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Interaction Between Caffeine and Creatine When Used as Concurrent Ergogenic Supplements: A Systematic Review

Sara Elosegui, Jaime López-Seoane, María Martínez-Ferrán, and Helios Pareja-Galeano

There is some controversy regarding the interactions between creatine (CRE) and caffeine (CAF) supplements. The aim of this systematic review was to study whether such ergogenic interaction occurs and to analyze the protocol to optimize their synchronous use. The PubMed, Web of Science, MEDLINE, CINAHL, and SPORTDiscus databases were searched until November 2021 following the PRISMA guidelines. Ten studies were included. Three studies observed that CRE loading before an acute dose of CAF before exercise did not interfere in the beneficial effect of CAF, whereas one study reported that only an acute supplementation (SUP) of CAF was beneficial but not the acute SUP of both. When chronic SUP with CRE + CAF was used, two studies reported that CAF interfered in the beneficial effect of CRE, whereas three studies did not report interaction between concurrent SUP, and one study reported synergy. Possible mechanisms of interaction are opposite effects on relaxation time and gastrointestinal distress derived from concurrent SUP. CRE loading does not seem to interfere in the acute effect of CAF. However, chronic SUP of CAF during CRE loading could interfere in the beneficial effect of CRE.

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The Effects of Supervised Exercise Training on Weight Control and Other Metabolic Outcomes in Patients With Type 2 Diabetes: A Meta-Analysis

Xingyun Zhu, Fang Zhang, Jing Chen, Yingxi Zhao, Tianhao Ba, Chu Lin, Yingli Lu, Tao Yu, Xiaoling Cai, Li Zhang, and Linong Ji

Few studies have investigated the dose–response relationship between exercise and weight control. This study aimed to assess the effects of different types of supervised exercise training on weight control and other metabolic outcomes in patients with type 2 diabetes mellitus and explore the dose–response relationship between exercise volume/duration and these outcomes. PubMed/MEDLINE, Embase, and Cochrane databases were searched for studies between January 1980 and June 2019. Randomized control trials in type 2 diabetes mellitus patients with supervised exercise training versus control treatment were included. The primary outcome was changes in body weight (kg). The secondary outcomes included changes in waist circumference (cm) and total body fat percentage (%). Forty-two randomized control trials, including 3,625 patients with type 2 diabetes mellitus were included. Overall, exercise treatment was associated with significant reduction in body weight (weighted mean differences, −1.10 kg; 95% CI [−1.58, −0.62], p < .01), waist circumference (weighted mean differences, −2.51 cm; 95% CI [−3.25, −1.77], p < .01), and total body fat (weighted mean differences, −1.16%; 95% CI [−1.58%, −0.75%], p < .01). The percentage of total body fat was reduced by all types of exercise, with a significant difference between aerobic exercise and resistance exercise (p = .02) and a significant difference between combined exercise and resistance exercise (p < .01). A higher volume of aerobic exercise and a higher volume of resistance exercise were superior in reducing body weight. In conclusion, supervised exercise training improved metabolic outcomes in general, while different types and volume of exercises have their own merits.

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Volume 32 (2022): Issue 1 (Jan 2022)

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Erratum: Kirk, Langan-Evans, & Morton (2020)

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Sustained Exposure to High Carbohydrate Availability Does Not Influence Iron-Regulatory Responses in Elite Endurance Athletes

Alannah K.A. McKay, Peter Peeling, David B. Pyne, Nicolin Tee, Marijke Welveart, Ida A. Heikura, Avish P. Sharma, Jamie Whitfield, Megan L. Ross, Rachel P.L. van Swelm, Coby M. Laarakkers, and Louise M. Burke

This study implemented a 2-week high carbohydrate (CHO) diet intended to maximize CHO oxidation rates and examined the iron-regulatory response to a 26-km race walking effort. Twenty international-level, male race walkers were assigned to either a novel high CHO diet (MAX = 10 g/kg body mass CHO daily) inclusive of gut-training strategies, or a moderate CHO control diet (CON = 6 g/kg body mass CHO daily) for a 2-week training period. The athletes completed a 26-km race walking test protocol before and after the dietary intervention. Venous blood samples were collected pre-, post-, and 3 hr postexercise and measured for serum ferritin, interleukin-6, and hepcidin-25 concentrations. Similar decreases in serum ferritin (17–23%) occurred postintervention in MAX and CON. At the baseline, CON had a greater postexercise increase in interleukin-6 levels after 26 km of walking (20.1-fold, 95% CI [9.2, 35.7]) compared with MAX (10.2-fold, 95% CI [3.7, 18.7]). A similar finding was evident for hepcidin levels 3 hr postexercise (CON = 10.8-fold, 95% CI [4.8, 21.2]; MAX = 8.8-fold, 95% CI [3.9, 16.4]). Postintervention, there were no substantial differences in the interleukin-6 response (CON = 13.6-fold, 95% CI [9.2, 20.5]; MAX = 11.2-fold, 95% CI [6.5, 21.3]) or hepcidin levels (CON = 7.1-fold, 95% CI [2.1, 15.4]; MAX = 6.3-fold, 95% CI [1.8, 14.6]) between the dietary groups. Higher resting serum ferritin (p = .004) and hotter trial ambient temperatures (p = .014) were associated with greater hepcidin levels 3 hr postexercise. Very high CHO diets employed by endurance athletes to increase CHO oxidation have little impact on iron regulation in elite athletes. It appears that variations in serum ferritin concentration and ambient temperature, rather than dietary CHO, are associated with increased hepcidin concentrations 3 hr postexercise.

