·m-2 and body fat (BF) ≥30%. Twenty-five (60%) dancers were classified as normal weight lean (NWL), and 17 dancers (40%) were classified as NWO. Significant differences were observed for BMI (NWL: 21.1 ± 1.7, NWO: 23.1 ± 1.6, p < 0.001), LM (NWL: 71.0 ± 2.9%, NWO: 62.5 ± 2.7%, p < 0.001), %BF (NWL: 24.8 ± 3.1%, NWO: 33.9 ± 2.6%, p < 0.001), and VAT (NWL: 130.6 ± 43.0 g, NWO: 232.3 ± 70.8 g, p < 0.001) between NWL and NWO. A significant difference was observed for carbohydrate intake (NWL: 4.7 ± 1.8 g·kg-1, NWO: 3.7 ± 1.0 g·kg-1, p = 0.020) between groups. Significant positive correlations with FM were observed between carbohydrate (kcal, p = 0.048), fat (kcal, p = 0.018; g·kg-1, p = 0.040), and total calories (p = 0.019) in NWO. Normal weight obesity in collegiate dancers may be more prevalent than previously perceived and may be significantly related to important health risk factors. The current study demonstrates the need for body composition assessments and emphasizing on promoting overall health in collegiate dancers.
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Affiliation(s)
- Ann F Brown
- Department of Movement Sciences, Human Performance Laboratory, University of Idaho, Moscow, Idaho
| | - Christopher J Alfiero
- Department of Movement Sciences, Human Performance Laboratory, University of Idaho, Moscow, Idaho
| | - Samantha J Brooks
- Department of Movement Sciences, Human Performance Laboratory, University of Idaho, Moscow, Idaho
| | - Shiloah A Kviatkovsky
- Department of Nutrition, Food & Exercise Sciences, Institute of Sport Sciences & Medicine, Florida State University, Tallahassee, Florida
| | - Abbie E Smith-Ryan
- Department of Exercise & Sport Science, Applied Physiology Laboratory, University of North Carolina Chapel Hill, Chapel Hill, North Carolina; and
| | - Michael J Ormsbee
- Department of Nutrition, Food & Exercise Sciences, Institute of Sport Sciences & Medicine, Florida State University, Tallahassee, Florida.,Discipline of Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal, Durban, South Africa
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Smith-Ryan AE, Brewer G, Gould LM, Blue MNM, Hirsch KR, Greenwalt CE, Harrison C, Cabre HE, Ryan ED. Acute feeding has minimal effect on the validity of body composition and metabolic measures: dual-energy X-ray absorptiometry and a multi-compartment model. Br J Nutr 2021; 128:1-13. [PMID: 34392839 DOI: 10.1017/s0007114521003147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Understanding the effects of acute feeding on body composition and metabolic measures is essential to the translational component and practical application of measurement and clinical use. To investigate the influence of acute feeding on the validity of dual-energy X-ray absorptiometry (DXA), a four-compartment model (4C) and indirect calorimetry metabolic outcomes, thirty-nine healthy young adults (n 19 females; age: 21·8 (sd 3·1) years, weight; 71·5 (sd 10·0) kg) participated in a randomised cross-over study. Subjects were provided one of four randomised meals on separate occasions (high carbohydrate, high protein, ad libitum or fasted baseline) prior to body composition and metabolic assessments. Regardless of macronutrient content, acute feeding increased DXA percent body fat (%fat) for the total sample and females (average constant error (CE):-0·30 %; total error (TE): 2·34 %), although not significant (P = 0·062); the error in males was minimal (CE: 0·11 %; TE: 0·86 %). DXA fat mass (CE: 0·26 kg; TE: 0·75 kg) and lean mass (LM) (CE: 0·83 kg; TE: 1·23 kg) were not altered beyond measurement error for the total sample. 4C %fat was significantly impacted from all acute feedings (avg CE: 0·46 %; TE: 3·7 %). 4C fat mass (CE: 0·71 kg; TE: 3·38 kg) and fat-free mass (CE: 0·55 kg; TE: 3·05 kg) exceeded measurement error for the total sample. RMR was increased for each feeding condition (TE: 1666·9 kJ/d; 398 kcal/d). Standard pre-testing fasting guidelines may be important when evaluating DXA and 4C %fat, whereas additional DXA variables (fat mass and LM) may not be significantly impacted by an acute meal. Measuring body composition via DXA under less stringent pre-testing guidelines may be valid and increase feasibility of testing in clinical settings.
