Agreement Between Heart Rate Variability - Derived vs. Ventilatory and Lactate Thresholds: A Systematic Review with Meta-Analyses

BACKGROUND

Determining thresholds by measuring blood lactate levels (lactate thresholds) or gas exchange (ventilatory thresholds) that delineate the different exercise intensity domains is crucial for training prescription. This systematic review with meta-analyses aims to assess the overall validity of the first and second heart rate variability - derived threshold (HRVT1 and HRVT2, respectively) by computing global effect sizes for agreement and correlation between HRVTs and reference - lactate and ventilatory (LT-VTs) - thresholds. Furthermore, this review aims to assess the impact of subjects' characteristics, HRV methods, and study protocols on the agreement and correlation between LT-VTs and HRVTs.

METHODS

Systematic computerised searches for studies determining HRVTs during incremental exercise in humans were conducted. The agreements and correlations meta-analyses were conducted using a random-effect model. Causes of heterogeneity were explored by subgroup analysis and meta-regression with subjects' characteristics, incremental exercise protocols, and HRV methods variables. The methodological quality was assessed using QUADAS-2 and STARDHRV tools. The risk of bias was assessed by funnel plots, fail-safe N test, Egger's test of the intercept, and the Begg and Mazumdar rank correlation test.

RESULTS

Fifty included studies (1160 subjects) assessed 314 agreements (95 for HRVT1, 219 for HRVT2) and 246 correlations (82 for HRVT1, 164 for HRVT2) between LT-VTs and HRVTs. The standardized mean differences were trivial between HRVT1 and LT1-VT1 (SMD = 0.08, 95% CI -0.04-0.19, n = 22) and between HRVT2 and LT2-VT2 (SMD = -0.06, 95% CI -0.15-0.03, n = 42). The correlations were very strong between HRVT1 and LT1-VT1 (r = 0.85, 95% CI 0.75-0.91, n = 22), and between HRVT2 and LT2-VT2 (r = 0.85, 95% CI 0.80-0.89, n = 41). Moreover, subjects' characteristics, type of ergometer, or initial and incremental workload had no impact on HRVTs determination.

CONCLUSION

HRVTs showed trivial differences and very strong correlations with LT-VTs and might thus serve as surrogates. These results emphasize the usefulness of HRVTs as promising, accessible, and cost-effective means for exercise and clinical prescription purposes.

Fueling the Firefighter and Tactical Athlete with Creatine: A Narrative Review of a Key Nutrient for Public Safety

Background/Objectives: Firefighters, tactical police officers, and warriors often engage in periodic, intermittent, high-intensity physical work in austere environmental conditions and have a heightened risk of premature mortality. In addition, tough decision-making challenges, routine sleep deprivation, and trauma exacerbate this risk. Therefore, identifying strategies to bolster these personnel's health and occupational performance is critical. Creatine monohydrate (CrM) supplementation may offer several benefits to firefighters and tactical athletes (e.g., police, security, and soldiers) due to its efficacy regarding physical performance, muscle, cardiovascular health, mental health, and cognitive performance. Methods: We conducted a narrative review of the literature with a focus on the benefits and application of creatine monohydrate among firefighters. Results: Recent evidence demonstrates that CrM can improve anaerobic exercise capacity and muscular fitness performance outcomes and aid in thermoregulation, decision-making, sleep, recovery from traumatic brain injuries (TBIs), and mental health. Emerging evidence also suggests that CrM may confer an antioxidant/anti-inflammatory effect, which may be particularly important for firefighters and those performing tactical occupations exposed to oxidative and physiological stress, which can elicit systemic inflammation and increase the risk of chronic diseases. Conclusions: This narrative review highlights the potential applications of CrM for related tactical occupations, with a particular focus on firefighters, and calls for further research into these populations.

