Salivary cortisol and testosterone responses to high-intensity cycling before and after an 11-day intensified training period

Is It Required to Abstain From Fluid Consumption in the 10 Min Before Collection of a Saliva Sample?

The noninvasive and reliable saliva collection method for stress-related endocrine biomarkers analysis has become common in field- and laboratory-based research in the last 15 years. Current guidelines recommend interrupting water consumption 10 min before saliva sampling to avoid inaccurate, diluted concentrations of the biomarkers being examined. However, the impact of saliva dilution on salivary cortisol and testosterone levels has not been examined yet. This was a randomized, crossover experiment. Fourteen active healthy males completed three separate cycle-bout trials, where a set volume of water (250 ml) was consumed 10, 5, or 1 min before saliva sampling. Saliva was collected pre-, post-, and 30 min postexercise. No differences were observed in resting samples in any of the trials (p < .05). However, salivary cortisol increased from pre- to postexercise in the 10 (+52%, p = 0.022) and 5-min trial (+36%, p = .005) only. Salivary testosterone also increased in 10 (+34%, p = .005), 5 (+37%, p < .001), and 1-min trials (+24%, p < .035). This study proposes that consuming water up to 1 min before providing a saliva sample will not dilute the sample, allowing for an accurate determination of salivary cortisol and testosterone concentration levels. Practically, the 10-min fluid abstinence required before saliva sampling in the previous guidelines could be reduced to 1 min; however, if examining the response of salivary cortisol to an exercise trail, a fluid abstinence of 5 min may be more appropriate. This conclusion will allow for less restriction on researchers and participants alike.

Plasma and salivary hormone responses to a 30-min exercise stress test in young, healthy, physically active females

Overreaching, a consequence of intensified training, is used by athletes to enhance performance. A blunted hormonal response to a 30-min interval exercise stress test (55/80) has been shown in males after intensified training, highlighting cortisol and testosterone as potential biomarkers of overreaching. Despite accounting for ~50% of the population, studies into hormonal responses to exercise in females are lacking. The menstrual cycle and oral contraceptives profoundly affect hormonal responses, necessitating separate investigations into the female response to the same exercise-stress test. On three separate visits, 13 females (6 oral contraceptive users, 7 eumenorrheic) completed a VO2max test, resting control trial, and 55/80 stress test. The 55/80 involves alternating between 1 min at 55% VO2max and 4 min at 80% VO2max. Blood and saliva were collected pre, post, and 30 min post-55/80, and at coinciding time points during the resting control trial. Plasma progesterone, estrogen, and plasma and salivary cortisol and testosterone were analyzed via ELISA. A significant elevation of salivary and plasma cortisol (~141% and ~87%, respectively, p < 0.001), salivary testosterone (~93%, p < 0.001), and plasma progesterone (~58%, p = 0.004) were evident from pre- to post-55/80. Plasma testosterone remained unchanged. Hormonal responses were attenuated in oral contraceptive users. The 55/80 induces hormonal elevations in females, similar in magnitude as males.

Stress is not so bad-cortisol level and psychological functioning after 8-week HIIT program during pregnancy: a randomized controlled trial

Background

Amid extensive pregnancy exercise research, the impact of High Intensity Interval Training (HIIT) on pregnant women's mental health is underexplored. Despite exercise benefits, it can trigger stress responses like elevated cortisol. This study fills the gap by investigating correlations between hair cortisol levels, mental health, and HIIT effects in pregnant women.

Methods

We conducted a randomized control trial among 38 Caucasian women in uncomplicated, singleton pregnancy (age 31.11 ± 4.03 years, 21.82 ± 4.30 week of gestation; mean ± SD). The experimental group comprised 22 women engaged in an 8-week high-intensity interval training program (HIIT). The comparative group consisted of 16 pregnant women undergoing an 8-week educational program (EDU). Before and after the interventions, all women were evaluated using the following tools: Hair cortisol level measurements, Beck Depression Inventory - II for depressive symptoms assessment, Childbirth Attitudes Questionnaire for childbirth fear measurement, 12-item Short Form Health Survey to gage health-related quality of life, International Physical Activity Questionnaire for physical activity level estimation, and a Progressive maximal exercise test to evaluate maternal exercise capacity.

Results

The key finding of our study reveals that women engaged in the HIIT intervention exhibited a distinct cortisol production pattern in contrast to the EDU group practicing standard moderate intensity physical activity. In the HIIT group, there was an increase in hair cortisol levels, while the EDU group showed a notable decrease. Remarkably, HIIT stimulated cortisol production without adversely impacting fear of childbirth and psychophysical condition during pregnancy. In fact, only the HIIT group showed a significant enhancement in mental health.

Conclusion

No links were discovered between hair cortisol levels and the severity of depressive symptoms, psychophysical well-being, or fear of childbirth. Hence, based on our research, employing cortisol levels during pregnancy as an indicator of negative stress or depression risk appears unwarranted.

Can salivary lactate be used as an anaerobic biomarker?

Background

Salivary lactate has been suggested as a non-invasive anaerobic biomarker in sports medicine for decades, yet has not been widely applied until now. This study aimed to explore possible issues related to its application and suggest directions for future method improvement.

Methods

A liquid chromatography-mass spectrometry (LC-MS) method for the determination of salivary lactate was developed, validated and applied on saliva samples collected from a group of professional sprinters (n = 20). The samples were collected via chewing a cotton ball for one minute and centrifuging it afterwards. The evaluation included variation with mouth rinse times, consistency at different sampling times, change after treadmill or cycle ergometer trainings, and association with blood lactate. Sample sizes were calculated prior to the study. One-way analysis of variance (ANOVA), intra-class correlation coefficients (ICC) and relative standard deviation (RSD) were used to evaluate data variances. Pearson correlation was applied to show correlation between salivary and blood lactate. Effect sizes and power were calculated following ANOVA and correlation analyses.

