Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability

The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with periodontal health, but the impact of periodontitis on nitrate-reducing capacity (NRC) and, therefore, nitric oxide availability has not been evaluated. The current study aimed to evaluate how periodontitis affects the NRC of the oral microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing that nitrate-reducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals (P < 0.05 in all five datasets with n = 20-82 samples per dataset). Secondly, subgingival plaque, saliva, and plasma samples were obtained from 42 periodontitis patients before and after periodontal treatment. The oral NRC was determined in vitro by incubating saliva with 8 mmol/L nitrate (a concentration found in saliva after nitrate-rich vegetable intake) and compared with the NRC of 15 healthy individuals. Salivary NRC was found to be diminished in periodontal patients before treatment (P < 0.05) but recovered to healthy levels 90 days post-treatment. Additionally, the subgingival levels of nitrate-reducing bacteria increased after treatment and correlated negatively with periodontitis-associated bacteria (P < 0.01). No significant effect of periodontal treatment on the baseline saliva and plasma nitrate and nitrite levels was found, indicating that differences in the NRC may only be revealed after nitrate intake. Our results suggest that an impaired NRC in periodontitis could limit dietary nitrate-derived nitric oxide levels, and the effect on systemic health should be explored in future studies.

Anti-infective characteristics of a new Carbothane ventricular assist device driveline

Objectives

Driveline infections are a major complication of ventricular assist device (VAD) therapy. A newly introduced Carbothane driveline has preliminarily demonstrated anti-infective potential against driveline infections. This study aimed to comprehensively assess the anti-biofilm capability of the Carbothane driveline and explore its physicochemical characteristics.

Methods

We assessed the Carbothane driveline against biofilm formation of leading microorganisms causing VAD driveline infections, including Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa and Candida albicans, using novel in vitro biofilm assays mimicking different infection micro-environments. The importance of physicochemical properties of the Carbothane driveline in microorganism-device interactions were analyzed, particularly focusing on the surface chemistry. The role of micro-gaps in driveline tunnels on biofilm migration was also examined.

Results

All organisms were able to attach to the smooth and velour sections of the Carbothane driveline. Early microbial adherence, at least for S. aureus and S. epidermidis, did not proceed to the formation of mature biofilms in a drip-flow biofilm reactor mimicking the driveline exit site environment. The presence of a driveline tunnel however, promoted staphylococcal biofilm formation on the Carbothane driveline. Physicochemical analysis of the Carbothane driveline revealed surface characteristics that may have contributed to its anti-biofilm activity, such as the aliphatic nature of its surface. The presence of micro-gaps in the tunnel facilitated biofilm migration of the studied bacterial species.

Conclusion

This study provides experimental evidence to support the anti-biofilm activity of the Carbothane driveline and uncovered specific physicochemical features that may explain its ability to inhibit biofilm formation.

LC/MS-based discrimination between plasma and urine metabolomic changes following exposure to ultraviolet radiation by using data modelling

INTRODUCTION

This study sought to compare between metabolomic changes of human urine and plasma to investigate which one can be used as best tool to identify metabolomic profiling and novel biomarkers associated to the potential effects of ultraviolet (UV) radiation.

METHOD

A pilot study of metabolomic patterns of human plasma and urine samples from four adult healthy individuals at before (S1) and after (S2) exposure (UV) and non-exposure (UC) were carried out by using liquid chromatography-mass spectrometry (LC-MS).

RESULTS

The best results which were obtained by normalizing the metabolites to their mean output underwent to principal components analysis (PCA) and Orthogonal Partial least squares-discriminant analysis (OPLS-DA) to separate pre-from post-of exposure and non-exposure of UV. This separation by data modeling was clear in urine samples unlike plasma samples. In addition to overview of the scores plots, the variance predicted-Q2 (Cum), variance explained-R2X (Cum) and p-value of the cross-validated ANOVA score of PCA and OPLS-DA models indicated to this clear separation. Q2 (Cum) and R2X (Cum) values of PCA model for urine samples were 0.908 and 0.982, respectively, and OPLS-DA model values were 1.0 and 0.914, respectively. While these values in plasma samples were Q2 = 0.429 and R2X = 0.660 for PCA model and Q2 = 0.983 and R2X = 0.944 for OPLS-DA model. LC-MS metabolomic analysis showed the changes in numerous metabolic pathways including: amino acid, lipids, peptides, xenobiotics biodegradation, carbohydrates, nucleotides, Co-factors and vitamins which may contribute to the evaluation of the effects associated with UV sunlight exposure.

CONCLUSIONS

The results of pilot study indicate that pre and post-exposure UV metabolomics screening of urine samples may be the best tool than plasma samples and a potential approach to predict the metabolomic changes due to UV exposure. Additional future work may shed light on the application of available metabolomic approaches to explore potential predictive markers to determine the impacts of UV sunlight.

Reduced nitric oxide synthesis in winter: A potential contributing factor to increased cardiovascular risk

BACKGROUND

Nitric oxide is a key signalling molecule that elicits a range of biological functions to maintain vascular homeostasis. A reduced availability of nitric oxide is implicated in the progression of cardiovascular diseases and increases the risk of pathogenic events.

AIMS

To compare the concentration of nitric oxide metabolites in healthy adults between winter and summer months.

DESIGN

An observational study of healthy adults (age 32 ± 9 years) living in central Scotland.

METHODS

Thirty-four healthy adults (13 females) were monitored for 7 days in summer and winter to record sunlight exposure (ultraviolet-A (UV-A) radiation), diet, and physical activity. At the end of each phase, blood pressure was measured, and samples of blood and saliva collected. The samples were analysed to determine the concentrations of plasma and salivary nitrate and nitrite and serum 25-hydroxyvitamin D (25(OH)D).

RESULTS

The participants maintained similar diets in each measurement phase but were exposed to more UV-A radiation (550%) and undertook more moderate-vigorous physical activity (23%) in the summer than in winter. Plasma nitrite (46%) and serum 25(OH)D (59%) were higher and blood pressure was lower in the summer compared to winter months. Plasma nitrite concentration was negatively associated with systolic, diastolic, and mean arterial blood pressure.

