KovaaK's aim trainer as a reliable metrics platform for assessing shooting proficiency in esports players: a pilot study

Esports research lacks game-based metrics platforms appropriate for adequately capturing esports performance. The aim of this pilot study was to assess the reliability of the KovaaK's first-person shooter (FPS) aim trainer as a metrics platform for assessing shooting proficiency in esports players. Ten FPS esports players completed two identical experimental trials (T) separated by three to five days. Each trial included four rounds (R) of testing, evaluating four shooting tasks: Micro Flicking, Macro Flicking, Strafe Tracking, and Wall Peeking. Reliability of performance outcomes (e.g., accuracy, headshot accuracy, hits per second, and total shots hit) were assessed using the intraclass correlation coefficient (ICC) and their 95% confidence intervals (CI), and significant differences were identified using repeated-measures analysis of variance (RM-ANOVA). Results indicated excellent, or good to excellent reliability for all outcome variables with the ICC estimates ranging between 0.947-0.995, with lower and upper bound 95% CIs ranging between 0.876-0.988, and 0.984-0.999, respectively. Significant improvements were seen between experimental trials in the Macro Flicking task for accuracy (p = .005) and hits per second (p = .009) only. Significant interactions between trial and round were identified in the Micro Flicking task for accuracy (p = .006), with post hoc analysis showing accuracy was significantly higher in T1R1 compared to T2R1 (87.74 ± 3.13 vs. 85.99 ± 3.05, respectively, p = .02), and in T2R4 compared to T2R2 (87.99 ± 2.89 vs. 84.70 ± 4.25, respectively, p = .049). Significant interactions were also identified in the Strafe Tracking task for headshot accuracy (p = .002), with post hoc analysis showing headshot accuracy was significantly higher in T1R2 compared to T2R2 (78.48 ± 8.15 vs. 76.79 ± 12.16, respectively, p = .003), and in T1R2 compared to T1R1 (78.48 ± 8.15 vs. 73.68 ± 17.94, respectively, p = .023). In summary, this study demonstrates that KovaaK's provides a reliable metrics platform for assessing shooting proficiency in esports, however, some variability in performance was observed.

A review of factors influencing drinking behaviours in young Australian adults using a behavioural framework approach

ISSUES

Young adults (aged 18-24 years) are more likely to binge drink than any other age group in Australia. These behaviours expose young adults to possible adverse events, with potential for acute harms.

APPROACH

A behavioural framework (capability, opportunity, motivation-behaviour [COM-B model]) was used to explore factors that influence the drinking behaviours of young Australian adults. Potential studies were identified by searching four online data bases. Content pertaining to factors moderating young adults' alcohol consumption behaviours (either increasing or decreasing alcohol consumption) in an Australian population was extracted. Factors were then categorised/mapped into the six sub-components of the COM-B model. A narrative synthesis/discussion was subsequently undertaken.

KEY FINDINGS

Factors increasing or reducing alcohol consumption behaviours were identified across all components of the COM-B model. Overall, alcohol consumption behaviours appear strongly influenced by physical and social opportunities, and young adults have reflective and automatic motivations (i.e., habitual processes, emotional responding and analytical decisional making that directs behaviour) to consume alcohol with purpose and/or reason.

IMPLICATIONS AND CONCLUSION

The use of a behavioural framework (e.g., the COM-B model) facilitates an integrated understanding of factors influencing alcohol consumption behaviours. Future harm minimisation strategies need to consider the interrelated, contemporary factors underpinning a young adult's decision to consume alcohol within the context of modern Australian society.

The effect of contact/collision sport participation without concussion on neurometabolites: A systematic review and meta-analysis of magnetic resonance spectroscopy studies

The aim of this study was to systematically review prior research investigating the effects of contact/collision sport participation on neurometabolite levels in the absence of concussion. Four online databases were searched to identify studies that measured neurometabolite levels in contact/collision sport athletes (without concussion) using proton (1 H) or phosphorus (31 P) magnetic resonance spectroscopy (MRS). All study designs were acceptable for inclusion. Meta-analytic procedures were used to quantify the effect of contact/collision sport participation on neurometabolite levels and explore the impact of specific moderating factors (where sufficient data were available). Narrative synthesis was used to describe outcomes that could not be meta-analysed. Nine observational studies involving 300 contact/collision sport athletes were identified. Six studies (providing 112 effect estimates) employed longitudinal (cohort) designs and three (that could not be meta-analysed) employed case-control designs. N-acetylaspartate (NAA; g = -0.331, p = 0.013) and total creatine (tCr; creatine + phosphocreatine; g = -0.524, p = 0.029), but not glutamate-glutamine (Glx), myo-inositol (mI) or total choline (tCho; choline-containing compounds; p's > 0.05), decreased between the pre-season and mid-/post-season period. Several moderators were statistically significant, including: sex (Glx: 6 female/23 male, g = -0.549, p = 0.013), sport played (Glx: 22 American football/4 association football [soccer], g = 0.724, p = 0.031), brain region (mI: 2 corpus callosum/9 motor cortex, g = -0.804, p = 0.015), and the MRS quantification approach (mI: 18 absolute/3 tCr-referenced, g = 0.619, p = 0.003; and tCho: 18 absolute/3 tCr-referenced, g = 0.554, p = 0.005). In case-control studies, contact/collision sport athletes had higher levels of mI, but not NAA or tCr compared to non-contact sport athletes and non-athlete controls. Overall, this review suggests that contact/collision sport participation has the potential to alter neurometabolites measured via 1 H MRS in the absence of concussion. However, further research employing more rigorous and consistent methodologies (e.g. interventional studies with consistent 1 H MRS pulse sequences and quantifications) is required to confirm and better understand the clinical relevance of observed effects.

Preparation procedures of food and beverage samples for oxygen bomb calorimetry: A scoping review and reporting checklist

Standardised bomb calorimetry methods are essential to accurately quantify the gross energy within food and beverages, yet no accepted protocols exist. The objective of this review was to synthesise literature on food and beverage sample preparation methods used for conducting bomb calorimetry. This synthesis enhances our understanding of the extent to which methodological variances may currently affect estimates of the caloric values of dietary items. Five electronic databases were searched for peer reviewed literature on food and beverage energy measurement via bomb calorimetry. Data were extracted on seven identified methodological themes, including: (1) initial homogenisation, (2) sample dehydration, (3) post-dehydration homogenisation, (4) sample presentation, (5) sample weight, (6) sample frequency, and (7) equipment calibration. A tabular and narrative approach was used to synthesise the data. Studies that specifically explored the impact of any methodological variance on the energy derived from foods and/or beverages were also considered. In total, 71 documents describing food and beverage sample preparation techniques and processes used for bomb calorimetry were identified. Only 8% of studies described all seven identified sample preparation and calibration processes. The most frequent approaches used included: initial homogenisation - mixing or blending (n = 21); sample dehydration - freeze drying (n = 37); post-dehydration homogenisation - grinding (n = 24); sample presentation - pelletisation (n = 29); sample weight - 1g (n = 14); sample frequency - duplicate (n = 17); and equipment calibration - benzoic acid (n = 30). The majority of studies that have measured food and beverage energy via bomb calorimetry do not describe sample preparation and calibration methods in detail. The extent to which different sample preparation processes influence the energy derived from food and beverage items is yet to be fully elucidated. Use of a bomb calorimetry reporting checklist (described within) may assist with improving the methodological quality of bomb calorimetry studies.

The availability and promotion of low alcohol beverages in licensed venues: an environmental audit on the Gold Coast, Australia

OBJECTIVES

Low-alcohol beverages (LABs) are becoming increasingly popular and more accepted in Australia. However, the extent to which these products are accessible in licensed venues remains unknown. This investigation aimed to explore the availability, visibility, advertising, and promotion of LAB products at licensed venues.

STUDY TYPE

A cross-sectional environmental audit of licensed venues in four entertainment locations on the Gold Coast, Queensland.

