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Gaffney-Stomberg E, Nakayama AT, Lutz LJ, McClung JP, O'Brien KO, Staab JS. Load carriage exercise increases calcium absorption and retention in healthy young women. J Bone Miner Res 2024; 39:39-49. [PMID: 38630876 DOI: 10.1093/jbmr/zjad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/16/2023] [Accepted: 12/05/2023] [Indexed: 04/19/2024]
Abstract
Aerobic exercise reduces circulating ionized Ca (iCa) and increases parathyroid hormone (PTH), but the cause and consequences on Ca handling are unknown. The objective of this study was to determine the effects of strenuous exercise on Ca kinetics using dual stable Ca isotopes. Twenty-one healthy women (26.4 ± 6.7 yr) completed a randomized, crossover study entailing two 6-d iterations consisting of either 60 min of treadmill walking at 65% VO2max wearing a vest weighing 30% body weight on study days 1, 3, and 5 (exercise [EX]), or a rest iteration (rest [REST]). On day 1, participants received intravenous 42Ca and oral 44Ca. Isotope ratios were determined by thermal ionization mass spectrometry. Kinetic modeling determined fractional Ca absorption (FCA), Ca deposition (Vo+), resorption (Vo-) from bone, and balance (Vbal). Circulating PTH and iCa were measured before, during, and after each exercise/rest session. Data were analyzed by paired t-test or linear mixed models using SPSS. iCa decreased and PTH increased (P < .001) during each EX session and were unchanged during REST. On day 1, urinary Ca was lower in the EX pool (25 ± 11 mg) compared to REST (38 ± 16 mg, P = .001), but did not differ over the full 24-h collection (P > .05). FCA was greater during EX (26.6 ± 8.1%) compared to REST (23.9 ± 8.3%, P < .05). Vbal was less negative during EX (-61.3 ± 111 mg) vs REST (-108 ± 23.5 mg, P < .05), but VO+ (574 ± 241 vs 583 ± 260 mg) and VO- (-636 ± 243 vs -692 ± 252 mg) were not different (P > .05). The rapid reduction in circulating iCa may be due to a change in the miscible Ca pool, resulting in increased PTH and changes in intestinal absorption and renal Ca handling that support a more positive Ca balance.
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Affiliation(s)
- Erin Gaffney-Stomberg
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, United States
| | - Anna T Nakayama
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, United States
| | - Laura J Lutz
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, United States
| | - James P McClung
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, United States
| | - Kimberly O O'Brien
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14850, United States
| | - Jeffery S Staab
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, United States
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Hughes L, Centner C. Idiosyncratic bone responses to blood flow restriction exercise: new insights and future directions. J Appl Physiol (1985) 2024; 136:283-297. [PMID: 37994414 DOI: 10.1152/japplphysiol.00723.2022] [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: 11/28/2022] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023] Open
Abstract
Applying blood flow restriction (BFR) during low-load exercise induces beneficial adaptations of the myotendinous and neuromuscular systems. Despite the low mechanical tension, BFR exercise facilitates a localized hypoxic environment and increase in metabolic stress, widely regarded as the primary stimulus for tissue adaptations. First evidence indicates that low-load BFR exercise is effective in promoting an osteogenic response in bone, although this has previously been postulated to adapt primarily during high-impact weight-bearing exercise. Besides studies investigating the acute response of bone biomarkers following BFR exercise, first long-term trials demonstrate beneficial adaptations in bone in both healthy and clinical populations. Despite the increasing number of studies, the physiological mechanisms are largely unknown. Moreover, heterogeneity in methodological approaches such as biomarkers of bone metabolism measured, participant and study characteristics, and time course of measurement renders it difficult to formulate accurate conclusions. Furthermore, incongruity in the methods of BFR application (e.g., cuff pressure) limits the comparability of datasets and thus hinders generalizability of study findings. Appropriate use of biomarkers, effective BFR application, and befitting study design have the potential to progress knowledge on the acute and chronic response of bone to BFR exercise and contribute toward the development of a novel strategy to protect or enhance bone health. Therefore, the purpose of the present synthesis review is to 1) evaluate current mechanistic evidence; 2) discuss and offer explanations for similar and contrasting data findings; and 3) create a methodological framework for future mechanistic and applied research.
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Affiliation(s)
- Luke Hughes
- Department of Sport Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
- Praxisklinik Rennbahn, Muttenz, Switzerland
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Hilkens L, Praster F, van Overdam J, Nyakayiru J, Singh-Povel CM, Bons J, van Loon LJ, van Dijk JW. Graded Replacement of Carbohydrate-Rich Breakfast Products with Dairy Products: Effects on Postprandial Aminoacidemia, Glycemic Control, Bone Metabolism, and Satiety. J Nutr 2024; 154:479-490. [PMID: 38092152 DOI: 10.1016/j.tjnut.2023.12.012] [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: 10/11/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Postprandial metabolic responses following dairy consumption have mostly been studied using stand-alone dairy products or milk-derived nutrients. OBJECTIVE Assessing the impact of ingesting dairy products as part of a common breakfast on postprandial aminoacidemia, glycemic control, markers of bone metabolism, and satiety. METHODS In this randomized, crossover study, 20 healthy young males and females consumed on 3 separate occasions an iso-energetic breakfast containing no dairy (NO-D), 1 dairy (ONE-D), or 2 dairy (TWO-D) products. Postprandial concentrations of amino acids, glucose, insulin, glucagon-like peptide-1 (GLP-1), calcium, parathyroid hormone (PTH), and markers of bone formation (P1NP) and resorption (CTX-I) were measured before and up to 300 min after initiating the breakfast, along with VAS-scales to assess satiety. RESULTS Plasma essential and branched-chained amino acids availability (expressed as total area under the curve (tAUC)) increased in a dose-dependent manner (P<0.05 for all comparisons). Plasma glucose tAUCs were lower in ONE-D and TWO-D compared with NO-D (P<0.05 for both comparisons). Plasma GLP-1 tAUC increased in a dose-dependent manner (P<0.05 for all comparisons), whereas no differences were observed in plasma insulin tAUC between conditions (P>0.05 for all comparisons). Serum calcium tAUCs were higher in ONE-D and TWO-D compared with NO-D (P<0.05 for both comparisons), along with lower PTH tAUCs in ONE-D and TWO-D compared with NO-D (P=0.001 for both comparisons). In accordance, serum CTX-I concentrations were lower in the late postprandial period in ONE-D and TWO-D compared with NO-D (P<0.01 for both comparisons). No differences were observed in P1NP tAUCs between conditions (P>0.05). The tAUC for satiety was higher in TWO-D compared with NO-D and ONE-D (P<0.05 for both comparisons). CONCLUSIONS Iso-energetic replacement of a carbohydrate-rich breakfast component with one serving of dairy improves postprandial amino acid availability, glycemic control, and bone metabolism. Adding a second serving of dairy in lieu of carbohydrates augments postprandial amino acid and GLP-1 concentrations while further promoting satiety. This study was registered at https://doi.org/10.1186/ISRCTN13531586 with Clinical Trial Registry number ISRCTN13531586.
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Affiliation(s)
- Luuk Hilkens
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands; Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Floor Praster
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Jan van Overdam
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | | | | | - Judith Bons
- Central Diagnostic Laboratory, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Luc Jc van Loon
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands; Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Jan-Willem van Dijk
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands.
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Koltun KJ, Sterczala AJ, Sekel NM, Krajewski KT, Martin BJ, Lovalekar M, Connaboy C, Flanagan SD, Wardle SL, O'Leary TJ, Greeves JP, Nindl BC. Effect of acute resistance exercise on bone turnover in young adults before and after concurrent resistance and interval training. Physiol Rep 2024; 12:e15906. [PMID: 38296351 PMCID: PMC10830389 DOI: 10.14814/phy2.15906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 02/05/2024] Open
Abstract
Weight-bearing physical activity can stimulate bone adaptation. This investigation explored the effect of an acute bout of resistance exercise before and after resistance+interval training on circulating biomarkers of bone metabolism and muscle-bone crosstalk. Healthy young male and female participants (n = 21 male, 28 ± 4 years; n = 17 female, 27 ± 5 years) performed a 6 × 10 squat test (75% 1RM) before and after a 12-week resistance+interval training program. Before and after completion of the training program, blood samples were collected at rest, immediately postexercise, and 2 h postexercise. Blood samples were analyzed for βCTX, P1NP, sclerostin, osteocalcin, IGF-1, and irisin. Significant effects of acute exercise (main effect of time) were observed as increases in concentrations of IGF-1, irisin, osteocalcin, and P1NP from rest to postexercise. A sex*time interaction indicated a greater decline in βCTX concentration from rest to 2 h postexercise and a greater increase in sclerostin concentration from rest to immediately postexercise in male compared with female participants. Sex differences (main effect of sex) were also observed for irisin and P1NP concentrations. In summary, changes in concentrations of biochemical markers of bone metabolism and muscle-bone crosstalk were observed in males and females after an acute bout of resistance exercise and following 12 weeks of resistance+interval training.
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Affiliation(s)
- Kristen J. Koltun
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Adam J. Sterczala
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Nicole M. Sekel
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Kellen T. Krajewski
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Brian J. Martin
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Mita Lovalekar
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Christopher Connaboy
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Shawn D. Flanagan
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | | | | | - Bradley C. Nindl
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
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Martínez-Noguera FJ, Alcaraz PE, Ortolano-Ríos R, Marín-Pagán C. One Season in Professional Cycling Is Enough to Negatively Affect Bone Health. Nutrients 2023; 15:3632. [PMID: 37630821 PMCID: PMC10458969 DOI: 10.3390/nu15163632] [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: 07/10/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Cycling is a very popular sport worldwide, and several studies have already indicated that cycling at various levels has a negative impact on bone health. This is of concern to both performance and health managers of many cycling teams at different levels because of its economic and social impact. Based on the scientific literature, we hypothesize that a single season at the professional level can negatively affect bone health status. The aim of this study was to assess how professional cycling affects bone health markers after one season. Densitometry was used to measure the bone mineral density (BMD), bone mineral content (BMC), bone area (BA), fat mass (FM), fat-free mass (FFM), T-score and Z-score in professional cyclists after one season. After one season at the professional level, cyclists' BMD decreased significantly in the legs, trunk, ribs and pelvis (p ≤ 0.05). BMC decreased in the arms and spine (p ≤ 0.05). BA decreased significantly in the arms and spine (p ≤ 0.05). In addition, a significant decrease in Z-score (p ≤ 0.05) and a decreasing trend in T-score and total BMD (p = 0.06) were observed. One season of professional cycling is enough to negatively affect bone health status.
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Affiliation(s)
- Francisco Javier Martínez-Noguera
- Research Center for High-Performance Sport, University of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.E.A.); (C.M.-P.)
| | - Pedro E. Alcaraz
- Research Center for High-Performance Sport, University of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.E.A.); (C.M.-P.)
| | - Raquel Ortolano-Ríos
- Sports Physiology Department, Faculty of Health Sciences, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain;
| | - Cristian Marín-Pagán
- Research Center for High-Performance Sport, University of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.E.A.); (C.M.-P.)
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Coombs CV, Wardle SL, Shroff R, Eisenhauer A, Tang JCY, Fraser WD, Greeves JP, O'Leary TJ. The effect of calcium supplementation on calcium and bone metabolism during load carriage in women: protocol for a randomised controlled crossover trial. BMC Musculoskelet Disord 2023; 24:496. [PMID: 37328859 DOI: 10.1186/s12891-023-06600-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/02/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Military field exercises are characterised by high volumes of exercise and prolonged periods of load carriage. Exercise can decrease circulating serum calcium and increase parathyroid hormone and bone resorption. These disturbances to calcium and bone metabolism can be attenuated with calcium supplementation immediately before exercise. This randomised crossover trial will investigate the effect of calcium supplementation on calcium and bone metabolism, and bone mineral balance, during load carriage exercise in women. METHODS Thirty women (eumenorrheic or using the combined oral contraceptive pill, intrauterine system, or intrauterine device) will complete two experimental testing sessions either with, or without, a calcium supplement (1000 mg). Each experimental testing session will involve one 120 min session of load carriage exercise carrying 20 kg. Venous blood samples will be taken and analysed for biochemical markers of bone resorption and formation, calcium metabolism, and endocrine function. Urine will be collected pre- and post-load carriage to measure calcium isotopes for the calculation of bone calcium balance. DISCUSSION The results from this study will help identify whether supplementing women with calcium during load carriage is protective of bone and calcium homeostasis. TRIAL REGISTRATION NCT04823156 (clinicaltrials.gov).
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Affiliation(s)
- Charlotte V Coombs
- Army Health and Performance Research, Army Headquarters, Andover, SP11 8HT, UK
| | - Sophie L Wardle
- Army Health and Performance Research, Army Headquarters, Andover, SP11 8HT, UK
| | - Rukshana Shroff
- Renal Unit, UCL Great Ormond Street Hospital for Children NHS Foundation Trust and Institute of Child Health, London, UK
| | | | | | | | - Julie P Greeves
- Army Health and Performance Research, Army Headquarters, Andover, SP11 8HT, UK
| | - Thomas J O'Leary
- Army Health and Performance Research, Army Headquarters, Andover, SP11 8HT, UK.
