Exercise-induced nausea is exaggerated by eating

Home-Based High-Intensity Interval Exercise Improves the Postprandial Glucose Response in Young Adults with Postprandial Hyperglycemia

Postprandial hyperglycemia can be corrected by exercise; however, the effect of home-based high-intensity interval exercise (HIIE), a new time-efficient exercise, on glycemic control is unclear. This study aimed to investigate the effect of home-based HIIE on postprandial hyperglycemia. Twelve young adult males (mean age: 24.3 ± 2.3 y) with postprandial hyperglycemia that had not yet led to diabetes completed home-based HIIE, moderate-intensity continuous exercise (MICE), and control conditions on separate days, randomly. The intervention began 30 min after the start of a standardized meal intake, with 11 min of HIIE completed at maximal effort in the home-based HIIE condition, 30 min of running performed at 50% maximum oxygen uptake in the MICE condition, or 30 min of sitting at rest completed in the control condition. The participants sat at rest after each intervention for up to 120 min. Interstitial fluid glucose concentrations were measured using a continuous glucose monitoring system that scanned every 15 min for up to 2 h after the meal. The glucose concentrations after the meal were significantly lower in the home-based HIIE and MICE conditions than in the control condition (p < 0.001). There were no significant differences in the glucose concentrations between the home-based HIIE and MICE conditions. In conclusion, home-based HIIE was able to correct postprandial hyperglycemia.

Gastrointestinal pathophysiology during endurance exercise: endocrine, microbiome, and nutritional influences

Gastrointestinal symptoms are abundant among athletes engaging in endurance exercise, particularly when exercising in increased environmental temperatures, at higher intensities, or over extremely long distances. It is currently thought that prolonged ischemia, mechanical damage to the epithelial lining, and loss of epithelial barrier integrity are likely contributors of gastrointestinal (GI) distress during bouts of endurance exercise, but due to the many potential causes and sporadic nature of symptoms this phenomenon has proven difficult to study. In this review, we cover known factors that contribute to GI distress symptoms in athletes during exercise, while further attempting to identify novel avenues of future research to help elucidate mechanisms leading to symptomology. We explore the link between the intestinal microbiome, the integrity of the gut epithelia, and add detail on gut hormone and peptide secretion that could potentially contribute to GI distress symptoms in athletes. The influence of nutrition and dietary supplementation strategies are also detailed, where much research has opened up new ideas and potential mechanisms for understanding gut pathophysiology during exercise. The etiology of gastrointestinal symptoms during endurance exercise is multi-factorial with neuroendocrine, microbial, and nutritional factors likely contributing to specific, individualized symptoms. Recent work in previously unexplored areas of both microbiome and gut peptide secretion are pertinent areas for future work, and the numerous supplementation strategies explored to date have provided insight into physiological mechanisms that may be targetable to reduce the incidence and severity of gastrointestinal symptoms in athletes.

Relationship between symptoms and both stage of change in adopting a healthy life style and quality of life in patients with liver cirrhosis: a cross-sectional study

BACKGROUND

Previous studies of patients with liver cirrhosis have not considered the broad range of symptoms or the association between healthy behavior and quality of life. The purposes of this study were to examine the association between symptoms and adopting exercise and consuming fruits and vegetables and to identify factors associated with quality of life in patients with liver cirrhosis.

METHODS

This cross-sectional study enrolled 91 consecutive patients with liver cirrhosis in one tertiary general hospital in South Korea between February 2016 and January 2017. Each study participant completed a self-administered questionnaire that measured symptom, stage of change in engaging in exercise and consumption of fruits and vegetables, and the Korean version of the 36-item Short-Form Health Survey. Multivariate ordinal logistic regression analysis and multiple regression models was used, respectively, to examine the association between each symptom with stage of change in engaging in exercise and consumption of fruits and vegetables and to evaluate factors affecting quality of life.