Results

The RSD of the LC-MS method was 19.70%. Salivary lactate concentration was affected by mouth rinse times before sampling (ANOVA p = 0.025, η ² = 0.40, 1 - β = 0.99, ICC = 0.23, mean RSD of four sampling = 55.30%), and stabilized after mouth rinsing for three times. The concentrations at resting state across three weeks were consistent at group level (ANOVA p = 0.57, η ² = 0.03, 1 - β = 0.20), but varied greatly individually (ICC = 0.22, mean RSD = 56.16%). Salivary lactate level significantly increased after treadmill and cycle ergometer trainings (ANOVA p = 0.0002, η ² = 0.46, 1 - β = 0.9999 and ANOVA p = 0.0019, η ² = 0.40, 1 - β = 0.9993, respectively), and displayed positive correlation with blood lactate concentration (r = 0.61, p = 0.0004, 1 - β = 0.9596). Significant difference between male and female participants was observed in none of the tests conducted in this study.

Discussion

Salivary lactate was found to be a potential anaerobic biomarker. However, reproducible methods for sample collection and analysis, as well as more knowledge on the secretion mechanism and pattern of salivary lactate are required to make it a practical anaerobic biomarker.

Lymphocyte and dendritic cell response to a period of intensified training in young healthy humans and rodents: A systematic review and meta-analysis

Background: Intensified training coupled with sufficient recovery is required to improve athletic performance. A stress-recovery imbalance can lead to negative states of overtraining. Hormonal alterations associated with intensified training, such as blunted cortisol, may impair the immune response. Cortisol promotes the maturation and migration of dendritic cells which subsequently stimulate the T cell response. However, there are currently no clear reliable biomarkers to highlight the overtraining syndrome. This systematic review and meta-analysis examined the effect of intensified training on immune cells. Outcomes from this could provide insight into whether these markers may be used as an indicator of negative states of overtraining. Methods: SPORTDiscus, PUBMED, Academic Search Complete, Scopus and Web of Science were searched until June 2022. Included articles reported on immune biomarkers relating to lymphocytes, dendritic cells, and cytokines before and after a period of intensified training, in humans and rodents, at rest and in response to exercise. Results: 164 full texts were screened for eligibility. Across 57 eligible studies, 16 immune biomarkers were assessed. 7 were assessed at rest and in response to a bout of exercise, and 9 assessed at rest only. Included lymphocyte markers were CD3⁺, CD4⁺ and CD8⁺ T cell count, NK cell count, NK Cytolytic activity, lymphocyte proliferation and CD4/CD8 ratio. Dendritic cell markers examined were CD80, CD86, and MHC II expression. Cytokines included IL-1β, IL-2, IL-10, TNF-α and IFN-γ. A period of intensified training significantly decreased resting total lymphocyte (d= -0.57, 95% CI -0.30) and CD8⁺ T cell counts (d= -0.37, 95% CI -0.04), and unstimulated plasma IL-1β levels (d= -0.63, 95% CI -0.17). Resting dendritic cell CD86 expression significantly increased (d = 2.18, 95% CI 4.07). All other biomarkers remained unchanged. Conclusion: Although some biomarkers alter after a period of intensified training, definitive immune biomarkers are limited. Specifically, due to low study numbers, further investigation into the dendritic cell response in human models is required.

Effects of Eccentric vs. Concentric Sports on Blood Muscular Damage Markers in Male Professional Players

Simple Summary

Muscle eccentric contractions produce a higher degree of damage compared to concentric contractions. However, during sport practice (training and competition), eccentric as well as concentric actions appear at different levels. The presence of muscle-specific proteins in circulation is indicative of damage. The present report compares three sport disciplines: cycling, mainly concentric, volleyball, mainly eccentric in the legs and concentric in the arms, and basketball, mainly eccentric. The aim was to analyze the pattern of muscular injury blood markers in professional players in two moments of the season: after a training period and after a competition period. Results show that after a training period, muscle damage blood markers are higher in basketball and volleyball players, as expected due to their dominant eccentric component. However, during competition, these markers are higher in cyclists as a result of frequent eccentric actions. Therefore, the component eccentric–concentric is not defined exclusively by the sport discipline. The moment of the season (training vs. competition) has to be considered as well. This information could help sport professional to planify more specific training programs, preparations for competition, as well as post-exercise recovery.

Abstract

Background: Repetitive eccentric contractions can lead to higher degree of damage compared to repetitive concentric contractions. However, this type of exercise does not reproduce the real situations during the season in competitive sport disciplines. Methods: We analyzed the pattern of muscle damage blood markers in male professionals from three disciplines: cycling (n = 18), mainly concentric, vs. basketball (n = 12) and volleyball (n = 14), both mainly eccentric. Circulating muscle markers were analyzed in two moments of the regular season: after a 20-day training (no competition) period (T1) and after a 20-day period of high demanding competition (T2). Results: Blood levels of creatine kinase and myoglobin (muscle markers) increased in all groups at T2 compared to T1 as a result of competition intensity. The lower increases were noticed in cyclists at the end of both periods. Testosterone levels decreased at T2 compared to T1 in all disciplines, with lower levels found in cyclists. However, cortisol plasma levels decreased in basketball and volleyball players at T2, but increased significantly in cyclists, suggesting a limited adaptation to the effort. Conclusions: The pattern of circulating muscle markers is different depending of the demanding efforts (training vs. competition) of each particular discipline.

Kinetic changes in sweat lactate following fatigue during constant workload exercise

It is useful to investigate various physiological responses induced by fatigue in athletes. Moreover, wearable noninvasive sensors, including sweat sensors, are compatible with fatigue evaluation because of their ease of use, and ability to measure repeatedly and continual data. This cross-sectional study aimed to clarify how sweat lactate elimination curves obtained during constant workload exercise changed following fatigue. Seventeen recreationally trained males (average age, 20.6 ± 0.8 years) completed two consecutive constant workload exercise tests (at 25% peak power) with rest intervals; the participants were encouraged to perform Test 1 until exhaustion and Test 2 only for 10 min. Subjective fatigue (numerical rating scale with face rating scale), sweat lactate, and sweat rate were measured for 10 min in each test. Subjective fatigue was compared using the Wilcoxon signed-rank test and time to each constant value between Tests 1 and 2 was compared using paired t-test. Subjective fatigue significantly increased during Test 2 compared with that during Test 1. After Test 1, the sweat lactate elimination curve demonstrated a leftward shift, as proved by the significantly sooner observation of the peak and constant values of sweat lactate (2, 3, and 4 μA) (p < 0.01). Our preliminary results suggest that the sweat lactate elimination curve is different in the fatigue state. Further research may provide insight in the application of this curve to the evaluation for fatigue.

The effect of different training modalities on resting hormonal level in active young males

The purpose of this study was to determine the changes in the resting level of serum cortisol, testosterone and T/C ratio in response to different training modalities and their variations. A secondary purpose was to identify if the various six weeks training programs are an effective way to improve physical fitness. 86 regularly active young males were assigned to one of six groups: Endurance constant running (ECR), Endurance interval running (EIR), Resistance training (RT), Explosive training (ET), Speed-endurance 50 m running (SER50) and Speed-endurance 150 m running (SER150) training. The resting levels of testosterone, cortisol and T/C ratio, as well as physical fitness, were measured. The ECR, EIR, and RT training program decreased COR level (P < 0.05). An increase of the T/C ratio was observed in the ECR and EIR group (P < 0.05). Except for SER50, each training program improved physical fitness. Our results suggest that endurance and resistance training modalities performed with a moderate to vigorous intensity may be a usable way to manage the resting cortisol level and enhance physical fitness in active young males.

Weekly Fluctuations in Salivary Hormone Responses and Their Relationships With Load and Well-Being in Semiprofessional, Male Basketball Players During a Congested In-Season Phase

PURPOSE

To assess weekly fluctuations in hormonal responses and their relationships with load and well-being during a congested in-season phase in basketball players.

METHODS

Ten semiprofessional, male basketball players were monitored during 4 congested in-season phase weeks consisting of 3 weekly matches. Salivary hormone variables (testosterone [T], cortisol [C], and T:C ratio) were measured weekly, and external load (PlayerLoad™ and PlayerLoad per minute), internal load session rating of perceived exertion, percentage of maximum heart rate (HR), summated HR zones, and well-being were assessed for each training session and match.

RESULTS

Significant (P < .05) moderate to large decreases in T were found in the third and fourth weeks compared with the first week. Nonsignificant moderate to large decreases in C were apparent in the last 2 weeks compared with previous weeks. Summated HR zones and perceived sleep significantly (P < .05) decreased in the fourth week compared with the first week; whereas, percentage of maximum HR significantly (P < .05) decreased in the fourth week compared with the second week. No significant relationships were found between weekly changes in hormonal responses and weekly changes in load and overall wellness.

CONCLUSIONS

A congested schedule during the in-season negatively impacted the hormonal responses of players, suggesting that T and C measurements may be useful to detect fluctuations in hormone balance in such scenarios. The nonsignificant relationships between weekly changes in hormonal responses and changes in load and well-being indicate that other factors might induce hormonal changes across congested periods in basketball players.

Polymorphonuclear leucocyte phagocytic function, γδ T-lymphocytes and testosterone as separate stress-responsive markers of prolonged, high-intensity training programs

Excessive exercise with limited recovery may lead to detrimental states of overreaching or the overtraining syndrome. Chronic maladaptation in endocrine and immune mechanisms occur with the incidence of these states. Exercise-induced cortisol and testosterone responses have been proposed as biomarkers of overreaching, with blunted responses following intensified-training periods. Yet, limited information on the effects of overreaching in immunity is available. Healthy individuals completed a 30-min running protocol (the RPE_TP) before and after a 12-day intensified-training period. Blood and saliva were collected before, after and 30min after RPE_TP at pre-training and post-training. Plasma and salivary cortisol and testosterone, leucocyte proliferation and polymorphonuclear leucocyte phagocytic activity were examined. Plasma and salivary cortisol were acutely unaffected pre-training (-14% and 0%, p ​> ​0.05) and post-training (-14% and +46%, p ​> ​0.05). Comparing pre-training with post-training, blunted responses were observed in plasma testosterone (43%-19%, p ​< ​0.05) and salivary testosterone (55%-24%, p ​> ​0.05). No acute or resting changes in total leucocyte counts or most leucocyte subsets occurred pre-training or post-training. Yet, a 194% acute elevation in γδ T-lymphocyte number occurred pre-training (p ​< ​0.05), and average resting concentrations were 174% higher post-training. Baseline phagocytic activity was 47% lower post-training (p ​< ​0.05). Intensified training was detrimental, significantly reducing phagocytic activity. Testosterone blunted post-training, indicating an excessive training-related hypothalamic-pituitary gonadal dysfunction. The γδ T-lymphocytes sensitivity to exercise was noted, rendering it as a potential stress-responsive cellular marker. The usefulness of the RPE_TP to track the onset of overreaching is proposed.

Acute effect of HIIT on testosterone and cortisol levels in healthy individuals: A systematic review and meta-analysis

To determine the acute effect of a single high-intensity interval training (HIIT) session on testosterone and cortisol levels in healthy individuals, a systematic search of studies was conducted in MEDLINE and Web of Science databases from inception to February 2020. Meta-analyses were performed to establish the acute effect of HIIT on testosterone and cortisol levels immediately after a single HIIT session; after 30 min and 60 min (primary outcomes); and after 120 min, 180 min, and 24 h (secondary outcomes, only for pre-post intervention groups). Potential effect-size modifiers were assessed by meta-regression analyses and analyses of variance. Study quality was assessed using the Cochrane's risk of bias tool and the Physiotherapy Evidence Database scale. The meta-analyses of 10 controlled studies (213 participants) and 50 pre-post intervention groups (677 participants) revealed a significant increase in testosterone immediately after a single HIIT session (d = 0.92 and 0.52, respectively), which disappeared after 30 min (d = 0.18 and -0.04), and returned to baseline values after 60 min (d = -0.37 and -0.16). Significant increases of cortisol were found immediately after (d = 2.17 and 0.64), after 30 min (d = 1.62 and 0.67) and 60 min (d = 1.32 and 0.27). Testosterone and cortisol levels decreased significantly after 120 min (d = -0.48 and -0.95, respectively) and 180 min (d = -0.29 and -1.08), and returned to baseline values after 24 h (d = 0.14 and -0.02). HIIT components and participant's characteristics seem to moderate the effect sizes. In conclusion, testosterone and cortisol increase immediately after a single HIIT session, then drop below baseline levels, and finally return to baseline values after 24 h. This meta-analysis provides a better understanding of the acute endocrine response to a single HIIT session, which would certainly be valuable for both clinicians and coaches in the prescription of exercise programs to improve health and performance. Testosterone and cortisol may be used as sensitive biomarkers to monitor the anabolic and catabolic response to HIIT.

Reliability of salivary cortisol and testosterone to a high-intensity cycling protocol to highlight overtraining

Athletes physically overload to improve performance. Unbalanced stress/recovery may induce overtraining, which is difficult to diagnosis as no diagnostic marker exists. Hormonal responses to a 55/80 cycle (30-min of alternating blocks of 1-min at 55% and 4-min at 80% maximum work rate) may highlight early-stage overtraining (overreaching), as blunted cortisol and testosterone responses to 55/80 follows intensified training. However, the reliability of hormonal responses to 55/80 when not overreached is unknown. Therefore, reported blunted hormonal responses could be due to inconsistent cortisol and testosterone responses to 55/80. Participants (n = 23) completed three 55/80 bouts, >7 days apart, with no exercise 24 h pre-trials. Pre-exercise urine osmolality and stress questionnaire responses were measured. Pre, post, and 30-min post-exercise saliva samples were collected for cortisol and testosterone assessment. Salivary cortisol and testosterone responses, osmolality and well-being were not different between trials. Salivary cortisol and testosterone elevated from pre- to post-exercise [by 4.2 nmol^.L^-1 (cortisol) and 307 pmol^.L^-1 (testosterone)], and 30 min post-exercise [by 160 pmol^.L^-1 (testosterone) only]. Intraclass correlation coefficients for pre to peak post-exercise cortisol (0.89; good) and testosterone (0.53; moderate) were calculated. This demonstrates that 55/80 induces reliable elevations of salivary cortisol and testosterone when in a healthy state.

Effects of Overtraining Status on the Cortisol Awakening Response-Endocrine and Metabolic Responses on Overtraining Syndrome (EROS-CAR)

The cortisol awakening response (CAR) is a distinct component of the circadian cortisol profile and has promise as a biomarker for the monitoring of athlete readiness and training status. Although some studies have suggested the CAR may be affected by the development of overtraining syndrome (OTS), this has yet to be systematically investigated.

PURPOSE

To compare the CAR and diurnal cortisol slope between athletes diagnosed with OTS, healthy athletes, and sedentary controls.

METHODS

This study was a secondary analysis of data from the Endocrine and Metabolic Responses on Overtraining study. Male participants were recruited to either OTS, healthy athlete, or sedentary control groups. The participants produced saliva samples immediately after waking (S1), 30 minutes after waking (S2), at 16:00 hours, and at 23:00 hours. Salivary cortisol concentration was determined by an electrochemiluminescence assay. Mixed-effects models were used to assess the conditional effect of group (sedentary controls, OTS, and healthy athletes) on the change in cortisol over time. Separate models were fit for the awakening samples (S1 and S2) and for the diurnal slope (linear change across S1, 16:00 h, and 23:00 h).

RESULTS

The models demonstrated significant time-by-group interaction for OTS for the 2 cortisol concentrations collected during the awakening period (β = -9.33, P < .001), but not for the diurnal cortisol slope (β = 0.02, P = .80).

CONCLUSIONS

These results suggest the CAR may be associated with OTS and should be considered within a panel of biomarkers. Further research is necessary to determine whether alterations in the CAR may precede the diagnosis of OTS.

The Effect of High-Intensity Exercise on Changes in Salivary and Serum Cortisol Proportion Dynamics

Typically, salivary cortisol is reported as 5–10% of total cortisol, but the stability of this proportion and the effect of exercise on the 24-h profile is unclear. Therefore, this study investigated the circadian rhythm of the proportion of serum cortisol represented by salivary cortisol, and the impact of acute high-intensity exercise. Recreationally trained males (n = 8, age = 25.7 ± 2.4 years, height = 174.7 ± 7.8 cm, mass = 69.8 ± 12.1 kg) completed two 24-h profiles (rest and exercise conditions) for serum (Q60) and salivary (Q120) cortisol. Exercise consisted of 5 × 30 s sprinting intervals on the cycle ergometer. Cortisol was assessed using commercially available assays. The proportion (Cprop) of serum cortisol (Cser) represented by salivary cortisol (Csal) was calculated as [Cprop = Csal/ Cser × 100]. Multilevel growth models tested for trends across the 24-h profile. The highest relation between Cser and Csal was observed at 08:00 AM (r = 0.90). The average Cprop was 5.95% and demonstrated a circadian profile characterized by a cubic model. Acute exercise did not alter Cser, Csal, or Cprop. Thus, the proportion of Cser represented by Csal changes across a 24-h period and should be accounted for if using salivary cortisol to reflect circadian output of cortisol.

Exercise-Induced Salivary Hormone Responses to High-Intensity, Self-Paced Running

PURPOSE

Physical overexertion can lead to detrimental overreaching states without sufficient recovery, which may be identifiable by blunted exercise-induced cortisol and testosterone responses. A running test (RPETP) elicits reproducible plasma cortisol and testosterone elevations (in a healthy state) and may detect blunted hormonal responses in overreached athletes. This current study determined the salivary cortisol and testosterone responses reproducibility to the RPETP, to provide greater practical validity using saliva compared with the previously utilized blood sampling. Second, the relationship between the salivary and plasma responses was assessed.

METHODS

A total of 23 active, healthy males completed the RPETP on 3 occasions. Saliva (N = 23) and plasma (N = 13) were collected preexercise, postexercise, and 30 minutes postexercise.

RESULTS

Salivary cortisol did not elevate in any RPETP trial, and reduced concentrations occurred 30 minutes postexercise (P = .029, η2 = .287); trial differences were observed (P < .001, η2 = .463). The RPETP elevated (P < .001, η2 = .593) salivary testosterone with no effect of trial (P = .789, η2 = .022). Intraindividual variability was 25% in cortisol and 17% in testosterone. "Fair" intraclass coefficients of .46 (cortisol) and .40 (testosterone) were found. Salivary and plasma cortisol positively correlated (R = .581, P = .037) yet did not for testosterone (R = .345, P = .248).

CONCLUSIONS

The reproducibility of salivary testosterone response to the RPETP is evident and supports its use as a potential tool, subject to further confirmatory work, to detect hormonal dysfunction during overreaching. Salivary cortisol responds inconsistently in a somewhat individualized manner to the RPETP.

The Interplay Between Plasma Hormonal Concentrations, Physical Fitness, Workload and Mood State Changes to Periods of Congested Match Play in Professional Soccer Players

Background

The regular assessment of hormonal and mood state parameters in professional soccer are proposed as good indicators during periods of intense training and/or competition to avoid overtraining.

Objective

The aim of this study was to analyze hormonal, psychological, workload and physical fitness parameters in elite soccer players in relation to changes in training and match exposure during a congested period of match play.

Methods

Sixteen elite soccer players from a team playing in the first Tunisian soccer league were evaluated three times (T1, T2, and T3) over 12 weeks. The non-congested period of match play was from T1 to T2, when the players played 6 games over 6 weeks. The congested period was from T2 to T3, when the players played 10 games over 6 weeks. From T1 to T3, players performed the Yo-Yo intermittent recovery test level 1 (YYIR1), the repeated shuttle sprint ability test (RSSA), the countermovement jump test (CMJ), and the squat jump test (SJ). Plasma Cortisol (C), Testosterone (T), and the T/C ratio were analyzed at T1, T2, and T3. Players had their mood dimensions (tension, depression, anger, vigor, fatigue, confusion, and a Total Mood Disturbance) assessed through the Profile of Mood State questionnaire (POMS). Training session rating of perceived exertion (sRPE) was also recorded on a daily basis in order to quantify internal training load and elements of monotony and strain.

Results

Significant performance declines (T1 < T2 < T3) were found for SJ performance (p = 0.04, effect size [ES] ES_1–2 = 0.15−0.06, ES_2–3 = 0.24) from T1 to T3. YYIR1 performance improved significantly from T1 to T2 and declined significantly from T2 to T3 (p = 0.001, ES_1–2 = 0.24, ES_2–3 = −2.54). Mean RSSA performance was significantly higher (p = 0.019, ES_1–2 = −0.47, ES_2–3 = 1.15) in T3 compared with T2 and T1. Best RSSA performance was significantly higher in T3 when compared with T2 and T1 (p = 0.006, ES_2–3 = 0.47, ES_1–2 = −0.56), but significantly lower in T2 when compared with to T1. T and T/C were significantly lower in T3 when compared with T2 and T1 (T: p = 0.03, ES_3–2 = −0.51, ES_3–1 = −0.51, T/C: p = 0.017, ES_3–2 = −1.1, ES_3–1 = −1.07). Significant decreases were found for the vigor scores in T3 when compared to T2 and T1 (p = 0.002, ES_1–2 = 0.31, ES_3–2 = −1.25). A significant increase was found in fatigue scores in T3 as compared to T1 and T2 (p = 0.002, ES_1–2 = 0.43, ES_2–3 = 0.81). A significant increase was found from T1 < T2 < T3 intension score (p = 0.002, ES_1–2 = 1.1, ES_2–3 = 0.2) and anger score (p = 0.03, ES_1–2 = 0.47, ES_2–3 = 0.33) over the study period. Total mood disturbance increased significantly (p = 0.02, ES_1–2 = 0.91, ES_2–3 = 1.1) from T1 to T3. Between T1-T2, significant relationships were observed between workload and changes in T (r = 0.66, p = 0.003), and T/C ratio (r = 0.62, p = 0.01). There were significant relationships between performance in RSSA_best and training load parameters (workload: r = 0.52, p = 0.03; monotony: r = 0.62, p = 0.01; strain: r = 0.62, p = 0.009). Between T2-T3, there was a significant relationship between Δ% of total mood disturbance and Δ% of YYIR1 (r = −0.54; p = 0.04), RSSA_best (r = 0.58, p = 0.01), SJ (r = −0,55, p = 0.01), T (r = 0.53; p = 0.03), and T/C (r = 0.5; p = 0.04).

Conclusion

An intensive period of congested match play significantly compromised elite soccer players’ physical and mental fitness. These changes were related to psychological but not hormonal parameters; even though significant alterations were detected for selected measures. Mood monitoring could be a simple and useful tool to determine the degree of preparedness for match play during a congested period in professional soccer.

Exercise Time and Intensity: How Much Is Too Much?

The growing prevalence and popularity of interval training necessitate additional guidelines in regard to maximal levels of time and intensity.

PURPOSE

To correlate salivary hormones and time in varying heart-rate (HR) zones. The hypothesis was that chronic exercise durations >9% of total exercise time in the >90% maximum HR zone would lead to decreased variation in salivary cortisol concentration after exercise in a 2-bout high-intensity protocol compared with less or more time in this zone.

METHODS

A total of 35 healthy adults who regularly exercised for an average of 8 hours per week recorded their HR during every training session for 3 weeks. Later, they completed an experimental day composed of two 30-minute high-intensity interval sessions separated by 4 hours of nonactive recovery. The authors collected saliva samples before, immediately following, and 30 minutes after each exercise session to assess changes in cortisol concentrations.

RESULTS

There was a correlation between weekly time training at an intensity >90% maximum HR and the variables associated with overtraining. Salivary cortisol concentration fluctuated less in the participants who exercised in this extreme zone for >40 minutes per week (P < .001).

CONCLUSION

Based on the current study data, for individuals who regularly exercise, 4% to 9% total training time above 90% maximum HR is the ideal duration to maximize fitness and minimize symptoms related to overreaching.

Reproducibility of Acute Steroid Hormone Responses in Men to Short-Duration Running

PURPOSE

Progressively overloading the body to improve physical performance may lead to detrimental states of overreaching/overtraining syndrome. Blunted cycling-induced cortisol and testosterone concentrations have been suggested to indicate overreaching after intensified training periods. However, a running-based protocol is yet to be developed or demonstrated as reproducible. This study developed two 30-min running protocols, (1) 50/70 (based on individualized physical capacity) and (2) RPETP (self-paced), and measured the reproducibility of plasma cortisol and testosterone responses.

METHODS

Thirteen recreationally active, healthy men completed each protocol (50/70 and RPETP) on 3 occasions. Venous blood was drawn preexercise, postexercise, and 30 min postexercise.

RESULTS

Cortisol was unaffected (both P > .05; 50/70, ηp2 = .090; RPETP, ηp2 = .252), while testosterone was elevated (both P < .05; 50/70, 35%, ηp2 = .714; RPETP, 42%, ηp2 = .892) with low intraindividual coefficients of variation (CVi) as mean (SD) (50/70, 7% [5%]; RPETP, 12% [9%]). Heart rate (50/70, effect size [ES] = 0.39; RPETP, ES = -0.03), speed (RPETP, ES = -0.09), and rating of perceived exertion (50/70 ES = -0.06) were unchanged across trials (all CVi < 5%, P < .05). RPETP showed greater physiological strain (P < .01).

CONCLUSIONS

Both tests elicited reproducible physiological and testosterone responses, but RPETP induced greater testosterone changes (likely due to increased physiological strain) and could therefore be considered a more sensitive tool to potentially detect overtraining syndrome. Advantageously for the practitioner, RPETP does not require a priori exercise-intensity determination, unlike the 50/70, enhancing its integration into practice.

Effect of Iron Supplementation on the Modulation of Iron Metabolism, Muscle Damage Biomarkers and Cortisol in Professional Cyclists

Background: The intense efforts made during 3-week stage races may reduce iron metabolism and hematological parameters. These efforts may increase the levels of circulating muscle damage markers and some hormones. All of these physiological changes may have negative consequences not only for the performance of athletes but also for their health. The main aim of this study was to evaluate the effects of supplementation with 80 mg/day of iron on haematological parameters, serum cortisol and biochemical muscle indicators on elite male cyclists during the 3-week stage race the Vuelta a España. Our secondary aim was to examine whether the hematological profile is associated with muscular damage parameters and cortisol. Methods: Eighteen elite male cyclists from two teams were randomly assigned to one of two groups: (1) control group (CG, n = 9; age: 26.1 ± 4.6 years; maximum oxygen uptake per kg: 78.0 ± 5.4 mL/kg/min) or (2) group treated with 80 mg/day iron (800 mg of iron protein succinylate, ITG, n = 9; age: 25.7 ± 6.4 years; maximum oxygen uptake per kg: 77.6 ± 6.5 mL/kg/min). The cyclists were subjected to blood tests one week before the start of the race (T1) and after 4 weeks of treatment, coinciding with the end of the competition (T2). Iron metabolism parameters, muscle damage indicators and serum cortisol were assessed. Repeated-measures ANOVA with group as a factor (GC and ITG) were used to examine the differences between groups throughout the study (time × group) after iron supplementation treatment. Results: Significant differences were observed between groups throughout the study in the group-by-time interaction and changes in serum iron (GC: −8.93 ± 10.35% vs. ITG: 0.60 ± 8.64%; p = 0.018), ferritin (GC: −13.88 ± 23.53% vs. ITG: 91.08 ± 118.30%; p = 0.004), haemoglobin (GC: 10.00 ± 3.32% vs. ITG: 13.04 ± 5.64%; p < 0.001), haematocrit (GC: −1.17 ± 3.78% vs. ITG: 7.32 ± 3.92%; p < 0.001) and cortisol (GC: 24.74 ± 25.84% vs. ITG: –13.54 ± 13.61%; p = 0.005). However, no significant group-by-time interaction was observed for the circulating muscle biomarkers. Additionally, significant negative correlations of serum iron, haemoglobin and haematocrit with muscle circulating biomarkers and cortisol (p < 0.05) were observed. Conclusions: Oral iron supplementation with 80 mg/day iron (800 mg of iron protein succinylate) effectively prevented a decline in haematological parameters (serum iron, ferritin, haemoglobin and haematocrit) and maintained optimal levels of recovery in elite cyclists during the Vuelta a España. Moreover, the hematological values were shown to have relationship with muscular recovery parameters.

Physical Activity and Bone Health: What Is the Role of Immune System? A Narrative Review of the Third Way

Bone tissue can be seen as a physiological hub of several stimuli of different origin (e.g., dietary, endocrine, nervous, immune, skeletal muscle traction, biomechanical load). Their integration, at the bone level, results in: (i) changes in mineral and protein composition and microarchitecture and, consequently, in shape and strength; (ii) modulation of calcium and phosphorous release into the bloodstream, (iii) expression and release of hormones and mediators able to communicate the current bone status to the rest of the body. Different stimuli are able to act on either one or, as usual, more levels. Physical activity is the key stimulus for bone metabolism acting in two ways: through the biomechanical load which resolves into a direct stimulation of the segment(s) involved and through an indirect load mediated by muscle traction onto the bone, which is the main physiological stimulus for bone formation, and the endocrine stimulation which causes homeostatic adaptation. The third way, in which physical activity is able to modify bone functions, passes through the immune system. It is known that immune function is modulated by physical activity; however, two recent insights have shed new light on this modulation. The first relies on the discovery of inflammasomes, receptors/sensors of the innate immunity that regulate caspase-1 activation and are, hence, the tissue triggers of inflammation in response to infections and/or stressors. The second relies on the ability of certain tissues, and particularly skeletal muscle and adipose tissue, to synthesize and secrete mediators (namely, myokines and adipokines) able to affect, profoundly, the immune function. Physical activity is known to act on both these mechanisms and, hence, its effects on bone are also mediated by the immune system activation. Indeed, that immune system and bone are tightly connected and inflammation is pivotal in determining the bone metabolic status is well-known. The aim of this narrative review is to give a complete view of the exercise-dependent immune system-mediated effects on bone metabolism and function.

Realising the Potential of Urine and Saliva as Diagnostic Tools in Sport and Exercise Medicine

Accurate monitoring of homeostatic perturbations following various psychophysiological stressors is essential in sports and exercise medicine. Various biomarkers are routinely used as monitoring tools in both clinical and elite sport settings. Blood collection and muscle biopsies, both invasive in nature, are considered the gold standard for the analysis of these biomarkers in exercise science. Exploring non-invasive methods of collecting and analysing biomarkers that are capable of providing accurate information regarding exercise-induced physiological and psychological stress is of obvious practical importance. This review describes the potential benefits, and the limitations, of using saliva and urine to ascertain biomarkers capable of identifying important stressors that are routinely encountered before, during, or after intense or unaccustomed exercise, competition, over-training, and inappropriate recovery. In particular, we focus on urinary and saliva biomarkers that have previously been used to monitor muscle damage, inflammation, cardiovascular stress, oxidative stress, hydration status, and brain distress. Evidence is provided from a range of empirical studies suggesting that urine and saliva are both capable of identifying various stressors. Although additional research regarding the efficacy of using urine and/or saliva to indicate the severity of exercise-induced psychophysiological stress is required, it is likely that these non-invasive biomarkers will represent "the future" in sports and exercise medicine.

The role of coach-athlete relationship quality in team sport athletes' psychophysiological exhaustion: implications for physical and cognitive performance

The present study aimed to examine associations between the quality of the coach-athlete relationship and athlete exhaustion by assessing physiological and cognitive consequences. Male and female athletes (N = 82) representing seven teams across four different sports, participated in a quasi-experimental study measuring physical performance on a 5-meter multiple shuttle test, followed by a Stroop test to assess cognitive performance. Participants provided saliva samples measuring cortisol as a biomarker of acute stress response and completed questionnaires measuring exhaustion, and coach-athlete relationship quality. Structural equation modelling revealed a positive relationship between the quality of the coach-athlete relationship and Stroop performance, and negative relationships between the quality of the coach-athlete relationship and cortisol responses to high-intensity exercise, cognitive testing, and exhaustion. The study supports previous research on socio-cognitive correlates of athlete exhaustion by highlighting associations with the quality of the coach-athlete relationship.

Non-targeted metabolomics in sport and exercise science

Metabolomics incorporates the study of metabolites that are produced and released through physiological processes at both the systemic and cellular levels. Biological compounds at the metabolite level are of paramount interest in the sport and exercise sciences, although research in this field has rarely been referred to with the global 'omics terminology. Commonly studied metabolites in exercise science are notably within cellular pathways for adenosine triphosphate production such as glycolysis (e.g., pyruvate and lactate), β-oxidation of free fatty acids (e.g., palmitate) and ketone bodies (e.g., β-hydroxybutyrate). Non-targeted metabolomic technologies are able to simultaneously analyse the large numbers of metabolites present in human biological samples such as plasma, urine and saliva. These analytical technologies predominately employ nuclear magnetic resonance spectroscopy and chromatography coupled to mass spectrometry. Performing experiments based on non-targeted methods allows for systemic metabolite changes to be analysed and compared to a particular physiological state (e.g., pre-/post-exercise) and provides an opportunity to prospect for metabolite signatures that offer beneficial information for translation into an exercise science context, for both elite performance and public health monitoring. This narrative review provides an introduction to non-targeted metabolomic technologies and discusses current and potential applications in sport and exercise science.

Monitoring internal training load and salivary immune-endocrine responses during an annual judo training periodization

The objective of this study was to examine the internal training load (TL), IgA, and salivary steroid hormone responses in elite youth judo athletes during an entire annual training periodization. Ten male judo athletes (18±2 years, 72.3±12.3 kg, and 175±6 cm) competing at a state/national level were examined for the TL and salivary imune-endocrine responses variations over an annual judo season, divided in three macrocyles composed by distinct periods denominated preparatory period (PP), competitive period (CP) and transition period (TP). At the end of PP and CP, saliva samples were collected to determine cortisol, testosterone and IgA concentrations. Throughout PP and CP the session-rating of perceived exertion and the total duration of each session were monitored, allowing the internal TL and weekly training strain (TS) calculation. During all macrocycles, significant decreases in TL and TS were observed during CP compared with PP (P<0.05), although no significant differences were observed for immune-endocrine concentrations between PP and CP (P>0.05). Specific variations were observed comparing periods with similar characteristics throughout the macrocycles as higher TL and TS (PP1 to PP2 and PP3, P<0.05), increased testosterone (CP1 to CP3, P=0.024) and decreased testosterone-cortisol ratio (PP1 to PP2, P=0.005). The present findings suggest that the internal TL variations over an annual multipeak traditional periodization did not influence the resting mucosal immune-endocrinal responses in young judo athletes.

Salivary alpha amylase not chromogranin A reflects sympathetic activity: exercise responses in elite male wheelchair athletes with or without cervical spinal cord injury

Background

Salivary alpha amylase (sAA) and chromogranin A (sCgA) have both been suggested as non-invasive markers for sympathetic nervous system (SNS) activity. A complete cervical spinal cord injury leading to tetraplegia is accompanied with sympathetic dysfunction; the aim of this study was to establish the exercise response of these markers in this in vivo model.

Methods

Twenty-six elite male wheelchair athletes (C6–C7 tetraplegia: N = 8, T6–L1 paraplegia: N = 10 and non-spinal cord injured controls: N = 8) performed treadmill exercise to exhaustion. Saliva and blood samples were taken pre, post and 30 min post exercise and analysed for sAA, sCgA and plasma adrenaline concentration, respectively.

Results

In all three subgroups, sAA and sCgA were elevated post exercise (P < 0.05). Whilst sCgA was not different between subgroups, a group × time interaction for sAA explained the reduced post-exercise sAA activity in tetraplegia (162 ± 127 vs 313 ± 99 (paraplegia) and 328 ± 131 U mL⁻¹ (controls), P = 0.005). The post-exercise increase in adrenaline was not apparent in tetraplegia (P = 0.74). A significant correlation was found between adrenaline and sAA (r = 0.60, P = 0.01), but not between adrenaline and sCgA (r = 0.06, P = 0.79).

Conclusions

The blunted post-exercise rise in sAA and adrenaline in tetraplegia implies that both reflect SNS activity to some degree. It is questionable whether sCgA should be used as a marker for SNS activity, both due to the exercise response which is not different between the subgroups and its non-significant relationship with adrenaline.