METHODS

An audit tool was developed. Licensed venues selected for auditing included bars, pubs, clubs, and nightclubs. Consent for conducting the audits was obtained from selected venues. Audits involved a walk-through of each venue's public areas and a review of their beverage menu to observe availability, visibility, advertising, and promotion of LAB products.

RESULTS

A total of 58 venues were identified, with 32 (55%) providing written consent to audit. Overall, 18 venues (56%) offered patrons the opportunity to purchase LAB products. At bar service areas, LAB products were 'not visible' in 20 (63%) venues, and 'somewhat visible' in 12 (38%) venues. No bar service areas displayed LAB products with 'high visibility'. Of 29 beverage menus audited, 10 (34%) displayed LAB products, with varying levels of visibility. LAB-related advertising and/or promotion was not identified in any of the venues.

CONCLUSIONS

LABs were available in approximately half the licensed venues audited; however, the visibility and promotion of these products were poor. There is capacity to improve access to and promote lower alcohol alternatives within licensed venues.

Effects of Cannabidiol on Exercise Physiology and Bioenergetics: A Randomised Controlled Pilot Trial

Background

Cannabidiol (CBD) has demonstrated anti-inflammatory, analgesic, anxiolytic and neuroprotective effects that have the potential to benefit athletes. This pilot study investigated the effects of acute, oral CBD treatment on physiological and psychological responses to aerobic exercise to determine its practical utility within the sporting context.

Methods

On two occasions, nine endurance-trained males (mean ± SD V̇O_2max: 57.4 ± 4.0 mL·min⁻¹·kg⁻¹) ran for 60 min at a fixed intensity (70% V̇O_2max) (RUN 1) before completing an incremental run to exhaustion (RUN 2). Participants received CBD (300 mg; oral) or placebo 1.5 h before exercise in a randomised, double-blind design. Respiratory gases (V̇O₂), respiratory exchange ratio (RER), heart rate (HR), blood glucose (BG) and lactate (BL) concentrations, and ratings of perceived exertion (RPE) and pleasure–displeasure were measured at three timepoints (T1–3) during RUN 1. V̇O_2max, RER_max, HR_max and time to exhaustion (TTE) were recorded during RUN 2. Venous blood was drawn at Baseline, Pre- and Post-RUN 1, Post-RUN 2 and 1 h Post-RUN 2. Data were synthesised using Cohen’s d_z effect sizes and 85% confidence intervals (CIs). Effects were considered worthy of further investigation if the 85% CI included ± 0.5 but not zero.

Results

CBD appeared to increase V̇O₂ (T2: + 38 ± 48 mL·min⁻¹, d_z: 0.25–1.35), ratings of pleasure (T1: + 0.7 ± 0.9, d_z: 0.22–1.32; T2: + 0.8 ± 1.1, d_z: 0.17–1.25) and BL (T2: + 3.3 ± 6.4 mmol·L⁻¹, d_z: > 0.00–1.03) during RUN 1 compared to placebo. No differences in HR, RPE, BG or RER were observed between treatments. CBD appeared to increase V̇O_2max (+ 119 ± 206 mL·min⁻¹, d_z: 0.06–1.10) and RER_max (+ 0.04 ± 0.05 d_z: 0.24–1.34) during RUN 2 compared to placebo. No differences in TTE or HR_max were observed between treatments. Exercise increased serum interleukin (IL)-6, IL-1β, tumour necrosis factor-α, lipopolysaccharide and myoglobin concentrations (i.e. Baseline vs. Post-RUN 1, Post-RUN 2 and/or 1-h Post-RUN 2, p’s < 0.05). However, the changes were small, making it difficult to reliably evaluate the effect of CBD, where an effect appeared to be present. Plasma concentrations of the endogenous cannabinoid, anandamide (AEA), increased Post-RUN 1 and Post-RUN 2, relative to Baseline and Pre-RUN 1 (p’s < 0.05). CBD appeared to reduce AEA concentrations Post-RUN 2, compared to placebo (− 0.95 ± 0.64 pmol·mL⁻¹, d_z: − 2.19, − 0.79).

Conclusion

CBD appears to alter some key physiological and psychological responses to aerobic exercise without impairing performance. Larger studies are required to confirm and better understand these preliminary findings.

Trial Registration This investigation was approved by the Sydney Local Health District’s Human Research Ethics Committee (2020/ETH00226) and registered with the Australia and New Zealand Clinical Trials Registry (ACTRN12620000941965).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00417-y.

Effects of Different Sources of Low-Dose Caffeine on Mood/Arousal and Cognitive Performance

In this study we investigated the effects of variously derived sources of low-dose caffeine on mood/arousal and cognitive performance. Twenty-two participants (15 men, 7 women; M age: 28.2, SD = 9.0 years) undertook five randomized, crossover trials in which they consumed either a water control (CON) or 80 mg of caffeine from one of four sources (coffee [COF], energy drink [END], capsule [CAP], and dissolvable mouth strip [STR]). We measured the participants' perceived efficacy of these varied caffeine sources pre-treatment; and we measured mood/arousal at pre-treatment, and again at 15 and 45 minutes post-treatment. We also measured choice reaction-time at 15 and 45 minutes post-treatment, and participants completed the psychomotor vigilance task (PVT) 45 minutes post-treatment. Caffeine increased participant ratings of alertness and decreased their ratings of tiredness irrespective of source (p's < .05), and all sources of caffeine decreased reaction time on the PVT (p's < .05), with ex-Gaussian distributional analysis localizing this to the tau-parameter, indicating lower variability. However, only the COF source was associated with improved 'overall mood' (p's < .05). Participants expected to perform better on the PVT with COF compared to CON, but there were no other significant associations between source expectancy and performance. In sum, a modest dose of caffeine, regardless of source, positively impacted mood/arousal and cognitive performance, and these effects did not appear to be influenced by expectations.

Effectiveness of self-managed home and community exercise interventions in improving physical activity, body adiposity and related health indices in adults living with HIV: a protocol for a systematic review

BACKGROUND AND OBJECTIVES

Disorders of adipose tissue distribution in people living with the human immunodeficiency virus (HIV) have been associated with significant metabolic derangements that increase their risk of cardiometabolic and other chronic diseases. Systematic reviews focusing on supervised laboratory-based exercise interventions demonstrate that these interventions improve adipose tissue distribution and related health outcomes in people living with HIV (PLWH). However, there is a need to examine the effectiveness of more pragmatic home or community exercise programmes. The aim of this review will be to synthesize existing evidence on the effectiveness of self-managed home or community exercise interventions to improve physical activity levels, adipose tissue distribution and associated health indices in PLWH.

METHODS

This review will encompass interventional studies that evaluate the effect of prescribed exercise programmes performed in the home or community with minimal supervision, by adults living with HIV. The following will be searched from inception: PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, SPORTDiscus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and Clinicaltrials.gov. Screening of studies and data extraction will be conducted by two independent reviewers. The risk of bias in included studies will be assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Risk of Bias In Non-Randomized Studies-of Interventions (ROBINS-I) tool for non-randomized concurrently controlled and single-arm interventional studies. A random effects meta-analysis will be used to pool effect estimates for outcomes of interest (measures of physical activity and body adiposity). However, if pooling is deemed inappropriate due to substantial differences between studies, a narrative synthesis will be performed. This protocol is written according to the Preferred Reporting Items for Systematic reviews and Meta-analysis Protocols 2015 statement (see Additional file 1).

DISCUSSION

This review shall provide evidence to support or disapprove the prescription of self-managed exercise interventions in a particularly vulnerable population. We will equally explore the potential impact of technology in improving physical activity outcomes. Our findings could help guide clinicians involved in the care of PLWH in prescribing exercise and inform the design of future trials and research.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021223357 .