CONCLUSIONS

Plasma nitrite, an established marker of nitric oxide synthesis, is higher in healthy adults during the summer than in winter. This may be mediated by a greater exposure to UV-A which stimulates the release of nitric oxide metabolites from skin stores. While it is possible that seasonal variation in nitric oxide availability may contribute to an increased blood pressure in the winter months, the overall impact on cardiovascular health remains to be determined.

The oral microbiome, nitric oxide and exercise performance

The human microbiome comprises ∼10¹³-10¹⁴ microbial cells which form a symbiotic relationship with the host and play a critical role in the regulation of human metabolism. In the oral cavity, several species of bacteria are capable of reducing nitrate to nitrite; a key precursor of the signaling molecule nitric oxide. Nitric oxide has myriad physiological functions, which include the maintenance of cardiovascular homeostasis and the regulation of acute and chronic responses to exercise. This article provides a brief narrative review of the research that has explored how diversity and plasticity of the oral microbiome influences nitric oxide bioavailability and related physiological outcomes. There is unequivocal evidence that dysbiosis (e.g. through disease) or disruption (e.g. by use of antiseptic mouthwash or antibiotics) of the oral microbiota will suppress nitric oxide production via the nitrate-nitrite-nitric oxide pathway and negatively impact blood pressure. Conversely, there is preliminary evidence to suggest that proliferation of nitrate-reducing bacteria via the diet or targeted probiotics can augment nitric oxide production and improve markers of oral health. Despite this, it is yet to be established whether purposefully altering the oral microbiome can have a meaningful impact on exercise performance. Future research should determine whether alterations to the composition and metabolic activity of bacteria in the mouth influence the acute responses to exercise and the physiological adaptations to exercise training.

Dietary Inorganic Nitrate as an Ergogenic Aid: An Expert Consensus Derived via the Modified Delphi Technique

Introduction

Dietary inorganic nitrate is a popular nutritional supplement, which increases nitric oxide bioavailability and may improve exercise performance. Despite over a decade of research into the effects of dietary nitrate supplementation during exercise there is currently no expert consensus on how, when and for whom this compound could be recommended as an ergogenic aid. Moreover, there is no consensus on the safe administration of dietary nitrate as an ergogenic aid. This study aimed to address these research gaps.

Methods

The modified Delphi technique was used to establish the views of 12 expert panel members on the use of dietary nitrate as an ergogenic aid. Over three iterative rounds (two via questionnaire and one via videoconferencing), the expert panel members voted on 222 statements relating to dietary nitrate as an ergogenic aid. Consensus was reached when > 80% of the panel provided the same answer (i.e. yes or no). Statements for which > 80% of the panel cast a vote of insufficient evidence were categorised as such and removed from further voting. These statements were subsequently used to identify directions for future research.

Results

The 12 panel members contributed to voting in all three rounds. A total of 39 statements (17.6%) reached consensus across the three rounds (20 yes, 19 no). In round one, 21 statements reached consensus (11 yes, 10 no). In round two, seven further statements reached consensus (4 yes, 3 no). In round three, an additional 11 statements reached consensus (5 yes, 6 no). The panel agreed that there was insufficient evidence for 134 (60.4%) of the statements, and were unable to agree on the outcome of the remaining statements.

Conclusions

This study provides information on the current expert consensus on dietary nitrate, which may be of value to athletes, coaches, practitioners and researchers. The effects of dietary nitrate appear to be diminished in individuals with a higher aerobic fitness (peak oxygen consumption [V̇O_2peak] > 60 ml/kg/min), and therefore, aerobic fitness should be taken into account when considering use of dietary nitrate as an ergogenic aid. It is recommended that athletes looking to benefit from dietary nitrate supplementation should consume 8–16 mmol nitrate acutely or 4–16 mmol/day nitrate chronically (with the final dose ingested 2–4 h pre-exercise) to maximise ergogenic effects, taking into consideration that, from a safety perspective, athletes may be best advised to increase their intake of nitrate via vegetables and vegetable juices. Acute nitrate supplementation up to ~ 16 mmol is believed to be safe, although the safety of chronic nitrate supplementation requires further investigation. The expert panel agreed that there was insufficient evidence for most of the appraised statements, highlighting the need for future research in this area.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01701-3.

A Personalized Smartphone-Delivered Just-in-time Adaptive Intervention (JitaBug) to Increase Physical Activity in Older Adults: Mixed Methods Feasibility Study

BACKGROUND

Just-in-time adaptive interventions (JITAIs) provide real time in-the-moment behavior change support to people when they need it most. JITAIs could be a viable way to provide personalized physical activity (PA) support to older adults in the community. However, it is unclear how feasible it is to remotely deliver a PA intervention through a smartphone to older adults or how acceptable they would find a JITAI targeting PA in everyday life.

OBJECTIVE

The aims of this study are to describe the development of JitaBug, a personalized smartphone-delivered JITAI designed to support older adults to increase or maintain their PA level, assess the feasibility of conducting an effectiveness trial of the JitaBug intervention, and explore the acceptability of JitaBug among older adults in a free-living setting.

METHODS

The intervention was developed using the Behavior Change Wheel and consisted of a wearable activity tracker (Fitbit) and a companion smartphone app (JitaBug) that delivered goal-setting, planning, reminders, and JITAI messages to encourage achievement of personalized PA goals. Message delivery was tailored based on time of day, real time PA tracker data, and weather conditions. We tested the feasibility of remotely delivering the intervention with older adults in a 6-week trial. Data collection involved assessment of PA through accelerometery and activity tracker, self-reported mood and mental well-being through ecological momentary assessment, and contextual information on PA through voice memos. Feasibility outcomes included recruitment capability and adherence to the intervention, intervention delivery in the wild, appropriateness of data collection methodology, adverse events, and participant satisfaction.

