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Pérez-Castillo ÍM, Williams JA, López-Chicharro J, Mihic N, Rueda R, Bouzamondo H, Horswill CA. Compositional Aspects of Beverages Designed to Promote Hydration Before, During, and After Exercise: Concepts Revisited. Nutrients 2023; 16:17. [PMID: 38201848 PMCID: PMC10781183 DOI: 10.3390/nu16010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Hypohydration can impair aerobic performance and deteriorate cognitive function during exercise. To minimize hypohydration, athletes are recommended to commence exercise at least euhydrated, ingest fluids containing sodium during long-duration and/or high-intensity exercise to prevent body mass loss over 2% and maintain elevated plasma osmolality, and rapidly restore and retain fluid and electrolyte homeostasis before a second exercise session. To achieve these goals, the compositions of the fluids consumed are key; however, it remains unclear what can be considered an optimal formulation for a hydration beverage in different settings. While carbohydrate-electrolyte solutions such as sports drinks have been extensively explored as a source of carbohydrates to meet fuel demands during intense and long-duration exercise, these formulas might not be ideal in situations where fluid and electrolyte balance is impaired, such as practicing exercise in the heat. Alternately, hypotonic compositions consisting of moderate to high levels of electrolytes (i.e., ≥45 mmol/L), mainly sodium, combined with low amounts of carbohydrates (i.e., <6%) might be useful to accelerate intestinal water absorption, maintain plasma volume and osmolality during exercise, and improve fluid retention during recovery. Future studies should compare hypotonic formulas and sports drinks in different exercise settings, evaluating different levels of sodium and/or other electrolytes, blends of carbohydrates, and novel ingredients for addressing hydration and rehydration before, during, and after exercise.
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Affiliation(s)
| | | | | | - Niko Mihic
- Real Madrid, Medical Services, 28055 Madrid, Spain; (J.L.-C.); (N.M.)
| | | | | | - Craig A. Horswill
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60608, USA;
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2
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Jayawardena R, Weerasinghe K, Trakman G, Madhujith T, Hills AP, Kalupahana NS. Sports Nutrition Knowledge Questionnaires Developed for the Athletic Population: a Systematic Review. Curr Nutr Rep 2023; 12:767-777. [PMID: 37715061 DOI: 10.1007/s13668-023-00494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE OF REVIEW Sports nutrition (SN) is pivotal in aiding athletes to reach peak performance, minimize sport-related injuries, enhance career longevity, and improve general health. An accurate assessment of athletes' sports nutrition knowledge (SNK) is required to design targeted nutrition education programs aimed at enhancing both nutritional knowledge and dietary practices. This review systematically evaluates studies that use questionnaires to assess the SNK of athletes engaged in athletics. RECENT FINDINGS The literature search was conducted in PubMed®, Web of Science®, and Scopus®, and 375 potentially relevant articles were identified. The total number of articles included in the present review is 11, with eight studies involving only athletic disciplines and three involving athletics and other sports. The majority (n = 8) of the questionnaires included general and SN aspects, with SN covering endurance athletes' knowledge of competition carbohydrate guidelines, gastrointestinal symptoms associated with exercise, and ultra-endurance athletes' sodium beliefs and practices. Questionnaires were either delivered online (n = 7) or self-administered in hard copy (n = 1). The three major strategies identified for developing questionnaires were based on previous literature and recent SN guidelines (n = 6), consultation with a panel of experts (n = 7), and the use of a previously developed sports nutrition knowledge questionnaires (SNKQ) (n = 4), with more than one approach used in five studies. Similarly, up to three validation approaches were used, including content, face, and construct validity. Seven studies used a test-retest procedure to ensure external reliability, and eight used Cronbach's alpha or kappa coefficient to assess internal consistency. Endurance and ultra-endurance athletes are the populations of interest for the majority of questionnaires developed for athletics, with most questionnaires incorporating general and SNK topics.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
| | - Kalani Weerasinghe
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Gina Trakman
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Terrence Madhujith
