Purpose: External counterpulsation (ECP) has previously been used to treat cardiac patients via compression of the lower extremities during diastole to increase venous return and coronary perfusion. However, the effects of ECP on exercise performance and markers of recovery in elite athletes are largely unknown. Methods: On 2 separate occasions, 48 h apart, 7 elite National Rugby League players performed an identical 60-min field-based conditioning session followed by a 30-min period of either regular ECP treatment or placebo. Power measures during repeated cycle bouts and countermovement jump height and contraction time derivatives were measured at rest and 5 h postexercise. Saliva samples and venous blood samples were taken at rest, postexercise, and 5 h postexercise to assess stress, inflammation, and muscle damage. Results: After ECP treatment, cycling peak power output (P = .028; 11%) and accumulated peak power (P = .027; 14%) increased compared with the placebo condition. Postexercise plasma interleukin 1 receptor antagonist only increased after ECP (P = .024; 84%), and concentrations of plasma interleukin 1 receptor antagonist tended to be higher (P = .093; 76%) 5 h postexercise. Furthermore, testosterone-to-cortisol ratio was increased above baseline and placebo 5 h postexercise (P = .017–.029; 24–77%). The ratio of postexercise salivary α-amylase to immunoglobulin A decreased after treatment (P = .013; 50%) compared with the placebo control. Conclusions: Exercise performance and hormonal indicators of stress were improved and inflammation markers were reduced following acute ECP.
Llion A. Roberts, Johnpaul Caia, Lachlan P. James, Tannath J. Scott and Vincent G. Kelly
Danny Lum and Tiago M. Barbosa
Purpose: To evaluate the effect of strength training on Olympic time-based sports (OTBS) time-trial performance and provide an estimate of the impact of type of strength training, age, training status, and training duration on OTBS time-trial performance. Methods: A search on 3 electronic databases was conducted. The analysis comprised 32 effects in 28 studies. Posttest time-trial performance of intervention and control group from each study was used to estimate the standardized magnitude of impact of strength training on OTBS time-trial performance. Results: Strength training had a moderate positive effect on OTBS time-trial performance (effect size = 0.59, P < .01). Subgroup meta-analysis showed that heavy weight training (effect size = 0.30, P = .01) produced a significant effect, whereas other modes did not induce significant effects. Training status as factorial covariate was significant for well-trained athletes (effect size = 0.62, P = .04), but not for other training levels. Meta-regression analysis yielded nonsignificant relationship with age of the participants recruited (β = −0.04; 95% confidence interval, −0.08 to 0.004; P = .07) and training duration (β = −0.05; 95% confidence interval, −0.11 to 0.02; P = .15) as continuous covariates. Conclusion: Heavy weight training is an effective method for improving OTBS time-trial performance. Strength training has greatest impact on well-trained athletes regardless of age and training duration.
Alexander S.D. Gamble, Jessica L. Bigg, Tyler F. Vermeulen, Stephanie M. Boville, Greg S. Eskedjian, Sebastian Jannas-Vela, Jamie Whitfield, Matthew S. Palmer and Lawrence L. Spriet
Several previous studies have reported performance decrements in team sport athletes who dehydrated approximately 1.5–2% of their body mass (BM) through sweating. This study measured on-ice sweat loss, fluid intake, sodium balance, and carbohydrate (CHO) intake of 77 major junior (JR; 19 ± 1 years), 60 American Hockey League (AHL; 24 ± 4 years), and 77 National Hockey League (NHL; 27 ± 5 years) players. Sweat loss was calculated from pre- to post-exercise BM plus fluid intake minus urine loss. AHL (2.03 ± 0.62 L/hr) and NHL (2.02 ± 0.74 L/hr) players had higher sweat rates (p < .05) than JR players (1.63 ± 0.58 L/hr). AHL (1.23 ± 0.69%; p = .006) and NHL (1.29% ± 0.63%; p < .001) players had ∼30% greater BM losses than JR players (0.89% ± 0.57%). There was no difference in fluid intake between groups (p > .05). Sodium deficits (sodium loss − intake) were greater (p < .05) in AHL (1.68 ± 0.74 g/hr) and NHL (1.56 ± 0.84 g/hr) players compared with JR players (1.01 ± 0.50 g/hr). CHO intake was similar between groups (14–20 g CHO/hr), with 29%, 32%, and 40% of JR, AHL, and NHL players consuming no CHO, respectively. In summary, sweat rates were high in all players, but the majority of players (74/77, 54/60, and 68/77 of JR, AHL, and NHL, respectively) avoided mild dehydration (>2% BM) during 60 min of practice. However, ∼15%, 41%, and 48% of the JR, AHL, and NHL players, respectively, may have reached mild dehydration and increased risk of performance decrements in a 90-min practice.