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Affiliation(s)
- Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gabrielle Brewer
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Malia N M Blue
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katie R Hirsch
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Casey E Greenwalt
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney Harrison
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hannah E Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric D Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Hoyle AT, Gould LM, Cabre HE, Gordon AN, Smith-Ryan AE. Effect Of Acute Feeding On Bioelectrical Impedance Vector Analysis Calculated Phase Angle In Healthy Subjects. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000762640.02872.bc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hirsch KR, Brewer GJ, Gould LM, Greenwalt CE, Nelson AG, Cabre HE, Blue MNM, Smith-Ryan AE. Effect Of Pre-Workout Essential Amino Acid Supplementation On High-Intensity Interval Training. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000762408.21505.9a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Saylor (Cabre) HE, Greenwalt CE, Gould LM, Gordon AN, Hoyle AT, Smith-Ryan AE. Relationship Between Maximal Fat Oxidation And Ventilatory Threshold In Endurance Trained Males. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000762188.71907.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Smith-Ryan AE, Weaver MA, Viera AJ, Weinberger M, Blue MNM, Hirsch KR. Promoting Exercise and Healthy Diet Among Primary Care Patients: Feasibility, Preliminary Outcomes, and Lessons Learned From a Pilot Trial With High Intensity Interval Exercise. Front Sports Act Living 2021; 3:690243. [PMID: 34337406 PMCID: PMC8322607 DOI: 10.3389/fspor.2021.690243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022] Open
Abstract
Physical activity and healthy diet are recognized as effective approaches for disease prevention. Controlled laboratory clinical trials support these approaches, yet minimal data exists supporting implementation of exercise as medicine within a healthcare setting. Objectives: To understand perception and barriers to exercise and nutrition from patients and physicians from a family medicine clinic (FMC) to inform the implementation of a laboratory-based exercise and nutrition lifestyle intervention (Phase I), and to determine the feasibility, adherence, and preliminary outcomes of implementing this lifestyle intervention into a FMC (Phase II). Methods: In phase I 10 patients and 5 physicians were interviewed regarding perceptions of exercise and nutrition practices. In phase II patients at risk for cardiovascular disease were enrolled into a lifestyle intervention (n = 16), within a FMC, manipulating diet and exercise. Cardiorespiratory fitness (CRF), body composition, and metabolic blood markers were completed at baseline, after the 12-week intervention, and at 24 weeks. Feasibility was defined by patients who completed the intervention and number of sessions vs. total available. Results: Prescribing high-intensity interval training and a meal replacement for 12 weeks in patients with at least one risk factor for cardiovascular disease, was shown to have moderate feasibility with 62.5% (n = 10) for patients completing the 12 week intervention, and poor feasibility for assessing effects 12 weeks after cessation of the intervention, with 50% (n = 5) participants returning. Tracking exercise electronically via FitBit had moderate fidelity (n = 9), with hardcopy logs yielding poor compliance (n = 6). This pilot study demonstrated preliminary effectiveness of this home-based approach for improving cardiorespiratory fitness with an average 4.31 ± 5.67 ml·kg·min−1 increase in peak oxygen consumption. Blood triglycerides and insulin were improved in 70% and 60% of the patients, respectively. Conclusions: Despite moderate feasibility, a home-based exercise and nutrition has the potential to be used as an effective approach for managing and mitigating cardiovascular disease risk factors. There were key lessons learned which will help to develop and adapt a larger scale lifestyle intervention into a clinical setting. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/study/NCT02482922, identifier NCT02482922.
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Affiliation(s)
- Abbie E Smith-Ryan
- Department of Exercise and Sport Science, Applied Physiology Laboratory, University of North Carolina, Chapel Hill, NC, United States.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, United States
| | - Mark A Weaver
- Department of Medicine and Biostatistics, University of North Carolina, Chapel Hill, NC, United States
| | - Anthony J Viera
- Department of Community and Family Medicine, Duke University, Duke, NC, United States
| | - Morris Weinberger
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Malia N M Blue
- Department of Exercise and Sport Science, Applied Physiology Laboratory, University of North Carolina, Chapel Hill, NC, United States.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, United States
| | - Katie R Hirsch
- Department of Exercise and Sport Science, Applied Physiology Laboratory, University of North Carolina, Chapel Hill, NC, United States.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, United States
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Blue MNM, Hirsch KR, Brewer GJ, Smith-Ryan AE. Abdominal Adiposity in Collegiate Football Linemen: A Study of Race and Position. Int J Sports Med 2021; 43:41-45. [PMID: 34255323 DOI: 10.1055/a-1518-8003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
American football linemen are at an increased risk for developing obesity-related diseases. This study evaluated the impact of race and position on abdominal fat (visceral adipose tissue and android fat percentage) in football linemen. Thirty-four offensive and defensive linemen (%fat: 27.1±7.2%) completed a total body dual-energy X-ray absorptiometry scan to estimate visceral fat and android fat percentage. Participants were stratified by race [Black: n=23; White: n=11] and position (Offense: n=18; Defense: n=16). Two separate two-way ANOVA tests [race × position] were completed. For visceral adipose tissue, there was no interaction (p=0.056), but there was an effect of race (Black: 0.57±0.34 kg; White: 1.51±0.56 kg; p <0.001) and position (Offense: 1.22±0.60 kg; Defense: 0.49±0.34 kg; p<0.001). For android fat percentage, there was no interaction (p=0.855) or race effect (Black: 31.5±11.3%; White: 40.9±8.6%; p=0.123); there was a position effect (Offense: 42.1±5.6%; Defense: 26.0±9.9%; p<0.001). Offensive linemen, regardless of race, had greater visceral adipose tissue and android fat percent compared to defensive linemen. White linemen had greater visceral adipose tissue, regardless of position. These results suggest football linemen, especially offensive linemen with increased abdominal adiposity, may benefit from tracking metabolic health during their collegiate career to mitigate obesity-related disease risk once retired from sport.
