Energy and Macronutrient Intakes in Young Athletes: A Systematic Review and Meta-analysis

The aim of this study was to conduct a systematic review and meta-analysis of differences in energy and macronutrient intakes between young athletes and non-athletes, considering age, gender and sport characteristics. The study included original research articles that compared energy and macronutrient intakes of 8 to 18-year-old athletes to non-athletes. Mean difference (MD) meta-analyses were performed to quantify energy and macronutrient intake differences between athletes and non-athletes. Eighteen observational studies were included. Results revealed that the energy and carbohydrate consumption of athletes was higher than that of non-athletes (MD=4.65kcal/kg/d, p<0.01 and MD=1.65% of total energy intake, p<0.01, respectively). Subgroup analyses revealed a significant effect of total training time on the observed mean differences between athletes and non-athletes. As practice time increased, the differences between athletes and non-athletes increased for carbohydrate and decreased for protein. Sport type analysis revealed a higher protein intake by mixed sport athletes compared to endurance and power sports. Analyses also indicated an age effect: the older the athletes, the smaller the differences between athletes and non-athletes for energy intake. However, the methods used to match groups and estimate dietary intakes forced us to moderate the results. More rigorous research methods are needed to define the dietary intakes of athletes and non-athletes.

P09-03 Costing the economic burden of sedentary behaviors in France

Background

There is strong evidence showing that sedentary behaviour (SB) increase the risk to develop several chronic diseases and to premature death (Chau et al., 2015). A dose response relation is observed with a more marked risk when people spend more than 7 hours/day in sitting position (Ekelund et al., 2019). The study INCA 3 on the lifestyle habits of French population indicated that 40% of people between 18 and 79 years had a high risk for health conditions with more than 7 hours of daily SB (ANSES, 2017). The economic consequences of this risk have never been evaluated. The aim of this study was to estimate the economic burden of SB-related diseases in France.

Methods

From meta-analysis or large cohorts based on individual SB time, we identified relative risk (RR) to develop cardiovascular disease (CVD), colon cancer, breast cancer and all-causes premature death after co-variables adjustments including physical activity. From RR and prevalence of SB time in France, a population attributable fraction approach was used to estimate the yearly number of cases for each disease. Data from the national health insurance were used to calculate the annual average costs per case for each disease. Then, disease-specific and total health-care costs attributable to prolonged SB time were calculated. Indirect costs for private sector and households were calculated in a second stage.

Results

In France, 66 528 premature deaths/year appear related to a daily SB time ≥ 8,6 hours Each year prolonged SB cost 559 millions € for the national health insurance, including 359 millions € for CVD (≥ 10 hours of daily SB), 170 millions € for breast cancer (≥ 6 hours of daily SB), and 31 millions € for colon cancer (≥ 5 hours of TV/day).

Conclusions

These preliminary results showed that many deaths could be avoided by reducing prolonged SB prevalence in France. Moreover, direct health-care costs attributable to SB related diseases represent a high economic burden for the French health system. To address this issue, strong responses should be implemented to tackle SB, complementary to physical activity promotion.

Costing the economic burden of prolonged sedentary behaviours in France

BACKGROUND

There is strong evidence showing that sedentary behaviour time increase the risk to develop several chronic diseases and to premature death. The economic consequences of this risk have never been evaluated in France. The aim of this study was to estimate the economic burden of prolonged sedentary behaviour in France.

METHODS

Based on individual sedentary behaviour time, relative risk to develop cardiovascular disease, colon cancer, breast cancer and all-causes of premature mortality were identified. From relative risk and prevalence of sedentary behaviour time, a population attributable fraction approach was used to estimate the yearly number of cases for each disease. Data from the National Health Insurance were used to calculate the annual average costs per case for each disease. Disease-specific and total healthcare costs attributable to prolonged sedentary behaviour time were calculated. Indirect costs from productivity loss due to morbidity and premature mortality were estimated using a friction cost approach.

RESULTS

In France, 51 193 premature deaths/year appear related to a prolonged daily sedentary behaviour time. Each year prolonged sedentary behaviour cost 494 million € for the national health insurance. Yearly productivity loss due to premature mortality attributable to prolonged sedentary behaviour cost 507 million € and yearly productivity loss due to morbidity cost between 43 and 147 million €.

CONCLUSION

Significant saving and many deaths could be avoided by reducing prolonged sedentary behaviour prevalence in France. To address this issue, strong responses should be implemented to tackle sedentary behaviour, complementary to physical activity promotion.

Case Report: Severe Hypercalcemia Following Vitamin D Intoxication in an Infant, the Underestimated Danger of Dietary Supplements

Vitamin D supplementation is routinely introduced in infants, according to medical guidelines. However, vitamin D overdose can result in life-threatening hypercalcemia. We report the case of a 3-month-old infant who suffered from severe hypercalcemia. Upon detailed questioning of the parents, a vitamin D administration error has been identified. Indeed, the parents had followed the advice of their midwife. They substituted the prescribed medicinal vitamin D by a dietary supplement, different in concentration and dosing, without performing the dose conversion needed. In fact, many different medications and dietary supplements with vitamin D exist, offering various concentrations and units of measurement. This case highlights the pivotal role of therapeutic education. Broadly, there is a need for harmonization of the regulation and labeling of dietary supplements and medications containing vitamin D.

