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Laura Capranica and Mindy L. Millard-Stafford

A prevailing theory (and practical application) is that elite performance requires early childhood skill development and training across various domains, including sport. Debate continues whether children specializing early (ie, training/competition in a single sport) have true advantage compared with those who sample various sports early and specialize in a single sport later (adolescence). Retrospective data and case studies suggest either model yields elite status depending upon the sport category (ie, situational: ball games, martial arts, fencing; quantitative: track and feld, swimming, skiing; or qualitative: gymnastics, diving, figure skating). However, potential risks of early specialization include greater attrition and adverse physical/emotional health outcomes. With the advent of the IOC Youth Olympic Games, increased emphasis on global youth competition has unknown implications but also represents a potential platform for investigation. Modification of youth competition formats should be based upon multidisciplinary research on psycho-physiological responses, and technical-tactical behaviors during competition. The assumption that a simple scaled-down approach of adult competitions facilitates the development of technical/tactical skills of youth athletes is not necessarily substantiated with field-based research. Relatively little evidence exists regarding the long-term effects of rigorous training and competitive schedules on children in specific sports. It is clear that more prospective studies are needed to understand the training dose that optimally develops adaptations in youth without inducing dropout, overtraining syndrome, and/or injury. Such an approach should be sport specific as well as gender based. Until such evidence exists, coaches and sport administrators will continue to rely upon their sport-specific dogma to influence programmatic development of our most vulnerable population.

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Mindy Millard-Stafford, Ann E. Swanson and Matthew T. Wittbrodt

Men outperform women in sports requiring muscular strength and/or endurance, but the relative influence of “nurture” versus “nature” remains difficult to quantify. Performance gaps between elite men and women are well documented using world records in second, centimeter, or kilogram sports. However, this approach is biased by global disparity in reward structures and opportunities for women. Despite policies enhancing female participation (Title IX legislation), US women only closed performance gaps by 2% and 5% in Olympic Trial swimming and running, respectively, from 1972 to 1980 (with no change thereafter through 2016). Performance gaps of 13% in elite middistance running and 8% in swimming (∼4-min duration) remain, the 5% differential between sports indicative of load carriage disadvantages of higher female body fatness in running. Conversely, sprint swimming exhibits a greater sex difference than sprint running, suggesting anthropometric/power advantages unique to swim-block starts. The ∼40-y plateau in the performance gap suggests a persistent dominance of biological influences (eg, longer limb levers, greater muscle mass, greater aerobic capacity, and lower fat mass) on performance. Current evidence suggests that women will not swim or run as fast as men in Olympic events, which speaks against eliminating sex segregation in these individual sports. Whether hormone reassignment sufficiently levels the playing field in Olympic sports for transgender females (born and socialized male) remains an issue to be tackled by sport-governing bodies.

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Scott A. Conger, Gordon L. Warren, Michelle A. Hardy and Mindy L. Millard-Stafford

Context:

Carbohydrate (CHO) and caffeine (CAF) both improve endurance performance.

Purpose:

To determine by systematic literature review coupled with meta-analysis whether CAF ingested with CHO (CHO+CAF) improves endurance performance more than CHO alone.

Methods:

Databases were searched using the keywords caffeine, endurance, exercise, carbohydrate, and performance. Criteria for inclusion were studies that used human subjects performing an endurance-exercise performance task and included both a CHO and CHO+CAF condition. Effect sizes (ESs) were calculated as the standardized mean difference.

Results:

Twenty-one studies met the criteria for analysis. ESs for individual studies ranged from –0.08 (trivial effect favoring CHO) to 1.01 (large effect favoring CHO+CAF). The overall ES equaled 0.26 (95% CI 0.15–0.38, p < .001), indicating that CHO+CAF provides a small but significant performance benefit over CHO. ES was not significantly (p > .05) related to CAF dose, exercise duration, or performance-assessment method. To determine whether ES of CHO+CAF vs. CHO was different than CAF compared with water (placebo), a subgroup meta-analysis compared 36 CAF vs. placebo studies against the 21 CHO+CAF vs. CHO studies. The overall ES for the former group of studies (ES = 0.51, 95% CI 0.40–0.61) was nearly 2-fold greater than in CHO+CAF vs. CHO studies (p = .006).