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Affiliation(s)
- Malia N M Blue
- Department of Exercise Science, High Point University, High Point, United States
| | - Katie R Hirsch
- Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, United States
| | - Gabrielle J Brewer
- Korey Stringer Institute, University of Connecticut, Storrs, United States
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, United States
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Trivisonno AJ, Laffan MR, Giuliani HK, Mota JA, Gerstner GR, Smith-Ryan AE, Ryan ED. The influence of age on the recovery from worksite resistance exercise in career firefighters. Exp Gerontol 2021; 152:111467. [PMID: 34237392 DOI: 10.1016/j.exger.2021.111467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/13/2022]
Abstract
Resistance exercise is an important strategy to reduce injuries and improve performance in the fire service. However, given the large age range of firefighters, it is important to determine if age influences their recovery following an acute bout of resistance exercise. PURPOSE To examine the changes in indirect markers of muscle damage in young and older firefighters following a feasible worksite resistance exercise routine. METHODS Nineteen young (25.5 ± 3.4 years) and 19 older male career firefighters (50.3 ± 3.5 years) completed pre-testing, an acute bout of resistance exercise, and post-testing at 24, 48, and 72 h post-exercise at their fire station. Prior to all testing, firefighters completed a work-related fatigue (WRF) questionnaire to account for potential unanticipated differences in previous shift workloads. Testing included perceived muscle soreness, ultrasonography to quantify muscle size and echo intensity (EI) of the vastus lateralis (VL) and biceps brachii (BB), countermovement jump (CMJ) height and velocity, upper body (UB) peak force (PF), lower body (LB) PF and rapid force, and electromyographic (EMG) amplitude of the VL. The resistance training session included 3 sets of 8-10 repetitions of a deadlift, shoulder press, lunge, and upright row exercise at 80% 1-RM. All recovery variables were analyzed using a linear mixed model, controlling for WRF. RESULTS There was no interaction (age × time) for any of the variables and a similar training volume were completed between groups (P ≥ 0.171). Muscle soreness, CMJ height and velocity, UB PF, LB rapid force and EMG amplitude at later time intervals (100-200 ms), and VL and BB muscle size were altered from baseline (P ≤ 0.044) for 48, 24, 48, 72, and 72 h post-exercise, respectively. Young firefighters exhibited greater CMJ height and velocity, LB PF, LB rapid force (200 ms), and lower VL EI values than the older firefighters (P ≤ 0.047). CONCLUSIONS Age did not influence the recovery from an acute bout of worksite resistance exercise in firefighters. However, UB muscle strength, CMJ performance, and LB rapid force production were reduced 24-72 h post-exercise. Appropriately scheduled and chronic on-duty resistance training may mitigate these decrements.
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Affiliation(s)
- Abigail J Trivisonno
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Megan R Laffan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hayden K Giuliani
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacob A Mota
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | - Gena R Gerstner
- Neuromechanics Laboratory, Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA; North Carolina Occupational Safety and Health Education and Research Center, Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric D Ryan
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Lane AR, Hackney AC, Smith-Ryan AE, Kucera K, Register-Mihalik JK, Ondrak K. Energy Availability and RED-S Risk Factors in Competitive, Non-elite Male Endurance Athletes. Transl Med Exerc Prescr 2021; 1:25-32. [PMID: 34296227 PMCID: PMC8294781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Relative Energy Deficiency in Sport (RED-S) is predicated on the assumption that low energy availability (EA) induces deficiencies-dysfunction in multiple physiologic systems. However, research on RED-S and EA in male athletes is limited in comparison to women. The aim of this study is to investigate EA and the risk factors for RED-S, and their potential associations in non-elite male endurance athletes. Laboratory assessments for resting metabolic rate (RMR), bone mineral density (BMD), blood hormonal biomarkers and maximal aerobic capacity were conducted on 60 competitive, recreationally trained male endurance athletes (age=43.4±11.6 years [mean±SD], training=10.9±2.7 h/wk, 7.1±8.8 years). Participants provided 7-days of training logs and 4-days of diet records. Diet and training records were used to calculate EA. Correlations were used to examine associations between EA and RMR, BMD, stress fractures and reproductive, metabolic and bone biomarkers. Mean EA was 28.7±13.4 kcal/kg fat free mass (FFM), which categorized our sample as low EA (based upon published criterion, < 30 kcal/kg FFM) and at a high risk for RED-S. Hormonal and bone biomarkers were in normal clinical ranges, even though EA was low. The only interesting significant association was EA being negatively associated with total body BMD (r = -0.360, P =0.005), opposite of expectations. On average our subjects displayed a state of low EA based upon the criterion which has been primarily developed from female-based research. Nonetheless, our participants displayed no major hormonal or bone health disturbances found in athletes diagnosed with RED-S. A value of < 30 kcal/kg FFM to diagnose low EA may not be appropriate for non-elite endurance trained men.
