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Henningsen K, Mika A, Alcock R, Gaskell SK, Parr A, Rauch C, Russo I, Snipe RMJ, Costa RJS. The increase in core body temperature in response to exertional-heat stress can predict exercise-induced gastrointestinal syndrome. Temperature (Austin) 2023; 11:72-91. [PMID: 38577295 PMCID: PMC10989703 DOI: 10.1080/23328940.2023.2213625] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/09/2023] [Indexed: 04/06/2024] Open
Abstract
Utilizing metadata from existing exertional and exertional-heat stress studies, the study aimed to determine if the exercise-associated increase in core body temperature can predict the change in exercise-induced gastrointestinal syndrome (EIGS) biomarkers and exercise-associated gastrointestinal symptoms (Ex-GIS). Endurance-trained individuals completed 2 h of running exercise in temperate (21.2-30.0°C) to hot (35.0-37.2°C) ambient conditions (n = 132 trials). Blood samples were collected pre- and post-exercise to determine the change in gastrointestinal integrity biomarkers and systemic inflammatory cytokines. Physiological and thermoregulatory strain variables were assessed every 10-15 min during exercise. The strength of the linear relationship between maximal (M-Tre) and change (Δ Tre) in rectal temperature and EIGS variables was determined via Spearman's rank correlation coefficients. While the strength of prediction was determined via simple and multiple linear regression analyses dependent on screened EIGS and Ex-GIS confounding factors. Significant positive correlations between Tre maximum (M-Tre) and change (Δ Tre) with I-FABP (rs = 0.434, p < 0.001; and rs = 0.305, p < 0.001; respectively), sCD14 (rs = 0.358, p < 0.001; and rs = 0.362, p < 0.001), systemic inflammatory response profile (SIR-Profile) (p < 0.001), and total Ex-GIS (p < 0.05) were observed. M-Tre and Δ Tre significantly predicted (adjusted R2) magnitude of change in I-FABP (R2(2,123)=0.164, p < 0.001; and R2(2,119)=0.058, p = 0.011; respectively), sCD14 (R2(2,81)=0.249, p < 0.001; and R2(2,77)=0.214, p < 0.001), SIR-Profile (p < 0.001), and total Ex-GIS (p < 0.05). Strong to weak correlations were observed between M-Tre and Δ Tre with plasma concentrations of I-FABP, sCD14, SIR-Profile, and Ex-GIS in response to exercise. M-Tre and Δ Tre can predict the magnitude of these EIGS variables and Ex-GIS in response to exercise.
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Affiliation(s)
- Kayla Henningsen
- Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia
| | - Alice Mika
- Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia
| | - Rebekah Alcock
- Department of Dietetics and Human Nutrition, La Trobe University, Bundoora, Victoria, Australia
| | - Stephanie K. Gaskell
- Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia
| | - Alexandra Parr
- Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia
| | - Christopher Rauch
- Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia
| | - Isabela Russo
- Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia
| | - Rhiannon M. J. Snipe
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
| | - Ricardo J. S. Costa
- Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia
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2
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Zhang L, Tian G, Huang L, Zhou M, Zhu J, Yi L, Mi M. Pterostilbene attenuates intestinal epithelial barrier loss induced by high loading intensity of exercise. Front Nutr 2022; 9:965180. [PMID: 35990348 PMCID: PMC9386544 DOI: 10.3389/fnut.2022.965180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
Mounting evidence suggested that high loading intensity of exercise might be detrimental to human health, especially the gastrointestinal tract. Pterostilbene (PTE), derived from grapes and blueberries, might reach a high concentration of intestinal contents. Our study aimed to evaluate PTE’s ability to prevent the loss of intestinal epithelial barrier in high loading intensity of exercise. The exercise model was established by the forced running of mice. An effective HPLC-UV method was developed to quantify PTE concentration in intestinal content. The mRNA changes were detected by quantitative polymerase chain reaction (qPCR). The structure of intestinal flora was analyzed by 16S rRNA sequencing. The PTE (100 mg/kg/d) could significantly attenuate exercise-induced intestinal epithelial barrier loss. Moreover, the HPLC-UV assay showed that the PTE concentration of intestinal content could last 12 h. Furthermore, the exercise increased the abundance of Alistipes, which was related to lipopolysaccharide (LPS) production but could not be reversed by PTE intervention. Besides, cell experiments showed that PTE could promote the expression of intestinal epithelial tight junction (TJ) molecules in vitro. In conclusion, PTE has a significant interest in preventing exercise-induced intestinal damage.