Perspective: Modeling Healthy Eating Patterns for Food-Based Dietary Guidelines-Scientific Concepts, Methodological Processes, Limitations, and Lessons

The relations between dietary features and human health are varied and complex. Health-related variables are many and they have intricate relations at different and interrelated nutritional levels: nutrients, food groups, and the complex overall pattern. Food-based dietary guidelines (FBDGs) are principally designed to synthesize this information to make it available to the public. Here, we describe the method used to establish healthy eating patterns (HEPs) for the latest French FBDGs, which consists of in-depth food pattern modeling using an enhanced optimization method that gathered all aspects of HEPs. We present the novelty of this food modeling approach for FBDGs, which aims to gather information related to nutrients, food contaminants, and epidemiological relations with long-term health, and to be combined with the objective of realistic dietary patterns that deviate minimally from the prevailing diet. We draw lessons from stepwise implementation of the method and discuss its strengths, limitations, and perspectives. In light of the modeled HEPs, we discuss the importance of food grouping; of accounting for dietary habits while not precluding modeled diets that can be realistic/acceptable; and of taking into account the exposure to food contaminants. We discuss the tolerance and flexibility to be applied to certain dietary reference values for nutrients and health-based guidance values for contaminants so that HEPs can ultimately be identified, and how account can be taken of varied health-related outcomes applied to food groups. Although the approach involves all the peculiar uncertainties of numerous optimization model parameters and input data, its merit is that it offers a rationalized approach to establishing HEPs with multiple constraints and competing objectives. It is also versatile because it is possible to operationalize further dimensions of dietary patterns to favor human and planetary health.

The need for European harmonization of Nutrivigilance in a public health perspective: a comprehensive review

According to the European Union regulation, some countries have established a pre-market notification system for food supplements while others have not. As this regulation is unfulfilled, a notified and marketed food supplement ingredient in one country may be forbidden in another. Even though food supplements shall not be placed on the market if unsafe, some products may still expose the consumers to risks. The risk is increased by easier access due to worldwide dissemination fostered by the internet and free movement of goods in the European Union. The Rapid Alert System for Food and Feed and the Emerging Risks Exchange Network are described. To date, the European Union legislation does not include a provision to establish a dedicated vigilance system for food supplements (Nutrivigilance). Six European Union countries have nevertheless set up national systems, which are presented. The present lack of European Union data collection harmonization, does not allow easy cooperation between countries. This article advocates for creating a coordinated European Nutrivigilance System to detect and scrutinize adverse effects of food supplements. This, to help in directing science-based risk assessments and reinforce the science-based decision of policy makers to improve public health safety.

[Food supplements: real food or fake medicine?]

"Food supplements: real food or fake medicine? Food supplements are regulatorily considered as food. As such, they are just supposed to bring nutrients to people whose diet would not cover their nutritional needs. Ideally, they should only be consumed after a nutritional check-up. In practice, consumers consider them as safe drugs but in reality, the Nutrivigilance scheme shows they are at risk and should not be consumed without a medical advice."

How to deal with COVID-19 epidemic-related lockdown physical inactivity and sedentary increase in youth? Adaptation of Anses' benchmarks

Faced with the spread of the SARS-CoV-2 virus, regulatory measures aiming to prevent interpersonal contaminations have been undertaken and among these, lockdown. Due to strong restrictions out-of-home movements, we hypothesize that overall physical activity will decrease and sedentary behavior increase. This could result in highest exposure to the well-known risk related to insufficient physical activity. To mitigate physical inactivity and sedentary behaviors health-related risks related to children and adolescents lockdown and school closure, Anses (French Agency for Food, Environmental and Occupational Health & Safety) has adapted, within the first days of the public authorities' prescription, its former benchmarks. This paper supports and comments Anses' Opinion by raising the questions of whether, why, and how to deal with short- or medium-term lockdown-related physical inactivity and sedentary behavior increases. Short-term and unknown long term-impacts on mental health and well-being, physical fitness and eating behaviors clearly appearing for children and adolescents as being the main issues of concern are highlighted. Targeting the compensations of the physical inactivity increase, the types, frequencies and durations of physical activity, are adapted to restricted environment. Sedentary behavior limitation and frequent interruptions becomes a priority. Overall, considering children and adolescents, the emerging risk justifies proposing specific adaptations and type of activities in order to ensure maintaining health underpinned, at least partly, by physiological equilibrium and physical fitness and avoid the installation of new unhealthy habits or routines that young people could keep after lockdown.

Cancers in France in 2015 attributable to insufficient physical activity

INTRODUCTION

Insufficient physical activity is a known risk factor for various co-morbidities, including cancer. Globally, its prevalence has increased markedly over the past decades. The aim of this study was to estimate the proportion and number of cancers that were attributable to insufficient physical activity in France in 2015.

METHODS

Population attributable fractions (PAFs) and numbers of cancer cases attributable to insufficient physical activity (<30 min daily of moderate-to-vigorous physical activity) were estimated by age, sex and cancer site. Assuming a 10-year lag-period, PAFs were calculated using physical activity prevalence from a cross-sectional French population survey and cancer-specific relative risks.

RESULTS

About half of all French adults were found to be insufficiently physically active, with great variation by age and sex. In 2015, an estimated 2973 cancer cases diagnosed in French adults aged 30y+ were attributable to insufficient physical activity, corresponding to 0.8% of all cancer cases (0.2% in men and 1.6% in women). This comprised 3.8% of all postmenopausal breast cancers (1620 cases), 3.6% of all colon cancers (902 cases) and 6.0% of all cancers of the corpus uteri (450 cases). If at least half of the recommended physical activity level was achieved, 1095 cancer cases could have been avoided.

CONCLUSION

Insufficient physical activity is associated to about 3000 cancer cases in France, a country with comparatively low but increasing prevalence of this risk factor. This result is important for setting priorities in cancer prevention programmes aiming to increase physical activity in France and Europe in general.