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Nichols QZ, Ramadoss R, Stanzione JR, Volpe SL. Micronutrient supplement intakes among collegiate and masters athletes: A cross-sectional study. Front Sports Act Living 2023; 5:854442. [PMID: 37090821 PMCID: PMC10117840 DOI: 10.3389/fspor.2023.854442] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/16/2023] [Indexed: 04/08/2023] Open
Abstract
ObjectiveIn our cross-sectional study, we evaluated micronutrient supplementation intake among Collegiate and Masters Athletes.MethodsWe conducted a cross-sectional study to assess micronutrient supplementation consumption in Collegiate and Masters Athletes, comparing sex and sport classification within each respective group. Micronutrient supplement consumption data were measured using a Food Frequency Questionnaire. A two-way analysis of variance was used to explore the differences among Collegiate and Masters Athletes' supplement intakes of the following vitamins and minerals: vitamins A, B6, B12, C, E, D, and calcium, folate, iron, magnesium niacin, riboflavin, selenium, thiamine, and zinc. When significant differences were found, a Bonferroni post hoc test was performed to identify specific group differences. The significance level was set a priori at p < 0.05.ResultsA total of 198 athletes (105 females and 93 males) were included in the study. Participants were 36.16 ± 12.33 years of age. Collegiate male athletes had significantly greater vitamin A [1,090.51 ± 154.72 vs. 473.93 ± 233.18 mg retinol activity equivalents (RAE)/day] (p < 0.036), folate [337.14 ± 44.79 vs. 148.67 ± 67.50 mcg dietary folate equivalents (DFE)/day] (p < 0.027), and magnesium (65.35 ± 8.28 vs. 31.28 ± 12.48 mg/day) (p < 0.031) intakes compared to Collegiate female athletes. Collegiate CrossFit Athletes (940.71 ± 157.54 mg/day) had a significantly greater vitamin C intake compared to Collegiate General Athletes (156.34 ± 67.79 mg/day) (p < 0.005), Collegiate Triathletes (88.57 ± 148.53 mg/day) (p < 0.027), Collegiate Resistance Training Athletes (74.28 ± 143.81 mg/day) (p < 0.020), and Collegiate Powerlifters (175.71 ± 128.63 mg/day) (p < 0.044). Masters females had significantly greater calcium intakes compared to Masters males (494.09 ± 65.73 vs.187.89 ± 77.23 mg/day, respectively) (p < 0.002). Collegiate Runners (41.35 ± 6.53 mg/day) had a significantly greater iron intake compared to Collegiate Powerlifters (4.50 ± 6.53 mg/day) (p < 0.024). Masters Swimmers (61.43 ± 12.10 mg/day) had significantly greater iron intakes compared to Masters General Athletes (13.97 ± 3.56 mg/day) (p < 0.014), Masters Runners (17.74 ± 2.32 mg/day) (p < 0.03), Masters Triathletes (11.95 ± 3.73 mg/day) (p < 0.008), Masters CrossFit Athletes (15.93 ± 5.36 mg/day) (p < 0.043), Masters Rowers (9.10 ± 3.36 mg/day) (p < 0.003), and Masters Cyclists (1.71 ± 9.88 mg/day) (p < 0.011). Masters Powerlifters (47.14 ± 9.65 mg/day) had significantly greater zinc intakes compared to Masters General Athletes (9.57 ± 2.84 mg/day) (p < 0.015), Masters Runners (10.67 ± 1.85 mg/day) (p < 0.017), Masters Triathletes (10.24 ± 2.98 mg/day) (p < 0.020), Masters Rowers (9.33 ± 2.68 mg/day) (p < 0.013), and Masters Cyclists (1.43 ± 7.88 mg/day) (p < 0.019). There were no other significant differences among the other micronutrient supplement intakes between the sexes or among the sport classification.ConclusionWe reported significant differences among female and male Collegiate and Masters Athletes. Additionally, we reported significant differences among Collegiate and Masters Athletes sport classifications. Further research should examine both dietary and micronutrient supplement intake among Collegiate and Masters Athletes to examine the extent that athletes exceed the Recommended Dietary Allowances (RDA), and the potential effects on health and performance.
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Affiliation(s)
- Quentin Z. Nichols
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA, United States
| | - Rohit Ramadoss
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA, United States
| | - Joseph R. Stanzione
- Nutrition & Scientific Affairs, Worldwide Sport Nutritional Supplements, Bohemia, NY, United States
| | - Stella L. Volpe
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA, United States
- Correspondence: Stella L. Volpe
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LUNDY BRONWEN, MCKAY ALANNAHKA, FENSHAM NIKITAC, TEE NICOLIN, ANDERSON BRYCE, MORABITO AIMEE, ROSS MEGANLR, SIM MARC, ACKERMAN KATHRYNE, BURKE LOUISEM. The Impact of Acute Calcium Intake on Bone Turnover Markers during a Training Day in Elite Male Rowers. Med Sci Sports Exerc 2023; 55:55-65. [PMID: 35977107 PMCID: PMC9770130 DOI: 10.1249/mss.0000000000003022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Although an acute exercise session typically increases bone turnover markers (BTM), the impact of subsequent sessions and the interaction with preexercise calcium intake remain unclear despite the application to the "real-life" training of many competitive athletes. METHODS Using a randomized crossover design, elite male rowers ( n = 16) completed two trials, a week apart, consisting of two 90-min rowing ergometer sessions (EX1, EX2) separated by 150 min. Before each trial, participants consumed a high (CAL; ~1000 mg) or isocaloric low (CON; <10 mg) calcium meal. Biochemical markers including parathyroid hormone (PTH), serum ionized calcium (iCa) and BTMs (C-terminal telopeptide of type I collagen, osteocalcin) were monitored from baseline to 3 h after EX2. RESULTS Although each session caused perturbances of serum iCa, CAL maintained calcium concentrations above those of CON for most time points, 4.5% and 2.4% higher after EX1 and EX2, respectively. The decrease in iCa in CON was associated with an elevation of blood PTH ( P < 0.05) and C-terminal telopeptide of type I collagen ( P < 0.0001) over this period of repeated training sessions and their recovery, particularly during and after EX2. Preexercise intake of calcium-rich foods lowered BTM over the course of a day with several training sessions. CONCLUSIONS Preexercise intake of a calcium-rich meal before training sessions undertaken within the same day had a cumulative and prolonged effect on the stabilization of blood iCa during exercise. In turn, this reduced the postexercise PTH response, potentially attenuating the increase in markers of bone resorption. Such practical strategies may be integrated into the athlete's overall sports nutrition plan, with the potential to safeguard long-term bone health and reduce the risk of bone stress injuries.
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Affiliation(s)
- BRONWEN LUNDY
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA,Rowing Australia, Yarralumla, Australian Capital Territory, AUSTRALIA
| | - ALANNAH K. A. MCKAY
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA
| | - NIKITA C. FENSHAM
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA
| | - NICOLIN TEE
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA
| | - BRYCE ANDERSON
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA
| | - AIMEE MORABITO
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA
| | - MEGAN L. R. ROSS
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA
| | - MARC SIM
- Institute for Nutrition Research, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, AUSTRALIA,School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, AUSTRALIA
| | - KATHRYN E. ACKERMAN
- Female Athlete Program, Boston Children’s Hospital and Harvard Medical School, Boston, MA
| | - LOUISE M. BURKE
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA
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Staab JS, Lutz LJ, Foulis SA, Gaffney-Stomberg E, Hughes JM. Load carriage aerobic exercise stimulates a transient rise in biochemical markers of bone formation and resorption. J Appl Physiol (1985) 2023; 134:85-94. [PMID: 36454676 PMCID: PMC9829485 DOI: 10.1152/japplphysiol.00442.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
Exercise can be both anabolic and catabolic for bone tissue. The temporal response of both bone formation and resorption following an acute bout of exercise is not well described. We assayed biochemical markers of bone and calcium metabolism for up to 3 days after military-relevant exercise. In randomized order, male (n = 18) and female (n = 2) Soldiers (means ± SD; 21.2 ± 4.1 years) performed a 60-min bout of load carriage (30% body mass; 22.4 ± 3.7 kg) treadmill exercise (EXER) or a resting control trial (REST). Blood samples were collected following provision of a standardized breakfast before (PRE), after (POST) exercise/rest, 1 h, 2 h, and 4 h into recovery. Fasted samples were also collected at 0630 on EXER and REST and for the next three mornings after EXER. Parathyroid hormone and phosphorus were elevated (208% and 128% of PRE, respectively, P < 0.05), and ionized calcium reduced (88% of PRE, P < 0.05) after EXER. N-terminal propeptide of type 1 collagen was elevated at POST (111% of PRE, P < 0.05), and the resorption marker, C-terminal propeptide of type 1 collagen was elevated at 1 h (153% of PRE, P < 0.05). Osteocalcin was higher than PRE at 1 through 4 h post EXER (119%-120% of PRE, P < 0.05). Sclerostin and Dickkopf-related protein-1 were elevated only at POST (132% and 121% of PRE, respectively, P < 0.05) during EXER. Trivial changes in biomarkers during successive recovery days were observed. These results suggest that 60 min of load carriage exercise elicits transient increases in bone formation and resorption that return to pre-exercise concentrations within 24 h post-exercise.NEW & NOTEWORTHY In this study, we demonstrated evidence for increases in both bone formation and resorption in the first 4 h after a bout of load carriage exercise. However, these changes largely disappear by 24 h after exercise. Acute formation and resorption of bone following exercise may reflect distinct physiological mechanoadaptive responses. Future work is needed to identify ways to promote acute post-exercise bone formation and minimize post-exercise resorption to optimize bone adaptation to exercise.
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Affiliation(s)
- Jeffery S Staab
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Laura J Lutz
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Stephen A Foulis
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Erin Gaffney-Stomberg
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Julie M Hughes
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
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10
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López-Torres O, Rodríguez-Longobardo C, Capel-Escoriza R, Fernández-Elías VE. Ergogenic Aids to Improve Physical Performance in Female Athletes: A Systematic Review with Meta-Analysis. Nutrients 2022; 15:nu15010081. [PMID: 36615738 PMCID: PMC9823656 DOI: 10.3390/nu15010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Most intervention studies investigating the effects of ergogenic aids (EAs) on sports performance have been carried out in the male population. Thus, the aim of this systematic review and meta-analysis was to summarize the effects in the existing literature of EAs used by female athletes on performance. A literature research was conducted, and a descriptive analysis of the articles included in the systematic review was carried out. Meta-analyses could be performed on 32 of the included articles, evaluating performance in strength, sprint, and cardiovascular capacity. A random-effects model and the standardized mean differences (SMD) ± 95% confidence intervals (CI) were reported. The results showed that caffeine helped to improve jumping performance, isometric strength values, and the number of repetitions until failure. Caffeine and sodium phosphate helped to improve sprint performance. Aerobic tests could be improved with the use of taurine, caffeine, and beta-alanine. No conclusive effects of beetroot juice, polyphenols, or creatine in improving aerobic performance were shown. In terms of anaerobic variables, both caffeine and sodium phosphate could help to improve repeated sprint ability. More studies are needed in female athletes that measure the effects of different EAs on sports performance, such as beetroot juice, beta-alanine or sodium phosphate, as the studies to date are scarce and there are many types of EA that need to be further considered in this population, such as creatine and taurine.
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Affiliation(s)
- Olga López-Torres
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Celia Rodríguez-Longobardo
- Social Sciences of Physical Activity, Sport and Leisure Department, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence:
| | - Raquel Capel-Escoriza
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Raquel Wellness Instituto de Nutrición y Salud, 28050 Madrid, Spain
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11
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Wilson-Barnes SL, Lanham-New SA, Lambert H. Modifiable risk factors for bone health & fragility fractures. Best Pract Res Clin Rheumatol 2022; 36:101758. [PMID: 35750569 DOI: 10.1016/j.berh.2022.101758] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Osteoporosis is an ageing disorder characterised by poor microstructural architecture of the bone and an increase in the risk of fragility fractures, which often leads to hospitalisation and eventually a loss of mobility and independence. By 2050, it is estimated that more than 30 million people in Europe will be affected by bone diseases, and European hospitalisation alone can approximately cost up to 3.5 billion euros each year [1]. Although inherited variation in bone mineral density (BMD) is pre-determined by up to 85% [2], there is a window of opportunity to optimise BMD and reduce fracture risk through key modifiable lifestyle factors during the life course. An optimal diet rich in micronutrients, such as calcium, vitamin D, and potassium, has long been considered an important modifiable component of bone health, which is attributed to their direct roles within bone metabolism. Recently, there has been emerging evidence to suggest that protein and even an adequate intake of fruit and vegetables may also play an important role in improving BMD [3,4]. Maintaining a physically active lifestyle is not only protective from non-communicable diseases such as cardiovascular disease but it also has been shown to lessen the risk of fractures later in life, thereby making it an imperative modifiable factor for bone health, particularly as it also supports peak bone mass attainment during childhood/adolescence and can facilitate the maintenance of bone mass throughout adulthood [5]. Other key lifestyle factors that could be potentially modified to reduce the risk of osteoporosis or osteoporotic fractures later in life include smoking status, alcohol intake, and body composition [6]. Therefore, the principle aim of this review is to highlight the recent evidence pertaining to modifiable lifestyle factors that contribute to optimal bone health and the prevention of fragility fractures in later life.
