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Elizabeth L. Abbey and Janet Walberg Rankin

Purpose:

This study compared the effect of a honey-sweetened beverage with those of a commercial sports drink and a placebo on performance and inflammatory response to a 90-min soccer simulation.

Methods:

Ten experienced male soccer players randomly performed 3 trials (honey [H], sports drink [S], and placebo [P]), consuming the beverage before and during halftime for a total of 1.0 g/kg carbohydrate for H and S. Performance measures included 5 sets (T1–T5) of a high-intensity run and agility and ball-shooting tests followed by a final progressive shuttle-run (PSR) test to exhaustion. Blood samples were drawn pretest, posttest (B2), and 1 hr posttest (B3) for markers of inflammation, oxygen radical absorbance capacity (ORAC), and hormone response.

Results:

T2–T5 were significantly slower than T1 (p < .05), and a decrease in PSR time was observed from baseline (–22.9%) for all treatments. No significant effect of the interventions was observed for any performance measures. Plasma IL-1ra levels increased posttest for all treatments (65.5% S, 63.9% P, and 25.8% H), but H was significantly less than S at posttest and P at B3. Other cytokines and ORAC increased at B2 (548% IL-6, 514% IL-10, 15% ORAC) with no difference by treatment.

Conclusion:

Acute ingestion of honey and a carbohydrate sports drink before and during a soccer-simulation test did not improve performance, although honey attenuated a rise in IL-1ra. Ingestion of carbohydrate and/or antioxidant-containing beverages at frequencies typical of a regulation match may not be beneficial for trained soccer players.

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Jonathon L. Stickford, Timothy D. Mickleborough, Alyce D. Fly and Joel M. Stager

Purpose:

Conjugated linoleic acid (CLA) has been reported to modify the inflammatory response associated with allergic airway disease, primarily in animal models. To extend these observations to humans, the effect of short-term CLA supplementation on the severity of exercise-induced bronchoconstriction (EIB) was investigated in asthmatics.

Methods:

Six subjects with physician-diagnosed asthma and EIB began the study on their usual diet, to which was added 4.8 g CLA/d for 8 wk. Pulmonary-function tests were administered before and after eucapnic voluntary hyperventilation (EVH) challenge at the commencement (Week 0) and conclusion of the treatment period (Week 8). Pre- and 90 min post-EVH challenge, urine was assayed for the presence of cysteinyl leukotrienes (LT) C4−E4 and 9α,11β-prostaglandin (PG) F2.

Results:

Pre- to post- EVH forced expiratory volume in 1 s (FEV1) did not significantly differ (p > .05) from Week 8 to Week 0. The pre- to post-EVH decline in FEV1 at Week 8 (–29.6% ± 6.6%) was not significantly different (p > .05) from that at Week 0 (–32.0% ± 5.5%). Area under the curve of FEV1 plotted against time from zero to 60 min (AUC0–60) was unaltered at Week 8 (–931% ± 350% change per minute) compared with Week 0 (−1,090% ± 270% change per minute). CLA supplementation did not alter forced midexpiratory flow, forced vital capacity (FVC), or FEV1/FVC. In addition, post-EVH urinary LTC4–E4 and 9α,11β-PGF2 were unchanged after CLA supplementation.

Conclusion:

Daily supplementation of 4.8 g CLA for 8 wk does not attenuate airway inflammation or hyperpnea-induced bronchoconstriction in asthmatic individuals.

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Steven R. McAnulty, David C. Nieman, Lisa S. McAnulty, Worley S. Lynch, Fuxia Jin and Dru A. Henson

Consumption of plant flavonoids, antioxidants, and n-3 fatty acids is proposed to have many potential health benefits derived primarily through antioxidant and anti-inflammatory activities. This study examined the effects of 1,000 mg quercetin + 1,000 mg vitamin C (QC); 1,000 mg quercetin, 1,000 mg vitamin C, 400 mg isoquercetin, 30 mg epigallocatechin gallate, and 400 mg n-3 fatty acids (QFO); or placebo (P), taken each day for 2 wk before and during 3 d of cycling at 57% Wmax for 3 hr, on plasma antioxidant capacity (ferricreducing ability of plasma [FRAP], oxygen-radical absorbance capacity [ORAC]), plasma oxidative stress (F2-isoprostanes), and plasma quercetin and vitamin C levels. Thirty-nine athletes were recruited and randomized to QC, QFO, or P. Blood was collected at baseline, after 2 wk supplementation, immediately postexercise, and 14 hr postexercise. Statistical design used a 3 (groups) × 4 (times) repeated-measures ANOVA with post hoc analyses. Plasma quercetin was significantly elevated in QC and QFO compared with P. Plasma F2-isoprostanes, FRAP, and vitamin C were significantly elevated and ORAC significantly decreased immediately postexercise, but no difference was noted in the overall pattern of change. Post hoc analyses revealed that the QC and QFO groups did not exhibit a significant increase in F2-isoprostanes from baseline to immediately postexercise compared with P. This study indicates that combining flavonoids and antioxidants with n-3 fatty acids is effective in reducing the immediate postexercise increase in F2-isoprostanes. Moreover, this effect occurs independently of changes in plasma antioxidant capacity.

