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How to Equalize High- and Low-Intensity Endurance Exercise Dose

Pekka Matomäki, Olli-Pekka Nuuttila, Olli J. Heinonen, Heikki Kyröläinen, and Ari Nummela

Purpose: Without appropriate standardization of exercise doses, comparing high- (HI) and low-intensity (LI) training outcomes might become a matter of speculation. In athletic preparation, proper quantification ensures an optimized stress-to-recovery ratio. This review aims to compare HI and LI doses by estimating theoretically the conversion ratio, 1:x, between HI and LI: How many minutes, x, of LI are equivalent to 1 minute of HI using various quantification methods? A scrutinized analysis on how the dose increases in relation to duration and intensity was also made. Analysis: An estimation was conducted across 4 categories encompassing 10 different approaches: (1) “arbitrary” methods, (2) physiological and perceptual measurements during exercise, (3) postexercise measurements, and comparison to (4a) acute and (4b) chronic intensity-related maximum dose. The first 2 categories provide the most conservative estimation for the HI:LI ratio (1:1.5–1:10), and the third, slightly higher (1:4–1:11). The category (4a) provides the highest estimation (1:52+) and (4b) suggests 1:10 to 1:20. The exercise dose in the majority of the approaches increase linearly in relation to duration and exponentially in relation to intensity. Conclusions: As dose estimations provide divergent evaluations of the HI:LI ratio, the choice of metric will have a large impact on the research designs, results, and interpretations. Therefore, researchers should familiarize themselves with the foundations and weaknesses of their metrics and justify their choice. Last, the linear relationship between duration and exercise dose is in many cases assumed rather than thoroughly tested, and its use should be subjected to closer scrutiny.

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Retraction. Pharmacokinetic Profile of Caffeine and Its Two Main Metabolites in Dried Blood Spots After Five Different Oral Caffeine Administration Forms—A Randomized Crossover Study

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The Anabolic Response to Protein Ingestion During Recovery From Exercise Has No Upper Limit in Magnitude and Duration In Vivo in Humans: A Commentary

Oliver C. Witard and Samuel Mettler

A comprehensive recent study by Trommelen et al. demonstrated that muscle tissue exhibits a greater capacity to incorporate exogenous exogenous protein-derived amino acids into bound muscle protein than was previously appreciated, at least when measured in “anabolically sensitive,” recreationally active (but not resistance-trained), young men following resistance exercise. Moreover, this study demonstrated that the duration of the postprandial period is modulated by the dose of ingested protein contained within a meal, that is, the postexercise muscle protein synthesis response to protein ingestion was more prolonged in 100PRO than 25PRO. Both observations represent important scientific advances in the field of protein metabolism. However, we respectfully caution that the practical implications of these findings may have been misinterpreted, at least in terms of dismissing the concept of protein meal distribution as an important factor in optimizing muscle tissue anabolism and/or metabolic health. Moreover, based on emerging evidence, this idea that the anabolic response to protein ingestion has no upper limit does not appear to translate to resistance-trained young women.

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Introducing IJSPP’s First Reviewer Incentive: A Submission-Fee Waiver

Dionne A. Noordhof and Øyvind Sandbakk

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Standing on the Shoulders of Giants: Essential Papers in Sports and Exercise Physiology

Jos J. de Koning and Carl Foster

Purpose: The purpose of this survey was to create a list of essential historical and contemporary readings for undergraduate and graduate students in the field of exercise physiology. Methods: Fifty-two exercise physiologists/sport scientists served as referees, and each nominated ∼25 papers for inclusion in the list. In total, 396 papers were nominated by the referees. This list was then sent back to the referees, with the instructions to nominate the “100 essential papers in sports and exercise physiology.” Results: The referees cast 4722 votes. The 100 papers with the highest number of votes received 51% (2406) of the total number of votes. A total of 37 papers in the list of “100 essential papers” were published >50 years ago, and 63 papers were published since 1973. Conclusions: This list of essential studies will provide a perspective on contemporary studies, the “giant’s shoulders” to enable young scholars to “see further” or to understand where they have “come from.” This compilation is also meant to impress on students that, given the (lack of) technology available in the past, some of the early science required enormous intuitive leaps on the part of historical scientists.