Conclusions:

CHO+CAF ingestion provides a significant but small effect to improve endurance performance compared with CHO alone. However, the magnitude of the performance benefit that CAF provides is less when added to CHO than when added to placebo.

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Matthew T. Wittbrodt, Mindy Millard-Stafford, Ross A. Sherman and Christopher C. Cheatham

Purpose:

The impact of mild hypohydration on physiological responses and cognitive performance following exercise-heat stress (EHS) were examined compared with conditions when fluids were ingested ad libitum (AL) or replaced to match sweat losses (FR).

Methods:

Twelve unacclimatized, recreationally-active men (22.2 ± 2.4 y) completed 50 min cycling (60%VO2peak) in the heat (32°C; 65% RH) under three conditions: no fluid (NF), AL, and FR. Before and after EHS, a cognitive battery was completed: Trail making, perceptual vigilance, pattern comparison, match-to-sample, and letter-digit recognition tests.

Results:

Hypohydration during NF was greater compared with AL and FR (NF: -1.5 ± 0.6; AL: -0.3 ± 0.8; FR: -0.1 ± 0.3% body mass loss) resulting in higher core temperature (by 0.4, 0.5 °C), heart rate (by 13 and 15 b·min-1), and physiological strain (by 1.3, 1.5) at the end of EHS compared with AL and FR, respectively. Cognitive performance (response time and accuracy) was not altered by fluid condition; however, mean response time improved (p < .05) for letter-digit recognition (by 56.7 ± 85.8 ms or 3.8%; p < .05) and pattern comparison (by 80.6 ± 57.4 ms or 7.1%; p < .001), but mean accuracy decreased in trail making (by 1.2 ± 1.4%; p = .01) after EHS (across all conditions).

Conclusions:

For recreational athletes, fluid intake effectively mitigated physiological strain induced by mild hypohydration; however, mild hypohydration resulting from EHS elicited no adverse changes in cognitive performance.

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Mindy L. Millard-Stafford, Phillip B. Sparling, Linda B. Rosskopf and Teresa K. Snow

Our purpose was to determine if sports drinks with 6 and 8% CHO differentially affect physiological responses or run performance in the heat. Ten men ran 32 km while ingesting: placebo (P), 6% carbohydrate-electrolyte (CE6), and 8% carbohydrate-electrolyte (CE8). At 15 km, a 250 mL drink labeled with deuterium oxide (D2O) was ingested. Blood glucose and respiratory exchange ratio were significantly higher (P < 0.05) for CE6 and CE8 compared to P. Rectal temperature (Tre) at 32 km was higher for CE8 (40.1 ± 0.2 °C) compared to P (39.5 ± 0.2 °C) but similar to CE6 (39.8 ± 0.2 °C). D2O accumulation was not different among drink trials. Run performance was 8% faster for CE8 (1062 ± 31 s) compared to P (1154 ± 56 s) and similar to CE6 (1078 ± 33 s). Confirming the ACSM Position Stand, 8% CE are acceptable during exercise in the heat and attenuate the decline in performance.

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Mindy Millard-Stafford, Gordon L. Warren, Leah Moore Thomas, J. Andrew Doyle, Teresa Snow and Kristen Hitchcock

Post-exercise nutrition is critical to facilitate recovery from training. To determine if added protein (P) or increased carbohydrate (CHO) differentially improves recovery, eight runners ingested: 6% CHO (CHO6), 8% CHO + 2% protein (CHOP), and isocaloric 10% CHO (CHO10) following a 21-km run plus treadmill run to fatigue (RTF) at 90% VO2max. RTF was repeated after 2 h recovery. After 24 h, a 5 km time trial was performed. Insulin and blood glucose were higher (P < 0.05) following CHO10 compared to CHO-P and CHO6, but did not affect improvement from the first to second RTF (29.6% ± 6, 40.5% ± 8.8, 40.5% ± 14.5) or 5 km time (1100 ± 36.3, 1110 ± 37.3, 1118 ± 36.5 s). CK was not different, but perceived soreness with CHO-P (2.1 ± 0.5) was lower than CHO10 (5.2 ± 0.7). Additional calories from CHO or P above that provided in sports drinks does not improve subsequent performance after recovery; but less soreness suggests benefits with CHO-P.