New cancer cases attributable to diet among adults aged 30-84 years in France in 2015

This study aimed to estimate the number of new cancer cases attributable to diet among adults aged 30-84 years in France in 2015, where convincing or probable evidence of a causal association exists, and, in a secondary analysis, where at least limited but suggestive evidence of a causal association exists. Cancer cases attributable to diet were estimated assuming a 10-year latency period. Dietary intake data were obtained from the 2006 French National Nutrition and Health Survey. Counterfactual scenarios of dietary intake were based on dietary guidelines. Corresponding risk relation estimates were obtained from meta-analyses, cohort studies and one case-control study. Cancer incidence data were obtained from the French Network of Cancer Registries. Nationally, unfavourable dietary habits led to 16 930 new cancer cases, representing 5·4 % of all new cancer cases. Low intake of fruit and dietary fibre was the largest contributor to this burden, being responsible for 4787 and 4389 new cancer cases, respectively. If this is expanded to dietary component and cancer pairs with at least limited but suggestive evidence of a causal association, 36 049 new cancer cases, representing 11·6 % of all new cancer cases, were estimated to be attributable to diet. These findings suggest that unfavourable dietary habits lead to a substantial number of new cancer cases in France; however, there is a large degree of uncertainty as to the number of cancers attributable to diet, including through indirect mechanisms such as obesity, and therefore additional research is needed to determine how diet affects cancer risk.

Cancers in France in 2015 attributable to high body mass index

BACKGROUND

Overweight, as defined by high body mass index (BMI), is an established risk factor for various morbidities including cancer. Globally, its prevalence has increased markedly over the past decades. The aim of this study was to estimate the proportion and number of cancers that were attributable to high BMI in France in 2015.

METHODS

Population attributable fractions (PAFs) and numbers of cancer cases attributable to high BMI (a population mean BMI above the optimum of 22kg/m2) were estimated by age and sex, for cancer sites with convincing or probable evidence of an established causal link. Assuming a 10-year lag-period, PAFs were calculated using mean BMI estimates from a cross-sectional French population survey, and relative risk estimates from published meta-analyses.

RESULTS

An estimated 18,639 cancer cases diagnosed in France in 2015 were attributable to high BMI, corresponding to 5.3% of all cancer cases (6.7% in women and 4.1% in men). This included 4507 cases of postmenopausal breast and 3380 cases of colon cancer. The highest estimated PAFs were for oesophageal adenocarcinoma and corpus uteri cancer (37% and 34%, respectively).

CONCLUSION

High BMI is associated with a substantial number of cancer cases in France, a country with a low but increasing prevalence of overweight and obesity when compared to other European countries. Assuming that the association between high BMI and cancer is causal, these results highlight the need to prioritise the prevention of this risk factor as part of cancer control planning in France and elsewhere in Europe.

Influence of phytosterol and phytostanol food supplementation on plasma liposoluble vitamins and provitamin A carotenoid levels in humans: An updated review of the evidence

Phytosterols and phytostanols (PAP) compete with cholesterol absorption in the intestine, resulting in a 5-15%-reduction in plasma total and LDL cholesterol. An important issue is the PAP potential to reduce the plasma concentrations of fat-soluble vitamins and provitamin A carotenoids. Here, an update of the scientific evidence is reviewed to evaluate plant PAP-enriched foods impact on plasma fat-soluble vitamins and carotenoid levels, and to discuss potential implications in terms of cardiovascular risk. Based on 49 human interventional and 3 bioavailability studies, results showed that regular consumption, particularly over the long term, of foods fortified with PAP as recommended in labeling does not significantly impact plasma vitamins A, D, and K concentration. A 10% significant median reduction was observed for α-tocopherol. Concerning carotenoids, while 13 studies did not demonstrate statistically significant plasma β-carotene reduction, 20 studies showed significant reductions, with median effect size of -24%. This decline can be mitigated or offset by increased fruits and vegetables consumption. Furthermore, higher cardiovascular risk was observed for differences in plasma β-carotene concentration of the same magnitude as the estimated average decrease by PAP consumption. These results are supported by the only study of β-carotene bioavailability showing decrease in absorption by phytosterols daily intake.

Dietary copper and human health: Current evidence and unresolved issues

Although copper (Cu) is recognized as an essential trace element, uncertainties remain regarding Cu reference values for humans, as illustrated by discrepancies between recommendations issued by different national authorities. This review examines human studies published since 1990 on relationships between Cu intake, Cu balance, biomarkers of Cu status, and health. It points out several gaps and unresolved issues which make it difficult to assess Cu requirements. Results from balance studies suggest that daily intakes below 0.8 mg/day lead to net Cu losses, while net gains are consistently observed above 2.4 mg/day. However, because of an incomplete collection of losses in all studies, a precise estimation of Cu requirements cannot be derived from available data. Data regarding the relationship between Cu intake and potential biomarkers are either too preliminary or inconclusive because of low specificity or low sensitivity to change in dietary Cu over a wide range of intakes. Results from observation and intervention studies do not support a link between Cu and a risk of cardiovascular disease, cognitive decline, arthritis or cancer for intakes ranging from 0.6 to 3mg/day, and limited evidence exists for impaired immune function in healthy subjects with a very low (0.38 mg/day) Cu intake. However, data from observation studies should be regarded with caution because of uncertainties regarding Cu concentration in various foods and water. Further studies that accurately evaluate Cu exposure based on reliable biomarkers of Cu status are needed.