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Manuela Konrad, David C. Nieman, Dru A. Henson, Krista M. Kennerly, Fuxia Jin and Sandra J. Wallner-Liebmann

This study tested the acute anti-inflammatory and immune-modulating influence of a quercetin-based supplement consumed by endurance athletes 15 min before an intense 2-hr run. In this randomized, crossover study, 20 runners (11 men, 9 women, age 38.4 ± 2.1 yr) completed two 2-hr treadmill runs at 70% VO2max (3 wk apart). Subjects ingested either 4 quercetin-based chews (Q-chew) or placebo chews (PL) 15 min before the runs. The 4 Q-chews provided 1,000 mg quercetin, 120 mg epigallocatechin 3-gallate, 400 mg isoquercetin, 400 mg each eicosapentaenoic acid and docosahexaenoic acid, 1,000 mg vitamin C, and 40 mg niacinamide. Subjects provided blood samples 30 min before, immediately after, and 1 hr postexercise and were analyzed for plasma quercetin, total blood leukocytes (WBC), C-reactive protein (CRP), 9 cytokines (IL-6, TNFα, GM-CSF, IFNγ, IL-1β, IL-2, IL-8, IL-10, and IL-12p70), granulocyte (GR) and monocyte (MO) phagocytosis (PHAG), and oxidative-burst activity (OBA). Plasma quercetin increased from 80.0 ± 26.0 μg/L to 6,337 ± 414 μg/L immediately postexercise and 4,324 ± 310 μg/L 1 hr postexercise after ingestion of Q-chews, compared with no change in PL (p < .001). Exercise caused significant increases in, CRP, GM-CSF, IL-10, IL-1β, IL-2, IL-6, IL-8, TNFα, GR-PHAG, and MO-PHAG and decreases in GR-OBA and MO-OBA, but no differences in the pattern of change were measured between Q-chew and PL trials. Acute ingestion of Q-chews 15 min before heavy exertion caused a strong increase in plasma quercetin levels but did not counter postexercise inflammation or immune changes relative to placebo.

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Matthijs T.W. Veltmeijer, Dineke Veeneman, Coen C.C.W. Bongers, Mihai G. Netea, Jos W. van der Meer, Thijs M.H. Eijsvogels and Maria T.E. Hopman

Purpose:

Exercise increases core body temperature (T C) due to metabolic heat production. However, the exercise-induced release of inflammatory cytokines including interleukin-6 (IL-6) may also contribute to the rise in T C by increasing the hypothalamic temperature set point. This study investigated whether the exercise-induced increase in T C is partly caused by an altered hypothalamic temperature set point.

Methods:

Fifteen healthy, active men age 36 ± 14 y were recruited. Subjects performed submaximal treadmill exercise in 3 randomized test conditions: (1) 400 mg ibuprofen and 1000 mg acetaminophen (IBU/APAP), (2) 1000 mg acetaminophen (APAP), and (3) a control condition (CTRL). Acetaminophen and ibuprofen were used to block the effect of IL-6 at a central and peripheral level, respectively. T C, skin temperature, and heart rate were measured continuously during the submaximal exercise tests.

Results:

Baseline values of T C, skin temperature, and heart rate did not differ across conditions. Serum IL-6 concentrations increased in all 3 conditions. A significantly lower peak T C was observed in IBU/APAP (38.8°C ± 0.4°C) vs CTRL (39.2°C ± 0.5°C, P = .02) but not in APAP (38.9°C ± 0.4°C) vs CTRL. Similarly, a lower ΔT C was observed in IBU/APAP (1.7°C ± 0.3°C) vs CTRL (2.0°C ± 0.5°C, P < .02) but not in APAP (1.7°C ± 0.5°C) vs CTRL. No differences were observed in skin temperature and heart-rate responses across conditions.

Conclusions:

The combined administration of acetaminophen and ibuprofen resulted in an attenuated increase in T C during exercise compared with a CTRL. This observation suggests that a prostaglandin-E2-induced elevated hypothalamic temperature set point may contribute to the exercise-induced rise in T C.

