Timing of postexercise carbohydrate-protein supplementation: roles of gastrointestinal blood flow and mucosal cell damage on gastric emptying in humans

Gastrointestinal function following endurance exercise under different environmental temperatures

PURPOSE

We determined the effects of different environmental temperatures on exercise-induced gastrointestinal (GI) damage and delayed gastric emptying (GE) rate.

METHODS

Eleven trained males completed three trials on different days, consisting of (1) exercise in a thermoneutral environment (CON, 23 °C), (2) exercise in a hot environment (HOT, 35 °C), and (3) exercise in a cold environment (COLD, 10 °C). The subjects performed high-intensity interval-type endurance exercises in all trials. Blood intestinal fatty acid binding protein (I-FABP) levels was determine before and after exercise. We evaluated Tmax (time when the 13C-excretion/h reached a maximum level) as an indication of the GE rate during post-exercise.

RESULTS

Rectal temperature during exercise was significantly higher (P < 0.001) in the HOT (38.7 ± 0.3 °C) trial compared with the CON (38.2 ± 0.3 °C) and COLD (38.2 ± 0.3 °C) trials, with no significant difference between the CON and COLD trials. Plasma I-FABP level after exercise (relative to the pre-exercise level) were significantly greater (P = 0.005) in the HOT trial (92.9 ± 69.6%) than in the CON (37.2 ± 31.6%) and COLD (37.6 ± 41.8%) trials. However, there was no significant difference between the CON and COLD trials. Moreover, the Tmax was delayed significantly (P = 0.006) in the HOT trial compared with the CON and COLD trials, with no significant difference between the CON and COLD trials.

CONCLUSION

GI function following endurance exercise was similar between thermoneutral and cold environments, while endurance exercise in a hot environment exacerbated GI function compared with thermoneutral and cold environments.

The Physiological Requirements of and Nutritional Recommendations for Equestrian Riders

Equestrian sport is under-researched within the sport science literature, creating a possible knowledge vacuum for athletes and support personnel wishing to train and perform in an evidence-based manner. This review aims to synthesise available evidence from equitation, sport, and veterinary sciences to describe the pertinent rider physiology of equestrian disciplines. Estimates of energy expenditure and the contribution of underpinning energy systems to equestrian performance are used to provide nutrition and hydration recommendations for competition and training in equestrian disciplines. Relative energy deficiency and disordered eating are also considered. The practical challenges of the equestrian environment, including competitive, personal, and professional factors, injury and concussion, and female participation, are discussed to better highlight novelty within equestrian disciplines compared to more commonly studied sports. The evidence and recommendations are supported by example scenarios, and future research directions are outlined.

Effects of sex and menstrual cycle phase on celiac artery blood flow during dynamic moderate-intensity leg exercise in young individuals

The purpose of this study was to clarify the effect of sex and menstrual cycle phase on celiac artery blood flow during dynamic exercise in healthy young humans. Eleven healthy young females (21 ± 2 yr, means ± SD) and 10 males (23 ± 3 yr) performed dynamic knee-extension and -flexion exercises at 30% of heart rate reserve for 4 min. The percent changes from baseline (Δ) for mean arterial blood pressure (MAP), mean blood flow (celMBF) in the celiac artery, and celiac vascular conductance (celVC) during exercise were calculated. Arterial blood pressure was measured using an automated sphygmomanometer, and celiac artery blood flow was recorded by Doppler ultrasonography. Female subjects performed the exercise test in the early follicular phase (EF) and in the midluteal phase (ML) of their menstrual cycle. The increase in MAP during exercise was not significantly (P > 0.05) different between sexes or between menstrual cycle phases (ΔMAP, EF in females: +16.6 ± 6.4%, ML in females: +20.2 ± 11.7%, and males: +19.9 ± 12.2%). The celMBF decreased during exercise in each group, but the response was not significantly (P > 0.05) different between sexes or between menstrual cycle phases (ΔcelMBF, EF in females: -24.6 ± 15.5%, ML in females: -25.2 ± 18.7%, and males: -29.2 ± 4.0%). The celVC decreased during dynamic exercise in each group, with no significant (P > 0.05) difference in the responses between sexes or between menstrual cycle phases (ΔcelVC, EF in females: -38.3 ± 15.0%, ML in females: -41.5 ± 19.1%, and males: -43.4 ± 7.2%). These results suggest that sex and menstrual cycle phase have minimal influence on hemodynamic responses in the splanchnic artery during dynamic moderate-intensity exercise in young healthy individuals.NEW & NOTEWORTHY During dynamic exercise, splanchnic organ blood flow is reduced from resting values. Whether sex and menstrual cycle phase influence splanchnic blood flow responses during exercise remains unknown. We show that the decrease in celiac artery blood flow during dynamic leg exercise does not differ between young females and males or between menstrual cycle phases. In young individuals, sex and menstrual cycle have minimal influence on splanchnic artery hemodynamic responses during dynamic moderate-intensity leg exercise.