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Hamstring Injuries, From the Clinic to the Field: A Narrative Review Discussing Exercise Transfer

Jordi Vicens-Bordas, Ali Parvaneh Sarand, Marco Beato, and Robert Buhmann

Purpose: The optimal approach to hamstring training is heavily debated. Eccentric exercises reduce injury risk; however, it is argued that these exercises transfer poorly to improved hamstring function during sprinting. Some argue that other exercises, such as isometric exercises, result in better transfer to running gait and should be used when training to improve performance and reduce injury risk. Given the performance requirements of the hamstrings during the terminal swing phase, where they are exposed to high strain, exercises should aim to improve the torque production during this phase. This should improve the hamstrings’ ability to resist overlengthening consequently, improving performance and limiting strain injury. Most hamstring training studies fail to assess running kinematics postintervention. Of the limited evidence available, only eccentric exercises demonstrate changes in swing-phase kinematics following training. Studies of other exercise modalities investigate effects on markers of performance and injury risk but do not investigate changes in running kinematics. Conclusions: Despite being inconsistent with principles of transfer, current evidence suggests that eccentric exercises result in transfer to swing-phase kinematics. Other exercise modalities may be effective, but the effect of these exercises on running kinematics is unknown.

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How Can We Make Research More Relevant for Sport Practice?

Thomas Haugen

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Long-Term Evaluation of Lipid Profile Changes in Olympic Athletes

Giuseppe Di Gioia, Lorenzo Buzzelli, Viviana Maestrini, Maria Rosaria Squeo, Erika Lemme, Sara Monosilio, Andrea Serdoz, Roberto Fiore, Domenico Zampaglione, Andrea Segreti, and Antonio Pelliccia

Dyslipidemia is a major contributor to the development of atherosclerotic cardiovascular disease. Despite high level of physical activity, athletes are not immune from dyslipidemia, but longitudinal data on the variation of lipids are currently lacking. We sought to assess lipid profile changes over time in Olympic athletes practicing different sports disciplines (power, skills, endurance, and mixed). We enrolled 957 consecutive athletes evaluated from London 2012 to Beijing 2022 Olympic Games. Dyslipidemia was defined as low-density lipoprotein (LDL) ≥115 mg/dl, high-density lipoprotein (HDL) <40 mg/dl for males, or HDL <50 mg/dl for females. Hypertriglyceridemia was defined as triglycerides >150 mg/dl. At the follow-up, a variation of ±40 mg/dl for LDL, ±6 mg/dl for HDL, and ±50 mg/dl for triglycerides was considered relevant. Athletes with follow-up <10 months or taking lower lipid agents were excluded. Follow-up was completed in 717 athletes (74.9%), with a mean duration of 55.6 months. Mean age was 27.2 ± 4.8 years old, 54.6% were male (n = 392). Overall, 19.8% (n = 142) athletes were dyslipidemic at both blood tests, being older, practicing nonendurance sports, and predominantly male. In 69.3% (n = 129) of those with elevated LDL at t 0, altered values were confirmed at follow-up, while the same occurred in 36.5% (n = 15) with hypo-HDL and 5.3% (n = 1) in those with elevated triglycerides. Weight and fat mass percentage modifications did not affect lipid profile variation. LDL hypercholesterolemia tends to persist over time especially among male, older, and nonendurance athletes. LDL hypercholesterolemia detection in athletes should prompt early preventive intervention to reduce the risk of future development of atherosclerotic disease.

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Erratum. Injury Prediction in Competitive Runners With Machine Learning

International Journal of Sports Physiology and Performance

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The Role of Musculoskeletal Training During Return to Performance Following Relative Energy Deficiency in Sport

Richard C. Blagrove, Katherine Brooke-Wavell, Carolyn R. Plateau, Carolyn Nahman, Amal Hassan, and Trent Stellingwerff

Background: Relative energy deficiency in sport (REDs) is a condition that is associated with negative health and performance outcomes in athletes. Insufficient energy intake relative to exercise energy expenditure, resulting in low energy availability, is the underlying cause, which triggers numerous adverse physiological consequences including several associated with musculoskeletal (MSK) health and neuromuscular performance. Purpose: This commentary aims to (1) discuss the health and performance implications of REDs on the skeletal and neuromuscular systems and (2) examine the role that MSK training (ie, strength and plyometric training) during treatment and return to performance following REDs might have on health and performance in athletes, with practical guidelines provided. Conclusions: REDs is associated with decreases in markers of bone health, lean body mass, maximal and explosive strength, and muscle work capacity. Restoration of optimal energy availability, mainly through an increase in energy intake, is the primary goal during the initial treatment of REDs with a return to performance managed by a multidisciplinary team of specialists. MSK training is an effective nonpharmacological component of treatment for REDs, which offers multiple long-term health and performance benefits, assuming the energy needs of athletes are met as part of their recovery. Supervised, prescribed, and gradually progressive MSK training should include a combination of resistance training and high-impact plyometric-based exercise to promote MSK adaptations, with an initial focus on achieving movement competency. Progressing MSK training exercises to higher intensities will have the greatest effects on bone health and strength performance in the long term.