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Affiliation(s)
- Saskia L Wilson-Barnes
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK.
| | - Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
| | - Helen Lambert
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
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12
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Xue M, Mackin C, Weng WH, Zhu J, Luo Y, Luo SXL, Lu AY, Hempel M, McVay E, Kong J, Palacios T. Integrated biosensor platform based on graphene transistor arrays for real-time high-accuracy ion sensing. Nat Commun 2022; 13:5064. [PMID: 36030295 PMCID: PMC9420106 DOI: 10.1038/s41467-022-32749-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 08/12/2022] [Indexed: 12/01/2022] Open
Abstract
Two-dimensional materials such as graphene have shown great promise as biosensors, but suffer from large device-to-device variation due to non-uniform material synthesis and device fabrication technologies. Here, we develop a robust bioelectronic sensing platform composed of more than 200 integrated sensing units, custom-built high-speed readout electronics, and machine learning inference that overcomes these challenges to achieve rapid, portable, and reliable measurements. The platform demonstrates reconfigurable multi-ion electrolyte sensing capability and provides highly sensitive, reversible, and real-time response for potassium, sodium, and calcium ions in complex solutions despite variations in device performance. A calibration method leveraging the sensor redundancy and device-to-device variation is also proposed, while a machine learning model trained with multi-dimensional information collected through the multiplexed sensor array is used to enhance the sensing system’s functionality and accuracy in ion classification. The potential of 2D materials for biosensing applications is often limited by large device-to-device variation. Here, the authors report a calibration method and a machine learning approach leveraging the redundancy of a sensing platform based on 256 integrated graphene transistors to enhance the system accuracy in real-time ion classification.
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Affiliation(s)
- Mantian Xue
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | | | - Wei-Hung Weng
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jiadi Zhu
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Yiyue Luo
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Shao-Xiong Lennon Luo
- Department of Chemistry and Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ang-Yu Lu
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Marek Hempel
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Elaine McVay
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jing Kong
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Tomás Palacios
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
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13
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Smith ES, McKay AKA, Kuikman M, Ackerman KE, Harris R, Elliott-Sale KJ, Stellingwerff T, Burke LM. Managing Female Athlete Health: Auditing the Representation of Female versus Male Participants among Research in Supplements to Manage Diagnosed Micronutrient Issues. Nutrients 2022; 14:3372. [PMID: 36014878 PMCID: PMC9412577 DOI: 10.3390/nu14163372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022] Open
Abstract
Micronutrient deficiencies and sub-optimal intakes among female athletes are a concern and are commonly prevented or treated with medical supplements. However, it is unclear how well women have been considered in the research underpinning current supplementation practices. We conducted an audit of the literature supporting the use of calcium, iron, and vitamin D. Of the 299 studies, including 25,171 participants, the majority (71%) of participants were women. Studies with exclusively female cohorts (37%) were also more prevalent than those examining males in isolation (31%). However, study designs considering divergent responses between sexes were sparse, accounting for 7% of the literature. Moreover, despite the abundance of female participants, the quality and quantity of the literature specific to female athletes was poor. Just 32% of studies including women defined menstrual status, while none implemented best-practice methodologies regarding ovarian hormonal control. Additionally, only 10% of studies included highly trained female athletes. Investigations of calcium supplementation were particularly lacking, with just two studies conducted in highly trained women. New research should focus on high-quality investigations specific to female athletes, alongside evaluating sex-based differences in the response to calcium, iron, and vitamin D, thus ensuring the specific needs of women have been considered in current protocols involving medical supplements.
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Affiliation(s)
- Ella S. Smith
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
| | - Alannah K. A. McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
| | - Megan Kuikman
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
| | - Kathryn E. Ackerman
- Wu Tsai Female Athlete Program, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Rachel Harris
- Female Athlete Performance and Health Initiative, Australian Institute of Sport, Canberra, ACT 2617, Australia
- Perth Orthopaedic and Sports Medicine Research Institute, West Perth, WA 6005, Australia
| | | | - Trent Stellingwerff
- Canadian Sport Institute-Pacific, Institute for Sport Excellence, 4371 Interurban Road, Victoria, BC V9E 2C5, Canada
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Louise M. Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
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14
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Guzman A, Kurgan N, Moniz SC, McCarthy SF, Sale C, Logan-Sprenger H, Elliott-Sale KJ, Hazell TJ, Klentrou P. Menstrual Cycle Related Fluctuations in Circulating Markers of Bone Metabolism at Rest and in Response to Running in Eumenorrheic Females. Calcif Tissue Int 2022; 111:124-136. [PMID: 35429247 DOI: 10.1007/s00223-022-00970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/10/2022] [Indexed: 11/02/2022]
Abstract
This study examined potential fluctuations in bone metabolic markers across the menstrual cycle both at rest and after a 30-min bout of continuous running at 80% of V̇O2max. Resting and post-exercise (0, 30, 90 min) sclerostin, parathyroid hormone (PTH), carboxy-terminal cross-linking telopeptide of type I collagen (β-CTXI), and procollagen type 1 N propeptide (PINP) were assessed in 10 eumenorrheic women (age: 21 ± 3 y, BMI: 23.2 ± 3.0 kg.m2) during the mid- to late-follicular (FP: day 8.0 ± 1.4) and mid-luteal (LP: day 22.0 ± 2.5) phases of the menstrual cycle. Ovulation was determined using ovulation kits and daily measurement of oral body temperature upon awakening. Menstrual cycle phase was subsequently confirmed by measurement of plasma estradiol and progesterone. On average, resting estradiol concentrations increased from 46.3 ± 8.9 pg·mL-1 in the FP to 67.3 ± 23.4 pg·mL-1 in the LP (p = 0.015), and resting progesterone increased from 4.12 ± 2.36 ng·mL-1 in the FP to 11.86 ± 4.49 ng·mL-1 in the LP (p < 0.001). At rest, there were no differences between menstrual cycle phases in sclerostin (FP: 260.1 ± 135.0 pg·mL-1; LP: 303.5 ± 99.9 pg·mL-1; p = 0.765), PTH (FP: 0.96 ± 0.64 pmol·L-1; LP: 0.79 ± 0.44 pmol·L-1; p = 0.568), β-CTXI (FP: 243.1 ± 158.0 ng·L-1; LP: 202.4 ± 92.3 ng·L-1; p = 0.198), and PINP (FP: 53.6 ± 8.9 μg·L-1; LP: 66.2 ± 20.2 μg·L-1; p = 0.093). Main effects for time (p < 0.05) were shown in sclerostin, PTH, β-CTXI and PINP, without phase or interaction effects. Sclerostin increased from pre- to immediately post-exercise (45%; p = 0.007), and so did PTH (43%; p = 0.011), both returning to resting concentrations 30 min post-exercise. β-CTXI decreased from pre- to post-exercise (20%; p = 0.027) and was still below its pre-exercise concentrations at 90 min post-exercise (17%; p = 0.013). PINP increased immediately post-exercise (29%; p < 0.001), returning to resting concentrations at 30 min post-exercise. These results demonstrate no effect of menstrual cycle phase on resting bone marker concentrations or on the bone metabolic marker response to intense exercise.
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Affiliation(s)
- Anne Guzman
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Nigel Kurgan
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Sara C Moniz
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Seth F McCarthy
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Craig Sale
- SHAPE Research Centre, Nottingham Trent University, Nottingham, UK
| | | | | | - Tom J Hazell
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Panagiota Klentrou
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada.
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15
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The Bone Biomarker Response to an Acute Bout of Exercise: A Systematic Review with Meta-Analysis. Sports Med 2022; 52:2889-2908. [DOI: 10.1007/s40279-022-01718-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 10/16/2022]
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16
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Prowting JL, Skelly LE, Kurgan N, Fraschetti EC, Klentrou P, Josse AR. Acute Effects of Milk vs. Carbohydrate on Bone Turnover Biomarkers Following Loading Exercise in Young Adult Females. Front Nutr 2022; 9:840973. [PMID: 35571916 PMCID: PMC9101466 DOI: 10.3389/fnut.2022.840973] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/07/2022] [Indexed: 11/17/2022] Open
Abstract
Dairy products and impact exercise have previously been identified to be independently beneficial for bone mineral properties, however, it is unknown how the combination of these two osteogenic interventions may alter acute bone turnover. Using a randomized crossover design, we compared the acute effects of consuming milk vs. an isoenergetic carbohydrate control beverage on bone biomarkers following loading exercise. Thirteen healthy female participants (Age = 20.3 ± 2.3y; BMI = 21.0 ± 1.1 kg/m2) consumed either 550 mL of 0% skim white milk (MILK) or 52.7 g of maltodextrin in 550 mL of water (CHO), both 5 min and 1 h following completion of a combined plyometric (198 impacts) and resistance exercise (3-4 sets/exercise, 8-12 reps/set, ∼75% 1-RM) bout. Venous blood samples were obtained pre-exercise, and 15 min, 75 min, 24 h and 48 h post-exercise to assess serum concentrations of bone resorption biomarkers, specifically carboxyl-terminal crosslinking telopeptide of type I collagen (CTX), receptor activator nuclear factor kappa-β ligand (RANKL), and sclerostin (SOST), as well as bone formation biomarkers, specifically osteoprotegerin (OPG) and osteocalcin (OC). When absolute biomarker concentrations were examined, there were no interaction or group effects for any biomarker, however, there were main time effects (p < 0.05) for RANKL, SOST, and OC, which were lower, and the OPG: OPG/RANKL ratio, which was higher at 75 min post-exercise compared with baseline in both conditions. In addition to assessing absolute biomarker concentrations at specific timepoints, we also evaluated the relative (% change) cumulative post-exercise response (75 min to 48 h) using an area under the curve (AUC) analysis. This analysis showed that the relative post-exercise CTX response was significantly lower in the MILK compared to the CHO condition (p = 0.03), with no differences observed in the other biomarkers. These results show that while milk does not appear to alter absolute concentrations of bone biomarkers compared to CHO, it may attenuate relative post-exercise bone resorption (i.e., blunt the usual catabolic response to exercise).
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Affiliation(s)
- Joel L. Prowting
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Lauren E. Skelly
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Nigel Kurgan
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Faculty of Applied Health Sciences, Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
| | - Emily C. Fraschetti
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Panagiota Klentrou
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Faculty of Applied Health Sciences, Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
| | - Andrea R. Josse
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Faculty of Applied Health Sciences, Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
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17
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Hew-Butler T, Aprik C, Byrd B, Sabourin J, VanSumeren M, Smith-Hale V, Blow A. Vitamin D supplementation and body composition changes in collegiate basketball players: a 12-week randomized control trial. J Int Soc Sports Nutr 2022; 19:34-48. [PMID: 35599918 PMCID: PMC9116404 DOI: 10.1080/15502783.2022.2046444] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Vitamin D promotes bone and muscle growth in non-athletes, suggesting supplementation may be ergogenic in athletes. Our primary aim was to determine if modest Vitamin D supplementation augments favorable body composition changes (increased bone and lean mass and decreased fat mass) and performance in collegiate basketball players following 12 weeks of standardized training. Methods Members of a men’s and women’s NCAA D1 Basketball team were recruited. Volunteers were randomized to receive either a weekly 4000 IU Vitamin D3 supplement (D3) or placebo (P) over 12 weeks of standardized pre-season strength training. Pre- and post-measurements included 1) serum 25-hydroxy vitamin D (25(OH)D); 2) body composition variables (total body lean, fat, and bone mass) using dual-energy X-ray absorptiometry (DXA) scans and 3) vertical jump test to assess peak power output. Dietary intake was assessed using Food Frequency questionnaires. Main outcome measures included changes (∆: post-intervention minus pre-intervention) in 25(OH)D, body composition, and performance. Results Eighteen of the 23 players completed the trial (8 females/10 males). Eight received the placebo (20 ± 1 years; 3 females) while ten received Vitamin D3 (20 ± 2 years; 5 females). Weekly Vitamin D3 supplementation induced non-significant increases (∆) in 25(OH)D (2.6 ± 7.2 vs. −3.5 ± 5.3 ng/mL; p = 0.06), total body bone mineral content (BMC) (73.1 ± 62.5 vs. 84.1 ± 46.5 g; p = 0.68), and total body lean mass (2803.9 ± 1655.4 vs. 4474.5 ± 11,389.8 g; p = 0.03), plus a non-significant change in body fat (−0.5 ± 0.8 vs. −1.1 ± 1.2%; p = 0.19) (Vitamin D3 vs. placebo supplementation groups, respectively). Pre 25(OH)D correlated with both Δ total fat mass (g) (r = 0.65; p = 0.003) and Δ total body fat% (r = 0.56; p = 0.02). No differences were noted in peak power output ∆ between the D3 vs. P group (−127.4 ± 335.4 vs. 50.9 ± 9 W; NS). Participants in the D3 group ingested significantly fewer total calories (−526.2 ± 583.9 vs. −10.0 ± 400 kcals; p = 0.02) than participants in the P group. Conclusions Modest (~517 IU/day) Vitamin D3 supplementation did not enhance favorable changes in total body composition or performance, over 3 months of training, in collegiate basketball players. Weight training provides a robust training stimulus for bone and lean mass accrual, which likely predominates over isolated supplement use with adequate caloric intakes.