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Affiliation(s)
- Amy R Lane
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Abbie E Smith-Ryan
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kristen Kucera
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Johna K Register-Mihalik
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kristin Ondrak
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
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Herda AA, Smith-Ryan AE, Kendall KL, Cramer JT, Stout JR. Evaluation of High-Intensity Interval Training and Beta-Alanine Supplementation on Efficiency of Electrical Activity and Electromyographic Fatigue Threshold. J Strength Cond Res 2021; 35:1535-1541. [PMID: 34027920 DOI: 10.1519/jsc.0000000000004038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Herda, AA, Smith-Ryan, AE, Kendall, KL, Cramer, JT, and Stout, JR. Evaluation of high-intensity interval training and beta-alanine supplementation on efficiency of electrical activity and electromyographic fatigue threshold. J Strength Cond Res 35(6): 1535-1541, 2021-The purpose of this study was to determine the effects of high-intensity interval training (HIIT) with or without β-alanine (BA) supplementation on the electromyographic fatigue threshold (EMGFT) and efficiency of electrical activity (EEA) in young women. Forty-four women (mean ± SD; age [yrs]: 21.7 ± 3.7; height [cm]: 166.3 ± 6.4; body mass [kg]: 66.1 ± 10.3) were randomly assigned to one of 3 treatment groups. The supplement groups performed HIIT on the cycle ergometer 3 times·wk-1 for 6 weeks. Electromyographic fatigue threshold and EEA were assessed at baseline (PRE), after 3 weeks of training (MID), and after 6 weeks of HIIT (POST). Two 2-way mixed factorial analyses of variance (time [PRE vs. MID vs. POST] × treatment (BA vs. PL vs. CON)] were used to analyze EMGFT and EEA with a predetermined level of significance α of 0.05. For EMGFT, there was no interaction (p = 0.26) and no main effect for time (p = 0.28) nor treatment (p = 0.86); thus, there were no changes in EMGFT regardless of training or supplementation status. For EEA, there was no interaction (p = 0.70) nor treatment (p = 0.79); however, there was a main effect for time (p < 0.01). Our findings indicated that neither training nor supplementation was effective in improving EMGFT in women. Efficiency of electrical activity was altered, potentially because of a learning effect. Coaches and practitioners may not use these tests to monitor training status; however, they may find EEA as a useful tool to track cycling efficiency.
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Affiliation(s)
- Ashley A Herda
- Department of Health, Sport, and Exercise Sciences, University of Kansas-Edwards Campus, Overland Park, Kansas
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Kristina L Kendall
- Department of Exercise and Sport Sciences, Edith Cowan University, Joondalup WA, Australia
| | - Joel T Cramer
- Department of Kinesiology College of Health Sciences, University of Texas-El Paso, El Paso, Texas; and
| | - Jeffrey R Stout
- Exercise Physiology & Rehabilitation Science and Kinesiology Units School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida
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Gould LM, Hirsch KR, Blue MNM, Cabre HE, Brewer GJ, Smith-Ryan AE. Effects of adiposity and body composition on adjusted resting energy expenditure in women. Am J Hum Biol 2021; 34:e23610. [PMID: 33961322 DOI: 10.1002/ajhb.23610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/09/2021] [Accepted: 04/19/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Fat-free mass (FFM) accounts for ~80% of the variance in resting energy expenditure (REE), and this relationship is complicated by adiposity. The objective was to compare adjusted REE and contributions of skeletal lean mass and fat mass (FM) to adjusted REE in women with varying adiposity levels using a novel approach. METHODS Women were divided into tertiles by body fat percent (%fat): Tertile 1 (T1): %fat = 18.5%-28.4%; Tertile 2 (T2): %fat = 28.5%-33.8%; Tertile 3 (T3): %fat = 34.0%-61.0%. Outcome measures were measured and adjusted REE, body composition (skeletal lean mass, FM, %fat) from dual-energy X-ray absorptiometry, and percent contribution of skeletal lean mass and FM to adjusted REE. RESULTS The main effect for tertiles (T1 vs. T2 vs. T3) was significant (p = .001); REE was significantly higher in T3 versus both T1 by 281 kcal/day (p = .001) and T2 by 215 kcal/day (p = .001). Expenditure from skeletal lean mass in T1 was significantly higher than T3 by 3.2% (p = .001). T3 had a significantly higher FM contribution than T1 by 5.1% (p = .001) and T2 by 3.9% (p = .001). CONCLUSIONS Women with elevated %fat experienced lower skeletal lean mass contribution and higher FM contribution to adjusted REE. FM may explain more of the variance in REE between women of different levels of adiposity.