RESULTS

Of the 46 recruited older adults (aged 56-72 years), 31 (67%) completed the intervention. The intervention was successfully delivered as intended; 87% (27/31) of the participants completed the intervention independently; 94% (2247/2390) of the PA messages were successfully delivered; 99% (2239/2261) of the Fitbit and 100% (2261/2261) of the weather data calls were successful. Valid and usable wrist-worn accelerometer data were obtained from 90% (28/31) of the participants at baseline and follow-up. On average, the participants recorded 50% (7.9/16, SD 7.3) of the voice memos, 38% (3.3/8, SD 4.2) of the mood assessments, and 50% (2.1/4, SD 1.6) of the well-being assessments through the app. Overall acceptability of the intervention was very good (23/30, 77% expressed satisfaction). Participant feedback suggested that more diverse and tailored PA messages, app use reminders, technical refinements, and an improved user interface could improve the intervention and make it more appealing.

CONCLUSIONS

This study suggests that a smartphone-delivered JITAI is an acceptable way to support PA in older adults in the community. Overall, the intervention is feasible; however, based on user feedback, the JitaBug app requires further technical refinements that may enhance use, engagement, and user satisfaction before moving to effectiveness trials.

Reliability and Validity of a 6-Minute Yo-Yo Intermittent Endurance Test Level 2 in Subelite Part Time Male Soccer Players

ABSTRACT

Gibson, N, Easton, C, Williams, M, McCunn, R, Gibson, NV. Reliability and validity of a 6-minute Yo-Yo Intermittent Endurance Test Level 2 in subelite part time male soccer players. J Strength Cond Res 36(4): 1011-1018, 2022-The aim of this study was to assess the reliability and relationship to maximal intermittent running performance of the 6-minute Yo-Yo Intermittent Endurance Test Level 2 (YYIET2), among subelite part time soccer players. Twenty male soccer players (15-22 years) completed three 6-minute YYIET2 trials with heart rate (HR), PlayerLoad, and rating of perceived exertion assessed during the protocol and HR and blood lactate assessed during 5 minutes of recovery. Subjects also completed a maximal version of the YYIET2 and the maximal Yo-Yo Intermittent Recovery Test Level 1 (YYIRT1) and 2 (YYIRT2). Heart rate at 4 and 6 minutes, PlayerLoad at 4 minutes, and HR recovery at 2, 3, 4, and 5 minutes during recovery from the 6-minute YYIET2 demonstrated little variance between tests. Correlations between variables measured during and after the 6-minute YYIET2 and distance covered in maximal tests ranged from r = 0.02 to -0.72. The 6-minute YYIET2 provides practitioners with a method of reliably assessing HR responses within subelite part time soccer players, although large correlations with maximal assessments suggest it can be used as a proxy measure for maximal intermittent running performance. Given its ease of administration and low time cost, the 6-minute YYIET2 offers practitioners a useful means of tracking training status and movement efficiency in players longitudinally.

Blood lactate concentrations during rest and exercise in people with Multiple Sclerosis: A systematic review and meta-analysis

BACKGROUND

Multiple Sclerosis (MS) is a chronic disorder which irreversibly damages axons within brain matter. Blood lactate concentration could be a biomarker of MS onset and progression, but no systematic review has yet sought to confirm or dispute the elevation and biomarker potential of blood lactate in people with MS (PwMS) or to consolidate understanding of lactate production during exercise in PwMS.

OBJECTIVE

To perform a systematic review and meta-analysis on blood lactate in PwMS during rest and exertion compared to Healthy Controls (HC) and following chronic exercise intervention.

METHODS

A systematic search of six electronic databases (PubMed, CINAHL, Science Direct, Cochrane Library, SPORTDiscus and PEDro) was performed on 10th April 2020. Mean, standard deviation and sample size for lactate measures at rest and during exercise were pooled to determine overall effect size using a random effects model.  The 20-point Appraisal tool for Cross-Sectional Studies was utilised to assess study quality and inherent risk of bias. To qualify for inclusion, studies had to include human adults (>18 years) with a confirmed clinical diagnosis of MS, be published in English, have undergone peer review, report absolute blood lactate values for data extraction, and if involving testing during/after exercise, to do so during bilateral exercise methods.

RESULTS

18 studies were qualitatively analysed and 15 studies quantitatively analysed. Outcome data was available for 1986 participants (n_MS = 1129). A total of 7 papers tested blood lactate during rest (Lactate_REST), 7 papers tested during sub-maximal intensity exercise (Lactate_SUB-MAX), and 8 papers tested during maximal intensity exercise (Lactate_MAX). Meta analyses showed elevated Lactate_REST and reduced Lactate_MAX in PwMS compared to HC, higher Lactate_MAX in lower EDSS-scoring PwMS compared to higher EDSS-scoring PwMS, and that Lactate_SUB-MAX decreases and Lactate_MAX increases in PwMS following a chronic exercise intervention. Qualitative analysis reported Lactate_REST to be reduced in PwMS following a chronic exercise intervention.

CONCLUSIONS

Lactate_REST is elevated in PwMS compared to HC. Lactate_MAX is lower in PwMS compared to HC and lower still in higher compared to lower EDSS-scoring groups of PwMS. Chronic exercise interventions have the potential to reduce Lacatate_SUB-MAX for a given power output and increase Lactate_MAX in PwMS compared to baseline values. Lactate_REST may be reduced in PwMS following a chronic exercise intervention but more research is required for confirmation. The results of this review were limited by small sample sizes and number of studies available for each testing condition, limited data available for potentially confounding/correlating factors (eg. VO₂ and power output) as well as heterogeneity of methodology adopted across studies, often due to lactate testing being a secondary outcome measure. PLS: Lactate levels in the blood are different during rest and at intense exercise levels in people with Multiple Sclerosis (MS) compared to healthy counterparts, with people with MS showing a smaller jump in lactate during intense exercise from a higher resting level. After exercising for at least 3 months, blood lactate levels during exercise may become more similar to the levels seen in people without Multiple Sclerosis, but more research is required to give a clearer picture of this. We can hopefully use blood lactate in future to measure the progression of MS in an individual as well as the effectiveness of their exercise programme.

