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Commentary in Response to “A Review of Nonpharmacological Strategies in the Treatment of Relative Energy Deficiency in Sport”

Nicole C.A. Strock, Kristen J. Koltun, and Emily A. Ricker

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Embracing Change: The Evolving Science of Relative Energy Deficiency in Sport

Megan A. Kuikman, Margo Mountjoy, Trent Stellingwerff, and Jamie F. Burr

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The Impact of Low Energy Availability on Nonexercise Activity Thermogenesis and Physical Activity Behavior in Recreationally Trained Adults

Alexandra Martin, Hande Hofmann, Clemens Drenowatz, Birgit Wallmann-Sperlich, Billy Sperlich, and Karsten Koehler

Energy availability describes the amount of dietary energy remaining for physiological functionality after the energy cost of exercise is deducted. The physiological and hormonal consequences of low energy availability (LEA) are well established, but the impact of LEA on physical activity behavior outside of exercise and, specifically, nonexercise activity thermogenesis (NEAT) has not been systematically examined. The authors conducted a secondary analysis of a repeated-measures crossover study in which recreationally trained young men (n = 6, 25 ± 1.0 years) underwent two 4-day conditions of LEA (15 kcal·kg fat-free mass−1 ·day−1) with and without endurance exercise (LEA + EX and LEA EX) and two energy-balanced control conditions (CON + EX and CON EX). The duration and intensity of physical activity outside of prescribed exercise were assessed using the SenseWear Pro3 armband. LEA did not alter NEAT (p = .41), nor time spent in moderate to vigorous (p = .20) and low-intensity physical activity (p = .17). However, time spent in low-intensity physical activity was lower in LEA + EX than LEA − EX (13.7 ± 0.3 vs. 15.2 ± 0.3 hr/day; p = .002). Short-term LEA does not seem to impact NEAT per se, but the way it is attained may impact physical activity behavior outside of exercise. As the participants expended similar amounts of energy during NEAT (900–1,300 kcal/day = 12.5–18.0 kcal·kg fat-free mass−1·day−1) and prescribed exercise bouts (15.0 kcal·kg fat-free mass−1·day−1), excluding it as a component of energy expenditure may skew the true energy available for physiological functionality in active populations.

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Acute Effect of Citrulline Malate on Repetition Performance During Strength Training: A Systematic Review and Meta-Analysis

Fredrik Tonstad Vårvik, Thomas Bjørnsen, and Adam M. Gonzalez

Citrulline malate (CitMal) is a dietary supplement that is suggested to enhance strength training performance. However, there is conflicting evidence on this matter. Thus, the purpose of this meta-analysis was to determine whether supplementing with CitMal prior to strength training could increase the total number of repetitions performed before reaching voluntary muscular failure. A systematic search was conducted wherein the inclusion criteria were double-blind, placebo-controlled studies in healthy participants that examined the effect of CitMal on repetitions to failure during upper body and lower body resistance exercises. The Hedges’s g standardized mean differences (SMD) between the placebo and CitMal trials were calculated and used in a random effect model. Two separate subanalyses were performed for upper body and lower body exercises. Eight studies, including 137 participants who consisted of strength-trained men (n = 101) and women (n = 26) in addition to untrained men (n = 9), fulfilled the inclusion criteria. Across the studies, 14 single-joint and multijoint exercises were performed with an average of 51 ± 23 total repetitions during 5 ± 3 sets per exercise at ∼70% of one-repetition maximum. Supplementing with 6–8 g of CitMal 40–60 min before exercise increased repetitions by 3 ± 5 (6.4 ± 7.9%) compared with placebo (p = .022) with a small SMD (0.196). The subanalysis for the lower body resulted in a tendency for an effect of the supplement (8.1 ± 8.4%, SMD: 0.27, p = .051) with no significant effect for the upper body (5.7 ± 8.4%, SMD: 0.16, p = .131). The current analysis observed a small ergogenic effect of CitMal compared with placebo. Acute CitMal supplementation may, therefore, delay fatigue and enhance muscle endurance during high-intensity strength training.