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Affiliation(s)
- Lacey M Gould
- Applied Physiology Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Katie R Hirsch
- Applied Physiology Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Malia N M Blue
- Applied Physiology Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, Alaska, USA
| | - Hannah E Cabre
- Applied Physiology Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gabrielle J Brewer
- Applied Physiology Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Center for Translational Research in Aging & Longevity, University of Arkansas for Medical Sciences, Little Rock, Alaska, USA
| | - Abbie E Smith-Ryan
- Human Biomechanics and Applied Physiology Laboratory, High Point University, High Point, North Carolina, USA.,Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA.,Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Tonelu JT, Shekhar S, Okigbo C, Leka H, Kim A, Purse B, Hirsch K, Wei B, Stolze B, McGrath J, Smith-Ryan AE, Soldin SJ, Janet HE. The Effects of Energy Restriction on Thyroid Hormone Dynamics. J Endocr Soc 2021. [DOI: 10.1210/jendso/bvab048.2001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background: Intermittent energy restriction (IER) is gaining popularity as a weight-loss strategy. However, the effect of short-term energy restriction on thyroid hormone dynamics is not well characterized. Methods: Nineteen healthy women age 23.36± 2.08 yr (mean ± SD) with normal baseline thyroid function and negative anti-thyroid antibodies underwent two 5-day interventions of a prescribed diet and identical standardized exercise in the early follicular phase of two menstrual cycles - neutral energy availability (NEA) 45 kCal/kg*LBM/d followed by deficient energy availability (DEA) 20 kCal/kg*LBM/d. Energy requirements were estimated as previously described (doi.org/10.1210/jendso/bvaa046.1468) and were used to generate a diet and exercise regimen for each participant. On day 5 of both interventions, body composition was assessed by BodPod®. Standardized NEA or DEA breakfast and lunch were provided as appropriate as well as a standardized NEA snack on both sampling visits. Blood sampling was performed for 8 hours starting at ~0800 h with measurement of TSH and growth hormone (GH) every 10 min, cortisol every 30 min, total T3 (TT3), reverse T3 (rT3) and total T4 (TT4) every 60 min, free T3 (FT3), free T4 (FT4) and TBG at the beginning and end of sampling. Liquid chromatography-tandem mass spectrometry (LC-MS) was used for measurements of all thyroid hormones, with the exception of TSH and TBG which were measured by ELISA as were GH and cortisol. Data were analyzed using ANOVA-RM and linear mixed models. Results are presented as mean or least squared mean ± sem. Results: Body mass index, bodyweight and % fat mass were not different between interventions. GH and cortisol were unaffected by DEA (p=0.46, p=0.63). TBG was not affected by time of day or dietary intervention (p=0.95, p=0.41). However, compared with NEA, TT3 (89.15 ± 2.89 vs 95.55 ± 2.89 ng/dL for DEA and NEA, respectively; p<0.0001) and TSH (0.92 ± 0.08 vs 1.03 ± 0.09 μIU/mL; p=0.0011) were lower after DEA, while TT4 (6.26 ± 0.25 vs 6.06 ± 0.25 μg/dL; p=0.04), FT4 (3.37 ± 0.26 vs 2.94 ± 0.25 ng/d;, p=0.0052) and rT3 (11.77 ± 0.58 vs 8.85 ± 0.51 ng/dL; p<0.0001) were higher. Regardless of dietary intervention, FT3 (p=0.0005), TT3 (p<0.0001), TT4 (p<0.0001) and TSH (p<0.0001) decreased across the day. Conclusion: Using LC-MS for as a more robust measure of thyroid hormones, we have now shown that changes in thyroid hormone dynamics occur after only 5 days of 55% energy restriction in the absence of alterations in body composition, cortisol, GH, TBG or the circadian pattern of thyroid hormone secretion. The decrease in TSH combined with the decrease in TT3 and increase in rT3 support the contribution of both central and peripheral mechanisms to these changes. Taken together these results provide support for a multi-level adaptation in thyroid hormone dynamics to conserve energy expenditure in response to short-term energy restriction.
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Affiliation(s)
| | - Skand Shekhar
- NIEHS, NICHD, National Institutes of Health, Bethesda, MD, USA
| | - Chinelo Okigbo
- NIEHS, National Institutes of Health, Research Triangle Park, NC, USA
| | - Helen Leka
- NIEHS, National Institutes of Health, Research Triangle Park, NC, USA
| | - Anne Kim
- NIEHS, National Institutes of Health, Research Triangle Park, NC, USA
| | - Bona Purse
- NIEHS, National Institutes of Health, Research Triangle Park, NC, USA
| | - Katie Hirsch
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bin Wei
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Brian Stolze
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Steven J Soldin
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Hall E Janet
- NIEHS, National Institutes of Health, Research Triangle Park, NC, USA
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Wohlgemuth KJ, Arieta LR, Brewer GJ, Hoselton AL, Gould LM, Smith-Ryan AE. Sex differences and considerations for female specific nutritional strategies: a narrative review. J Int Soc Sports Nutr 2021; 18:27. [PMID: 33794937 PMCID: PMC8015182 DOI: 10.1186/s12970-021-00422-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/12/2021] [Indexed: 12/17/2022] Open
Abstract
Although there is a plethora of information available regarding the impact of nutrition on exercise performance, many recommendations are based on male needs due to the dominance of male participation in the nutrition and exercise science literature. Female participation in sport and exercise is prevalent, making it vital for guidelines to address the sex-specific nutritional needs. Female hormonal levels, such as estrogen and progesterone, fluctuate throughout the mensural cycle and lifecycle requiring more attention for effective nutritional considerations. Sex-specific nutritional recommendations and guidelines for the active female and female athlete have been lacking to date and warrant further consideration. This review provides a practical overview of key physiological and nutritional considerations for the active female. Available literature regarding sex-specific nutrition and dietary supplement guidelines for women has been synthesized, offering evidenced-based practical information that can be incorporated into the daily lives of women to improve performance, body composition, and overall health.