A restricted cubic spline approach to assess the association between high fat fish intake and red blood cell EPA + DHA content

BACKGROUND AND AIMS

Fish, especially fatty fish, are the main contributor to eicosapentaenoic (EPA) and docosahexaenoic (DHA) intake. EPA and DHA concentrations in red blood cells (RBC) has been proposed as a cardiovascular risk factor, with <4% and >8% associated with the lowest and greatest protection, respectively. The relationship between high fat fish (HFF) intake and RBC EPA + DHA content has been little investigated on a wide range of fish intake, and may be non-linear. We aimed to study the shape of this relationship among high seafood consumers.

METHODS AND RESULTS

Seafood consumption records and blood were collected from 384 French heavy seafood consumers and EPA and DHA were measured in RBC. A multivariate linear regression was performed using restricted cubic splines to consider potential non-linear associations. Thirty-six percent of subjects had an RBC EPA + DHA content lower than 4% and only 5% exceeded 8%. HFF consumption was significantly associated with RBC EPA + DHA content (P [overall association] = 0.021) adjusted for sex, tobacco status, study area, socioeconomic status, age, alcohol, other seafood, meat, and meat product intakes. This relationship was non-linear: for intakes higher than 200 g/wk, EPA + DHA content tended to stagnate. Tobacco status and fish contaminants were negatively associated with RBC EPA + DHA content.

CONCLUSION

Because of the saturation for high intakes, and accounting for the concern with exposure to trace element contaminants, intake not exceeding 200 g should be considered.

Dietary intakes and antioxidant status in mind-body exercising pre- and postmenopausal women

OBJECTIVE

The decline in antioxidant defenses due to both estrogen loss and frequent adoption of poor dietary choices exposes postmenopausal women to cardiovascular diseases. Adequate nutrition and physical exercise are two factors of health promotion. This study investigated whether regular practice of mind-body exercise (yoga and/or tai chi) alters dietary intake and antioxidant status and balances the menopause-related increases in lipid peroxidation and cardiovascular risk.

DESIGN

Cross-sectional study.

SETTING

The study was conducted in an urban community in Bangkok (Thailand) between May and August 2007.

PARTICIPANTS

Premenopausal (Pre M; 39±8 yrs; n=56) and postmenopausal (Post M; 54±5 yrs; n=39) women who had been practicing yoga (Y) and/or tai chi (TC) more than 3 hours/week for a year, or who had no regular physical activity practice (sedentary, S).

MEASUREMENTS

All participants completed food frequency questionnaires and 4-day food and activity records. Blood was collected on day 5. Factorial ANOVA tests were performed according to menopause status, exercise, and hormone replacement therapy (HRT) groups.

RESULTS

Post M had higher (p = 0.01) dietary fiber intake compared with Pre M. Yoga practitioners had lower BMI (p = 0.004) and lower fat intake (p = 0.02) compared with their S and TC counterparts. Plasma total antioxidant status was significantly and independently lower and higher in Y and Post M groups, respectively. However, no difference was shown after adjusting for BMI. Regardless of menopause status and HRT, the activity of erythrocyte glutathione peroxidase - an aerobic training-responsive enzyme - was higher (p < 0.001) in TC practitioners compared with other groups. No effects were shown on erythrocyte superoxide dismutase activity, plasma lipid peroxidation (TBARS) or total homocysteine concentrations.

CONCLUSION

Yoga and tai chi exercises can be used as components of a strategy to promote healthy lifestyles (balanced diet and moderate intensity exercise) in vulnerable populations, such as menopausal women, in order to prevent aging induced oxidative stress-related diseases.

Effects of tai chi training on antioxidant capacity in pre- and postmenopausal women

The risk of oxidative stress-related metabolic diseases increases with menopause and physical inactivity. We hypothesized that an 8-week Tai Chi (TC) training program (2 sessions in class; 2 sessions at home; 1-1:15/session) would improve antioxidant capacity and reduce cardiovascular risks in both pre- (n = 8) and postmenopausal (n = 7) sedentary women. Selected measures of physical fitness and blood parameters were analyzed before and after the program. Besides the well-known effects of TC on balance, flexibility, and maximum leg extensor strength, TC (1) increased erythrocyte glutathione peroxidase activity—an aerobic training-responsive antioxidant enzyme—and plasma total antioxidant status and (2) decreased plasma total homocysteine, a cardiovascular risk marker. In addition to being a low-velocity, low-impact, and relatively safe, TC is a suitable physical activity design for pre- and postmenopausal women to increase antioxidant defenses. Investigating breathing effects during TC movements would be an interesting area for further research in diseases prevention.

Potential pitfalls of health claims from a public health nutrition perspective

The European Union is implementing a new regulatory framework for nutrition and health claims (HCs) that will greatly impact the communication of health messages on foodstuffs. In particular, approved HCs will be included in a positive register of generic claims. In the currently available literature, assessment of the relevance of HCs has mainly been related to scientific substantiation, and the issue of relevance in terms of public health has tended to be overlooked. Interestingly, the new regulation states that claims must be well understood by the average consumer. This article delves beyond the issue of scientific substantiation of claims and reviews possible discrepancies between consumer perception/understanding of HCs and the public health nutrition reality, which can confuse or mislead the consumer and ultimately impact public health nutrition. Six pitfalls are described herein and a comprehensive overview of the critical examination of any HC is proposed.