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Affiliation(s)
- Lidong Zhang
- Chongqing Key Laboratory of Nutrition and Food Safety, Research Center for Nutrition and Food Safety, Chongqing Medical Nutrition Research Center, Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Guoliang Tian
- Chongqing Key Laboratory of Nutrition and Food Safety, Research Center for Nutrition and Food Safety, Chongqing Medical Nutrition Research Center, Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Li Huang
- Chongqing Key Laboratory of Nutrition and Food Safety, Research Center for Nutrition and Food Safety, Chongqing Medical Nutrition Research Center, Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Min Zhou
- Chongqing Key Laboratory of Nutrition and Food Safety, Research Center for Nutrition and Food Safety, Chongqing Medical Nutrition Research Center, Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jundong Zhu
- Chongqing Key Laboratory of Nutrition and Food Safety, Research Center for Nutrition and Food Safety, Chongqing Medical Nutrition Research Center, Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Long Yi
- Chongqing Key Laboratory of Nutrition and Food Safety, Research Center for Nutrition and Food Safety, Chongqing Medical Nutrition Research Center, Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Mantian Mi
- Chongqing Key Laboratory of Nutrition and Food Safety, Research Center for Nutrition and Food Safety, Chongqing Medical Nutrition Research Center, Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
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Ogden HB, Fallowfield JL, Child RB, Davison G, Fleming SC, Delves SK, Millyard A, Westwood CS, Layden JD. Acute L-Glutamine Supplementation does not improve Gastrointestinal Permeability, Injury or Microbial Translocation in Response to Exhaustive High Intensity Exertional-Heat Stress. Eur J Sport Sci 2021; 22:1865-1876. [PMID: 34726114 DOI: 10.1080/17461391.2021.2001575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PurposeExertional-heat stress adversely distrupts (GI) barrier integrity and, through subsequent microbial translocation (MT), can result in potentially fatal exertional-heat stroke. Acute glutamine (GLN) supplementation is a potential nutritional countermeasure, although the practical value of current supplementation regimens is questionable. Method: Ten males completed two high-intensity exertional-heat stress tests (EHST) involving running in the heat (40°C and 40% relative humidity) at lactate threshold to volitional exhaustion. Participants ingested GLN (0.3 g·kg·FFM-1) or a non-calorific placebo (PLA) one hour prior to the EHST. Venous blood was drawn pre-, post- and one-hour post-EHST. GI permeability was assessed using a serum dual-sugar absorption test (DSAT) and small intestinal epithelial injury using plasma Intestinal Fatty-Acid Binding Protein (I-FABP). MT was assessed using the Bacteroides/total 16S DNA ratio. Results: Volitional exhaustion occurred after 22:19 ± 2:22 (minutes: seconds) in both conditions, during which whole-body physiological responses and GI symptoms were not different (p ˃ 0.05). GI permeability (serum DSAT) was greater following GLN (0.043 ± 0.020) than PLA (0.034 ± 0.019) (p = 0.02; d = 0.47), but small intestine epithelial injury (I-FABP) increased comparably (p = 0.22; η2p = 0.16) following the EHST in both trials (GLN Δ = 1.25 ± 0.63 ng·ml-1; PLA Δ= 0.92 ± 0.44 ng·ml-1). GI MT (Bacteroides/total 16S DNA ratio) was unchanged in either condition following the EHST (p = 0.43). Conclusion: Acute low-dose (0.3 g·kg-1 fat free mass) GLN supplementation ingested one hour before high-intesity exertional-heat stress worsened GI permeability, but did not influence either small intestinal epithilial injury or microbial translocation.Highlights: The pathophysiology of exertional-heat stroke is widely hypothesised to be at least in part attributable to a systemic inflammatory response caused by the leak of gastrointestinal microbes into the circulating blood.Acute high-dose (0.9 g·kg·FFM-1) L-glutamine supplementation is widely promoted as a practical strategy to protect gastrointestinal barrier integrity during exertional-heat stress. However, previously validated doses are often poorly tolerated and cannot be recommended for widespread implementation.This study examined the efficacy of low-dose (0.30 g·kg·FFM-1; ∼20 grams) acute L-glutamine supplementation on small intestinal injury, permeability, and microbial translocation in response a high-intensity exertional-heat stress test to exhaustion (20 - 30 minutes). This type of exercise accounts for the majority of exertional-heat stroke cases in the military.Despite being universally well-tolerated across all participants, acute low-dose L-glutamine supplementation worsened gastrointestinal permeability, without influencing either small intestinal injury or microbial translocation. These findings do not support the application of low-dose L-glutamine supplementation to help prevent exertional-heat stroke.
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Affiliation(s)
- Henry B Ogden
- School of Sport, Health and Wellbeing, Plymouth MARJON University, Plymouth, United Kingdom
| | | | - Robert B Child
- School of Chemical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Glen Davison
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, United Kingdom
| | | | | | - Alison Millyard
- School of Sport, Health and Wellbeing, Plymouth MARJON University, Plymouth, United Kingdom
| | - Caroline S Westwood
- School of Sport, Health and Wellbeing, Plymouth MARJON University, Plymouth, United Kingdom
| | - Joseph D Layden
- School of Sport, Health and Wellbeing, Plymouth MARJON University, Plymouth, United Kingdom
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Gaskell SK, Rauch CE, Costa RJS. Gastrointestinal Assessment and Therapeutic Intervention for the Management of Exercise-Associated Gastrointestinal Symptoms: A Case Series Translational and Professional Practice Approach. Front Physiol 2021; 12:719142. [PMID: 34557109 PMCID: PMC8452991 DOI: 10.3389/fphys.2021.719142] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/05/2021] [Indexed: 12/31/2022] Open
Abstract
This translational research case series describes the implementation of a gastrointestinal assessment protocol during exercise (GastroAxEx) to inform individualised therapeutic intervention of endurance athletes affected by exercise-induced gastrointestinal syndrome (EIGS) and associated gastrointestinal symptoms (GIS). A four-phase approach was applied. Phase 1: Clinical assessment and exploring background history of exercise-associated gastrointestinal symptoms. Phase 2: Individual tailored GastroAxEx laboratory simulation designed to mirror exercise stress, highlighted in phase 1, that promotes EIGS and GIS during exercise. Phase 3: Individually programmed therapeutic intervention, based on the outcomes of Phase 2. Phase 4: Monitoring and readjustment of intervention based on outcomes from field testing under training and race conditions. Nine endurance athletes presenting with EIGS, and two control athletes not presenting with EIGS, completed Phase 2. Two athletes experienced significant thermoregulatory strain (peak core temperature attained > 40°C) during the GastroAxEx. Plasma cortisol increased substantially pre- to post-exercise in n = 6/7 (Δ > 500 nmol/L). Plasma I-FABP concentration increased substantially pre- to post-exercise in n = 2/8 (Δ > 1,000 pg/ml). No substantial change was observed in pre- to post-exercise for systemic endotoxin and inflammatory profiles in all athletes. Breath H2 responses showed that orocecal transit time (OCTT) was delayed in n = 5/9 (90-150 min post-exercise) athletes, with the remaining athletes (n = 4/9) showing no H2 turning point by 180 min post-exercise. Severe GIS during exercise was experienced in n = 5/9 athletes, of which n = 2/9 had to dramatically reduce work output or cease exercise. Based on each athlete's identified proposed causal factors of EIGS and GIS during exercise (i.e., n = 9/9 neuroendocrine-gastrointestinal pathway of EIGS), an individualised gastrointestinal therapeutic intervention was programmed and advised, adjusted from a standard EIGS prevention and management template that included established strategies with evidence of attenuating EIGS primary causal pathways, exacerbation factors, and GIS during exercise. All participants reported qualitative data on their progress, which included their previously presenting GIS during exercise, such as nausea and vomiting, either being eliminated or diminished resulting in work output improving (i.e., completing competition and/or not slowing down during training or competition as a result of GIS during exercise). These outcomes suggest GIS during exercise in endurance athletes are predominantly related to gastrointestinal functional and feeding tolerance issues, and not necessarily gastrointestinal integrity and/or systemic issues. GastroAxEx allows for informed identification of potential causal pathway(s) and exacerbation factor(s) of EIGS and GIS during exercise at an individual level, providing a valuable informed individualised therapeutic intervention approach.