Effects of Acute Sleep Loss on Physical Performance: A Systematic and Meta-Analytical Review

BACKGROUND

Sleep loss may influence subsequent physical performance. Quantifying the impact of sleep loss on physical performance is critical for individuals involved in athletic pursuits.

DESIGN

Systematic review and meta-analysis.

SEARCH AND INCLUSION

Studies were identified via the Web of Science, Scopus, and PsycINFO online databases. Investigations measuring exercise performance under 'control' (i.e., normal sleep, > 6 h in any 24 h period) and 'intervention' (i.e., sleep loss, ≤ 6 h sleep in any 24 h period) conditions were included. Performance tasks were classified into different exercise categories (anaerobic power, speed/power endurance, high-intensity interval exercise (HIIE), strength, endurance, strength-endurance, and skill). Multi-level random-effects meta-analyses and meta-regression analyses were conducted, including subgroup analyses to explore the influence of sleep-loss protocol (e.g., deprivation, restriction, early [delayed sleep onset] and late restriction [earlier than normal waking]), time of day the exercise task was performed (AM vs. PM) and body limb strength (upper vs. lower body).

RESULTS

Overall, 227 outcome measures (anaerobic power: n = 58; speed/power endurance: n = 32; HIIE: n = 27; strength: n = 66; endurance: n = 22; strength-endurance: n = 9; skill: n = 13) derived from 69 publications were included. Results indicated a negative impact of sleep loss on the percentage change (%_Δ) in exercise performance (n = 959 [89%] male; mean %_Δ =  - 7.56%, 95% CI - 11.9 to - 3.13, p = 0.001, I² = 98.1%). Effects were significant for all exercise categories. Subgroup analyses indicated that the pattern of sleep loss (i.e., deprivation, early and late restriction) preceding exercise is an important factor, with consistent negative effects only observed with deprivation and late-restriction protocols. A significant positive relationship was observed between time awake prior to the exercise task and %_Δ in performance for both deprivation and late-restriction protocols (~ 0.4% decrease for every hour awake prior to exercise). The negative effects of sleep loss on different exercise tasks performed in the PM were consistent, while tasks performed in the AM were largely unaffected.

CONCLUSIONS

Sleep loss appears to have a negative impact on exercise performance. If sleep loss is anticipated and unavoidable, individuals should avoid situations that lead to experiencing deprivation or late restriction, and prioritise morning exercise in an effort to maintain performance.

Youth Athlete Development and Nutrition

Adolescence (ages 13–18 years) is a period of significant growth and physical development that includes changes in body composition, metabolic and hormonal fluctuations, maturation of organ systems, and establishment of nutrient deposits, which all may affect future health. In terms of nutrition, adolescence is also an important time in establishing an individual’s lifelong relationship with food, which is particularly important in terms of the connection between diet, exercise, and body image. The challenges of time management (e.g., school, training, work and social commitments) and periods of fluctuating emotions are also features of this period. In addition, an adolescent’s peers become increasingly powerful moderators of all behaviours, including eating. Adolescence is also a period of natural experimentation and this can extend to food choice. Adolescent experiences are not the same and individuals vary considerably in their behaviours. To ensure an adolescent athlete fulfils his/her potential, it is important that stakeholders involved in managing youth athletes emphasize eating patterns that align with and support sound physical, physiological and psychosocial development and are consistent with proven principles of sport nutrition.

Belief in caffeine's ergogenic effect on cognitive function and endurance performance: A sham dose-response study

This study aimed to determine if belief in caffeine's ergogenic potential influences choice reaction time (CRT) and/or running performance. Twenty-nine healthy individuals (23.7 ± 5 years, 16 males) completed two trials (one week apart). Before the trials, participants indicated their "belief" in caffeine's ergogenic effects and previous "experience" using caffeine for performance. On arrival, participants randomly received either sham "Low (100mg; LD)" or "High (300mg; HD)" dose caffeine capsules 30-min before commencing the CRT test, followed by a 10km run. Paired samples t-tests determined differences between trials for CRT latency (Ex-Gaussian analysis; μ-, σ- and τ-) and running performance using the entire cohort and sub-groups exhibiting strong "beliefs"+/-"experience". Sham caffeine dose did not influence CRT (μ-, σ- and τ-respectively, LD: 400 ± 53ms vs. HD: 388 ± 41ms; LD: 35 ± 18ms vs. HD: 34 ± 17ms; LD: 50 ± 24ms vs. HD: 52 ± 19ms, all p's > 0.05). Neither belief (n = 6), nor belief + experience (n = 4), influenced this effect. Furthermore, caffeine dose did not influence run time (LD: 49.05 ± 3.75min vs. HD: 49.06 ± 3.85min, p = 0.979). Belief (n = 9) (LD: 48.93 ± 3.71min vs. HD: 48.9 ± 3.52min, p = 0.976), and belief + experience (n = 6) (LD: 48.68 ± 1.87min vs. HD: 49.55 ± 1.75min, p = 0.386) didn't influence this effect. A dose-response to sham caffeine ingestion was not evident on cognitive or endurance performance in healthy individuals, regardless of their convictions about caffeine's ergogenicity.

The influence of exercise training volume alterations on the gut microbiome in highly-trained middle-distance runners

The aim of this study was to determine the influence of training volume alterations on diversity and composition of the gut microbiome in a free-living cohort of middle-distance runners. Fourteen highly-trained middle-distance runners (n = 8 men; [Formula: see text]O_2peak = 70.1 ± 4.3 ml·kg·min^-1; n = 6 women, [Formula: see text]O_2peak: 59.0 ± 3.2 ml·kg·min^-1) completed three weeks of normal training (NormTr), three weeks of high-volume training (HVolTr; a 10, 20 and 30% increase in training volume during each successive week from NormTr), and a one-week taper (TaperTr; 55% exponential reduction in training volume from HVolTr week three). Faecal samples were collected before and immediately after each training phase to quantify alpha-diversity and composition of the gut microbiome. A three-day diet record was collected during each training phase and a maximal incremental running test was completed after each training phase. Results showed no significant changes in nutritional intake, alpha-diversity, or global microbial composition following HVolTr or TaperTr compared to NormTr (p's > 0.05). Following HVolTr, there was a significant decrease in Pasterellaceae (p = 0.03), Lachnoclostridium (p = 0.02), Haemophilus (p = 0.03), S. parasagunis (p = 0.02), and H. parainfluenzae (p = 0.03), while R. callidus (p = 0.03) significantly increased. These changes did not return to NormTr levels following TaperTr. This study shows that the alpha-diversity and global composition of the gut microbiome were unaffected by changes in training volume. However, an increase in training volume led to several changes at the lower taxonomy levels that did not return to pre-HVolTr levels following a taper period.

Assessment of an integrated knowledge translation intervention to improve nutrition intakes among patients undergoing elective bowel surgery: a mixed-method process evaluation

BACKGROUND

A large evidence-practice gap exists regarding provision of nutrition to patients following surgery. The aim of this study was to evaluate the processes supporting the implementation of an intervention designed to improve the timing and adequacy of nutrition following bowel surgery.

METHODS

A mixed-method pilot study, using an integrated knowledge translation (iKT) approach, was undertaken at a tertiary teaching hospital in Australia. A tailored, multifaceted intervention including ten strategies targeted at staff or patients were co-developed with knowledge users at the hospital and implemented in practice. Process evaluation outcomes included reach, intervention delivery and staffs' responses to the intervention. Quantitative data, including patient demographics and surgical characteristics, intervention reach, and intervention delivery were collected via chart review and direct observation. Qualitative data (responses to the intervention) were sequentially collected from staff during one-on-one, semi-structured interviews. Quantitative data were summarized using median (IQR), mean (SD) or frequency(%), while qualitative data were analysed using content analysis.