Antioxidant supplementation preserves antioxidant response in physical training and low antioxidant intake

The present controlled-training double-blind study (supplemented (S) group,n7; placebo (P) group,n10) was designed to investigate whether an antioxidant mixture (Se 150 μg, retinyl acetate mg, ascorbic acid 120 mg, α-tocopheryl succinate) would allow overloaded triathletes to avoid adaptation failure in the antioxidant system. Dietary intakes were recorded. The supplement of Se, and vitamins A and E provided 100 % of the French RDA. Four weeks of overloaded training (OT) followed 4 weeks of normal training (NT). After NT and OT, biological studies were conducted at rest and after a duathlon test (run 5 km, cycle 20 km, run 5 km). During the 4-week period of NT, blood levels of GSH levels increased in response to supplementation (P<0·05) and remained elevated during OT. Plasma glutathione peroxidase activity was significantly higher in the S group in all situations after NT and OT (P<0·01). The S group had increased erythrocyte Cu,Zn-superoxide dismutase activity in response to OT (P<0·05). Supplementation significantly reduced (P<0·05) the magnitude in duathlon-induced creatine kinase isoenzyme MB mass increase, which tended to be higher with OT (P=0·09). We conclude that the antioxidant mixture helped to preserve the antioxidant system during an OT-induced stress in subjects with initially low antioxidant intakes. Effects of supplementation during NT and/or OT are shown mostly by the alleviated muscle damage. The effects of the antioxidant mixture were observed for doses that can be provided by a diversified and well-balanced diet. The maintenance of normal nutritional status with regard to the antioxidant intake (Se, vitamins C and E) plays a key role in antioxidant adaptive effects during NT and OT.

Antioxidant vitamin status in high exposure to oxidative stress in competitive athletes

We conducted a cross-sectional study in 118 well-trained athletes to investigate 'high exposure' to sub-deficient antioxidant status, and consequently to oxidative damage, in relation to estimated daily energy expenditure (EE) and dietary antioxidant intake. Subjects completed 7 d food and activity records. Blood samples were obtained on day 8. Of the athletes 81, 60 and 43 % had intakes of vitamins E, C and β-carotene below two-thirds of the French RDA respectively, which is adjusted for EE (FRDAa). The deficit in vitamin E intake was positively correlated with EE (r0·51,P>0·0001). All the athletes had normal plasma vitamins E and C and 14 % had marginal plasma β-carotene. Plasma thiobarbituric acid-reactive substances (TBARS) did not increase with increased EE. As evidenced by ANOVA, EE-induced vitamin C intakes increased and consequently led to increased plasma ascorbic acid concentrations. In male athletes, plasma total carotenoids were negatively correlated with plasma TBARS concentrations (r–0·31,P>0·006). The relationship between vitamin C intakes and plasma concentrations was logarithmic (r0·59,P> 0·0001). To summarize, it is not clear whether vitamin E requirements are overestimated with reference to EE in the FRDAa. Daily requirements for vitamin C do not exceed 200 mg. Our present results could be interpreted as meaning that carotenoids play a protective role as exogenous antioxidants. Carotenoid intakes in athletes must be considered carefully.

Atrophy-related ubiquitin ligases, atrogin-1 and MuRF1 are up-regulated in aged rat Tibialis Anterior muscle

A phenotypic feature of aging is skeletal muscle wasting. It is characterized by a loss of muscle mass and strength. Age-related loss of muscle mass occurs through a reduction in the rate of protein synthesis, an increase in protein degradation or a combination of both. However, the underlying mechanism is still poorly understood. To test the hypothesis that the ubiquitin-proteasome pathway contributes to this phenomenon, we studied MuRF1 and atrogin-1 expression in Tibialis Anterior muscle of aged rats. These two E3 ligases are considered as sensitive markers of muscle protein degradation by the ubiquitin-proteasome system. Our results revealed that, in skeletal muscle of aged rats, the decline in muscle mass is accompanied by an increase in the level of oxidized proteins and ubiquitin conjugates (90%) whereas the functionality of the proteasome remains constant compared to young rats. Furthermore, the level of both MuRF1 and atrogin-1 mRNA is markedly up-regulated in aged muscle (respectively x2 and x2.5). Taken together these data argue for the involvement of the ubiquitin-proteasome pathway in sarcopenia of fast-twitch muscle, in particular through increased expression of MuRF1 and atrogin-1. Moreover, we observed a decrease in the IGF-1/Akt signalling pathways and elevated level of TNFalpha mRNA in aged rat muscle. Therefore, IGF-1/Akt and TNFalpha represent potential mediators implicated in the regulation of MuRF1 and atrogin-1 genes during aging.

Physical activity alters antioxidant status in exercising elderly subjects

Nutritional adequacy and physical activity are two aspects of a health-promoting lifestyle. Not much is known about antioxidant nutrient requirements for exercising elderly (EE) subjects. The question of whether exercise training alters the status of antioxidant vitamins as well as trace elements in elderly subjects and fails to balance the age-related increase in oxidative stress is addressed in this study. There were 18 EE (68.1+/-3.1 years), 7 sedentary elderly (SE; 70.4+/-5.0 years), 17 exercising young (EY; 31.2+/-7.1 years) and 8 sedentary young (SY; 27.1+/-5.8 years) subjects who completed 7-day food and activity records. Each subject's blood was sampled on Day 8. A similar selenium (Se) status but a higher erythrocyte glutathione peroxidase (GSH-Px) activity were found in EE subjects as compared with EY and SE subjects. Blood oxidized glutathione was higher and plasma total thiol was lower in EE subjects as compared with EY subjects. Mean vitamin C (167 vs. 106 mg/day), vitamin E (11.7 vs. 8.3 mg/day) and beta-carotene (4 vs. 2.4 mg/day) intakes were higher in EE subjects as compared with EY subjects. However, EE subjects exhibited the lowest plasma carotenoid concentrations, especially in beta-carotene, which was not related to intakes. Despite high intakes of antioxidant micronutrients, no adaptive mechanism able to counteract the increased oxidative stress in aging was found in EE subjects. Results on GSH-Px activity illustrate that the nature of the regulation of this biomarker of Se status is different in response to training and aging. These data also strongly suggest specific antioxidant requirements for athletes with advancing age, with a special attention to carotenoids.