Application of V̇ o2 to the Critical Power Model to Derive the Critical V̇ o2

ABSTRACT

Succi, PJ, Dinyer, TK, Byrd, MT, Voskuil, CC, and Bergstrom, HC. Application of V̇ o2 to the critical power model to derive the critical V̇ o2 . J Strength Cond Res 36(12): 3374-3380, 2022-The purposes of this study were to (a) determine whether the critical power (CP) model could be applied to V̇ o2 to estimate the critical V̇ o2 (CV̇ o2 ) and (b) to compare the CV̇ o2 with the V̇ o2 at CP (V̇ o2 CP), the ventilatory threshold (VT), respiratory compensation point (RCP), and the CV̇ o2 without the V̇ o2 slow component (CV̇ o2 slow). Nine subjects performed a graded exercise test to exhaustion to determine V̇ o2 peak, VT, and RCP. The subjects performed 4 randomized, constant power output work bouts to exhaustion. The time to exhaustion (T Lim ), the total work (W Lim ), and the total volume of oxygen consumed with (TV̇ o2 ) and without the slow component (TV̇ o2 slow) were recorded during each trial. The linear regressions of the TV̇ o2 vs. T Lim , TV̇ o2 slow vs. T Lim , and W Lim vs. T Lim relationship were performed to derive the CV̇ o2 , CV̇ o2 slow, and CP, respectively. A 1-way repeated-measures analysis of variance ( p ≤ 0.05) with follow-up Sidak-Bonferroni corrected pairwise comparisons indicated that CV̇ o2 (42.49 ± 3.22 ml·kg -1 ·min -1 ) was greater than VT (30.80 ± 4.66 ml·kg -1 ·min -1 ; p < 0.001), RCP (36.74 ± 4.49 ml·kg -1 ·min -1 ; p = 0.001), V̇ o2 CP (36.76 ± 4.31 ml·kg -1 ·min -1 ; p < 0.001), and CV̇ o2 slow (38.26 ± 2.43 ml·kg -1 ·min -1 ; p < 0.001). However, CV̇ o2 slow was not different than V̇ o2 CP ( p = 0.140) or RCP ( p = 0.235). Thus, the CP model can be applied to V̇ o2 to derive the CV̇ o2 and theoretically is the highest metabolic steady state that can be maintained for an extended period without fatigue. Furthermore, the ability of the CV̇ o2 to quantify the metabolic cost of exercise and the inefficiency associated with the V̇ o2 slow component may provide a valuable tool for researchers and coaches to examine endurance exercise.

A critical review of critical power

The elegant concept of a hyperbolic relationship between power, velocity, or torque and time to exhaustion has rightfully captivated the imagination and inspired extensive research for over half a century. Theoretically, the relationship's asymptote along the time axis (critical power, velocity, or torque) indicates the exercise intensity that could be maintained for extended durations, or the "heavy-severe exercise boundary". Much more than a critical mass of the extensive accumulated evidence, however, has persistently shown the determined intensity of critical power and its variants as being too high to maintain for extended periods. The extensive scientific research devoted to the topic has almost exclusively centered around its relationships with various endurance parameters and performances, as well as the identification of procedural problems and how to mitigate them. The prevalent underlying premise has been that the observed discrepancies are mainly due to experimental 'noise' and procedural inconsistencies. Consequently, little or no effort has been directed at other perspectives such as trying to elucidate physiological reasons that possibly underly and account for those discrepancies. This review, therefore, will attempt to offer a new such perspective and point out the discrepancies' likely root causes.

Association Between Changes in Serum and Skeletal Muscle Metabolomics Profile With Maximum Power Output Gains in Response to Different Aerobic Training Programs: The Times Study

Purpose: High heterogeneity of the response of cardiorespiratory fitness (CRF) to standardized exercise doses has been reported in different training programs, but the associated mechanisms are not widely known. This study investigated whether changes in the metabolic profile and pathways in blood serum and the skeletal muscle are associated with the inter-individual variability of CRF responses to 8-wk of continuous endurance training (ET) or high-intensity interval training (HIIT).

Methods: Eighty men, young and sedentary, were randomized into three groups, of which 70 completed 8 wk of intervention (> 90% of sessions): ET, HIIT, or control. Blood and vastus lateralis muscle tissue samples, as well as the measurement of CRF [maximal power output (MPO)] were obtained before and after the intervention. Blood serum and skeletal muscle samples were analyzed by 600 MHz ¹H-NMR spectroscopy (metabolomics). Associations between the pretraining to post-training changes in the metabolic profile and MPO gains were explored via three analytical approaches: (1) correlation between pretraining to post-training changes in metabolites' concentration levels and MPO gains; (2) significant differences between low and high MPO responders; and (3) metabolite contribution to significantly altered pathways related to MPO gains. After, metabolites within these three levels of evidence were analyzed by multiple stepwise linear regression. The significance level was set at 1%.

Results: The metabolomics profile panel yielded 43 serum and 70 muscle metabolites. From the metabolites within the three levels of evidence (15 serum and 4 muscle metabolites for ET; 5 serum and 1 muscle metabolites for HIIT), the variance in MPO gains was explained: 77.4% by the intervention effects, 6.9, 2.3, 3.2, and 2.2% by changes in skeletal muscle pyruvate and valine, serum glutamine and creatine phosphate, respectively, in ET; and 80.9% by the intervention effects; 7.2, 2.2, and 1.2% by changes in skeletal muscle glycolate, serum creatine and creatine phosphate, respectively, in HIIT. The most changed and impacted pathways by these metabolites were: arginine and proline metabolism, glycine, serine and threonine metabolism, and glyoxylate and dicarboxylate metabolism for both ET and HIIT programs; and additional alanine, aspartate and glutamate metabolism, arginine biosynthesis, glycolysis/gluconeogenesis, and pyruvate metabolism for ET.

Conclusion: These results suggest that regulating the metabolism of amino acids and carbohydrates may be a potential mechanism for understanding the inter-individual variability of CRF in responses to ET and HIIT programs.