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Affiliation(s)
| | | | - Ricardo J. S. Costa
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
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5
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Ribeiro FM, Petriz B, Marques G, Kamilla LH, Franco OL. Is There an Exercise-Intensity Threshold Capable of Avoiding the Leaky Gut? Front Nutr 2021; 8:627289. [PMID: 33763441 PMCID: PMC7982409 DOI: 10.3389/fnut.2021.627289] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 02/10/2021] [Indexed: 12/16/2022] Open
Abstract
Endurance-sport athletes have a high incidence of gastrointestinal disorders, compromising performance and impacting overall health status. An increase in several proinflammatory cytokines and proteins (LPS, I-FABP, IL-6, IL-1β, TNF-α, IFN-γ, C-reactive protein) has been observed in ultramarathoners and triathlon athletes. One of the most common effects of this type of physical activity is the increase in intestinal permeability, known as leaky gut. The intestinal mucosa's degradation can be identified and analyzed by a series of molecular biomarkers, including the lactulose/rhamnose ratio, occludin and claudin (tight junctions), lipopolysaccharides, and I-FABP. Identifying the molecular mechanisms involved in the induction of leaky gut by physical exercise can assist in the determination of safe exercise thresholds for the preservation of the gastrointestinal tract. It was recently shown that 60 min of vigorous endurance training at 70% of the maximum work capacity led to the characteristic responses of leaky gut. It is believed that other factors may contribute to this effect, such as altitude, environmental temperature, fluid restriction, age and trainability. On the other hand, moderate physical training and dietary interventions such as probiotics and prebiotics can improve intestinal health and gut microbiota composition. This review seeks to discuss the molecular mechanisms involved in the intestinal mucosa's adaptation and response to exercise and discuss the role of the intestinal microbiota in mitigating these effects.
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Affiliation(s)
- Filipe M Ribeiro
- Post-graduation Program in Physical Education, Catholic University of Brasilia, Brasilia, Brazil.,Center for Proteomic and Biochemical Analysis, Post-graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil.,Laboratory of Molecular Exercise Physiology, University Center - UDF, Brasilia, Brazil
| | - Bernardo Petriz
- Center for Proteomic and Biochemical Analysis, Post-graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil.,Laboratory of Molecular Exercise Physiology, University Center - UDF, Brasilia, Brazil.,Postgraduate Program in Health Promotion, University of Franca (Unifran), São Paulo, Brazil
| | - Gabriel Marques
- Laboratory of Molecular Exercise Physiology, University Center - UDF, Brasilia, Brazil
| | - Lima H Kamilla
- Center for Proteomic and Biochemical Analysis, Post-graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil
| | - Octavio L Franco
- Post-graduation Program in Physical Education, Catholic University of Brasilia, Brasilia, Brazil.,Center for Proteomic and Biochemical Analysis, Post-graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil.,S-Inova Biotech, Catholic University Dom Bosco, Biotechnology Program, Campo Grande, Brazil
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6
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Ogden HB, Fallowfield JL, Child RB, Davison G, Fleming SC, Edinburgh RM, Delves SK, Millyard A, Westwood CS, Layden JD. Reliability of gastrointestinal barrier integrity and microbial translocation biomarkers at rest and following exertional heat stress. Physiol Rep 2021; 8:e14374. [PMID: 32170836 PMCID: PMC7070100 DOI: 10.14814/phy2.14374] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/14/2020] [Accepted: 01/21/2020] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Exertional heat stress adversely distrupts (GI) barrier integrity and, through subsequent microbial translocation (MT), negativly impacts health. Despite widespread application, the temporal reliability of popular GI barrier integity and MT biomarkers is poorly characterised. METHOD Fourteen males completed two 80-min exertional heat stress tests (EHST) separated by 7-14 days. Venous blood was drawn pre, immediately- and 1-hr post both EHSTs. GI barrier integrity was assessed using the serum Dual-Sugar Absorption Test (DSAT), Intestinal Fatty-Acid-Binding Protein (I-FABP) and Claudin-3 (CLDN-3). MT was assessed using plasma Lipopolysaccharide Binding Protein (LBP), total 16S bacterial DNA and Bacteroides DNA. RESULTS No GI barrier integrity or MT biomarker, except absolute Bacteroides DNA, displayed systematic trial order bias (p ≥ .05). I-FABP (trial 1 = Δ 0.834 ± 0.445 ng ml-1 ; trial 2 = Δ 0.776 ± 0.489 ng ml-1 ) and CLDN-3 (trial 1 = Δ 0.317 ± 0.586 ng ml-1 ; trial 2 = Δ 0.371 ± 0.508 ng ml-1 ) were increased post-EHST (p ≤ .01). All MT biomarkers were unchanged post-EHST. Coefficient of variation and typical error of measurement post-EHST were: 11.5% and 0.004 (ratio) for the DSAT 90-min postprobe ingestion; 12.2% and 0.004 (ratio) at 150-min postprobe ingestion; 12.1% and 0.376 ng ml-1 for I-FABP; 4.9% and 0.342 ng ml-1 for CLDN-3; 9.2% and 0.420 µg ml-1 for LBP; 9.5% and 0.15 pg µl-1 for total 16S DNA; and 54.7% and 0.032 for Bacteroides/total 16S DNA ratio. CONCLUSION Each GI barrier integrity and MT translocation biomarker, except Bacteroides/total 16S ratio, had acceptable reliability at rest and postexertional heat stress.