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Affiliation(s)
- Tamara Hew-Butler
- Exercise Science and Athletics Departments, Oakland University, Rochester, Michigan, USA
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, Michigan, USA
| | - Carrie Aprik
- Exercise Science and Athletics Departments, Oakland University, Rochester, Michigan, USA
| | - Brigid Byrd
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, Michigan, USA
| | - Jordan Sabourin
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, Michigan, USA
| | - Matthew VanSumeren
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, Michigan, USA
| | - Valerie Smith-Hale
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, Michigan, USA
| | - Andrew Blow
- Precision, Fuel & Hydration, Minneapolis, Mn, USA
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18
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Wherry SJ, Swanson CM, Kohrt WM. Acute catabolic bone metabolism response to exercise in young and older adults: A narrative review. Exp Gerontol 2022; 157:111633. [PMID: 34826573 PMCID: PMC10103539 DOI: 10.1016/j.exger.2021.111633] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 12/13/2022]
Abstract
Exercise is recommended for cardiometabolic benefits and to preserve or improve bone health, especially for older adults at increased risk of fracture. However, exercise interventions have modest benefits on areal bone mineral density (aBMD), and exercise can lead to bone loss in young athletes under certain conditions. In this narrative review, we discuss evidence for a disruption in calcium homeostasis during exercise that may diminish the skeletal benefits of exercise. Topics include 1) a general overview of the effects of exercise on aBMD; 2) discussion of the exercise-induced disruption in calcium homeostasis; 3) factors that influence the magnitude of the exercise-induced disruption in calcium homeostasis, including age, sex, and exercise mode, intensity, and duration; 4) oral calcium supplementation to minimize the exercise-induced disruption in calcium homeostasis; and 5) potential for exercise-induced increase in parathyroid hormone to be both catabolic and anabolic to bone.
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Affiliation(s)
- Sarah J Wherry
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, United States of America.
| | - Christine M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America
| | - Wendy M Kohrt
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, United States of America
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19
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Mu S, Xia Y, Wu Q, Ji C, Dai H, Zhang M, Jiao J, Shi F, Liu S, Wang G, Shen T, Tian Y, Yang L, Fu Q, Zhao Y. Response of Bone Metabolism Markers to Ice Swimming in Regular Practitioners. Front Physiol 2021; 12:731523. [PMID: 34899374 PMCID: PMC8662563 DOI: 10.3389/fphys.2021.731523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 11/03/2021] [Indexed: 12/04/2022] Open
Abstract
Objective: Both exercise and cold exposure cause physiological stress and they often occur in combination. However, the effects of exercise during severe cold on variation in bone metabolism in humans have remained elusive. The aim of this study was to investigate the variations in circulating bone metabolism markers after ice swimming (IS). Methods: Eighty-seven women and men aged 42–84 years old were recruited to perform regular IS activities. Serum parathyroid hormone (PTH), total calcium (Ca2+), total phosphorus (Pi), total magnesium (Mg2+), N-terminal osteocalcin (N-MID), total propeptide of procollagen 1 (TPINP), and C-terminal telopeptide of type 1 collagen (β-CTX) were measured 30 min before and 30 min after IS. Bone mineral content (BMC) and bone mineral density (BMD) were assessed at lumbar spine 1–4 (L1–L4) and femoral neck (FN). The IS habits were obtained from questionnaires and the 10-year probability of osteoporotic fracture was calculated using the FRAX® tool with and without a BMD value of the FN. Results: There were significant increases in PTH (median, 40.120–51.540 pg/mL), Ca2+ (median, 2.330–2.400 mmol/L), and Pi (median, 1.100–1.340 mmol/L) and significant decreases in TPINP (median, 38.190–36.610 ng/mL) and β-CTX (median, 0.185–0.171 ng/mL), while there was a trend for increased serum Mg2+ (P = 0.058) but no significant change in N-MID (P = 0.933) after IS in all subjects. The increases in the proportions of cases of hyperparathyroidemia, hypercalcemia, and hyperphosphatemia in those performing IS were statistically significant. The baseline levels and the changes of bone metabolism markers had associations with osteoporosis and bone status, but these may be age and sex dependent. Finally, there were significant correlations among the bone metabolism markers. Conclusion: IS caused significant alterations in bone metabolic markers, specifically, increases in PTH, Ca2+ and Pi should raise concerns about potential cardiovascular health risks in severe cold exercise. Additionally, a divergence between PTH elevation and a decline in bone turnover, which shown a special change of bone metabolism after IS and may suggest potential therapeutic implications of cold exercise in PTH and bone metabolic disorders.
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Affiliation(s)
- Shuai Mu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chao Ji
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Huixu Dai
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming Zhang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jiao Jiao
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Feng Shi
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shengye Liu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guangbin Wang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tao Shen
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ye Tian
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liqing Yang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qin Fu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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20
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Martínez-Noguera FJ, Alcaraz PE, Ortolano-Ríos R, Dufour S, Marín-Pagán C. Professional cyclists have lower levels of bone markers than amateurs. Is there a risk of osteoporosis in cyclist? Bone 2021; 153:116102. [PMID: 34245935 DOI: 10.1016/j.bone.2021.116102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/02/2021] [Accepted: 06/30/2021] [Indexed: 10/20/2022]
Abstract
Currently, there is a greater number of amateurs that practice cycling. However, there is no clear evidence regarding bone health in amateur cyclists compared to professional cyclists, as the latter has shown to have lower bone mineral content and density. Therefore, the aim of this study was to identify the differences in bone variables between professional (PRO) and amateur (AMA) road cyclists, and to see if these differences were related to differences in cycling performance. A parallel trial was carried out with 15 AMA and 10 PRO cyclists. All cyclists visited the laboratory twice: 1) in a fasted state, body composition measured by dual-energy X-ray absorptiometry (DXA) and 2) physiological variables measured using an incremental test until exhaustion. Significantly lower values were found in bone mineral density, bone mineral content and fat free mass in PRO compared to AMA (p < 0.05). In addition, significantly higher power was produced in ventilatory thresholds 1 and 2 (VT1 and VT2) and VO2MAX in PRO compared to AMA (p < 0.05). Overall, PRO cyclists had lower values in bone health and muscle mass but better results in performance compared to AMA.
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Affiliation(s)
| | - Pedro E Alcaraz
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain.
| | - Raquel Ortolano-Ríos
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain
| | - Stéphane Dufour
- University of Strasbourg, Faculty of Medicine, Translational Medicine Federation (FMTS), UR 3072, France; University of Strasbourg, Faculty of Sport Sciences, France.
| | - Cristian Marín-Pagán
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain.
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21
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Wherry SJ, Blatchford PJ, Swanson CM, Wellington T, Boxer RS, Kohrt WM. Maintaining serum ionized calcium during brisk walking attenuates the increase in bone resorption in older adults. Bone 2021; 153:116108. [PMID: 34252605 PMCID: PMC8478867 DOI: 10.1016/j.bone.2021.116108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/26/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Endurance exercise can cause a decrease in serum ionized calcium (iCa) and increases in parathyroid hormone (PTH) and bone resorption, reflected by serum carboxy-terminal collagen crosslinks (CTX). We developed a calcium clamp to prevent the decrease in iCa during exercise, which attenuated increases in PTH and CTX during vigorous cycling in young men. The goal was to determine whether this occurs in older adults during brisk walking. METHODS Twelve older adults (6 men, 6 women) performed two identical 60-min treadmill walking bouts with Ca gluconate or half-normal saline infusion. Blood sampling for iCa, total calcium (tCa), phosphate (P), PTH, and CTX, occurred before, during, and for 4 h after exercise. RESULTS iCa decreased during exercise with the saline infusion (p = 0.04) and this provoked increases in PTH and CTX (both p < 0.01). The Ca clamp prevented the decrease in serum iCa during exercise and attenuated the PTH and CTX responses. CONCLUSIONS Preventing the exercise-induced decrease in iCa markedly attenuated the increases in PTH and CTX. The cause of the decrease in iCa during exercise remains unclear, but the increases in PTH and CTX are likely counter-regulatory responses to defend serum iCa. This contention is supported by previous observations that the disruption of Ca homeostasis during exercise occurs regardless of training status. It will be important to establish whether this acute catabolic effect of exercise diminishes the potential chronic anabolic effects of exercise on bone.
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Affiliation(s)
- Sarah J Wherry
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, United States of America.
| | - Patrick J Blatchford
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, United States of America; Department of Biostatistics and Bioinformatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America
| | - Christine M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America
| | - Toby Wellington
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America
| | - Rebecca S Boxer
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, United States of America
| | - Wendy M Kohrt
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, United States of America
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22
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Hamstra-Wright KL, Huxel Bliven KC, Napier C. Training Load Capacity, Cumulative Risk, and Bone Stress Injuries: A Narrative Review of a Holistic Approach. Front Sports Act Living 2021; 3:665683. [PMID: 34124660 PMCID: PMC8192811 DOI: 10.3389/fspor.2021.665683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/14/2021] [Indexed: 01/09/2023] Open
Abstract
Bone stress injuries (BSIs) are a common orthopedic injury with short-term, and potentially long-term, effects. Training load capacity, influenced by risk factors, plays a critical role in the occurrence of BSIs. Many factors determine how one's body responds to repetitive loads that have the potential to increase the risk of a BSI. As a scientific community, we have identified numerous isolated BSI risk factors. However, we have not adequately analyzed the integrative, holistic, and cumulative nature of the risk factors, which is essential to determine an individual's specific capacity. In this narrative review, we advocate for a personalized approach to monitor training load so that individuals can optimize their health and performance. We define “cumulative risk profile” as a subjective clinical determination of the number of risk factors with thoughtful consideration of their interaction and propose that athletes have their own cumulative risk profile that influences their capacity to withstand specific training loads. In our narrative review, we outline BSI risk factors, discuss the relationship between BSIs and training load, highlight the importance of individualizing training load, and emphasize the use of a holistic assessment as a training load guide.
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Affiliation(s)
- Karrie L Hamstra-Wright
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, United States
| | - Kellie C Huxel Bliven
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States
| | - Christopher Napier
- Menrva Research Group, Faculty of Applied Science, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Vancouver, BC, Canada.,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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23
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Wherry SJ, Miller RM, Jeong SH, Beavers KM. The Ability of Exercise to Mitigate Caloric Restriction-Induced Bone Loss in Older Adults: A Structured Review of RCTs and Narrative Review of Exercise-Induced Changes in Bone Biomarkers. Nutrients 2021; 13:1250. [PMID: 33920153 PMCID: PMC8070587 DOI: 10.3390/nu13041250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Despite the adverse metabolic and functional consequences of obesity, caloric restriction- (CR) induced weight loss is often contra-indicated in older adults with obesity due to the accompanying loss of areal bone mineral density (aBMD) and subsequent increased risk of fracture. Several studies show a positive effect of exercise on aBMD among weight-stable older adults; however, data on the ability of exercise to mitigate bone loss secondary to CR are surprisingly equivocal. The purpose of this review is to provide a focused update of the randomized controlled trial literature assessing the efficacy of exercise as a countermeasure to CR-induced bone loss among older adults. Secondarily, we present data demonstrating the occurrence of exercise-induced changes in bone biomarkers, offering insight into why exercise is not more effective than observed in mitigating CR-induced bone loss.
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Affiliation(s)
- Sarah J. Wherry
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, USA
| | - Ryan M. Miller
- Department of Internal Medicine, Sections on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
| | - Sarah H. Jeong
- Z. Smith Reynolds Library, Wake Forest University, Winston-Salem, NC 27109, USA;
| | - Kristen M. Beavers
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, USA
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24
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Hilkens L, Knuiman P, Heijboer M, Kempers R, Jeukendrup AE, van Loon LJ, van Dijk JW. Fragile bones of elite cyclists: to treat or not to treat? J Appl Physiol (1985) 2021; 131:26-28. [PMID: 33703944 DOI: 10.1152/japplphysiol.01034.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Luuk Hilkens
- School of Sport and Exercise, HAN University of Applied Sciences, Netherlands
| | - Pim Knuiman
- School of Biomedical Sciences, University of Leeds, United Kingdom
| | | | | | - Asker E. Jeukendrup
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Luc J.C. van Loon
- Department of Human Movement Sciences, Maastricht University Medical Centre, Netherlands
| | - Jan-Willem van Dijk
- School of Sport and Exercise, HAN University of Applied Sciences, Netherlands
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25
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Reduced Endurance Capacity and Suboptimal Energy Availability in Top-Level Female Cyclists. Int J Sports Physiol Perform 2021; 16:1194–1203. [PMID: 33626509 DOI: 10.1123/ijspp.2020-0513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/11/2020] [Accepted: 09/14/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Women's professional cycling has grown in popularity, and this increase is also apparent in Brazil, which has increased its female cycling calendar in recent years. The aim of this observational study was to (1) determine training and competition loads of a top-level Brazilian female cycling team, (2) evaluate nutrition and clinical health, and (3) measure whether exercise capacity changed throughout the season. METHODS Training and competition data were collected over the season using global positioning system monitors, while laboratory-based physiological and performance measures (incremental cycling test, 30-s Wingate, 4-km time trial) and clinical and nutritional analyses were performed at time points throughout the season. RESULTS Total distance covered over the year was 11,124 (2895) km (7382-14,698 km). Endurance capacity was reduced over the season (P = .005) but not anaerobic power (all P > .05). Nutrition and stress markers remained largely unchanged throughout the season, although there were some individual fluctuations in some measures, and testosterone concentration was low for some. Median estimated energy availability ranged between 32.3 and 56.8 kcal·kgLBM-1·d-1 during training and 26.4 and 53.8 kcal·kgLBM-1·d-1 during competition. Percentage of training spent in optimal estimated energy availability was generally low, with 3 athletes spending <35% within the optimal intake. CONCLUSIONS Substantial training and competition loads of the monitored professional Brazilian female cyclists may have reduced exercise capacity toward the end of the season, indicative of a grueling yearlong schedule. Several athletes may have had suboptimal energy availability during the season, potentially affecting testosterone concentration. These data demonstrate the difficulties in maintaining optimal nutrition, health, and performance throughout a season in professional female cycling and highlight the need for quality sport-science support for this type of top-level athlete.