Creatine for Exercise and Sports Performance, with Recovery Considerations for Healthy Populations

Creatine is one of the most studied and popular ergogenic aids for athletes and recreational weightlifters seeking to improve sport and exercise performance, augment exercise training adaptations, and mitigate recovery time. Studies consistently reveal that creatine supplementation exerts positive ergogenic effects on single and multiple bouts of short-duration, high-intensity exercise activities, in addition to potentiating exercise training adaptations. In this respect, supplementation consistently demonstrates the ability to enlarge the pool of intracellular creatine, leading to an amplification of the cell's ability to resynthesize adenosine triphosphate. This intracellular expansion is associated with several performance outcomes, including increases in maximal strength (low-speed strength), maximal work output, power production (high-speed strength), sprint performance, and fat-free mass. Additionally, creatine supplementation may speed up recovery time between bouts of intense exercise by mitigating muscle damage and promoting the faster recovery of lost force-production potential. Conversely, contradictory findings exist in the literature regarding the potential ergogenic benefits of creatine during intermittent and continuous endurance-type exercise, as well as in those athletic tasks where an increase in body mass may hinder enhanced performance. The purpose of this review was to summarize the existing literature surrounding the efficacy of creatine supplementation on exercise and sports performance, along with recovery factors in healthy populations.

Critical oxygenation: Can muscle oxygenation inform us about critical power?

The power-duration relationship is well documented for athletic performance and is formulated out mathematically in the critical power (CP) model. The CP model, when applied properly, has great predictive power, e.g. pedaling at a specific power output on an ergometer the model precisely calculates the time over which an athlete can sustain this power. However, CP presents physiological inconsistencies and process-oriented problems. The rapid development of near-infrared spectroscopy (NIRS) to measure muscle oxygenation (SmO₂) dynamics provides a physiological exploration of the CP model on a conceptual and empirical level. Conceptually, the CP model provides two components: first CP is defined as the highest metabolic rate that can be achieved through oxidative means. And second, work capacity above CP named W'. SmO₂ presents a steady-state in oxygen supply and demand and thereby represents CP specifically at a local level of analysis. Empirically, exploratory data quickly illustrates the relationship between performance and SmO₂, as shown during 3-min all-out cycling tests to assess CP. During these tests, performance and SmO₂ essentially mirror each other, and both CP and W' generate solid correlation with what would be deemed their SmO₂ counterparts: first, the steady-state of SmO₂ correlates with CP. And second, the tissue oxygen reserve represented in SmO₂, when calculated as an integral corresponds to W'. While the empirical data presented is preliminary, the proposition of a concurring physiological model to the current CP model is a plausible inference. Here we propose that SmO₂ steady-state representing CP as critical oxygenation or CO. And the tissue oxygen reserve above CO would then be identified as O'. This new CO model could fill in the physiological gap between the highly predictive CP model and at times its inability to track human physiology consistently. For simplicity's sake, this would include acute changes in physiology as a result of changing climate or elevation with travel, which can affect performance. These types of acute fluctuations, but not limited to, would be manageable when applying a CO model in conjunction with the CP model. Further, modeling is needed to investigate the true potential of NIRS to model CP, with a focus on repeatability, recovery, and systemic vs local workloads.

Creatine Supplementation in Women's Health: A Lifespan Perspective

Despite extensive research on creatine, evidence for use among females is understudied. Creatine characteristics vary between males and females, with females exhibiting 70–80% lower endogenous creatine stores compared to males. Understanding creatine metabolism pre- and post-menopause yields important implications for creatine supplementation for performance and health among females. Due to the hormone-related changes to creatine kinetics and phosphocreatine resynthesis, supplementation may be particularly important during menses, pregnancy, post-partum, during and post-menopause. Creatine supplementation among pre-menopausal females appears to be effective for improving strength and exercise performance. Post-menopausal females may also experience benefits in skeletal muscle size and function when consuming high doses of creatine (0.3 g·kg⁻¹·d⁻¹); and favorable effects on bone when combined with resistance training. Pre-clinical and clinical evidence indicates positive effects from creatine supplementation on mood and cognition, possibly by restoring brain energy levels and homeostasis. Creatine supplementation may be even more effective for females by supporting a pro-energetic environment in the brain. The purpose of this review was to highlight the use of creatine in females across the lifespan with particular emphasis on performance, body composition, mood, and dosing strategies.

Would creatine supplementation augment exercise performance during a low carbohydrate high fat diet?