- Department of Food Science and Technology, Faculty of Agriculture, University of Peradeniya, Peradeniya, Sri Lanka
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Tasmania, Australia
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3
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McCubbin AJ. Modelling sodium requirements of athletes across a variety of exercise scenarios - identifying when to test and target, or season to taste. Eur J Sport Sci 2022; 23:992-1000. [PMID: 35616504 DOI: 10.1080/17461391.2022.2083526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractEvidence suggests the focus for sodium replacement during exercise should be maintenance of plasma sodium concentration ([Na+]plasma) for any given total body water (TBW) volume. The sodium intake to achieve stable [Na+]plasma given known fluid and electrolyte intakes and losses can be mathematically estimated. Therefore the aim of this investigation was to model sodium requirements of athletes during exercise, observing the influence of sweat rate, exercise duration, body mass, baseline [Na+]plasma and sweat potassium [K+]sweat, and relevance to competition (soccer, elite marathon, and 160 km ultramarathon running). Models were constructed across a range of sweat sodium concentrations ([Na+]sweat) (20-80 mmol·L-1), sweat rates (0.5-2.5 L·h-1) and fluid replacement (10-90% of losses). In the competition-specific scenarios, fluid replacement was calculated to achieve 2% TBW losses. Sodium requirements were driven by fluid replacement (% of losses) and [Na+]sweat, with minimal or no influence of other variables. Replacing sodium was unnecessary in all realistic scenarios modelled for a soccer match and elite marathon. In contrast, the 160 km ultramarathon required ≥47% sodium replacement when [Na+]sweat was ≥40 mmol·L-1 and >80% of fluid losses were replaced. In conclusion, sodium requirements to maintain stable [Na+]plasma during exercise depend on both the proportion of fluid losses replaced, and [Na+]sweat. Only when prolonged exercise is coupled with aggressive fluid replacement (>80%) and whole body [Na+]sweat ≥40 mmol·L-1 does sweat composition testing and significant, targeted sodium replacement appear necessary.
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Affiliation(s)
- Alan J McCubbin
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
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4
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Gauckler P, Kesenheimer JS, Kronbichler A, Kolbinger FR. Edema-like symptoms are common in ultra-distance cyclists and driven by overdrinking, use of analgesics and female sex - a study of 919 athletes. J Int Soc Sports Nutr 2021; 18:73. [PMID: 34863204 PMCID: PMC8643017 DOI: 10.1186/s12970-021-00470-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 11/10/2021] [Indexed: 11/12/2022] Open
Abstract
Background Ultra-endurance cyclists regularly report various extents of bodily decline during long-distance bicycle rides, including potential kidney function-related symptoms such as swelling of body parts and urine changes. This study aimed to assess the prevalence of these symptoms in a representative cohort of ultra-endurance cyclists and shed light on potential predictors related to the ride, the rider and the rider’s behavior. Methods Between November 26 and December 14, 2020, 1350 people participated in an online survey investigating potential kidney-related symptoms of ultra-distance cycling. Frequency and severity of edema-like (“swelling”) symptoms and perceived changes in urine output, concentration and quality were associated with ride-related factors, demographic parameters and rider behavior-related variables. Results A total of 919 participants met the predefined inclusion criteria. The majority (N = 603, 65.6%) stated that they suffered from at least one potential kidney function-related symptom, out of which 498 (54.2%) stated one or more edema-like (“swelling”) symptoms. In correlational and multiple regression analyses, female sex, intake of analgesics and drinking strategies correlated with swelling symptoms. Further analyses indicated that drinking due to thirst and/or drinking adapted to ambient sweating and temperature negatively correlated with swelling symptoms, whereas “drinking as much as possible” enhanced these. Intake of analgesics was moderately positively correlated with swelling symptoms. Conclusions According to our survey, edema-like symptoms occur in the majority of ultra-distance cyclists and female sex, drinking strategy and intake of analgesic drugs are major predictors thereof. Studies are needed to investigate the underlying pathophysiological processes of such symptoms. Supplementary Information The online version contains supplementary material available at 10.1186/s12970-021-00470-0.