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Affiliation(s)
- Henry B Ogden
- School of Sport, Health and Wellbeing, Plymouth MARJON University, Plymouth, United Kingdom
| | | | - Robert B Child
- School of Chemical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Glen Davison
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, United Kingdom
| | | | | | | | - Alison Millyard
- School of Sport, Health and Wellbeing, Plymouth MARJON University, Plymouth, United Kingdom
| | - Caroline S Westwood
- School of Sport, Health and Wellbeing, Plymouth MARJON University, Plymouth, United Kingdom
| | - Joseph D Layden
- School of Sport, Health and Wellbeing, Plymouth MARJON University, Plymouth, United Kingdom
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7
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Ogden HB, Child RB, Fallowfield JL, Delves SK, Westwood CS, Layden JD. The Gastrointestinal Exertional Heat Stroke Paradigm: Pathophysiology, Assessment, Severity, Aetiology and Nutritional Countermeasures. Nutrients 2020; 12:E537. [PMID: 32093001 PMCID: PMC7071449 DOI: 10.3390/nu12020537] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 12/12/2022] Open
Abstract
Exertional heat stroke (EHS) is a life-threatening medical condition involving thermoregulatory failure and is the most severe condition along a continuum of heat-related illnesses. Current EHS policy guidance principally advocates a thermoregulatory management approach, despite growing recognition that gastrointestinal (GI) microbial translocation contributes to disease pathophysiology. Contemporary research has focused to understand the relevance of GI barrier integrity and strategies to maintain it during periods of exertional-heat stress. GI barrier integrity can be assessed non-invasively using a variety of in vivo techniques, including active inert mixed-weight molecular probe recovery tests and passive biomarkers indicative of GI structural integrity loss or microbial translocation. Strenuous exercise is strongly characterised to disrupt GI barrier integrity, and aspects of this response correlate with the corresponding magnitude of thermal strain. The aetiology of GI barrier integrity loss following exertional-heat stress is poorly understood, though may directly relate to localised hyperthermia, splanchnic hypoperfusion-mediated ischemic injury, and neuroendocrine-immune alterations. Nutritional countermeasures to maintain GI barrier integrity following exertional-heat stress provide a promising approach to mitigate EHS. The focus of this review is to evaluate: (1) the GI paradigm of exertional heat stroke; (2) techniques to assess GI barrier integrity; (3) typical GI barrier integrity responses to exertional-heat stress; (4) the aetiology of GI barrier integrity loss following exertional-heat stress; and (5) nutritional countermeasures to maintain GI barrier integrity in response to exertional-heat stress.
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Affiliation(s)
- Henry B. Ogden
- Faculty of Sport, Health and Wellbeing, Plymouth MARJON University, Derriford Rd, Plymouth PL6 8BH, UK; (C.S.W.); (J.D.L.)
| | - Robert B. Child
- School of Chemical Engineering, University of Birmingham, Birmingham B15 2QU, UK;
| | | | - Simon K. Delves
- Institute of Naval Medicine, Alverstoke PO12 2DW, UK; (J.L.F.); (S.K.D.)
| | - Caroline S. Westwood
- Faculty of Sport, Health and Wellbeing, Plymouth MARJON University, Derriford Rd, Plymouth PL6 8BH, UK; (C.S.W.); (J.D.L.)
| | - Joseph D. Layden
- Faculty of Sport, Health and Wellbeing, Plymouth MARJON University, Derriford Rd, Plymouth PL6 8BH, UK; (C.S.W.); (J.D.L.)
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8
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Laitano O, Leon LR, Roberts WO, Sawka MN. Controversies in exertional heat stroke diagnosis, prevention, and treatment. J Appl Physiol (1985) 2019; 127:1338-1348. [DOI: 10.1152/japplphysiol.00452.2019] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
During the past several decades, the incidence of exertional heat stroke (EHS) has increased dramatically. Despite an improved understanding of this syndrome, numerous controversies still exist within the scientific and health professions regarding diagnosis, pathophysiology, risk factors, treatment, and return to physical activity. This review examines the following eight controversies: 1) reliance on core temperature for diagnosing and assessing severity of EHS; 2) hypothalamic damage induces heat stroke and this mediates “thermoregulatory failure” during the immediate recovery period; 3) EHS is a predictable condition primarily resulting from overwhelming heat stress; 4) heat-induced endotoxemia mediates systemic inflammatory response syndrome in all EHS cases; 5) nonsteroidal anti-inflammatory drugs for EHS prevention; 6) EHS shares similar mechanisms with malignant hyperthermia; 7) cooling to a specific body core temperature during treatment for EHS; and 8) return to physical activity based on physiological responses to a single-exercise heat tolerance test. In this review, we present and discuss the origins and the evidence for each controversy and propose next steps to resolve the misconception.
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Affiliation(s)
- Orlando Laitano
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Lisa R. Leon
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - William O. Roberts
- Department of Family Medicine and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota
| | - Michael N. Sawka
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia
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9
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Costa RJS, Gaskell SK, McCubbin AJ, Snipe RMJ. Exertional-heat stress-associated gastrointestinal perturbations during Olympic sports: Management strategies for athletes preparing and competing in the 2020 Tokyo Olympic Games. Temperature (Austin) 2019; 7:58-88. [PMID: 32166105 PMCID: PMC7053925 DOI: 10.1080/23328940.2019.1597676] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/05/2019] [Accepted: 03/14/2019] [Indexed: 12/15/2022] Open
Abstract
Exercise-induced gastrointestinal syndrome (EIGS) is a common characteristic of exercise. The causes appear to be multifactorial in origin, but stem primarily from splanchnic hypoperfusion and increased sympathetic drive. These primary causes can lead to secondary outcomes that include increased intestinal epithelial injury and gastrointestinal hyperpermeability, systemic endotoxemia, and responsive cytokinemia, and impaired gastrointestinal function (i.e. transit, digestion, and absorption). Impaired gastrointestinal integrity and functional responses may predispose individuals, engaged in strenuous exercise, to gastrointestinal symptoms (GIS), and health complications of clinical significance, both of which may have exercise performance implications. There is a growing body of evidence indicating heat exposure during exercise (i.e. exertional-heat stress) can substantially exacerbate these gastrointestinal perturbations, proportionally to the magnitude of exertional-heat stress, which is of major concern for athletes preparing for and competing in the upcoming 2020 Tokyo Olympic Games. To date, various hydration and nutritional strategies have been explored to prevent or ameliorate exertional-heat stress associated gastrointestinal perturbations. The aims of the current review are to comprehensively explore the impact of exertional-heat stress on markers of EIGS, examine the evidence for the prevention and (or) management of EIGS in relation to exertional-heat stress, and establish best-practice nutritional recommendations for counteracting EIGS and associated GIS in athletes preparing for and competing in Tokyo 2020.