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Affiliation(s)
- Kealey J Wohlgemuth
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Luke R Arieta
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Gabrielle J Brewer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Andrew L Hoselton
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Lacey M Gould
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Nutrition, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA.
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Brewer GJ, Blue MNM, Hirsch KR, Saylor HE, Gould LM, Nelson AG, Smith-Ryan AE. Validation of InBody 770 bioelectrical impedance analysis compared to a four-compartment model criterion in young adults. Clin Physiol Funct Imaging 2021; 41:317-325. [PMID: 33752260 DOI: 10.1111/cpf.12700] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Multi-frequency bioelectrical impedance analysis (MF-BIA) offers enhanced body composition outcomes in a time-efficient manner. The accuracy of stand-up MF-BIA compared against a four-compartment (4C) criterion lacks evidence. OBJECTIVES To validate a stand-up MF-BIA compared to a 4C criterion for fat mass (FM), fat-free mass (FFM) and body fat percentage (%fat). SUBJECTS/METHODS Eighty-two healthy (32% men) normal-weight (BMI: 18.5-24.9 kg/m2 ) young adults were measured for body composition determined from a stand-up MF-BIA and 4C model. Validity statistics included total error (TE) and standard error of the estimate (SEE) to examine prediction error between methods. RESULTS For the total sample, prediction error was the highest for %fat (TE = 4.2%; SEE = 3.9%) followed by FM (TE = 2.4 kg; SEE = 2.2 kg) and FFM (TE = 2.4 kg; SEE = 2.2 kg). In men, %fat (TE = 2.5%; SEE = 2.2%) and FM (TE = 1.9 kg; SEE = 1.6 kg) were ideal; FFM was similar to FM (TE = 1.9 kg; SEE = 1.6 kg). In women, %fat (TE = 4.7%; SEE = 4.4%) ranged from good to fairly good, and FM was very good to excellent (TE = 2.6 kg; SEE = 2.4 kg); FFM was similar to FM (TE = 2.6 kg; SEE = 2.3 kg). CONCLUSIONS Stand-up MF-BIA may overestimate %fat and FM, and underestimate FFM compared to a 4C model. FM and FFM estimates from MF-BIA demonstrate good agreement to a 4C model and may be a practical measure of body composition in normal-weight adults. The highest error was seen in %fat for both sexes, with greater error in women.
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Affiliation(s)
- Gabrielle J Brewer
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Malia N M Blue
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Katie R Hirsch
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Hannah E Saylor
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Alyson G Nelson
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
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Smith-Ryan AE, Hirsch KR, Saylor HE, Gould LM, Blue MNM. Nutritional Considerations and Strategies to Facilitate Injury Recovery and Rehabilitation. J Athl Train 2021; 55:918-930. [PMID: 32991705 DOI: 10.4085/1062-6050-550-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Nutritional interventions are not commonly a standard of care in rehabilitation interventions. A nutritional approach has the potential to be a low-cost, high-volume strategy that complements the existing standard of care. In this commentary, our aim is to provide an evidence-based, practical guide for athletes with injuries treated surgically or conservatively, along with healing and rehabilitation considerations. Injuries are a normal and expected part of exercise participation. Regardless of severity, an injury typically results in the athlete's short- or long-term removal from participation. Nutritional interventions may augment the recovery process and support optimal healing; therefore, incorporating nutritional strategies is important at each stage of the healing process. Preoperative nutrition and nutritional demands during rehabilitation are key factors to consider. The physiological response to wounds, immobilization, and traumatic brain injuries may be improved by optimizing macronutrient composition, caloric consumption, and nutrient timing and using select dietary supplements. Previous research supports practical nutrition recommendations to reduce surgical complications, minimize deficits after immobilization, and maximize the chance of safe return to play. These recommendations include identifying the individual's caloric requirements to ensure that energy needs are being met. A higher protein intake, with special attention to evenly distributed consumption throughout the day, will help to minimize loss of muscle and strength during immobilization. Dietary-supplement strategies may be useful when navigating the challenges of appropriate caloric intake and timing and a reduced appetite. The rehabilitation process also requires a strong nutritional plan to enhance recovery from injury. Athletic trainers, physical therapists, and other health care professionals should provide basic nutritional recommendations during rehabilitation, discuss the timing of meals with respect to therapy, and refer the patient to a registered dietitian if warranted. Because nutrition plays an essential role in injury recovery and rehabilitation, nutritional interventions should become a component of standard-of-care practice after injury. In this article, we address best practices for implementing nutritional strategies among patients with athletic injuries.