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26
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A Review of Nonpharmacological Strategies in the Treatment of Relative Energy Deficiency in Sport. Int J Sport Nutr Exerc Metab 2021; 31:268-275. [PMID: 33465762 DOI: 10.1123/ijsnem.2020-0211] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/08/2020] [Accepted: 11/18/2020] [Indexed: 11/18/2022]
Abstract
Relative energy deficiency in sport (RED-S) can result in negative health and performance outcomes in both male and female athletes. The underlying etiology of RED-S is low energy availability (LEA), which occurs when there is insufficient dietary energy intake to meet exercise energy expenditure, corrected for fat-free mass, leaving inadequate energy available to ensure homeostasis and adequate energy turnover (optimize normal bodily functions to positively impact health), but also optimizing recovery, training adaptations, and performance. As such, treatment of RED-S involves increasing energy intake and/or decreasing exercise energy expenditure to address the underlying LEA. Clinically, however, the time burden and methodological errors associated with the quantification of energy intake, exercise energy expenditure, and fat-free mass to assess energy availability in free-living conditions make it difficult for the practitioner to implement in everyday practice. Furthermore, interpretation is complicated by the lack of validated energy availability thresholds, which can result in compromised health and performance outcomes in male and female athletes across various stages of maturation, ethnic races, and different types of sports. This narrative review focuses on pragmatic nonpharmacological strategies in the treatment of RED-S, featuring factors such as low carbohydrate availability, within-day prolonged periods of LEA, insufficient intake of bone-building nutrients, lack of mechanical bone stress, and/or psychogenic stress. This includes the implementation of strategies that address exacerbating factors of LEA, as well as novel treatment methods and underlying mechanisms of action, while highlighting areas of further research.
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27
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Dolan E, Dumas A, Keane KM, Bestetti G, Freitas LHM, Gualano B, Kohrt W, Kelley GA, Pereira RMR, Sale C, Swinton P. The influence of acute exercise on bone biomarkers: protocol for a systematic review with meta-analysis. Syst Rev 2020; 9:291. [PMID: 33308281 PMCID: PMC7733242 DOI: 10.1186/s13643-020-01551-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/30/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Bone is a plastic tissue that is responsive to its physical environment. As a result, exercise interventions represent a potential means to influence the bone. However, little is currently known about how various exercise and participant characteristics interact to influence bone metabolism. Acute, controlled, interventions provide an in vivo model through which the acute bone response to exercise can be investigated, typically by monitoring circulating bone biomarkers. Currently, substantial heterogeneity in factors such as study design, quality, exercise, and participant characteristics render it difficult to synthesize and evaluate the available evidence. Using a systematic review and meta-analytic approach, the aim of this investigation is to quantify the effect of an acute exercise bout on circulating bone biomarkers as well as examine the potential factors that may moderate this response, e.g., variation in participant, exercise, and sampling characteristics. METHODS This protocol was designed in accordance with the PRISMA-P guidelines. Seven databases (MEDLINE, Embase, Sport Discus, Cochrane CENTRAL, PEDro, LILACS, and Ibec) will be systematically searched and supplemented by a secondary screening of the reference lists of all included articles. The PICOS (Population, Intervention, Comparator, Outcomes and Study Design) approach was used to guide the determination of the eligibility criteria. Participants of any age, sex, training, or health status will be considered for inclusion. We will select studies that have measured the bone biomarker response before and after an acute exercise session. All biomarkers considered to represent the bone metabolism will be considered for inclusion, and sensitivity analyses will be conducted using reference biomarkers for the measurement of bone resorption and formation (namely β-CTX-1 and P1NP). Multi-level, meta-regression models within a Bayesian framework will be used to explore the main effect of acute exercise on bone biomarkers as well as potential moderating factors. The risk of bias for each individual study will be evaluated using a modified version of the Downs and Black checklist while certainty in resultant outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. DISCUSSION A better understanding of the bone metabolic response to an acute bout of exercise has the potential to advance our understanding of the mechanisms through which this stimulus impacts bone metabolism, including factors that may moderate this response. Additionally, we will identify current gaps in the evidence base and provide recommendations to inform future research. SYSTEMATIC REVIEW REGISTRATION This protocol was prospectively registered in the Open Science Framework Registry ( https://osf.io/6f8dz ).
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Affiliation(s)
- E Dolan
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil.
| | - A Dumas
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - K M Keane
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - G Bestetti
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - L H M Freitas
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - B Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil.,Food Research Centre, University of São Paulo, Sao Paulo, SP, Brazil
| | - W Kohrt
- Centre for Women's Health Research, School of Medicine, University of Colorado, Aurora, USA
| | - G A Kelley
- Department of Biostatistics, West Virginia University, Morgantown, USA
| | - R M R Pereira
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - C Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - P Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
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28
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Ying Z, Ruotao T, Haili W, Shuqin L, Linxiu B, Xuemin L, Qing L. A study of the genetic and prenatal developmental toxicity potential of lithothamnion sp. Drug Chem Toxicol 2020; 45:1644-1651. [PMID: 33297793 DOI: 10.1080/01480545.2020.1853150] [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: 10/22/2022]
Abstract
Due to its calcium-rich and diverse multimineral profile, Aquamin (derived from the red seaweed Lithothamnion sp.) is used globally as a dietary food supplement. Published reports on the genetic and prenatal developmental toxicity of Lithothamnion sp. do not exist. In accordance with the standardized protocols set by the Ministry of Health of the People's Republic of China (GB-15193), the following studies were performed: the Ames test, the mammalian erythrocyte micronucleus test, the mammalian spermatocyte chromosome test, and prenatal developmental toxicity testing. The results showed that Lithothamnion sp. did not induce a significant increase in the following: revertant colony numbers for Salmonella typhimurium strains TA 97, 98, 100, 102 and 1535; frequency of micronucleated polychromatic erythrocytes (MNPCE); spermatocyte chromosomal aberration rate. In the prenatal developmental toxicity study, no mortality, no abnormal changes in behavior and activities, and the absence of toxic symptoms and abnormalities in macroscopic autopsy were observed in each dam/all pups. Compared to the negative control group, Lithothamnion sp. at all tested doses had no effects on body weight gain, number of corpora lutea and implantations, fetal body weight and length, external, visceral and skeletal malformations. In conclusion, Lithothamnion sp. did not cause genetic toxicity. Furthermore, the prenatal developmental toxicity no observed adverse effect level (NOAEL) was determined to be greater than 2000 mg/kg.bw.
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Affiliation(s)
- Zhang Ying
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Tian Ruotao
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Wu Haili
- College of Life Science, Shanxi University, Taiyuan, China
| | - Li Shuqin
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Bian Linxiu
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Li Xuemin
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Li Qing
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
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29
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Collins J, Maughan RJ, Gleeson M, Bilsborough J, Jeukendrup A, Morton JP, Phillips SM, Armstrong L, Burke LM, Close GL, Duffield R, Larson-Meyer E, Louis J, Medina D, Meyer F, Rollo I, Sundgot-Borgen J, Wall BT, Boullosa B, Dupont G, Lizarraga A, Res P, Bizzini M, Castagna C, Cowie CM, D'Hooghe M, Geyer H, Meyer T, Papadimitriou N, Vouillamoz M, McCall A. UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research. Br J Sports Med 2020; 55:416. [PMID: 33097528 DOI: 10.1136/bjsports-2019-101961] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 01/09/2023]
Abstract
Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.
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Affiliation(s)
- James Collins
- Intra Performance Group, London, UK.,Performance and Research Team, Arsenal Football Club, London, UK
| | | | - Michael Gleeson
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Johann Bilsborough
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,New England Patriots, Foxboro, MA, USA
| | - Asker Jeukendrup
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,MySport Science, Birmingham, UK
| | - James P Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - S M Phillips
- Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Armstrong
- Human Performance Laboratory, University of Connecticut, Storrs, CT, USA
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Rob Duffield
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia
| | - Enette Larson-Meyer
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Julien Louis
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Daniel Medina
- Athlete Care and Performance, Monumental Sports & Entertainment, Washington, DC, USA
| | - Flavia Meyer
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ian Rollo
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,PepsiCo Life Sciences, Global R&D, Gatorade Sports Science Institute, Birmingham, UK
| | | | - Benjamin T Wall
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | | | - Gregory Dupont
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Peter Res
- Dutch Olympic Team, Amsterdam, Netherlands
| | - Mario Bizzini
- Research and Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
| | - Carlo Castagna
- University of Rome Tor Vergata, Rome, Italy.,Technical Department, Italian Football Federation (FIGC), Florence, Italy.,Italian Football Referees Association, Bologna, Italy
| | - Charlotte M Cowie
- Technical Directorate, Football Association, Burton upon Trent, UK.,Medical Committee, UEFA, Nyon, Switzerland
| | - Michel D'Hooghe
- Medical Committee, UEFA, Nyon, Switzerland.,Medical Centre of Excelence, Schulthess Clinic, Zurich, Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Tim Meyer
- Medical Committee, UEFA, Nyon, Switzerland.,Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | | | | | - Alan McCall
- Performance and Research Team, Arsenal Football Club, London, UK .,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia.,Sport, Exercise and Health Sciences, School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
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30
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Dolan E, Varley I, Ackerman KE, Pereira RMR, Elliott-Sale KJ, Sale C. The Bone Metabolic Response to Exercise and Nutrition. Exerc Sport Sci Rev 2020; 48:49-58. [PMID: 31913188 DOI: 10.1249/jes.0000000000000215] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bone (re)modeling markers can help determine how the bone responds to different types, intensities, and durations of exercise. They also might help predict those at risk of bone injury. We synthesized evidence on the acute and chronic bone metabolic responses to exercise, along with how nutritional factors can moderate this response. Recommendations to optimize future research efforts are made.
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Affiliation(s)
| | - Ian Varley
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Kathryn E Ackerman
- Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Rosa Maria R Pereira
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Kirsty Jayne Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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31
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Gao R, Rapin N, Elnajmi AM, Gordon J, Zello GA, Chilibeck PD. Skim milk as a recovery beverage after exercise is superior to a sports drink for reducing next-day postprandial blood glucose and increasing postprandial fat oxidation. Nutr Res 2020; 82:58-66. [PMID: 32977252 DOI: 10.1016/j.nutres.2020.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/31/2020] [Accepted: 08/14/2020] [Indexed: 11/25/2022]
Abstract
We determined the effect of consuming low-glycemic index (LGI) skim milk compared to a high-glycemic index (HGI) sports drink following evening exercise on fat oxidation and blood lipids after a subsequent high-energy breakfast. We hypothesized that postexercise skim milk consumption, compared to sports drink, would increase fat oxidation and lower harmful blood lipid and glucose concentrations after a next-day high-energy breakfast. In this randomized counterbalanced crossover trial, 20 overweight-obese participants (body mass index ≥ 25 kg/m2) underwent 4 conditions: 90-minute exercise (50% Vo2peak) followed by sports drink (EX-HGI), exercise followed by isoenergetic skim milk (EX-LGI), exercise followed by water (Exercise), and a control condition (Control). The amount of the sports drink or milk consumed postexercise was based on the energy used during exercise plus 10%. Blood lipids, glucose, and fat oxidation were assessed before and for 6 hours after a high-energy breakfast the next morning. Fat oxidation was highest for EX-LGI (6.7 ± 2.7 g/h) and lowest for EX-HGI (6.0 ± 1.8 g/h) (condition main effect; P = .042). Triglyceride concentration and total area under the curve were higher with EX-HGI than Exercise (1.7 ± 1.6 vs 1.3 ± 1.0 mmol/L, P = .037, and 11.7 ± 9.4 vs 8.6 ± 6.0 mmol L-1 h, P = .005, respectively). Glucose concentration was lower with EX-LGI than EX-HGI (4.1 ± 1.1 vs 4.4 ± 1.1 mmol/L, P = .027). Homeostatic model assessment of insulin resistance was higher with EX-HGI than Control (2.32 ± 1.15 vs 1.86 ± 0.97, P = .005). In conclusion, evening postexercise skim milk consumption, compared with a high-GI sports drink, significantly reduced blood glucose and possibly increased fat oxidation after a high-energy breakfast the next morning.
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Affiliation(s)
- Ruirui Gao
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5B2; Sport Science College, Beijing Sport University, Beijing 100084, China.
| | - Nicole Rapin
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5B2.
| | - Abdulrahman M Elnajmi
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5B2.
| | - Julianne Gordon
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5B2.
| | - Gordon A Zello
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5E5.
| | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5B2.