High-glycemic index meal acutely potentiates blood pressure response to static handgrip exercise in healthy humans

Blood glucose levels acutely increase postprandially depending on the type of meal consumed. However, it remains unclear whether postprandial hyperglycemia temporally affects cardiovascular responses to static handgrip exercise (SHG-ex). Thus, this study aimed to examine whether increased blood glucose induced by consumption of a high-glycemic index (HGI) meal affects pressor response to SHG-ex. A total of 14 healthy participants (7 women and 7 men) consumed an HGI meal, a low-glycemic index (LGI) meal, or no meal (control). Participants performed 30% maximal voluntary contraction SHG-ex followed by a postexercise muscle ischemia (PEMI) test before the meal and 60 min after consuming the meal. Blood glucose, plasma insulin, and plasma triglyceride levels were measured, and the area under the curve until 60 min (AUC0-60 min) after meal consumption was calculated. The HGI and LGI groups showed higher blood glucose and insulin AUC0-60 min than the control group (P < 0.001). At 60 min after the meal, the changes in blood pressure during SHG-ex were significantly greater in the HGI group, but not in the LGI group, than in the control group. The changes in blood pressure at the onset and end of SHG-ex 60 min after the meal were positively correlated with blood glucose AUC0-60 min (r = 0.321, P = 0.038; r = 0.402, P = 0.008, respectively) and plasma insulin AUC0-60 min (r = 0.339, P = 0.028; r = 0.302, P = 0.052, respectively). However, no association was observed during PEMI. These data suggest that postprandial hyperglycemia and hyperinsulinemia acutely exaggerate pressor response during SHG-ex in healthy young adults.NEW & NOTEWORTHY Postprandial hyperglycemia following consumption of a high-glycemic index (HGI) meal potentiated blood pressure response to static handgrip exercise (SHG-ex) in healthy young adults. These findings provide important insight into the role of the diet on acute circulatory response to exercise in healthy adults.

The Impact of Heat Acclimation on Gastrointestinal Function following Endurance Exercise in a Hot Environment

To determine the effects of heat acclimation on gastrointestinal (GI) damage and the gastric emptying (GE) rate following endurance exercise in a hot environment. Fifteen healthy men were divided into two groups: endurance training in hot (HOT, 35 °C, n = 8) or cool (COOL, 18 °C, n = 7) environment. All subjects completed 10 days of endurance training (eight sessions of 60 min continuous exercise at 50% of the maximal oxygen uptake (V·O2max). Subjects completed a heat stress exercise tests (HST, 60 min exercise at 60% V·O2max) to evaluate the plasma intestinal fatty acid-binding protein (I-FABP) level and the GE rate following endurance exercise in a hot environment (35 °C) before (pre-HST) and after (post-HST) the training period. We assessed the GE rate using the ¹³C-sodium acetate breath test. The core temperature during post-HST exercise decreased significantly in the HOT group compared to the pre-HST (p = 0.004) but not in the COOL group. Both the HOT and COOL groups showed exercise-induced plasma I-FABP elevations in the pre-HST (p = 0.002). Both groups had significantly attenuated exercise-induced I-FABP elevation in the post-HST. However, the reduction of exercise-induced I-FABP elevation was not different significantly between both groups. GE rate following HST did not change between pre- and post-HST in both groups, with no significant difference between two groups in the post-HST. Ten days of endurance training in a hot environment improved thermoregulation, whereas exercise-induced GI damage and delay of GE rate were not further attenuated compared with training in a cool environment.

Effects of different temperatures of carbohydrate-protein-containing drinks on gastric emptying rate after exercise in healthy young men: randomized crossover trial

Background

The present study examined the effects of different temperatures of carbohydrate-protein-containing drinks after exercise on the subsequent gastric emptying rate in healthy young men.