Low carbohydrate high fat (LCHF) diets are emerging in popularity. Several athletics have adopted LCHF diets in an attempt to improve exercise performance and body composition by enhancing fat utilization. However, these diets impair maximal and supramaximal exercise performance due to limited glycogen stores as well as increasing ratings of perceived exertion (RPE). All of these factors may impact training volume and compliance, leading to less optimal training adaptations over time. In contrast, LCHF diets is an effective strategy for weight and fat mass loss and is beneficial for a variety of metabolic processes. One potential nutritional strategy to off-set the negative aspects of a LCHF is creatine (Cr). Creatine supplementation has been shown to increase muscle power output and reduce the rate of fatigue; thereby allowing individuals to work at a higher intensity for a greater duration. Furthermore, Cr supplementation may positively enhance body composition (gains in muscle mass and possibly aid in fat mass loss). Despite the popularity of both LCHF and creatine supplementation, there is no data available investigating the effects of Cr supplementation on exercise performance and body composition during LCHF diets in humans. We would hypothesize that Cr supplementation may augment exercise performance (anerobic power and strength) during a LCHF diet compared to a LCHF diet and placebo. In addition, combining Cr with a LCHF diet would further increase body fat loss and improve body composition compared to a LCHF diet and/or low-fat diets (LFDs) placebo. Our hypotheses would be under the assumption that total caloric intake and protein intake are matched. Future research is warranted to examine chronic exercise with LCHF diets with and without creatine and compare performance and body composition changes to high carbohydrate diets.

Effects of Dietary Supplements on Adaptations to Endurance Training

Endurance training leads to a variety of adaptations at the cellular and systemic levels that serve to minimise disruptions in whole-body homeostasis caused by exercise. These adaptations are differentially affected by training volume, training intensity, and training status, as well as by nutritional choices that can enhance or impair the response to training. A variety of supplements have been studied in the context of acute performance enhancement, but the effects of continued supplementation concurrent to endurance training programs are less well characterised. For example, supplements such as sodium bicarbonate and beta-alanine can improve endurance performance and possibly training adaptations during endurance training by affecting buffering capacity and/or allowing an increased training intensity, while antioxidants such as vitamin C and vitamin E may impair training adaptations by blunting cellular signalling but appear to have little effect on performance outcomes. Additionally, limited data suggest the potential for dietary nitrate (in the form of beetroot juice), creatine, and possibly caffeine, to further enhance endurance training adaptation. Therefore, the objective of this review is to examine the impact of dietary supplements on metabolic and physiological adaptations to endurance training.

Supplements and Nutritional Interventions to Augment High-Intensity Interval Training Physiological and Performance Adaptations-A Narrative Review

High-intensity interval training (HIIT) involves short bursts of intense activity interspersed by periods of low-intensity exercise or rest. HIIT is a viable alternative to traditional continuous moderate-intensity endurance training to enhance maximal oxygen uptake and endurance performance. Combining nutritional strategies with HIIT may result in more favorable outcomes. The purpose of this narrative review is to highlight key dietary interventions that may augment adaptations to HIIT, including creatine monohydrate, caffeine, nitrate, sodium bicarbonate, beta-alanine, protein, and essential amino acids, as well as manipulating carbohydrate availability. Nutrient timing and potential sex differences are also discussed. Overall, sodium bicarbonate and nitrates show promise for enhancing HIIT adaptations and performance. Beta-alanine has the potential to increase training volume and intensity and improve HIIT adaptations. Caffeine and creatine have potential benefits, however, longer-term studies are lacking. Presently, there is a lack of evidence supporting high protein diets to augment HIIT. Low carbohydrate training enhances the upregulation of mitochondrial enzymes, however, there does not seem to be a performance advantage, and a periodized approach may be warranted. Lastly, potential sex differences suggest the need for future research to examine sex-specific nutritional strategies in response to HIIT.

Association of skeletal muscle and serum metabolites with maximum power output gains in response to continuous endurance or high-intensity interval training programs: The TIMES study - A randomized controlled trial

BACKGROUND

Recent studies have begun to identify the molecular determinants of inter-individual variability of cardiorespiratory fitness (CRF) in response to exercise training programs. However, we still have an incomplete picture of the molecular mechanisms underlying trainability in response to exercise training.

OBJECTIVE

We investigated baseline serum and skeletal muscle metabolomics profile and its associations with maximal power output (MPO) gains in response to 8-week of continuous endurance training (ET) and high-intensity interval training (HIIT) programs matched for total units of exercise performed (the TIMES study).

METHODS

Eighty healthy sedentary young adult males were randomized to one of three groups and 70 were defined as completers (> 90% of sessions): ET (n = 30), HIIT (n = 30) and control (CO, n = 10). For the CO, participants were asked to not exercise for 8 weeks. Serum and skeletal muscle samples were analyzed by 1H-NMR spectroscopy. The targeted screens yielded 43 serum and 70 muscle reproducible metabolites (intraclass > 0.75; coefficient of variation < 25%). Associations of baseline metabolites with MPO trainability were explored within each training program via three analytical strategies: (1) correlations with gains in MPO; (2) differences between high and low responders to ET and HIIT; and (3) metabolites contributions to the most significant pathways related to gains in MPO. The significance level was set at P < 0.01 or false discovery rate of 0.1.