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Affiliation(s)
- Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill.,Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill
| | - Katie R Hirsch
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill
| | - Hannah E Saylor
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill
| | - Lacey M Gould
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Malia N M Blue
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill
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Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2021; 18:13. [PMID: 33557850 PMCID: PMC7871530 DOI: 10.1186/s12970-021-00412-w] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/28/2021] [Indexed: 01/01/2023] Open
Abstract
Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. Is creatine an anabolic steroid? 3. Does creatine cause kidney damage/renal dysfunction? 4. Does creatine cause hair loss / baldness? 5. Does creatine lead to dehydration and muscle cramping? 6. Is creatine harmful for children and adolescents? 7. Does creatine increase fat mass? 8. Is a creatine 'loading-phase' required? 9. Is creatine beneficial for older adults? 10. Is creatine only useful for resistance / power type activities? 11. Is creatine only effective for males? 12. Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages? To answer these questions, an internationally renowned team of research experts was formed to perform an evidence-based scientific evaluation of the literature regarding creatine supplementation.
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Affiliation(s)
- Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, Florida, USA.
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | - Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Andrew R Jagim
- Sports Medicine Department, Mayo Clinic Health System, La Crosse, WI, USA
| | - Richard B Kreider
- Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, USA
| | - Eric S Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Darryn S Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
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Walton SR, Kerr ZY, Brett BL, Chandran A, DeFreese JD, Smith-Ryan AE, Stoner L, Echemendia RJ, McCrea M, Meehan Iii WP, Guskiewicz KM. Health-promoting behaviours and concussion history are associated with cognitive function, mood-related symptoms and emotional-behavioural dyscontrol in former NFL players: an NFL-LONG Study. Br J Sports Med 2021; 55:683-690. [PMID: 33397673 DOI: 10.1136/bjsports-2020-103400] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine the relationships among self-reported sport-related concussion (SRC) history and current health-promoting behaviours (exercise frequency, diet quality and sleep duration) with self-reported measures of brain health (cognitive function, symptoms of depression and anxiety and emotional-behavioural dyscontrol) in former NFL players. METHODS In this cross-sectional study, a questionnaire was sent to former NFL players. Respondents reported SRC history (categorical: 0; 1-2; 3-5; 6-9; 10+ concussions), number of moderate-to-vigorous aerobic and resistance exercise sessions per week, diet quality (Rapid Eating Assessment for Participants-Shortened) and average nightly sleep duration. Outcomes were Patient-Reported Outcomes Measurement Information System Cognitive Function, Depression, and Anxiety, and Neuro-QoL Emotional-Behavioral Dyscontrol domain T-scores. Multivariable linear regression models were fit for each outcome with SRC history, exercise frequency, diet quality and sleep duration as explanatory variables alongside select covariates. RESULTS Multivariable regression models (n=1784) explained approximately 33%-38% of the variance in each outcome. For all outcomes, SRC history (0.144≤|β|≤0.217) was associated with poorer functioning, while exercise frequency (0.064≤|β|≤0.088) and diet quality (0.057≤|β|≤0.086) were associated with better functioning. Sleeping under 6 hours per night (0.061≤|β|≤0.093) was associated with worse depressive symptoms, anxiety and emotional-behavioural dyscontrol. CONCLUSION Several variables appear to be associated with mood and perceived cognitive function in former NFL players. SRC history is non-modifiable in former athletes; however, the effects of increasing postplaying career exercise frequency, making dietary improvements, and obtaining adequate sleep represent important potential opportunities for preventative and therapeutic interventions.
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Affiliation(s)
- Samuel R Walton
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Zachary Y Kerr
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Benjamin L Brett
- Neurosurgery/Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Avinash Chandran
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- NCAA Injury Surveillance Program, Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - J D DeFreese
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Abbie E Smith-Ryan
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lee Stoner
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ruben J Echemendia
- Psychology, University of Missouri Kansas City, Kansas City, Missouri, USA
- Neuropsychology, University Orthopedics Center Concussion Clinic, State College, PA, USA
| | - Michael McCrea
- Neurosurgery/Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - William P Meehan Iii
- Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kevin M Guskiewicz
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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49
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Guest NS, VanDusseldorp TA, Nelson MT, Grgic J, Schoenfeld BJ, Jenkins NDM, Arent SM, Antonio J, Stout JR, Trexler ET, Smith-Ryan AE, Goldstein ER, Kalman DS, Campbell BI. International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr 2021; 18:1. [PMID: 33388079 PMCID: PMC7777221 DOI: 10.1186/s12970-020-00383-4] [Citation(s) in RCA: 173] [Impact Index Per Article: 57.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 10/31/2020] [Indexed: 12/13/2022] Open
Abstract
Following critical evaluation of the available literature to date, The International Society of Sports Nutrition (ISSN) position regarding caffeine intake is as follows: 1. Supplementation with caffeine has been shown to acutely enhance various aspects of exercise performance in many but not all studies. Small to moderate benefits of caffeine use include, but are not limited to: muscular endurance, movement velocity and muscular strength, sprinting, jumping, and throwing performance, as well as a wide range of aerobic and anaerobic sport-specific actions. 2. Aerobic endurance appears to be the form of exercise with the most consistent moderate-to-large benefits from caffeine use, although the magnitude of its effects differs between individuals. 3. Caffeine has consistently been shown to improve exercise performance when consumed in doses of 3-6 mg/kg body mass. Minimal effective doses of caffeine currently remain unclear but they may be as low as 2 mg/kg body mass. Very high doses of caffeine (e.g. 9 mg/kg) are associated with a high incidence of side-effects and do not seem to be required to elicit an ergogenic effect. 4. The most commonly used timing of caffeine supplementation is 60 min pre-exercise. Optimal timing of caffeine ingestion likely depends on the source of caffeine. For example, as compared to caffeine capsules, caffeine chewing gums may require a shorter waiting time from consumption to the start of the exercise session. 5. Caffeine appears to improve physical performance in both trained and untrained individuals. 6. Inter-individual differences in sport and exercise performance as well as adverse effects on sleep or feelings of anxiety following caffeine ingestion may be attributed to genetic variation associated with caffeine metabolism, and physical and psychological response. Other factors such as habitual caffeine intake also may play a role in between-individual response variation. 7. Caffeine has been shown to be ergogenic for cognitive function, including attention and vigilance, in most individuals. 8. Caffeine may improve cognitive and physical performance in some individuals under conditions of sleep deprivation. 9. The use of caffeine in conjunction with endurance exercise in the heat and at altitude is well supported when dosages range from 3 to 6 mg/kg and 4-6 mg/kg, respectively. 10. Alternative sources of caffeine such as caffeinated chewing gum, mouth rinses, energy gels and chews have been shown to improve performance, primarily in aerobic exercise. 11. Energy drinks and pre-workout supplements containing caffeine have been demonstrated to enhance both anaerobic and aerobic performance.