Effect of a congested match schedule on immune-endocrine responses, technical performance and session-RPE in elite youth soccer players

This study investigated the effects of a congested match schedule (7 matches played in 7 days) on steroid hormone concentrations, mucosal immunity, session rating of perceived exertion (S-RPE) and technical performance in 16 elite youth soccer players (14.8 ± 0.4 years; 170.6 ± 9.4 cm; 64.9 ± 7 kg). No change was observed for salivary cortisol concentration across match time points (P = 0.33; effect size [ES] = 0.13-0.48). In contrast, there was a decrease in salivary testosterone and salivary IgA (SIgA) concentrations from the 1st compared with the last time point (P = 0.01 and 0.001, ES = 0.42 and 0.67, respectively). The SIgA concentration varied across time points (P < 0.001) with the highest value observed at the 3rd time point (rest day) (3rd vs all time point; ES = 0.47-0.73). No changes were observed for S-RPE across time points (P > 0.05). A higher number of tackles and interceptions were observed during the 4th match vs 1st and 7th matches (P < 0.001; ES = 2.25 and 1.90, respectively). The present data demonstrate that accumulated fatigue related to participation in a congested match schedule might induce a decrease in testosterone concentration in youth players and negatively affect their mucosal immunity and capacity to perform certain technical actions.

Exercise-induced responses in salivary testosterone, cortisol, and their ratios in men: a meta-analysis

BACKGROUND

Testosterone, cortisol and their ratios may be indicators of anabolic status, but technical issues surrounding blood sampling has limited wider application. The advent of salivary testosterone (sal-T) analysis simplified sample acquisition, resulting in a subsequent rapid increase in the number of published research articles.

OBJECTIVE

The objective of this study was to undertake a meta-analysis to determine the effect of acute exercise bouts on post exercise sal-T and salivary cortisol (sal-C) concentrations and their ratio (sal-T:C).

DATA SOURCES

Relevant databases such as PubMed, Web of Science, Science Direct and SPORTDiscus were searched up to and including 31 December 2013 for the term 'saliva AND testosterone AND exercise'.

STUDY SELECTION

Studies (n = 21) selected from the 933 identified included randomised controlled trials (RCTs; n = 2), uncontrolled trials (UCTs; n = 18) and control trials (CTs; n = 1), all of which had an exercise component characterised as either aerobic, resistance or power training, each with acute sal-T and sal-C measurement obtained within 30 min of exercise bout completion.

STUDY APPRAISAL AND SYNTHESIS METHODS

A meta-analysis was conducted on change in sal-T, sal-C and the sal-T:C ratio following exercise using standard difference in means (SDM) and a random effects model.

RESULTS

For aerobic, resistance and power exercise, the overall SDMs for sal-T were 0.891, 1.061 and 0.509, respectively; for sal-C, the SDMs were 3.041, 0.773 and 1.200, respectively. For sal-T:C, the SDMs were -2.014, 0.027 and -0.968, respectively. RCTs, UCTs and CTs were separated by subgroup analysis. There were significant differences in overall weighted SDM values for sal-T between RCTs, UCTs and CTs within exercise modes. When examining aerobic exercise interventions, a quantitative interaction of study design was observed. RCTs resulted in a greater SDM than UCTs (1.337 vs. 0.446). Power interventions displayed a qualitative interaction with study design. UCTs where baseline measures were obtained 24 h before exercise had an SDM of -1.128, whereas UCTs where baseline was determined immediately prior to exercise had an SDM of 0.486. The single CT trial had an SDM of 2.260. Resistance exercise interventions were primarily UCTs; however, an observed influence of baseline sampling time whereby immediately pre- and 24 h pre-exercise resulted in differing SDMs. The sole resistance exercise RCTs resulted in the greatest SDM (2.500).

CONCLUSION

The current body of evidence regarding acute responses of sal-T to exercise is weak. This meta-analysis identifies varying exercise-dependent effect sizes. Each appear to be greatly influenced by study design and sample timing. There is a need for more RCTs and a standardised methodology for the measurement of salivary hormones in order to better determine the effect of exercise modality.

Intensive resistance exercise and circadian salivary testosterone concentrations among young male recreational lifters

Strength and morphological adaptations to resistance exercise are mediated in part by anabolic hormones such as testosterone, yet the time course of variability in circadian hormone concentrations is not well characterized. This study, investigated how the circadian rhythm of salivary testosterone is altered by resistance exercise in young men. Twenty healthy young male recreational lifters (age, 18.0 ± 1.3 years) with 2 years of experience in weightlifting were recruited. A randomized controlled trial was conducted, and subjects were randomly assigned to either the resistance exercise group (n = 10), who completed a series of resistance exercise (3 times a week, in the afternoon, 6-7 repetitions, at 85% of 1 repetition maximum for 3 weeks), or a control group (n = 10), who did not exercise during the 3 weeks. Before and after the study, an unstimulated saliva sample (2 ml) was taken every 2 hours for a maximum of 16 hours during each day. A significant decrease was observed in the resistance exercise (44.2%, p = 0.001) and control group (46.1%, p = 0.001) for salivary testosterone at each time point compared with baseline (p = 0.001). There was also no significant difference between the exercise and resting conditions in both groups for salivary testosterone (p > 0.05), except a significantly higher increase by 38.4% vs. -0.02% (p = 0.001), at 1730 hours during exercise sessions in the resistance exercise group compared with the control group. Resistance exercise has no noteworthy effect on circadian secretion of salivary testosterone throughout the 16 waking hours. These results indicate that athletes can undertake resistance exercise in either the morning or afternoon with the knowledge that a similar testosterone response can be expected regardless of the time of day.

Alternative treatment modalities for the hypogonadal patient

Testosterone (T) deficiency syndrome (TDS) is a prevalent condition, commonly managed with exogenous T. Despite an abundance of T formulations, alternative treatments are often sought for various reasons. To evaluate outcomes of alternative therapies, a PubMed search was performed of all publications that included men with TDS from 1990 through October 2013, with results summarized. Proposed mechanisms of action were also reviewed to provide a pathophysiologic basis for reported outcomes. Nonpharmacologic therapies that increase endogenous T are weight loss, exercise, and varicocelectomy, while medications used off-label include aromatase inhibitors, human chorionic gonadotropin, and selective estrogen receptor modulators. All reported therapies increase T, while changes in estradiol and adverse events vary by therapeutic class. Although limited data preclude direct comparisons between therapies, exercise and weight loss alone or in combination with medications may be considered first line. The role for surgical therapy in TDS remains undefined and requires further study.