Dietary nitrate and population health: a narrative review of the translational potential of existing laboratory studies

BACKGROUND

Dietary inorganic nitrate (NO3-) is a polyatomic ion, which is present in large quantities in green leafy vegetables and beetroot, and has attracted considerable attention in recent years as a potential health-promoting dietary compound. Numerous small, well-controlled laboratory studies have reported beneficial health effects of inorganic NO3- consumption on blood pressure, endothelial function, cerebrovascular blood flow, cognitive function, and exercise performance. Translating the findings from small laboratory studies into 'real-world' applications requires careful consideration.

MAIN BODY

This article provides a brief overview of the existing empirical evidence basis for the purported health-promoting effects of dietary NO3- consumption. Key areas for future research are then proposed to evaluate whether promising findings observed in small animal and human laboratory studies can effectively translate into clinically relevant improvements in population health. These proposals include: 1) conducting large-scale, longer duration trials with hard clinical endpoints (e.g. cardiovascular disease incidence); 2) exploring the feasibility and acceptability of different strategies to facilitate a prolonged increase in dietary NO3- intake; 3) exploitation of existing cohort studies to explore associations between NO3- intake and health outcomes, a research approach allowing larger samples sizes and longer duration follow up than is feasible in randomised controlled trials; 4) identifying factors which might account for individual differences in the response to inorganic NO3- (e.g. sex, genetics, habitual diet) and could assist with targeted/personalised nutritional interventions; 5) exploring the influence of oral health and medication on the therapeutic potential of NO3- supplementation; and 6) examining potential risk of adverse events with long term high- NO3- diets.

CONCLUSION

The salutary effects of dietary NO3- are well established in small, well-controlled laboratory studies. Much less is known about the feasibility and efficacy of long-term dietary NO3- enrichment for promoting health, and the factors which might explain the variable responsiveness to dietary NO3- supplementation between individuals. Future research focussing on the translation of laboratory data will provide valuable insight into the potential applications of dietary NO3- supplementation to improve population health.

Generation and validation of ActiGraph GT3X+ accelerometer cut-points for assessing physical activity intensity in older adults. The OUTDOOR ACTIVE validation study

The study of physical activity in older adults is becoming more and more relevant. For evaluation of physical activity recommendations, intensity-specific accelerometer cut-points are utilized. However, research on accelerometer cut-points for older adults is still scarce. The aim of the study was to generate placement-specific cut-points of ActiGraph GT3X+ activity counts and raw measures of acceleration to determine physical activity intensity in older adults. A further aim was to compare the validity of the generated cut-points for a range of different physical activities. The study was a single experimental trial using a convenience sample. Study participants were 20 adults aged 59 to 73 years. Accelerometers were worn at six different placements (one on each wrist, one on each ankle, and two at the hip) and breath-by-breath indirect calorimetry was used as the reference for energy. The experiment comprised of two parts; a) The first required participants to walk on a treadmill at incremental speeds (3.0-5.0 km·h-1), and b) Five different everyday activities (reading, cleaning, shopping, cycling, aerobics) were staged in the laboratory setting. Accelerometer cut-points (activity counts, raw data) were derived for each of the investigated placements by linear regression using the treadmill part. Performance of the cut-points was assessed by applying the cut-points to the everyday activities. We provide cut-points for six placements and two accelerometer metrics in the specific age group. However, the derived cut-points did not outperform published ones. More research and innovative approaches are needed for improving internal and external validity of research results across populations and age groups.

Prior Knowledge of the Grading Criteria Increases Functional Movement Screen Scores in Youth Soccer Players

ABSTRACT

Bryson, A, Arthur, R, and Easton, C. Prior knowledge of the grading criteria increases Functional Movement Screen scores in youth soccer players. J Strength Cond Res 35(3): 762-768, 2021-We sought to determine whether familiarity with the grading criteria of the Functional Movement Screen (FMS) impacted the outcome score in elite youth soccer players. Thirty-two trained male youth soccer players (aged 17 ± 1 years) participated in a randomized control trial. Subjects were randomly assigned to evenly sized control and experimental groups, who each completed the FMS on 2 separate occasions. Subjects in the experimental group were provided the FMS grading criteria between their first and second screens. Time-synchronized video footage was used to grade the FMS using standardized criteria. Structured interviews were then conducted with selected subjects (n = 4) in the experimental group to establish athletes' perception of the FMS. The experimental group had a large increase in overall FMS score from the first to the second screen in comparison with the control group (Δ2.0 ± 1.0, p < 0.001, d = 1.3). Scores for the deep squat, hurdle step, and rotary stability tests components of the FMS all increased in the experimental group in comparison with the control group (p < 0.05). Thematic analysis of the interview data suggested that the subjects in the experimental group improved their understanding between good and poor technique during the FMS. These findings support the notion that FMS scores are influenced by awareness of the grading criteria. As a consequence, the FMS may not be suitable for objectively predicting injury in youth soccer players.