RESULTS

Experiencing nausea was associated with more readiness for change in engaging in exercise, but experiencing shortness of breath was associated with less readiness for change in engaging in exercise. Experiencing right upper quadrant pain was associated with more readiness for change in engaging in consumption of fruits and vegetables. Muscle cramps, anorexia, right upper quadrant pain and body pain, itching, ascites or edema, bruising, and change in appearance negatively affected quality of life.

CONCLUSIONS

The results suggest that the types of symptoms experienced by a patient with liver cirrhosis hinder or promote the patient's adoption of exercise and dietary behavior. Experiencing symptoms may negatively affect quality of life. Caregivers should provide supportive care to patients with liver cirrhosis, which includes assessing and managing symptoms to improve quality of life.

Prevalence and Determinants of Fasted Training in Endurance Athletes: A Survey Analysis

Athletes may choose to perform exercise in the overnight-fasted state for a variety of reasons related to convenience, gut comfort, or augmenting the training response, but it is unclear how many endurance athletes use this strategy. We investigated the prevalence and determinants of exercise performed in the overnight-fasted state among endurance athletes using an online survey and examined differences based on sex, competitive level, and habitual dietary pattern. The survey was completed by 1,950 endurance athletes (51.0% female, mean age 40.9 ± 11.1 years). The use of fasted training was reported by 62.9% of athletes, with significant effects of sex (p < .001, Cramer’s V [φc] = 0.18, 90% CI [0.14, 0.22]), competitive level (p < .001, φc = 0.09, 90% CI [0.5, 0.13]), and habitual dietary pattern noted (p < .001, φc = 0.26, 90% CI [0.22, 0.29]). Males, nonprofessional athletes, and athletes following a low-carbohydrate, high-fat diet were most likely to perform fasted training. The most common reasons for doing so were related to utilizing fat as a fuel source (42.9%), gut comfort (35.5%), and time constraints/convenience (31.4%), whereas the most common reasons athletes avoided fasted training were that it does not help their training (47.0%), performance was worse during fasted training (34.7%), or greater hunger (34.6%). Overall, some athletes perform fasted training because they think it helps their training, whereas others avoid it because they think it is detrimental to their training goals, highlighting a need for future research. These findings offer insights into the beliefs and practices related to fasted-state endurance training.

Role of lactic acidosis as a mediator of sprint-mediated nausea

This study aims to determine whether there is a relationship between nausea level and lactic acidosis during recovery from sprinting. In all, 13 recreationally active males completed a 60 s bout of maximal intensity cycling. Prior to and for 45 min following exercise, blood pH, pCO2 , and lactate levels were measured together with nausea. In response to sprinting, nausea, lactate, and H+ concentrations increased and remained elevated for at least 10 min (p < .001), whereas pCO2 increased only transiently (p < .001) before falling below pre-exercise levels (p < .001), with all these variables returning toward pre-exercise levels during recovery. Both measures of nausea adopted for analyses (nausea profile, NP; visual analogue scale, VAS), demonstrated significant repeated measures correlation (rmcorr) post-exercise between nausea and plasma lactate (VAS and NPrrm > 0.595, p < .0001) and H+ concentrations (VAS and NPrrm > 0.689, p < .0001), but an inconsistent relationship with pCO2 (VAS rrm  = 0.250, p = .040; NP rrm  = 0.144, p = .248) and bicarbonate levels (VAS rrm  = -0.252, p = .095; NP rrm  = -0.397, p = .008). Linear mixed modeling was used to predict the trajectory of nausea over time, with both lactate and H+ concentrations found to be key predictors of nausea (p < .0001). In conclusion, this study reveals a strong positive relationship between nausea and both H+ and lactate concentrations during recovery from sprinting, a finding consistent with H+ and lactate being potential mediators of nausea post-sprinting. However, as the timing of the recovery of both H+ and lactate was delayed, compared to that of nausea, further research is required to confirm these findings and investigate other potential mechanisms.