Plasma glutathione peroxidase activity as a potential indicator of hypoxic stress in breath-hold diving

INTRODUCTION

Diving mammals can cope with oxidants which are produced in excess during the reoxygenation of hypoxic tissues. This study addresses the question of whether antioxidants can adapt and whether it allows humans to tolerate the hypoxic stress induced by a single breath-holding in the course of a dynamic diving exercise and protect them from oxidative insult.

METHODS

There were 20 male subjects who performed submaximal apnea dynamic diving (ADD). Nine control subjects stayed out of the water and breathed normally. Venous blood samples were collected 1 h before and immediatly after ADD.

RESULTS

ADD induced a significant increase in plasma glutathione peroxidase (GPx-3) activity (from 397.5 +/- 44.4 to 410 +/- 43 U x L(-1)), blood reduced glutathione (GSH) (from 1060 +/- 302 to 1292 +/- 213 micromol x L(-1)), and in plasma creatine kinase activity (from 215 +/- 137 to 235 +/- 152 U x L(-1)). The activity of the erythrocyte superoxide dismutase and glutathione peroxidase, as well as the blood oxidized glutathione and the plasma thiobarbituric acid reactive substances concentrations, were maintained at their basal level. The level of training, characterized by the duration and distance of the dive, had no effect on the markers used.

CONCLUSION

GPx-3 and GSH could constitute the most readily mobilizable antioxidants that would then contribute to the buffering against a sudden increase in the generation of radical oxygen species. These biomarkers could be used as tools for establishing oxidative stress during hypoxia. The response of GPx-3 to hypoxia could be of physiological relevance.

Plasma homocysteine is related to folate intake but not training status

BACKGROUND AND AIM

Lifestyle including intakes of several essential nutrients and physical activity are of particular interest in reducing plasma total homocysteine concentration (tHcy), a risk factor for cardiovascular diseases. The aim of this study was to determine in athletes, whether dietary factors such as intakes of folate, vitamin B6 and B12 were associated with lower plasma tHcy, and whether this depended on daily energy expenditure (EE) and type of physical activity performed (aerobic, anaerobic, intermittent).

METHODS

Seventy-four well-trained athletes completed 7-day food and activity records in a cross-sectional study. Blood was sampled on day 8.

RESULTS

Percentage of vegetal protein, vitamin B6, and folate intakes were higher and tHcy was lower (1) in athletes with high EE (> 16.72 MJ/d) compared to athletes with lower EE; (2) in aerobic athletes compared to intermittent athletes and sedentary subjects. After backward step by step analysis, folate intake was the only significant variable retained in the model to explain tHcy variability. Moreover, after introducing folate intake as a covariate in ANOVA tests, group effects on tHcy were no longer significant. Nutrient density of folate was inversely correlated to tHcy in athletes (r = -0.33; P = 0.004).

CONCLUSION

High energy intake (> 16.72 MJ/d) allows the necessary folate intake (> 500 microg/d) for tHcy decrease to occur, which is moreover favored by aerobic activity. The mechanism underlying low tHcy in relation to high EE could only play a minor role when compared to the effect of dietary folate intake on tHcy.

Swimming and Cycling Overloaded Training in Triathlon has no Effect on Running Kinematics and Economy

The aim of the study was to verify whether an overloaded training (OT) in triathlon deteriorates running kinematics (RK) and running economy (RE). Thirteen well-trained male long-distance triathletes (age: 28.1 +/- 4.3 yrs; V.O (2max): 65.0 +/- 3.1 ml O (2) . min (-1) . kg (-1)) were divided into two groups: completed an individualized OT program (OG; n = 7) or maintained a normal level of training (NT) (CG; n = 6) for a duration of 3 weeks. Every week, each triathlete completed a standardized questionnaire to quantify the influence of training loads on mood state. To reach OT, total training load (h . 3 wk (-1)) was increased by 24 %; swimming and cycling total volumes were increased by 46 and 57 %, respectively, but the distance run was not modified in order to limit the risk of injuries. RK and RE were determined on treadmill test at 12 km . h (-1) before and after the 3 weeks. The 3-week swimming and cycling OT in triathlon was sufficiently stressful to alter mood state but not to deteriorate the running kinematics and economy parameters in our previously well-trained male long-distance triathletes.

Increase in selenium requirements with physical activity loads in well-trained athletes is not linear

Selenium requirements in athletes are supposed to be increased with energy expenditure (EE) to preserve selenium status and an optimal antioxidant balance. The question of whether selenium intakes are related to EE and whether plasma selenium status induces up-regulation in erythrocyte endogenous antioxidant defense and decreases plasma oxidative damage markers in athletes was addressed. 118 well-trained athletes completed 7 d food and activities records in a cross-sectional study. Blood was sampled on day 8. Among the athletes, 23% of the males and 66% of the females had selenium intakes below two-third of the French RDA. Plasma selenium concentrations in most of less trained athletes were lower than the postulated concentration to be required to maximize erythrocyte GSH-Px activity. Athletes with the highest daily EE had the highest selenium intakes, percentage of vegetal protein intakes and plasma selenium concentrations. Only 2.6% of the athletes exhibited low plasma selenium concentrations (< 0.75 micromol/l). The relation between plasma selenium and EE was polynomial (r = 0.50; P < 0.005). Erythrocyte GSH-Px activity in athletes was not linked to selenium status. Selenium requirements are increased in athletes without being linearly related to EE.