Jason P. Brandenburg and Luisa V. Giles
Blueberries are abundant with anthocyanins possessing antioxidant and anti-inflammatory properties. As these properties combat fatigue and promote recovery, blueberry supplementation may enhance performance and recovery. Thus, the objectives were to examine the effects of two blueberry supplementation protocols on running performance, physiological responses, and short-term recovery. Using a randomized, double-blind, placebo (PLA)-controlled crossover design, 14 runners completed an 8-km time trial (TT) after supplementation with 4 days of blueberries (4DAY), 4 days of a PLA, or 2 days of placebo followed by 2 days of blueberries (2DAY). Heart rate and ratings of perceived exertion were monitored during the TT. Blood lactate, vertical jump, reactive strength index, and salivary markers were assessed before and after. No significant differences were observed for time to complete the TT (PLA: 3,010 ± 459 s; 2DAY: 3,014 ± 488 s; 4DAY: 3,011 ± 423 s), heart rate, ratings of perceived exertion, or any of the salivary markers. An interaction effect (p = .027) was observed for blood lactate, with lower post-TT concentrations in 4DAY (5.4 ± 2.0 mmol/L) than PLA (6.6 ± 2.5 mmol/L; p = .038) and 2DAY (7.4 ± 3.4 mmol/L; p = .034). Post-TT decreases in vertical jump height were not different, whereas the decline in reactive strength index was less following 4DAY (−6.1% ± 13.5%) than the other conditions (PLA: −12.6% ± 10.1%; 2DAY: −11.6% ± 11.5%; p = .038). Two days of supplementation did not influence performance or physiological stress. Although 4 days of supplementation did not alter performance, it blunted the increase in blood lactate, perhaps reflecting altered lactate production and/or clearance, and offset the decrease in dynamic muscle function post-TT, as indicated by the reactive strength index differences.
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.
Claire E. Badenhorst, Katherine E. Black and Wendy J. O’Brien
Hepcidin, a peptide hormone with an acknowledged evolutionary function in iron homeostasis, was discovered at the turn of the 21st century. Since then, the implications of increased hepcidin activity have been investigated as a potential advocate for the increased risk of iron deficiency in various health settings. Such implications are particularly relevant in the sporting community where peaks in hepcidin postexercise (∼3–6 hr) are suggested to reduce iron absorption and recycling, and contribute to the development of exercise-induced iron deficiency in athletes. Over the last decade, hepcidin research in sport has focused on acute and chronic hepcidin activity following single and repeated training blocks. This research has led to investigations examining possible methods to attenuate postexercise hepcidin expression through dietary interventions. The majority of macronutrient dietary interventions have focused on manipulating the carbohydrate content of the diet in an attempt to determine the health of athletes adopting the low-carbohydrate or ketogenic diets, a practice that is a growing trend among endurance athletes. During the process of these macronutrient dietary intervention studies, an observable coincidence of increased cumulative hepcidin activity to low energy availability has emerged. Therefore, this review aims to summarize the existing literature on nutritional interventions on hepcidin activity, thus, highlighting the link of hepcidin to energy availability, while also making a case for the use of hepcidin as an individualized biomarker for low energy availability in males and females.
Julian A. Owen, Matthew B. Fortes, Saeed Ur Rahman, Mahdi Jibani, Neil P. Walsh and Samuel J. Oliver
Identifying mild dehydration (≤2% of body mass) is important to prevent the negative effects of more severe dehydration on human health and performance. It is unknown whether a single hydration marker can identify both mild intracellular dehydration (ID) and extracellular dehydration (ED) with adequate diagnostic accuracy (≥0.7 receiver-operating characteristic–area under the curve [ROC-AUC]). Thus, in 15 young healthy men, the authors determined the diagnostic accuracy of 15 hydration markers after three randomized 48-hr trials; euhydration (water 36 ml·kg−1·day−1), ID caused by exercise and 48 hr of fluid restriction (water 2 ml·kg−1·day−1), and ED caused by a 4-hr diuretic-induced diuresis begun at 44 hr (Furosemide 0.65 mg/kg). Body mass was maintained on euhydration, and dehydration was mild on ID and ED (1.9% [0.5%] and 2.0% [0.3%] of body mass, respectively). Urine color, urine specific gravity, plasma osmolality, saliva flow rate, saliva osmolality, heart rate variability, and dry mouth identified ID (ROC-AUC; range 0.70–0.99), and postural heart rate change identified ED (ROC-AUC 0.82). Thirst 0–9 scale (ROC-AUC 0.97 and 0.78 for ID and ED) and urine osmolality (ROC-AUC 0.99 and 0.81 for ID and ED) identified both dehydration types. However, only the thirst 0–9 scale had a common dehydration threshold (≥4; sensitivity and specificity of 100%; 87% and 71%, 87% for ID and ED). In conclusion, using a common dehydration threshold ≥4, the thirst 0–9 scale identified mild intracellular and ED with adequate diagnostic accuracy. In young healthy adults’, thirst 0–9 scale is a valid and practical dehydration screening tool.