RESULTS

The intervention reached 34 patients. Eighty-four percent of nursing staff received an awareness and education session, while 0% of medical staff received a formal orientation or awareness and education session, despite the original intention to deliver these sessions. Several strategies targeted at patients had high fidelity, including delivery of nutrition education (92%); and prescription of oral nutrition supplements (100%) and free fluids immediately post-surgery (79%). Prescription of a high energy high protein diet on postoperative day one (0%) and oral nutrition supplements on postoperative day zero (62%); and delivery of preoperative nutrition handout (74%) and meal ordering education (50%) were not as well implemented. Interview data indicated that staff regard nutrition-related messages as important, however, their acceptance, awareness and perceptions of the intervention were mixed.

CONCLUSIONS

Approximately half the patient-related strategies were implemented well, which is likely attributed to the medical and nursing staff involved in intervention design championing these strategies. However, some strategies had low delivery, which was likely due to the varied awareness and acceptance of the intervention among staff on the ward. These findings suggest the importance of having buy-in from all staff when using an iKT approach to design and implement interventions.

The Impact of Post-Prandial Delay Periods on Ad Libitum Consumption of a Laboratory Breakfast Meal

This study examined the impact of varying the holding time following an ad libitum laboratory breakfast on acute dietary behaviour and subsequent intake. 24 participants (20 females (age: 23.4±6.3 y; BMI: 23.9±3.9 kg·m-2, mean±SD)) completed three trials following a quasi-randomized, crossover design. Each trial (seven day separation) incorporated a defined post-prandial delay (DPD) period of either zero (no delay), one or three hours following a buffet breakfast consumed over 30-minutes. Dietary intake outcomes included energy, macronutrient and core food group intakes. On completion of the DPD period, participants left the laboratory and recorded all food/beverages consumed for the remainder of the day. One-way repeated-measures ANOVA assessed all outcomes, with post hoc analysis conducted on significant main effects. Energy and carbohydrate intakes were significantly lower on no delay vs one hour (p = 0.014) and three hour (p = 0.06) DPD trials (EI: 1853±814 kJ vs. 2250±1345 kJ vs. 1948±1289 kJ; CHO: 68±34 g vs. 77±44 vs. 69±43 g; respectively). DPD periods did not influence the time to consume next meal or energy, macronutrient and core food group intakes for the remainder of the day. Delaying participants from leaving a laboratory alters dietary intake at an ad libitum test meal. The post-meal holding period is an important methodological consideration when planning laboratory studies to assess appetite. Novelty Bullets: 1. Delaying participants from leaving a laboratory alters dietary intake at ad libitum breakfast meals. 2. The length of the delay period did not affect dietary intake at ad libitum breakfast meals.

Consistency of hangover experiences after a night of drinking: A controlled laboratory study

OBJECTIVE

Research into cognitive performance during a hangover has produced equivocal findings. This study investigated the reliability of inducing hangover symptoms and effects on cognitive performance (including applied tasks) under standardised conditions.

METHOD

Twenty-one participants (13 M; 24 ± 3 years) completed two identical trials, involving alcohol consumption and an overnight laboratory stay. Outcome measures included: hangover severity (a single-item 'Hangover' rating, and a sum of hangover symptoms [Overall Symptoms Score (OSS)]), cognitive function (trail making test), simulated driving (standard deviation of lateral position; lane crossings), and typing performance. Spearman's correlations were used to assess reliability between trials for all participants, and when ratings of 'Hangover' were consistent.

RESULTS

Participants demonstrated reliable 'Hangover' rating change from baseline (Trial A: 2.0 [2.0]; Trial B: 2.0 [2.0], rho = 0.680, p = 0.001), but not for OSS (Trial A: 8.0 [12.0]; Trial B: 5.0 [9.0], rho = 0.309, p = 0.173). Performance in cognitive/applied tasks (range rho = 0.447-0771) was consistent, except simulated driving (range rho = 0.035-0.272), however the impairment was trivial. The subgroup analysis did not reveal substantial changes in reliability.

CONCLUSION

A single 'Hangover' rating was a reliable way of determining 'mild' to 'moderate' hangover severity. The present data could be used to assist the methodological design of future hangover research.

The Effect of Consuming Carbohydrate With and Without Protein on the Rate of Muscle Glycogen Re-synthesis During Short-Term Post-exercise Recovery: a Systematic Review and Meta-analysis

Background

Rapid restoration of muscle glycogen stores is imperative for athletes undertaking consecutive strenuous exercise sessions with limited recovery time (e.g. ≤ 8 h). Strategies to optimise muscle glycogen re-synthesis in this situation are essential. This two-part systematic review and meta-analysis investigated the effect of consuming carbohydrate (CHO) with and without protein (PRO) on the rate of muscle glycogen re-synthesis during short-term post-exercise recovery (≤ 8 h).

Methods

Studies were identified via the online databases Web of Science and Scopus. Investigations that measured muscle glycogen via needle biopsy during recovery (with the first measurement taken ≤ 30 min post-exercise and at least one additional measure taken ≤ 8 h post-exercise) following a standardised exercise bout (any type) under the following control vs. intervention conditions were included in the meta-analysis: part 1, water (or non-nutrient beverage) vs. CHO, and part 2, CHO vs. CHO+PRO. Publications were examined for methodological quality using the Rosendal scale. Random-effects meta-analyses and meta-regression analyses were conducted to evaluate intervention efficacy.

Results

Overall, 29 trials (n = 246 participants) derived from 21 publications were included in this review. The quality assessment yielded a Rosendal score of 61 ± 8% (mean ± standard deviation). Part 1: 10 trials (n = 86) were reviewed. Ingesting CHO during recovery (1.02 ± 0.4 g·kg body mass (BM)⁻¹ h⁻¹) improved the rate of muscle glycogen re-synthesis compared with water; change in muscle glycogen (MG_Δ) re-synthesis rate = 23.5 mmol·kg dm⁻¹ h⁻¹, 95% CI 19.0–27.9, p < 0.001; I² = 66.8%. A significant positive correlation (R² = 0.44, p = 0.027) was observed between interval of CHO administration (≤ hourly vs. > hourly) and the mean difference in rate of re-synthesis between treatments. Part 2: 19 trials (n = 160) were reviewed. Ingesting CHO+PRO (CHO: 0.86 ± 0.2 g·kg BM⁻¹ h⁻¹; PRO: 0.27 ± 0.1 g·kg BM⁻¹ h⁻¹) did not improve the rate of muscle glycogen re-synthesis compared to CHO alone (0.95 ± 0.3 g·kg BM⁻¹ h⁻¹); MG_Δ re-synthesis rate = 0.4 mmol·kg  dm⁻¹ h⁻¹, 95% CI −2.7 to 3.4, p = 0.805; I² = 56.4%.

Conclusions

Athletes with limited time for recovery between consecutive exercise sessions should prioritise regular intake of CHO, while co-ingesting PRO with CHO appears unlikely to enhance (or impede) the rate of muscle glycogen re-synthesis.

Trial Registration

Registered at the International Prospective Register of Systematic Reviews (PROSPERO) (identification code CRD42020156841).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-020-00297-0.

Muscle fiber typology is associated with the incidence of overreaching in response to overload training

Variability in the performance responses following an overload training period and subsequent taper was associated with the variation in the muscle fiber typology of the gastrocnemius. Runners with an estimated higher proportion of type I fibers (i.e., lower carnosine z-score) were able to maintain performance in response to an overload training period and subsequently achieve a superior performance supercompensation. These findings show that muscle fiber typology contributes to the variability in performance responses following training.

Evaluation of an intervention to improve nutrition intake in patients undergoing elective colorectal surgery: A mixed-methods pilot study

OBJECTIVES

Timely and adequate nutrition after surgery is important. The aim of this study was to evaluate the effects of an intervention, developed using an integrated knowledge translation approach, designed to improve oral intake among postoperative colorectal patients.