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Affiliation(s)
- Ricardo J S Costa
- Monash University, Department of Nutrition Dietetics and Food, Notting Hill, Victoria, Australia
| | - Stephanie K Gaskell
- Monash University, Department of Nutrition Dietetics and Food, Notting Hill, Victoria, Australia
| | - Alan J McCubbin
- Monash University, Department of Nutrition Dietetics and Food, Notting Hill, Victoria, Australia
| | - Rhiannon M J Snipe
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Science, Burwood, Victoria, Australia
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10
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Keaney LC, Kilding AE, Merien F, Dulson DK. Keeping Athletes Healthy at the 2020 Tokyo Summer Games: Considerations and Illness Prevention Strategies. Front Physiol 2019; 10:426. [PMID: 31057419 PMCID: PMC6479135 DOI: 10.3389/fphys.2019.00426] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/27/2019] [Indexed: 12/23/2022] Open
Abstract
Keeping athletes healthy will be important for optimal athletic performance at the 2020 Tokyo Summer Olympic and Paralympic Games. Athletes will be exposed to several stressors during the preparatory and competition phases of the Summer Games that have the potential to depress immunity and increase illness risk. This mini-review provides an overview on effective and practical stressor-specific illness prevention strategies that can be implemented to maintain and protect the health of Olympic and Paralympic athletes.
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Affiliation(s)
- Lauren C Keaney
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Andrew E Kilding
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Fabrice Merien
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand.,AUT Roche Diagnostics Laboratory, Auckland University of Technology, Auckland, New Zealand
| | - Deborah K Dulson
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
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11
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Willmott AGB, Hayes M, James CA, Dekerle J, Gibson OR, Maxwell NS. Once- and twice-daily heat acclimation confer similar heat adaptations, inflammatory responses and exercise tolerance improvements. Physiol Rep 2018; 6:e13936. [PMID: 30575321 PMCID: PMC6302546 DOI: 10.14814/phy2.13936] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 11/29/2022] Open
Abstract
This experiment aimed to investigate the efficacy of twice-daily, nonconsecutive heat acclimation (TDHA) in comparison to once-daily heat acclimation (ODHA) and work matched once- or twice-daily temperate exercise (ODTEMP, TDTEMP) for inducing heat adaptations, improved exercise tolerance, and cytokine (immune) responses. Forty males, matched biophysically and for aerobic capacity, were assigned to ODHA, TDHA, ODTEMP, or TDTEMP. Participants completed a cycling-graded exercise test, heat acclimation state test, and a time to task failure (TTTF) at 80% peak power output in temperate (TTTFTEMP : 22°C/40% RH) and hot conditions (TTTFHOT : 38°C/20% RH), before and after 10-sessions (60 min of cycling at ~2 W·kg-1 ) in 45°C/20% RH (ODHA and TDHA) or 22°C/40% RH (ODTEMP or TDTEMP). Plasma IL-6, TNF-α, and cortisol were measured pre- and postsessions 1, 5, and 10. ODHA and TDHA induced equivalent heat adaptations (P < 0.05) (resting rectal temperature [-0.28 ± 0.22, -0.28 ± 0.19°C], heart rate [-10 ± 3, -10 ± 4 b·min-1 ], and plasma volume expansion [+10.1 ± 5.6, +8.5 ± 3.1%]) and improved heat acclimation state (sweat set point [-0.22 ± 0.18, -0.22 ± 0.14°C] and gain [+0.14 ± 0.10, +0.15 ± 0.07 g·sec-1 ·°C-1 ]). TTTFHOT increased (P < 0.001) following ODHA (+25 ± 4%) and TDHA (+24 ± 10%), but not ODTEMP (+5 ± 14%) or TDTEMP (+5 ± 17%). TTTFTEMP did not improve (P > 0.05) following ODHA (+14 ± 4%), TDHA (14 ± 8%), ODTEMP (9 ± 10%) or TDTEMP (8 ± 13%). Acute (P < 0.05) but no chronic (P > 0.05) increases were observed in IL-6, TNF-α, or cortisol during ODHA and TDHA, or ODTEMP and TDTEMP. Once- and twice-daily heat acclimation conferred similar magnitudes of heat adaptation and exercise tolerance improvements, without differentially altering immune function, thus nonconsecutive TDHA provides an effective, logistically flexible method of HA, benefitting individuals preparing for exercise-heat stress.