Antioxidant supplementation and tapering exercise improve exercise-induced antioxidant response

OBJECTIVE AND METHODS

The present controlled-training, double-blind study (supplemented, n = 7; placebo, n = 9) investigated whether taper training (TT) and antioxidant supplementation, i.e., 150 micro g of selenium, 2000 IU of retinol, 120 mg of ascorbic acid and 30 IU of alpha-tocopherol, modulates antioxidant potential, redox status and oxidative damage occurrence both at rest and in response to exercise. Two weeks of TT followed four weeks of overloaded training. Dietary intakes were recorded. Before and after TT, triathletes did a duathlon consisting of 5-km run, 20-km bike and 5-km run. Biological studies were conducted at rest and after exercise.

RESULTS

Whatever the nutritional status, TT induced a decrease in resting blood reduced glutathione (GSH) concentration (p < 0.001), erythrocyte superoxide dismutase (SOD) activity (p < 0.0001) and plasma total antioxidant status (TAS) (p < 0.05). Only in the supplemented group (Su) with TT, did plasma glutathione peroxidase (GSH-Px) activity decrease (p < 0.05) and CD4(+) cell concentration increase (p < 0.05). However, antioxidant supplementation increased plasma TAS increase in response to exercise and TT (p < 0.05). After exercise, TT also induced a lower decrease in blood reduced and oxidized (GSSG) glutathione (p < 0.01) in both groups, but TT had no effect on lipoperoxidation as estimated by plasma thiobarbituric reactive substances or on muscular damage occurrence estimated by plasma creatine kinase isoenzyme MB mass.

CONCLUSION

During TT, antioxidant supplementation at nutritional doses reinforces antioxidant status response to exercise, with an effect on exercise-induced oxidative stress, and no effect on oxidative damage.

Muscle enzyme release does not predict muscle function impairment after triathlon

BACKGROUND

We sought to determine the effects of a long distance triathlon (4 km swim, 120 km bike-ride, and 30 km run) on the four-day kinetics of the biochemical markers of muscle damage, and whether they were quantitatively linked with muscle function impairment and soreness.

METHODS

EXPERIMENTAL DESIGN

Data were collected from 2 days before until 4 days after the completion of the race.

PARTICIPANTS

Twelve triathletes performed the triathlon and five did not.

MEASURES

Maximal voluntary contraction (MVC), muscle soreness (DOMS) and total serum CK, CK-MB, LDH, AST and ALT activities were assessed.

RESULTS

Significant changes after triathlon completion were found for all muscle damage indirect markers over time (p < 0.0001). MVC of the knee extensor and flexor muscles decreased over time (p < 0.05). There is disparity in the time point at which peak values where reached for DOMS, MVC and enzyme leakage. There is no correlation between serum enzyme leakage, DOMS and MVC impairment which occur after triathlon.

CONCLUSIONS

Long distance triathlon race caused muscle damage, but extent, as well as muscle recovery cannot be evaluated by the magnitude of changes in serum enzyme activities. Muscle enzyme release cannot be used to predict the magnitude of the muscle function impairment caused by muscle damage.

Effects of endurance training on skeletal muscle oxidative capacities with and without selenium supplementation

The purpose of this study was to examine the changes induced by endurance training, with or without selenium (Se) supplementation on: 1) mitochondrial activity of succinate dehydrogenase (SDH) and cytochrome c oxidase (Cyt Ox),2) the myosin heavy chain (MHC) expression in muscle fibers and 3) their association with aerobic performance. Twenty-four male students volunteered to participate in this double blind study: selenium (Sel, N = 12) vs placebo (Pla, N = 12). During a 10-wk endurance training program, the Sel group received a daily Se supplementation containing 180 micrograms of organic selenium (selenomethionine), while the Pla group received a placebo. Before (Pre) and after (Post) the program (3 sessions wk-1) an endurance exercise (Capmax) was performed in order to determine the aerobic endurance capacity assessed by the total oxygen uptake during the running test (VO2tot). All parameters of aerobic performance were increased in both groups, concomitantly to a rise in mitochondrial Cyt Ox activity. Two positive relationships were found: 1) between type I MHC and VO2tot increments (r = 0.65, P < 0.05), 2) between training volumes and VO2tot increments (r = 0.53, P < 0.05; N = 23). The training program produced an 8.2% significant increase in type I MHC (P < 0.05) while type II MHC decrease was not significant (-4.4%). Although they were almost non-existent before the program, muscle fibers which co-expressed type I and II MHC displayed a marked increase afterwards (4.9 +/- 5.7 vs 1.1 +/- 2.1%, P < 0.05). Muscle GSH-Px activity, at rest, did not respond to endurance training or Se supplementation. The results suggest that the neuromuscular system is still in an evolutive state after 10 weeks of endurance training, and that selenium supplementation has no effect on endurance training-induced adaptations.