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Diaz-Castro J, Mira-Rufino PJ, Moreno-Fernandez J, Chirosa I, Chirosa JL, Guisado R, Ochoa JJ. Ubiquinol supplementation modulates energy metabolism and bone turnover during high intensity exercise. Food Funct 2020; 11:7523-7531. [PMID: 32797125 DOI: 10.1039/d0fo01147a] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bone and energy metabolism are profoundly influenced by exercise. The objective of this study was to determine for the first time whether a short-term supplementation with ubiquinol could have a modulating effect on bone turnover and energy metabolism associated with strenuous exercise. The participants (n = 100 healthy and well-trained firemen) were randomly divided into two groups: ubiquinol group (ubiquinol (200 mg day-1)) and control group (placebo) for two weeks. The protocol consisted of conducting two identical strenuous exercise tests with a rest period between tests of 24 h. Blood samples were collected before supplementation (basal value) (T1), after supplementation (T2), after the first physical exercise test (T3), after 24 h of rest (T4), and after the second physical exercise test (T5). Parathyroid hormone (PTH), osteocalcin (OC), osteoprotegerin (OPG), osteopontin (OPN), sclerotin (SOST), alkaline phosphatase (AP), adrenocorticotropin (ACTH), insulin, leptin, adrenaline, noradrenaline and peroxisome proliferator activated receptor-γ coactivator-1α (PGC-1α) were determined. Our protocol increased ACTH, SOST, PTH and OC levels, while it decreased OPN. This protocol also increased adrenaline, noradrenaline and PCG-1α, and decreased insulin. After ubiquinol supplementation, PTH, OC, OPG, alkaline phosphatase, leptin, insulin, noradrenaline and PGC-1α levels increased in the supplemented group compared to the control group after the exercise protocol. Strenuous exercise has a clear effect on energy metabolism and bone turnover. These effects are modulated by ubiquinol supplementation, which especially increases the biomarkers of bone formation during strenuous exercise. In addition, ubiquinol has a beneficial effect on the mobilization of energy sources, fact that it could represent an ergogenic and physiological advantage for skeletal muscles.
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Affiliation(s)
- Javier Diaz-Castro
- Department of Physiology, University of Granada, Granada, 18071, Spain and Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, 18071, Spain.
| | - Pablo Javier Mira-Rufino
- Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, 18071, Spain. and Human Nutrition Ph.D. Program, University of Granada, Granada, 18071, Spain
| | - Jorge Moreno-Fernandez
- Department of Physiology, University of Granada, Granada, 18071, Spain and Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, 18071, Spain.
| | - Ignacio Chirosa
- Department of Physical Education, University of Granada, Granada, 18071, Spain
| | - Javier Luis Chirosa
- Department of Physical Education, University of Granada, Granada, 18071, Spain
| | - Rafael Guisado
- Faculty of Health Sciences, University of Granada, Granada, 18071, Spain
| | - Julio J Ochoa
- Department of Physiology, University of Granada, Granada, 18071, Spain and Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, 18071, Spain.
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Viggers R, Al-Mashhadi Z, Fuglsang-Nielsen R, Gregersen S, Starup-Linde J. The Impact of Exercise on Bone Health in Type 2 Diabetes Mellitus-a Systematic Review. Curr Osteoporos Rep 2020; 18:357-370. [PMID: 32529455 DOI: 10.1007/s11914-020-00597-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Type 2 diabetes mellitus (T2DM) is associated with an increased fracture risk. Weight loss in T2DM management may result in lowering of bone mass. In this systematic literature review, we aimed to investigate how exercise affects bone health in people with T2DM. Furthermore, we examined the types of exercise with the potential to prevent and treat bone fragility in people with T2DM. RECENT FINDINGS Exercise differs in type, mechanical load, and intensity, as does the osteogenic response to exercise. Aerobic exercise improves metabolic health in people with T2DM. However, the weight-bearing component of exercise is essential to bone health. Weight loss interventions in T2DM induce a loss of bone mass that may be attenuated if accompanied by resistance or weight-bearing exercise. Combination of weight-bearing aerobic and resistance exercise seems to be preventive against excessive bone loss in people with T2DM. However, evidence is sparse and clinical trials investigating the effects of exercise on bone health in people with T2DM are warranted.
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Affiliation(s)
- R Viggers
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Z Al-Mashhadi
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus C, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
| | - R Fuglsang-Nielsen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus C, Denmark
- Department of Internal Medicine, Regional Hospital Randers, Randers, Denmark
| | - S Gregersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus C, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark
| | - J Starup-Linde
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark
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Zhang Y, Tian R, Wu H, Li X, Li S, Bian L. Evaluation of acute and sub-chronic toxicity of lithothamnion sp. in mice and rats. Toxicol Rep 2020; 7:852-858. [PMID: 32714840 PMCID: PMC7372146 DOI: 10.1016/j.toxrep.2020.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/30/2020] [Accepted: 07/11/2020] [Indexed: 02/06/2023] Open
Abstract
Lithothamnion sp. is widely available as a marine algae-derived calcium and multi-mineral dietary supplement. In an acute toxicity test, Lithothamnion sp. was deemed non-toxic with a LD50 >10 g/kg BW. In a standard sub-chronic toxicity study, the no-observed-adverse-effect-level (NOAEL) of Lithothamnion sp. in rats was >2 g/kg BW.
Lithothamnion sp., a red algae of the Corallinaceae family, when harvested in its calcareous form, is rich in calcium, magnesium and a variety of trace minerals. It is used as a beneficial dietary mineral supplement across the world (Aquamin F). This study was designed to evaluate the acute and sub-chronic toxicity of Lithothamnion sp. according to the Procedure and Methods of Food Safety Toxicological Assessment GB-15193 (China). In an acute toxicity test, mice (n = 20, 10 male, 10 female) were administered a single dose of 10 g/kg BW of Lithothamnion sp. No mortality, or signs of toxicity were observed. In the sub-chronic toxicity arm of the study, SD rats (n = 80, 40 male, 40 female) were randomly divided into four groups with 10 rats in each group and provided pelleted food containing the algae at either 0.00 %, 0.625 %, 1.25 %, 2.50 % inclusion rates for 90 days. Lithothamnion sp. at all inclusion rates did not cause any mortality, and no treatment-related changes were observed in body weight, organ weight, feed consumption, feed utilization rate, urinalysis, hematological and biochemical blood analysis, gross necropsy or histopathologic examinations. In summary, the median lethal dose (LD50) of Lithothamnion sp. was >10 g/kg BW. The no-observed-adverse-effect-level (NOAEL) for female and male rats of Lithothamnion sp. under these experimental conditions was 2.69 g/kg BW and 2.10 g/kg BW respectively.
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Affiliation(s)
- Ying Zhang
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, 030012, China.,College of Life Science, Shanxi University, Taiyuan, 030006, China
| | - Ruotao Tian
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, 030012, China
| | - Haili Wu
- College of Life Science, Shanxi University, Taiyuan, 030006, China
| | - Xuemin Li
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, 030012, China
| | - Shuqin Li
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, 030012, China
| | - Linxiu Bian
- Institute of Toxicology, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, 030012, China
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Abstract
Athletes should pay more attention to their bone health, whether this relates to their longer-term bone health (e.g. risk of osteopenia and osteoporosis) or their shorter-term risk of bony injuries. Perhaps the easiest way to do this would be to modify their training loads, although this advice rarely seems popular with coaches and athletes for obvious reasons. As such, other possibilities to support the athletes’ bone health need to be explored. Given that bone is a nutritionally modified tissue and diet has a significant influence on bone health across the lifespan, diet and nutritional composition seem like obvious candidates for manipulation. The nutritional requirements to support the skeleton during growth and development and during ageing are unlikely to be notably different between athletes and the general population, although there are some considerations of specific relevance, including energy availability, low carbohydrate availability, protein intake, vitamin D intake and dermal calcium and sodium losses. Energy availability is important for optimising bone health in the athlete, although normative energy balance targets are highly unrealistic for many athletes. The level of energy availability beyond which there is no negative effect for the bone needs to be established. On the balance of the available evidence it would seem unlikely that higher animal protein intakes, in the amounts recommended to athletes, are harmful to bone health, particularly with adequate calcium intake. Dermal calcium losses might be an important consideration for endurance athletes, particularly during long training sessions or events. In these situations, some consideration should be given to pre-exercise calcium feeding. The avoidance of vitamin D deficiency and insufficiency is important for the athlete to protect their bone health. There remains a lack of information relating to the longer-term effects of different dietary and nutritional practices on bone health in athletes, something that needs to be addressed before specific guidance can be provided.
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Mathis SL, Pivovarova AI, Hicks SM, Alrefai H, MacGregor GG. Calcium loss in sweat does not stimulate PTH release: A study of Bikram hot yoga. Complement Ther Med 2020; 51:102417. [PMID: 32507433 DOI: 10.1016/j.ctim.2020.102417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/26/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
It has been hypothesized that sweat loss during exercise causes a disruption in calcium homeostasis that activates bone resorption and over time leads to low bone mineral density. The purpose of this small pilot study was to determine whether dermal calcium loss from a bout of excessive sweating during light intensity physical activity triggers an increase in biomarkers of bone resorption. Biochemical markers related to bone homeostasis were measured before and after a 90 min Bikram hot yoga practice performed in a room heated to 105 °F with 40 % humidity. Participants were five females with a mean age of 47.4 ± 4.7 years. Nude body weight, serum total calcium (Ca2+), free ionized calcium, albumin, parathyroid hormone (PTH) and CTX-I were measured before and after a Bikram hot yoga practice. Mean estimated sweat loss was 1.54 ± 0.65 L, which elicited a 1.9 ± 0.9 % decrease in participant's body weight. Mean Ca2+ concentration in sweat was 2.9 ± 1.7 mg/dl and the estimated mean total calcium lost was 41.3 ± 16.4 mg. Serum ionized Ca2+ increased from 4.76 ± 0.29 mg/dl to 5.35 ± 0.36 mg/dl after the Bikram hot yoga practice (p = 0.0118). Serum PTH decreased from pre- 33.9 ± 3.3 pg/ml to post- 29.9 ± 2.1 pg/ml yoga practice (p = 0.0015) when adjusted for hemoconcentration (PTHADJ), implying a decrease in PTH secretion. We conclude that calcium loss in sweat during 90 min of Bikram hot yoga did not trigger an increase in PTH secretion and did not initiate bone resorption.
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Affiliation(s)
- Shannon L Mathis
- Department of Kinesiology, The University of Alabama in Huntsville, Huntsville, AL, United States
| | | | - Sarah M Hicks
- Alabama College of Osteopathic Medicine, Dothan, AL, United States
| | - Hasan Alrefai
- Department of Biological Sciences, The University of Alabama in Huntsville, Huntsville, AL, United States
| | - Gordon G MacGregor
- Alabama College of Osteopathic Medicine, Dothan, AL, United States; Department of Biological Sciences, The University of Alabama in Huntsville, Huntsville, AL, United States; Yogalytes, Huntsville, AL, United States.
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Kohrt WM, Wolfe P, Sherk VD, Wherry SJ, Wellington T, Melanson EL, Swanson CM, Weaver CM, Boxer RS. Dermal Calcium Loss Is Not the Primary Determinant of Parathyroid Hormone Secretion during Exercise. Med Sci Sports Exerc 2020; 51:2117-2124. [PMID: 31009423 DOI: 10.1249/mss.0000000000002017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Exercise can cause a decrease in serum ionized calcium (iCa) concentration, which stimulates parathyroid hormone (PTH) secretion and activates bone resorption. We postulated that dermal Ca loss during cycling exercise is the major determinant of the serum iCa, PTH, and bone resorption (C-terminal telopeptide of type 1 collagen [CTX]) responses. METHODS To investigate this, women (n = 13) and men (n = 12) age 18 to 45 yr performed the same exercise bout under cool (18°C) and warm (26°C) conditions. Exercise was 60 min of cycling at ~75% of peak aerobic power. Sweat samples were obtained during exercise using a skin patch method, and blood samples were obtained before and during exercise and during 60 min of recovery. RESULTS Sweat volume and estimated sweat Ca loss were 50% higher for the warm condition than the cool condition. Despite this, there were no differences between thermal conditions in the changes (mean, 95% confidence interval [95% CI]) in iCa (cool, -0.07 mg·dL; 95% CI, -0.16 to 0.03); warm, -0.07 mg·dL; 95% CI, -0.20 to 0.05), PTH (cool, 34.4 pg·mL; 95% CI, 23.6-45.2; warm: 35.8 pg·mL; 95% CI, 22.4-49.1), or CTX (cool, 0.11 ng·mL; 95% CI, 0.08-0.13; warm, 0.15 ng·mL; 95% CI, 0.11-0.18). Adjusting for exercise-related shifts in plasma volume revealed a marked decline in vascular iCa content in the first 15 min of exercise (cool, -0.85 mg·dL; 95% CI, -1.01 to -0.68; warm, -0.85 mg·dL; 95% CI, -1.05 to -0.66), before substantial sweat Ca loss had occurred. CONCLUSIONS This indicates that dermal Ca loss was not the primary trigger for the increases in PTH and CTX during exercise. Further research is necessary to understand the causes and consequences of the disruption in Ca homeostasis during exercise and specifically the extravascular shift in iCa.
