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Andy J. King, Joshua T. Rowe and Louise M. Burke

 = carbohydrate. To be eligible for this review, studies were required to have investigated a CHO hydrogel compound during prolonged, endurance exercise defined as continuous running, cycling, triathlon, rowing, swimming, and cross-country skiing greater than 1-hr duration. Studies with exercise durations lasting

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Jason T. Penry and Melinda M. Manore

Choline plays a central role in many physiological pathways, including neurotransmitter synthesis (acetylcholine), cell-membrane signaling (phospholipids), lipid transport (lipoproteins), and methyl-group metabolism (homocysteine reduction). Endurance exercise might stress several of these pathways, increasing the demand for choline as a metabolic substrate. This review examines the current literature linking endurance exercise and choline demand in the human body. Also reviewed are the mechanisms by which exercise might affect blood choline levels, and the links between methyl metabolism and the availability of free choline are highlighted. Finally, the ability of oral choline supplements to augment endurance performance is assessed. Most individuals consume adequate amounts of choline, although there is evidence that current recommendations might be insufficient for some adult men. Only strenuous and prolonged physical activity appears sufficient to significantly decrease circulating choline stores. Moreover, oral choline supplementation might only increase endurance performance in activities that reduce circulating choline levels below normal.

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Stefan M. Pasiakos, Holly L. McClung, James P. McClung, Maria L. Urso, Matthew A. Pikosky, Gregory J. Cloutier, Roger A. Fielding and Andrew J. Young

This study examined alterations in skeletal-muscle growth and atrophy-related molecular events after a single bout of moderate-intensity endurance exercise. Muscle biopsies were obtained from 10 men (23 ± 1 yr, body mass 80 ± 2 kg, and VO2peak 45 ± 1 ml · kg−1 · min−1) immediately (0 hr) and 3 hr after a 60-min bout of cycle exercise (60% ± 5% VO2peak). Corresponding muscle biopsies were also obtained under resting conditions. The phosphorylation status of insulin/IGF-PI3K molecular-signaling proteins, ubiquitin-proteasome-related gene expression, FOXO transcription factors, and myogenic regulatory factors in muscle samples was analyzed using multiplex analysis, Western blotting, and quantitative real-time polymerase chain reaction (qRT-PCR). A condition–time interaction was observed for Akt phosphorylation (p < .05) with multiplexing. Regardless of endurance exercise, Akt phosphorylation decreased and ERK phosphorylation increased at 3 hr compared with 0 hr (p < .05). Levels of p70S6K phosphorylation were 110% greater (p < .05) at 3 hr than at 0 hr using Western blots. MuRF mRNA expression postexercise increased; levels were 4.7- and 5.7-fold greater (p < .05) at 0 hr and 3 hr, respectively, than at rest with qRT-PCR. Atrogin mRNA expression was up-regulated 3.2-fold 3 hr postexercise compared with rest. These findings demonstrate modest changes in the molecular responses to moderate endurance exercise in the absence of nutrition. This study provides the groundwork for future investigations designed to optimize the metabolic conditions necessary to positively influence the cellular mechanisms specific to skeletal-muscle protein turnover during recovery from endurance exercise.

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Katrien De Bock, Bert O. Eijnde, Monique Ramaekers and Peter Hespel


The purpose of this study was to investigate the effect of acute and 4-week Rhodiola rosea intake on physical capacity, muscle strength, speed of limb movement, reaction time, and attention.


PHASE I: A double blind placebo-controlled randomized study (n = 24) was performed, consisting of 2 sessions (2 days per session). Day 1: One hour after acute Rhodiola rosea intake (R, 200-mg Rhodiola rosea extract containing 3% rosavin + 1% salidroside plus 500 mg starch) or placebo (P, 700 mg starch) speed of limb movement (plate tapping test), aural and visual reaction time, and the ability to sustain attention (Fepsy Vigilance test) were assessed. Day 2: Following the same intake procedure as on day 1, maximal isometric knee-extension torque and endurance exercise capacity were tested. Following a 5-day washout period, the experimental procedure was repeated, with the treatment regimens being switched between groups (session 2). PHASE II: A double blind placebo-controlled study (n = 12) was performed. Subjects underwent sessions 3 and 4, identical to Phase I, separated by a 4-week R/P intake, during which subjects ingested 200 mg R/P per day.