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Affiliation(s)
- Philipp Gauckler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | | | - Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | - Fiona R Kolbinger
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
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Turner O, Mitchell N, Ruddock A, Purvis A, Ranchordas M. Elite squash players nutrition knowledge and influencing factors. J Int Soc Sports Nutr 2021; 18:46. [PMID: 34112186 PMCID: PMC8194110 DOI: 10.1186/s12970-021-00443-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/16/2021] [Indexed: 11/24/2022] Open
Abstract
Background There is a reported mismatch between macronutrient consumption and contemporary macronutrient guidelines in elite standard squash players. Suboptimal dietary practices could be due to a lack of nutrition knowledge among players. Subsequently, the purpose of this study was to assess the sports nutrition knowledge of elite squash players through the Nutrition for Sport Knowledge Questionnaire (NSKQ) and provide an indication of whether players require nutrition support to increase their nutrition knowledge. Methods This cross-sectional study assessed the nutrition knowledge of 77 elite squash players via the NSKQ over the period of June 2020 to August 2020. Results Players conveyed average nutrition knowledge with a mean NSKQ score of 48.78 ± 10.06 (56.07% ± 11.56%). There were no significant differences in NSKQ score between male and female players (p = .532). There was found to be a weak positive association between world ranking and NSKQ score (r = .208) and age and NSKQ score (r = .281). Players who had a relevant undergraduate degree (e.g. BSc Sport & Exercise Science) had significantly greater NSKQ score than players with no relevant qualifications (p = .022). Players who consulted a sports nutritionist to obtain their main source of nutrition information were shown to have significantly greater knowledge than those who acquired knowledge from a sports scientist (p = .01) or the internet / social media (p = .007). Conclusions Players should consult with a sports nutritionist to increase their sport nutrition knowledge. Future research should quantify the effectiveness of a nutritional education intervention at increasing nutrition knowledge in players. Supplementary Information The online version contains supplementary material available at 10.1186/s12970-021-00443-3.
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Affiliation(s)
- Ollie Turner
- Academy of Sport & Physical Activity, Sheffield Hallam University, Sheffield, England. .,English Institute of Sport, Sheffield, England.
| | | | - Alan Ruddock
- Academy of Sport & Physical Activity, Sheffield Hallam University, Sheffield, England
| | - Alison Purvis
- Academy of Sport & Physical Activity, Sheffield Hallam University, Sheffield, England
| | - Mayur Ranchordas
- Academy of Sport & Physical Activity, Sheffield Hallam University, Sheffield, England
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Abstract
Participation in ultramarathons continues to grow, especially among older individuals and among younger runners who may have less running and wilderness experience than many past participants. While ultramarathons tend to have relatively few serious medical issues, adverse medical incidents do occur. These factors make it increasingly important that appropriate safety precautions and medical support are defined and implemented at these events to enhance the safety of participants, spectators, and volunteers. This document establishes the minimum recommended level of medical support that should be available at ultramarathons based on current knowledge and the experience of the authors. It offers a balance that is intended to avoid excessive stress on the local medical system while also precluding undue burden on events to provide medical support beyond that which is practical. We propose a three-level classification system to define the extent of medical services, personnel, systems, supplies, and equipment in place and recommend the level of medical support based on event size, distance/duration, remoteness, and environmental conditions that may be encountered during the event. This document also outlines the recommended education and training of medical providers and discusses other medical and logistical considerations related to the provision of medical support at ultramarathons. We suggest that ultramarathon organizers review and adopt these recommendations to enhance safety and reduce the risk of adverse events to participants.
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7
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Manevitz Z, Leshem M, Heled Y, Epstein Y, Gershon B, Kodesh E. Exertional sodium loss does not increase immediate salt appetite or dietary sodium intake in athletes. Appetite 2021; 162:105181. [PMID: 33667501 DOI: 10.1016/j.appet.2021.105181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
We tested whether salt preference increases immediately after exertion-induced Na+ loss in sweat, and whether this may generalise to an increase in habitual dietary Na+ intake. For the first aim, trained athletes (n = 20) exercised in 2 ambient temperatures and sweat Na+ loss related to immediate salt preference assessed by taste, intake and psychophysical tests. For the second aim, we compared dietary and urinary Na+, and salt preference, seasoning and hedonics in the athletes and sedentary men (n = 20). No relationship was found between sodium loss during exercise and immediate preference for salt or psychophysical responses, and no differences in comparison to sedentary men. However, athlete diet had fewer foods (29.4 ± 1.5 vs 37.8 ± 1.9, p < 0.001), less seasoning (19 vs 32. p = 0.011) and more athletes reported dietary limitations (31 vs 11, p < 0.05), although nutrient content did not differ. Together these might suggest athlete adherence to a healthy diet at the expense of variety and flavour and a dissociation between dietary reports and intake. Athletes, more than controls, liked foods rich in energy and K+ suggesting compensatory-driven hedonics, although overall their intake did not differ. The findings are consistent with the absence of a salt appetite responding to Na+ loss in humans, and specifically that trained athletes do not increase their preference for salt in immediate response to exertion-induced Na+ loss and are not at risk for increased dietary Na+ compared to sedentary men.