Activation of the Gluteus Maximus During Performance of the Back Squat, Split Squat, and Barbell Hip Thrust and the Relationship With Maximal Sprinting

ABSTRACT

Williams, MJ, Gibson, N, Sorbie, GG, Ugbolue, UC, Brouner, J, and Easton, C. Activation of the gluteus maximus during performance of the back squat, split squat, and barbell hip thrust and the relationship with maximal sprinting. J Strength Cond Res 35(1): 16-24, 2021-The purpose of this research was to compare muscle activation of the gluteus maximus and ground reaction force between the barbell hip thrust, back squat, and split squat and to determine the relationship between these outcomes and vertical and horizontal forces during maximal sprinting. Twelve, male, team sport athletes (age, 25.0 ± 4.0 years; stature, 184.1 ± 6.0 cm; body mass, 82.2 ± 7.9 kg) performed separate movements of the 3 strength exercises at a load equivalent to their individual 3 repetition maximum. The ground reaction force was measured using force plates and the electromyography (EMG) activity of the upper and lower gluteus maximus and was recorded in each leg and expressed as percentage of the maximum voluntary isometric contraction (MVIC). Subjects then completed a single sprint on a nonmotorized treadmill for the assessment of maximal velocity and horizontal and vertical forces. Although ground reaction force was lower, peak EMG activity in the gluteus maximus was higher in the hip thrust than in the back squat (p = 0.024; 95% confidence interval [CI] = 4-56% MVIC) and split squat (p = 0.016; 95% CI = 6-58% MVIC). Peak sprint velocity correlated with both anterior-posterior horizontal force (r = 0.72) and peak ground reaction force during the barbell hip thrust (r = 0.69) but no other variables. The increased activation of gluteus maximus during the barbell hip thrust and the relationship with maximal running speed suggests that this movement may be optimal for training this muscle group in comparison to the back squat and split squat.

Nitrate-rich beetroot juice offsets salivary acidity following carbohydrate ingestion before and after endurance exercise in healthy male runners

There have been recent calls for strategies to improve oral health in athletes. High carbohydrate diets, exercise induced dehydration and transient perturbations to immune function combine to increase oral disease risk in this group. We tested whether a single dose of nitrate (NO₃^-) would offset the reduction in salivary pH following carbohydrate ingestion before and after an exercise bout designed to cause mild dehydration. Eleven trained male runners (V˙O2max 53 ± 9 ml∙kg^-1∙min^-1, age 30 ± 7 years) completed a randomised placebo-controlled study comprising four experimental trials. Participants ingested the following fluids one hour before each trial: (a) 140 ml of water (negative-control), (b) 140 ml of water (positive-control), (c) 140 ml of NO₃^- rich beetroot juice (~12.4 mmol NO₃^-) (NO₃^- trial) or (d) 140 ml NO₃^- depleted beetroot juice (placebo-trial). During the negative-control trial, participants ingested 795 ml of water in three equal aliquots: before, during, and after 90 min of submaximal running. In the other trials they received 795 ml of carbohydrate supplements in the same fashion. Venous blood was collected before and after the exercise bout and saliva was sampled before and repeatedly over the 20 min following carbohydrate or water ingestion. As expected, nitrite (NO₂^-) and NO₃^- were higher in plasma and saliva during the NO₃^- trial than all other trials (all P<0.001). Compared to the negative-control, salivary-pH was significantly reduced following the ingestion of carbohydrate in the positive-control and placebo trials (both P <0.05). Salivary-pH was similar between the negative-control and NO₃^- trials before and after exercise despite ingestion of carbohydrate in the NO₃^- trial (both P≥0.221). Ingesting NO₃^- attenuates the expected reduction in salivary-pH following carbohydrate supplements and exercise-induced dehydration. NO₃^- should be considered by athletes as a novel nutritional strategy to reduce the risk of developing acidity related oral health conditions.

Development and validation of the Referee Training Activity Questionnaire (RTAQ): Towards a better understanding of the training practices of soccer officials

To develop and assess the validity of the Referee Training Activity Questionnaire (RTAQ), a systematic process was employed: 1) item generation; 2) assessments of content and face validity; and 3) assessments of criterion validity. In stage 1, items were generated following semi-structured interviews with an expert panel (n = 8). Following content analyses, the RTAQ was developed and comprised 3 primary sections (12 sub-sections) assessing: 1) attributes perceived to underpin soccer officiating performance; 2) general training information; and 3) specific training practices. In stage 2, the preliminary RTAQ was assessed for content and face validity by a sample of experts (n = 6). Based upon the content validity index (CVI), content validity was confirmed for 8 sub-sections (CVI ≥ 0.78) with 5 sub-sections being deemed invalid (CVI < 0.78). Various amendments were carried out in accordance with participant feedback. In stage 3, the RTAQ was completed by a cohort of officials (n = 25) who subsequently recorded a detailed training diary. Negligible mean biases, wide 95% LOA, and significant Pearson correlations were observed between the RTAQ and training diaries for most training activities, suggesting the RTAQ holds promise as a useful and effective alternative of acquiring insight into the training practices of soccer officials.

Venous occlusion during blood collection decreases plasma nitrite but not nitrate concentration in humans

BACKGROUND

To maintain vascular tone and blood flow when tissue oxygenation is reduced, nitrite anions are reduced to nitric oxide (NO). From a practical perspective, it is unclear how the application of a tourniquet during blood collection might influence measurement of NO metabolites. Accordingly, this study evaluated the effect of venous occlusion on plasma nitrite and nitrate during venous blood collection.

METHODS

Fifteen healthy participants completed two trials that were preceded by the ingestion of nitrate-rich beetroot juice (BRJ; total of ~8.4 mmol nitrate) or no supplementation (control). In both trials, blood was collected using a venepuncture needle while a tourniquet was applied to the upper arm and using an indwelling intravenous cannula, from the opposing arm. The venepuncture samples were collected at 35 s post occlusion. Changes in the oxygenation of forearm flexor muscles were assessed using near-infrared spectroscopy. Plasma nitrite and nitrate were analysed using gas-phase chemiluminescence.

RESULTS

In the control trial, plasma nitrite was significantly elevated when collected via the cannula (179 ± 67 nM) compared to venepuncture (112 ± 51 nM, P = 0.03). The ingestion of BRJ increased plasma nitrite and values remained higher when sampled from the cannula (473 ± 164 nM) compared to venepuncture (387 ± 136 nM, P < 0.001). Plasma nitrate did not differ between collection methods in either trial (all P > 0.05). The delta changes in total-, deoxy-, and oxy-haemoglobin were all significantly greater during venepuncture sample compared to the cannula sample at the point of blood collection (all P < 0.05).

