It is the position of Sports Dietitians Australia (SDA) that exercise in hot and/or humid environments, or with significant clothing and/or equipment that prevents body heat loss (i.e., exertional heat stress), provides significant challenges to an athlete’s nutritional status, health, and performance. Exertional heat stress, especially when prolonged, can perturb thermoregulatory, cardiovascular, and gastrointestinal systems. Heat acclimation or acclimatization provides beneficial adaptations and should be undertaken where possible. Athletes should aim to begin exercise euhydrated. Furthermore, preexercise hyperhydration may be desirable in some scenarios and can be achieved through acute sodium or glycerol loading protocols. The assessment of fluid balance during exercise, together with gastrointestinal tolerance to fluid intake, and the appropriateness of thirst responses provide valuable information to inform fluid replacement strategies that should be integrated with event fuel requirements. Such strategies should also consider fluid availability and opportunities to drink, to prevent significant under- or overconsumption during exercise. Postexercise beverage choices can be influenced by the required timeframe for return to euhydration and co-ingestion of meals and snacks. Ingested beverage temperature can influence core temperature, with cold/icy beverages of potential use before and during exertional heat stress, while use of menthol can alter thermal sensation. Practical challenges in supporting athletes in teams and traveling for competition require careful planning. Finally, specific athletic population groups have unique nutritional needs in the context of exertional heat stress (i.e., youth, endurance/ultra-endurance athletes, and para-sport athletes), and specific adjustments to nutrition strategies should be made for these population groups.
Alan J. McCubbin, Bethanie A. Allanson, Joanne N. Caldwell Odgers, Michelle M. Cort, Ricardo J.S. Costa, Gregory R. Cox, Siobhan T. Crawshay, Ben Desbrow, Eliza G. Freney, Stephanie K. Gaskell, David Hughes, Chris Irwin, Ollie Jay, Benita J. Lalor, Megan L.R. Ross, Gregory Shaw, Julien D. Périard, and Louise M. Burke
Zhen Zeng, Christoph Centner, Albert Gollhofer, and Daniel König
Purpose: Setting the optimal cuff pressure is a crucial part of prescribing blood-flow-restriction training. It is currently recommended to use percentages of each individual’s arterial occlusion pressure, which is most accurately determined by Doppler ultrasound (DU). However, the practicality of this gold-standard method in daily training routine is limited due to high costs. An alternative solution is pulse oximetry (PO). The main purpose of this study was to evaluate validity between PO and DU measurements and to investigate whether sex has a potential influence on these variables. Methods: A total of 94 subjects were enrolled in the study. Participants were positioned in a supine position, and a 12-cm-wide cuff was applied in a counterbalanced order at the most proximal portion of the right upper and lower limbs. The cuff pressure was successively increased until pulse was no longer detected by DU and PO. Results: There were no significant differences between the DU and PO methods when measuring arterial occlusion pressure at the upper limb (P = .308). However, both methods showed considerable disagreement for the lower limbs (P = .001), which was evident in both men (P = .028) and women (P = .008). No sex differences were detected. Conclusions: PO is reasonably accurate to determine arterial occlusion pressure of the upper limbs. For lower limbs, PO does not seem to be a valid instrument when assessing the optimal cuff pressure for blood-flow-restriction interventions compared with DU.