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Affiliation(s)
- Wendy M Kohrt
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, CO.,Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Aurora, CO
| | - Pamela Wolfe
- Department of Preventive Medicine and Biometrics, University of Colorado Denver, Aurora, CO
| | - Vanessa D Sherk
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO
| | - Sarah J Wherry
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, CO.,Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Aurora, CO
| | - Toby Wellington
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, CO
| | - Edward L Melanson
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, CO.,Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Aurora, CO.,Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO
| | - Christine M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO
| | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Rebecca S Boxer
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, CO.,Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Aurora, CO
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Wherry SJ, Swanson CM, Wolfe P, Wellington T, Boxer RS, Schwartz RS, Kohrt WM. Bone Biomarker Response to Walking under Different Thermal Conditions in Older Adults. Med Sci Sports Exerc 2020; 51:1599-1605. [PMID: 31083027 DOI: 10.1249/mss.0000000000001967] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Endurance exercise can cause a decrease in serum ionized calcium (iCa) and increases in parathyroid hormone (PTH) and c-terminal telopeptide of type I collagen (CTX), which may be due to Ca loss in sweat. PURPOSE This study aimed to determine whether exercise in a warm environment exaggerates the decrease in iCa and increases in PTH and CTX compared with a cool environment in older adults. METHODS Twelve women and men 61-78 yr old performed two identical 60-min treadmill bouts at ~75% of maximal heart rate under warm and cool conditions. Serum iCa, PTH, and CTX were measured every 15 min starting 15 min before and continuing for 60 min after exercise. Sweat Ca loss was estimated from sweat volume and sweat Ca concentration. RESULTS Sweat volume was low and variable; there were no differences in sweat volume or Ca concentration between conditions. iCa decreased after 15 min of exercise, and the change was similar in both conditions. Increases in PTH (warm: 16.4, 95% confidence interval [CI] = 6.2, 26.5 pg·mL; cool: 17.3, 95% CI = 8.1, 26.4 pg·mL) and CTX (warm: 0.08, 95% CI = 0.05, 0.11 ng·mL; cool: 0.08, 95% CI = 0.01, 0.16 ng·mL) from before to immediately after exercise were statistically significant and similar between conditions. Adjusting for plasma volume shifts did not change the results. CONCLUSION The increases in PTH and CTX, despite the low sweat volume, suggest that dermal Ca loss is not a major factor in the decrease in iCa and increases in PTH and CTX observed during exercise in older adults.
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Affiliation(s)
- Sarah J Wherry
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Christine M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Pamela Wolfe
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Toby Wellington
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Rebecca S Boxer
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.,VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO
| | - Robert S Schwartz
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.,VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO
| | - Wendy M Kohrt
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.,VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO
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Ireland A, Mittag U, Degens H, Felsenberg D, Ferretti JL, Heinonen A, Koltai E, Korhonen MT, McPhee JS, Mekjavic I, Piasecki J, Pisot R, Radak Z, Simunic B, Suominen H, Wilks DC, Winwood K, Rittweger J. Greater maintenance of bone mineral content in male than female athletes and in sprinting and jumping than endurance athletes: a longitudinal study of bone strength in elite masters athletes. Arch Osteoporos 2020; 15:87. [PMID: 32524289 PMCID: PMC7286845 DOI: 10.1007/s11657-020-00757-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 05/11/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED We investigated longitudinal changes in tibia bone strength in master power (jumping and sprinting) and endurance (distance) athletes of both sexes. Bone mass but not cross-sectional moment of inertia was better maintained in power than endurance athletes over time, particularly in men and independent of changes in performance. OBJECTIVE Assessment of effects of sex and athletic discipline (lower limb power events, e.g. sprint running and jumping versus endurance running events) on longitudinal changes in bone strength in masters athletes. METHODS We examined tibia and fibula bone properties at distal (4% distal-proximal tibia length) and proximal (66% length) sites using peripheral quantitative computed tomography (pQCT) in seventy-one track and field masters athletes (30 male, 41 female, age at baseline 57.0 ± 12.2 years) in a longitudinal cohort study that included at least two testing sessions over a mean period of 4.2 ± 3.1 years. Effects of time, as well as time × sex and time × discipline interactions on bone parameters and calf muscle cross-sectional area (CSA), were examined. RESULTS Effects of time were sex and discipline-dependent, even following adjustment for enrolment age, sex and changes in muscle CSA and athletic performance. Male sex and participation in power events was associated with better maintenance of tibia bone mineral content (BMC, an indicator of bone compressive strength) at 4% and 66% sites. In contrast, there was no strong evidence of sex or discipline effects on cross-sectional moment of inertia (CSMI, an indicator of bone bending and torsional strength-P > 0.3 for interactions). Similar sex and discipline-specific changes were also observed in the fibula. CONCLUSIONS Results suggest that male athletes and those participating in lower limb power-based rather than endurance-based disciplines have better maintenance of bone compressive but not bending and torsional strength.
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Affiliation(s)
- Alex Ireland
- grid.25627.340000 0001 0790 5329Department of Life Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD UK
| | - Uwe Mittag
- grid.7551.60000 0000 8983 7915Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Hans Degens
- grid.25627.340000 0001 0790 5329Department of Life Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD UK ,grid.419313.d0000 0000 9487 602XLithuanian Sports University, Kaunas, Lithuania ,grid.10414.300000 0001 0738 9977University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
| | - Dieter Felsenberg
- grid.7468.d0000 0001 2248 7639Osteology and Orphane Bone Diseases and Charité – Campus Benjamin Franklin, Centre of Muscle and Bone Research, Humboldt-University Berlin and Free University, Berlin, Germany
| | - José L. Ferretti
- grid.10814.3c0000 0001 2097 3211Center for P-Ca Metabolism Studies (CEMFoC), National University of Rosario, Rosario, Argentina
| | - Ari Heinonen
- grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Erika Koltai
- grid.472475.70000 0000 9243 1481Research Institute of Sport Science, University of Physical Education, Budapest, Hungary
| | - Marko T. Korhonen
- grid.9681.60000 0001 1013 7965Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jamie S. McPhee
- grid.25627.340000 0001 0790 5329Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Igor Mekjavic
- grid.11375.310000 0001 0706 0012Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia ,grid.61971.380000 0004 1936 7494Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC Canada
| | - Jessica Piasecki
- grid.25627.340000 0001 0790 5329Department of Life Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD UK ,grid.12361.370000 0001 0727 0669Sport Health and Performance Enhancement Centre, Nottingham Trent University, Nottingham, UK
| | - Rado Pisot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Zsolt Radak
- grid.472475.70000 0000 9243 1481Research Institute of Sport Science, University of Physical Education, Budapest, Hungary
| | - Bostjan Simunic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Harri Suominen
- grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Désirée C. Wilks
- grid.25627.340000 0001 0790 5329Department of Life Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD UK
| | - Keith Winwood
- grid.25627.340000 0001 0790 5329Department of Life Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD UK
| | - Jörn Rittweger
- grid.7551.60000 0000 8983 7915Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany ,grid.6190.e0000 0000 8580 3777Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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Stecker RA, Harty PS, Jagim AR, Candow DG, Kerksick CM. Timing of ergogenic aids and micronutrients on muscle and exercise performance. J Int Soc Sports Nutr 2019; 16:37. [PMID: 31477133 PMCID: PMC6721335 DOI: 10.1186/s12970-019-0304-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/21/2019] [Indexed: 11/10/2022] Open
Abstract
The timing of macronutrient ingestion in relation to exercise is a purported strategy to augment muscle accretion, muscle and athletic performance, and recovery. To date, the majority of macronutrient nutrient timing research has focused on carbohydrate and protein intake. However, emerging research suggests that the strategic ingestion of various ergogenic aids and micronutrients may also have beneficial effects. Therefore, the purpose of this narrative review is to critically evaluate and summarize the available literature examining the timing of ergogenic aids (caffeine, creatine, nitrates, sodium bicarbonate, beta-alanine) and micronutrients (iron, calcium) on muscle adaptations and exercise performance. In summary, preliminary data is available to indicate the timing of caffeine, nitrates, and creatine monohydrate may impact outcomes such as exercise performance, strength gains and other exercise training adaptations. Furthermore, data is available to suggest that timing the administration of beta-alanine and sodium bicarbonate may help to minimize known untoward adverse events while maintaining potential ergogenic outcomes. Finally, limited data indicates that timed ingestion of calcium and iron may help with the uptake and metabolism of these nutrients. While encouraging, much more research is needed to better understand how timed administration of these nutrients and others may impact performance, health, or other exercise training outcomes.
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Affiliation(s)
- Richard A Stecker
- Exercise and Performance Nutrition Laboratory, School of Health Sciences, Lindenwood University, St. Charles, MO, 63301, USA
| | - Patrick S Harty
- Exercise and Performance Nutrition Laboratory, School of Health Sciences, Lindenwood University, St. Charles, MO, 63301, USA
| | - Andrew R Jagim
- Human Performance Lab, Sports Medicine, Mayo Clinic Health System, Onalaska, WI, USA
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, S4S 0A2, Canada
| | - Chad M Kerksick
- Exercise and Performance Nutrition Laboratory, School of Health Sciences, Lindenwood University, St. Charles, MO, 63301, USA.
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Baker LB. Physiology of sweat gland function: The roles of sweating and sweat composition in human health. Temperature (Austin) 2019; 6:211-259. [PMID: 31608304 PMCID: PMC6773238 DOI: 10.1080/23328940.2019.1632145] [Citation(s) in RCA: 240] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 12/21/2022] Open
Abstract
The purpose of this comprehensive review is to: 1) review the physiology of sweat gland function and mechanisms determining the amount and composition of sweat excreted onto the skin surface; 2) provide an overview of the well-established thermoregulatory functions and adaptive responses of the sweat gland; and 3) discuss the state of evidence for potential non-thermoregulatory roles of sweat in the maintenance and/or perturbation of human health. The role of sweating to eliminate waste products and toxicants seems to be minor compared with other avenues of excretion via the kidneys and gastrointestinal tract; as eccrine glands do not adapt to increase excretion rates either via concentrating sweat or increasing overall sweating rate. Studies suggesting a larger role of sweat glands in clearing waste products or toxicants from the body may be an artifact of methodological issues rather than evidence for selective transport. Furthermore, unlike the renal system, it seems that sweat glands do not conserve water loss or concentrate sweat fluid through vasopressin-mediated water reabsorption. Individuals with high NaCl concentrations in sweat (e.g. cystic fibrosis) have an increased risk of NaCl imbalances during prolonged periods of heavy sweating; however, sweat-induced deficiencies appear to be of minimal risk for trace minerals and vitamins. Additional research is needed to elucidate the potential role of eccrine sweating in skin hydration and microbial defense. Finally, the utility of sweat composition as a biomarker for human physiology is currently limited; as more research is needed to determine potential relations between sweat and blood solute concentrations.
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Affiliation(s)
- Lindsay B Baker
- Gatorade Sports Science Institute, PepsiCo R&D Physiology and Life Sciences, Barrington, IL, USA
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Gaffney-Stomberg E, Nakayama AT, Guerriere KI, Lutz LJ, Walker LA, Staab JS, Scott JM, Gasier HG, McClung JP. Calcium and vitamin D supplementation and bone health in Marine recruits: Effect of season. Bone 2019; 123:224-233. [PMID: 30902791 DOI: 10.1016/j.bone.2019.03.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 02/13/2019] [Accepted: 03/17/2019] [Indexed: 12/16/2022]
Abstract
Stress fractures are common overuse injuries caused by repetitive bone loading. These fractures are of particular concern for military recruits and athletes resulting in attrition in up to 60% of recruits that sustain a fracture. Army and Navy recruits supplemented with daily calcium and vitamin D (Ca + D) demonstrated improved bone strength and reduced stress fractures. The aim of the current study was to evaluate whether Ca + D supplementation improves measures of bone health in recruits undergoing United States Marine Corps initial military training (IMT), and whether the effect of supplementation on indices of bone health varied by season. One-hundred ninety-seven Marine recruits (n = 107 males, n = 90 females, mean age = 18.9 ± 1.6 y) were randomized to receive either Ca + D fortified snack bars (2000 mg Ca and 1000 IU vitamin D per day) or placebo divided into twice daily doses during 12 weeks of IMT. Anthropometrics, fasted blood samples, and peripheral quantitative computed tomography (pQCT) scans of the tibial metaphysis and diaphysis were collected upon entrance to- and post-training (12 weeks later). Half of the volunteers entered training in July and the other half started in February. Time-by-group interactions were observed for vitamin D status (25OHD) and the bone turnover markers, BAP, TRAP and OCN. 25OHD increased and BAP, TRAP and OCN all decreased in the Ca + D group (p < .05). Training increased distal tibia volumetric BMD (+1.9 ± 2.8%), BMC (+2.0 ± 3.1%), and bone strength index (BSI; +4.0 ± 4.0%) and diaphyseal BMC (+1.0 ± 2.2%) and polar stress strain index (SSIp; +0.7 ± 2.1%) independent of Ca + D supplementation (p < .05 for all). When analyzed by season, change in BSI was greater in the Ca + D group as compared to placebo in the summer iteration only (T*G; p < .05). No other effects of supplementation on bone tissue were observed. When categorized by tertile of percent change in BSI, recruits demonstrating the greatest changes in BSI and 25OHD entered training with the lowest levels of 25OHD (p < .05). Over all, these results suggest that Ca + D supplementation reduced some markers of bone formation and resorption and the decline in 25OHD over training in volunteers that started training in the summer was prevented by supplementation. Baseline 25OHD and trajectory may impact bone responses to IMT, but little effect of Ca + D supplementation was observed at the investigated doses.