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Effect of Predicted Versus Measured Thoracic Gas Volume on Body Fat Percentage in Young Adults

Jeremy B. Ducharme, Ann L. Gibson, and Christine M. Mermier

The BodPod® (COSMED, Concord, CA) uses predicted (pTGV) or measured thoracic gas volume (mTGV) during estimations of percentage body fat (%BF). In young adults, there is inconsistent evidence on the variation between pTGV and mTGV, and the effect of sex as a potential covariate on this relationship is unknown. This study examined the difference between TGV assessments and its effect on %BF and potential sex differences that may impact this relationship. A retrospective analysis of BodPod® pTGV and mTGV for 95 men and 86 women ages 18–30 years was performed. Predicted TGV was lower than mTGV for men (−0.49 ± 0.7 L; p < .0001). For men, %BF derived by pTGV was lower than that by mTGV (−1.3 ± 1.8%; p < .0001). For women, no differences were found between pTGV and mTGV (−0.08 ± 0.6 L; p > .05) or %BF (−0.03 ± 0.2%; p > .05). The two-predictor model of sex and height was able to account for 57.9% of the variance in mTGV, F(2, 178) = 122.5, p < .0001. Sex corrected for the effect of height was a significant predictor of mTGV (β = 0.483 L, p < .0001). There is bias for pTGV to underestimate mTGV in individuals with a large mTGV, which can lead to significant underestimations of %BF in young adults; this was especially evident for men in this study. Sex is an important covariate that should be considered when deciding to use pTGV. The results indicate that TGV should be measured whenever possible for both men and women ages 18–30 years.

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Habitual Caffeine Consumption Does Not Interfere With the Acute Caffeine Supplementation Effects on Strength Endurance and Jumping Performance in Trained Individuals

Vitor de Salles Painelli, Emerson L. Teixeira, Bruno Tardone, Marina Moreno, Jonatas Morandini, Victória H. Larrain, and Flávio O. Pires

The long-standing caffeine habituation paradigm was never investigated in strength endurance and jumping exercise performance through a straightforward methodology. The authors examined if habitual caffeine consumption would influence the caffeine ergogenic effects on strength endurance and jumping performance as well as perceptual responses. Thirty-six strength-trained individuals were mathematically allocated into tertiles according to their habitual caffeine consumption: low (20 ± 11 mg/day), moderate (88 ± 33 mg/day), and high consumers (281 ± 167 mg/day). Then, in a double-blind, crossover, counterbalanced fashion, they performed a countermovement vertical jump test and a strength endurance test either after caffeine (6 mg/kg) and placebo supplementation or after no supplementation (control). Perceptual responses such as ratings of perceived exertion and pain were measured at the termination of the exercises. Acute caffeine supplementation improved countermovement vertical jump performance (p = .001) and total repetitions (p = .004), regardless of caffeine habituation. Accordingly, analysis of absolute change from the control session showed that caffeine promoted a significantly greater improvement in both countermovement vertical jump performance (p = .004) and total repetitions (p = .0001) compared with placebo. Caffeine did not affect the rating of perceived exertion and pain in any exercise tests, irrespective of tertiles (for all comparisons, p > .05 for both measures). Caffeine side effects were similar in low, moderate, and high caffeine consumers. These results show that habitual caffeine consumption does not influence the potential of caffeine as an ergogenic aid in strength endurance and jumping exercise performance, thus challenging recommendations to withdraw from the habitual caffeine consumption before supplementing with caffeine.