METHODS

A pre/post, mixed-methods pilot study was undertaken at a tertiary teaching hospital in Australia. Patients who had undergone elective colorectal surgery and were admitted to the ward where 10 nutrition-related strategies had been implemented were included. Quantitative data, including patient demographics, timing and type of nutrition consumed, and protein and energy intake were collected pre- and post-intervention via chart audits, direct observations, and verbal clarification. Qualitative data on patient (n = 18) responses to the intervention were collected through one-on-one, semistructured interviews and analyzed using inductive content analysis.

RESULTS

Sixty-four patients were observed (30 pre- and 34 post-intervention). Significant improvements were seen for the following outcomes (presented as median [interquartile range], pre- versus post-intervention): time (h) to first dietary intake (15.7 [7.4-22.5] versus 4.9 [3.7-14.2]); patient energy intakes (kJ) on day 1 (1719 [947-2200] versus 3530 [2192-5169]) and day 2 (2506 [1071-3749] versus 4144 [2987-5889]); and patient protein intake (g) on day 1 (3.3 [1.8-11.2] versus 30.3 [20-45]) and day 2 (10.8 [3.5-29.9] versus 39.6 [30.7-59]). Prescription of free fluids as first diet type increased from 13% to 79% pre- and post-intervention, respectively. There were no significant differences in time (h) to first solid dietary intake (86.1 [60.1-104] versus 69.2 [46.1-115.5]) and overall proportion of patients who met both their estimated energy and protein requirements while in hospital pre- and post-intervention (22 versus 37%). Patients reported positive experiences with the intervention.

CONCLUSION

A multifaceted intervention developed using an integrated knowledge translation approach has the potential to improve oral intake in patients who undergo colorectal surgery. A larger-scale trial is required to confirm these findings and assess the effects of the intervention on clinical outcomes and costs.

Cognitive effects of acute aerobic exercise: Exploring the influence of exercise duration, exhaustion, task complexity and expectancies in endurance-trained individuals

The cognitive effects of acute aerobic exercise were investigated in endurance-trained individuals. On two occasions, 21 cyclists; 11 male (VO_2max: 57 ± 9 mL·kg^-1·min^-1) and 10 female (VO_2max: 51 ± 9 mL·kg^-1·min^-1), completed 45 min of fixed, moderate-intensity (discontinuous) cycling followed by an incremental ride to exhaustion. Cognitive function was assessed at Baseline, after 15 and 45 min of exercise (15EX and 45EX) and at Exhaustion using a 4-Choice Reaction Time (CRT) test and the Stroop test (Incongruent and Congruent Reaction Time [RT]). A sham capsule was administered on one occasion to determine whether the cognitive response to exercise was robust to the influence of a placebo. CRT, Congruent RT and Incongruent RT decreased (improved) at 15EX, 45EX and Exhaustion compared to Baseline (p's<0.005). While CRT and Congruent RT were faster at 45EX than 15EX (p's<0.020), Incongruent RT was not (p= 1.000). The sham treatment did not affect cognition. When performed at a moderate-intensity, longer duration exercise (up to 45 min) may improve cognition to a greater extent than shorter duration exercise; however, the magnitude of improvement appears to decrease with increasing task complexity. HI/EE performed following a sustained bout of dehydrating activity may not impair cognition.

Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research

Cannabidiol (CBD) is a non-intoxicating cannabinoid derived from Cannabis sativa. CBD initially drew scientific interest due to its anticonvulsant properties but increasing evidence of other therapeutic effects has attracted the attention of additional clinical and non-clinical populations, including athletes. Unlike the intoxicating cannabinoid, Δ9-tetrahydrocannabinol (Δ9-THC), CBD is no longer prohibited by the World Anti-Doping Agency and appears to be safe and well-tolerated in humans. It has also become readily available in many countries with the introduction of over-the-counter "nutraceutical" products. The aim of this narrative review was to explore various physiological and psychological effects of CBD that may be relevant to the sport and/or exercise context and to identify key areas for future research. As direct studies of CBD and sports performance are is currently lacking, evidence for this narrative review was sourced from preclinical studies and a limited number of clinical trials in non-athlete populations. Preclinical studies have observed robust anti-inflammatory, neuroprotective and analgesic effects of CBD in animal models. Preliminary preclinical evidence also suggests that CBD may protect against gastrointestinal damage associated with inflammation and promote healing of traumatic skeletal injuries. However, further research is required to confirm these observations. Early stage clinical studies suggest that CBD may be anxiolytic in "stress-inducing" situations and in individuals with anxiety disorders. While some case reports indicate that CBD improves sleep, robust evidence is currently lacking. Cognitive function and thermoregulation appear to be unaffected by CBD while effects on food intake, metabolic function, cardiovascular function, and infection require further study. CBD may exert a number of physiological, biochemical, and psychological effects with the potential to benefit athletes. However, well controlled, studies in athlete populations are required before definitive conclusions can be reached regarding the utility of CBD in supporting athletic performance.

Consumption of a smoothie or cereal-based breakfast: impact on thirst, hunger, appetite and subsequent dietary intake

Smoothies are a popular breakfast option. However, liquids may evoke weaker satiation than nutritionally comparable semi-solid and solid foods. This study examined consumption of cereal and milk (CM) or a nutritionally comparable fruit smoothie (FS) for breakfast on subsequent dietary behaviours, in a controlled laboratory setting. Twenty-five participants (age 25 ± 6 y) completed three trials, receiving either CM or FS for breakfast. Afterwards, participants remained isolated for 4 h with ad libitum access to foods/beverages. A repeat trial (CM or FS) allowed exploration of normal variability. Post-breakfast energy intake (EI) (CM = 1465(2436) vs. FS = 1787(3190) kJ, Median (IQR), p = 0.099), time to intake of next food/fluid (meal latency) (CM = 146(97) vs. FS = 180(100) min, p = 0.127), and subjective hunger, desire to eat, fullness and thirst ratings were similar between conditions (p's > 0.05). The mean coefficient of variation for EI and meal latency were 41% and 21%, respectively. Consumption of a FS does not negatively impact acute EI and meal latency.

Engaging hospitalised patients in their nutrition care using technology: development of the NUTRI-TEC intervention

Background

Nutrition is vital for health and recovery during hospitalisation, however most patients fail to meet minimum dietary requirements and up to 50% of patients are malnourished in hospital. When patients participate in nutrition care, their dietary intakes are improved. Advances in health information technology (HIT) have broadened the ways by which patients can participate in care. Our team has developed an innovative, HIT-based intervention (called NUTRI-TEC; engaging patients in their nutrition care using technology), facilitating patient participation in their nutrition care in hospital. This paper aims to describe the systematic and iterative process by which the intervention was developed.

Methods

NUTRI-TEC development was informed by the Medical Research Council guidance for developing complex interventions and underpinned by theoretical frameworks and concepts (i.e. integrated knowledge translation and patient participation in care), existing evidence and a rigorous program of research. The intervention was co-developed by the multidisciplinary research team and stakeholders, including health consumers (patients), health professionals and industry partners. We used an iterative development and evaluation cycle and regularly tested the intervention with hospital patients and clinicians.

Results

The NUTRI-TEC intervention involves active patient participation in their nutrition care during hospitalisation. It has two components: 1) Patient education and training; and 2) Guided nutrition goal setting and patient-generated dietary intake tracking. The first component includes brief education on the importance of meeting energy/protein requirements in hospital; and training on how to use the hospital’s electronic foodservice system, accessed via bedside computer screens. The second component involves patients recording their food intake after each meal on their bedside computer and tracking their intakes relative to their goals. This is supported with brief, daily goal-setting sessions with a health care professional.

Conclusions

NUTRI-TEC is a HIT intervention designed to enable patient participation in their nutrition care in hospital. As research on HIT interventions to engage patients in health care in the hospital setting is in its infancy, and as gaps and inconsistencies in the development of such interventions exist, this paper will inform future development of HIT-based interventions in the hospital setting.