PHASE I: Compared with P, acute R intake in Phase I increased 0 < -05) time to exhaustion from 16.8 ± 0.7 min to 17.2 ± 0.8 min. Accordingly, VO2peak (p < .05) and VCO2peak(p< .05) increased during R compared to P from 50.9 ± 1.8 ml • min-1 • kg−1 to 52.9 ± 2.7 ml • min-1 • kg"’ (VO2peak) and from 60.0 ± 2.3 ml • min-1 • kg-’ to 63.5 ± 2.7 ml • min-1 kg-1 (VCO2peak). Pulmonary ventilation (p = .07) tended to increase more during R than during P(P: 115.9±7.7L/min; R: 124.8 ± 7.7 L/min). All other parameters remained unchanged. PHASE II: Four-week R intake did not alter any of the variables measured.


Acute Rhodiola rosea intake can improve endurance exercise capacity in young healthy volunteers. This response was not altered by prior daily 4-week Rhodiola intake.

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Jeremy C. Young, Nicholas G. Dowell, Peter W. Watt, Naji Tabet and Jennifer M. Rusted

While there is evidence that age-related changes in cognitive performance and brain structure can be offset by increased exercise, little is known about the impact long-term high-effort endurance exercise has on these functions. In a cross-sectional design with 12-month follow-up, we recruited older adults engaging in high-effort endurance exercise over at least 20 years, and compared their cognitive performance and brain structure with a nonsedentary control group similar in age, sex, education, IQ, and lifestyle factors. Our findings showed no differences on measures of speed of processing, executive function, incidental memory, episodic memory, working memory, or visual search for older adults participating in long-term high-effort endurance exercise, when compared without confounds to nonsedentary peers. On tasks that engaged significant attentional control, subtle differences emerged. On indices of brain structure, long-term exercisers displayed higher white matter axial diffusivity than their age-matched peers, but this did not correlate with indices of cognitive performance.

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Bettina Mittendorfer and Samuel Klein

Endurance exercise increases the use of endogenous fuels to provide energy for working muscles. Elderly subjects oxidize more glucose and less fat during moderate intensity exercise. This shift in substrate use is presumably caused by age-related changes in skeletal muscle, including decreased skeletal muscle respiratory capacity, because adipose tissue lipolysis and plasma fatty acid availability are not rate limiting. Endurance training in elderly subjects increases muscle respiratory capacity, decreases glucose production and oxidation, and increases fat oxidation thereby correcting or compensating for the alterations in substrate oxidation associated with aging.

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Sharon L. Miller, Carl M. Maresh, Lawrence E. Armstrong, Cara B. Ebbeling, Shannon Lennon and Nancy R. Rodriguez

The interaction of substrates and hormones in response to ingestion of intact proteins during endurance exercise is unknown. This study characterized substrate and hormone responses to supplementation during endurance exercise. Nine male runners participated in 3 trials in which a non-fat (MILK), carbohydrate (CHO), or placebo (PLA) drink was consumed during a 2-hour treadmill >· run at 65% V̇O2max. Circulating levels of insulin, glucagon, epinephrine, norepi-nephrine, growth hormone, testosterone, and cortisol were measured. Plasma substrates included glucose, lactate, free fatty acids, and select amino acids. Except for insulin and cortisol, hormones increased with exercise. While post-exercise insulin concentrations declined similarly in all 3 trials, the glucagon increase was greatest following MILK consumption. CHO blunted the post-exercise increase in growth hormone compared to levels in MILK. Free fatty acids and plasma amino acids also were responsive to nutritional supplementation with both CHO and MILK attenuating the rise in free fatty acids compared to the increase observed in PLA. Correspondingly, respiratory exchange ratio increased during CHO. Essential amino acids increased significantly only after MILK and were either unchanged or decreased in CHO. PLA was characterized by a decrease in branched-chain amino acid concentrations. Modest nutritional supplementation in this study altered the endocrine response as well as substrate availability and utilization following and during an endurance run, respectively.