Ching T. Lye, Swarup Mukherjee, and Stephen F. Burns
This study examined if plant sterols and walking reduce postprandial triacylglycerol (TAG) concentrations in Chinese men with elevated body mass index (≥ 23.5 kg/m2). Fifteen Chinese men (mean [SD]: age = 25  years and body mass index = 26.2 [1.5] kg/m2] completed four 10-day trials in random order with a 7- to 10-day washout between trials: (a) daily consumption of a control margarine while sedentary (C-S), (b) daily consumption of margarine containing 2 g/day of plant sterols while sedentary (PS-S), (c) daily consumption of a control margarine with 30-min daily walking (C-W), and (d) daily consumption of margarine containing 2 g/day of plant sterols with 30-min daily walking (PS-W). On Day 11 of each trial, postprandial TAG was measured after a high-fat milkshake. The 5-hr total area under the TAG curve was 22%, 25%, and 12% lower on PS-W (mean [SD]: 8.9 [4.3] mmol·5 hr/L) than C-S (11.4 [4.5] mmol·5 hr/L; p = .005; d = 0.56), PS-S (11.9 [4.9] mmol·5 hr/L; p = .004; d = 0.67), and C-W (10.1 [4.4] mmol·5 hr/L; p = .044; d = 0.27) trials, respectively. Similarly, 5-hr incremental area for PS-W (4.5 [2.7] mmol·5 hr/L) was 31%, 32%, and 18% lower than C-S (6.6 [3.3] mmol·5 hr/L; p = .005; d = 0.62), PS-S (6.6 [3.4] mmol·5 hr/L; p = .004; d = 0.64), and C-W (5.5 [2.8] mmol·5 hr/L; p = .032; d = 0.29). Ten days of daily plant sterol intake combined with walking presents an intervention strategy to lower postprandial TAG in Chinese men with elevated body mass index.
Brianna J. Stubbs, Pete J. Cox, Tom Kirk, Rhys D. Evans, and Kieran Clarke
Exogenous ketone drinks may improve athletic performance and recovery, but information on their gastrointestinal tolerability is limited. Studies to date have used a simplistic reporting methodology that inadequately represents symptom type, frequency, and severity. Herein, gastrointestinal symptoms were recorded during three studies of exogenous ketone monoester (KME) and salt (KS) drinks. Study 1 compared low- and high-dose KME and KS drinks consumed at rest. Study 2 compared KME with isocaloric carbohydrate (CHO) consumed at rest either when fasted or after a standard meal. Study 3 compared KME+CHO with isocaloric CHO consumed before and during 3.25 hr of bicycle exercise. Participants reported symptom type and rated severity between 0 and 8 using a Likert scale at regular intervals. The number of visits with no symptoms reported after ketone drinks was n = 32/60 in Study 1, n = 9/32 in Study 2, and n = 20/42 in Study 3. Following KME and KS drinks, symptoms were acute but mild and were fully resolved by the end of the study. High-dose KS drinks caused greater total-visit symptom load than low-dose KS drinks (13.8 ± 4.3 vs. 2.0 ± 1.0; p < .05) and significantly greater time-point symptom load than KME drinks 1–2 hr postdrink. At rest, KME drinks caused greater total-visit symptom load than CHO drinks (5.0 ± 1.6 vs. 0.6 ± 0.4; p < .05). However, during exercise, there was no significant difference in total-visit symptom load between KME+CHO (4.2 ± 1.0) and CHO (7.2 ± 1.9) drinks. In summary, exogenous ketone drinks cause mild gastrointestinal symptoms that depend on time, the type and amount of compound consumed, and exercise.
Stephen S. Cheung
Øyvind Skattebo, Thomas Losnegard, and Hans Kristian Stadheim
Purpose: Long-distance cross-country skiers specialize to compete in races >50 km predominantly using double poling (DP). This emphasizes the need for highly developed upper-body endurance capacities and an efficient DP technique. The aim of this study was to investigate potential effects of specialization by comparing physiological capacities and kinematics in DP between long-distance skiers and skiers competing using both techniques (skating/classic) in several competition formats (“all-round skiers”). Methods: Seven male long-distance (32  y, 183  cm, 76  kg) and 6 all-round (25  y, 181  cm, 75  kg) skiers at high international levels conducted submaximal workloads and an incremental test to exhaustion for determination of peak oxygen uptake (VO2peak) and time to exhaustion (TTE) in DP and running. Results: In DP and running maximal tests, TTE showed no difference between groups. However, long-distance skiers had 5–6% lower VO2peak in running (81  vs 85  mL·kg−1·min−1; P = .07) and DP (73  vs 78  mL·kg−1·min−1; P < .01) than all-round skiers. In DP, long-distance skiers displayed lower submaximal O2 cost than all-round skiers (3.8 ± 3.6%; P < .05) without any major differences in cycle times or cyclic patterns of joint angles and center of mass. Lactate concentration over a wide range of speeds (45–85% of VO2peak) did not differ between groups, even though each workload corresponded to a slightly higher percentage of VO2peak for long-distance skiers (effect size: 0.30–0.68). Conclusions: The long-distance skiers displayed lower VO2peak but compensated with lower O2 cost to perform equally with the all-round skiers on a short TTE test in DP. Furthermore, similar submaximal lactate concentration and reduced O2 cost could be beneficial in sustaining high skiing speeds in long-duration competitions.