Methods

Twelve healthy young men completed two, 1-day trials in random order. In both trials, the participants completed intermittent cycling exercise for 20 min, consisting of a 120% heart rate peak for 20 s, followed by 25 W for 40 s. Participants consumed 400 mL of carbohydrate-protein-containing drink (0.85 MJ) at 4 °C (EX + 4 °C) or 60 °C (EX + 60 °C) over a 5-min period after exercise. The participants sat on a chair for 2.5 h to measure their gastric emptying rate using the ¹³C-sodium acetate breath test. Subjective feelings of gastrointestinal discomfort and appetite were measured using a visual analog scale. Interstitial fluid glucose levels after drinking were measured using a continuous glucose-monitoring device.

Results

The percentage excretion of ¹³CO₂ tended to be higher at EX + 60 °C than at EX + 4 °C from the start of the test until 30 min after drink ingestion (5.7 ± 0.5 vs. 6.5 ± 0.4%dose/h for the EX + 4 °C and EX + 60 °C trials, respectively; effect sizes [ES] = 0.277, p = 0.065). The time of maximum ¹³CO₂ emissions per hour (Tmax-calc) and the time of half ¹³CO₂ emissions per hour (T_1/2) did not differ between trials. Subjective gastrointestinal discomfort was lower at EX + 60 °C compared to EX + 4 °C (ES = 0.328, p = 0.041). There were no significant differences in interstitial fluid glucose levels between the different temperatures of carbohydrate-protein-containing drinks after exercise (p = 0.698).

Conclusions

Consumption of warm carbohydrate-protein-containing drinks after exercise may accelerate gastric emptying in the very early phase and may reduce gastric discomfort.

Trial registration

University Hospital Medical Information Network, UMIN000045626. Registered on June 10, 2021.

Blood pressure and celiac artery blood flow responses during increased inspiratory muscle work in healthy males

NEW FINDINGS

What is the central question of this study? Increased work of breathing and the accumulation of metabolites have neural and cardiovascular consequences through a respiratory muscle-induced metaboreflex. The influence of respiratory muscle-induced metaboreflex on splanchnic blood flow in humans remains unknown. What is the main finding and its importance? Celiac artery blood flow decreased gradually during inspiratory resistive breathing, accompanied by a progressive increase in arterial blood pressure. It is possible that respiratory muscle-induced metaboreflex contributes to splanchnic blood flow regulation.

ABSTRACT

The purpose of this study was to clarify the effect of increasing inspiratory muscle work on celiac artery blood flow. Eleven healthy young males completed the study. The subjects performed voluntary hyperventilation with or without inspiratory resistance (loading or non-loading trial) (tidal volume of 40% of vital capacity and breathing frequency of 20 breaths/min). The loading trial was conducted with inspiratory resistance (40% of maximal inspiratory pressure) and was terminated when the subjects could no longer maintain the target tidal volume or breathing frequency. The non-loading trial was conducted without inspiratory resistance and was the same length as the loading trial. Arterial blood pressure was recorded using finger photoplethysmography, and celiac artery blood flow was measured using Doppler ultrasound. Mean arterial blood pressure (MAP) increased gradually during the loading trial (89.0±10.8 to 103.9±17.3 mmHg, mean ± SD) but not in the non-loading trial (88.7±5.9 to 90.4±9.9 mmHg). Celiac artery blood flow and celiac vascular conductance decreased gradually during the loading trial (601.2±155.7 to 482.6±149.5 mL/min and 6.9±2.2 to 4.8±1.7 mL/min/mmHg, respectively), but were unchanged in the non-loading trial (630.7±157.1 to 635.6±195.7 mL/min and 7.1±1.8 to 7.2±2.9 mL/min/mmHg, respectively). These results show that increasing inspiratory muscle work affects splanchnic blood flow regulation, and we suggest that it is possibly mediated by the inspiratory muscle-induced metaboreflex. This article is protected by copyright. All rights reserved.

The effects of different temperatures of post-exercise protein-containing drink on gastric motility and energy intake in healthy young men