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Laura Capranica, Maria Francesca Piacentini, Shona Halson, Kathryn H. Myburgh, Etsuko Ogasawara and Mindy Millard-Stafford

Sport is recognized as playing a relevant societal role to promote education, health, intercultural dialogue, and the individual development, regardless of an individual’s gender, race, age, ability, religion, political affiliation, sexual orientation, and socioeconomic background. Yet, it was not until the 2012 Summer Olympic Games in London that every country’s delegation included a female competitor. The gender gap in sport, although closing, remains, due to biological differences affecting performance, but it is also influenced by reduced opportunity and sociopolitical factors that influence full female participation across a range of sports around the world. Until the cultural environment is equitable, scientific discussion related to physiological differences using methods that examine progression in male and female world-record performances is limited. This commentary is intended to provide a forum to discuss issues underlying gender differences in sport performance from a global perspective and acknowledge the influence of cultural and sociopolitical factors that continue to ultimately affect female performance.

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Mindy Millard-Stafford, Linda B. Rosskopf, Teresa K. Snow and Bryan T. Hinson

Twelve highly trained male runners ran 15 km at self-selected pace on a treadmill in warm conditions to demonstrate differences in physiological responses, fluid preferences, and performance when ingesting sports drinks or plain water before and during exercise. One hour prior to the start of running, an equal volume (1,000 ml) of either water or a 6% or an 8% carbohydrate-electrolyte (CE) drink was ingested. Blood glucose was significantly higher 30 min following ingestion of 6% and 8% CE compared to water, significantly lower at 60 min postingestion with both sports drinks than with water, but similar after 7.5 km of the run for all beverages. During the first 13.4 km, oxygen uptake and run times were not different between trials; however, the final 1.6-km performance run was faster with both CE drinks compared to water. Despite a lower preexercise blood glucose, CE consumption prior to and during exercise significantly improved performance in the last 1.6 km of a 15-km run compared to water.

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Kirk J. Cureton, Gordon L. Warren, Mindy L. Millard-Stafford, Jonathan E. Wingo, Jennifer Trilk and Maxime Buyckx

This double-blind experiment examined the effects of a caffeinated sports drink during prolonged cycling in a warm environment. Sixteen highly trained cyclists completed 3 trials: placebo, carbohydrate-electrolyte sports drink (CES), and caffeinated sports drink (CES+CAF). Subjects cycled for 135 min, alternating between 60% and 75% VO2max every 15 min for the first 120 min, followed by a 15-min performance ride. Maximal voluntary (MVC) and electrically evoked contractile properties of the knee extensors were measured before and after cycling. Work completed during the performance ride was 15–23% greater for CES+CAF than for the other beverages. Ratings of perceived exertion were lower with CES+CAF than with placebo and CES. After cycling, the MVC strength loss was two-thirds less for CES+CAF than for the other beverages (5% vs. 15%). Data from the interpolated-twitch technique indicated that attenuated strength loss with CES+CAF was explained by reduced intrinsic muscle fatigue.

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Mindy L. Millard-Stafford, Kirk J. Cureton, Jonathan E. Wingo, Jennifer Trilk, Gordon L. Warren and Maxime Buyckx

Caffeine is regarded as a diuretic despite evidence that hydration is not impaired with habitual ingestion. The purpose of this study was to determine whether a caffeinated sports drink impairs fluid delivery and hydration during exercise in warm, humid conditions (28.5 °C, 60% relative humidity). Sixteen cyclists completed 3 trials: placebo (P), carbohydrate-electrolyte (CE), and caffeinated (195 mg/L) sports drink (CAF+CE). Subjects cycled for 120 min at 60–75%VO2max followed by 15 min of maximal-effort cycling. Heart rate and rectal temperature were similar until the final 15 min, when these responses and exercise intensity were higher with CAF+CE than with CE and P. Sweat rate, urine output, plasma-volume losses, serum electrolytes, and blood deuterium-oxide accumulation were not different. Serum osmolality was higher with CAF+CE vs. P but not CE. The authors conclude that CAF+CE appears as rapidly in blood as CE and maintains hydration and sustains cardiovascular and thermoregulatory function as well as CE during exercise in a warm, humid environment.