The role of IL-6 in exercise-induced anorexia in normal-weight boys

Our previous study showed that interleukin-6 (IL-6) is associated with suppression of appetite after high-intensity exercise (HIEX), but an independent role in food intake (FI) was not defined. We hypothesized that IL-6 suppresses appetite and FI, independently of appetite hormones, after HIEX in normal-weight (NW) boys. We investigated the effect of HIEX, with and without the inflammation inhibitor ibuprofen (IBU), on IL-6, other biomarkers of inflammation and appetite, FI, and ratings of appetite in NW boys. Fifteen NW boys (aged 13–18 years) were randomly assigned in a crossover design to 4 sessions: (i) water and rest, (ii) IBU and rest, (iii) water and HIEX, and (iv) IBU and HIEX. HIEX consisted of three 10-min bouts of exercise at 75% of maximal oxygen uptake with 90 s of active rest between bouts. IBU (300 mg) was given as a liquid suspension. FI, ratings of appetite, and plasma biomarkers of appetite, inflammation, stress, and glucose control were measured. FI was not affected by HIEX or IBU. Appetite increased over time (p = 0.002) but was lower after HIEX (p < 0.001) and not affected by IBU. HIEX, but not IBU, resulted in higher levels of IL-6 (p < 0.001) and cortisol (p < 0.001) and lower active ghrelin (p < 0.001). IL-6 correlated with active ghrelin (r = 0.37; p = 0.036) and cortisol (r = 0.26; p = 0.049). An independent role for IL-6 in appetite suppression was not supported. However, IL-6 was correlated with active ghrelin and cortisol, thus potentially mediating appetite via these interactions.

Decreased Appetite after High-Intensity Exercise Correlates with Increased Plasma Interleukin-6 in Normal-Weight and Overweight/Obese Boys

Background: High-intensity exercise (HIEX) suppresses appetite in adults and is thought to be mediated by appetite-regulating hormones. However, the effects of HIEX-induced inflammatory and stress biomarkers on appetite control and body weight have not been reported in children or adults. Objective: The objective of this study was to describe the effects of acute HIEX at 70% peak oxygen consumption (VO2peak) on postexercise appetite and selective biomarkers of inflammation, stress, and appetite regulatory hormones in normal-weight (NW) and in overweight/obese boys. Methods: NW (n = 11) and overweight/obese (n = 11) boys aged 10-18 y were randomly assigned in a crossover design to either rest or HIEX. Visual analog scale appetite ratings and plasma biomarkers of appetite, inflammation, stress, and glucose control were measured after HIEX or rest. Results: Appetite increased from baseline to 110 min (P < 0.001), but was lower after HIEX (P = 0.04), with no difference between body weight groups. HIEX also resulted in lower active ghrelin (P < 0.001) and increased interleukin-6 (IL-6; P < 0.001), tumor necrosis factor-α (P < 0.001), and cortisol (P < 0.001) concentrations, independent of body weight. It increased blood glucose (P = 0.002) and insulin (P = 0.028) concentrations in NW but not overweight and obese boys. Leptin, glucagon-like peptide 1, peptide tyrosine tyrosine, C-reactive protein, and cortisol were not affected by HIEX. An inverse correlation was found between IL-6 and appetite (r = -0.379; P = 0.012), but not any other biomarkers. Conclusions: HIEX resulted in reduced appetite that correlated with an increase in IL-6 in both NW and overweight/obese boys. However, although a role for IL-6 in the response can be suggested, the suppression of appetite was potentially mediated by the decrease in active ghrelin and/or increase in cortisol. This trial was registered at clinicaltrials.gov as NCT02619461.

Nutritional indicators for gastrointestinal symptoms in female runners: the 'Marikenloop study'

OBJECTIVES

Among runners the reported prevalence of exercise-induced gastrointestinal (GI) symptoms is high (25%-83%). We aimed to investigate the prevalence of GI symptoms in women during a 5-10 km run in general and to explore the association between nutritional intakes and GI symptoms.

SETTING

As part of the Marikenloop-study (a cohort study to identify predictor variables of running injuries), a cross-sectional questionnaire was distributed in interested runners of the '2013 Marikenloop'.