Michele Merlini, Greg Whyte, Sam Marcora, Mike Loosemore, Neil Chester and John Dickinson
Purpose: To investigate the impact of twice-daily inhalation of 100 µg of salmeterol (SAL) or 12 µg of formoterol (FOR) in addition to a strength- and power-training program over a 5-wk period on a 30-m sprint, strength, power, mood, stress, and skinfold thickness. Methods: In a randomized, single-blind study, 23 male and 15 female nonasthmatic, recreationally active individuals were recruited (mean [SD] age 26.3 [5.4] y, weight 76.2 [11.5] kg, height 176.9 [8.5] cm). Participants completed 3 standardized whole-body strength- and power-training sessions per week for 5 wk during which they were assigned to an SAL, FOR, or placebo group. Participants used their inhaler twice per day as instructed and completed assessments of sprint, strength, and power at baseline and 1 wk after cessation of the training program. The assessments included a 30-m sprint, vertical jump, 1-repetition-maximum (1RM) bench press, 1RM leg press, peak torque flexion and extension, anthropometric evaluation, and Rest-Q questionnaires. Results: After 5 wk of strength and power training, 30-m sprint time reduced in the FOR (0.29 [0.11] s, P = .049) and SAL (0.35 [0.05] s, P = .040) groups compared with placebo (+0.01 [0.11] s). No significant change was found in other assessments of strength, mood, or skinfold thickness. Conclusions: When strength and power training are combined with the inhalation of FOR or SAL over a 5-wk period, moderately trained individuals experience an improvement in 30-m sprint performance.
Teun van Erp, Marco Hoozemans, Carl Foster and Jos J. de Koning
Purpose: A valid measure for training load (TL) is an important tool for cyclists, trainers, and sport scientists involved in professional cycling. The aim of this study was to explore the influence of exercise intensity on the association between kilojoules (kJ) spent and different measures of TL to arrive at valid measures of TL. Methods: Four years of field data were collected from 21 cyclists of a professional cycling team, including 11,716 training and race sessions. kJ spent was obtained from power output measurements, and others TLs were calculated based on the session rating of perceived exertion (sRPE), heart rate (Lucia training impulse [luTRIMP]), and power output (training stress score [TSS]). Exercise intensity was expressed by the intensity factor (IF). To study the effect of exercise intensity on the association between kJ spent and various other TLs (sRPE, luTRIMP, and TSS), data from low- and high-intensity sessions were subjected to regression analyses using generalized estimating equations. Results: This study shows that the IF is significantly different for training and race sessions (0.59 [0.03] vs 0.73 [0.03]). Significant regression coefficients show that kJ spent is a good predictor of sRPE, and luTRIMP, as well as TSS. However, IF does not influence the associations between kJ spent and sRPE and luTRIMP, while the association with TSS is different when sessions are done with low or high IF. Conclusion: It seems that the TSS reacts differently to exercise intensity than sRPE and luTRIMP. A possible explanation could be the quadratic relation between IF and TSS.
Paola Rodriguez-Giustiniani and Stuart D.R. Galloway
The present study examined the impact of hormonal differences between late follicular (LF) and midluteal (ML) phases on restoration of fluid balance following dehydration. Ten eumenorrheic female participants were dehydrated by 2% of their body mass through overnight fluid restriction followed by exercise-heat stress. Trials were undertaken during the LF (between Days 10 and 13 of the menstrual cycle) and ML phases (between Days 18 and 23 of the menstrual cycle) with one phase repeated to assess reliability of observations. Following dehydration, participants ingested a volume equivalent to 100% of mass loss of a commercially available sports drink in four equal volumes over 30 min. Mean serum values for steroid hormones during the ML (estradiol [E2]: 92 ± 11 pg/ml, progesterone: 19 ± 4 ng/ml) and LF (estradiol [E2]: 232 ± 64 pg/ml, progesterone: 3 ± 2 ng/ml) were significantly different between phases. Urine tests confirmed no luteinizing hormone surge evident during LF trials. There was no effect of menstrual cycle phase on cumulative urine volume during the 3-hr rehydration period (ML: 630 [197–935] ml, LF: 649 [180–845] ml) with percentage of fluid retained being 47% (33–85)% on ML and 46% (37–89)% on LF (p = .29). There was no association between the progesterone:estradiol ratio and fluid retained in either phase. Net fluid balance, urine osmolality, and thirst intensity were not different between phases. No differences in sodium (ML: −61 [−36 to −131] mmol, LF: −73 [−5 to −118] mmol; p = .45) or potassium (ML: −36 [−11 to −80] mmol, LF: −30 [−19 to −89] mmol; p = .96) balance were observed. Fluid replacement after dehydration does not appear to be affected by normal hormonal fluctuations during the menstrual cycle in eumenorrheic young women.