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Affiliation(s)
- Zev Manevitz
- Physical Therapy Department, Tel Aviv University, Israel
| | - Micah Leshem
- School of Psychological Sciences, University of Haifa, Israel.
| | - Yuval Heled
- The Faculty of Science, Kibbutzim College of Education, Technology and the Arts, Tel Aviv, Israel
| | - Yoram Epstein
- Physical Therapy Department, Tel Aviv University, Israel
| | - Barak Gershon
- The Ribstein Center for Sport Medicine and Research, Wingate Institute, Israel
| | - Einat Kodesh
- Physical Therapy Department, University of Haifa, Israel
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8
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Lipman GS, Hew-Butler T, Phillips C, Krabak B, Burns P. Prospective Observational Study of Weight-based Assessment of Sodium Supplements on Ultramarathon Performance (WASSUP). SPORTS MEDICINE - OPEN 2021; 7:13. [PMID: 33594588 PMCID: PMC7886928 DOI: 10.1186/s40798-021-00302-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/24/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Sodium supplements are ubiquitous in endurance running, but their impact on performance has been subjected to much debate. The objective of the study was to assess the effect of sodium supplementation as a weight-based predictor of race performance in ultramarathon runners. METHODS Prospective observational study during an 80 km (50 mi) stage of a 6-stage 250 km (155 mi) ultramarathon in Chile, Patagonia, Namibia, and Mongolia. Finish line hydration status as measured by weight change, point-of-care serum sodium, and questionnaire provided sodium ingestion categories at 33rd percentile and 66th percentile both for weight-adjusted rate and total sodium consumption, then analyzed for significant relationships to race performance, dysnatremia, and hydration. RESULTS Two hundred sixty-six participants were enrolled, with 217 (82%) with complete sodium supplement rate data, 174 (80%) with finish line sodium, and 161 (74%) with both pre-race weights and total sodium ingestion allowing weight-based analysis. Sodium intake ranged from 131-533 mg/h/kg (2-7.2 gm), with no statistically significant impact on pace, race time, or quintile rank. These outcomes did not change when sodium intake was analyzed as a continuous variable or by sub-group analysis of the 109 (68%) normonatremic runners. When controlled for weight-adjusted sodium intake, performance was poorly correlated with hydration (r = - 0.152, 95% CI - 0.348-0.057). Dehydrated runners outperformed those overhydrated, with 11% of top 25th percentile finishers dehydrated (versus 2.8% overhydrated), with 3.6 min/km faster pace and time 4.6 h faster finishing time. CONCLUSIONS No association was found between sodium supplement intake and ultramarathon performance. Dehydrated runners were found to have the best performance. This reinforces the message to avoid overhydration.
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Affiliation(s)
- Grant S Lipman
- Department of Emergency Medicine, Stanford University School of Medicine, 900 Welch Rd, Suite #350, Palo Alto, CA, 94304, USA.
| | - Tamara Hew-Butler
- Exercise and Sport Science, College of Education, Wayne State University, Detroit, MI, USA
| | - Caleb Phillips
- Computational Science, University of Colorado, Boulder, CO, USA
| | - Brian Krabak
- Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Patrick Burns
- Department of Emergency Medicine, Stanford University School of Medicine, 900 Welch Rd, Suite #350, Palo Alto, CA, 94304, USA
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Paternoster N, Baggio E, Pelosi E. Personalized hydratation status in endurance and ultra-endurance: A review. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This review aims to investigate the physiological mechanisms that underlie the hydro-electrolyte balance of the human body and the most appropriate hydration modalities for individuals involved in physical and sports activities, with a focus on ultra-endurance events. The role of effective hydration in achieving optimal sports performance is also investigated. An adequate pre-hydration is essential to perform physical and sporting activity in a condition of eu-hydration and to mantain physiologic levels of plasma electrolyte. To achieve these goals, athletes need to consume adequate drinks together with consuming meals and fluids, in order to provide an adequate absorption of the ingested fluids and the expulsion of those in excess through diuresis. Therefore, there are important differences between individuals in terms of sweating rates, the amount of electrolytes loss and the specific request of the discipline practiced and the sporting event to pursue.