RESULTS

The exercise programs generated similar gains in MPO (ET = 21.4 ± 8.0%; HIIT = 24.3 ± 8.5%). MPO associated baseline metabolites supported by all three levels of evidence were: serum glycerol, muscle alanine, proline, threonine, creatinine, AMP and pyruvate for ET, and serum lysine, phenylalanine, creatine, and muscle glycolate for HIIT. The most common pathways suggested by the metabolite profiles were aminoacyl-tRNA biosynthesis, and carbohydrate and amino acid metabolism.

CONCLUSION

We suggest that MPO gains in both programs are potentially associated with metabolites indicative of baseline amino acid and translation processes with additional evidence for carbohydrate metabolism in ET.

Examining work-to-rest ratios to optimize upper body sprint interval training

The objective was to compare the metabolic influence of varying work-to-rest ratios during upper body sprint interval training (SIT). Forty-two recreationally-trained men were randomized into a training group [10 s work - 2 min of rest (10:2) or 4 min of rest (10:4), or 30 s work - 4 min of rest (30:4)] or a control group (CON). Participants underwent six training sessions over two weeks. Assessments consisted of a graded exercise test [maximal oxygen consumption (VO₂peak) and peak power output (PPO)], four constant-work rate trials [critical power, anaerobic working capacity, and electromyographic fatigue threshold], and an upper body Wingate test (mean/peak power and total work). Post-training absolute and relative VO₂peak was greater than pre-training for 30:4 (p = .005 and p = .009, respectively), but lower for CON (p = .001 and p = .006, respectively). Post-training PPO was greater in 30:4 (p < .001). No differences were observed during the constant-work rate trials or Wingate test. Traditional SIT appears to have enhanced VO₂peak in the upper body over a short-term two-week intervention.

Sports and energy drinks

Presently, sports and energy drinks are widely spread not only among athletes, but also among ordinary people of different ages. The purpose of these beverages is to effectively compensate for the loss of water, energy and electrolytes in the human body before or after some exhausting activities. A questionnaire survey on energy drinks conducted in all eight federal districts of the Russian Federation shows that the younger groups of the Russian population (aged 12–17 and 18–30) drink tonic beverages more often than the older groups (aged 31–45 and 45–60). Further, a recent rise in unreasonable consumption of sports and energy drinks among teenagers may lead to various diseases: obesity, type 2 diabetes, heart disease and tooth enamel erosion. Finally, the authors analyse the composition of energy beverages and thoroughly describe each of their main components (L-carnitine, creatine, caffeine, taurine, and juice-containing products). These components are used by athletes due to their effects: L-carnitine helps reduce the signs of physical and mental overstrain, and stimulates working capacity; creatine improves endurance and anaerobic activity; caffeine raises aerobic endurance by increasing the oxidation of fats, thereby helping preserve glycogen in the muscles; taurine plays an important role as an antioxidant protector in the regulation of Ca++ transport, and as a regulator of osmotic pressure in the tissues.

ISSN exercise & sports nutrition review update: research & recommendations

Background

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. In the year 2017 alone, 2082 articles were published under the key words ‘sport nutrition’. Consequently, staying current with the relevant literature is often difficult.

Methods

This paper is an ongoing update of the sports nutrition review article originally published as the lead paper to launch the Journal of the International Society of Sports Nutrition in 2004 and updated in 2010. It presents a well-referenced overview of the current state of the science related to optimization of training and performance enhancement through exercise training and nutrition. Notably, due to the accelerated pace and size at which the literature base in this research area grows, the topics discussed will focus on muscle hypertrophy and performance enhancement. As such, this paper provides an overview of: 1.) How ergogenic aids and dietary supplements are defined in terms of governmental regulation and oversight; 2.) How dietary supplements are legally regulated in the United States; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of nutritional approaches to augment skeletal muscle hypertrophy and the potential ergogenic value of various dietary and supplemental approaches.

Conclusions

This updated review is to provide ISSN members and individuals interested in sports nutrition with information that can be implemented in educational, research or practical settings and serve as a foundational basis for determining the efficacy and safety of many common sport nutrition products and their ingredients.

The Critical Power Model as a Potential Tool for Anti-doping

Existing doping detection strategies rely on direct and indirect biochemical measurement methods focused on detecting banned substances, their metabolites, or biomarkers related to their use. However, the goal of doping is to improve performance, and yet evidence from performance data is not considered by these strategies. The emergence of portable sensors for measuring exercise intensities and of player tracking technologies may enable the widespread collection of performance data. How these data should be used for doping detection is an open question. Herein, we review the basis by which performance models could be used for doping detection, followed by critically reviewing the potential of the critical power (CP) model as a prototypical performance model that could be used in this regard. Performance models are mathematical representations of performance data specific to the athlete. Some models feature parameters with physiological interpretations, changes to which may provide clues regarding the specific doping method. The CP model is a simple model of the power-duration curve and features two physiologically interpretable parameters, CP and W′. We argue that the CP model could be useful for doping detection mainly based on the predictable sensitivities of its parameters to ergogenic aids and other performance-enhancing interventions. However, our argument is counterbalanced by the existence of important limitations and unresolved questions that need to be addressed before the model is used for doping detection. We conclude by providing a simple worked example showing how it could be used and propose recommendations for its implementation.