Sang-Ho Lee, Steven D. Scott, Elizabeth J. Pekas, Jeong-Gi Lee, and Song-Young Park
Purpose: Athletes in combat sports undergo rapid changes in body weight prior to competition in order to gain a size advantage over their opponent. However, these large weight changes with concomitant high-intensity exercise training create poor lipid profiles and high levels of oxidative stress, which can be detrimental to health and sport performance. Therefore, the purpose of this study was to investigate the ability of the nutritional supplement octacosanol to combat the physiological detriments that occur in taekwondo players during rapid weight loss with high-intensity exercise training. Methods: A total of 26 male taekwondo players were randomly divided into 2 groups: An experimental group performed a 5% weight-loss and taekwondo training program with 40-mg octacosanol intake (OCT; n = 13) for 6 d, and a control group performed the same weight-loss and taekwondo training program with a placebo (CON; n = 13). Results: There were significant (P < .05) group × time interactions for low-density lipoprotein and triglycerides, which significantly decreased (Δ18  mg/dL and Δ80  mg/dL, respectively), and high-density lipoprotein, which significantly increased (Δ10  mg/dL), in the OCT group compared with the CON group. There were also significant (P < .05) group × time interactions for superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA), with SOD increasing (Δ226  U/gHb) in the OCT group, while GPx decreased (Δ20  U/gHb) and MDA increased (Δ72 [0.04] nmol/mL) in the CON group. Conclusion: These results suggest that octacosanol may be a beneficial supplement to protect against the poor cholesterol levels and oxidative stress that occurs during taekwondo training.
David M. Shaw, Fabrice Merien, Andrea Braakhuis, Daniel Plews, Paul Laursen, and Deborah K. Dulson
This study investigated the effect of the racemic β-hydroxybutyrate (βHB) precursor, R,S-1,3-butanediol (BD), on time-trial (TT) performance and tolerability. A repeated-measures, randomized, crossover study was conducted in nine trained male cyclists (age, 26.7 ± 5.2 years; body mass, 69.6 ± 8.4 kg; height, 1.82 ± 0.09 m; body mass index, 21.2 ± 1.5 kg/m2; VO2peak,63.9 ± 2.5 ml·kg−1·min−1; W max, 389.3 ± 50.4 W). Participants ingested 0.35 g/kg of BD or placebo 30 min before and 60 min during 85 min of steady-state exercise, which preceded a ∼25- to 35-min TT (i.e., 7 kJ/kg). The ingestion of BD increased blood D-βHB concentration throughout exercise (0.44–0.79 mmol/L) compared with placebo (0.11–0.16 mmol/L; all p < .001), which peaked 1 hr following the TT (1.38 ± 0.35 vs. 0.34 ± 0.24 mmol/L; p < .001). Serum glucose and blood lactate concentrations were not different between trials (all p > .05). BD ingestion increased oxygen consumption and carbon dioxide production after 20 min of steady-state exercise (p = .002 and p = .032, respectively); however, no further effects on cardiorespiratory parameters were observed. Within the BD trial, moderate to severe gastrointestinal symptoms were reported in five participants, and low levels of dizziness, nausea, and euphoria were reported in two participants. However, this had no effect on TT duration (placebo, 28.5 ± 3.6 min; BD, 28.7 ± 3.2 min; p = .62) and average power output (placebo, 290.1 ± 53.7 W; BD, 286.4 ± 45.9 W; p = .50). These results suggest that BD has no benefit for endurance performance.