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Affiliation(s)
- Nanci S Guest
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Room 5326A, Toronto, ON, M5S 1A8, Canada.
| | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, 30144, USA
| | | | - Jozo Grgic
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia
| | - Brad J Schoenfeld
- Department of Health Sciences, CUNY Lehman College, Bronx, NY, 10468, USA
| | - Nathaniel D M Jenkins
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, 52240, USA
| | - Shawn M Arent
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Colombia, SC, 29208, USA
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - Jose Antonio
- Exercise and Sport Science, Nova Southeastern University, Davie, FL, 33314, USA
| | - Jeffrey R Stout
- Institue of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, 32816, USA
| | | | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, Applied Physiology Laboratory, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Erica R Goldstein
- Institue of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, 32816, USA
| | - Douglas S Kalman
- Nutrion Department, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, 33314, USA
- Scientific Affairs. Nutrasource, Guelph, ON, Canada
| | - Bill I Campbell
- Performance & Physique Enhancement Laboratory, University of South Florida, Tampa, FL, 33612, USA
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50
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Mock MG, Hirsch KR, Blue MN, Trexler ET, Roelofs EJ, Smith-Ryan AE. Post-Exercise Ingestion of Low or High Molecular Weight Glucose Polymer Solution Does Not Improve Cycle Performance in Female Athletes. J Strength Cond Res 2021; 35:124-131. [PMID: 29489721 PMCID: PMC6110985 DOI: 10.1519/jsc.0000000000002560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Mock, MG, Hirsch, KR, Blue, MNM, Trexler, ET, Roelofs, EJ, and Smith-Ryan, AE. Postexercise ingestion of low or high molecular weight glucose polymer solution does not improve cycle performance in female athletes. J Strength Cond Res 35(1): 124-131, 2021-The current study sought to evaluate the effects of postexercise ingestion of a high molecular weight (HMW) glucose polymer solution compared with an isocaloric low molecular weight (LMW) solution or placebo (PLA) on subsequent cycling performance in female athletes. In a randomized, double-blind, placebo-controlled, cross-over design, 10 competitive female cyclists (Mean ± SD; Age = 25.7 ± 5.0 years; V̇o2peak = 49.7 ± 4.3 ml·kg-1·min-1) completed 3 testing sessions separated by 7-10 days. Visits consisted of a ride-to-exhaustion (RTE) at 75% V̇o2peak, followed by immediate consumption of 700 ml containing either: 1.2 g·kg-1 LMW (maltodextrin/dextrose/fructose); 1.2 g·kg-1 HMW (Vitargo); or 0.066 g·kg-1 PLA (noncaloric flavoring). After 2 hours of rest, subjects performed a 15-minute time trial (TT). Respiratory exchange ratio (RER) was assessed via indirect calorimetry during exercise. Total body water (TBW) was measured using bioelectrical impedance to assess fluid balance. When covaried for estrogen, there was no treatment effect on distance (km; p = 0.632) or power output (watts; p = 0.974) during the 15-minute TT. Respiratory exchange ratio was not significantly different during the LMW and HWM TTs (p > 0.999), but both were significantly higher than PLA (p = 0.039, p = 0.001, respectively). Changes in total body water pre-exercise to postexercise were not significantly different between trials (p = 0.777). Despite benefits of HMW on cycling performance previously reported in males, current results demonstrate no ergogenic effect of HMW or LMW in females. Sex differences in substrate utilization may account for the discrepancy, and further research involving performance nutrition for female athletes is merited.
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Affiliation(s)
- Meredith G. Mock
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Katie R. Hirsch
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Malia N.M. Blue
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Eric T. Trexler
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Erica J. Roelofs
- Nutrition, Health, and Human Performance Department, Meredith College, Raleigh, NC, USA
| | - Abbie E. Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
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