PARTICIPANTS

433 female runners filled in the questionnaire.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was the frequency of running-related GI symptoms during running in general and during the last (training) run. Furthermore, dietary intake was determined before and during this run. Secondary outcome measures were several demographic and anthropometric variables.

RESULTS

During running in general, 40% of the participants suffered from GI symptoms and during their last run, 49%. The GI symptoms side ache, flatulence, urge to defecate and regurgitation and/or belching were most commonly reported. Lower age (OR=0.98, 95% CI 0.96 to 1.00), minor running experience (OR=3.1, 95% CI 1.7 to 5.7), higher body mass index (OR=1.1, 95% CI 1.0 to 1.2), consuming carbohydrate-containing drinks during running (OR=10.5, 95% CI 1.4 to 80.3) and experiencing GI symptoms during running in general OR=5.0, 95% CI 3.2 to 7.8) significantly contributed to GI symptoms during the last run in the logistic regression analysis. In contrast, time of eating and carbohydrate-containing drinks consumed prior to the run were not related to GI symptoms.

CONCLUSIONS

In conclusion, the current study confirms the high prevalence of GI symptoms in female runners. Several predictor variables contributed to the GI symptoms but more research is needed to specify the effects of prerunning eating and carbohydrate-containing drinks on GI symptoms during running.

TRIAL REGISTRATION NUMBER

Marikenloop study 2013: 50-50310-98-156 (ZonMw).

Pre-bout standing body sway differs between adult boxers who do and do not report post-bout motion sickness

Background

Motion sickness is characterized by subjective symptoms that include dizziness and nausea. Studies have shown that subjective symptoms of motion sickness are preceded by differences in standing body sway between those who experience the symptoms and those who are not. Boxers often report dizziness and nausea immediately after bouts. We predicted that pre-bout standing body sway would differ between boxers who experienced post-bout motion sickness and those who did not.

Methodology/Principal Findings

We collected data on standing body sway before bouts. During measurement of body sway participants performed two visual tasks. In addition, we varied stance width (the distance between the heels). Postural testing was conducted separately before and after participants' regular warm-up routines. After bouts, we collected self-reports of motion sickness incidence and symptoms. Results revealed that standing body sway was greater after warm-up than before warm-up, and that wider stance width was associated with reduced sway. Eight of 15 amateur boxers reported motion sickness after a bout. Two statistically significant interactions revealed that standing body sway before bouts differed between participants who reported post-bout motion sickness and those who did not.

Conclusions/Significance

The results suggest that susceptibility to motion sickness in boxers may be manifested in characteristic patterns of body sway. It may be possible to use pre-bout data on postural sway to predict susceptibility to post-bout motion sickness.

Efeitos do exercício físico sobre o trato gastrintestinal

O impacto do exercício sobre o trato gastrintestinal (TGI), apesar de pouco investigado, é uma área de grande interesse. O exercício aeróbio intenso e de longa duração pode provocar sintomas gastrintestinais. Estes podem ser divididos em sintomas superiores (vômitos, náuseas e pirose retroesternal - azia) e inferiores (diarréia, cólica abdominal, perda de apetite, sangramento, aceleração dos movimentos intestinais e vontade de defecar). A etiologia desses sintomas durante o exercício é multifatorial e inclui a redução do fluxo sanguíneo intestinal, a liberação de hormônios gastrintestinais, o estresse mecânico sobre o TGI, a desidratação, os fatores psicológicos, a idade, o sexo, a dieta e o nível de treinamento do indivíduo. Por outro lado, o exercício de baixa intensidade tem efeito protetor sobre o TGI, principalmente com relação à predisposição a certas doenças como o câncer de cólon, a diverticulite, a colelitíase e a constipação. Diversos mecanismos são postulados para explicar os efeitos do exercício sobre o TGI, contribuindo para o desenvolvimento de estratégias terapêuticas no tratamento de indivíduos com sintomas e doenças gastrintestinais.