CONCLUSIONS

Venous occlusion during venepuncture blood collection lowers plasma nitrite concentration, potentially due to localised changes in haemoglobin concentration and/or a suppression of endogenous NO synthesis. Accordingly, the method of blood collection to enable measurements of NO metabolites should be carefully considered and consistently reported by researchers.

How the menstrual cycle and menstruation affect sporting performance: experiences and perceptions of elite female rugby players

OBJECTIVES

To explore athletes' past and current experiences and perceptions of the menstrual cycle in relation to its impact on sporting performance.

METHODS

15 international female rugby players participated in individual semi-structured interviews (age: 24.5±6.2 years). All interviews were recorded and transcribed verbatim, resulting in 37 376 words of text for descriptive and thematic analysis. Inter-rater reliability checks resulted in a concordance of agreement of 83%.

RESULTS

Almost all athletes (93%) reported menstrual cycle-related symptoms. Thirty-three per cent perceived heavy menstrual bleeding and 67% considered these symptoms impaired their performances. Two-thirds of athletes self-medicated to alleviate symptoms. Thematic analysis generated 262 meaning units, 38 themes, 10 categories and 4 general dimensions. The four general dimensions were: (1) symptoms: physiological and psychological menstrual cycle-related symptoms such as dysmenorrhoea, flooding, reduced energy levels, worry, distraction, fluctuating emotions and reduced motivation; (2) impact: perceived impact of menstruation on different aspects of daily lives and performance including negative and neutral responses; (3) resolution: the methods/approaches in dealing with menstruation-related concerns including accepting, or adapting and managing symptoms with self-medication or expert treatment; (4) support: available support and comfortability in discussing menstrual cycle-related issues.

CONCLUSIONS

This study provides the first in-depth insight into athlete's experiences of the menstrual cycle and perceived impact on training and competition. It highlights individual responses to menstrual 'issues' and emphasises the need for clinicians and support staff to undertake menstrual cycle profiling, monitoring and continue to develop awareness, openness, knowledge and understanding of the menstrual cycle.

Effects of Chlorhexidine mouthwash on the oral microbiome

Following a single blind, cross-over and non-randomized design we investigated the effect of 7-day use of chlorhexidine (CHX) mouthwash on the salivary microbiome as well as several saliva and plasma biomarkers in 36 healthy individuals. They rinsed their mouth (for 1 min) twice a day for seven days with a placebo mouthwash and then repeated this protocol with CHX mouthwash for a further seven days. Saliva and blood samples were taken at the end of each treatment to analyse the abundance and diversity of oral bacteria, and pH, lactate, glucose, nitrate and nitrite concentrations. CHX significantly increased the abundance of Firmicutes and Proteobacteria, and reduced the content of Bacteroidetes, TM7, SR1 and Fusobacteria. This shift was associated with a significant decrease in saliva pH and buffering capacity, accompanied by an increase in saliva lactate and glucose levels. Lower saliva and plasma nitrite concentrations were found after using CHX, followed by a trend of increased systolic blood pressure. Overall, this study demonstrates that mouthwash containing CHX is associated with a major shift in the salivary microbiome, leading to more acidic conditions and lower nitrite availability in healthy individuals.

Dietary intake of inorganic nitrate in vegetarians and omnivores and its impact on blood pressure, resting metabolic rate and the oral microbiome

Vegetarian diets are commonly associated with lower blood pressure levels. This has been related to greater consumption of inorganic nitrate, since vegetables are the main source of this anion. Dietary nitrate is reduced to nitrite by commensal bacteria in the mouth, which in turn leads to increased circulatory nitrite availability. Nitrite can form nitric oxide by several pathways promoting a reduction in the vascular tone and lower blood pressure. This study tested whether vegetarians have higher concentrations of nitrite in saliva and plasma, and lower blood pressure and resting metabolic rate (RMR), due to higher intakes of nitrate, compared to omnivores. Following a non-randomized, cross-over and single-blinded design we measured dietary nitrate intake, blood pressure and RMR in young and healthy vegetarians (n = 22) and omnivores (n = 19) with similar characteristics after using placebo or antibacterial mouthwash for a week to inhibit oral bacteria. Additionally, we analyzed salivary and plasma nitrate and nitrite concentrations, as well as the oral nitrate-reduction rate and oral microbiome in both groups. Dietary nitrate intake in vegetarians (97 ± 79 mg/day) was not statistically different (P > 0.05) to omnivores (78 ± 47 mg/day). Salivary and plasma nitrate and nitrite concentrations were similar after placebo mouthwash in both groups (P > 0.05). The oral nitrate-reducing capacity, abundance of oral bacterial species, blood pressure and RMR were also similar between vegetarians and omnivores (P > 0.05). Antibacterial mouthwash significantly decreased abundance of oral nitrate-reducing bacterial species in vegetarians (^_16.9%; P < 0.001) and omnivores (^_17.4%; P < 0.001), which in turn led to a significant reduction of the oral nitrate-reducing capacity in vegetarians (-78%; P < 0.001) and omnivores (-85%; P < 0.001). However, this did not lead to a significant increase in blood pressure and RMR in either groups (P > 0.05). These findings suggest that vegetarian diets may not alter nitrate and nitrite homeostasis, or the oral microbiome, compared to an omnivore diet. Additionally, inhibition of oral nitrite synthesis for a week with antibacterial mouthwash did not cause a significant raise in blood pressure and RMR in healthy, young individuals independent of diet.

The evolution of multiple active site configurations in a designed enzyme

Developments in computational chemistry, bioinformatics, and laboratory evolution have facilitated the de novo design and catalytic optimization of enzymes. Besides creating useful catalysts, the generation and iterative improvement of designed enzymes can provide valuable insight into the interplay between the many phenomena that have been suggested to contribute to catalysis. In this work, we follow changes in conformational sampling, electrostatic preorganization, and quantum tunneling along the evolutionary trajectory of a designed Kemp eliminase. We observe that in the Kemp Eliminase KE07, instability of the designed active site leads to the emergence of two additional active site configurations. Evolutionary conformational selection then gradually stabilizes the most efficient configuration, leading to an improved enzyme. This work exemplifies the link between conformational plasticity and evolvability and demonstrates that residues remote from the active sites of enzymes play crucial roles in controlling and shaping the active site for efficient catalysis.