Sports nutrition for the recreational athlete

BACKGROUND

Recreational sports participation provides many potential health benefits. However, some athletes experience medical problems associated with, or exacerbated by, a mismanagement of the relationship between their diet and sporting endeavours.

OBJECTIVE

The aim of this article is to highlight recent developments in clinical sports nutrition, with a focus on providing evidence-based advice and resources for the management of common medical presentations.

DISCUSSION

A low dietary energy intake relative to exercise energy demands (ie low energy availability) may result in an array of medical issues. An evidence-based framework for advice on sports supplements is available.

Women Experience the Same Ergogenic Response to Caffeine as Men

PURPOSE

This study aimed to determine whether 1) consumption of caffeine improves endurance cycling performance in women and 2) sex differences exist in the magnitude of the ergogenic and plasma responses to caffeine supplementation.

METHODS

Twenty-seven (11 women and 16 men) endurance-trained cyclists and triathletes participated in this randomized, double-blind, placebo-controlled, crossover study. Participants completed an incremental exercise test to exhaustion, two familiarization trials, and two performance trials. Ninety minutes before the performance trials, participants ingested opaque capsules containing either 3 mg·kg body mass of anhydrous caffeine or a placebo. They then completed a set amount of work (75% of peak sustainable power output) in the fastest possible time. Plasma was sampled at baseline, preexercise, and postexercise for caffeine. Strict standardization and verification of diet, hydration, training volume and intensity, and contraceptive hormone phase (for women) were implemented.

RESULTS

Performance time was significantly improved after caffeine administration in women (placebo: 3863 ± 419 s, caffeine: 3757 ± 312 s; P = 0.03) and men (placebo: 3903 ± 341 s, caffeine: 3734 ± 287 s; P < 0.001). The magnitude of performance improvement was similar for women (mean = 4.3%, 95% CI = 0.4%-8.2%) and men (4.6%, 2.3%-6.8%). Plasma caffeine concentrations were similar between sexes before exercise, but significantly greater in women after exercise (P < 0.001).

CONCLUSIONS

Ingestion of 3 mg·kg body mass of caffeine enhanced endurance exercise performance in women. The magnitude of the performance enhancement observed in women was similar to that of men, despite significantly greater plasma caffeine concentrations after exercise in women. These results suggest that the current recommendations for caffeine intake (i.e., 3-6 mg·kg caffeine before exercise to enhance endurance performance), which are derived almost exclusively from studies on men, may also be applicable to women.

Effects of alcohol intoxication goggles (fatal vision goggles) with a concurrent cognitive task on simulated driving performance

Objective: Fatal vision goggles (FVGs) are image-distorting equipment used to simulate alcohol impairment in driver education programs. Unlike alcohol, which disrupts cognitive processes, FVG only induces visual impairment. Performing concurrent cognitive tasks while wearing FVG may reduce the wearer's attentional resources and provide a better simulation of alcohol intoxication. This study examined the impact of wearing FVG with/without administration of a concurrent cognitive task on simulated driving.Methods: Twenty-one males (23 ± 3 y, mean ± SD) participated in this randomized, repeated-measures study involving two experimental trials. In each trial, participants completed a baseline drive then an experimental drive under one of two conditions: (1) FVG and (2) FVG with additional cognitive demand (FVG + CD). The driving test included 3 separate scenarios (Task 1, 2, 3) lasting ∼5min each. Lateral (standard deviation of lane position [SDLP]; number of lane crossings [LCs]) and longitudinal control parameters (average speed; standard deviation of speed [SDSP]; distance headway; minimum distance headway) were monitored in Tasks 1 and 2. Latency to two different stimuli (choice reaction time [CRT]) was examined in Task 3.Results: In Task 1, SDLP and LC were unaffected by either condition. However, SDSP increased significantly from baseline with FVG, irrespective of cognitive demand. In Task 2, distance headway decreased significantly from baseline with FVG, but increased significantly with FVG + CD. Minimum distance headway was significantly decreased, while SDLP increased significantly and LC increased (although not statistically significant) in both conditions relative to baseline. In Task 3, a significant increase in CRT occurred with FVG + CD, but not with FVG alone.Conclusions: Wearing FVG negatively impacted simulated driving performance. However, effects were isolated to specific performance outcomes and were dependent on complexity of the driving task. Addition of a secondary cognitive task exacerbates the effects of FVG on select driving outcomes (i.e. lane position, SDSP), influences the effect direction on other measures (i.e. distance headway), and has a detrimental effect on reaction time to stimuli embedded in the scenario, that is not observed with FVG alone. Future studies using FVG as a surrogate means to alcohol intoxication should consider these results, informing methodological decisions to reduce potential for confounding effects.

Identifying errors in meals provided to and sourced by patients on therapeutic diets in hospital

BACKGROUND AND OBJECTIVES

Patients requiring therapeutic diets in hospital are at risk of exposer to dietary errors that may pose an acute threat to their safety. This study aimed to determine the prevalence of meal-related errors among hospitalised patients prescribed therapeutic diets, following the implementation of an electronic foodservice system (EFS).

METHODS AND STUDY DESIGN

This observational study involved six wards in a tertiary metropolitan hospital that used an EFS for meal ordering and plating. Participants were adult medical inpatients receiving a therapeutic diet for medical or nutritional reasons. Meal accuracy was assessed for up to 48-hours per patient by comparing the dietary items placed on patients' meal trays or personal meals consumed by patients to their therapeutic diet prescription. Inaccuracies were categorised as critical or non-critical errors and were identified as having occurred at one of four steps in the EFS: menu planning (main-meals), meal assembly (mainmeals), meal delivery (mid- and main-meals) and meal consumption (personal-meals).

RESULTS

A total of 167 inpatients were included in the study. Of the 906 meals assessed, 69 errors (8%) were observed; with 97% classified as critical. Error rates differed according to the foodservice system step assessed: 17% for menu planning, <1% for meal assembly, 53% for meal delivery: main-meals, 9% for meal delivery: mid-meals and 33% meal consumption.

CONCLUSION

An EFS almost completely eliminated errors associated with meal assembly. However, when foodservice staff and patients selected dietary items at ward level (without a guiding system) a substantial number of potentially critical errors occurred.

Sensitive and Reliable Measures of Driver Performance in Simulated Motor-Racing

Motor racing is a physically and mentally demanding sport, associated with a high degree of risk for drivers. Hence, driving simulation provides a safe alternative to explore the impact acute physiological perturbations (e.g. heat stress or dehydration) on a driver's performance. This study aimed to determine sensitive and reliable simulated driving performance parameters that could be employed in future driving performance studies. Thirty-six healthy males (age: 26.5 ± 8.1 y, body mass: 75.6 ± 12.2 kg, mean ± SD) completed a single experimental trial involving four simulated motor-racing drives (2 initial drives and 2 repeat drives) separated by a 1 h period. Drives were conducted under two conditions, with one condition (wearing Fatal Vision Goggles (FVG)) designed to impair driving performance by distorting vision. Sensitivity was assessed by comparing Normal vs FVG outcomes and reliability was determined by comparing initial vs repeat drives for the same condition. Measures of driving performance included lap time (LT), sector-time (ST) for one section of the track, position displacement to a marker on the first track corner (PD), and vehicle Speed at PD. Results indicated that LT and ST were reliable and sensitive performance measures to a visual disturbance. However, PD was neither sensitive nor reliable and Speed at PD was not sensitive as driving performance measures to the study conditions. Overall, this study demonstrates two sensitive and reliable performance measures (LT and ST) that can be used to assess simulated motor-racing performance in future investigations.