The sports psychiatrist and performance-enhancing drugs

Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the effects of different classes of substances used for doping, side-effects of doping, and treatment of affected athletes. There is variable evidence for the performance-enhancing effects and side-effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions.

Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies

The current review clarifies the cardiometabolic health effects of high-intensity interval training (HIIT) in adults. A systematic search (PubMed) examining HIIT and cardiometabolic health markers was completed on 15 October 2015. Sixty-five intervention studies were included for review and the methodological quality of included studies was assessed using the Downs and Black score. Studies were classified by intervention duration and body mass index classification. Outcomes with at least 5 effect sizes were synthesised using a random-effects meta-analysis of the standardised mean difference (SMD) in cardiometabolic health markers (baseline to postintervention) using Review Manager 5.3. Short-term (ST) HIIT (<12 weeks) significantly improved maximal oxygen uptake (VO₂ max; SMD 0.74, 95% CI 0.36 to 1.12; p<0.001), diastolic blood pressure (DBP; SMD -0.52, 95% CI -0.89 to -0.16; p<0.01) and fasting glucose (SMD -0.35, 95% CI -0.62 to -0.09; p<0.01) in overweight/obese populations. Long-term (LT) HIIT (≥12 weeks) significantly improved waist circumference (SMD -0.20, 95% CI -0.38 to -0.01; p<0.05), % body fat (SMD -0.40, 95% CI -0.74 to -0.06; p<0.05), VO₂ max (SMD 1.20, 95% CI 0.57 to 1.83; p<0.001), resting heart rate (SMD -0.33, 95% CI -0.56 to -0.09; p<0.01), systolic blood pressure (SMD -0.35, 95% CI -0.60 to -0.09; p<0.01) and DBP (SMD -0.38, 95% CI -0.65 to -0.10; p<0.01) in overweight/obese populations. HIIT demonstrated no effect on insulin, lipid profile, C reactive protein or interleukin 6 in overweight/obese populations. In normal weight populations, ST-HIIT and LT-HIIT significantly improved VO₂ max, but no other significant effects were observed. Current evidence suggests that ST-HIIT and LT-HIIT can increase VO₂ max and improve some cardiometabolic risk factors in overweight/obese populations.

Heart-Rate Variability Threshold as an Alternative for Spiro-Ergometry Testing: A Validation Study

Mankowski, RT, Michael, S, Rozenberg, R, Stokla, S, Stam, HJ, and Praet, SFE. Heart-rate variability threshold as an alternative for spiro-ergometry testing: a validation study. J Strength Cond Res 31(2): 474-479, 2017-Although spiro-ergometry is the established "gold standard" for determination of the second ventilatory threshold (VT2), it is a costly and rather time-consuming method. Previous studies suggest that assessing the second anaerobic threshold (AT2) on the basis of heart rate variability (HRV) during exercise may be a more cost-effective and noninvasive manner. However, appropriate validation studies, are still lacking. Eleven healthy, moderately trained subjects underwent 3 incremental exercise tests. Ventilation, oxygen uptake (V[Combining Dot Above]O2), CO2 production (V[Combining Dot Above]CO2), and HRV were measured continuously. Exercise testing was performed in 3 oxygen (FiO2) conditions of inspired air (14, 21, and 35% of oxygen). Participants and assessors were blinded to the FiO2 conditions. Two research teams assessed VT2s and HRVT2s independently from each other. Mean workloads corresponding to VT2 and HRVT2 in hypoxia were, respectively, 19 ± 17% (p = 0.01) and 15 ± 15% (p = 0.1) lower in comparison with hyperoxic conditions. Bland-Altman analysis showed low estimation bias (2.2%) and acceptably precise 95% limits of agreement for workload -15.7% to 20.1% for all FiO2 conditions. Bias was the lowest under normoxic conditions (1.1%) in comparison with hypoxia (3.7%) and hyperoxia (4.7%). Heart rate variability-based AT2 assessment had a most acceptable agreement with VT2 under normoxic conditions. This simple HRVT2 assessment may have potential applications for exercise monitoring in commercial fitness settings.

Drug abuse in athletes

Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions.