No evidence of oxidative stress after a triathlon race in highly trained competitors

Long distance triathlons, due to the large amounts of oxygen uptake they cause, may lead to the generation of reactive oxygen species, and consequently to oxidative stress and damage. We sought to verify this hypothesis. Twelve of the 18 male triathletes who participated in the study took part in a long distance triathlon, the others did not. The prerace blood samples were drawn 48 h before the race and repeatedly until the fourth day of recovery. The myoglobin concentrations increased immediately after the race. The concentrations of methemoglobin, disulfide glutathione (GSSG), and thiobarbituric reactive substances did not significantly change after the race. Although the race induced an inflammatory response, evidenced by the variations in neopterin concentrations and leukocyte counts, there was no consecutive oxidative stress. The basal GSH values were correlated significantly with cycling training volume (r = 0.55) and VO2max (r = 0.53). Muscle damage can occur without evidence of oxidative stress or oxidative damage. We conclude that the magnitude of the antioxidant defense system enhancement depends on training loads. Because of their training status, the triathletes did not suffer from oxidative damage after they finished the long distance triathlon race.

Effects of strenuous exercise on serum myosin heavy chain fragments in male triathletes

During the Nice Triathlon (June 26, 1994), the serum levels of type I myosin heavy chain (MHC) fragments and creatine kinase (CK and CK-MB) activities were assessed in 12 athletes in order to evaluate the exercise-induced muscle damage. Blood samples (BS) were taken 2 days before the event (baseline), on arrival, 6 and 24 h later, and 2 and 4 days later. The mean results (and SD) were respectively: MHC (microU.I-1): 142 (69), 156 (116), 242 (144), 1183 (574), 2603 (1405), 1002 (523); CK (U.I-1): 109 (27), 626 (267), 1188 (562), 1159 (442), 633 (385), 224 (119). The CK peak occurred at BS-6h for 8 subjects, and at BS-24h for the other ones. The MHC peak occurred at BS-48h in all the subjects. The CK-MB/CK ratios exhibited a profile similar to those described previously. Serum MHC peak values were correlated with CK ones (r = 0.67; p < 0.05). After a four-day recovery period, as the CK values had decreased, the MHC levels were still elevated. The main result of the study is the MHC peak occurrence at BS-48h in all the subjects.

[Factors limiting performance in the triathlon]

Triathlon is a multievent sport (swimming, cycling, running). Long duration triathlons can induce physiological stress that can be modulated by environmental conditions. Certain factors promote performance, others limit it. A minimal level of maximal oxygen uptake is required, but it does not always determine the performance. For triathletes, the low hematocrit values do not reflect anemia and therefore do not limit performance. The appearance of clinical signs of dehydration and of digestive impairment may limit performance. The performance in swimming does not play the most important role in triathlon performance, but the physiological conditions in which the first transition is made can limit performance in the two following events; this is also the case for the second transition. Triathlon races cause muscle damage whose signs persist several days. Given the hormonal responses and the indices of muscle damage, it appears necessary to rest at least 5 days to avoid over-training. It is difficult to define precisely how much one should train for each of the three events. However, it can be concluded that triathlon training has to be taken as a whole.

Mitochondria changes in human muscle after prolonged exercise, endurance training and selenium supplementation

The functional and structural responses to acute exercise (E) and training, (T) with or without selenium supplementation (Sel), were investigated in a double-blind study on 24 young male subjects. The Sel or the placebo were given over 10 weeks of an endurance training programme. Prior to the programme and on its conclusion muscle biopsies were taken from the vastus lateralis muscle before and after an exhausting treadmill test of maximal endurance capacity (Capmax). The muscle samples were examined by electron microscopy to make a quantitative analysis of the mitochondria population in the muscle fibres. The number of mitochondria per area (QA) and the relative surface occupied by the total mitochondria profile area (AA) were estimated. The mean area per mitochondrion (â) was obtained by the quotient AA/QA. The effects of the isolated or combined independent variables T, E and Sel were analysed by nonparametric tests. Training induced significant increases in both QA (30%, P < 0.001) and AA (52%, P < 0.001), without changing â; T + Sel produced a slight rise of AA (27%, P < 0.001), which resulted in larger (24%, P < 0.001) â. The E produced an enlargement of â resembling swelling. This phenomenon was also found for the combinations E + T and E + T + Sel, but it was then far more pronounced in E + T. The training effects observed are in agreement with previous descriptions. In contrast, the changes observed after acute exercise seem to indicate a remarkable short-term plasticity of muscle mitochondria. The results in Sel would seem to suggest a dampening effect of the selenium on the mitochondria changes, both in chronic and acute exercise. The mechanism of this action on mitochondrial turnover is uncertain, but might be related to a higher efficiency of the selenium-dependent enzyme glutathione peroxidase.

Selenium and training effects on the glutathione system and aerobic performance

Changes in blood glutathione antioxidant system in response to exercise and training, and aerobic performance, were investigated. Selenium (Se) supplementation effects on these changes were evaluated. The study was double blind. Both groups selenium (Sel, N = 12) and placebo (Pla, N = 12), followed a 10-wk endurance training program, with a prolonged exhaustive exercise bout performed (Cap Max), before (Pre) and after (Post) training. Blood was sampled before (Bef) and after (Aft) Cap Max. The oxidation of blood glutathione after Cap Max exercise showed a reactive oxygen species production. Training developed maximal aerobic power and capacity, significantly increased (P < 0.001) plasma and erythrocyte glutathione peroxidase (GPx) activity, and decreased (P < 0.001) erythrocyte glutathione reductase activity. The Se supplementation caused an increase in the basal plasma GPx level (P < 0.05). There was also a correlation (r = 0.66, P < 0.05) between the variation in VO2max and that of erythrocyte GPx only in supplemented subjects. Our results confirm that blood glutathione remains a sensitive marker of oxidative stress induced by exhausting submaximal exercise and that the antioxidant potential of GPx can be developed by endurance training. Se supplementation at the dose used had no effect on physical performance.