No Impact of Heat Stress and Dehydration on Short Duration Simulated Motor-Racing Performance

Motor-racing drivers are often exposed to hot environments and may be susceptible to fluid loss and hydration issues, which could influence driving performance. This study assessed the effect of dehydration and heat stress on performance during a short, simulated motor-racing task. Nine healthy males (age: 26.6 ± 7.5 y, body mass: 78.8 ± 12.5 kg, mean ± SD) completed two passive dehydration (sauna) procedures (targeting -1% and -3% body mass loss (BML)) on separate occasions. Driving performance was assessed pre-dehydration (Baseline), immediately post-dehydration (Hot) and following a cooling period (Cool). Measures of driving performance included lap time and sector-time for one section of the track. Subjective ratings of mood, thermal stress and comfort were also collected during trials. Mean lap times were not different between Baseline, Hot, Cool conditions for both 1% (68.44 ± 1.43 s, 68.06 ± 1.17 s, 68.23 ± 1.25 s) and 3% (68.33 ± 1.68 s, 68.01 ± 1.15 s, 68.06 ± 1.26 s) trials respectively. In addition, mean sector times were not different between Baseline, Hot, Cool conditions for both 1% (11.61 ± 0.28 s, 11.55 ± 0.45 s, 11.59 ± 0.35 s) and 3% (11.49 ± 0.33 s, 11.56 ± 0.33 s, 11.63 ± 0.71 s) trials respectively. Changes in participants' subjective ratings (i.e. decreased alertness, concentration and comfort; increased tiredness and light-headedness) were observed at both levels of dehydration (1% and 3% BML), irrespective of heat stress. Thus, fluid loss and heat stress are unlikely to affect driver's motor-racing performance during short duration events. However, the impact of dehydration and heat stress on tasks of longer duration that accurately represent the demands associated with motor-racing requires further consideration.

Tattoos do not affect exercise-induced localised sweat rate or sodium concentration

OBJECTIVES

Skin tattoos have been shown to reduce localised sweat rate and increase sweat sodium concentration ([Na⁺]) when sweating is artificially stimulated. This study investigated whether similar responses are observed with exercise-induced sweating.

DESIGN

Unblinded, within-participant control, single trial.

METHODS

Twenty-two healthy individuals (25.1±4.8 y (Mean±SD), 14 males) with a unilateral tattoo ≥11.4cm² in size, ≥2 months in age, and shaded ≥50% participated in this investigation. Participants undertook 20min of intermittent cycling (4×5min intervals) on a stationary ergometer in a controlled environment (24.6±1.1°C; 64±6% RH). Resultant sweat was collected into absorbent patches applied at two pairs of contralateral skin sites (pair 1: Tattoo vs. Non-Tattoo; pair 2: Control 1 vs. Control 2 (both non-tattooed)), for determination of sweat rate and sweat [Na⁺]. Paired samples t-tests were used to determine differences between contralateral sites.

RESULTS

Tattoo vs. Non-Tattoo: Neither sweat rate (Mean±SD: 0.92±0.37 vs. 0.94±0.43mg·cm^-2·min^-1, respectively; p=0.693) nor sweat [Na⁺] (Median(IQR): 37(32-52) vs. 37(31-45) mM·L^-1, respectively; p=0.827) differed. Control 1 vs. Control 2: Neither sweat rate (Mean±SD: 1.19±0.53 vs. 1.19±0.53mg·cm^-2·min^-1, respectively; p=0.917) nor sweat [Na⁺] (Median(IQR): 29(26-41) vs. 31(25-43)mM·L^-1, respectively; p=0.147) differed. The non-significant differences for sweat rate and [Na⁺] between Tattoo vs. Non-Tattoo were inside the range of the within participant variability (sweat rate CVi=5.4%; sweat [Na⁺] CVi=4.4%).

CONCLUSIONS

Skin tattoos do not appear to alter the rate or [Na⁺] of exercise-induced sweating. The influence of skin tattoos on localised sweat responses may have previously been over-estimated.

Hospital Staffs' Perceptions of Postoperative Nutrition Among Colorectal Patients: A Qualitative Study

BACKGROUND

After lower gastrointestinal surgery, few patients start eating within timeframes outlined by evidence-based guidelines or meet their nutrition requirements in hospital. The present study explored hospital staffs' perceptions of factors influencing timely and adequate feeding after colorectal surgery to inform future interventions for improving postoperative nutrition practices and intakes.

METHODS

This qualitative exploratory study was conducted at an Australian hospital where Enhanced Recovery After Surgery guidelines had not been formally implemented. One-on-one semistructured interviews were conducted with hospital staff who provided care to patients undergoing colorectal surgery. Interviews lasted from 21 to 47 minutes and were audio recorded and transcribed verbatim. Data were analyzed using inductive thematic analysis. Emergent themes and subthemes were discussed by all investigators to ensure consensus of interpretation.

RESULTS

Eighteen staff participated in interviews, including 9 doctors, 5 nurses, 2 dietitians, and 2 foodservice staff. Staffs' responses formed 3 themes: (1) variability in perceived acceptability of postoperative feeding; (2) improving dynamics and communication within the treating team; and (3) optimizing dietary intakes with available resources.

CONCLUSION

Staff and organizational factors need to be considered when attempting to improve postoperative nutrition among patients who undergo colorectal surgery. Introducing a feeding protocol, enhancing intraprofessional and interdisciplinary communication, and ensuring the availability of appropriate, nutrient-dense foods are pivotal to improve nutrition practices and intakes.

Challenges following a personalised diet adhering to dietary guidelines in a sample of Australian university students

BACKGROUND

Food-based dietary guidelines are designed to support populations to adopt a healthy diet. University students studying nutrition related courses are typically en-route to professional roles that involve advocating a healthy diet.

AIM

The present study compared the dietary intake of university students enrolled in a foundation nutrition course against the Australian Dietary Guidelines (ADGs) and Nutrient Reference Values (NRVs), and explored students' experiences of following a 3-day self-determined diet plan adhering to the ADGs/NRVs.

METHODS

Students (n = 115) initially collected, and subsequently analysed a 3-day prospective diet record to determine food group/nutrient intake. Individuals then modified their diet to comply with recommendations (ADGs/NRVs) and attempted to implement the diet plan. Challenges associated with meeting the ADGs/NRVs were described in an online survey form.

RESULTS

Baseline food group and nutrient intakes deviated from the guidelines, with 'lean meats & alternatives' the only group consumed in recommended quantities. Students demonstrated the capacity to plan a modified personal diet adhering to the ADGs food group recommendations. However, when following this, several key challenges to dietary adherence were identified. Challenges were categorised as personal/behavioural factors (e.g. the quantity/type of food) and societal factors (e.g. time, cost, social factors).

CONCLUSION

Overall, this study highlights challenges influencing adherence to dietary guidelines in a sample of undergraduate university students. Understanding these factors may help tailor advice to facilitate improved dietary patterns in this population group.

A qualitative exploration of factors influencing medical staffs' decision-making around nutrition prescription after colorectal surgery

BACKGROUND

Enhanced Recovery After Surgery (ERAS) guidelines recommend early oral feeding with nutritionally adequate diets after surgery. However, studies have demonstrated variations in practice and poor adherence to these recommendations among patients who have undergone colorectal surgery. Given doctors are responsible for prescribing patients' diets after surgery, this study explored factors which influenced medical staffs' decision-making regarding postoperative nutrition prescription to identify potential behaviour change interventions.

METHODS

This qualitative study involved one-on-one, semi-structured interviews with medical staff involved in prescribing nutrition for patients following colorectal surgery across two tertiary teaching hospitals. Purposive sampling was used to recruit participants with varying years of clinical experience. The Theoretical Domains Framework (TDF) underpinned the development of a semi-structured interview guide. Interviews were audio recorded, with data transcribed verbatim before being thematically analysed. Emergent themes and sub-themes were discussed by all investigators to ensure consensus of interpretation.

RESULTS

Twenty-one medical staff were interviewed, including nine consultants, three fellows, four surgical trainees and five junior medical doctors. Three overarching themes emerged from the data: (i) Prescription preferences are influenced by perceptions, experience and training; (ii) Modifying prescription practices to align with patient-related factors; and (iii) Peers influence prescription behaviours and attitudes towards nutrition.