Interval running with self-selected recovery: Physiology, performance, and perception

This study (1) compared the physiological responses and performance during a high-intensity interval training (HIIT) session incorporating externally regulated (ER) and self-selected (SS) recovery periods and (2) examined the psychophysiological cues underpinning SS recovery durations. Following an incremental maximal exercise test to determine maximal aerobic speed (MAS), 14 recreationally active males completed 2 HIIT sessions on a non-motorised treadmill. Participants performed 12 × 30 s running intervals at a target intensity of 105% MAS interspersed with 30 s (ER) or SS recovery periods. During SS, participants were instructed to provide themselves with sufficient recovery to complete all 12 efforts at the required intensity. A semi-structured interview was undertaken following the completion of SS. Mean recovery duration was longer during SS (51 ± 15 s) compared to ER (30 ± 0 s; p < .001; d = 1.46 ± 0.46). Between-interval heart rate recovery was higher (SS: 19 ± 9 b min^-1; ER: 8 ± 5 b min^-1; p < .001; d = 1.43 ± 0.43) and absolute time ≥90% maximal heart rate (HR_max) was lower (SS: 335 ± 193 s; ER: 433 ± 147 s; p = .075; d = 0.52 ± 0.39) during SS compared to ER. Relative time ≥105% MAS was greater during SS (90 ± 6%) compared to ER (74 ± 20%; p < .01; d = 0.87 ± 0.40). Different sources of afferent information underpinned decision-making during SS. The extended durations of recovery during SS resulted in a reduced time ≥90% HR_max but enhanced time ≥105% MAS, compared with ER exercise. Differences in the afferent cue utilisation of participants likely explain the large levels of inter-individual variability observed.

Salivary nitrite production is elevated in individuals with a higher abundance of oral nitrate-reducing bacteria

Nitric oxide (NO) can be generated endogenously via NO synthases or via the diet following the action of symbiotic nitrate-reducing bacteria in the oral cavity. Given the important role of NO in smooth muscle control there is an intriguing suggestion that cardiovascular homeostasis may be intertwined with the presence of these bacteria. Here, we measured the abundance of nitrate-reducing bacteria in the oral cavity of 25 healthy humans using 16S rRNA sequencing and observed, for 3.5 h, the physiological responses to dietary nitrate ingestion via measurement of blood pressure, and salivary and plasma NO metabolites. We identified 7 species of bacteria previously known to contribute to nitrate-reduction, the most prevalent of which were Prevotella melaninogenica and Veillonella dispar. Following dietary nitrate supplementation, blood pressure was reduced and salivary and plasma nitrate and nitrite increased substantially. We found that the abundance of nitrate-reducing bacteria was associated with the generation of salivary nitrite but not with any other measured variable. To examine the impact of bacterial abundance on pharmacokinetics we also categorised our participants into two groups; those with a higher abundance of nitrate reducing bacteria (> 50%), and those with a lower abundance (< 50%). Salivary nitrite production was lower in participants with lower abundance of bacteria and these individuals also exhibited slower salivary nitrite pharmacokinetics. We therefore show that the rate of nitrate to nitrite reduction in the oral cavity is associated with the abundance of nitrate-reducing bacteria. Nevertheless, higher abundance of these bacteria did not result in an exaggerated plasma nitrite response, the best known marker of NO bioavailability. These data from healthy young adults suggest that the abundance of oral nitrate-reducing bacteria does not influence the generation of NO through the diet, at least when the host has a functional minimum threshold of these microorganisms.

Intra-session and Inter-day Reliability of the Myon 320 Electromyography System During Sub-maximal Contractions

Electromyography systems are widely used within the field of scientific and clinical practices. The reliability of these systems are paramount when conducting research. The reliability of Myon 320 Surface Electromyography System is yet to be determined. This study aims to determine the intra-session and inter-day reliability of the Myon 320 Surface Electromyography System. Muscle activity from fifteen participants was measured at the anterior deltoid muscle during a bilateral front raise exercise, the vastus lateralis muscle during a squat exercise and the extensor carpi radialis brevis (ECRB) muscle during an isometric handgrip task. Intra-session and inter-day reliability was calculated by intraclass correlation coefficient, standard error of measurement and coefficient of variation (CV). The normalized root mean squared (RMS) surface electromyographic signals produced good intra-session and inter-day testing intraclass correlation coefficient values (range: 0.63–0.97) together with low standard error of measurement (range: 1.49–2.32) and CV (range: 95% Confidence Interval = 0.36–12.71) measures for the dynamic-and-isometric contractions. The findings indicate that the Myon 320 Surface Electromyography System produces good to fair reliability when examining intra-session and inter-day reliability. Findings of the study provide evidence of the reliability of electromyography between trials which is essential during clinical testing.

Injury surveillance of female adult Zumba® dancers

BACKGROUND

We sought to describe the patterns of injury and to establish the injury incidence rates associated with Zumba®.

METHODS

Zumba® dancers were invited to complete an anonymous web-based survey containing 13 demographic background and 14 (1 year retrospective) injury history questions. Inclusion criteria stated that the respondents had to be aged 18-64 years and currently involved in group-based classes of Zumba®, either as a registered instructor or class participant. Binomial logistic regression analysis was used to predict the odds of injury during Zumba® and Mann-Whitney Tests were employed to ascertain differences between groups.

RESULTS

The survey response rate was 74%. The final sample of respondents (N.=138; female=100%) included 19 registered instructors and 119 class participants, of which 58% and 16%, respectively, sustained ≥1 injury during Zumba® in the past year. The odds of injury was 7 (95% CI 2-19) times greater (P<0.01) for registered instructors than for class participants. Zumba® dancers had a 17 (95% CI 7-28) % greater (P<0.01) odds of injury for every 1 hour of non-Zumba®-related moderate to vigorous physical activity (MVPA) engagement per week. The injury incidence rate for registered instructors and class participants was 5.7 (95% CI 3.1-8.2) and 3.9 (95% CI 2.5-5.3) injuries per 1000 hours of exposure, respectively.

