Gastrointestinal (GI) symptoms may affect up to 90% of competitors during endurance races. Studies have typically assessed GI symptoms retrospectively or only over an acute timeframe, and information on the validity and reliability of the questionnaires employed is lacking. This investigation aimed to estimate the frequency of GI distress experienced by runners over 30 days and to establish the validity and reliability of a retrospective GI symptom questionnaire. Runners (70 men, 75 women) recorded GI symptoms with a prospective journal for 30 days. Retrospective GI symptom data were then collected after the 30-day period on two occasions within one week. GI symptoms were rated on a 0–10 scale. Descriptive statistics for GI symptoms are reported as medians (interquartile ranges) because of nonnormal distributions. Men and women experienced at least one GI symptom on 84.0% (59.8–95.1%) and 78.3% (50.0–95.2%) of runs, respectively. Moderate-to-severe GI symptoms (score of ≥5) were experienced on 13.8% (6.7–37.3%) and 21.7% (5.3–41.2%) of runs for men and women. Spearman’s rho correlations between journal ratings and retrospective questionnaire ratings ranged from 0.47 to 0.82 (all p < .001), although they were highest when journal ratings were quantified as mean 30-day values (all rho ≥ 0.59). Reliability of the retrospective questionnaire ratings was high (rho = 0.78–0.92; p < .001). In comparison with tracking GI symptoms with a daily journal, retrospective questionnaires seem to offer a convenient and reasonably valid and reliable method of quantifying GI symptoms over 30 days.
Patrick B. Wilson
Urine specific gravity (USG) thresholds are used in practice and research to determine hypohydration. However, some limited research has found that body size and body composition may impact USG, suggesting that fixed cutoffs may be insensitive. Cross-sectional data from 3,634 participants of the 2007–2008 National Health and Nutrition Examination Survey were analyzed. Along with USG, body mass index (BMI), estimated lean body mass (LBM), and dietary intake were quantified. Logistic regression models were used to evaluate whether higher quintiles of BMI and LBM were associated with elevated USG (USG ≥ 1.020 and ≥1.025) after accounting for dietary moisture and sodium. The USG (1.018 ± 0.0003 vs. 1.015 ± 0.0004); BMI (28.4 ± 0.2 vs. 28.0 ± 0.2 kg/m2); LBM (60.9 ± 0.3 vs. 42.2 ± 0.2 kg); dietary moisture (3,401 ± 92 vs. 2,759 ± 49 g/day); and dietary sodium (4,171 ± 85 vs. 2,959 ± 50) were greater in men than in women (p < .05). Men and women in the fifth quintiles of BMI or LBM (vs. Quintile 1) had greater odds (2.00–3.68, p < .05) of elevated USG. (The only exception was for the association between BMI and USG ≥ 1.025 in men.) Being in Quintile 4 of LBM or BMI (vs. Quintile 1) also tended to be associated with higher odds of elevated of USG, though this pattern was more consistent when using USG ≥ 1.020 than USG ≥ 1.025. In summary, BMI and LBM are associated with USG at the population level. These results affirm that USG depends on body size and composition and raise questions about using fixed USG thresholds for determining hypohydration, particularly for people in the upper quintiles of BMI and LBM.
Patrick B. Wilson
Psoriasis confers risk for cardiometabolic disorders. Cardiorespiratory fitness is inversely associated with risk of cardiometabolic disorders in other populations, but limited data have been published assessing cardiorespiratory fitness among individuals with psoriasis. This investigation aimed to: 1) assess cardiorespiratory fitness among individuals with psoriasis in the general population; and 2) compare levels to individuals without psoriasis.
A secondary data analysis from the 2003–2004 National Health and Nutritional Examination Survey was performed. Cardiorespiratory fitness was assessed with a treadmill test, while measures of psoriasis severity included rating of psoriasis as a life problem and body surface area involvement.
Twenty-six of 1093 participants reported a psoriasis diagnosis (population weighted prevalence 2.9%). Individuals with psoriasis had lower cardiorespiratory fitness compared with individuals without psoriasis (36.2 vs. 39.1 mL∙kg-1∙min-1, P = .009). No differences in self-reported or accelerometer physical activity were found by psoriasis diagnosis. Cardiorespiratory fitness was not significantly lower in those reporting high life impairment or body surface area involvement.
Cardiorespiratory fitness may be lower in individuals with psoriasis and these differences may not be explained by self-reported disease severity measures or physical activity. Future studies should examine whether validated measures of psoriasis severity predict lower cardiorespiratory fitness.
Jaison L. Wynne and Patrick B. Wilson
Beer is used to socialize postexercise, celebrate sport victory, and commiserate postdefeat. Rich in polyphenols, beer has antioxidant effects when consumed in moderation, but its alcohol content may confer some negative effects. Despite beer’s popularity, no review has explored its effects on exercise performance, recovery, and adaptation. Thus, a systematic literature search of three databases (PubMed, SPORTDiscus, and Web of Science) was conducted by two reviewers. The search resulted in 16 studies that were appraised and reviewed. The mean PEDro score was 5.1. When individuals are looking to rehydrate postexercise, a low-alcohol beer (<4%) may be more effective. If choosing a beer higher in alcoholic content (>4%), it is advised to pair this with a nonalcoholic option to limit diuresis, particularly when relatively large volumes of fluid (>700 ml) are consumed. Adding Na+ to alcoholic beer may improve rehydration by decreasing fluid losses, but palatability may decrease. These conclusions are largely based on studies that standardized beverage volume, and the results may not apply equally to situations where people ingest fluids and food ad libitum. Ingesting nonalcoholic, polyphenol-rich beer could be an effective strategy for preventing respiratory infections during heavy training. If consumed in moderation, body composition and strength qualities seem largely unaffected by beer. Mixed results that limit sweeping conclusions are owed to variations in study design (i.e., hydration and exercise protocols). Future research should incorporate exercise protocols with higher ecological validity, recruit more women, prioritize chronic study designs, and use ad libitum fluid replacement protocols for more robust conclusions.