CONCLUSIONS

Individual beliefs, patient-related factors and the social influence of peers (particularly seniors) appeared to strongly influence medical staffs' decision-making regarding postoperative nutrition prescription. As such, a multi-faceted approach to behaviour change is required to target individual and organisational barriers to enacting evidence-based feeding recommendations.

The effect of different post-exercise beverages with food on ad libitum fluid recovery, nutrient provision, and subsequent athletic performance

This study investigated the effect of consuming either water or a carbohydrate (CHO)-electrolyte sports beverage ('Sports Drink') ad libitum with food during a 4 h post-exercise recovery period on fluid restoration, nutrient provision and subsequent endurance cycling performance. On two occasions, 16 endurance-trained cyclists; 8 male [M] (age: 31 ± 9 y; VO_2max: 54 ± 6 mL·kg^-1·min^-1) and 8 female [F] (age: 33 ± 8 y; VO_2max: 50 ± 7 mL·kg^-1·min^-1); lost 2.3 ± 0.3% and 1.6 ± 0.3% of their body mass (BM), respectively during 1 h of fixed-intensity cycling. Participants then had ad libitum access to either Water or Sports Drink and food for the first 195 min of a 4 h recovery period. At the conclusion of the recovery period, participants completed a cycling performance test consisting of a 45 min fixed-intensity pre-load and an incremental test to volitional exhaustion (peak power output, PPO). Beverage intake; total water/nutrient intake; and indicators of fluid recovery (BM, urine output, plasma osmolality [P_OSM]) were assessed periodically throughout trials. Participants returned to a similar state of net positive fluid balance prior to recommencing exercise, regardless of the beverage provided (Water: +0.4 ± 0.5 L; Sports Drink: +0.3 ± 0.3 L, p = 0.529). While Sports Drink increased post-exercise energy (M: +1.8 ± 1.0 MJ; F: +1.3 ± 0.5 MJ) and CHO (M: +114 ± 31 g; F: +84 ± 25 g) intake (i.e. total from food and beverage) (p's < 0.001), this did not improve subsequent endurance cycling performance (Water: 337 ± 40 W [M] and 252 ± 50 W [F]; Sports Drink: 340 ± 40 W [M] and 258 ± 47 W [F], p = 0.242). Recovery beverage recommendations should consider the post-exercise environment (i.e. the availability of food), an individual's tolerance for food and fluid pre-/post-exercise, the immediate requirements for refuelling (i.e. CHO demands of the activity) and the athlete's overall dietary goals.

The influence of a fruit smoothie or cereal and milk breakfast on subsequent dietary intake: a pilot study

Smoothies are popular breakfast foods. This study examined the effect of consuming Cereal & Milk (CM) or a nutritionally-comparable Fruit Smoothie (FS) for breakfast on daily energy intake (EI) in free-living adults and the extent to which individuals compensated for calories ingested in a High Energy Fruit Smoothie (HE). Ten participants (28.4 ± 2.2y; 23.3 ± 1.0 kg·m ^-2, Mean ± SEM) attended the laboratory on 3 consecutive days per week for 3 weeks. Each week, they received a CM, FS or HE breakfast, then recorded all food/beverages consumed across the remainder of the day. The CM and FS were energy-matched to participants' usual breakfast (1675 ± 283 kJ), while the HE contained an additional 100 kJ·kg^-1 of maltodextrin (3019 ± 335 kJ). Mean 3-day EI was similar on CM and FS (7894 ± 547 vs. 7570 ± 463 kJ, p > .05), but elevated on HE (8861 ± 726 kJ, p =  .012). Thus, individuals who substitute CM for a FS breakfast should be mindful that energy-dense beverages may result in increased daily EI.

Post-exercise Ingestion of Carbohydrate, Protein and Water: A Systematic Review and Meta-analysis for Effects on Subsequent Athletic Performance

BACKGROUND

Athletes may complete consecutive exercise sessions with limited recovery time between bouts (e.g. ≤ 4 h). Nutritional strategies that optimise post-exercise recovery in these situations are therefore important.

OBJECTIVE

This two-part review investigated the effect of consuming carbohydrate (CHO) and protein with water (W) following exercise on subsequent athletic (endurance/anaerobic exercise) performance.

DATA SOURCES

Studies were identified by searching the online databases SPORTDiscus, PubMed, Web of Science and Scopus.

STUDY ELIGIBILITY CRITERIA AND INTERVENTIONS

Investigations that measured endurance performance (≥ 5 min duration) ≤ 4 h after a standardised exercise bout (any type) under the following control vs. intervention conditions were included: Part 1: W vs. CHO ingested with an equal volume of W (CHO + W); and, Part 2: CHO + W vs. protein (PRO) ingested with CHO and an equal volume of W (PRO + CHO + W), where CHO or energy intake was matched.

STUDY APPRAISAL AND SYNTHESIS METHODS

Publications were examined for bias using the Rosendal scale. Random-effects meta-analyses and meta-regression analyses were conducted to evaluate intervention efficacy.

RESULTS

The quality assessment yielded a Rosendal score of 63 ± 9% (mean ± standard deviation). Part 1: 45 trials (n = 486) were reviewed. Ingesting CHO + W (102 ± 50 g CHO; 0.8 ± 0.6 g CHO kg^-1 h^-1) improved exercise performance compared with W (1.6 ± 0.7 L); %_Δ mean power output = 4.0, 95% confidence interval 3.2-4.7 (I ² = 43.9). Improvement was attenuated when participants were 'Fed' (a meal 2-4 h prior to the initial bout) as opposed to 'Fasted' (p = 0.012). Part 2: 13 trials (n = 125) were reviewed. Ingesting PRO + CHO + W (35 ± 26 g PRO; 0.5 ± 0.4 g PRO kg^-1) did not affect exercise performance compared with CHO + W (115 ± 61 g CHO; 0.6 ± 0.3 g CHO·kg body mass^-1 h^-1; 1.2 ± 0.6 L); %_Δ mean power output = 0.5, 95% confidence interval - 0.5 to 1.6 (I ² = 72.9).

CONCLUSIONS

Athletes with limited time for recovery between consecutive exercise sessions should prioritise CHO and fluid ingestion to enhance subsequent athletic performance. PROSPERO REGISTRATION NUMBER: CRD42016046807.

Caffeine content of Nespresso® pod coffee

BACKGROUND:

Little independent information on the caffeine content of the popular Nespresso^® coffee pod range exists.

AIM:

To quantify the caffeine content of Nespresso^® pod coffees.

METHODS:

Initially, three serves (ristretto (S), espresso (M), lungo (L)) of two pod varieties (Livanto and Roma) were prepared on three different Nespresso^® machines (2 × U-Delonghi (1 × 5 years since purchase (old), 1 × recently purchased (new)), 1 × new Lattissima Pro (alternate)) using two different batches (sleeves). Caffeine content was then determined via triplicate samples using high-performance liquid chromatography. Differences in content (i.e. serve size, machine or sleeve) were determined via an analysis of variance or paired sample t-tests.

RESULTS:

Coffees prepared on different machines or pods from different sleeves did not influence the caffeine content (old = 63 ± 13, new = 60 ± 8, alternate = 60 ± 10 mg·serve^-1; p = 0.537, sleeveA = 63 ± 11, sleeveB = 59 ± 9 mg·serve^-1; p = 0.134). Less caffeine was delivered in S (51 ± 7 mg·serve^-1) compared to larger sizes (M = 66 ± 7 and L = 66 ± 10 mg·serve^-1). Subsequently, the caffeine content from two serve sizes (S and L) from 17 other varieties within the Nespresso^® range was determined and compared to the manufacturer's values. Caffeine content (all pods) ranged from 19 to 147 mg·serve^-1, and represented 51-162% of manufacturer's values.

CONCLUSION:

Nespresso^® consumers are exposed to variable amounts of caffeine, which often differ from the manufacturer's reports.