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Quality Control of Protein Supplements: A Review

Bruno Ruiz Brandão da Costa, Rafaela Rocha Roiffé, and Márcia Nogueira da Silva de la Cruz

The growing consumer awareness regarding health and fitness has been leading to a huge rise in the consumption of nutritional supplements and, consequently, to an increase in concerns about their quality. In this sense, one of the most consumed products is protein supplements and, despite being safer than other types of supplements, there are several studies showing incompatibilities between what is present on the labels and their actual content. Therefore, this review is focused on gathering information about the problems arising from poor manufacturing practices and inadequate quality control of sport protein supplements. These issues are mainly related to three aspects: reduction of the supplements’ nutritional value, the presence of pharmacological substances, and contamination with microorganisms or toxic metals. Regarding the first aspect, reports about the “classic” addition of nitrogen-rich compounds to mask the protein content measured by the Kjeldahl method were discussed, as well as recent topics such as the addition of cheaper proteins to produce an “undetectable” adulteration in whey protein supplements. With respect to the presence of pharmacological compounds, it is a finding that is not very common in protein supplements; however, even trace amounts of foreign substances in this type of product may cause adverse effects to consumers, and, in the case of an elite athlete, may result in doping. Finally, we discuss about the contamination with microorganisms and toxic metals, this latter being a subject that should be further explored due to few studies in the literature.

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Volume 31 (2021): Issue 3 (May 2021)

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Isolated Leucine and Branched-Chain Amino Acid Supplementation for Enhancing Muscular Strength and Hypertrophy: A Narrative Review

Daniel L. Plotkin, Kenneth Delcastillo, Derrick W. Van Every, Kevin D. Tipton, Alan A. Aragon, and Brad J. Schoenfeld

Branched-chain amino acids (BCAA) are one of the most popular sports supplements, marketed under the premise that they enhance muscular adaptations. Despite their prevalent consumption among athletes and the general public, the efficacy of BCAA has been an ongoing source of controversy in the sports nutrition field. Early support for BCAA supplementation was derived from extrapolation of mechanistic data on their role in muscle protein metabolism. Of the three BCAA, leucine has received the most attention because of its ability to stimulate the initial acute anabolic response. However, a substantial body of both acute and longitudinal research has now accumulated on the topic, affording the ability to scrutinize the effects of BCAA and leucine from a practical standpoint. This article aims to critically review the current literature and draw evidence-based conclusions about the putative benefits of BCAA or leucine supplementation on muscle strength and hypertrophy as well as illuminate gaps in the literature that warrant future study.

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Higher Physical Activity Is Related to Lower Neck Adiposity in Young Men, but to Higher Neck Adiposity in Young Women: An Exploratory Study

Maria Jose Arias-Tellez, Francisco M. Acosta, Jairo H. Migueles, Jose M. Pascual-Gamarra, Elisa Merchan-Ramirez, Clarice M. de Lucena Martins, Jose M. Llamas-Elvira, Borja Martinez-Tellez, and Jonatan R. Ruiz

The role of lifestyle behaviors on neck adipose tissue (NAT), a fat depot that appears to be involved in the pathogenesis of different cardiometabolic diseases and in inflammatory status, is unknown. In this cross-sectional and exploratory study, the authors examined the relationship between sedentary time and physical activity (PA) with neck adiposity in young adults. A total of 134 subjects (69% women, 23 ± 2 years) were enrolled. The time spent in sedentary behavior and PA of different intensity were objectively measured for 7 consecutive days (24 hr/day), using a wrist (nondominant)-worn accelerometer. The NAT volume was assessed using computed tomography, and the compartmental (subcutaneous, intermuscular, and perivertebral) and total NAT volumes were determined at the level of vertebra C5. Anthropometric indicators and body composition (by dual-energy X-ray absorptiometry) were determined. The time spent in light physical activity and moderate physical activity (MPA) and the overall PA were inversely associated with the intermuscular NAT volume in men, as were the MPA and overall PA with total NAT volume (all ps ≤ .04). Sedentary time was directly related to the total NAT volume (p = .04). An opposite trend was observed in women, finding a direct relationship of MPA with the subcutaneous NAT; of light physical activity, MPA, and overall PA with the perivertebral NAT; and of light physical activity with total NAT volumes (all ps ≤ .05). The observed associations were weak, and after adjusting for multiplicity, the results became nonsignificant (p > .05). These findings suggest that the specific characteristics of PA (time and intensity) might have sex-dependent implications in the accumulation of NAT.