Patrick B. Wilson and Leilani A. Madrigal
Omega-3 polyunsaturated fatty acids (PUFAs) have important physiological functions and may offer select benefits for athletic performance and recovery. The purpose of this investigation was to assess dietary and whole blood omega-3 PUFAs among collegiate athletes. In addition, a brief questionnaire was evaluated as a valid tool for quantifying omega-3 PUFA intake. Fifty-eight athletes (9 males, 49 females) completed a 21-item questionnaire developed to assess omega-3 PUFA intake and provided dried whole blood samples to quantify α-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and the HS-Omega-3 Index. Geometric means (95% confidence intervals) for the HS-Omega-3 Index were 4.79% (4.37–5.25%) and 4.75% (4.50–5.01%) for males and females, respectively. Median dietary intakes of ALA, EPA, and DHA were all below 100 mg. Among females, several dietary omega-3 PUFA variables were positively associated with whole blood EPA, with total EPA (rho = 0.67, p < .001) and total DHA (rho = 0.69, p < .001) intakes showing the strongest correlations. Whole blood DHA among females showed positive associations with dietary intakes, with total EPA (rho = 0.62, p < .001) and total DHA (rho = 0.64, p < .001) intakes demonstrating the strongest correlations. The HS-Omega-3 Index in females was positively correlated with all dietary variables except ALA. Among males, the only significant correlation was between food and whole blood EPA (rho = 0.83, p < .01). Collegiate athletes had relatively low intakes of omega-3 PUFAs. A 21-item questionnaire may be useful for screening female athletes for poor omega-3 PUFA status.
Leilani A. Madrigal and Patrick B. Wilson
This study assessed the hormonal and psychological responses to a free-throw shooting competition in twelve NCAA Division I female collegiate basketball players. Salivary cortisol, alpha-amylase, and testosterone were collected before and after the competition, in addition to a self-reported measure of anxiety. Using nonparametric statistics, cortisol (Z = –3.06, p = .002) and testosterone (Z = –2.67, p = .008) levels were significantly higher precompetition compared with postcompetition. There were no statistically significant differences between winners and losers for anxiety or hormone responses. Concentration disruption (rho = .63, p = .03) and total competitive anxiety (rho = .68, p = .02) were positively correlated with precompetition cortisol. Concentration disruption also correlated positively with postcompetition cortisol (rho = .62 p = .03) and postcompetition testosterone (rho = .64, p = .03). Future studies are needed to examine the psychological and physiological stress responses of basketball players during different competition tasks.
Patrick B. Wilson, Stacy J. Ingraham, Chris Lundstrom, and Gregory Rhodes
The effects of dietary factors such as carbohydrate (CHO) on endurance-running performance have been extensively studied under laboratory-based and simulated field conditions. Evidence from “reallife” events, however, is poorly characterized. The purpose of this observational study was to examine the associations between prerace and in-race nutrition tendencies and performance in a sample of novice marathoners.
Forty-six college students (36 women and 10 men) age 21.3 ± 3.3 yr recorded diet for 3 d before, the morning of, and during a 26.2-mile marathon. Anthropometric, physiological, and performance measurements were assessed before the marathon so the associations between diet and marathon time could be included as part of a stepwise-regression model.
Mean marathon time was 266 ± 42 min. A premarathon 2-mile time trial explained 73% of the variability in marathon time (adjusted R 2 = .73, p < .001). Day-before + morning-of CHO (DBMC) was the only other significant predictor of marathon time, explaining an additional 4% of the variability in marathon time (adjusted R 2 = .77, p = .006). Other factors such as age, body-mass index, gender, day-before + morning-of energy, and in-race CHO were not significant independent predictors of marathon time.
In this sample of primarily novice marathoners, DBMC intake was associated with faster marathon time, independent of other known predictors. These results suggest that novice and recreational marathoners should consider consuming a moderate to high amount of CHO in the 24–36 hr before a marathon.
Alex M. Ehlert, Hannah M. Twiddy, and Patrick B. Wilson
Caffeine ingestion can improve performance across a variety of exercise modalities but can also elicit negative side effects in some individuals. Thus, there is a growing interest in the use of caffeine mouth rinse solutions to improve sport and exercise performance while minimizing caffeine’s potentially adverse effects. Mouth rinse protocols involve swilling a solution within the oral cavity for a short time (e.g., 5–10 s) before expectorating it to avoid systemic absorption. This is believed to improve performance via activation of taste receptors and stimulation of the central nervous system. Although reviews of the literature indicate that carbohydrate mouth rinsing can improve exercise performance in some situations, there has been no attempt to systematically review the available literature on caffeine mouth rinsing and its effects on exercise performance. To fill this gap, a systematic literature search of three databases (PubMed, SPORTDiscus, and Web of Science) was conducted by two independent reviewers. The search resulted in 11 randomized crossover studies that were appraised and reviewed. Three studies found significant positive effects of caffeine mouth rinsing on exercise performance, whereas the remaining eight found no improvements or only suggestive benefits. The mixed results may be due to heterogeneity in the methods across studies, interindividual differences in bitter tasting, and differences in the concentrations of caffeine solutions. Future studies should evaluate how manipulating the concentration of caffeine solutions, habitual caffeine intake, and genetic modifiers of bitter taste influence the efficacy of caffeine mouth rinsing as an ergogenic strategy.