Dietary intake is independently associated with the maximal capacity for fat oxidation during exercise

Eicosapentaenoic Acid and Medium-Chain Triacylglycerol Structured Lipid Supplementation Improves Muscular Endurance Exercise Performance and Reduces Muscle Fatigue in Young Healthy Male

OBJECTIVE

Structured lipids containing medium-chain fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) from fish oil (EPA/MCT) and it improve overall endurance. However, their effects on local muscle endurance remain unclear. This study aimed to investigate the effects of EPA/MCT intake on muscle endurance during leg extension exercises and subsequent muscle fatigue.

METHODS

This 8-week, placebo-controlled, randomized, double-blind parallel-group trial involved 20 healthy young men. Subjects were randomly assigned to an EPA/MCT group (10 subjects) and a placebo group (PL group, 10 subjects). They consumed 4560 mg of the test food daily for 8 wk before an exercise intervention. The EPA/MCT supplement contained 600 mg of EPA, 260 mg of DHA, and 1890 mg of MCT (1110 mg of octanoic acid and 780 mg of decanoic acid). After the 8-week intervention, the subjects performed four sets of leg extension exercises at 40% of their body weight until exhaustion. The number of repetitions per set and the total repetitions across the four sets served as indicators of muscle endurance. Isometric maximum voluntary contraction (MVC), range of motion, circumference, muscle thickness, echo intensity, and muscle stiffness were measured before and after exercise to assess muscle fatigue.

RESULTS

There was no difference between the groups in the number of repetitions for sets 1-4 or in the total number of repetitions during the leg extension exercise. In the EPA/MCT group, a significant negative correlation was observed between the increase in the blood EPA/AA ratio and the rate of decrease in the number of repetitions. Additionally, the decrease in MVC after exercise was significantly smaller in the EPA/MCT group than in the PL group.

CONCLUSION

Our study results suggest that an 8-week intake of EPA/MCT can increase the blood EPA/AA ratio and improve muscle endurance performance. Additionally, EPA/MCT intake reduces muscle fatigue after exercise.

Efficacy of providing energy expenditure information to guide weight loss interventions in people with obesity: A randomized controlled trial

Resting energy expenditure (REE) and metabolic fuel utilization (carbohydrate or fat) proxied by respiratory quotient (RQ) from indirect calorimetry enables more precise measurement of energy needs and fat oxidation capacity. The study compared the effectiveness of providing energy expenditure information during diet and exercise weight intervention versus standard of care (SOC) on weight loss outcomes. Fifty-two participants with obesity were recruited from a specialist weight loss service, randomized 1:1 to intervention (INT) or SOC only. Participants in INT received four-weekly dietetic counselling, using biofeedback from energy expenditure data to recommend caloric restriction and physical activity goals, in addition to SOC. The primary outcome was the mean difference in weight loss between both groups after 24 weeks. Secondary outcomes include participant acceptability and tolerability using indirect calorimetry. Participants in the INT group demonstrated additional weight loss (-2.3 kg [95% CI: -3.1, -1.5]; p <.001), reduced waist circumference (-3.9 cm [95% CI: -5.48, -2.26]; p <.001), and decreased body fat percentage (-1.5% [95% CI:-2.31, -0.72], p <.001), compared to SOC, after adjusting for baseline body mass index, age, and sex. Forty-two percent (10/24) of participants in INT group achieved the minimum clinically significant threshold of 5% weight loss from baseline, compared to 8% (2/26) in the SOC group (p = .007). Participant acceptability and tolerability of indirect calorimetry were high, with mean scores of 4.5 ± 0.6 and 4.2 ± 0.7 (5-point Likert scale). The study establishes the safety and practical integration of biofeedback using indirect calorimetry promoting improved self-regulation and enhancing weight loss.

Greater Relative First and Second Lactate Thresholds in Females Compared With Males: Consideration for Exercise Prescription

PURPOSE

To investigate differences between females and males at lactate thresholds 1 (LT1) and 2 (LT2).

METHODS

Twenty-four female and twenty male participants performed an incremental cycle-ergometer test until exhaustion, where LT1 and LT2 were determined in each volunteer.

RESULTS

Power output at LT1 and LT2 was lower in females than in males (P < .001). In addition, power output relative to peak power was higher in females at LT1 and LT2 (P < .001). However, heart rate was higher in females than males at LT1 and LT2 (P = .008). Furthermore, the heart rate relative to maximal heart rate was higher in females compared with males at LT1 and LT2 (P = .002).

CONCLUSION

Females and males may be in a different metabolic situation at the same percentage of maximum. This study helps to reduce sex bias in science, and future guidelines should consider establishing exercise prescription recommendations according to sex.

CLINICAL TRIAL

NCT06104150.

Females have better metabolic flexibility in different metabolically challenging stimuli

The first aim was to explore the difference in metabolic flexibility between sexes in response to changing exercise intensity under control conditions. The second aim was to evaluate metabolic flexibility between sexes in response to exercise intensity adding two different metabolically challenging stimuli (glycogen depletion and heat). Eleven males (22 ± 3 years, 176.2 ± 4 cm, 68.4 ± 4.9 kg, and 60.2 ± 4.1 mL/kg FFM/min) and nine females (22 ± 2 years, 166.7 ± 4.5 cm, 61.9 ± 2.9 kg, and 64.2 ± 5.6 mL/kg FFM/min) performed a maximal incremental exercise test (30 W every 3 min) on a cycle ergometer under three conditions: control (24 h high-carbohydrate diet followed by the incremental test), glycogen depletion (glycogen-depletion protocol followed by 24 h low-carbohydrate diet and then the incremental test), and heat (24 h high-carbohydrate diet followed by 30 min passive heating and then the incremental test in heat). In the last minute of each step, lactate was analysed, fat (FATox/FFM) and carbohydrate oxidation (CHox/FFM), and energy expenditure (EE/FFM) normalized to fat-free mass (FFM) was estimated by indirect calorimetry. Females presented a greater FATox/FFM as exercise intensity increases across conditions (control, glycogen depletion, and heat) (p = 0.006). In contrast, CHox/FFM was not significantly different between sexes at any specific intensity across conditions (p > 0.05). Consequently, EE/FFM was higher in females throughout the different intensities across conditions (p = 0.002). Finally, lactate concentration was not different between sexes at the same intensities across conditions (p = 0.87). In conclusion, females present a greater metabolic flexibility, due to the higher FATox/FFM throughout the different intensities, regardless of whether the test is performed in conditions emphasizing the oxidative pathway (glycogen depletion) or the glycolytic pathway (heat). Clinical trials: NCT05703100.

Reliability of the Metabolic Response During Steady-State Exercise at FATmax in Young Men with Obesity

Purpose: In this study we evaluated the reliability of blood lactate levels (BLa), energy expenditure and substrate utilization during prolonged exercise at the intensity that elicits maximal fat oxidation (FATmax). Furthermore, we investigated the accuracy of a single graded exercise test (GXT) for predicting energy metabolism at FATmax. Methods: Seventeen young men with obesity (26 ± 6 years; 36.4 ± 7.2 %body fat) performed a GXT on a treadmill in a fasted state (10-12 h) for the assessment of FATmax and cardiorespiratory fitness. Afterward, each subject performed two additional prolonged FATmax trials (102 ± 11 beats·min-1; 60-min) separated by 7 days. Indirect calorimetry was used for the assessment of energy expenditure and substrate utilization kinetics whereas capillary blood samples were taken for the measurement of BLa. Results: The BLa (limits of agreement (LoA): -1.2 to 0.8 mmol∙L-1; p = 1.0), fat utilization (LoA: -8.0 to 13.4 g∙h-1; p = 0.06), and carbohydrate utilization (LoA: -27.6 to 22.4 g∙h-1; p = 0.41) showed a good agreement whereas a modest systematic bias was found for energy expenditure (LoA: -16811 to 33355 kJ∙h-1; p < 0.05). All the aforementioned parameters showed a moderate to good reliability (Intraclass correlation coefficient: 0.67-0.92). The GXT overestimated fat (~46%) and carbohydrate (~26%) utilization as well as energy expenditure (36%) during steady-state exercise at FATmax. Conversely the GXT underestimated BLa (~28%). Conclusion: a single GXT cannot be used for an accurate prediction of energy metabolism during prolonged exercise in men with obesity. Thus, an additional steady-state FATmax trial (40-60 min) should be performed for a tailored and precise exercise prescription.

Peak fat oxidation, peak oxygen uptake, and running performance increase during pre-season in sub-elite male football players

PURPOSE

In Football, the high-intensity running bouts during matches are considered decisive. Interestingly, recent studies showed that peak fat oxidation rates (PFO) are higher in football players than other athletes. This study aimed to investigate whether PFO increases following a pre-season. Secondarily, and due to COVID-19, we investigated whether PFO is related to the physical performance in a subgroup of semi-professional male football players.

METHODS

Before and after 8 weeks of pre-season training, 42 sub-elite male football players (18 semi-professionals and 24 non-professionals) had a dual-energy x-ray absorptiometry scan and performed a graded exercise test on a treadmill for the determination of PFO, the exercise intensity eliciting PFO (Fatmax) and peak oxygen uptake (V̇O2peak). Additionally, the semi-professional players performed a Yo-Yo Intermittent Recovery Test level 2 (YYIR2) before and after pre-season training to determine football-specific running performance.

RESULTS

PFO increased by 11 ± 10% (mean ± 95% CI), p = 0.031, and V̇O2peak increased by 5 ± 1%, p < 0.001, whereas Fatmax was unchanged (+12 ± 9%, p = 0.057), following pre-season training. PFO increments were not associated with increments in V̇O2peak (Pearson's r2 = 0.00, p = 0.948) or fat-free mass (FFM) (r2 = 0.00, p = 0.969). Concomitantly, YYIR2 performance increased in the semi-professional players by 39 ± 17%, p < 0.001, which was associated with changes in V̇O2peak (r2 = 0.35, p = 0.034) but not PFO (r2 = 0.13, p = 0.244).

CONCLUSIONS

PFO, V̇O2peak, and FFM increased following pre-season training in sub-elite football players. However, in a subgroup of semi-professional players, increments in PFO were not associated with improvements in YYIR2 performance nor with increments in V̇O2peak and FFM.

Toward Exercise Guidelines for Optimizing Fat Oxidation During Exercise in Obesity: A Systematic Review and Meta-Regression

BACKGROUND

Exercise training performed at maximal fat oxidation (FATmax) is an efficient non-pharmacological approach for the management of obesity and its related cardio-metabolic disorders.

OBJECTIVES

Therefore, this work aimed to provide exercise intensity guidelines and training volume recommendations for maximizing fat oxidation in patients with obesity.

METHODS

A systematic review of original articles published in English, Spanish or French languages was carried out in EBSCOhost, PubMed and Scopus by strictly following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Those studies that analyzed maximal fat oxidation (MFO) and FATmax in patients with obesity (body fat > 25% for men; > 35% for women) by calculating substrate oxidation rates through indirect calorimetry during a graded exercise test with short-duration stages (< 10 min) were selected for quantitative analysis. The accuracy of relative oxygen uptake (% peak oxygen uptake [%[Formula: see text]O2peak]) and relative heart rate (% peak heart rate [%HRpeak]) for establishing FATmax reference values was investigated by analyzing their intra-individual and inter-study variation. Moreover, cluster analysis and meta-regression were used for determining the influence of biological factors and methodological procedures on MFO and FATmax.

RESULTS

Sixty-four manuscripts were selected from 146 records; 23 studies only recruited men (n = 465), 14 studies only evaluated women (n = 575), and 27 studies included individuals from both sexes (n = 6434). The majority of the evaluated subjects were middle-aged adults (aged 40-60 y; 84%) with a poor cardiorespiratory fitness (≤ 43 mL·kg-1·min-1; 81%), and the reported MFO ranged from 0.27 to 0.33 g·min-1. The relative heart rate at FATmax (coefficient of variation [CV]: 8.8%) showed a lower intra-individual variation compared with relative oxygen uptake (CV: 17.2%). Furthermore, blood lactate levels at FATmax ranged from 1.3 to 2.7 mmol·L-1 while the speed and power output at FATmax fluctuated from 4 to 5.1 km·h-1 and 42.8-60.2 watts, respectively. Age, body mass index, cardiorespiratory fitness, FATmax, the type of ergometer and the stoichiometric equation used to calculate the MFO independently explained MFO values (R2 = 0.85; p < 0.01). The MFO in adolescents was superior in comparison with MFO observed in young and middle-aged adults. On the other hand, the MFO was higher during treadmill walking in comparison with stationary cycling. Body fat and MFO alone determined 29% of the variation in FATmax (p < 0.01), noting that individuals with body fat > 35% showed a heart rate of 61-66% HRpeak while individuals with < 35% body fat showed a heart rate between 57 and 64% HRpeak. Neither biological sex nor the analytical procedure for computing the fat oxidation kinetics were associated with MFO and FATmax.

CONCLUSION

Relative heart rate rather than relative oxygen uptake should be used for establishing FATmax reference values in patients with obesity. A heart rate of 61-66% HRpeak should be recommended to patients with > 35% body fat while a heart rate of 57-64% HRpeak should be recommended to patients with body fat < 35%. Moreover, training volume must be higher in adults to achieve a similar fat oxidation compared with adolescents whereas exercising on a treadmill requires a lower training volume to achieve significant fat oxidation in comparison with stationary cycling.

The role of sex in the relationship between fasting adipokines levels, maximal fat oxidation during exercise, and insulin resistance in young adults with excess adiposity

AIM

Previous evidence suggest that a sexual dimorphism in exercise fat oxidation and adipokines levels may explain a lower risk of cardio-metabolic disorders in women. Therefore, we investigated the role of sex in the relationship between adipokines levels, maximal fat oxidation (MFO) during exercise and insulin resistance.

METHODS

Fifty young adults with excess adiposity (31 women; body fat: 38.7 ± 5.3%) were included in this study. The fasting levels of leptin, adiponectin, glucose and insulin were determined from blood samples and the homeostatic model assessment of insulin resistance index (HOMA-IR) subsequently calculated. Body fat percentage and visceral adipose tissue (VAT) were assessed through dual-energy X-ray absorptiometry whereas MFO was estimated during an incremental-load exercise test after an overnight fasting through indirect calorimetry.

RESULTS

Men had lower levels of body fat (d = 1.80), adiponectin (d = 1.35), leptin (d = 0.43) and MFO (d = 1.25) than women. Conversely, men showed higher VAT (d = 0.85) and fasting glucose levels (d = 0.89). No sex differences were observed in HOMA-IR (d = 0.34). Adipokines levels were not associated with MFO in both sexes (r < 0.30), whereas adiponectin levels were inversely related with HOMA-IR in both men (r = -0.58) and women (r = -0.50). Leptin concentration was associated to HOMA-IR only in men (r = 0.41), while no statistically significant relationships were observed between MFO and HOMA-IR in both sexes (r < 0.44).

CONCLUSION

Insulin resistance was similar between sexes regardless of superior levels of adipokines and MFO during exercise in women. Therefore, adiponectin and leptin may regulate glucose homeostasis without altering whole body fat oxidation rate during exercise.

Eicosapentaenoic Acid and Medium-Chain Triacylglycerol Structured Lipids Improve Endurance Performance

PURPOSE

The effects of intake of STGs containing esterified eicosapentaenoic acid (EPA) and medium-chain triglycerides (MCTs) on cardiorespiratory endurance have not yet been reported. This study aimed to examine the efficacy of interesterified structured lipids EPA and MCTs on cardiorespiratory endurance.

METHODS

This 8-week randomized double-blind placebo-controlled parallel-group study involved 19 healthy men. The participants were randomly assigned to a group that received interesterified structured lipids EPA and MCTs (STG group, 9 participants) or a group receiving a PM of EPA and MCTs (PM group, 10 participants). The outcome measures were time to exhaustion (TTE) and time to reach the anaerobic threshold in the peak oxygen uptake (VO2peak) test, VO2peak, and anaerobic threshold.

RESULTS

The increase in TTE in the VO2peak test after the intervention period compared with before the intervention period was significantly greater in the STG group (53 ± 53 s) than in the PM group (-10 ± 63 s; p < 0.05). Similarly, the increase in time to reach the anaerobic threshold was significantly greater in the STG group (82 ± 55 s) than in the PM group (-26 ± 52 s; p < 0.001).

CONCLUSION

This study demonstrated that the consumption of interesterified structured lipids EPA and MCTs improved endurance in humans.

Pre-exercise meal on oxidation of energy substrates during maximal exercise test in non-trained individuals

Objective

This study aimed to compare the influence of a high carbohydrate meal versus high-fat meal on the oxidation of substrates during an exercise incremental test.

Materials and methods

Ten untrained male subjects underwent two days of the protocol. Randomly, they received a high carbohydrate meal or a high-fat meal, receiving the other one in the next protocol. On both days, they performed an incremental treadmill test, with heart rate and maximal oxygen consumption to estimate the oxidation of substrates.

Results

The high-fat meal showed an increase in the absolute amount of oxidized fat along with the incremental test (P < 0.05; effect size = 0.9528), and a reduction in the respiratory exchange ratio at low intensities (P < 0.05; effect size = 0.7765).

Conclusion

The meals presented no difference when compared to maximum oxidation point of substrates, the oxidation rate of substrates over time, and heart rate. A pre-test high-fat meal in untrained individuals was shown to be a modulating factor of total oxidized fats throughout the exercise, although it did not exert a significant effect on the rate of this oxidation over time.

Effect of Low-Carbohydrate Diet on Beta-Hydroxybutyrate Ketogenesis Metabolic Stimulation and Regulation of NLRP3 Ubiquitination in Obese Saudi Women

The effects of a ketogenic diet (KD) on anthropometric indices, the lipid profile, and the benefits of the ketone body beta-hydroxybutyrate (BHB) as an inhibitor of the NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome in obese women were investigated in this study. From January to March 2021, 23 obese adult women (n = 23) with an average age of 35.30 years and BMI of 33.96 kg/m² followed a KD. Instructions for the KD were given to eligible participants, with a typical plan and a menu for all the main meals, snacks, and drinks permitted over seven days. They were also free to change meals according to their preferences provided that they followed the plan. The participants attended six times throughout the intervention for measurements of their anthropometric indices, BHB levels, interleukin-1beta (1L-1β) levels, and completion of a questionnaire (pre-intervention, mid-intervention, and post-intervention). Following the KD caused significant weight loss, a reduction in waist circumference and BHB levels, as well as a reduction in BMI and appetite. Cholesterol, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) increased slightly. However, low-density lipoprotein cholesterol (LDL-C) in serum increased significantly (p < 0.05), and 1L-1β decreased significantly (p < 0.0001). The results show that the KD effectively encouraged weight loss and NLRP3 inflammasome inhibition. Based on the questionnaire results, it was found that a variety of physical symptoms, including overall energy, physical activity, mood, sleep, focus, skin conditions, and menstruation, had significantly improved.

Maximal Fat Oxidation during Incremental Upper and Lower Body Exercise in Healthy Young Males

The aim of this study is to determine the magnitude of maximal fat oxidation (MFO) during incremental upper and lower body exercise. Thirteen non-specifically trained male participants (19.3 ± 0.5 y, 78.1 ± 9.1 kg body mass) volunteered for this repeated-measures study, which had received university ethics committee approval. Participants undertook two incremental arm crank (ACE) and cycle ergometry (CE) exercise tests to volitional exhaustion. The first test for each mode served as habituation. The second test was an individualised protocol, beginning at 40% of the peak power output (PO_peak) achieved in the first test, with increases of 10% PO_peak until volitional exhaustion. Expired gases were recorded at the end of each incremental stage, from which fat and carbohydrate oxidation rates were calculated. MFO was taken as the greatest fat oxidation value during incremental exercise and expressed relative to peak oxygen uptake (%V˙O_2peak). MFO was lower during ACE (0.44 ± 0.24 g·min^-1) than CE (0.77 ± 0.31 g·min^-1; respectively, p < 0.01) and occurred at a lower exercise intensity (53 ± 21 vs. 67 ± 18%V˙O_2peak; respectively, p < 0.01). Inter-participant variability for MFO was greatest during ACE. These results suggest that weight loss programs involving the upper body should occur at lower exercise intensities than for the lower body.

Factors Influencing Substrate Oxidation During Submaximal Cycling: A Modelling Analysis

BACKGROUND

Multiple factors influence substrate oxidation during exercise including exercise duration and intensity, sex, and dietary intake before and during exercise. However, the relative influence and interaction between these factors is unclear.

OBJECTIVES

Our aim was to investigate factors influencing the respiratory exchange ratio (RER) during continuous exercise and formulate multivariable regression models to determine which factors best explain RER during exercise, as well as their relative influence.

METHODS

Data were extracted from 434 studies reporting RER during continuous cycling exercise. General linear mixed-effect models were used to determine relationships between RER and factors purported to influence RER (e.g., exercise duration and intensity, muscle glycogen, dietary intake, age, and sex), and to examine which factors influenced RER, with standardized coefficients used to assess their relative influence.

RESULTS

The RER decreases with exercise duration, dietary fat intake, age, VO2max, and percentage of type I muscle fibers, and increases with dietary carbohydrate intake, exercise intensity, male sex, and carbohydrate intake before and during exercise. The modelling could explain up to 59% of the variation in RER, and a model using exclusively easily modified factors (exercise duration and intensity, and dietary intake before and during exercise) could only explain 36% of the variation in RER. Variables with the largest effect on RER were sex, dietary intake, and exercise duration. Among the diet-related factors, daily fat and carbohydrate intake have a larger influence than carbohydrate ingestion during exercise.

CONCLUSION

Variability in RER during exercise cannot be fully accounted for by models incorporating a range of participant, diet, exercise, and physiological characteristics. To better understand what influences substrate oxidation during exercise further research is required on older subjects and females, and on other factors that could explain additional variability in RER.

Associations between heart rate variability and maximal fat oxidation in two different cohorts of healthy sedentary adults

BACKGROUND AND AIMS

Resting heart rate variability (HRV) and maximal fat oxidation (MFO) during exercise are both considered as a noninvasive biomarkers for early detection of cardiovascular risk factors. Thus, this study aimed to analyze the relationship between resting HRV parameters and MFO during exercise, and the intensity of exercise that elicit MFO (Fatmax) in healthy sedentary adults.

METHODS AND RESULTS

A total of 103 healthy young adults (22.2 ± 2.3 years old, 67% female; from the ACTIBATE cohort) and 67 healthy middle-aged adults (53.1 ± 5.0 years old, 52% female; from the FIT-AGEING cohort) were included in this cross-sectional study. HRV was assessed using a Polar RS800CX heart rate monitor, while MFO and Fatmax were determined during a graded exercise treadmill test using indirect calorimetry. No significant associations were observed for healthy young adults (standardized β coefficients ranged from -0.063 to 0.094, and all P ≥ 0.347) and for middle-aged adults (standardized β coefficients ranged from -0.234 to 0.090, and all P ≥ 0.056). Nevertheless, only a weak association was observed between one HRV parameter in time-domain (the percentage of R-R intervals that shows a difference higher than 50 ms [pNN50]) and MFO in the cohort of middle-aged adults (β coefficient = -0.279, and P = 0.033).

CONCLUSION

The results of this study suggest that resting HRV parameters are not associated with MFO and Fatmax during exercise in two independent cohorts of healthy sedentary young and middle-aged adults, respectively.

Associations of resting and peak fat oxidation with sex hormone profile and blood glucose control in middle-aged women

BACKGROUND AND AIMS

Menopause may reduce fat oxidation. We investigated whether sex hormone profile explains resting fat oxidation (RFO) or peak fat oxidation (PFO) during incremental cycling in middle-aged women. Secondarily, we studied associations of RFO and PFO with glucose regulation.

METHOD AND RESULTS

We measured RFO and PFO of 42 women (age 52-58 years) with indirect calorimetry. Seven participants were pre- or perimenopausal, 26 were postmenopausal, and nine were postmenopausal hormone therapy users. Serum estradiol (E2), follicle-stimulating hormone, progesterone, and testosterone levels were quantified with immunoassays. Insulin sensitivity (Matsuda index) and glucose tolerance (area under the curve) were determined by glucose tolerance testing. Body composition was assessed with dual-energy X-ray absorptiometry; physical activity with self-report and accelerometry; and diet, with food diaries. Menopausal status or sex hormone levels were not associated with the fat oxidation outcomes. RFO determinants were fat mass (β = 0.44, P = 0.006) and preceding energy intake (β = -0.40, P = 0.019). Cardiorespiratory fitness (β = 0.59, P = 0.002), lean mass (β = 0.49, P = 0.002) and physical activity (self-reported β = 0.37, P = 0.020; accelerometer-measured β = 0.35, P = 0.024) explained PFO. RFO and PFO were not related to insulin sensitivity. Higher RFO was associated with poorer glucose tolerance (β = 0.52, P = 0.002).

CONCLUSION

Among studied middle-aged women, sex hormone profile did not explain RFO or PFO, and higher fat oxidation capacity did not indicate better glucose control.

Beyond the Calorie Paradigm: Taking into Account in Practice the Balance of Fat and Carbohydrate Oxidation during Exercise?

Recent literature shows that exercise is not simply a way to generate a calorie deficit as an add-on to restrictive diets but exerts powerful additional biological effects via its impact on mitochondrial function, the release of chemical messengers induced by muscular activity, and its ability to reverse epigenetic alterations. This review aims to summarize the current literature dealing with the hypothesis that some of these effects of exercise unexplained by an energy deficit are related to the balance of substrates used as fuel by the exercising muscle. This balance of substrates can be measured with reliable techniques, which provide information about metabolic disturbances associated with sedentarity and obesity, as well as adaptations of fuel metabolism in trained individuals. The exercise intensity that elicits maximal oxidation of lipids, termed LIPOXmax, FATOXmax, or FATmax, provides a marker of the mitochondrial ability to oxidize fatty acids and predicts how much fat will be oxidized over 45–60 min of low- to moderate-intensity training performed at the corresponding intensity. LIPOXmax is a reproducible parameter that can be modified by many physiological and lifestyle influences (exercise, diet, gender, age, hormones such as catecholamines, and the growth hormone-Insulin-like growth factor I axis). Individuals told to select an exercise intensity to maintain for 45 min or more spontaneously select a level close to this intensity. There is increasing evidence that training targeted at this level is efficient for reducing fat mass, sparing muscle mass, increasing the ability to oxidize lipids during exercise, lowering blood pressure and low-grade inflammation, improving insulin secretion and insulin sensitivity, reducing blood glucose and HbA_1c in type 2 diabetes, and decreasing the circulating cholesterol level. Training protocols based on this concept are easy to implement and accept in very sedentary patients and have shown an unexpected efficacy over the long term. They also represent a useful add-on to bariatric surgery in order to maintain and improve its weight-lowering effect. Additional studies are required to confirm and more precisely analyze the determinants of LIPOXmax and the long-term effects of training at this level on body composition, metabolism, and health.

Biomarkers and genetic polymorphisms associated with maximal fat oxidation during physical exercise: implications for metabolic health and sports performance

The maximal fat oxidation rate (MFO) assessed during a graded exercise test is a remarkable physiological indicator associated with metabolic flexibility, body weight loss and endurance performance. The present review considers existing biomarkers related to MFO, highlighting the validity of maximal oxygen uptake and free fatty acid availability for predicting MFO in athletes and healthy individuals. Moreover, we emphasize the role of different key enzymes and structural proteins that regulate adipose tissue lipolysis (i.e., triacylglycerol lipase, hormone sensitive lipase, perilipin 1), fatty acid trafficking (i.e., fatty acid translocase cluster of differentiation 36) and skeletal muscle oxidative capacity (i.e., citrate synthase and mitochondrial respiratory chain complexes II-V) on MFO variation. Likewise, we discuss the association of MFO with different polymorphism on the ACE, ADRB3, AR and CD36 genes, identifying prospective studies that will help to elucidate the mechanisms behind such associations. In addition, we highlight existing evidence that contradict the paradigm of a higher MFO in women due to ovarian hormones activity and highlight current gaps regarding endocrine function and MFO relationship.

Changes in Fat Oxidation and Body Composition after Combined Exercise Intervention in Sedentary Obese Chinese Adults

(1) Background: Evidence suggests that aerobic exercise and high-intensity interval training (HIIT) might increase fat oxidation and reduce fat. However, limited research has examined the effects of combining progressive aerobic exercise and HIIT interventions in sedentary adults with overweight and obesity, and differences in its effects between men and women remain unclear. The purpose of this study was to investigate the effects of combined progressive aerobic exercise and HIIT (CAEH) on fat oxidation and fat reduction in sedentary Chinese adults and compare sex differences in sedentary adults after seven weeks. (2) Methods: Eighty-four sedentary obese adults were enrolled and allocated to two groups in baseline (experimental (EXP) group:42; control (CON) group:42), and fifty-six subjects (EXP:31; CON:25) completed the experiments and were included in the final analysis. Subjects in the EXP group performed CAEH three times per week for seven weeks. Subjects in the CON group were advised to continue with their normal daily activities. Anthropometric, lipid profile, cardiorespiratory fitness, and fat oxidation outcomes were assessed before and after the intervention. (3) Results: After seven weeks of the CAEH intervention, compared with the CON group, the EXP group showed significant increases in fat oxidation at rest (FO_rest) (+0.03 g/min, p < 0.01), maximal fat oxidation (MFO) (+0.05 g/min, p < 0.01), and maximal oxygen intake (VO₂max) (+3.2 mL/kg/min, p < 0.01). The changes in the percentages of the FO_rest (+57%) and the VO₂max (+16%) were significantly greater (+20%, +6%) in males than in females (p < 0.05, p < 0.05). The body mass index (BMI) (−1.2 kg/m², p < 0.01), body fat percentage (−3.2%, p < 0.001), visceral fat area (−12.8 cm², p < 0.001), and total cholesterol (TC) levels (−0.4 mmol/L, p < 0.05) were significantly decreased in the EXP group. (4) Conclusions: Seven weeks of the CAEH intervention effectively improved FO_rest, MFO, and VO₂max in sedentary obese adults, and the improvements in FO_rest and VO₂max were more pronounced in males than in females. CAEH also improved body composition and TC levels in sedentary obese adults.

New Horizons in Carbohydrate Research and Application for Endurance Athletes

The importance of carbohydrate as a fuel source for exercise and athletic performance is well established. Equally well developed are dietary carbohydrate intake guidelines for endurance athletes seeking to optimize their performance. This narrative review provides a contemporary perspective on research into the role of, and application of, carbohydrate in the diet of endurance athletes. The review discusses how recommendations could become increasingly refined and what future research would further our understanding of how to optimize dietary carbohydrate intake to positively impact endurance performance. High carbohydrate availability for prolonged intense exercise and competition performance remains a priority. Recent advances have been made on the recommended type and quantity of carbohydrates to be ingested before, during and after intense exercise bouts. Whilst reducing carbohydrate availability around selected exercise bouts to augment metabolic adaptations to training is now widely recommended, a contemporary view of the so-called train-low approach based on the totality of the current evidence suggests limited utility for enhancing performance benefits from training. Nonetheless, such studies have focused importance on periodizing carbohydrate intake based on, among other factors, the goal and demand of training or competition. This calls for a much more personalized approach to carbohydrate recommendations that could be further supported through future research and technological innovation (e.g., continuous glucose monitoring). Despite more than a century of investigations into carbohydrate nutrition, exercise metabolism and endurance performance, there are numerous new important discoveries, both from an applied and mechanistic perspective, on the horizon.

Accelerometer-measured physical activity and sedentary time are associated with maximal fat oxidation in young adults

The present work aimed to examine the association between physical activity (PA) and sedentary behaviour with maximal fat oxidation (MFO) in young individuals. A total of 77 active adults (30 women; 22.8 ± 4.5 years) were included in this cross-sectional study in which PA and sedentary behaviour were measured using accelerometers for 7 consecutive days. PA was classified into different intensities (i.e. light, moderate, vigorous, and moderate-to-vigorous) and sedentary behaviour into sedentary time (i.e. time, number of bouts, and length of bouts) and sedentary breaks (i.e. time, number of breaks, and length of breaks). MFO was determined using a graded cycloergometer test through indirect calorimetry and relativized to lean mass (MFO_LM) and lean leg mass (MFO_LL). Positive associations were found for light and vigorous PA in relation with MFO, MFO_LM and MFO_LL, independently of cofounders (P ≤ 0.01). Moreover, a negative association was found between MFO and MFO_LM and the length of sedentary bouts which was accentuated after adjusting by cardiorespiratory fitness (P ≤ 0.05). These results suggest that light and vigorous PA and sedentary behaviour are related to MFO during exercise. Despite this, further interventional studies are needed to clarify if increments of light and vigorous PA could enhance MFO in different populations.

Neither Postabsorptive Resting Nor Postprandial Fat Oxidation Are Related to Peak Fat Oxidation in Men With Chronic Paraplegia

The peak rate of fat oxidation (PFO) achieved during a graded exercise test is an important indicator of metabolic health. In healthy individuals, there is a significant positive association between PFO and total daily fat oxidation (FO). However, conditions resulting in metabolic dysfunction may cause a disconnect between PFO and non-exercise FO. Ten adult men with chronic thoracic spinal cord injury (SCI) completed a graded arm exercise test. On a separate day following an overnight fast (≥ 10 h), they rested for 60 min before ingesting a liquid mixed meal (600 kcal; 35% fat, 50% carbohydrate, 15% protein). Expired gases were collected and indirect calorimetry data used to determine FO at rest, before and after feeding, and during the graded exercise test. Participants had “good” cardiorespiratory fitness (VO_2peak: 19.2 ± 5.2 ml/kg/min) based on normative reference values for SCI. There was a strong positive correlation between PFO (0.30 ± 0.08 g/min) and VO_2peak (r = 0.86, p = 0.002). Additionally, postabsorptive FO at rest was significantly and positively correlated with postprandial peak FO (r = 0.77, p = 0.01). However, PFO was not significantly associated with postabsorptive FO at rest (0.08 ± 0.02 g/min; p = 0.97), postprandial peak FO (0.10 ± 0.03 g/min; p = 0.43), or incremental area under the curve postprandial FO (p = 0.22). It may be advantageous to assess both postabsorptive FO at rest and PFO in those with SCI to gain a more complete picture of their metabolic flexibility and long-term metabolic health.

Effect of Ethnicity on Changes in Fat and Carbohydrate Oxidation in Response to Short-Term High Intensity Interval Training (HIIT): A Pilot Study

This study compared changes in substrate metabolism with high intensity interval training (HIIT) in women of different ethnicities. Twelve Caucasian (C) and ten Hispanic women (H) (age = 24 ± 5 yr) who were inactive completed nine sessions of HIIT at 85 percent peak power output (%PPO). Pre-training, changes in fat oxidation (FOx) and carbohydrate oxidation (CHOOx) during progressive cycling were measured on two days to compute the minimum difference (MD). This test was repeated after the last training session. Between baseline tests, estimates of FOx and CHOOx were not different (p > 0.05) and were highly related (intraclass correlation coefficient equal to 0.72 to 0.88), although the coefficient of variation of maximal fat oxidation (MFO) was equal to 30%. Training significantly increased MFO (p = 0.03) in C (0.19 ± 0.06 g/min to 0.21 ± 0.06 g/min, d = 0.66) and H (0.16 ± 0.03 g/min to 0.19 ± 0.03 g/min, d = 1.3) that was similar (p = 0.92) between groups. There was a significant interaction for FOx (p = 0.003) as it was only increased in H versus C, although both groups exhibited reduced CHO oxidation (p = 0.002) with training. Use of MD revealed that only 3 of 22 women show meaningful increases in MFO (>0.08 g/min). The preliminary data reveals that a small dose of low-volume HIIT does not alter fat and CHO oxidation and there is little effect of ethnicity on the response to training.

Re-Evaluating the Oxidative Phenotype: Can Endurance Exercise Save the Western World?

Mitochondria are popularly called the "powerhouses" of the cell. They promote energy metabolism through the tricarboxylic acid (TCA) cycle and oxidative phosphorylation, which in contrast to cytosolic glycolysis are oxygen-dependent and significantly more substrate efficient. That is, mitochondrial metabolism provides substantially more cellular energy currency (ATP) per macronutrient metabolised. Enhancement of mitochondrial density and metabolism are associated with endurance training, which allows for the attainment of high relative VO2 max values. However, the sedentary lifestyle and diet currently predominant in the Western world lead to mitochondrial dysfunction. Underdeveloped mitochondrial metabolism leads to nutrient-induced reducing pressure caused by energy surplus, as reduced nicotinamide adenine dinucleotide (NADH)-mediated high electron flow at rest leads to "electron leak" and a chronic generation of superoxide radicals (O2-). Chronic overload of these reactive oxygen species (ROS) damages cell components such as DNA, cell membranes, and proteins. Counterintuitively, transiently generated ROS during exercise contributes to adaptive reduction-oxidation (REDOX) signalling through the process of cellular hormesis or "oxidative eustress" defined by Helmut Sies. However, the unaccustomed, chronic oxidative stress is central to the leading causes of mortality in the 21st century-metabolic syndrome and the associated cardiovascular comorbidities. The endurance exercise training that improves mitochondrial capacity and the protective antioxidant cellular system emerges as a universal intervention for mitochondrial dysfunction and resultant comorbidities. Furthermore, exercise might also be a solution to prevent ageing-related degenerative diseases, which are caused by impaired mitochondrial recycling. This review aims to break down the metabolic components of exercise and how they translate to athletic versus metabolically diseased phenotypes. We outline a reciprocal relationship between oxidative metabolism and inflammation, as well as hypoxia. We highlight the importance of oxidative stress for metabolic and antioxidant adaptation. We discuss the relevance of lactate as an indicator of critical exercise intensity, and inferring from its relationship with hypoxia, we suggest the most appropriate mode of exercise for the case of a lost oxidative identity in metabolically inflexible patients. Finally, we propose a reciprocal signalling model that establishes a healthy balance between the glycolytic/proliferative and oxidative/prolonged-ageing phenotypes. This model is malleable to adaptation with oxidative stress in exercise but is also susceptible to maladaptation associated with chronic oxidative stress in disease. Furthermore, mutations of components involved in the transcriptional regulatory mechanisms of mitochondrial metabolism may lead to the development of a cancerous phenotype, which progressively presents as one of the main causes of death, alongside the metabolic syndrome.

The influence of age, sex and cardiorespiratory fitness on maximal fat oxidation rate

Fat oxidation decreases with age, yet no studies have previously investigated if aging affects the maximal fat oxidation rate (MFO) during exercise in men and women differently. We hypothesized that increased age would be associated with a decline in MFO and this would be more pronounced in women due to menopause, compared with men. In this cross-sectional study design, 435 (247/188, male/female) subjects of varying ages performed a DXA scan, a submaximal graded exercise test and a maximal oxygen uptake test, to measure MFO and cardiorespiratory fitness (CRF) by indirect calorimetry. Subjects were stratified into 12 groups according to sex (male/female), age (<45, 45-55 and >55 years), CRF (below average and above average). Women aged <45 years had a higher MFO relative to fat free mass (FFM) (mg/min/kg) compared with men, regardless of CRF. However, there were no differences in MFO (mg/min/kg FFM) between men and women, in the groups aged between 45-55 and >55 years. In summary, we found that women aged <45 years display a higher MFO (mg/min/kg FFM) compared with men and that this sexual divergence is abolished after the age of 45 years. Novelty: Maximal fat oxidation rate is higher in young women compared with men. This sex-related difference is attenuated after the age of 45 years. Cardiorespiratory fitness does not influence this sex-related difference.

Relationships between diet and basal fat oxidation and maximal fat oxidation during exercise in sedentary adults

BACKGROUND AND AIMS

To study the relationships between different dietary factors (i.e., energy, macronutrient and fatty acid intake, food group consumption, and dietary pattern) and basal fat oxidation (BFox) and maximal fat oxidation during exercise (MFO) in sedentary adults.

METHOD AND RESULTS

A total of 212 (n = 130 women; 32.4 ± 15.1 years) sedentary healthy adults took part in the present study. Information on the different dietary factors examined was gathered through a food frequency questionnaire and three nonconsecutive 24 h recalls. Energy and macronutrient intakes and food consumption were then estimated and dietary patterns calculated. BFox and MFO were measured by indirect calorimetry following standard procedures. Our study shows that dietary fiber intake was positively associated with BFox after taking into consideration the age, sex, and energy intake. A significant positive association between nut consumption and BFox was observed, which became nonsignificant after taking into consideration the age and energy intake. Fat intake and the dietary quality index (DQI), and the DQI for the Mediterranean diet were positively associated with MFO, which was attenuated after taking sex, age, and energy intake into consideration.

CONCLUSION

A higher dietary fiber intake and fat intake are associated with higher BFox and MFO, respectively, in sedentary adults.

CLINICAL TRIALS

ClinicalTrials.gov, ID: NCT02365129 (https://clinicaltrials.gov/ct2/show/study/NCT02365129) & ID: NCT03334357 (https://clinicaltrials.gov/ct2/show/NCT03334357).

Resting skeletal muscle PNPLA2 (ATGL) and CPT1B are associated with peak fat oxidation rates in men and women but do not explain observed sex differences

NEW FINDINGS

What is the central question of this study? What is the relationship between proteins in skeletal muscle and adipose tissue determined at rest and at peak rates of fat oxidation in men and women? What is the main finding and its importance? The resting contents of proteins in skeletal muscle involved in triglyceride hydrolysis and mitochondrial lipid transport were more strongly associated with peak fat oxidation rates than proteins related to lipid transport or hydrolysis in adipose tissue. Although females displayed higher relative rates of fat oxidation than males, this was not explained by the proteins measured in this study, suggesting that other factors determine sex differences in fat metabolism.

ABSTRACT

We explored key proteins involved in fat metabolism that might be associated with peak fat oxidation (PFO) and account for sexual dimorphism in fuel metabolism during exercise. Thirty-six healthy adults [15 women; 40 ± 11 years of age; peak oxygen consumption 42.5 ± 9.5 ml (kg body mass)^-1  min^-1 ; mean ± SD] completed two exercise tests to determine PFO via indirect calorimetry. Resting adipose tissue and/or skeletal muscle biopsies were obtained to determine the adipose tissue protein content of PLIN1, ABHD5 (CGI-58), LIPE (HSL), PNPLA2 (ATGL), ACSL1, CPT1B and oestrogen receptor α (ERα) and the skeletal muscle protein content of FABP 3 (FABPpm), PNPLA2 (ATGL), ACSL1, CTP1B and ESR1 (ERα). Moderate strength correlations were found between PFO [in milligrams per kilogram of fat-free mass (FFM) per minute] and the protein content of PNPLA2 (ATGL) [r_s  = 0.41 (0.03-0.68), P < 0.05] and CPT1B [r_s  = 0.45 (0.09-0.71), P < 0.05] in skeletal muscle. No other statistically significant bivariate correlations were found consistently. Females had a greater relative PFO than males [7.1 ± 1.9 vs. 4.5 ± 1.3 and 7.3 ± 1.7 vs. 4.8 ± 1.2 mg (kg FFM)^-1  min^-1 in the adipose tissue (n = 14) and skeletal muscle (n = 12) subgroups, respectively (P < 0.05)]. No statistically significant sex differences were found in the content of these proteins. The regulation of PFO might involve processes relating to intramyocellular triglyceride hydrolysis and mitochondrial fatty acid transport, and adipose tissue is likely to play a more minor role than muscle. Sex differences in fat metabolism are likely to be attributable to factors other than the resting content of proteins in skeletal muscle and adipose tissue relating to triglyceride hydrolysis and fatty acid transport.

Determinants of Peak Fat Oxidation Rates During Cycling in Healthy Men and Women

This study explored lifestyle and biological determinants of peak fat oxidation (PFO) during cycle ergometry, using duplicate measures to account for day-to-day variation. Seventy-three healthy adults (age range: 19-63 years; peak oxygen consumption [V˙O2peak]: 42.4 [10.1] ml·kg BM-1·min-1; n = 32 women]) completed trials 7-28 days apart that assessed resting metabolic rate, a resting venous blood sample, and PFO by indirect calorimetry during an incremental cycling test. Habitual physical activity (combined heart rate accelerometer) and dietary intake (weighed record) were assessed before the first trial. Body composition was assessed 2-7 days after the second identical trial by dual-energy X-ray absorptiometry scan. Multiple linear regressions were performed to identify determinants of PFO (mean of two cycle tests). A total variance of 79% in absolute PFO (g·min-1) was explained with positive coefficients for V˙O2peak (strongest predictor), FATmax (i.e the % of V˙O2peak that PFO occurred at), and resting fat oxidation rate (g·min-1), and negative coefficients for body fat mass (kg) and habitual physical activity level. When expressed relative to fat-free mass, 64% of variance in PFO was explained: positive coefficients for FATmax (strongest predictor), V˙O2peak, and resting fat oxidation rate, and negative coefficients for male sex and fat mass. This duplicate design revealed that biological and lifestyle factors explain a large proportion of variance in PFO during incremental cycling. After accounting for day-to-day variation in PFO, V˙O2peak and FATmax were strong and consistent predictors of PFO.

Effect of Ingestion of Medium-Chain Triglycerides on Substrate Oxidation during Aerobic Exercise Could Depend on Sex Difference in Middle-Aged Sedentary Persons

Fat oxidation (FAO) during aerobic exercise and whole-body FAO via lipid intake are thought to be important for the maintenance of health, such as the prevention of type 2 diabetes and obesity in sedentary persons in their 40s and 50s. Medium-chain triglycerides (MCTs) ingestion has been attracting attention. However, the effects of difference of sex and the composition of medium-chain fatty acids (MCFAs) are unclear, so we examined the effects of these factors on FAO during aerobic exercise. We conducted a randomized, double-blind, placebo-controlled, 3-arm, within-participants crossover trial. FAO during low- to moderate-intensity exercise was compared when octanoate-rich MCTs (C8R), decanoate-rich MCTs (C10R), or carbohydrate (control) was ingested. Three 2-week interventions were separated by two 2-week washout periods. An increase of FAO during exercise after the C8R diet was found in males, but not in females. An increase of carbohydrate oxidation (CAO) and oxygen uptake during exercise after the C10R diet was found in females, but not in males. In a pooled estimate of the effect of MCTs (C8R and C10R) in women and men, FAO increased during exercise. In conclusion, short-term ingestion of MCTs by middle-aged sedentary persons could increase FAO during aerobic exercise compared to carbohydrate ingestion, but the enhancing effect of MCTs on substrate utilization and oxygen uptake might vary, depending on sex and the composition of MCFAs.

Similar rates of fat oxidation during graded submaximal exercise in women of different body composition

BACKGROUND

Moderate intensity exercise ranging 40-60% of maximum oxygen uptake is advised to promote energy expenditure and fat oxidation in overweight and obese people. Although fat oxidation has been shown to be highly variable among individual, there is still a relative uncertainty regarding exercise prescription for women specifically. This article aimed to determine whether indicators of body composition can be used to narrow the exercise intensity range for exercise prescription in women.

METHODS

A total of 35 healthy women (age 30.8±9.5 yr) classified according to their BMI in normal weight (NOR; ≤24.9 kg·m2), overweight (OVW; 25-29.9 kg·m2) and obese groups (OBE; ≥30 kg·m2) completed a submaximal graded test (intensities eliciting ~30%, 40%, 50% and 60% of maximum oxygen uptake). Blood lactate, perceived exertion and absolute and relative substrate oxidation for fat (OXFAT) and carbohydrates (OXCHO) were measured at each stage.

RESULTS

Perceived exertion and blood lactate increased as a function of exercise but did not differ across groups. There were no significant changes in absolute and relative OXFAT across groups, or as a function of exercise intensity. Peak OXFAT occurred at the 40%, 50% and 40% stages for NOR, OVW and OBE groups, respectively, with no significant differences across groups.

CONCLUSION

We measured no differences, but considerable inter-individual variation, in fat oxidation in women of different body composition. This result is in agreement with previous research based on exercise performed at constant rate and in independent participant groups. Our findings do not support the fat oxidation hypothesis, and further emphasise the perspective that exercise prescription should be individualised and likely be based on considerations other than substrate oxidation.

High-Fat Ketogenic Diets and Physical Performance: A Systematic Review

Use of high-fat, ketogenic diets (KDs) to support physical performance has grown in popularity over recent years. While these diets enhance fat and reduce carbohydrate oxidation during exercise, the impact of a KD on physical performance remains controversial. The objective of this work was to assess the effect of KDs on physical performance compared with mixed macronutrient diets [control (CON)]. A systematic review of the literature was conducted using PubMed and Cochrane Library databases. Randomized and nonrandomized studies were included if participants were healthy (free of chronic disease), nonobese [BMI (kg/m2) <30], trained or untrained men or women consuming KD (<50 g carbohydrate/d or serum or whole-blood β-hydroxybutyrate >0.5 mmol/L) compared with CON (fat, 12-38% of total energy intake) diets for ≥14 d, followed by a physical performance test. Seventeen studies (10 parallel, 7 crossover) with 29 performance (13 endurance, 16 power or strength) outcomes were identified. Of the 13 endurance-type performance outcomes, 3 (1 time trial, 2 time-to-exhaustion) reported lower and 10 (4 time trials, 6 time-to-exhaustion) reported no difference in performance between the KD compared with CON. Of the 16 power or strength performance outcomes, 3 (1 power, 2 strength) reported lower, 11 (4 power, 7 strength) no difference, and 2 (power) enhanced performance in the KD compared with the CON. Risk of bias identified some concern of bias primarily due to studies allowing participants to self-select diet intervention groups and the inability to blind participants to the study intervention. Overall, the majority of null results across studies suggest that a KD does not have a positive or negative impact on physical performance compared with a CON diet. However, discordant results between studies may be due to multiple factors, such as the duration consuming study diets, training status, performance test, and sex differences, which will be discussed in this systematic review.

Maximum Aerobic Function: Clinical Relevance, Physiological Underpinnings, and Practical Application

The earliest humans relied on large quantities of metabolic energy from the oxidation of fatty acids to develop larger brains and bodies, prevent and reduce disease risk, extend longevity, in addition to other benefits. This was enabled through the consumption of a high fat and low-carbohydrate diet (LCD). Increased fat oxidation also supported daily bouts of prolonged, low-intensity, aerobic-based physical activity. Over the past 40-plus years, a clinical program has been developed to help people manage their lifestyles to promote increased fat oxidation as a means to improve various aspects of health and fitness that include reducing excess body fat, preventing disease, and optimizing human performance. This program is referred to as maximum aerobic function, and includes the practical application of a personalized exercise heart rate (HR) formula of low-to-moderate intensity associated with maximal fat oxidation (MFO), and without the need for laboratory evaluations. The relationship between exercise training at this HR and associated laboratory measures of MFO, health outcomes and athletic performance must be verified scientifically.

Association between sleep quality and time with energy metabolism in sedentary adults

The aim of the present study was to investigate the relationship of sleep quality and time with basal metabolic rate (BMR) and fuel oxidation in basal conditions and during exercise in sedentary middle-aged adults. We also studied the mediation role of dietary intake and adherence to the traditional Mediterranean Diet in the relationship between sleep parameters and energy metabolism parameters.A secondary analysis of the FIT-AGEING study was undertaken. 70 middle-aged sedentary adults (40-65 years old) participated in the present study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and wrist accelerometers (ActiSleep, Actigraph, Pensacola, Florida, USA) for 7 consecutive days. BMR was measured with indirect calorimetry and fuel oxidation was estimated through stoichiometric equations. Maximal fat oxidation was determined by a walking graded exercise test and dietary intake with 24 h recalls. Adherence to the traditional Mediterranean diet was assessed through the PREDIMED questionnaire. PSQI global score (poor sleep quality) was associated with lower basal fat oxidation (BFox), both expressed in g/min and as a percentage of BMR, independently of confounders. We did not find any association between other sleep and energy metabolism parameters. No mediating role of the dietary intake or PREDIMED global score was observed in the association of PSQI and BFox. In conclusion, our study showed that a subjective poor sleep quality was associated with lower BFox, which is not mediated by dietary intake in sedentary adults.

Lipid Metabolism Links Nutrient-Exercise Timing to Insulin Sensitivity in Men Classified as Overweight or Obese

CONTEXT

Pre-exercise nutrient availability alters acute metabolic responses to exercise, which could modulate training responsiveness.

OBJECTIVE

To assess acute and chronic effects of exercise performed before versus after nutrient ingestion on whole-body and intramuscular lipid utilization and postprandial glucose metabolism.

DESIGN

(1) Acute, randomized, crossover design (Acute Study); (2) 6-week, randomized, controlled design (Training Study).

SETTING

General community.

PARTICIPANTS

Men with overweight/obesity (mean ± standard deviation, body mass index: 30.2 ± 3.5 kg⋅m-2 for Acute Study, 30.9 ± 4.5 kg⋅m-2 for Training Study).

INTERVENTIONS

Moderate-intensity cycling performed before versus after mixed-macronutrient breakfast (Acute Study) or carbohydrate (Training Study) ingestion.

RESULTS

Acute Study-exercise before versus after breakfast consumption increased net intramuscular lipid utilization in type I (net change: -3.44 ± 2.63% versus 1.44 ± 4.18% area lipid staining, P < 0.01) and type II fibers (-1.89 ± 2.48% versus 1.83 ± 1.92% area lipid staining, P < 0.05). Training Study-postprandial glycemia was not differentially affected by 6 weeks of exercise training performed before versus after carbohydrate intake (P > 0.05). However, postprandial insulinemia was reduced with exercise training performed before but not after carbohydrate ingestion (P = 0.03). This resulted in increased oral glucose insulin sensitivity (25 ± 38 vs -21 ± 32 mL⋅min-1⋅m-2; P = 0.01), associated with increased lipid utilization during exercise (r = 0.50, P = 0.02). Regular exercise before nutrient provision also augmented remodeling of skeletal muscle phospholipids and protein content of the glucose transport protein GLUT4 (P < 0.05).

CONCLUSIONS

Experiments investigating exercise training and metabolic health should consider nutrient-exercise timing, and exercise performed before versus after nutrient intake (ie, in the fasted state) may exert beneficial effects on lipid utilization and reduce postprandial insulinemia.

Menstrual cycle phase does not affect whole body peak fat oxidation rate during a graded exercise test

Female sex hormones fluctuate in a predictable manner throughout the menstrual cycle in eumenorrheic women. In studies conducted in both animal and humans, estrogen and progesterone have been found to exert individual metabolic effects during both rest and exercise, suggesting that estrogen may cause an increase in fat oxidation during exercise. However, not all studies find these metabolic changes with the natural physiological variation in the sex hormones. To date, no studies have investigated whether whole body peak fat oxidation rate (PFO) and maximal fat oxidation intensity (FAT_max) are affected at different time points [mid-follicular (MF), late-follicular (LF), and mid-luteal (ML)] in the menstrual cycle, where plasma estrogen and progesterone are either at their minimum or maximum. We hypothesized that an increased plasma estrogen concentration together with low progesterone concentration in LF would result in a modest but significant increase in PFO. We found no differences in body weight, body composition, or peak oxygen uptake (V̇o_2peak) between any of the menstrual phases in the 19 healthy, young eumenorrheic women included in this study. PFO [MF: 0.379 (0.324-0.433) g/min; LF: 0.375 (0.329-0.421) g/min; ML: 0.382 (0.337-0.442) g/min; mean ± (95% CI)] and resting plasma free fatty acid concentrations [MF: 392 (293-492) µmol/l; LF: 477 (324-631) µmol/l; ML: 396 (285-508) µmol/L] were also similar across the menstrual cycle phases. Contrary to our hypothesis, we conclude that the naturally occurring fluctuations in the sex hormones estrogen and progesterone do not affect the whole body PFO and FAT_max in young eumenorrheic women measured during a graded exercise test.NEW & NOTEWORTHY Menstrual cycle phase does not affect the peak fat oxidation rate during a graded exercise test. Natural physiological fluctuations in estrogen do not increase peak fat oxidation rate. FAT_max is not influenced by menstrual cycle phase in healthy, young eumenorrheic women.

Enhancement of Fat Oxidation during Submaximal Exercise in Sedentary Persons: Variations by Medium-Chain Fatty Acid Composition and Age Group

Previous studies in recreational and trained athletes aged mostly in their 20s have reported that short-term ingestion of medium-chain triacylglycerols (MCT) enhances fat oxidation (FAO) during submaximal exercise. However, whether the FAO-enhancing effect of MCT with a different composition of medium-chain fatty acids (MCFA) occurs in older sedentary persons is unclear. The present study investigated the effect of MCT ingestion with different proportions of MCFA in sedentary participants in their 40's and 50's. Participants ingested 0 g of MCT (control), 6 g of octanoic acid-rich MCT (OAR), or 6 g of decanoic acid-rich MCT (DAR) for 14 days separated by a 14-day washout period in random order. Cumulative FAO (F_cv ) during submaximal, fixed, and incremental exercise was evaluated at workload from 20 W to the appearance of a ventilation threshold (VT). During the 20 W fixed-load exercise, F_cv was significantly (p < 0.05) higher in the OAR than in the control. At appearance of VT, intervention effect of power output was significantly higher in the OAR and DAR than in the control. In a subgroup analysis by age, intervention effects of maximal FAO rate and oxygen uptake in the upper age subgroup were higher in the OAR and DAR than in the control. In a pooled analysis with age subgroup and diet, the integrated pooled estimate of F_cv during submaximal exercise was significantly higher in 6 g of MCT ingestion than 0 g ingestion. Our data show that the effect of MCT might differ depending on the age group and the proportion of MCFA, while MCT could enhance FAO during submaximal exercise.

Impact of exercise training status on the fiber type-specific abundance of proteins regulating intramuscular lipid metabolism

Endurance training enhances the capacity for fat oxidation during exercise due to increased utilization of intramuscular lipid (IMCL). This study quantitatively investigated the impact of exercise training status on muscle fiber type-specific abundance of regulatory proteins involved in IMCL utilization. Endurance-trained [n = 7 subjects, peak oxygen consumption (V̇o_2peak) 62.6 ± 4.1 (SD) mL·min^-1·kg^-1] and non-endurance-trained (n = 8 subjects, V̇o_2peak 44.9 ± 5.3 mL·min^-1·kg^-1) young men completed an incremental exercise test to determine maximal fat oxidation (MFO) and maximal oxygen uptake. Fiber type-specific IMCL content and protein abundance were assessed with immunofluorescence microscopy and immunoblot analysis of pooled single muscle fibers and whole muscle. Endurance-trained individuals displayed a higher MFO rate (0.45 ± 0.15 vs. 0.19 ± 0.07 g/min, P < 0.05), a greater proportion of type I muscle fibers, and higher IMCL content compared with untrained individuals (P < 0.05). Adipose triglyceride lipase, hormone-sensitive lipase, perilipin 2, perilipin 5, and hydroxyacyl-coenzyme A dehydrogenase abundances were ~2-3-fold higher in type I muscle fibers compared with type IIa fibers (P < 0.05). Correspondingly, these lipid proteins and oxidative enzymes were higher in endurance-trained individuals when assessed in whole muscle. MFO rate was strongly related to the proportion of type I fibers (R = 0.81, P < 0.01). The abundance of proteins involved in the regulation of IMCL storage and oxidation is highly muscle fiber type specific. The increased capacity for fat oxidation in endurance-trained individuals corresponded with increased IMCL content and elevated abundance of lipolytic and oxidative enzymes in combination with a greater proportion of type I muscle fibers.NEW & NOTEWORTHY We have utilized contemporary techniques to compare the fiber type-specific characteristics of skeletal muscle from endurance-trained athletes and untrained individuals. We show that type I muscle fibers have a coordinated upregulation of proteins controlling intramuscular lipid storage, mobilization, and oxidation. Furthermore, the enhanced capacity for intramuscular lipid storage and utilization in endurance-trained individuals is related to the increased expression of lipid regulatory proteins combined with a greater proportion of type I muscle fibers.

Fat oxidation at rest and during exercise in male monozygotic twins

PURPOSE

We aimed to investigate if hereditary factors, leisure-time physical activity (LTPA) and metabolic health interact with resting fat oxidation (RFO) and peak fat oxidation (PFO) during ergometer cycling.

METHODS

We recruited 23 male monozygotic twin pairs (aged 32-37 years) and determined their RFO and PFO with indirect calorimetry for 21 and 19 twin pairs and for 43 and 41 twin individuals, respectively. Using physical activity interviews and the Baecke questionnaire, we identified 10 twin pairs as LTPA discordant for the past 3 years. Of the twin pairs, 8 pairs participated in both RFO and PFO measurements, and 2 pairs participated in either of the measurements. We quantified the participants' metabolic health with a 2-h oral glucose tolerance test.

RESULTS

Fat oxidation within co-twins was correlated at rest [intraclass correlation coefficient (ICC) = 0.54, 95% confidence interval (CI) 0.15-0.78] and during exercise (ICC = 0.67, 95% CI 0.33-0.86). The LTPA-discordant pairs had no pairwise differences in RFO or PFO. In the twin individual-based analysis, PFO was positively correlated with the past 12-month LTPA (r = 0.26, p = 0.034) and the Baecke score (r = 0.40, p = 0.022) and negatively correlated with the area under the curve of insulin (r = - 0.42, p = 0.015) and glucose (r = - 0.31, p = 0.050) during the oral glucose tolerance test.

CONCLUSIONS

Hereditary factors were more important than LTPA for determining fat oxidation at rest and during exercise. Additionally, PFO, but not RFO, was associated with better metabolic health.

Two Weeks of High-Intensity Interval Training in Combination With a Non-thermal Diffuse Ultrasound Device Improves Lipid Profile and Reduces Body Fat Percentage in Overweight Women

This study evaluated the effectiveness of an innovative strategy which combined low-frequency ultra sound (LOFU) with high-intensity interval training (HIIT) to improve physical fitness and promote body fat loss in overweight sedentary women. A placebo controlled, parallel group randomized experimental design was used to investigate the efficacy of a 2-week combined LOFU and HIIT program (3 sessions per week). Participants were allocated into either the Experimental HIIT group (HIIT_EXP, n = 10) or Placebo HIIT group (HIIT_PLA, n = 10). Baseline exercise testing (maximal oxygen uptake, lower limb strength and substrate oxidation test), dietary assessment, anthropometric measures and blood sampling were completed in week 1 and repeated in week 4 to determine changes following the program (Post-HIIT). During each training session, the HIIT_EXP and HIIT_PLA groups wore a non-thermal diffuse ultrasound belt. However, the belt was only switched on for the HIIT_EXP group. Delta change scores were calculated for body weight, body fat percentage (Fat%), muscle mass, V.O_2max, hip and waist circumferences, and all lipid variables from Baseline to Post-HIIT. Statistical analysis was completed using a repeated-measures factorial analysis of variance by group (HIIT_PLA and HIIT_EXP) and time (Baseline and Post-HIIT). Results showed significant improvements in maximal oxygen uptake (HIIT_EXP; Baseline 24.7 ± 5.4 mL kg^–1 min^–1, Post-HIIT 28.1 ± 5.5 mL kg^–1 min^–1 and HIIT_PLA; Baseline 28.4 ± 5.9 mL kg^–1 min^–1, Post-HIIT 31.4 ± 5.5 mL kg^–1 min^–1) for both groups. Significant decreases in Fat% (HIIT_EXP; Baseline 32.7 ± 3.2%, Post-HIIT 28.9 ± 3.5% and HIIT_PLA; Baseline 28.9 ± 3.5%, Post-HIIT 28.9 ± 3.4% kg), waist circumference (HIIT_EXP; Baseline 95.8 ± 9.6 cm, Post-HIIT 89.3 ± 8.9 cm and HIIT_PLA; Baseline 104.3 ± 3.5 cm, Post-HIIT 103.6 ± 3.4 cm) and triglycerides (HIIT_EXP; −29.2%, HIIT_PLA; −6.7%) were observed in the HIIT_EXP group only. These results show that HIIT combined with LOFU was an effective intervention to improve body composition, lipid profile, and fitness. This combined strategy allowed overweight, sedentary women to achieve positive health outcomes in as little as 2 weeks.

Determination and validation of peak fat oxidation in endurance-trained men using an upper body graded exercise test

Peak fat oxidation rate (PFO) and the intensity that elicits PFO (Fat_max ) are commonly determined by a validated graded exercise test (GE) on a cycling ergometer with indirect calorimetry. However, for upper body exercise fat oxidation rates are not well elucidated and no protocol has been validated. Thus, our aim was to test validity and inter-method reliability for determination of PFO and Fat_max in trained men using a GE protocol applying double poling on a ski-ergometer. PFO and Fat_max were assessed during two identical GE tests (GE1 and GE2) and validated against separated short continuous exercise bouts (SCE) at 35%, 50%, and 65% of V̇O_2peak on the ski-ergometer in 10 endurance-trained men (V̇O_2peak : 65.1 ± 1.0 mL·min^-1 ·kg^-1 , mean ± SEM). Between GE tests no differences were found in PFO (GE1: 0.42 ± 0.03; GE2: 0.45 ± 0.03 g·min^-1 , P = .256) or Fat_max (GE1: 41 ± 2%; GE2: 43 ± 3% of V̇O_2peak , P = .457) and the intra-individual coefficient of variation (CV) was 8 ± 2% and 11 ± 2% for PFO and Fat_max , respectively. Between GE and SCE tests, PFO (GE_avg : 0.44 ± 0.03; SCE; 0.47 ± 0.06 g·min^-1 , P = .510) was not different, whereas a difference in Fat_max (GE_avg : 42 ± 2%; SCE: 52 ± 4% of V̇O_2peak , P = .030) was observed with a CV of 17 ± 4% and 15 ± 4% for PFO and Fat_max , respectively. In conclusion, GE has a high day-to-day reliability in determination of PFO and Fat_max in trained men, whereas it is unclear if PFO and Fat_max determined by GE reflect continuous exercise in general.

Assessment of maximal fat oxidation during exercise: A systematic review

Maximal fat oxidation during exercise (MFO) and the exercise intensity eliciting MFO (Fat_max ) are considered biological markers of metabolic health and performance. A wide range of studies have been performed to increase our knowledge about their regulation by exercise and/or nutritional intervention. However, numerous data collection and analysis approaches have been applied, which may have affected the MFO and Fat_max estimation. We aimed to systematically review the available studies describing and/or comparing different data collection and analysis approach factors that could affect MFO and Fat_max estimation in healthy individuals and patients. Two independent researchers performed the search. We included all original studies in which MFO and/or Fat_max were estimated by indirect calorimetry through an incremental graded exercise protocol published from 2002 to 2019. This systematic review provides key information about the factors that could affect MFO and Fat_max estimation: ergometer type, metabolic cart used, warm-up duration and intensity, stage duration and intensities imposed in the graded exercise protocol, time interval selected for data analysis, stoichiometric equation selected to estimate fat oxidation, data analysis approach, time of the day when the test was performed, fasting time/previous meal before the test, and testing days for MFO/Fat_max and maximal oxygen uptake assessment. We suggest that researchers measuring MFO and Fat_max should take into account these key methodological issues that can considerably affect the accuracy, validity, and reliability of the measurement. Likewise, when comparing different studies, it is important to check whether the above-mentioned key methodological issues are similar in such studies to avoid ambiguous and unacceptable comparisons.

Effect of a four-week ketogenic diet on exercise metabolism in CrossFit-trained athletes

BACKGROUND

The ketogenic diet is becoming a popular nutritional model among athletes. However, the relationship between its use and metabolism during exercise seems to have not been fully investigated.

METHODS

The aim of the study was to assess the effects of a four-week ketogenic diet (KD) on fat and carbohydrate (CHO) utilization during an incremental cycling test (ICT) in CrossFit-trained female (n = 11) and male (n = 11) athletes. During the ICT (while consuming the customary diet and after the KD), oxygen uptake and carbon dioxide exhalation were registered, and CHO and fat utilization as well as energy expenditure were calculated.

RESULTS

In males, the KD led to an increase in fat utilization (g·min- 1·kgFFM- 1 and % oxidation). It was particularly noticeable at exercise intensities up to 80% of VO2max. An increase in the area under the curve (AUC) was seen in males but not in females at up to ≤65% VO2max of fat utilization.

CONCLUSIONS

Male CrossFit-trained athletes seem to be more prone to shifts in macronutrient utilization (in favor of fat utilization) during submaximal intensity exercise under a ketogenic diet than are female athletes.

TRIAL REGISTRATION

Clinical Trials Gov, NCT03665948 . Registered 11 September 2018 (retrospectively registered).

Fat Oxidation Rates in Professional Soccer Players

PURPOSE

Large interindividual variation exists in maximal fat oxidation (MFO) rates and the exercise intensity at which it occurs (FATMAX). However, there are no data describing the shape of the fat oxidation curve or if individual differences exist when tested on separate occasions. Furthermore, there are limited data on fat metabolism in professional team sport athletes. Therefore, the aim of this study was to test-retest the concavity (shape) and intercept (height) of fat oxidation curves within a group of professional soccer players.

METHOD

On two occasions, 16 professional male soccer players completed a graded exercise test in a fasted state (≥5 h). Rates of fat oxidation were determined using indirect calorimetry. Maximal oxygen uptake (V˙O2max) was measured to calculate FATMAX (%V˙O2max). The shape of the fat oxidation curves were modeled on an individual basis using third-degree polynomial. Test-by-test differences, in the shape and vertical shift of the fat oxidation curves, were established to assess within-individual variability.

RESULTS

Average absolute MFO was 0.69 ± 0.15 g·min (range, 0.45-0.99 g·min). On a group level, no significant differences were found in MFO between the two tests. No differences were found (P > 0.05) in the shape of the fat oxidation curves in 13 of 16 players (test 1 vs test 2). There were also no differences (P > 0.05) in the vertical shift of the fat oxidation curves in 10 players.

CONCLUSIONS

In general, the shape of the fat oxidation curve does not change within an individual; however, the vertical shift is more susceptible to change, which may be due to training status and body composition. Understanding a player's metabolism may be of value to practitioners working within sport, with regard to personalizing nutrition strategies.

Nutrient-nutrient interactions: competition, bioavailability, mechanism and function in health and diseases

The Nutrition Society Spring Conference 2018, held in Glasgow, brought together experts focusing on the interaction between different nutrients and how this impacts absorption, metabolism and health from biochemical and physiological perspectives. This cross-cutting theme was examined from a range of perspectives, bringing together experts on topics ranging from food processing to the impact of inflammation on nutrient status. Two plenary lectures provided a food landscape and lifecourse background to the proceedings, with on the first day a focus on processed/ultra-processed foods and their nutrient composition and, on the second day, a plenary lecture exploring the role that nutrient-nutrient interactions within the maternal diet have for the lifelong health of the offspring. The meeting was framed around three symposia, examining the competition and bioavailability of dietary components, nutrient-nutrient interactions and their role in protection from chronic diseases and the mechanisms of nutrient-nutrient interactions. The meeting ended with a round table, and an overall conclusion highlighting the opportunities to derive further understanding of the short- and long-term implications of diets through the study of nutrient-nutrient interactions.

Evaluation of a graded exercise test to determine peak fat oxidation in individuals with low cardiorespiratory fitness

The maximal capacity to utilise fat (peak fat oxidation, PFO) may have implications for health and ultra-endurance performance and is commonly determined by incremental exercise tests employing 3-min stages. However, 3-min stages may be insufficient to attain steady-state gas kinetics, compromising test validity. We assessed whether 4-min stages produce steady-state gas exchange and reliable PFO estimates in adults with peak oxygen consumption < 40 mL·kg−1·min−1. Fifteen participants (9 females) completed a graded test to determine PFO and the intensity at which this occurred (FATMAX). Three short continuous exercise sessions (SCE) were then completed in a randomised order, involving completion of the graded test to the stage (i) preceding, (ii) equal to (SCEequal), or (iii) after the stage at which PFO was previously attained, whereupon participants then continued to cycle for 10 min at that respective intensity. Expired gases were sampled at minutes 3–4, 5–6, 7–8, and 9–10. Individual data showed steady-state gas exchange was achieved within 4 min during SCEequal. Mean fat oxidation rates were not different across time within SCEequal nor compared with the graded test at FATMAX (both p > 0.05). However, the graded test displayed poor surrogate validity (SCEequal, minutes 3–4 vs. 5–6, 7–8, and 9–10) and day-to-day reliability (minutes 3–4, SCEequal vs. graded test) to determine PFO, as evident by correlations (range: 0.47–0.83) and typical errors and 95% limits of agreement (ranges: 0.03–0.05 and ±0.09–0.15 g·min−1, respectively). In conclusion, intraindividual variation in PFO is substantial despite 4-min stages establishing steady-state gas exchange in individuals with low fitness. Individual assessment of PFO may require multiple assessments.

Effect of New Zealand Blackcurrant Extract on Physiological Responses at Rest and during Brisk Walking in Southeast Asian Men: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study

New Zealand blackcurrant (NZBC) extract affects cardiovascular and metabolic responses during rest and exercise in Caucasian men. Ethnicity and nutritional habits may affect responses to nutritional ergogenic aids. We examined the effects of NZBC extract on cardiovascular, metabolic, and physiological responses during seated rest and moderate-intensity exercise in Southeast Asian men. Seventeen healthy Thai men (age: 22 ± 3 years; body mass index (BMI): 21.8 ± 1.1 kg·m^-2) participated. Resting metabolic equivalent (1-MET) was measured (Oxycon™ mobile, Germany), and an incremental walking protocol was completed to establish the relationship between walking speed and MET. In a double-blind, randomized, placebo-controlled, crossover design, cardiovascular (Physioflow, n = 12) and physiological responses (Oxycon, n = 17) were measured during both seated rest and a 30-min treadmill walk at five metabolic equivalent (5-MET), with either a seven-day intake of placebo (PL) or two capsules of NZBC extract (each 300 mg capsule contains 35% blackcurrant extract) with a 14-day washout. Paired t-tests were used with significance accepted at p < 0.05 and a trend for 0.05 > p ≤ 0.10. During 30 min of treadmill walking at 5-MET, no differences were observed for heart rate and substrate oxidation. With intake of NZBC during treadmill walking, there was a trend for increased stroke volume by 12% (PL: 83.2 ± 25.1; NZBC: 93.0 ± 24.3 mL; p = 0.072) and cardiac output increased by 12% (PL: 9.2 ± 2.6; NZBC: 10.3 ± 2.8 L·min^-1; p = 0.057). Systemic vascular resistance decreased by 10% (PL: 779 ± 267; NZBC: 697 ± 245 dyn·s·cm^-5; p = 0.048). NZBC extract had no effect on metabolic, physiological, and cardiovascular parameters during seated rest and exercise-induced fat oxidation in Thai men, in contrast to observations in Caucasian men. During treadmill walking, Thai men showed cardiovascular response, indicating vasodilatory effects during moderate-intensity exercise with the intake of NZBC extract. Our findings suggest that the ergogenic responses to anthocyanin intake from New Zealand blackcurrant may be ethnicity-dependent.

Weight loss, improved physical performance, cognitive function, eating behavior, and metabolic profile in a 12-week ketogenic diet in obese adults

The ketogenic diet (KD) is being increasingly promoted as a strategy to fight obesity. Although the KD is effective for weight loss and weight control, comprehensive determination of its relationship with biochemical, physiological and psychological changes is still largely unexplored. We hypothesized that a 12-week KD (12KD) would significantly affect body weight, physical performance, cognitive function, eating behaviors, the metabolic and hormonal profile in obese adults, although differently in men and women. In an uncontrolled intervention, 35 sedentary obese adults (13 men, 25 women), aged 37 ± 7 years with a BMI 36.1 ± 5.6 kg/m² underwent a 12KD between March 2017 and June 2017 at the University of Primorska. The 12KD resulted in decreased appetite, significant weight loss of participants (-18 ± 9 kg men vs. -11 ± 3 kg women; P < .001), decreased emotional and external eating (P < .001 for both), increased body image satisfaction (P < .001) and improved physical performance (P < .001). Biochemically, a significant drop in glucose (P = .026), and a significant increase in LDL-cholesterol (P = .031), CRP (P = .007), and BDNF (P = .035) were observed in the first 2 weeks; then, all listed parameters returned to baseline. On the other hand, a significant reduction in insulin (P < .001) and leptin levels (P < .001), and a significant increase in adiponectin (P = .008) and NPY (P = .009) were detected throughout the duration of the 12KD. Our results show the efficacy of the 12KD on weight loss, physical performance, cognitive function, eating behaviors and metabolic profile. However, the long-term effects of a KD on these outcomes needs to be further studied before general recommendations can be made.

Medium-chain Triglycerides with Maltodextrin Increase Fat Oxidation during Moderate-intensity Exercise and Extend the Duration of Subsequent High-intensity Exercise

Medium-chain triglycerides (MCT) are useful for increasing fat utilization during exercise. The highest rate of fat oxidation during submaximal exercise tends to precede the lactate threshold in untrained adults. In our previous study, blood lactate concentration was more than 4 mmol/L (onset of blood lactate) in recreational athletes during exercise at a workload corresponding to 60% peak O₂ uptake (V^･o₂), which was below ventilation threshold. In the present study, we investigated the effect of 2 week of ingestion of food containing 6 g MCT on substrate oxidation during moderate-intensity (50% peak V^･o₂) exercise and high-intensity (70% peak V^･o₂) exercise in recreational athletes. For comparison, two experimental trials were conducted after participants had been administered isoenergic test foods (MCT-supplemented food with mainly maltodextrin-containing carbohydrate (MCT + CHO) or CHO) for 2 weeks, with a washout period between trials. Participants were instructed to perform cycle ergometer exercise at a workload corresponding to 50% peak V^･o₂ for 40 min followed by a workload corresponding to 70% peak V^･o₂ until exhaustion. Fat oxidation was significantly increased in the MCT + CHO trial (13.3 ± 2.7 g/40 min, mean ± SD, p < 0.05) during moderate-intensity exercise and the duration was extended significantly (23.5 ± 19.4 min, p < 0.05) during subsequent high-intensity exercise, compared with that observed in the CHO trial (fat oxidation; 11.7 ± 2.8 g/40 min, duration; 17.6 ± 16.1 min). In conclusion, continuous ingestion of 6 g MCT with maltodextrin could increase fat oxidation during moderate-intensity exercise and extend the duration of subsequent high-intensity exercise in recreational athletes, compared with the ingestion of isoenergic maltodextrin alone.

Dietary sugars, exercise and hepatic carbohydrate metabolism

The present paper reviews the physiological responses of human liver carbohydrate metabolism to physical activity and ingestion of dietary sugars. The liver represents a central link in human carbohydrate metabolism and a mechanistic crux point for the effects of dietary sugars on athletic performance and metabolic health. As a corollary, knowledge regarding physiological responses to sugar ingestion has potential application to either improve endurance performance in athletes, or target metabolic diseases in people who are overweight, obese and/or sedentary. For example, exercise increases whole-body glycogen utilisation, and the breakdown of liver glycogen to maintain blood glucose concentrations becomes increasingly important as exercise intensity increases. Accordingly, prolonged exercise at moderate-to-high exercise intensity results in depletion of liver glycogen stores unless carbohydrate is ingested during exercise. The exercise-induced glycogen deficit can increase insulin sensitivity and blood glucose control, and may result in less hepatic lipid synthesis. Therefore, the induction and maintenance of a glycogen deficit with exercise could be a specific target to improve metabolic health and could be achieved by carbohydrate (sugar) restriction before, during and/or after exercise. Conversely, for athletes, maintaining and restoring these glycogen stores is a priority when competing in events requiring repeated exertion with limited recovery. With this in mind, evidence consistently demonstrates that fructose-containing sugars accelerate post-exercise liver glycogen repletion and could reduce recovery time by as much as half that seen with ingestion of glucose (polymers)-only. Therefore, athletes aiming for rapid recovery in multi-stage events should consider ingesting fructose-containing sugars to accelerate recovery.