Effects of pre-irradiation of low-level laser therapy with different doses and wavelengths in skeletal muscle performance, fatigue, and skeletal muscle damage induced by tetanic contractions in rats

This study aimed to evaluate the effects of low-level laser therapy (LLLT) immediately before tetanic contractions in skeletal muscle fatigue development and possible tissue damage. Male Wistar rats were divided into two control groups and nine active LLLT groups receiving one of three different laser doses (1, 3, and 10 J) with three different wavelengths (660, 830, and 905 nm) before six tetanic contractions induced by electrical stimulation. Skeletal muscle fatigue development was defined by the percentage (%) of the initial force of each contraction and time until 50 % decay of initial force, while total work was calculated for all six contractions combined. Blood and muscle samples were taken immediately after the sixth contraction. Several LLLT doses showed some positive effects on peak force and time to decay for one or more contractions, but in terms of total work, only 3 J/660 nm and 1 J/905 nm wavelengths prevented significantly (p < 0.05) the development of skeletal muscle fatigue. All doses with wavelengths of 905 nm but only the dose of 1 J with 660 nm wavelength decreased creatine kinase (CK) activity (p < 0.05). Qualitative assessment of morphology revealed lesser tissue damage in most LLLT-treated groups, with doses of 1-3 J/660 nm and 1, 3, and 10 J/905 nm providing the best results. Optimal doses of LLLT significantly delayed the development skeletal muscle performance and protected skeletal muscle tissue against damage. Our findings also demonstrate that optimal doses are partly wavelength specific and, consequently, must be differentiated to obtain optimal effects on development of skeletal muscle fatigue and tissue preservation. Our findings also lead us to think that the combined use of wavelengths at the same time can represent a therapeutic advantage in clinical settings.

A new single work bout test to estimate critical power and anaerobic work capacity

The purpose of this study was to develop a 3-minute, all-out test protocol using the Monark cycle ergometer for estimating the critical power (CP) and anaerobic work capacity (AWC) with the resistance based on body weight. Twelve moderately trained adults (mean age ± SD = 23.2 ± 3.5 years) performed an incremental cycle ergometer test to exhaustion. The CP and AWC were estimated from the original work limit (W(lim)) vs. time limit (T(lim)) relationship (CP(PT)) and a 3-minute all-out test (CP(3min)) against a fixed resistance and compared with the CP and AWC estimated from the new 3-minute tests on the Monark cycle ergometer (CP(3.5%) and CP(4.5%)). The resistance values for the CP(3.5%) and CP(4.5%) tests were set at 3.5 and 4.5% of the subject's body weight (kilograms). The results indicated that there were no significant differences (p > 0.05) among mean CP values for CP(PT) (178 ± 47 W), CP(3.5%) (173 ± 40 W), and CP(4.5%) (186 ± 44 W). The mean CP(3min) (193 ± 54 W), however, was significantly greater than CP(PT) and CP(3.5%). There were no significant differences in AWC for the CP(PT) (13,412 ± 6,247 J), CP(3min) (10,895 ± 2,923 J), and CP(4.5%) (9,842 ± 4,394 J). The AWC values for the CP(PT) and CP(3min), however, were significantly greater than CP(3.5%) (8,357 ± 2,946 J). The results of this study indicated that CP and AWC could be estimated from a single 3-minute work bout test on the Monark cycle ergometer with the resistance set at 4.5% of the body weight. A single work bout test with the resistance based on the individual's body weight provides a practical and accessible method to estimate CP and AWC.

The possible combinatory effects of acute consumption of caffeine, creatine, and amino acids on the improvement of anaerobic running performance in humans

Preexercise nutritional investigations have recently become a popular avenue of examining the interaction of multiple ingredients on exercise and training methods. The critical velocity (CV) test is used to quantify the relationship between total running distance and time to exhaustion (TTE), yielding aerobic (CV) and anaerobic parameters (anaerobic running capacity [ARC]). The purpose of this study was to examine the hypothesis that a preexercise supplement containing caffeine, creatine, and amino acids (Game Time; Corr-Jen Laboratories Inc, Aurora, CO) would positively impact CV and ARC in college-aged men and women. In a single-blind crossover design, 10 participants consumed the preexercise supplement (ACT) or placebo (PL) before each testing session. Each participant completed runs to exhaustion on a treadmill at 110%, 90% (day 1), and 105% and 100% (day 2) of the peak velocity (PV) determined from a graded exercise test. The ACT elicited a 10.8% higher ARC (P = .02) compared with the PL, whereas no difference was found in CV (0.6%, P = .38). The TTE was greater for the ACT than the PL at 110% (ACT = 125.7 ± 9.6 seconds, PL = 117.3 ± 12.6 seconds), 105% (ACT = 156.9 ± 11.0 seconds, PL = 143.8 ± 12.9 seconds), and 100% PV (ACT = 185.7 ± 10.7 seconds, PL = 169.7 ± 12.8 seconds) (P = .01-.04); but there was no difference for the TTE at 90% PV (ACT = 353.5 ± 52.7 seconds, PL = 332.7 ± 54.0 seconds) (P = .08). These findings suggest that the acute ingestion of this preexercise supplement may be an effective strategy for improving anaerobic performance, but appears to have no effect on aerobic power.