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Affiliation(s)
- Ashley G. B. Willmott
- Environmental Extremes LaboratoryUniversity of BrightonBrightonEastbourneUnited Kingdom
| | - Mark Hayes
- Environmental Extremes LaboratoryUniversity of BrightonBrightonEastbourneUnited Kingdom
| | - Carl A. James
- Environmental Extremes LaboratoryUniversity of BrightonBrightonEastbourneUnited Kingdom
- Institut Sukan Negara (National Sports Institute)National Sports ComplexKuala LumpurMalaysia
| | - Jeanne Dekerle
- Environmental Extremes LaboratoryUniversity of BrightonBrightonEastbourneUnited Kingdom
| | - Oliver R. Gibson
- Centre for Human Performance, Exercise and Rehabilitation (CHPER)Brunel University LondonUxbridgeUnited Kingdom
| | - Neil S. Maxwell
- Environmental Extremes LaboratoryUniversity of BrightonBrightonEastbourneUnited Kingdom
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12
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Pires W, Veneroso CE, Wanner SP, Pacheco DAS, Vaz GC, Amorim FT, Tonoli C, Soares DD, Coimbra CC. Association Between Exercise-Induced Hyperthermia and Intestinal Permeability: A Systematic Review. Sports Med 2018; 47:1389-1403. [PMID: 27943148 DOI: 10.1007/s40279-016-0654-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Prolonged and strenuous physical exercise increases intestinal permeability, allowing luminal endotoxins to translocate through the intestinal barrier and reach the bloodstream. When recognized by the immune system, these endotoxins trigger a systemic inflammatory response that may affect physical performance and, in severe cases, induce heat stroke. However, it remains to be elucidated whether there is a relationship between the magnitude of exercise-induced hyperthermia and changes in intestinal permeability. OBJECTIVE In this systematic review, we evaluated whether an exercise-induced increase in core body temperature (T Core) is associated with an exercise-induced increase in intestinal permeability. METHODS The present systematic review screened the MEDLINE/PubMed and Web of Science databases in September 2016, without any date restrictions. Sixteen studies that were performed in healthy participants, presented original data, and measured both the exercise-induced changes in T Core and intestinal permeability were selected. These studies assessed intestinal permeability through the measurement of sugar levels in the urine and measurement of intestinal fatty acid binding protein or lipopolysaccharide levels in the blood. RESULTS Exercise increased both T Core and intestinal permeability in most of the 16 studies. In addition, a positive and strong correlation was observed between the two parameters (r = 0.793; p < 0.001), and a T Core exceeding 39 °C was always associated with augmented permeability. CONCLUSION The magnitude of exercise-induced hyperthermia is directly associated with the increase in intestinal permeability.
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Affiliation(s)
- Washington Pires
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, 6627 Avenida Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil.,Department of Physical Education, Institute of Life Sciences, Universidade Federal de Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Christiano E Veneroso
- Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Samuel P Wanner
- Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Diogo A S Pacheco
- Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gisele C Vaz
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, 6627 Avenida Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Fabiano T Amorim
- Department of Physical Education, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.,Department of Health, Exercise Science and Sport, University of New Mexico, Albuquerque, New Mexico, USA
| | - Cajsa Tonoli
- Department of Human Physiology and Sports Medicine, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Danusa D Soares
- Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Cândido C Coimbra
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, 6627 Avenida Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil. .,Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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13
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Sheahen BL, Fell JW, Zadow EK, Hartley TF, Kitic CM. Intestinal damage following short-duration exercise at the same relative intensity is similar in temperate and hot environments. Appl Physiol Nutr Metab 2018; 43:1314-1320. [PMID: 29874478 DOI: 10.1139/apnm-2018-0057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increasing temperature and exercise disrupt tight junctions of the gastrointestinal tract although the contribution of environmental temperature to intestinal damage when exercising is unknown. This study investigated the effect of 2 different environmental temperatures on intestinal damage when exercising at the same relative intensity. Twelve men (mean ± SD; body mass, 81.98 ± 7.95 kg; height, 182.6 ± 7.4 cm) completed randomised cycling trials (45 min, 70% maximal oxygen uptake) in 30 °C/40% relative humidity (RH) and 20 °C/40%RH. A subset of participants (n = 5) also completed a seated passive trial (30 °C/40%RH). Rectal temperature and thermal sensation (TSS) were recorded during each trial and venous blood samples collected at pre- and post-trial for the analysis of intestinal fatty acid-binding protein (I-FABP) level as a marker of intestinal damage. Oxygen uptake was similar between 30 °C and 20 °C exercise trials, as intended (p = 0.94). I-FABP increased after exercise at 30 °C (pre-exercise: 585 ± 188 pg·mL-1; postexercise: 954 ± 411 pg·mL-1) and 20 °C (pre-exercise: 571 ± 175 pg·mL-1; postexercise: 852 ± 317 pg·mL-1) (p < 0.0001) but the magnitude of damage was similar between temperatures (p = 0.58). There was no significant increase in I-FABP concentration following passive heat exposure (p = 0.59). Rectal temperature increased during exercise trials (p < 0.001), but not the passive trial (p = 0.084). TSS increased more when exercising in 30 °C compared with 20 °C (p < 0.001). There was an increase in TSS during the passive heat trial (p = 0.03). Intestinal damage, as measured by I-FABP, following exercise in the heat was similar to when exercising in a cooler environment at the same relative intensity. Passive heat exposure did not increase I-FABP. It is suggested that when exercising in conditions of compensable heat stress, the increase in intestinal damage is predominantly attributable to the exercise component, rather than environmental conditions.
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Affiliation(s)
- Brodie L Sheahen
- Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania.,Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania
| | - James W Fell
- Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania.,Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania
| | - Emma K Zadow
- Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania.,Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania
| | - Thomas F Hartley
- Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania.,Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania
| | - Cecilia M Kitic
- Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania.,Sports Performance Optimisation Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Newnham, Launceston 7250, Tasmania
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14
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The effect of bovine colostrum supplementation on intestinal injury and circulating intestinal bacterial DNA following exercise in the heat. Eur J Nutr 2018; 58:1441-1451. [PMID: 29574607 PMCID: PMC6561991 DOI: 10.1007/s00394-018-1670-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/20/2018] [Indexed: 01/07/2023]
Abstract
Purpose Exercise-induced changes in intestinal permeability are exacerbated in the heat. The aim of this study was to determine the effect of 14 days of bovine colostrum (Col) supplementation on intestinal cell damage (plasma intestinal fatty acid-binding protein, I-FABP) and bacterial translocation (plasma bacterial DNA) following exercise in the heat. Methods In a double-blind, placebo-controlled, crossover design, 12 males completed two experimental arms (14 days of 20 g/day supplementation with Col or placebo, Plac) consisting of 60 min treadmill running at 70% maximal aerobic capacity (30 °C, 60% relative humidity). Blood samples were collected pre-exercise (Pre-Ex), post-exercise (Post-Ex) and 1 h post-exercise (1 h Post-Ex) to determine plasma I-FABP concentration, and bacterial DNA (for an abundant gut species, Bacteroides). Results Two-way repeated measures ANOVA revealed an arm × time interaction for I-FABP (P = 0.005, with greater Post-Ex increase in Plac than Col, P = 0.01: Plac 407 ± 194% of Pre-Ex vs Col, 311 ± 134%) and 1 h Post-Ex (P = 0.036: Plac 265 ± 80% of Pre-Ex vs Col, 229 ± 56%). There was no interaction (P = 0.904) but there was a main effect of arm (P = 0.046) for plasma Bacteroides/total bacterial DNA, with lower overall levels evident in Col. Conclusion This is the first investigation to demonstrate that Col can be effective at reducing intestinal injury following exercise in the heat, but exercise responses (temporal pattern) of bacterial DNA were not influenced by Col (although overall levels may be lower).
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15
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Nutrition and Supplementation Considerations to Limit Endotoxemia When Exercising in the Heat. Sports (Basel) 2018; 6:sports6010012. [PMID: 29910316 PMCID: PMC5969196 DOI: 10.3390/sports6010012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 02/07/2023] Open
Abstract
Exercise-induced heat production is further elevated by exercise performed in hot conditions and this can subsequently impact inflammation, and gastrointestinal (GI) health. Implementing nutrition and supplementation strategies under these conditions may support the hyperthermic response, the systemic inflammatory response, GI permeability and integrity, and exercise performance. Therefore, the aim of this brief review is to explore athletes' inflammatory response of two key biomarkers, lipopolysaccharide (LPS), and interleukin-6 (IL-6), and provide nutrition and supplementation recommendations when exercising in hot conditions. There is emerging evidence that probiotics, glutamine, and vitamin C can preserve GI integrity, which may improve performance during exercise in the heat. Glucose rich food when consumed with water, before and during exercise in the heat, also appear to limit endotoxemia, preserve GI integrity, and reduce the incidence of GI disturbances compared with water alone. The use of non-steroidal anti-inflammatory drugs (NSAIDs) may compromise GI integrity and this may result in greater leakage of endotoxins during long duration exercise in the heat. Further work is required to elucidate the impact of nutrition and supplementation strategies, in particular the use of NSAIDs, when exercising in the heat.
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16
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Kashima H, Harada N, Miyamoto K, Fujimoto M, Fujita C, Endo MY, Kobayashi T, Miura A, Fukuba Y. Timing of postexercise carbohydrate-protein supplementation: roles of gastrointestinal blood flow and mucosal cell damage on gastric emptying in humans. J Appl Physiol (1985) 2017; 123:606-613. [PMID: 28596270 DOI: 10.1152/japplphysiol.00247.2017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/01/2017] [Accepted: 06/07/2017] [Indexed: 01/25/2023] Open
Abstract
It is well known that protein ingestion immediately after exercise greatly stimulates muscle protein synthesis during the postexercise recovery phase. However, immediately after strenuous exercise, the gastrointestinal (GI) mucosa is frequently injured by hypoperfusion in the organ/tissue, possibly resulting in impaired GI function (e.g., gastric emptying; GE). The aim of this study was to examine the effect of GI blood flow on the GE rate. Eight healthy young subjects performed an intermittent supramaximal cycling exercise for 30 min, which consisted of a 120% V̇o2peak for 20 s, followed by 20 W for 40 s. The subjects ingested 300 ml of a nutrient drink containing carbohydrate-protein at either 5 min postexercise in one trial (PE-5) or 30 min postexercise in another trial (PE-30). In the control trial (Con), the subjects ingested the same drink without exercise. The celiac artery blood flow (CABF) and superior mesenteric artery blood flow (SMABF) and GE rate were assessed by ultrasonography. Before drink ingestion in PE-5, CABF significantly decreased from baseline, whereas in PE-30, it returned to baseline. Following drink ingestion in PE-5, CABF did not change from baseline, but it significantly increased in PE-30 and Con. SMABF increased significantly later in PE-5 than in PE-30 and Con. The GE rate was consistently slower in PE-5 than in PE-30 and Con. In conclusion, the CABF response after exercise seems to modulate the subsequent GE rate and SMABF response.NEW & NOTEWORTHY A carbohydrate-protein drink was ingested at either 5 min (i.e., profoundly decreased celiac artery blood flow; CABF) or 30 min (i.e., already recovered CABF) postexercise. In the 5-min postexercise trial, the gastric emptying (GE) rate and superior mesenteric artery blood flow (SMABF) response were slower than those in the 30-min postexercise trial. The GE rate and SMABF response may be altered depending on the postexercise CABF response.