The present study examined the effects of different temperatures of protein-containing drink after exercise on subsequent gastric motility and energy intake in healthy young men. Twelve healthy young men completed three, 1-d trials in a random order. In all trials, the subjects ran on a treadmill for 30 min at 80% of maximum heart rate. In exercise + cold drink (2°C) and exercise + hot drink (60°C) trials, the subjects consumed 300 ml of protein-containing drink (0·34 MJ) at 2°C or 60°C over a 5-min period after exercise. In the exercise (i.e. no preload) trial, the subjects sat on a chair for 5 min after exercise. Then, the subjects sat on a chair for 30 min to measure their gastric motility with an ultrasound imaging system in all trials. Thereafter, the subjects consumed a test meal until they felt comfortably full. Energy intake in the exercise + hot drink trial was 14 % and 15 % higher than the exercise (P = 0·046, 95% CI 4·010, 482·538) trial and exercise + cold drink (P = 0·001, 95% CI 160·089, 517·111) trial, respectively. The frequency of the gastric contractions in the exercise + hot drink trial was higher than the exercise (P = 0·023) trial and exercise + cold drink (P = 0·007) trial. The total frequency of gastric contractions was positively related to energy intake (r = 0·386, P = 0·022). These findings demonstrate that consuming protein-containing drink after exercise at 60°C increases energy intake and that this increase may be related to the modulation of the gastric motility.

A Comparison of Intermittent and Continuous Exercise Bouts at Different Intensities on Appetite and Postprandial Metabolic Responses in Healthy Men

Exercise intensity affects many potential postprandial responses, but there is limited information on the influence of exercise modality. Therefore, the aim of this study was to investigate if the nature of exercise at two different intensities would affect gastric emptying rate (GER), appetite and metabolic responses following ingestion of a semi-solid meal. Twelve healthy men completed, in a random order, four 60-min cycles at 60% VO_2peak (MOD), 40% VO_2peak (LOW) and in a continuous (CON) or intermittent (INT) manner. INT consisted of 20 × 1-min exercise bouts with 2-min rest breaks. INT and CON were matched for total work output at each intensity. GER of the post-exercise meal was measured for 2 h using the 13C-breath method. Blood glucose, substrate utilisation and appetite ratings were measured at regular intervals throughout all trials and 24-h energy intake (EI) post-trials was assessed. GER-Delta over Baseline (DOB) was lower (p < 0.05) on MOD-INT vs. MOD-CON from 30–120 min post-meal. Blood glucose was higher mid-exercise (p < 0.05) on MOD-INT vs. MOD-CON. Although post-exercise LOW-CON was significantly higher than LOW-INT (p < 0.05), blood glucose was also higher 30-min post-meal ingestion on both CON trials compared to INT (p < 0.001). No interaction effect was observed for perceived appetite responses 2 h after meal ingestion (all p > 0.05). 24-h post-trial EI was similar between LOW-CON vs. LOW-INT (p > 0.05), although MOD-INT vs. MOD-CON 3500 ± 1419 vs. 2556 ± 989 kCal: p < 0.001 was elevated. In summary, MOD-INT exercise delays GER without stimulating perceived appetite in the 2 h period after meal ingestion, although EI was greater in the 24-h post-trial.

Timing of Nutrient Ingestion after Mild to Moderate Cycling Exercise Does Not Affect Gastric Emptying Rate in Humans

This study examined the effect of carbohydrate drink ingestion timing on gastrointestinal tract blood flow and motility after mild cycling exercise. Eight healthy participants were randomly assigned to ingest a liquid solution with 75 g glucose at either 5 min (PE-5) or 30 min (PE-30) after a single bout of leg cycling exercise according to target heart rate (approximately 120 beats/min). As the control trial (Con), participants ingested the same liquid solution without exercise. Celiac artery blood flow (BF), superior mesenteric artery BF, and gastric emptying rate were assessed by ultrasonography before and for 60 min after ingesting the glucose solution. Blood lactate, glucose, and plasma insulin were also measured at baseline and for 60 min after ingesting the glucose solution. Celiac artery BF significantly decreased from resting baseline immediately after exercise in both the PE-5 and PE-30 trials, and then returned to resting baseline just before the ingestion of glucose solution in the PE-30 trial. After ingesting the glucose solution, changes in celiac artery BF, superior mesenteric artery BF, % gastric emptying rate, blood lactate, blood glucose, and plasma insulin were not significantly different among the three trials. The timing of nutrient ingestion after mild exercise does not seem to impact the subsequent gastrointestinal motility, blood flow, and glycemic responses.