CONCLUSIONS

Zumba® presents a low risk of injury; for registered instructors, the increased risk of injury is likely due to the high total volume of MVPA participated in weekly.

Salsa dance and Zumba fitness: Acute responses during community-based classes

BACKGROUND

Research interest in both partnered Latin dance and non-partnered Latin-themed aerobic dance has increased in recent years, likely a result of the gaining popularity of these types of instructor-led group classes among the mainstream dance and fitness audiences; however, the efficacy of these activities for the purposes of health promotion currently remains unclear. The purpose of this study was to simultaneously assess the physiological responses and psychological experiences during salsa dance and Zumba fitness in a community sample of physically inactive women.

METHODS

Twenty-four participants, aged 22-56 years, visited the laboratory to perform a graded exercise test for determination of maximal oxygen uptake and maximal heart rate. The participants then attended 2 partnered salsa dance and 2 non-partnered Zumba fitness classes each in a counterbalanced order over a 2-week period. The 1-h classes were taught by certified instructors in established venues in the Royal Borough of Kingston and the surrounding communities of London, UK. Physiological data were collected using a wrist-worn ActiGraph wGT3X+ accelerometer with accompanying heart rate monitor and were processed using previously validated dance-specific techniques. Psychological experiences were measured via the Subjective Exercise Experiences Scale.

RESULTS

There was a significantly higher (p < 0.001) total time spent in moderate-to-vigorous physical activity (51.2 ± 3.1 vs. 32.6 ± 5.9 min), total energy expenditure (411 ± 66 vs. 210 ± 46 kcal), and total step count (6773 ± 556 vs. 4108 ± 781 steps) during Zumba fitness when compared to salsa dance. Significant pre- to post-class improvements in positive well-being (p < 0.01, partial η ² = 0.41) and psychological distress (p < 0.001, partial η ² = 0.72) were simultaneously observed for both salsa dance and Zumba fitness.

CONCLUSION

The acute responses to classes of partnered Latin dance and non-partnered Latin-themed aerobic dance suggest that in physically inactive women participation is indeed efficacious in terms of community-based physical activity and psychosocial health promotion.

The health-enhancing efficacy of Zumba® fitness: An 8-week randomised controlled study

The purpose of this study was to gain a holistic understanding of the efficacy of Zumba® fitness in a community-recruited cohort of overweight and physically inactive women by evaluating (i) its physiological effects on cardiovascular risk factors and inflammatory biomarkers and (ii) its mental health-enhancing effects on factors of health-related quality of life (HRQoL). Participants were randomly assigned to either engagement in one to two 1 h classes of Zumba® fitness weekly (intervention group; n = 10) or maintenance of habitual activity (control group; n = 10). Laboratory assessments were conducted pre- (week 0) and post-intervention (week 8) with anthropometric, physiological, inflammatory and HRQoL data collected. In the intervention group, maximal oxygen uptake significantly increased (P < 0.05; partial η(2) = 0.56) by 3.1 mL · kg(-1) · min(-1), per cent body fat significantly decreased (P < 0.05; partial η(2) = 0.42) by -1.2%, and interleukin-6 and white blood cell (WBC) count both significantly decreased (P < 0.01) by -0.4 pg · mL(-1) (partial η(2) = 0.96) and -2.1 × 10(9) cells · L(-1) (partial η(2) = 0.87), respectively. Large magnitude enhancements were observed in the HRQoL factors of physical functioning, general health, energy/fatigue and emotional well-being. When interpreted in a community-based physical activity and psychosocial health promotion context, our data suggest that Zumba® fitness is indeed an efficacious health-enhancing activity for adults.

Impact of low-volume, high-intensity interval training on maximal aerobic capacity, health-related quality of life and motivation to exercise in ageing men

There is a demand for effective training methods that encourage exercise adherence during advancing age, particularly in sedentary populations. This study examined the effects of high-intensity interval training (HIIT) exercise on health-related quality of life (HRQL), aerobic fitness and motivation to exercise in ageing men. Participants consisted of males who were either lifelong sedentary (SED; N = 25; age 63 ± 5 years) or lifelong exercisers (LEX; N = 19; aged 61 ± 5 years). [Formula: see text] and HRQL were measured at three phases: baseline (Phase A), week seven (Phase B) and week 13 (Phase C). Motivation to exercise was measured at baseline and week 13. [Formula: see text] was significantly higher in LEX (39.2 ± 5.6 ml kg min(-1)) compared to SED (27.2 ± 5.2 ml kg min(-1)) and increased in both groups from Phase A to C (SED 4.6 ± 3.2 ml kg min(-1), 95 % CI 3.1 - 6.0; LEX 4.9 ± 3.4 ml kg min(-1), 95 % CI 3.1-6.6) Physical functioning (97 ± 4 LEX; 93 ± 7 SED) and general health (70 ± 11 LEX; 78 ± 11 SED) were significantly higher in LEX but increased only in the SED group from Phase A to C (physical functioning 17 ± 18, 95 % CI 9-26, general health 14 ± 14, 95 % CI 8-21). Exercise motives related to social recognition (2.4 ± 1.2 LEX; 1.5 ± 1.0 SED), affiliation (2.7 ± 1.0 LEX; 1.6 ± 1.2 SED) and competition (3.3 ± 1.3 LEX; 2.2 ± 1.1) were significantly higher in LEX yet weight management motives were significantly higher in SED (2.9 ± 1.1 LEX; 4.3 ± 0.5 SED). The study provides preliminary evidence that low-volume HIIT increases perceptions of HRQL, exercise motives and aerobic capacity in older adults, to varying degrees, in both SED and LEX groups.