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Joan Khoo, Subbiah Dhamodaran, Dan-Dan Chen, Siew-Yoon Yap, Richard Yuan-Tud Chen and Roger Ho-Heng Tian

The adipokines chemerin and adiponectin are reciprocally related in the pathogenesis of insulin resistance and inflammation in obesity. Weight loss increases adiponectin and reduces chemerin, insulin resistance, and inflammation, but the effects of caloric restriction and physical activity are difficult to separate in combined lifestyle modification. We compared effects of diet- or exercise-induced weight loss on chemerin, adiponectin, insulin resistance, and inflammation in obese men. Eighty abdominally obese Asian men (body mass index [BMI] ≥ 30 kg/m2, waist circumference [WC] ≥ 90 cm, mean age 42.6 years) were randomized to reduce daily intake by ~500 kilocalories (n = 40) or perform moderate-intensity aerobic and resistance exercise (200–300 min/week) (n = 40) to increase energy expenditure by a similar amount for 24 weeks. The diet and exercise groups had similar decreases in energy deficit (−456 ± 338 vs. −455 ± 315 kcal/day), weight (−3.6 ± 3.4 vs. −3.3 ± 4.6 kg), and WC (−3.4 ± 4.4 vs. −3.6 ± 3.2 cm). The exercise group demonstrated greater reductions in fat mass (−3.9 ± 3.5 vs. −2.7 ± 5.3 kg), serum chemerin (−9.7 ± 11.1 vs. −4.3 ± 12.4 ng/ml), the inflammatory marker high-sensitivity C-reactive protein (−2.11 ± 3.13 vs. −1.49 ± 3.08 mg/L), and insulin resistance as measured by homeostatic model assessment (−2.45 ± 1.88 vs. −1.38 ± 3.77). Serum adiponectin increased only in the exercise group. Exercise-induced fat mass loss was more effective than dieting for improving adipokine profile, insulin resistance, and systemic inflammation in obese men, underscoring metabolic benefits of increased physical activity.

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Shona L. Halson, Marc J. Quod, David T. Martin, Andrew S. Gardner, Tammie R. Ebert and Paul B. Laursen

Cold water immersion (CWI) has become a popular means of enhancing recovery from various forms of exercise. However, there is minimal scientific information on the physiological effects of CWI following cycling in the heat.

Purpose:

To examine the safety and acute thermoregulatory, cardiovascular, metabolic, endocrine, and inflammatory responses to CWI following cycling in the heat.

Methods:

Eleven male endurance trained cyclists completed two simulated ~40-min time trials at 34.3 ± 1.1°C. All subjects completed both a CWI trial (11.5°C for 60 s repeated three times) and a control condition (CONT; passive recovery in 24.2 ± 1.8°C) in a randomized cross-over design. Capillary blood samples were assayed for lactate, glucose, pH, and blood gases. Venous blood samples were assayed for catecholamines, cortisol, testosterone, creatine kinase, C-reactive protein, IL-6, and IGF-1 on 7 of the 11 subjects. Heart rate (HR), rectal (Tre), and skin temperatures (Tsk) were measured throughout recovery.

Results:

CWI elicited a significantly lower HR (CWI: Δ116 ± 9 bpm vs. CONT: Δ106 ± 4 bpm; P = .02), Tre (CWI: Δ1.99 ± 0.50°C vs. CONT: Δ1.49 ± 0.50°C; P = .01) and Tsk. However, all other measures were not significantly different between conditions. All participants subjectively reported enhanced sensations of recovery following CWI.

Conclusion:

CWI did not result in hypothermia and can be considered safe following high intensity cycling in the heat, using the above protocol. CWI significantly reduced heart rate and core temperature; however, all other metabolic and endocrine markers were not affected by CWI.

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Adam R. Jajtner, Jay R. Hoffman, Adam M. Gonzalez, Phillip R. Worts, Maren S. Fragala and Jeffrey R. Stout

Context:

Resistance training is a common form of exercise for competitive and recreational athletes. Enhancing recovery from resistance training may improve the muscle-remodeling processes, stimulating a faster return to peak performance.

Objective:

To examine the effects of 2 different recovery modalities, neuromuscular electrical stimulation (NMES) and cold-water immersion (CWI), on performance and biochemical and ultrasonographic measures.

Participants:

Thirty resistance-trained men (23.1 ± 2.9 y, 175.2 ± 7.1 cm, 82.1 ± 8.4 kg) were randomly assigned to NMES, CWI, or control (CON).

Design and Setting:

All participants completed a high-volume lower-body resistance-training workout on d 1 and returned to the human performance laboratory 24 (24H) and 48 h (48H) postexercise for follow-up testing.

Measures:

Blood samples were obtained preexercise (PRE) and immediately (IP), 30 min (30P), 24 h (24H), and 48 h (48H) post. Subjects were examined for performance changes in the squat exercise (total repetitions and average power per repetition), biomarkers of inflammation, and changes in cross-sectional area and echo intensity (EI) of the rectus femoris (RF) and vastus lateralis muscles.

Results:

No differences between groups were observed in the number of repetitions (P = .250; power: P = .663). Inferential-based analysis indicated that increases in C-reactive protein concentrations were likely increased by a greater magnitude after CWI compared with CON, while NMES possibly decreased more than CON from IP to 24H. Increases in interleukin-10 concentrations between IP and 30P were likely greater in CWI than NMES but not different from CON. Inferential-based analysis of RF EI indicated a likely decrease for CWI between IP and 48H. No other differences between groups were noted in any other muscle-architecture measures.

Conclusions:

Results indicated that CWI induced greater increases in pro- and anti-inflammatory markers, while decreasing RF EI, suggesting that CWI may be effective in enhancing short-term muscle recovery after high-volume bouts of resistance exercise.

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Michael F. Joseph, Kathryn Taft, Maria Moskwa and Craig R. Denegar

Study Design:

Systematic literature review.

Objective:

To assess the efficacy of deep friction massage (DFM) in the treatment of tendinopathy.

Context:

Anecdotal evidence supports the efficacy of DFM for the treatment of tendinopathy. An advanced understanding of the etiopathogenesis of tendinopathy and the resultant paradigm shift away from an active inflammatory model has taken place since the popularization of the DFM technique by Cyriax for the treatment of “tendinitis.” However, increasing mechanical load to the tendinopathic tissue, as well as reducing molecular cross-linking during the healing process via transverse massage, offers a plausible explanation for observed responses in light of the contemporary understanding of tendinopathy.

Evidence Acquisition:

The authors surveyed research articles in all languages by searching PubMed, Scopus, Pedro, CINAHL, PsycINFO, and the Cochrane Library using the terms deep friction massage, deep tissue massage, deep transverse massage, Cyriax, soft tissue mobilization, soft tissue mobilisation, cross friction massage, and transverse friction massage. They included 4 randomized comparison trials, 3 at the extensor carpi radialis brevis (ECRB) and 1 supraspinatus outlet tendinopathy; 2 nonrandomized comparison trials, both receiving DFM at the ECRB; and 3 prospective noncomparison trials—supraspinatus, ECRB, and Achilles tendons. Articles meeting inclusion criteria were assessed based on PEDro and Centre for Evidence-Based Medicine rating scales.

Results:

Nine studies met the inclusion criteria.

Evidence Synthesis:

The heterogeneity of dependent measures did not allow for meta-analysis.

Conclusion:

The varied locations, study designs, etiopathogenesis, and outcome tools used to examine the efficacy of DFM make a unified conclusion tenuous. There is some evidence of benefit at the elbow in combination with a Mills manipulation, as well as for supraspinatus tendinopathy in the presence of outlet impingement and along with joint mobilization. The examination of DFM as a single modality of treatment in comparison with other methods and control has not been undertaken, so its isolated efficacy has not been established. Excellent anecdotal evidence remains along with a rationale for its use that fits the current understanding of tendinopathy.

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Peter A. Hosick, Robert G. McMurray, A.C. Hackney, Claudio L. Battaglini, Terry P. Combs and Joanne S. Harrell

Reports suggest children with high aerobic fitness (VO2max; mL/kg/min) have healthier profiles of TNF-α and IL-6; however, research has not accounted for differences in adiposity between high-fit and low-fit individuals. Thus, this study examined differences in inflammatory markers of obese and normal weight children of different fitness levels, using two different VO2max units: per unit of fat free mass (VO2FFM) or total body mass (VO2kg). Children (n = 124; ages 8–12) were divided into four matched groups; normal weight high-fit (NH), normal weight low-fit (NL), obese high-fit (OH), and obese low-fit (OL). Height, weight, skinfolds, body mass index (BMI), and predicted VO2max were measured and a morning, fasting blood sample taken. IL-6 was elevated in the NL and OL groups compared with the NH group, as well as the OL group compared with the OH group. No differences were found in TNF-α. The relationship between IL-6 or TNF-α and the two units of predicted VO2max did not differ suggesting that either VO2FFM or VO2kg can be used to describe aerobic power when studying inflammation and exercise in youth. The relationship between IL-6 or TNF-α and predicted VO2max, whether expressed per mass or per fat-free mass was similar, suggesting that both can be used to describe aerobic power when studying inflammation and exercise in youth. Given the polar design of this study, this relationship should be confirmed including overweight subjects.