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Matthew Erlenbusch, Mark Haub, Kathy Munoz, Susan MacConnie and Belinda Stillwell

The purpose of this investigation was to clarify, via a meta-analysis, whether the literature favors a high-fat or a high-carbohydrate diet to yield superior endurance exercise performance. Twenty published trials were analyzed to compare exercise performance under different diets. The average effect size of −0.60 indicated that subjects following a high-carbohydrate diet exercised longer until exhaustion. The training status of subjects (trained vs. untrained) was significantly related to effect size (r = −0.576, P < 0.01) and effect sizes separated between trained and untrained subjects were −0.05 and −2.84 respectively. The test for homogeneity revealed significant heterogeneity among effect sizes (χ2 [19] = 43.30, P < 0.05), indicating all of the trials are not describing the same effect. Given this significant heterogeneity, a conclusive endorsement of a high-carbohydrate diet based on the literature is difficult to make. Highly dissimilar trial protocols are the primary reason for heterogeneity.

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Beau Kjerulf Greer, John L. Woodard, Jim P. White, Eric M. Arguello and Emily M. Haymes

The purpose of this study was to determine whether branched-chain amino acid (BCAA) supplementation attenuates indirect indicators of muscle damage during endurance exercise as compared with an isocaloric, carbohydrate (CHO) beverage or a noncaloric placebo (PLAC) beverage. Nine untrained men performed three 90-min cycling bouts at 55% VO2peak. Subjects, blinded to beverage selection, ingested a total of 200 kcal of energy via the CHO or BCAA beverage before and at 60 min of exercise, or they drank the PLAC beverage. Creatine kinase (CK), lactate dehydrogenase (LDH), isokinetic leg-extension and fexion torque, and muscle soreness were assessed before and immediately, 4 h, 24 h, and 48 h post exercise. The trials were separated by 8 wk. CK activities were significantly lower after the BCAA trial than in the PLAC trial at 4, 24, and 48 h post exercise, as well as lower than the CHO beverage at 24 h post exercise. CK was lower in the CHO trial at the 24- and 48-h time points than in the PLAC trial. LDH activities were lower in the BCAA trial at 4 h than in the PLAC trial. As compared with the CHO and PLAC trials, ratings of perceived soreness were lower at 24 h post exercise, and leg-fexion torque was higher at the 48-h time point after the BCAA trial. The present data suggest that BCAA supplementation attenuates muscle damage during prolonged endurance exercise in untrained college-age men. CHO ingestion attenuates CK activities at 24 and 48 h post exercise as compared with a placebo beverage.

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Richard B. Kreider, Gary W. Miller, Deborah Schenck, Charles W. Cortes, Victor Miriel, C. Thomas Somma, Pam Rowland, Caroll Turner and Dawn Hill

Six trained male cyclists and triathletes participated in a double blind study to determine the effects of phosphate loading on maximal and endurance exercise performance. Subjects ingested either 1 gm of tribasic sodium phosphate or a glucose placebo four times daily for 3 days prior to performing either an incremental maximal cycling test or a simulated 40-km time trial on a computerized race simulator. They continued the supplementation protocol for an additional day and then performed the remaining maximal or performance exercise test. Subjects observed a 17-day washout period between testing sessions and repeated the experiment with the alternate supplement regimen in identical fashion. Metabolic data were collected at 15-sec intervals while venous blood samples and 2D-echocardiographic data were collected during each stage of exercise during the maximal exercise test and at 8-km intervals during the 404cm time trial. Results indicate that phosphate loading attenuated anaerobic threshold, increased myocardial ejection fraction and fractional shortening, increased maximal oxidative capacity, and enhanced endurance performance in competitive cyclists and triathletes.