The effects of creatine loading and gender on anaerobic running capacity

Creatine (Cr) loading consists of short-term, high-dosage Cr supplementation and has been shown to increase intramuscular total Cr content. Increases in body weight (BW) have been shown to result from Cr loading, with differences by gender, and increased BW may impact weight-bearing exercise. The critical velocity (CV) test is used to quantify the relationship between total running distance and time to exhaustion. The CV test provides the variable, anaerobic running capacity (ARC), which is an estimate of the anaerobic energy reserves in muscle. The purpose of this study was to examine the effects of gender and Cr loading on ARC. Fifty moderately trained men and women volunteered to participate in this randomized, double-blinded, placebo (PL)-controlled, repeated-measures study. After a familiarization session, a 3-day testing procedure was conducted. A maximal oxygen consumption test VO(2)max) on a treadmill was performed on day 1 to establish the maximum velocity (Vmax) at VO(2)max and to record BW. Days 2 and 3 involved treadmill running at varying percentages of Vmax. Participants were randomly assigned to either the Cr or PL group and received 20 packets of the Cr supplement (1 packet = 5 g Cr citrate, 18 g dextrose) or 20 packets of the PL (1 packet = 18 g dextrose). After consuming 4 packets daily for 5 consecutive days, the 3-day testing procedure was repeated. The male Cr loading group exhibited a 23% higher (p = 0.003) ARC compared to the PL group. Nonsignificant BW increases were found for the Cr groups. These findings suggest that Cr loading may be an effective strategy for improving ARC in men, but not in women, and revealed only nonsignificant increases in BW. Creatine loading may be used before competition by athletes to provide improvements in high-intensity, short-duration activities.

The effects of a pre-workout supplement containing caffeine, creatine, and amino acids during three weeks of high-intensity exercise on aerobic and anaerobic performance

Background

A randomized, single-blinded, placebo-controlled, parallel design study was used to examine the effects of a pre-workout supplement combined with three weeks of high-intensity interval training (HIIT) on aerobic and anaerobic running performance, training volume, and body composition.

Methods

Twenty-four moderately-trained recreational athletes (mean ± SD age = 21.1 ± 1.9 yrs; stature = 172.2 ± 8.7 cm; body mass = 66.2 ± 11.8 kg, VO₂max = 3.21 ± 0.85 l·min^-1, percent body fat = 19.0 ± 7.1%) were assigned to either the active supplement (GT, n = 13) or placebo (PL, n = 11) group. The active supplement (Game Time^®, Corr-Jensen Laboratories Inc., Aurora, CO) was 18 g of powder, 40 kcals, and consisted of a proprietary blend including whey protein, cordyceps sinensis, creatine, citrulline, ginseng, and caffeine. The PL was also 18 g of powder, 40 kcals, and consisted of only maltodextrin, natural and artificial flavors and colors. Thirty minutes prior to all testing and training sessions, participants consumed their respective supplements mixed with 8-10 oz of water. Both groups participated in a three-week HIIT program three days per week, and testing was conducted before and after the training. Cardiovascular fitness (VO₂max) was assessed using open circuit spirometry (Parvo-Medics TrueOne^® 2400 Metabolic Measurement System, Sandy, UT) during graded exercise tests on a treadmill (Woodway, Pro Series, Waukesha, WI). Also, four high-speed runs to exhaustion were conducted at 110, 105, 100, and 90% of the treadmill velocity recorded during VO₂max, and the distances achieved were plotted over the times-to-exhaustion. Linear regression was used to determine the slopes (critical velocity, CV) and y-intercepts (anaerobic running capacity, ARC) of these relationships to assess aerobic and anaerobic performances, respectively. Training volumes were tracked by summing the distances achieved during each training session for each subject. Percent body fat (%BF) and lean body mass (LBM) were assessed with air-displacement plethysmography (BOD POD^®, Life Measurement, Inc., Concord, CA).

Results

Both GT and PL groups demonstrated a significant (p = 0.028) increase in VO₂max from pre- to post-training resulting in a 10.3% and 2.9% improvement, respectively. CV increased (p = 0.036) for the GT group by 2.9%, while the PL group did not change (p = 0.256; 1.7% increase). ARC increased for the PL group by 22.9% and for the GT group by 10.6%. Training volume was 11.6% higher for the GT versus PL group (p = 0.041). %BF decreased from 19.3% to 16.1% for the GT group and decreased from 18.0% to 16.8% in the PL group (p = 0.178). LBM increased from 54.2 kg to 55.4 kg (p = 0.035) for the GT group and decreased from 52.9 kg to 52.4 kg in the PL group (p = 0.694).

Conclusion

These results demonstrated improvements in VO₂max, CV, and LBM when GT is combined with HIIT. Three weeks of HIIT alone also augmented anaerobic running performance, VO₂max and body composition.

ISSN exercise & sport nutrition review: research & recommendations

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients.