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Cho W, Jung H, Hong S, Yang HI, Park DH, Suh SH, Lee DH, Choe YS, Kim JY, Lee W, Jeon JY. The effect of a short-term ketogenic diet on exercise efficiency during graded exercise in healthy adults. J Int Soc Sports Nutr 2023; 20:2264278. [PMID: 37791478 PMCID: PMC10552596 DOI: 10.1080/15502783.2023.2264278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/22/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVE We examined the effects of short-term KD on exercise efficiency and hormonal response during and after the graded exercise testing. METHODS Fourteen untrained healthy adults (8 males, 6 females, age 26.4 ± 3.1 [SD] years; BMI 24.8 ± 4.6 kg/m2; peak VO2max 54.0 ± 5.8 ml/kg FFM/min) completed 3-days of a mixed diet (MD) followed by another 3-days of KD after 3-days of washout period. Upon completion of each diet arm, participants underwent graded exercise testing with low- (LIE; 40% of VO2max), moderate- (MIE; 55%), and high-intensity exercise (HIE; 70%). Exercise efficiency was calculated as work done (kcal/min)/energy expenditure (kcal/min). RESULTS Fat oxidation during the recovery period was higher in KD vs. MD. Despite identical workload during HIE, participants after having KD vs. MD showed higher energy expenditure and lower exercise efficiency (10.1 ± 0.7 vs. 12.5 ± 0.3%, p < .01). After KD, free fatty acid (FFA) concentrations were higher during MIE and recovery vs. resting, and beta-hydroxybutylate (BOHB) was lower at HIE vs. resting. Cortisol concentrations after KD was higher during recovery vs. resting, with no significant changes during graded exercise testing after MD. CONCLUSIONS Our data suggest that short-term KD is favorable to fat metabolism leading increased circulating FFA and BOHB during LIE to MIE. However, it is notable that KD may cause 1) exercise inefficiency manifested by increased energy expenditure and 2) elevated exercise stress during HIE and recovery. Trial registration: KCT0005172, International Clinical Trials Registry Platform.
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Affiliation(s)
- Wonhee Cho
- Syracuse University, Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse, NY, USA
- Yonsei University, Department of Sport Industries, Seoul, South Korea
| | - Hwaebong Jung
- Yonsei University, Department of Materials Science and Engineering, Seoul, South Korea
| | - Sunghyun Hong
- Yonsei University, Department of Sport Industries, Seoul, South Korea
| | - Hyuk In Yang
- Yonsei University, Department of Sport Industries, Seoul, South Korea
| | - Dong-Hyuk Park
- Yonsei University, Department of Sport Industries, Seoul, South Korea
| | - Sang-Hoon Suh
- Yonsei University, Department of Physical Education, Seoul, South Korea
| | - Dong Hoon Lee
- Yonsei University, Department of Sport Industries, Seoul, South Korea
- Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, MA, USA
- Nanyang Technological University, Lee Kong Chian School of Medicine, Nanyang, Singapore
| | | | - Joon Young Kim
- Syracuse University, Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse, NY, USA
| | - Wooyoung Lee
- Yonsei University, Department of Materials Science and Engineering, Seoul, South Korea
| | - Justin Y. Jeon
- Yonsei University, Department of Sport Industries, Seoul, South Korea
- Yonsei University College of Medicine, Cancer Prevention Center, Yonsei Cancer Center, Seoul, South Korea
- Yonsei University, Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Seoul, South Korea
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Martinez IG, Mika AS, Biesiekierski JR, Costa RJS. The Effect of Gut-Training and Feeding-Challenge on Markers of Gastrointestinal Status in Response to Endurance Exercise: A Systematic Literature Review. Sports Med 2023; 53:1175-1200. [PMID: 37061651 DOI: 10.1007/s40279-023-01841-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Nutrition during exercise is vital in sustaining prolonged activity and enhancing athletic performance; however, exercise-induced gastrointestinal syndrome (EIGS) and exercise-associated gastrointestinal symptoms (Ex-GIS) are common issues among endurance athletes. Despite this, there has been no systematic assessment of existing trials that examine the impact of repetitive exposure of the gastrointestinal tract to nutrients before and/or during exercise on gastrointestinal integrity, function, and/or symptoms. OBJECTIVE This systematic literature review aimed to identify and synthesize research that has investigated the impact of 'gut-training' or 'feeding-challenge' before and/or during exercise on markers of gastrointestinal integrity, function, and symptoms. METHODS Five databases (Ovid MEDLINE, EMBASE, CINAHL Plus, Web of Science Core Collection, and SPORTDiscus) were searched for literature that focused on gut-training or feeding-challenge before and/or during exercise that included EIGS and Ex-GIS variables. Quality assessment was conducted in duplicate and independently using the Cochrane Collaboration's risk-of-bias (RoB 2) tool. RESULTS Overall, 304 studies were identified, and eight studies were included after screening. Gut-training or feeding-challenge interventions included provision of carbohydrates only (n = 7) in various forms (e.g., gels or liquid solutions) during cycling or running, or carbohydrate with protein (n = 1) during intermittent exercise, over a varied duration (4-28 days). Gut discomfort decreased by an average of 47% and 26% with a 2-week repetitive carbohydrate feeding protocol (n = 2) and through repeated fluid ingestion over five trials (n = 1), respectively. Repetitive carbohydrate feeding during exercise for 2 weeks resulted in the reduction of carbohydrate malabsorption by 45-54% (n = 2), but also led to no significant change (n = 1). The effect of gut-training and feeding-challenges on the incidence and severity of Ex-GIS were assessed using different tools (n = 6). Significant improvements in total, upper, and lower gastrointestinal symptoms were observed (n = 2), as well as unclear results (n = 4). No significant changes in gastric emptying rate (n = 2), or markers of intestinal injury and permeability were found (n = 3). Inconclusive results were found in studies that investigated plasma inflammatory cytokine concentration in response to exercise with increased carbohydrate feeding (n = 2). CONCLUSIONS Overall, gut-training or feeding-challenge around exercise may provide advantages in reducing gut discomfort, and potentially improve carbohydrate malabsorption and Ex-GIS, which may have exercise performance implications.
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Affiliation(s)
- Isabel G Martinez
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Alice S Mika
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Jessica R Biesiekierski
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Ricardo J S Costa
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia.
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Abstract
NEW FINDINGS What is the topic of this review? The potential role of nutrition in exertional heat stroke. What advances does it highlight? Certain nutritional and dietary strategies used by athletes and workers may exert a protective effect the pathophysiological processes of exertional heat stroke, whereas others may be detrimental. While current evidence suggests that some of these practices may be leveraged as a potential countermeasure to exertional heat stroke, further research on injury-related outcomes in humans is required. ABSTRACT Exertional heat stroke (EHS) is a life-threatening illness and an enduring problem among athletes, military servicemen and -women, and occupational labourers who regularly perform strenuous activity, often under hot and humid conditions or when wearing personal protective equipment. Risk factors for EHS and mitigation strategies have generally focused on the environment, health status, clothing, heat acclimatization and aerobic conditioning, but the potential role of nutrition is largely underexplored. Various nutritional and dietary strategies have shown beneficial effects on exercise performance and health and are widely used by athletes and other physically active populations. There is also evidence that some of these practices may dampen the pathophysiological features of EHS, suggesting possible protection or abatement of injury severity. Promising candidates include carbohydrate ingestion, appropriate fluid intake and glutamine supplementation. Conversely, some nutritional factors and low energy availability may facilitate the development of EHS, and individuals should be cognizant of these. Therefore, the aims of this review are to present an overview of EHS along with its mechanisms and pathophysiology, discuss how selected nutritional considerations may influence EHS risk focusing on their impact on the key pathophysiological processes of EHS, and provide recommendations for future research. With climate change expected to increase EHS risk and incidence in the coming years, further investigation on how diet and nutrition may be optimized to protect against EHS would be highly beneficial.
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Affiliation(s)
- Jason K. W. Lee
- Human Potential Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,Heat Resilience and Performance Centre, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,Department of Physiology, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,N.1 Institute for HealthNational University of SingaporeSingapore,Global Asia InstituteNational University of SingaporeSingapore,Institute for Digital MedicineYong Loo Lin School of MedicineNational University of SingaporeSingapore,Singapore Institute for Clinical SciencesAgency for Science, Technology and Research (A*STAR)Singapore,Campus for Research Excellence and Technological Enterprise (CREATE)SingaporeSingapore
| | - Beverly Tan
- Human Potential Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,Campus for Research Excellence and Technological Enterprise (CREATE)SingaporeSingapore
| | - Henry B. Ogden
- Army Recruit Health and Performance ResearchHeadquarters of Army Recruiting and Initial Training Command, UpavonPewseyUK,Department of Sport, Health and WellbeingPlymouth Marjon UniversityPlymouthUK
| | - Shaun Chapman
- Army Recruit Health and Performance ResearchHeadquarters of Army Recruiting and Initial Training Command, UpavonPewseyUK,Cambridge Centre for Sport and Exercise SciencesSchool of Psychology and Sport ScienceAnglia Ruskin UniversityCambridgeUK
| | - Michael N. Sawka
- School of Biological SciencesGeorgia Institute of TechnologyAtlantaGAUSA
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Cicchella A, Stefanelli C, Massaro M. Upper Respiratory Tract Infections in Sport and the Immune System Response. A Review. Biology (Basel) 2021; 10:biology10050362. [PMID: 33922542 PMCID: PMC8146667 DOI: 10.3390/biology10050362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 02/07/2023]
Abstract
Simple Summary This review aims at clarifying the relationships of heavy training with the upper respiratory tract infections (URTI), a topic which has reach the public awareness with the recent outbreaks of Covid 19. The URTIs are quite common in several sport activities among athletes who undergo heavy training. Causes of URTI are still poorly understood, because can be related with innate and genetic susceptibility and with several environmental factors connected with training load and nutrition. The time course of the inflammation process affecting URTI after training, has been also reviewed. After a survey of the possible physiological and psychological causes (stressors), including a survey of the main markers of inflammation currently found in scientific literature (mainly catecholamines), we provided evidence of the ingestion of carbohydrates, C, D, and E vitamins, probiotics and even certain fat, in reducing URTI in athletes. Possible countermeasures to URTI can be a correct nutrition, sleep hygiene, a proper organization of training loads, and the use of technique to reduce stress in professional athletes. There is a lack of studies investigating social factors (isolation) albeit with Covid 19 this gap has been partially fill. The results can be useful also for non-athletes. Abstract Immunity is the consequence of a complex interaction between organs and the environment. It is mediated the interaction of several genes, receptors, molecules, hormones, cytokines, antibodies, antigens, and inflammatory mediators which in turn relate and influence the psychological health. The immune system response of heavily trained athletes resembles an even more complex conditions being theorized to follow a J or S shape dynamics at times. High training loads modify the immune response elevating the biological markers of immunity and the body susceptibility to infections. Heavy training and/or training in a cold environment increase the athletes’ risk to develop Upper Respiratory Tract Infections (URTIs). Therefore, athletes, who are considered healthier than the normal population, are in fact more prone to infections of the respiratory tract, due to lowering of the immune system in the time frames subsequent heavy training sessions. In this revision we will review the behavioral intervention, including nutritional approaches, useful to minimize the “open window” effect on infection and how to cope with stressors and boost the immune system in athletes.
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Affiliation(s)
- Antonio Cicchella
- Department for Quality of Life Studies, University of Bologna, 40127 Bologna, Italy;
- Correspondence: ; Tel.: +39-051-2088772
| | - Claudio Stefanelli
- Department for Quality of Life Studies, University of Bologna, 40127 Bologna, Italy;
| | - Marika Massaro
- Institute of Clinical Physiology, National Research Council (CNR), 73047 Lecce, Italy;
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Terink R, Witkamp RF, Hopman MTE, Siebelink E, Savelkoul HFJ, Mensink M. A 2 Week Cross-over Intervention with a Low Carbohydrate, High Fat Diet Compared to a High Carbohydrate Diet Attenuates Exercise-Induced Cortisol Response, but Not the Reduction of Exercise Capacity, in Recreational Athletes. Nutrients 2021; 13:E157. [PMID: 33418951 DOI: 10.3390/nu13010157] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/29/2020] [Accepted: 01/01/2021] [Indexed: 12/21/2022] Open
Abstract
Low carbohydrate, high fat (LCHF) diets are followed by athletes, but questions remain regarding effects of LCHF on metabolic adaptation, exercise-induced stress, immune function and their time-course. In this cross-over study, 14 recreational male athletes (32.9 ± 8.2 years, VO2max 57.3 ± 5.8 mL/kg/min) followed a two week LCHF diet (<10 En% carbohydrates (CHO), ~75En% Fat) and a two week HC diet (>50 En% CHO), in random order, with a wash-out period of >2 weeks in between. After 2 days and 2 weeks on either diet, participants performed cycle ergometry for 90 min at 60%Wmax. Blood samples for analysis of cortisol, free fatty acids (FFA), glucose and ketones, and saliva samples for immunoglobin A (s-IgA) were collected at different time points before and after exercise. The LCHF diet resulted in higher FFA, higher ketones and lower glucose levels compared to the HC diet (p < 0.05). Exercise-induced cortisol response was higher after 2 days on the LCHF diet (822 ± 215 nmol/L) compared to 2 weeks on the LCHF diet (669 ± 243 nmol/L, p = 0.004) and compared to both test days following the HC diet (609 ± 208 and 555 ± 173 nmol/L, both p < 0.001). Workload was lower, and perceived exertion higher, on the LCHF diet compared to the HC diet on both occasions. A drop in s-IgA following exercise was not seen after 2 days on the LCHF diet, in contrast to the HC diet. In conclusion, the LCHF diet resulted in reduced workload with metabolic effects and a pronounced exercise-induced cortisol response after 2 days. Although indications of adaptation were seen after 2 weeks on the LCHF diet, work output was still lower.
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Côrte ACRE, Camargo-Junior F, Chalhub T, Moraes Filho JMD, Santos R, Feitosa F, Freire R, Benayon P, Hausen M, Bachini F, Wolff A, Pereira G, Aguiar R, Itaborahy A. COVID-19 AND ITS EFFECT ON OLYMPIC SPORT: THE IMPORTANCE OF STUDYING SOCIAL ISOLATION AND THE HARM IT CAUSES, IN ORDER TO MINIMIZE IT. REV BRAS MED ESPORTE 2020. [DOI: 10.1590/1517-869220202605237107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT In March 2020, the World Health Organization (WHO) declared the disease caused by the SARS-CoV2 virus, known as COVID-19, to be a pandemic. The sporting world, too, is suffering from the global effects of this disease, with the postponement or cancellation of competitions, including the 2020 Tokyo Olympic Games. As a proposal for containing the disease, social isolation was declared. Despite the importance of this measure, it was harmful for Olympic athletes, as they had to stay away from their training site and trainers, as well as their interdisciplinary teams. It is therefore important to study this harm caused, in order to minimize it. In general, it is believed that regular physical activity is associated with improved immune system functioning. The lack of training can therefore have significant consequences for the performance and health of the Olympic athlete. From the athlete's point of view, the impaired immune system, due to the reduced frequency of physical exercise, leaves them more vulnerable to contracting or developing infections or other diseases. The risk of harm due to the decreased performance of preventive works is also evident in this population. The reductions in training load and intensity can cause changes in the athlete's body composition and affect various aspects of cardiorespiratory fitness, as well as reducing strength levels and muscle potency. In relation to the athlete's mental health, two aspects are particularly challenging: isolation and uncertainty. Based on the possible harm caused by social isolation, the need is seen for a specific and joint work, in an attempt to minimize it. This work addresses the following topics: (I) context: transmission, symptoms, diagnosis, treatment, discharge criteria, isolation and post-pandemic consequences; (II) harm and proposals: nutritional, physiological, biomechanical and psychological. Level of evidence II; Review Article.
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Marcucci-barbosa LS, Martins-junior F, Lobo LF, Morais MG, Moreira JM, Vieira ELM, Nunes-silva A. 10 km running race induces an elevation in the plasma myokine level of nonprofessional runners. Sport Sci Health 2020; 16:313-21. [DOI: 10.1007/s11332-019-00608-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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8
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El-Chab A, Simpson C, Lightowler H. The Effect of Consuming a Liquid Diet vs a Solid Diet 24-hr Preexperimental Trials on Adherence in Athletes. Int J Sport Nutr Exerc Metab 2019; 29:493-7. [PMID: 30676140 DOI: 10.1123/ijsnem.2018-0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/12/2018] [Accepted: 12/23/2018] [Indexed: 11/18/2022]
Abstract
Discrepancies in energy and macronutrient intakes between tests are apparent even when a solid prepackaged diet (Sdiet) is used to standardize dietary intake for preexperimental trials. It is unknown whether a liquid prepackaged diet (Ldiet) leads to improved adherence, resulting in lower variability in energy and macronutrient intakes. This study assesses the ability of athletes to replicate a diet when an Ldiet or Sdiet was used as a dietary standardization technique. In a cross-over design, 30 athletes were randomly assigned to either Sdiet or Ldiet. Each diet was consumed for two nonconsecutive days. Participants were instructed to consume all the meals provided and to return any leftovers. The coefficient of variation (CV) was calculated for each nutrient for the two methods and reported as the average CV. The Bland-Altman plots show that differences between Days 1 and 2 in energy and macronutrient intakes for both diets were close to zero, with the exception of some outliers. The %CV for Sdiet was higher than Ldiet (5% and 3% for energy, 5% and 3% for carbohydrate, 5% and 2% for protein, and 5% and 3% for fat, respectively). There was a strong positive correlation for energy and all macronutrients between Days 1 and 2 for both methods (r > .80; p < .05). Ldiet is an effective technique to standardize diet preexperimental trials and could be used as an alternative to Sdiet. Furthermore, Ldiet may lead to additional improvements in the compliance of participants to the diet and also decrease the cost and time of preparation.
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Hoekstra SP, Leicht CA, Kamijo YI, Kinoshita T, Stephenson BT, Goosey-Tolfrey VL, Bishop NC, Tajima F. The inflammatory response to a wheelchair half-marathon in people with a spinal cord injury - the role of autonomic function. J Sports Sci 2019; 37:1717-1724. [DOI: 10.1080/02640414.2019.1586296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sven P. Hoekstra
- The Peter Harrison Centre for Disability Sport; School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Christof A. Leicht
- The Peter Harrison Centre for Disability Sport; School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Yoshi-Ichiro Kamijo
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tokio Kinoshita
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Ben T. Stephenson
- The Peter Harrison Centre for Disability Sport; School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Victoria L. Goosey-Tolfrey
- The Peter Harrison Centre for Disability Sport; School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Nicolette C. Bishop
- The Peter Harrison Centre for Disability Sport; School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
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Abstract
Evidence suggests that periods of heavy intense training can result in impaired immune cell function, and whether this leaves elite athletes at greater risk of infections and upper respiratory symptoms (URS) is still debated. There is some evidence that episodes of URS do cluster around important periods of competition and intense periods of training. Since reducing URS, primarily from an infectious origin, may have implications for performance, a large amount of research has focused on nutritional strategies to improve immune function at rest and in response to exercise. Although there is some convincing evidence that meeting requirements of high intakes in carbohydrate and protein and avoiding deficiencies in nutrients such as vitamin D and antioxidants is integral for optimal immune health, well-powered randomised controlled trials reporting improvements in URS beyond such intakes are lacking. Consequently, there is a need to first understand whether the nutritional practices adopted by elite athletes increases their risk of URS. Second, promising evidence in support of efficacy and mechanisms of immune-enhancing nutritional supplements (probiotics, bovine colostrum) on URS needs to be followed up with more randomised controlled trials in elite athletes with sufficient participant numbers and rigorous procedures with clinically relevant outcome measures of immunity.
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Affiliation(s)
- Neil C Williams
- a Exercise and Health Research Group, Department of Sport Science, School of Science and Technology , Nottingham Trent University , Nottingham , UK
| | - Sophie C Killer
- b British Athletics, English Institute of Sport, National Performance Institute, Loughborough University , Loughborough , UK
| | | | - Arwel Wyn Jones
- d Lincoln Institute for Health, University of Lincoln , Lincoln , UK
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Terink R, Bongers CCWG, Witkamp RF, Mensink M, Eijsvogels TM, Klein Gunnewiek JMT, Hopman MTE. Changes in cytokine levels after prolonged and repeated moderate intensity exercise in middle-aged men and women. Transl Sports Med 2018. [DOI: 10.1002/tsm2.23] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- R. Terink
- Division of Human Nutrition; Wageningen University & Research (WUR); Wageningen The Netherlands
| | - C. C. W. G. Bongers
- Department of Physiology, Radboud Institute for Health Sciences; Radboud University Nijmegen; Nijmegen The Netherlands
| | - R. F. Witkamp
- Division of Human Nutrition; Wageningen University & Research (WUR); Wageningen The Netherlands
| | - M. Mensink
- Division of Human Nutrition; Wageningen University & Research (WUR); Wageningen The Netherlands
| | - T. M. Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences; Radboud University Nijmegen; Nijmegen The Netherlands
| | - J. M. T. Klein Gunnewiek
- Clinical Chemistry and Haematology Laboratory; Gelderse Vallei Hospital (ZGV); Ede The Netherlands
| | - M. T. E. Hopman
- Division of Human Nutrition; Wageningen University & Research (WUR); Wageningen The Netherlands
- Department of Physiology, Radboud Institute for Health Sciences; Radboud University Nijmegen; Nijmegen The Netherlands
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12
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Guy JH, Vincent GE. Nutrition and Supplementation Considerations to Limit Endotoxemia When Exercising in the Heat. Sports (Basel) 2018; 6:E12. [PMID: 29910316 DOI: 10.3390/sports6010012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 02/07/2023] Open
Abstract
Exercise-induced heat production is further elevated by exercise performed in hot conditions and this can subsequently impact inflammation, and gastrointestinal (GI) health. Implementing nutrition and supplementation strategies under these conditions may support the hyperthermic response, the systemic inflammatory response, GI permeability and integrity, and exercise performance. Therefore, the aim of this brief review is to explore athletes' inflammatory response of two key biomarkers, lipopolysaccharide (LPS), and interleukin-6 (IL-6), and provide nutrition and supplementation recommendations when exercising in hot conditions. There is emerging evidence that probiotics, glutamine, and vitamin C can preserve GI integrity, which may improve performance during exercise in the heat. Glucose rich food when consumed with water, before and during exercise in the heat, also appear to limit endotoxemia, preserve GI integrity, and reduce the incidence of GI disturbances compared with water alone. The use of non-steroidal anti-inflammatory drugs (NSAIDs) may compromise GI integrity and this may result in greater leakage of endotoxins during long duration exercise in the heat. Further work is required to elucidate the impact of nutrition and supplementation strategies, in particular the use of NSAIDs, when exercising in the heat.
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13
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Hennigar SR, McClung JP, Pasiakos SM. Nutritional interventions and the IL-6 response to exercise. FASEB J 2017; 31:3719-3728. [PMID: 28507168 DOI: 10.1096/fj.201700080r] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 04/24/2017] [Indexed: 01/24/2023]
Abstract
IL-6 is a pleiotropic cytokine with a wide range of biologic effects. In response to prolonged exercise, IL-6 is synthesized by contracting skeletal muscle and released into circulation. Circulating IL-6 is thought to maintain energy status during exercise by acting as an energy sensor for contracting muscle and stimulating glucose production. If tissue damage occurs, immune cells infiltrate and secrete cytokines, including IL-6, to repair skeletal muscle damage. With adequate rest and nutrition, the IL-6 response to exercise is attenuated as skeletal muscle adapts to training. However, sustained elevations in IL-6 due to repeated bouts of unaccustomed activities or prolonged exercise with limited rest may result in untoward physiologic effects, such as accelerated muscle proteolysis and diminished nutrient absorption, and may impair normal adaptive responses to training. Recent intervention studies have explored the role of mixed meals or carbohydrate, protein, ω-3 fatty acid, or antioxidant supplementation in mitigating exercise-induced increases in IL-6. Emerging evidence suggests that sufficient energy intake before exercise is an important factor in attenuating exercise-induced IL-6 by maintaining muscle glycogen. We detail various nutritional interventions that may affect the IL-6 response to exercise in healthy human adults and provide recommendations for future research exploring the role of IL-6 in the adaptive response to exercise.-Hennigar, S. R., McClung, J. P., Pasiakos, S. M. Nutritional interventions and the IL-6 response to exercise.
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Affiliation(s)
- Stephen R Hennigar
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA; .,Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA
| | - James P McClung
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA
| | - Stefan M Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA
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14
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Peake JM, Neubauer O, Walsh NP, Simpson RJ. Recovery of the immune system after exercise. J Appl Physiol (1985) 2016; 122:1077-1087. [PMID: 27909225 DOI: 10.1152/japplphysiol.00622.2016] [Citation(s) in RCA: 167] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/31/2016] [Accepted: 11/16/2016] [Indexed: 12/27/2022] Open
Abstract
The notion that prolonged, intense exercise causes an "open window" of immunodepression during recovery after exercise is well accepted. Repeated exercise bouts or intensified training without sufficient recovery may increase the risk of illness. However, except for salivary IgA, clear and consistent markers of this immunodepression remain elusive. Exercise increases circulating neutrophil and monocyte counts and reduces circulating lymphocyte count during recovery. This lymphopenia results from preferential egress of lymphocyte subtypes with potent effector functions [e.g., natural killer (NK) cells, γδ T cells, and CD8+ T cells]. These lymphocytes most likely translocate to peripheral sites of potential antigen encounter (e.g., lungs and gut). This redeployment of effector lymphocytes is an integral part of the physiological stress response to exercise. Current knowledge about changes in immune function during recovery from exercise is derived from assessment at the cell population level of isolated cells ex vivo or in blood. This assessment can be biased by large changes in the distribution of immune cells between blood and peripheral tissues during and after exercise. Some evidence suggests that reduced immune cell function in vitro may coincide with changes in vivo and rates of illness after exercise, but more work is required to substantiate this notion. Among the various nutritional strategies and physical therapies that athletes use to recover from exercise, carbohydrate supplementation is the most effective for minimizing immune disturbances during exercise recovery. Sleep is an important aspect of recovery, but more research is needed to determine how sleep disruption influences the immune system of athletes.
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Affiliation(s)
- Jonathan M Peake
- School of Biomedical Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; .,Centre of Excellence for Applied Sport Science Research, Queensland Academy of Sport, Brisbane, Queensland, Australia
| | - Oliver Neubauer
- School of Biomedical Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Neil P Walsh
- Extremes Research Group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, United Kingdom; and
| | - Richard J Simpson
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas
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Louis J, Marquet LA, Tiollier E, Bermon S, Hausswirth C, Brisswalter J. The impact of sleeping with reduced glycogen stores on immunity and sleep in triathletes. Eur J Appl Physiol 2016; 116:1941-54. [PMID: 27491620 PMCID: PMC5020129 DOI: 10.1007/s00421-016-3446-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/26/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE We investigated the effects of a 3-week dietary periodization on immunity and sleep in triathletes. METHODS 21 triathletes were divided into two groups with different nutritional guidelines during a 3-week endurance training program including nine twice a day sessions with lowered (SL group) or maintained (CON group) glycogen availability during the overnight recovery period. In addition to performance tests, sleep was monitored every night. Systemic and mucosal immune parameters as well as the incidence of URTI were monitored every week of the training/nutrition protocol. Two-ways ANOVA and effect sizes were used to examine differences in dependent variables between groups at each time point. RESULTS The SL group significantly improved 10 km running performance (-1 min 13 s, P < 0.01, d = 0.38), whereas no improvement was recorded in the CON group (-2 s, NS). No significant changes in white blood cells counts, plasma cortisol and IL-6 were recorded over the protocol in both groups. The vitamin D status decreased in similar proportions between groups, whereas salivary IgA decreased in the SL group only (P < 0.05, d = 0.23). The incidence of URTI was not altered in both groups. All participants in both groups went to bed earlier during the training program (SL -20 min, CON -27 min, P < 0.05, d = 0.28). In the SL group, only sleep efficiency slightly decreased by 1.1 % (P < 0.05, d = 0.25) and the fragmentation index tended to increase at the end of the protocol (P = 0.06). CONCLUSION Sleeping and training the next morning regularly with reduced glycogen availability has minimal effects on selected markers of immunity, the incidence of URTI and sleeping patterns in trained athletes.
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Affiliation(s)
- Julien Louis
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK.
| | - Laurie-Anne Marquet
- Laboratory of Sport, Expertise and Performance, French National Institute of Sport, Expertise and Performance, Paris, France
- Laboratory of Human Motricity, Education, Sport and Health, University of Nice Sophia-Antipolis, Nice, France
| | - Eve Tiollier
- Laboratory of Sport, Expertise and Performance, French National Institute of Sport, Expertise and Performance, Paris, France
| | - Stéphane Bermon
- Laboratory of Human Motricity, Education, Sport and Health, University of Nice Sophia-Antipolis, Nice, France
- Institut Monégasque de Médecine et Chirurgie du Sport, Monte Carlo, Monaco
| | - Christophe Hausswirth
- Laboratory of Sport, Expertise and Performance, French National Institute of Sport, Expertise and Performance, Paris, France
| | - Jeanick Brisswalter
- Laboratory of Human Motricity, Education, Sport and Health, University of Nice Sophia-Antipolis, Nice, France
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El-Chab A, Simpson C, Lightowler H. The reproducibility of a diet using three different dietary standardisation techniques in athletes. Eur J Clin Nutr 2016; 70:954-8. [PMID: 27094626 DOI: 10.1038/ejcn.2016.55] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/25/2016] [Accepted: 02/21/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Participants are often asked to replicate their diet before each trial to control dietary intake. However, little is known about the reproducibility of the diet using different approaches. The aim was to assess the reproducibility of a diet when a controlled diet (Cdiet), food record (Frecord) and 24-h dietary recall (Drecall) were used as dietary standardisation techniques. SUBJECTS/METHODS Thirty athletes completed six visits to the laboratory. On the first occasion, a Drecall was performed and subjects were asked to replicate exactly the same diet on the day before visit 2, when another Drecall was performed. The day before the third visit, subjects completed a Frecord, which was presented at visit 3 and assessed using Drecall to ensure comparability between methods. Subjects were asked to replicate this Frecord before visit 4, which was assessed using Drecall. Finally, subjects were provided with a Cdiet of known composition, which they consumed for 24 h before visits 5 and 6. For each method, the difference in energy and macronutrient intakes between both occasions was measured. RESULTS Despite finding no differences in mean energy and macronutrient intakes between visits for any technique, important within-subject differences were apparent. The range of percentage coefficient of variation for all variables was between 2.7 and 5.8% for Cdiet, 10.1 and 18.6% for Frecord and 7.1 and 11.7% for Drecall. CONCLUSIONS This study has shown that Cdiet is the best approach to standardise dietary intake, especially when the expected effect of an intervention is small and an enhanced reliability is required.
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Affiliation(s)
- A El-Chab
- Department of Sport & Health Sciences, Oxford Brookes University, Oxford, UK
| | - C Simpson
- Department of Sport & Health Sciences, Oxford Brookes University, Oxford, UK
| | - H Lightowler
- Department of Sport & Health Sciences, Oxford Brookes University, Oxford, UK
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Wolkow A, Ferguson SA, Vincent GE, Larsen B, Aisbett B, Main LC. The Impact of Sleep Restriction and Simulated Physical Firefighting Work on Acute Inflammatory Stress Responses. PLoS One 2015; 10:e0138128. [PMID: 26378783 PMCID: PMC4574982 DOI: 10.1371/journal.pone.0138128] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/25/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study investigated the effect restricted sleep has on wildland firefighters' acute cytokine levels during 3 days and 2 nights of simulated physical wildfire suppression work. METHODS Firefighters completed multiple days of physical firefighting work separated by either an 8-h (Control condition; n = 18) or 4-h (Sleep restriction condition; n = 17) sleep opportunity each night. Blood samples were collected 4 times a day (i.e., 06:15, 11:30, 18:15, 21:30) from which plasma cytokine levels (IL-6, IL-8, IL-1β, TNF-α, IL-4, IL-10) were measured. RESULTS The primary findings for cytokine levels revealed a fixed effect for condition that showed higher IL-8 levels among firefighters who received an 8-h sleep each night. An interaction effect demonstrated differing increases in IL-6 over successive days of work for the SR and CON conditions. Fixed effects for time indicated that IL-6 and IL-4 levels increased, while IL-1β, TNF-α and IL-8 levels decreased. There were no significant effects for IL-10 observed. CONCLUSION Findings demonstrate increased IL-8 levels among firefighters who received an 8-h sleep when compared to those who had a restricted 4-h sleep. Firefighters' IL-6 levels increased in both conditions which may indicate that a 4-h sleep restriction duration and/or period (i.e., 2 nights) was not a significant enough stressor to affect this cytokine. Considering the immunomodulatory properties of IL-6 and IL-4 that inhibit pro-inflammatory cytokines, the rise in IL-6 and IL-4, independent of increases in IL-1β and TNF-α, could indicate a non-damaging response to the stress of simulated physical firefighting work. However, given the link between chronically elevated cytokine levels and several diseases, further research is needed to determine if firefighters' IL-8 and IL-6 levels are elevated following repeated firefighting deployments across a fire season and over multiple fire seasons.
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Affiliation(s)
- Alexander Wolkow
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia
- Bushfire Co-Operative Research Centre, East Melbourne 3002, Australia
| | - Sally A. Ferguson
- Bushfire Co-Operative Research Centre, East Melbourne 3002, Australia
- Central Queensland University, Appleton Institute, Wayville 5034, Australia
| | - Grace E. Vincent
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia
- Bushfire Co-Operative Research Centre, East Melbourne 3002, Australia
| | - Brianna Larsen
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia
- Bushfire Co-Operative Research Centre, East Melbourne 3002, Australia
| | - Brad Aisbett
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia
- Bushfire Co-Operative Research Centre, East Melbourne 3002, Australia
| | - Luana C. Main
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia
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Abstract
Skeletal muscle has the capacity to increase energy turnover by ∼1000 times its resting rate when contracting at the maximum force/power output. Since ATP is not stored in any appreciable quantity, the muscle requires a coordinated metabolic response to maintain an adequate supply of ATP to sustain contractile activity. The integration of intracellular metabolic pathways is dependent upon the cross-bridge cycling rate of myosin and actin, substrate availability and the accumulation of metabolic byproducts, all of which can influence the maintenance of contractile activity or result in the onset of fatigue. In addition, the mobilisation of extracellular substrates is dependent upon the integration of both the autonomic nervous system and endocrine systems to coordinate an increase in both carbohydrate and fat availability. The current review examines the evidence for skeletal muscle to generate power over short and long durations and discusses the metabolic response to sustain these processes. The review also considers the endocrine response from the perspective of the sympathoadrenal system to integrate extracellular substrate availability with the increased energy demands made by contracting skeletal muscle. Finally, the review briefly discusses the evidence that muscle acts in an endocrine manner during exercise and what role this might play in mobilising extracellular substrates to augment the effects of the sympathoadrenal system.
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Affiliation(s)
- Derek Ball
- School of Life SciencesHeriot-Watt University, Edinburgh EH14 4AS, UK
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Sciberras JN, Galloway SD, Fenech A, Grech G, Farrugia C, Duca D, Mifsud J. The effect of turmeric (Curcumin) supplementation on cytokine and inflammatory marker responses following 2 hours of endurance cycling. J Int Soc Sports Nutr 2015; 12:5. [PMID: 25628521 DOI: 10.1186/s12970-014-0066-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 12/18/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endurance exercise induces IL-6 production from myocytes that is thought to impair intracellular defence mechanisms. Curcumin inhibits NF-κB and activator protein 1, responsible for cytokine transcription, in cell lines. The aim of this study was to investigate the effect of curcumin supplementation on the cytokine and stress responses following 2 h of cycling. METHODS Eleven male recreational athletes (35.5 ± 5.7 years; Wmax 275 ± 6 W; 87.2 ± 10.3 kg) consuming a low carbohydrate diet of 2.3 ± 0.2 g/kg/day underwent three double blind trials with curcumin supplementation, placebo supplementation, and no supplementation (control) to observe the response of serum interleukins (IL-6, IL1-RA, IL-10), cortisol, c-reactive protein (CRP), and subjective assessment of training stress. Exercise was set at 95% lactate threshold (54 ± 7% Wmax) to ensure that all athletes completed the trial protocol. RESULTS The trial protocol elicted a rise in IL-6 and IL1-RA, but not IL-10. The supplementation regimen failed to produce statistically significant results when compared to placebo and control. IL-6 serum concentrations one hour following exercise were (Median (IQR): 2.0 (1.8-3.6) Curcumin; 4.8 (2.1-7.3) Placebo; 3.5 (1.9-7.7) Control). Differences between supplementation and placebo failed to reach statistical significance (p = 0.18) with the median test. Repeated measures ANOVA time-trial interaction was at p = 0.06 between curcumin supplementation and placebo. A positive correlation (p = 0.02) between absolute exercise intensity and 1 h post-exercise for IL-6 concentration was observed. Participants reported "better than usual" scores in the subjective assessment of psychological stress when supplementing with curcumin, indicating that they felt less stressed during training days (p = 0.04) compared to placebo even though there was no difference in RPE during any of the training days or trials. CONCLUSION The limitations of the current regimen and trial involved a number of factors including sample size, mode of exercise, intensity of exercise, and dose of curcumin. Nevertheless these results provide insight for future studies with larger samples, and multiple curcumin dosages to investigate if different curcumin regimens can lead to statistically different interleukin levels when compared to a control and placebo.
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Correia-Oliveira CR, Bertuzzi R, Dal'Molin Kiss MAP, Lima-Silva AE. Strategies of dietary carbohydrate manipulation and their effects on performance in cycling time trials. Sports Med 2014; 43:707-19. [PMID: 23657935 DOI: 10.1007/s40279-013-0054-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The relationship between carbohydrate (CHO) availability and exercise performance has been thoroughly discussed. CHO improves performance in both prolonged, low-intensity and short, high-intensity exercises. Most studies have focused on the effects of CHO supplementation on the performance of constant-load, time-to-exhaustion exercises. Nevertheless, in the last 20 years, there has been a consistent increase in research on the effects of different forms of CHO supplementation (e.g., diet manipulation, CHO supplementation before or during exercise) on performance during closed-loop exercises, such as cycling time trials (TTs). A TT is a highly reproducible exercise and reflects a more realistic scenario of competition compared with the time-to-exhaustion test. CHO manipulation has been performed in various time periods, such as days before, minutes before, during a TT or in a matched manner (e.g. before and during a TT). The purpose of this review is to address the possible effects of these different forms of CHO manipulation on the performance during a cycling TT. Previous data suggest that when a high-CHO diet (~70% of CHO) is consumed before a TT (24-72 h before), the mean power output increases and reduces the TT time. When participants are supplemented with CHO (from 45 to 400 g) prior to a TT (from 2 min to 6 h before the TT), mean power output and time seem to improve due to an increase in CHO oxidation. Similarly, this performance also seems to increase when participants ingest CHO during a TT because such consumption maintains plasma glucose levels. A CHO mouth rinse also improves performance by activating several brain areas related to reward and motor control through CHO receptors in the oral cavity. However, some studies reported controversial results concerning the benefits of CHO on TT performance. Methodological issues such as time of supplementation, quantity, concentration and type of CHO ingested, as well as the TT duration and intensity, should be considered in future studies because small variations in any of these factors may have beneficial or adverse effects on TT performance.
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Affiliation(s)
- Carlos Rafaell Correia-Oliveira
- Sports Science Research Group, Faculty of Nutrition, Federal University of Alagoas, Lorival Melo Mota Avenue, S/N, Tabuleiro do Martins, Maceio, AL 57072970, Brazil
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Gunzer W, Konrad M, Pail E. Exercise-induced immunodepression in endurance athletes and nutritional intervention with carbohydrate, protein and fat-what is possible, what is not? Nutrients 2012; 4:1187-1212. [PMID: 23112908 PMCID: PMC3475230 DOI: 10.3390/nu4091187] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 08/23/2012] [Accepted: 08/24/2012] [Indexed: 01/08/2023] Open
Abstract
Heavily exercising endurance athletes experience extreme physiologic stress, which is associated with temporary immunodepression and higher risk of infection, particularly upper respiratory tract infections (URTI). The aim of this review is to provide a critical up-to-date review of existing evidence on the immunomodulatory potential of selected macronutrients and to evaluate their efficacy. The results of 66 placebo-controlled and/or crossover trials were compared and analysed. Among macronutrients, the most effective approach to maintain immune function in athletes is to consume ≥6% carbohydrate during prolonged exercise. Because inadequate nutrition affects almost all aspects of the immune system, a well-balanced diet is also important. Evidence of beneficial effects from other macronutrients is scarce and results are often inconsistent. Using a single nutrient may not be as effective as a mixture of several nutritional supplements. Due to limited research evidence, with the exception of carbohydrate, no explicit recommendations to reduce post-exercise URTI symptoms with single macronutrients can be derived.
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Affiliation(s)
| | - Manuela Konrad
- Author to whom correspondence should be addressed; ; Tel.: +43-316-5453-6762; Fax: +43-316-5453-6741
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Abstract
During the last few decades, scientific evidence has confirmed a wide range of health benefits related to regular physical activity. How physical activity affects the immune function and infection risk is, however, still under debate. Commonly, intensive exercise suppresses the activity and levels of several immune cells, while other immune functions may be stimulated by moderate physical activity. With this knowledge, the understanding of the relationship between different levels of physical activity on the immune function has been raised as a potential tool to protect health not only in athletes but also in the general population; the mechanisms that translate a physically active lifestyle into good health continue to be investigated. Reviewing the literature, although several outcomes (i.e. the mechanisms by which different levels and duration of physical activity programmes affect numerous cell types and responses) remain unclear, given that the additional benefits encompass healthy habits including exercise, the use of physical activity programmes may result in improved health of elderly populations. Moderate physical activity or moderate-regulated training may enhance the immune function mainly in less fit subjects or sedentary population and the pre-event fitness status also seems to be an important individual factor regarding this relationship. Although adequate nutrition and regular physical activity habits may synergistically improve health, clinical trials in athletes using nutritional supplements to counteract the immune suppression have been inconclusive so far.Further research is necessary to find out to what extent physical activity training can exert an effect on the immune function.
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Robson-Ansley P, Barwood M, Eglin C, Ansley L. The effect of carbohydrate ingestion on the interleukin-6 response to a 90-minute run time trial. Int J Sports Physiol Perform 2009; 4:186-94. [PMID: 19567922 DOI: 10.1123/ijspp.4.2.186] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Fatigue is a predictable outcome of prolonged physical activity; yet its biological cause remains uncertain. During exercise, a polypeptide messenger molecule interleukin- 6 (IL-6) is actively produced. Previously, it has been demonstrated that administration of recombinant IL-6 (rhIL-6) impairs 10-km run performance and heightened sensation of fatigue in trained runners. Both high carbohydrate diets and carbohydrate ingestion during prolonged exercise have a blunting effect on IL-6 levels postendurance exercise. We hypothesized that carbohydrate ingestion may improve performance during a prolonged bout of exercise as a consequence of a blunted IL-6 response. Seven recreationally trained fasted runners completed two 90-min time trials under CHO supplemented and placebo conditions in a randomized order. The study was of a double-blinded, placebo-controlled, cross-over study design. Distance covered in 90 min was significantly greater following exogenous carbohydrate ingestion compared with the placebo trial (19.13+/-1.7 km and 18.29+/-1.9 km, respectively, p=.0022). While postexercise IL-6 levels were significantly lower in the CHO trial compared with the placebo trial (5.3+/-1.9 pg.mL(-1) and 6.6+/-3.0 pg.mL(-1), respectively; p=.0313), this difference was considered physiologically too small to mediate the improvement in time trial performance.
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Chen YJ, Wong SHS, Chan COW, Wong CK, Lam CW, Siu PMF. Effects of glycemic index meal and CHO-electrolyte drink on cytokine response and run performance in endurance athletes. J Sci Med Sport 2008; 12:697-703. [PMID: 18789762 DOI: 10.1016/j.jsams.2008.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Revised: 01/24/2008] [Accepted: 05/24/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the effect of the glycemic index (GI) of a pre-exercise (PRE-ex) meal on plasma cytokine responses and endurance performance when carbohydrate-electrolyte (CHO-E) drink was consumed during exercise. METHODS Eight endurance-trained male runners (age: 28.6+/-2.7 years; body mass: 61.9+/-1.71 kg; V O(2max): 58.5+/-1.6 ml kg(-1)min(-1)) completed three trials in a randomized order. The pre-exercise meal consisted of either high-GI (HGI) (GI=83), low-GI (LGI) foods (GI=36) or control (CON) (low energy sugar-free jelly) was given to the participant 2h before a 21-km performance run on a level treadmill. During each trial, 2 ml kg(-1) BM of 6.6% CHO-E solution was consumed immediately before exercise and every 2.5-km afterward. Blood samples were collected before (pre-meal), and 120 min after ingestion the meal (120 min), immediately (POST), and 60 min (POST-60 min) after exercise. RESULTS No difference was found in time to complete the 21-km run between LGI and HGI. The interleukin-6 (IL-6) level increased by more than 100 times immediately after exercise in the three trials and returned to the basal level only on LGI at POST-60 min. In contrast, interleukin-2 (IL-2) level showed a transitory decrease at POST on CON (p<0.001). Glucose concentrations did not recover to the pre-meal level by POST-60 min on HGI only. Cortisol concentrations increased throughout the exercise and were lower on LGI when compared with CON (p<0.05) at POST-60 min. CONCLUSIONS HGI and LGI demonstrated similar performance when CHO-E solution was consumed during a 21-km run. However, pre-exercise LGI meal attenuated the increases in cortisol and quickened the recovery of the increased IL-6 value.
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Affiliation(s)
- Y J Chen
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
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25
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Abstract
Strenuous bouts of prolonged exercise and heavy training are associated with depressed immune cell function. Furthermore, inadequate or inappropriate nutrition can compound the negative influence of heavy exertion on immunocompetence. Dietary deficiencies of protein and specific micronutrients have long been associated with immune dysfunction. An adequate intake of iron, zinc and vitamins A, E, B6 and B12 is particularly important for the maintenance of immune function, but excess intakes of some micronutrients can also impair immune function and have other adverse effects on health. Immune system depression has also been associated with an excess intake of fat. To maintain immune function, athletes should eat a well-balanced diet sufficient to meet their energy requirements. An athlete exercising in a carbohydrate-depleted state experiences larger increases in circulating stress hormones and a greater perturbation of several immune function indices. Conversely, consuming 30-60 g carbohydrate x h(-1) during sustained intensive exercise attenuates rises in stress hormones such as cortisol and appears to limit the degree of exercise-induced immune depression. Convincing evidence that so-called 'immune-boosting' supplements, including high doses of antioxidant vitamins, glutamine, zinc, probiotics and Echinacea, prevent exercise-induced immune impairment is currently lacking.
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Affiliation(s)
- Michael Gleeson
- School of Sport and Exercise Sciences, Loughborough University, Loughborough LE11 3TU, UK.
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Garrod R, Ansley P, Canavan J, Jewell A. Exercise and the inflammatory response in chronic obstructive pulmonary disease (COPD)—Does training confer anti-inflammatory properties in COPD? Med Hypotheses 2007; 68:291-8. [PMID: 17010529 DOI: 10.1016/j.mehy.2006.07.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2006] [Accepted: 07/19/2006] [Indexed: 01/21/2023]
Abstract
There is increasing evidence that systemic inflammation plays an important role in the pathogenesis of COPD. Inflammatory markers show relationships with exercise performance, health related quality of life and breathlessness. These are important clinical outcomes in the management of COPD. Even more so is the consideration that systemic inflammation in COPD may be directly associated with mortality and deterioration of disease. Long-term exercise training clearly has beneficial properties in healthy subjects, whether the same is true in COPD remains to be seen. This review discusses aspects of the anti-inflammatory effects of exercise in relation to patients with COPD. There is intriguing evidence that the exercise-induced cytokine response differs in COPD patients compared with healthy subjects. We consider the role of IL-6 in the manifestation of fatigue in COPD and consider the implications of raised CRP- and TNF-alpha. Early data suggests beneficial effects of polyunsaturated fatty acid PUFA supplementation and exercise training in combination with appropriate nutritional support may yield rewarding therapeutic benefits. This review raises the hypothesis that physical training in COPD is associated with immunological changes that may confer anti-inflammatory benefits and in part, explain changes seen after pulmonary rehabilitation in COPD patients.
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Affiliation(s)
- Rachel Garrod
- Faculty of Health and Social Care Sciences, School of Physiotherapy, St George's University of London, Cranmer Terrace, SW17ORE, United Kingdom.
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Moreira A, Kekkonen RA, Delgado L, Fonseca J, Korpela R, Haahtela T. Nutritional modulation of exercise-induced immunodepression in athletes: a systematic review and meta-analysis. Eur J Clin Nutr 2006; 61:443-60. [PMID: 17136044 DOI: 10.1038/sj.ejcn.1602549] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Heavy exercise induces marked immunodepression that is multifactorial in origin. Nutrition can modulate normal immune function. OBJECTIVE To assess the efficacy of nutritional supplements in exercise-induced immunodepression in athletes. DESIGN Systematic review. REVIEW METHODS Randomised and/or controlled trials of athletes undertaking nutritional supplements to minimise the immunodepression after exercise were retrieved. The primary outcome measure was incidence of upper respiratory tract (URT) illness symptoms after exercise, and secondary outcomes included cortisol, cell counts, plasma cytokine concentration, cell proliferative response, oxidative burst, natural killer cell activity and immunoglobulins. When data were available for a pooled estimate of the effect of intervention, meta-analyses were conducted for direct comparisons. RESULTS Forty-five studies were included (1603 subjects). The studies were heterogeneous in terms of exercise interventions, selection of athletes, settings and outcomes. The overall methodological quality of most of the trials was poor. Twenty studies addressed carbohydrate supplementation, eight glutamine, 13 vitamin C and four others interventions. Three trials assessed the effect of intervention on prevention of URT infections. The pooled rate ratio for URT infections after vitamin C supplementation against placebo was 0.49 (0.34-0.71). Carbohydrate supplementation attenuated the increase in cortisol and neutrophils after exercise; vitamin C attenuated the decrease in lymphocytes after exercise. No other interventions had significant or consistent effect on any of the studied outcomes. CONCLUSIONS Although the prevention of URT infections by vitamin C was supported by two trials, further studies are needed. The available evidence failed to support a role for other nutritional supplements in preventing exercise-induced immune suppression. Larger trials with clinically relevant and uniform end points are necessary to clarify the role of these nutritional interventions.
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Affiliation(s)
- A Moreira
- Laboratory of Immunology, Faculty of Medicine, University of Porto, Porto, Portugal.
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Sellar CM, Syrotuik DG, Field CJ, Bell GJ. The effect of dietary control and carbohydrate supplementation on the immune and hormonal responses to rowing exercise. Appl Physiol Nutr Metab 2006; 31:588-96. [PMID: 17111013 DOI: 10.1139/h06-036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To determine the effect of carbohydrate supplementation on the immune and stress hormone responses to 1 h of strenuous rowing exercise, 22 male subjects were randomly assigned to a placebo (PLA, n = 11) or carbohydrate (CHO, n = 11) group. Subjects completed 3 d of modified dietary intake, a standardized pre-exercise meal, and consumed either a carbohydrate beverage (1 g·kg body mass–1) or a non-caloric placebo drink before, during, and after a 1 h rowing trial. Increases were observed in adrenocorticotrophic hormone, cortisol, blood leukocytes, neutrophils, and natural killer cell concentrations and activity, whereas the ability of peripheral blood monouclear cells (PBMCs) to respond (interleukin-2 (IL-2) production) to stimulation was reduced 5 min after exercise in both groups (p < 0.05). Lymphocytes were also elevated, but in the PLA group only (p < 0.05). One hour after exercise, blood leukocytes remained elevated owing to increased neutrophil concentrations, whereas a number of lymphocyte subsets (CD3+, CD3+/4+, CD3+/8+, CD20+, CD25+, CD4+/25+, CD8+/25+) and the ability of PBMCs to respond to stimulation (IL-2, interferon-γ (IFN-γ) production) were lower than resting values in both groups (p < 0.05). Carbohydrate supplementation to athletes in the post-prandial state undergoing a 1 h rowing trial resulted in attenuation of the post-exercise increase in peripheral blood lymphocyte concentration, but had little effect on the ability of PBMCs to produce cytokines following stimulation, natural killer cell activity, stress hormone concentrations, exercise performance, or self-reported incidence of illness during the 14 d period following the experimental trial.
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Affiliation(s)
- Christopher M Sellar
- Faculty of Physical Education & Recreation, E-488, Van Vliet Centre, University of Alberta, Edmonton, AB T6G 2H9, Canada.
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Abstract
Acute, sustained, moderate- to high-intensity exercise has been shown to induce significant alterations in the distribution and function of leukocytes during recovery. In many instances, these changes have been found to reflect a transient impairment of immune function in vitro during recovery from such exercise. Carbohydrate supplementation during exercise has been associated with an attenuation of cortisol production. Because cortisol has been linked to immunosuppression, a growing body of research has examined the influence of carbohydrate supplementation on immune function in response to exercise. New areas along this line of inquiry involve examination of the cytokine response to exercise and the role that carbohydrate may play in regulating the production of proinflammatory cytokines. Inter-relations among the immune response, production of specific cytokines, and cortisol are also examined. The clinical significance of an attenuated immune response when exercising as a result of the administration of supplemental carbohydrate is yet to be determined.
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Affiliation(s)
- William A Braun
- Human Performance Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, California 91768, USA.
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Abstract
The unexplained underperformance syndrome (UPS), previously known as the overtraining syndrome (OTS), has been defined as a persistent decrement in athletic performance capacity despite 2 weeks of relative rest. It has been proposed that UPS may be caused by excessive cytokine release during and following exercise causing a chronic inflammatory state and 'cytokine sickness'. This article extends that hypothesis by proposing that time-dependent sensitisation could provide a model through which the aetiology of UPS may be explained. In this model, the principal abnormal factors in UPS are an increased production of and/or intolerance to interleukin (IL)-6 during exercise. Strategies to attenuate the IL-6 response to exercise that may also reduce an athlete's susceptibility to UPS are proposed.
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Affiliation(s)
- Paula Robson
- UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Sports Science Institute of South Africa, University of Cape Town, Newlands, South Africa.
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Abstract
PURPOSE OF REVIEW Despite much current debate regarding central and peripheral neural mechanisms which may be responsible for the onset of fatigue during prolonged exercise, maintenance of nutritional and hydration status remains critical for successful participation in ultra-endurance exercise. This review focuses on substrate and fluid homeostasis during ultra-endurance exercise and the use of nutritional supplementation both as ergogenic aid and to attenuate exercise-induced immunosuppression. RECENT FINDINGS Current evidence continues to support mandatory high carbohydrate intakes (1). before the event to maximize muscle glycogen stores, (2). during the event to prevent hypoglycaemia and (3). after the event to optimize post-event repletion of endogenous carbohydrate stores. No consistent performance benefit has yet been shown following a high-fat diet. Greater utilization of intrafascicular triglyceride stores appears to account for additional fat utilization in females. Recent trends towards excessive fluid intake have resulted in frequent reports of hyponatraemic hyperhydration in ultra-distance athletes, with greater incidence in women than in men. Carbohydrate supplementation during the event attenuates immunosuppressive hormonal and cytokine responses to ultra-endurance exercise, but may impair vitamin C absorption, while the ergogenic value of caffeine supplementation in ultra-endurance performance is currently being questioned. SUMMARY Meeting macronutrient and fluid intake demands remains an important priority for ultra-endurance athletes. Yet these athletes are reported to present with a high incidence of disordered eating patterns during periods of training, and excessive fluid replacement strategies have resulted in an increased incidence of water intoxication with resultant central nervous system dysfunction.
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Affiliation(s)
- Edith M Peters
- Department of Physiology, Nelson Mandela Faculty of Health Sciences, University of Natal, Durban, South Africa.
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