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Affiliation(s)
- Nicolò Paternoster
- Centro di Medicina, Venice, Italy
- Centro Medico Fisioterapico, Magenta, Padova, Italy
| | | | - Ettore Pelosi
- Poliambulatorio Vitalia, Torino, Italy
- Centro PET Irmet – Affidea, Torino, Italy
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10
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Rothschild JA, Kilding AE, Plews DJ. Pre-Exercise Nutrition Habits and Beliefs of Endurance Athletes Vary by Sex, Competitive Level, and Diet. J Am Coll Nutr 2020; 40:517-528. [PMID: 32926647 DOI: 10.1080/07315724.2020.1795950] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the self-reported beliefs and practices relating to pre-exercise nutrition intake among endurance athletes of varying ages and competitive levels and examine differences based on sex, competitive level, and habitual dietary pattern. METHOD An anonymous online survey was circulated internationally in English and completed by 1950 athletes of varying competitive levels (51.0% female, mean age 40.9 years [range 18:78]). Survey questions included training background, determinants of pre-exercise nutrition intake and composition, and timing relative to exercise. RESULTS Prior to morning exercise, 36.4%, 36.0%, and 27.6% of athletes consumed carbohydrate-containing food/drinks before almost every workout, some of the time, and never/rarely, respectively, with significant effects of sex (p < 0.001, Cramer's V (ϕc) = 0.15) and competitive level (p < 0.001, ϕc = 0.09). Nutritional intake before exercise varied based on workout duration for 47.6% of athletes, with significant effects of sex (ϕc = 0.15) and habitual diet (ϕc = 0.19), and based on workout intensity for 39.1% of athletes, with significant effects of sex (ϕc = 0.13) and habitual diet (ϕc = 0.17, all p < 0.001). Additionally, 89.0% of athletes reported using at least some type of dietary supplement (including caffeine from coffee/tea) within 1 hour before exercise. CONCLUSIONS Overall, nearly all factors measured relating to pre-exercise nutrition intake varied by sex, competitive level, habitual dietary pattern, and/or intensity/duration of the training session and suggest a large number of athletes may not be following current recommendations for optimizing endurance training adaptations.
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Affiliation(s)
- Jeffrey A Rothschild
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Andrew E Kilding
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Daniel J Plews
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
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11
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Grzebisz N. Determinants of the Cardiovascular Capacity of Amateur Long-Distance Skiers during the Transition Period. Diagnostics (Basel) 2020; 10:diagnostics10090675. [PMID: 32899523 PMCID: PMC7555765 DOI: 10.3390/diagnostics10090675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to identify determinants of the cardiovascular capacity of 16 male amateur long-distance skiers during the transition period. These factors can vary from amateur marathon skiers, who represent a sort of midpoint between inactive people and professional athletes. Cardiovascular capacity depends mainly on the volume and intensity of the training, which are different between these groups. Finding the factors affecting heart condition of amateur athletes can be an important element in their health care and can help the athletes to achieve their full performance potential. Therefore, ergospirometric and hematological tests were performed. As a result, predictors for volume oxygen uptake were determined using a regression model, which included the following variables: the percentage of monocytes (p = 0.031), the concentration of sodium (p = 0.004), and total calcium (p = 0.03). All these parameters negatively affected VO2 max. Biochemical and physiological monitoring of amateur athletes can help to protect their health and prepare them properly for their training. The growing popularity of long-distance competitions among middle-aged amateur athletes and the lack of guidance on how to assess their health indicate the need for further research.