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Affiliation(s)
- Hideaki Kashima
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Nao Harada
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Kanae Miyamoto
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Masaki Fujimoto
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Chiaki Fujita
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Masako Yamaoka Endo
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Toshio Kobayashi
- Department of Health Promotion and Development, Graduate School of Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akira Miura
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Yoshiyuki Fukuba
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
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17
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Pugh JN, Impey SG, Doran DA, Fleming SC, Morton JP, Close GL. Acute high-intensity interval running increases markers of gastrointestinal damage and permeability but not gastrointestinal symptoms. Appl Physiol Nutr Metab 2017; 42:941-947. [PMID: 28511020 DOI: 10.1139/apnm-2016-0646] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to investigate the effects of high-intensity interval running on markers of gastrointestinal (GI) damage and permeability alongside subjective symptoms of GI discomfort. Eleven male runners completed an acute bout of high-intensity interval training (HIIT) (eighteen 400-m runs at 120% maximal oxygen uptake) where markers of GI permeability, intestinal damage, and GI discomfort symptoms were assessed and compared with resting conditions. Compared with rest, HIIT significantly increased serum lactulose/rhamnose ratio (0.051 ± 0.016 vs. 0.031 ± 0.021, p = 0.0047; 95% confidence interval (CI) = 0.006 to 0.036) and sucrose concentrations (0.388 ± 0.217 vs. 0.137 ± 0.148 mg·L-1; p < 0.001; 95% CI = 0.152 to 0.350). In contrast, urinary lactulose/rhamnose (0.032 ± 0.005 vs. 0.030 ± 0.005; p = 0.3; 95% CI = -0.012 to 0.009) or sucrose concentrations (0.169% ± 0.168% vs. 0.123% ± 0.120%; p = 0.54; 95% CI = -0.199 to 0.108) did not differ between HIIT and resting conditions. Plasma intestinal-fatty acid binding protein (I-FABP) was significantly increased (p < 0.001) during and in the recovery period from HIIT whereas no changes were observed during rest. Mild symptoms of GI discomfort were reported immediately and at 24 h post-HIIT, although these symptoms did not correlate to GI permeability or I-FABP. In conclusion, acute HIIT increased GI permeability and intestinal I-FABP release, although these do not correlate with symptoms of GI discomfort. Furthermore, by using serum sampling, we provide data showing that it is possible to detect changes in intestinal permeability that is not observed using urinary sampling over a shorter time-period.
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Affiliation(s)
- Jamie N Pugh
- a Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Samuel G Impey
- a Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Dominic A Doran
- a Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
| | | | - James P Morton
- a Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Graeme L Close
- a Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
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18
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Sefton JM, McAdam JS, Pascoe DD, Lohse KR, Banda RL, Henault CB, Cherrington AR, Adams NE. Evaluation of 2 Heat-Mitigation Methods in Army Trainees. J Athl Train 2016; 51:936-945. [PMID: 27710091 DOI: 10.4085/1062-6050-51.10.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Heat injury is a significant threat to military trainees. Different methods of heat mitigation are in use across military units. Mist fans are 1 of several methods used in the hot and humid climate of Fort Benning, Georgia. OBJECTIVES To determine if (1) the mist fan or the cooling towel effectively lowered participant core temperature in the humid environment found at Fort Benning and (2) the mist fan or the cooling towel presented additional physiologic or safety benefits or detriments when used in this environment. DESIGN Randomized controlled clinical trial. SETTING Laboratory environmental chamber. PATIENTS OR OTHER PARTICIPANTS Thirty-five physically active men aged 19 to 35 years. INTERVENTION(S) (1) Mist fan, (2) commercial cooling towel, (3) passive-cooling (no intervention) control. All treatments lasted 20 minutes. Participants ran on a treadmill at 60% V̇o2max. MAIN OUTCOME MEASURE(S) Rectal core temperature, heart rate, thermal comfort, perceived temperature, perceived wetness, and blood pressure. RESULTS Average core temperature increased during 20 minutes of cooling (F1,28 = 64.76, P < .001, ηp2 = 0.70), regardless of group (F1,28 = 3.41, P = .08, ηp2 = 0.11) or condition (F1,28 < 1.0). Core temperature, heart rate, and blood pressure did not differ among the 3 conditions. Perceived temperature during 20 minutes of cooling decreased (F1,30 = 141.19, P < .001, ηp2 = 0.83) regardless of group or condition. Perceived temperature was lower with the mist-fan treatment than with the control treatment (F1,15 = 7.38, P = .02, ηp2 = 0.32). The mist-fan group perceived themselves to be cooler even at elevated core temperatures. CONCLUSIONS The mist fan and cooling towel were both ineffective at lowering core temperature. Core temperature continued to increase after exercise in all groups. The mist fan produced feelings of coolness while the core temperature remained elevated, possibly increasing the risk of heat illness.
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Affiliation(s)
- JoEllen M Sefton
- Warrior Research Center, School of Kinesiology, Auburn University, AL
| | - J S McAdam
- Warrior Research Center, School of Kinesiology, Auburn University, AL
| | - David D Pascoe
- Warrior Research Center, School of Kinesiology, Auburn University, AL
| | - K R Lohse
- Warrior Research Center, School of Kinesiology, Auburn University, AL
| | | | - Corbin B Henault
- Warrior Research Center, School of Kinesiology, Auburn University, AL
| | | | - N E Adams
- Warrior Research Center, School of Kinesiology, Auburn University, AL
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19
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Exercise as an Adjuvant Therapy for Hematopoietic Stem Cell Mobilization. Stem Cells Int 2016; 2016:7131359. [PMID: 27123008 PMCID: PMC4830735 DOI: 10.1155/2016/7131359] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/03/2016] [Accepted: 02/07/2016] [Indexed: 12/13/2022] Open
Abstract
Hematopoietic stem cell transplant (HSCT) using mobilized peripheral blood hematopoietic stem cells (HSPCs) is the only curative strategy for many patients suffering from hematological malignancies. HSPC collection protocols rely on pharmacological agents to mobilize HSPCs to peripheral blood. Limitations including variable donor responses and long dosing protocols merit further investigations into adjuvant therapies to enhance the efficiency of HSPCs collection. Exercise, a safe and feasible intervention in patients undergoing HSCT, has been previously shown to robustly stimulate HSPC mobilization from the bone marrow. Exercise-induced HSPC mobilization is transient limiting its current clinical potential. Thus, a deeper investigation of the mechanisms responsible for exercise-induced HSPC mobilization and the factors responsible for removal of HSPCs from circulation following exercise is warranted. The present review will describe current research on exercise and HSPC mobilization, outline the potential mechanisms responsible for exercise-induced HSPC mobilization, and highlight potential sites for HSPC homing following exercise. We also outline current barriers to the implementation of exercise as an adjuvant therapy for HSPC mobilization and suggest potential strategies to overcome these barriers.
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20
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Sessions J, Bourbeau K, Rosinski M, Szczygiel T, Nelson R, Sharma N, Zuhl M. Carbohydrate gel ingestion during running in the heat on markers of gastrointestinal distress. Eur J Sport Sci 2016; 16:1064-72. [DOI: 10.1080/17461391.2016.1140231] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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