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Affiliation(s)
- Erin Gaffney-Stomberg
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America.
| | - Anna T Nakayama
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America; Oak Ridge Institute for Science and Education, Oakridge, TN 37830, United States of America
| | - Katelyn I Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Laura J Lutz
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Leila A Walker
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Jeffery S Staab
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Jonathan M Scott
- Department of Military and Emergency Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, United States of America
| | - Heath G Gasier
- Department of Military and Emergency Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, United States of America
| | - James P McClung
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
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Heffernan SM, Horner K, De Vito G, Conway GE. The Role of Mineral and Trace Element Supplementation in Exercise and Athletic Performance: A Systematic Review. Nutrients 2019; 11:nu11030696. [PMID: 30909645 PMCID: PMC6471179 DOI: 10.3390/nu11030696] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/12/2019] [Accepted: 03/19/2019] [Indexed: 12/11/2022] Open
Abstract
Minerals and trace elements (MTEs) are micronutrients involved in hundreds of biological processes. Deficiency in MTEs can negatively affect athletic performance. Approximately 50% of athletes have reported consuming some form of micronutrient supplement; however, there is limited data confirming their efficacy for improving performance. The aim of this study was to systematically review the role of MTEs in exercise and athletic performance. Six electronic databases and grey literature sources (MEDLINE; EMBASE; CINAHL and SportDISCUS; Web of Science and clinicaltrials.gov) were searched, in accordance with PRISMA guidelines. Results: 17,433 articles were identified and 130 experiments from 128 studies were included. Retrieved articles included Iron (n = 29), Calcium (n = 11), Magnesium, (n = 22), Phosphate (n = 17), Zinc (n = 9), Sodium (n = 15), Boron (n = 4), Selenium (n = 5), Chromium (n = 12) and multi-mineral articles (n = 5). No relevant articles were identified for Copper, Manganese, Iodine, Nickel, Fluoride or Cobalt. Only Iron and Magnesium included articles of sufficient quality to be assigned as 'strong'. Currently, there is little evidence to support the use of MTE supplementation to improve physiological markers of athletic performance, with the possible exception of Iron (in particular, biological situations) and Magnesium as these currently have the strongest quality evidence. Regardless, some MTEs may possess the potential to improve athletic performance, but more high quality research is required before support for these MTEs can be given. PROSPERO preregistered (CRD42018090502).
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Affiliation(s)
- Shane Michael Heffernan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin 4, Ireland.
| | - Katy Horner
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin 4, Ireland.
| | - Giuseppe De Vito
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin 4, Ireland.
| | - Gillian Eileen Conway
- School of Food Science and Environmental Health, Dublin Institute of Technology, Dublin 8, Ireland.
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Nutrition for the Prevention and Treatment of Injuries in Track and Field Athletes. Int J Sport Nutr Exerc Metab 2019; 29:189-197. [PMID: 30676133 DOI: 10.1123/ijsnem.2018-0290] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Injuries are an inevitable consequence of athletic performance with most athletes sustaining one or more during their athletic careers. As many as one in 12 athletes incur an injury during international competitions, many of which result in time lost from training and competition. Injuries to skeletal muscle account for over 40% of all injuries, with the lower leg being the predominant site of injury. Other common injuries include fractures, especially stress fractures in athletes with low energy availability, and injuries to tendons and ligaments, especially those involved in high-impact sports, such as jumping. Given the high prevalence of injury, it is not surprising that there has been a great deal of interest in factors that may reduce the risk of injury, or decrease the recovery time if an injury should occur: One of the main variables explored is nutrition. This review investigates the evidence around various nutrition strategies, including macro- and micronutrients, as well as total energy intake, to reduce the risk of injury and improve recovery time, focusing upon injuries to skeletal muscle, bone, tendons, and ligaments.
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Kohrt WM, Wherry SJ, Wolfe P, Sherk VD, Wellington T, Swanson CM, Weaver CM, Boxer RS. Maintenance of Serum Ionized Calcium During Exercise Attenuates Parathyroid Hormone and Bone Resorption Responses. J Bone Miner Res 2018; 33:1326-1334. [PMID: 29572961 PMCID: PMC6538281 DOI: 10.1002/jbmr.3428] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/08/2018] [Accepted: 03/15/2018] [Indexed: 01/12/2023]
Abstract
Exercise can cause a decrease in serum ionized calcium (iCa) and increases in parathyroid hormone (PTH) and bone resorption. We used a novel intravenous iCa clamp technique to determine whether preventing a decline in serum iCa during exercise prevents increases in PTH and carboxy-terminal collagen crosslinks (CTX). Eleven cycling-trained men (aged 18 to 45 years) underwent two identical 60-min cycling bouts with infusion of Ca gluconate or saline. Blood sampling for iCa, total calcium (tCa), PTH, CTX, and procollagen type 1 amino-terminal propeptide (P1NP) occurred before, during, and for 4 hours after exercise; results are presented as unadjusted and adjusted for plasma volume shifts (denoted with subscript ADJ). iCa decreased during exercise with saline infusion (p = 0.01 at 60 min) and this was prevented by Ca infusion (interaction, p < 0.007); there were abrupt decreases in Ca content (iCaADJ and tCaADJ ) in the first 15 min of exercise under both conditions. PTH and CTX were increased at the end of exercise (both p < 0.01) on the saline day, and markedly attenuated (-65% and -71%; both p < 0.001) by Ca. CTX remained elevated for 4 hours after exercise on the saline day (p < 0.001), despite the return of PTH to baseline by 1 hour after exercise. P1NP increased in response to exercise (p < 0.001), with no difference between conditions, but the increase in P1NPADJ was not significant. Results for PTHADJ and CTXADJ were similar to unadjusted results. These findings demonstrate that bone resorption is stimulated early in exercise to defend serum iCa. Vascular Ca content decreased early in exercise, but neither the reason why this occurred, nor the fate of Ca, are known. The results suggest that the exercise-induced increase in PTH had an acute catabolic effect on bone. Future research should determine whether the increase in PTH generates an anabolic response that occurs more than 4 hours after exercise. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Wendy M Kohrt
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Eastern Colorado Geriatric Research, Education, and Clinical Center, VA Eastern Colorado Healthcare System, Denver, CO, USA
| | - Sarah J Wherry
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Pamela Wolfe
- Department of Preventive Medicine and Biometrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Vanessa D Sherk
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Toby Wellington
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Christine M Swanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Connie M Weaver
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Rebecca S Boxer
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Eastern Colorado Geriatric Research, Education, and Clinical Center, VA Eastern Colorado Healthcare System, Denver, CO, USA
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Male Flat Jockeys Do Not Display Deteriorations in Bone Density or Resting Metabolic Rate in Accordance With Race Riding Experience: Implications for RED-S. Int J Sport Nutr Exerc Metab 2018; 28:434-439. [DOI: 10.1123/ijsnem.2017-0371] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Despite consistent reports of poor bone health in male jockeys, it is not yet known if this is a consequence of low energy availability or lack of an osteogenic stimulus. Given the rationale that low energy availability is a contributing factor in low bone health, we tested the hypothesis that both hip and lumbar bone mineral density (BMD) should progressively worsen in accordance with the years of riding. In a cross-sectional design, male apprentice (n = 17) and senior (n = 14) jockeys (matched for body mass and fat-free mass) were assessed for hip and lumbar spine BMD, as well as both measured and predicted resting metabolic rate (RMR). Despite differences (p < .05) in years of race riding (3.4 ± 2 vs. 16.3 ± 6.8), no differences were apparent (p > .05) in hip (−0.9 ± 1.1 vs. −0.8 ± 0.7) and lumbar Z-scores (−1.3 ± 1.4 vs. −1.5 ± 1) or measured RMR (1,459 ± 160 vs. 1,500 ± 165 kcal/day) between apprentices and senior jockeys, respectively. Additionally, years of race riding did not demonstrate any significant correlations (p > .05) with either hip or lumbar spine BMD. Measured RMR was also not different (p > .05) from predicted RMR in either apprentice (1,520 ± 44 kcal/day) or senior jockeys (1,505 ± 70 kcal/day). When considered with previously published data examining underreporting of energy intake and direct assessments of energy expenditure, we suggest that low BMD in jockeys is not due to low energy availability per se but rather the lack of an osteogenic stimulus associated with riding.
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Baker BS, Reiser RF. Longitudinal Assessment of Bone Mineral Density and Body Composition in Competitive Cyclists. J Strength Cond Res 2018; 31:2969-2976. [PMID: 28700517 DOI: 10.1519/jsc.0000000000002128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Baker, BS and Reiser II, RF. A longitudinal assessment of bone mineral density and body composition in competitive cyclists. J Strength Cond Res 31(11): 2969-2976, 2017-Competitive cycling has been associated with low bone mineral density (BMD); however, BMD is a multifaceted issue. The purpose of this study was to investigate how age (18-49 years), sex, USA Cycling Category (elite-4), and racing type (road and multiple bikes), influenced body composition across a season in competitive cyclists. February marked the preseason, where 42 participants (22 males, 20 females) completed a health history and cycling questionnaire, 4-day dietary log and a dual-energy X-ray absorptiometry scan, and repeated the measures 180 ± 11 days later. Preseason BMD and Z-Scores were within healthy ranges and similar between sexes, age groups, competition levels and racing-type groups (p ≥ 0.053). Age was significantly correlated with whole group BMD (r = 0.309; p = 0.047). Postseason analysis revealed very encouraging findings as no significant changes in BMD or Z-Score were observed in any group (p ≥ 0.067). A significant main effect for time was found in all groups as lean mass (LM) decreased and fat mass increased across the season (p ≤ 0.001). Additional analysis showed a significant time × group interaction as cat. 1 riders decreased body mass and body mass index, whereas cat. 4 riders responded in the opposite direction (p ≤ 0.037). Postseason correlations highlighted significant positive relationships between BMD and age, LM, and Kcal ingested (r ≥ 0.309; p ≤ 0.047). The only significant negative correlate of BMD was percent body fat (r = -0.359; p = 0.020). Armed with this information, cyclists and coaches should aim to prioritize balance between body mass and caloric intake while meeting the demands of training to minimize risk of cycling related low bone mass.
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Affiliation(s)
- Breanne S Baker
- 1Department of Health and Exercise Science, The University of Oklahoma, Norman, Oklahoma; and 2Department of Health and Exercise Science, School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado
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Mathis SL, Caputo JL. Resistance Training Is Associated With Higher Lumbar Spine and Hip Bone Mineral Density in Competitive Male Cyclists. J Strength Cond Res 2018; 32:274-279. [DOI: 10.1519/jsc.0000000000002209] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lurati AR. Health Issues and Injury Risks Associated With Prolonged Sitting and Sedentary Lifestyles. Workplace Health Saf 2017; 66:285-290. [DOI: 10.1177/2165079917737558] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Using a case study, this article reviews the health risks associated with prolonged sitting and the reasons sedentary workers are at risk for musculoskeletal injuries. Other health issues associated with prolonged sitting or sedentary behavior as well as the benefits of exercise are also explored. Finally, evidence-based interventions to reduce health risks associated with prolonged sitting may increase productivity.
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Sherk VD, Wherry SJ, Barry DW, Shea KL, Wolfe P, Kohrt WM. Calcium Supplementation Attenuates Disruptions in Calcium Homeostasis during Exercise. Med Sci Sports Exerc 2017; 49:1437-1442. [PMID: 28248693 DOI: 10.1249/mss.0000000000001239] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
An exercise-induced decrease in serum ionized calcium (iCa) is thought to trigger an increase in parathyroid hormone (PTH), which can stimulate bone resorption. PURPOSE The purpose of this study was to determine whether taking a chewable calcium (Ca) supplement 30 min before exercise mitigates disruptions in Ca homeostasis and bone resorption in competitive male cyclists. METHODS Fifty-one men (18 to 45 yr old) were randomized to take either 1000 mg Ca (CA) or placebo (PL) 30 min before a simulated 35-km cycling time trial. Serum iCa and PTH were measured before and immediately after exercise and a marker of bone resorption (C-terminal telopeptide of type I collagen) was measured before and 30 min after exercise. RESULTS Serum iCa decreased in both groups from before to after exercise (mean ± SD, CA = 4.89 ± 0.16 to 4.76 ± 0.11 mg·dL, PL = 4.92 ± 0.15 to 4.66 ± 0.22 mg·dL, both P ≤ 0.01); the decrease was greater (P = 0.03) in the PL group. There was a nonsignificant (P = 0.07) attenuation of the increase in PTH by Ca supplementation (CA = 30.9 ± 13.0 to 79.7 ± 42.6 pg·mL, PL = 37.1 ± 14.8 to 111.5 ± 49.4 pg·mL, both P ≤ 0.01), but no effect of Ca on the change in C-terminal telopeptide of type I collagen, which increased in both groups (CA = 0.35 ± 0.17 to 0.50 ± 0.21 ng·mL, PL = 0.36 ± 0.13 to 0.54 ± 0.22 ng·mL, both P ≤ 0.01). CONCLUSION It is possible that ingesting Ca only 30 min before exercise was not a sufficient time interval to optimize gut Ca availability during exercise. Further studies will be needed to determine whether adequate Ca supplementation before and/or during exercise can fully mitigate the exercise-induced decrease in serum iCa and increases in PTH and bone resorption.
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Affiliation(s)
- Vanessa D Sherk
- 1Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO; and 2Department of Preventative Medicine and Biostatistics, University of Colorado Anschutz Medical Campus, Aurora, CO
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