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Affiliation(s)
- Natalia Grzebisz
- Faculty of Dietetics, Vistula School of Hospitality, 02-787 Warsaw, Poland
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12
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Martínez-Navarro I, Montoya-Vieco A, Collado E, Hernando B, Panizo N, Hernando C. Muscle Cramping in the Marathon: Dehydration and Electrolyte Depletion vs. Muscle Damage. J Strength Cond Res 2020; 36:1629-1635. [PMID: 32796418 DOI: 10.1519/jsc.0000000000003713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Martínez-Navarro, I, Montoya-Vieco, A, Collado, E, Hernando, B, Panizo, N, and Hernando, C. Muscle Cramping in the marathon: Dehydration and electrolyte depletion vs. muscle damage. J Strength Cond Res XX(X): 000-000, 2020-Our aim was to compare dehydration variables, serum electrolytes, and muscle damage serum markers between runners who suffered exercise-associated muscle cramps (EAMC) and runners who did not suffer EAMC in a road marathon. We were also interested in analyzing race pacing and training background. Nighty-eight marathoners took part in the study. Subjects were subjected to a cardiopulmonary exercise test. Before and after the race, blood and urine samples were collected and body mass (BM) was measured. Immediately after the race EAMC were diagnosed. Eighty-eight runners finished the marathon, and 20 of them developed EAMC (24%) during or immediately after the race. Body mass change, post-race urine specific gravity, and serum sodium and potassium concentrations were not different between crampers and noncrampers. Conversely, runners who suffered EAMC exhibited significantly greater post-race creatine kinase (464.17 ± 220.47 vs. 383.04 ± 253.41 UI/L, p = 0.034) and lactate dehydrogenase (LDH) (362.27 ± 72.10 vs. 307.87 ± 52.42 UI/L, p = 0.002). Twenty-four hours post-race also values of both biomarkers were higher among crampers (CK: 2,438.59 ± 2,625.24 vs. 1,166.66 ± 910.71 UI/L, p = 0.014; LDH: 277.05 ± 89.74 vs. 227.07 ± 37.15 UI/L, p = 0.021). The difference in the percentage of runners who included strength conditioning in their race training approached statistical significance (EAMC: 25%, non-EAMC: 47.6%; p = 0.074). Eventually, relative speed between crampers and noncrampers only differed from the 25th km onward (p < 0.05). Therefore, runners who suffered EAMC did not exhibit a greater degree of dehydration and electrolyte depletion after the marathon but displayed significantly higher concentrations of muscle damage biomarkers.
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Affiliation(s)
- Ignacio Martínez-Navarro
- Physical Education and Sports Department, University of Valencia, Valencia, Spain.,Sports Health Unit, Vithas Hospital October 9, Valencia, Spain
| | - Antonio Montoya-Vieco
- Physical Education and Sports Department, University of Valencia, Valencia, Spain.,Sports Health Unit, Vithas Hospital October 9, Valencia, Spain
| | - Eladio Collado
- Faculty of Health Sciences, Jaume I University, Castellon, Spain
| | | | - Nayara Panizo
- Department of Medicine, Jaume I University, Castellon, Spain.,Universitary Clinical Hospital of Valencia
| | - Carlos Hernando
- Sport Service, Jaume I University, Castellon, Spain.,Department of Education and Specific Didactics, Jaume I University, Castellon, Spain
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13
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Impact of 3-day high and low dietary sodium intake on sodium status in response to exertional-heat stress: a double-blind randomized control trial. Eur J Appl Physiol 2019; 119:2105-2118. [PMID: 31377851 DOI: 10.1007/s00421-019-04199-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/26/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE To determine the impact of altering dietary sodium intake for 3 days preceding exercise on sweat sodium concentration [Na+], and cardiovascular and thermoregulatory variables. METHODS Fifteen male endurance athletes (runners n = 8, cyclists n = 7) consumed a low (LNa, 15 mg kg-1 day-1) or high (HNa, 100 mg kg-1 day-1) sodium diet, or their usual free-living diet [UDiet, 46 (37-56) mg kg-1 day-1] for 3 days in a double-blind, randomized cross-over design, collecting excreted urine (UNa) and refraining from exercise. On day 4, they completed 2 h running at 55% [Formula: see text]O2max or cycling at 55% maximum aerobic power in Tamb 35 °C. Pre- and post-exercise blood samples were collected, and sweat from five sites using absorbent patches along the exercise protocol. RESULTS UNa on days 2-3 pre-exercise [mean (95% CI) LNa 16 (12-19) mg kg-1 day-1, UDiet 46 (37-56) mg kg-1 day-1, HNa 79 (72-85) mg kg-1 day-1; p < 0.001] and pre-exercise aldosterone [LNa 240 (193-286) mg kg-1 day-1, UDiet 170 (116-224) mg kg-1 day-1, HNa 141 (111-171) mg kg-1 day-1; p = 0.001] reflected sodium intake as expected. Pre-exercise total body water was greater following HNa compared to LNa (p < 0.05), but not UDiet. Estimated whole-body sweat [Na+] following UDiet was 10-11% higher than LNa and 10-12% lower than HNa (p < 0.001), and correlated with pre-exercise aldosterone (1st h r = - 0.568, 2nd h r = - 0.675; p < 0.01). Rectal temperature rose more quickly in LNa vs HNa (40-70 min; p < 0.05), but was similar at the conclusion of exercise, and no significant differences in heart rate or perceived exertion were observed. CONCLUSIONS Three day altered sodium intake influenced urinary sodium excretion and sweat [Na+], and the rise in rectal temperature, but had no effect on perceived exertion during moderate-intensity exercise in hot ambient conditions.