The Gastrointestinal Exertional Heat Stroke Paradigm: Pathophysiology, Assessment, Severity, Aetiology and Nutritional Countermeasures

Exertional heat stroke (EHS) is a life-threatening medical condition involving thermoregulatory failure and is the most severe condition along a continuum of heat-related illnesses. Current EHS policy guidance principally advocates a thermoregulatory management approach, despite growing recognition that gastrointestinal (GI) microbial translocation contributes to disease pathophysiology. Contemporary research has focused to understand the relevance of GI barrier integrity and strategies to maintain it during periods of exertional-heat stress. GI barrier integrity can be assessed non-invasively using a variety of in vivo techniques, including active inert mixed-weight molecular probe recovery tests and passive biomarkers indicative of GI structural integrity loss or microbial translocation. Strenuous exercise is strongly characterised to disrupt GI barrier integrity, and aspects of this response correlate with the corresponding magnitude of thermal strain. The aetiology of GI barrier integrity loss following exertional-heat stress is poorly understood, though may directly relate to localised hyperthermia, splanchnic hypoperfusion-mediated ischemic injury, and neuroendocrine-immune alterations. Nutritional countermeasures to maintain GI barrier integrity following exertional-heat stress provide a promising approach to mitigate EHS. The focus of this review is to evaluate: (1) the GI paradigm of exertional heat stroke; (2) techniques to assess GI barrier integrity; (3) typical GI barrier integrity responses to exertional-heat stress; (4) the aetiology of GI barrier integrity loss following exertional-heat stress; and (5) nutritional countermeasures to maintain GI barrier integrity in response to exertional-heat stress.

The effects of isomaltulose ingestion on gastric parameters and cycling performance in young men

Background/Objective

Isomaltulose is a disaccharide with a low glycaemic index and plays a role in maintaining postprandial glucose. The maintenance of glucose availability during prolonged exercise has been shown to enhance exercise performance. The present study compared the effects of pre-exercise isomaltulose versus maltodextrin ingestion on gastric parameters and cycling performance in young men.

Methods

Fourteen young men (mean ± S.D., age 23 ± 2 years) performed 60 min of continuous cycling at 75% of maximum heart rate followed by a 15-min exercise performance test while ingesting a 500-mL of water containing 100 mg of ¹³C-sodium acetate with either 50 g of isomaltulose or 50 g of maltodextrin. Gastrointestinal discomfort was assessed periodically using an 11-point visual analogue scale throughout the study. The gastric emptying rate was evaluated periodically with the ¹³C-sodium acetate breath test. For the exercise performance test, participants were instructed to pedal a cycle ergometer, exerting as much effort as possible at a self-selected pace.

Results

Plasma glucose and insulin concentrations measured at 30 min after ingestion were lower in the isomaltulose trial than in the maltodextrin trial. There were no differences in mean power output during the exercise performance test, gastric emptying rate or the subjective feelings of gastrointestinal discomfort between both trials.

Conclusion

Under the current exercise protocol, pre-exercise ingestion of isomaltulose compared with maltodextrin provided no additional benefit relative to gastric emptying or aerobic exercise performance. Both isomaltulose and maltodextrin ingestion did not influence gastrointestinal distress during 60 min of cycling and performance test.

Timing of post-resistance exercise nutrient ingestion: effects on gastric emptying and glucose and amino acid responses in humans

This study examined the effects of post-resistance exercise protein ingestion timing on the rate of gastric emptying (GE) and blood glucose (BG) and plasma branched-chain amino acid (BCAA) responses. In all, eleven healthy participants randomly ingested 400 ml of a nutrient-rich drink containing 12 g carbohydrates and 20 g protein at rest (Con), at 5 min (post-exercise (PE)-5) or at 30 min (PE-30) after a single bout of strenuous resistance exercises. The first and second sets comprised ten repetitions at 50 % of each participant's one-repetition maximum (1RM). The third, fourth and fifth sets comprised ten repetitions at 75 % of 1RM, and the sixth set involved repeated repetitions until exhaustion. Following ingestion of the nutrient-rich drink, we assessed the GE rate using 13C-sodium acetate breath test and evaluated two parameters according to the T max-calc (time when the recovery per hour is maximised), which is a standard analytical method, and T 1/2 (time when the total cumulative dose of [13CO2] reaches one-half). T max-calc and T 1/2 were slower for the PE-5 condition than for either the PE-30 or Con condition (T max-calc; Con: 53 (sd 7) min, PE-5: 83 (sd 16) min, PE-30: 62 (sd 9) min, T 1/2; Con: 91 (sd 7) min, PE-5: 113 (sd 21) min, PE-30: 91 (sd 11) min, P<0·05). BG and BCAA responses were also slower for the PE-5 condition than for either the PE-30 or Con condition. Ingesting nutrients immediately after strenuous resistance exercise acutely delayed GE, which affected BG and plasma BCAA levels in blood circulation.