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Sequential Submaximal Training in Elite Male Rowers Does Not Result in Amplified Increases in Interleukin-6 or Hepcidin

Nikita C. Fensham, Alannah K.A. McKay, Nicolin Tee, Bronwen Lundy, Bryce Anderson, Aimee Morabito, Megan L.R. Ross, and Louise M. Burke

Previous research investigating single bouts of exercise have identified baseline iron status and circulating concentrations of interleukin-6 (IL-6) as contributors to the magnitude of postexercise hepcidin increase. The current study examined the effects of repeated training bouts in close succession on IL-6 and hepcidin responses. In a randomized, crossover design, 16 elite male rowers completed two trials, a week apart, with either high (1,000 mg) or low (<50 mg) calcium pre-exercise meals. Each trial involved two, submaximal 90-min rowing ergometer sessions, 2.5 hr apart, with venous blood sampled at baseline; pre-exercise; and 0, 1, 2, and 3 hr after each session. Peak elevations in IL-6 (approximately 7.5-fold, p < .0001) and hepcidin (approximately threefold, p < .0001) concentrations relative to baseline were seen at 2 and 3 hr after the first session, respectively. Following the second session, concentrations of both IL-6 and hepcidin remained elevated above baseline, exhibiting a plateau rather than an additive increase (2 hr post first session vs. 2 hr post second session, p = 1.00). Pre-exercise calcium resulted in a slightly greater elevation in hepcidin across all time points compared with control (p = .0005); however, no effect on IL-6 was evident (p = .27). Performing multiple submaximal training sessions in close succession with adequate nutritional support does not result in an amplified increase in IL-6 or hepcidin concentrations following the second session in male elite rowers. Although effects of calcium intake require further investigation, athletes should continue to prioritize iron consumption around morning exercise prior to exercise-induced hepcidin elevations to maximize absorption.

Open access

Erratum: Rogers et al. (2021)

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Evening Whey Protein Intake, Rich in Tryptophan, and Sleep in Elite Male Australian Rules Football Players on Training and Nontraining Days

Cassandra Ferguson, Brad Aisbett, Michele Lastella, Spencer Roberts, and Dominique Condo

Objectives: To investigate the effect of evening whey protein supplementation, rich in tryptophan, on sleep in elite male Australian Rules Football players. Design: Double-blinded, counterbalanced, randomized, cross-over study. Methods: Sleep was assessed using wrist activity monitors and sleep diaries in 15 elite male Australian Football League players on two training and nontraining days following evening consumption of an isocaloric whey protein supplement or placebo in preseason. A 5-day preintervention period was implemented to determine habitual dietary intake and baseline sleep measures. These habitual data were used to inform the daily dietary intake and timing of ingestion of the evening whey protein supplement or placebo on the intervention days. The whey protein supplement or placebo was consumed 3 hr prior to habitual bedtime. Results: Separate one-way repeated-measures analyses of covariance revealed no differences between the whey protein supplement and the placebo on sleep duration, sleep onset latency, sleep efficiency, or wake after sleep onset on either training or nontraining days. Conclusions: Evening whey protein supplementation, rich in tryptophan, does not improve acute sleep duration or quality in elite male Australian Football League players. However, elite athletes may be able to ingest a high protein/energy intake close to bedtime without impairing sleep, which is important for athlete recovery. Future research should investigate the effect of evening protein intake, high in tryptophan, on sleep duration and quality, including sleep staging during periods of restricted sleep and in poor-sleeping athletes.

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The Hyperhydration Potential of Sodium Bicarbonate and Sodium Citrate

Jason C. Siegler, Amelia J. Carr, William T. Jardine, Lilia Convit, Rebecca Cross, Dale Chapman, Louise M. Burke, and Megan Ross

Buffering agents have not been comprehensively profiled in terms of their capacity to influence water retention prior to exercise. The purpose of this investigation was to profile the fluid retention characteristics of sodium bicarbonate (BIC) and sodium citrate (CIT) to determine the efficacy of these buffering mediums as hyperhydrating agents. Nineteen volunteers (13 males and six females; age = 28.3 ± 4.9 years) completed three trials (randomized and cross-over design). For each trial, a baseline measurement of body mass, capillary blood, and urine was collected prior to ingestion of their respective condition (control condition [CON] = 25 ml/kg artificially sweetened water; BIC condition = CON + 7.5 g/L of sodium in the form of BIC; CIT condition = CON + 7.5 g/L of sodium in the form of CIT). The fluid loads were consumed in four equal aliquots (0, 20, 40 and 60 min; fluid intake was 1.972 ± 361 ml [CON]; 1.977 ± 360 ml [BIC]; 1.953 ± 352 ml [CIT]). Samples were recorded at 20 (body mass and urine) and 60 min (blood) intervals for 180 min. Blood buffering capacity (HCO3 ) was elevated (p < .001) in both BIC (32.1 ± 2.2 mmol/L) and CIT (28.9 ± 3.8 mmol/L) at 180 min compared with CON (25.1 ± 1.8 mmol/L). Plasma volume expansion was greater (p < .001) in both BIC (8.1 ± 1.3%) and CIT (5.9 ± 1.8%) compared with CON (−1.1 ± 1.4%); whereas, total urine production was lower in BIC and CIT at 180 min (BIC vs. CON, mean difference of 370 ± 85 ml; p < .001; CIT vs. CON, mean difference of 239 ± 102 ml; p = .05). There were no increases observed in body mass (p = .9). Under resting conditions, these data suggest BIC and CIT induce a greater plasma hypervolemic response as compared with water alone.