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Wilson PB. 'I think I'm gonna hurl': A Narrative Review of the Causes of Nausea and Vomiting in Sport. Sports (Basel) 2019; 7:E162. [PMID: 31277403 PMCID: PMC6680692 DOI: 10.3390/sports7070162] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 06/25/2019] [Accepted: 07/02/2019] [Indexed: 12/27/2022] Open
Abstract
Exercise-associated gastrointestinal (GI) distress can negatively impact athletic performance and interfere with exercise training. Although there are a few universal underlying causes of GI distress, each symptom often has its own unique triggers and, therefore, its own prevention and management strategies. One of the most troubling GI symptoms an athlete can experience during training and competition is nausea/vomiting. The prevalence of nausea varies with several factors, two of the most important being exercise intensity and duration. Relatively brief, high-intensity exercise (e.g., sprinting, tempo runs) and ultra-endurance exercise are both associated with more frequent and severe nausea. The potential causes of nausea in sport are numerous and can include catecholamine secretion, hypohydration, heat stress, hyponatremia, altitude exposure, excessive fluid/food consumption, hypertonic beverage intake, pre-exercise intake of fatty- or protein-rich foods (especially in close proximity to exercise), prolonged fasting, various supplements (caffeine, sodium bicarbonate, ketones), certain drugs (antibiotics, opioids), GI infections, and competition-related anxiety. Beyond directly addressing these aforementioned causes, antiemetic drugs (e.g., ondansetron) may also be useful for alleviating nausea in some competitive situations. Given the commonness of nausea in sport and its potential impact on exercise performance, athletes and sports medicine practitioners should be aware of the origins of nausea and strategies for dealing with this troublesome gut complaint.
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Affiliation(s)
- Patrick B Wilson
- Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA.
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15
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Hoffman MD, White MD. Belief in the need for sodium supplementation during ultramarathons remains strong: findings from the Ultrarunners Longitudinal TRAcking (ULTRA) study. Appl Physiol Nutr Metab 2019; 45:118-122. [PMID: 31163112 DOI: 10.1139/apnm-2019-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In the past, ultramarathon runners have commonly believed that consuming sodium supplements, as capsules or tablets, will prevent exercise-associated hyponatremia (EAH), dehydration, muscle cramping, and nausea, but accumulating evidence indicates that sodium supplementation during ultramarathons is not necessary and may be potentially dangerous. In this work, beliefs about whether sodium supplements should be made available at ultramarathons were assessed during 2018 among 1152 participants of the Ultrarunners Longitudinal TRAcking (ULTRA) study, of which 85.2% had completed an ultramarathon during 2014-2018. Two-thirds (66.4%) of study participants indicated that sodium supplements should be made available at ultramarathons, supported by beliefs that they prevent EAH (65.5%) and muscle cramping (59.1%). Of those indicating that sodium supplements should not be made available, 85.0% indicated it is because runners can provide their own, 27.9% indicated it is because they are not necessary, and 12.1% indicated they could increase thirst drive and cause overhydration. In general, there was a tendency for those who were older, less active in running ultramarathons in recent years, and with a longer history of ultramarathon running to be less likely to know that sodium supplements do not help prevent EAH, muscle cramping, and nausea. Novelty Ultramarathon runners continue to have misunderstandings about the need for sodium supplementation during ultramarathons. Few ultramarathon runners recognize that supplementing sodium intake beyond that in food and drink is generally not necessary during ultramarathons or that it could result in overhydration. Continued educational efforts are warranted to help ensure safe participation in the sport.
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Affiliation(s)
- Martin D Hoffman
- Physical Medicine and Rehabilitation Service, Department of Veterans Affairs, Northern California Health Care System, Sacramento, CA 95655, USA.,Department of Physical Medicine and Rehabilitation, University of California Davis Medical Center, Sacramento, CA, USA
| | - Matthew D White
- Laboratory for Exercise and Environmental Physiology, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
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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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