Safety and efficacy of a probiotic cocktail containing P. acidilactici and L. plantarum for gastrointestinal discomfort in endurance runners: randomized double-blinded crossover clinical trial

Probiotics are increasingly used to treat conditions associated with gastrointestinal injury and permeability, including exercise-induced gastrointestinal discomfort. This study assessed safety and efficacy of a probiotic in altering the intestinal milieu and mitigating gastrointestinal symptoms (GIS) in endurance runners. In a double blind, crossover study, 16 runners were randomized to 4 weeks of daily supplementation with a probiotic cocktail containing Pediococcus acidilactici bacteria and Lactobacillus plantarum or placebo. Fasting blood and stool samples were collected for measurement of gut permeability markers, immune parameters, and microbiome analyses. Treadmill run tests were performed before and after treatment; participants ran at 65%-70% of VO2max at 27 °C for a maximum of 90 min or until fatigue/GIS developed. A blood sample was collected after the treadmill run test. In healthy individuals, 4 weeks of probiotic supplementation did not alter health parameters, although a marginal reduction in aspartate aminotransferase levels was observed with probiotic treatment only (p = 0.05). GIS, gut permeability-associated parameters (intestinal fatty acid binding protein, lipopolysaccharide binding protein, zonulin, and cytokines), and intestinal microbial content were not altered by the probiotic supplementation. Post-run measurements of GIS and gut-associated parameters did not differ between groups; however, the observed lack of differences is confounded by an absence of measurable functional outcome as GIS was not sufficiently induced during the run. Under the current study conditions, the probiotic was safe to use, and did not affect gut- or immune-associated parameters, or intestinal symptoms in a healthy population. The probiotic might reduce tissue damage, but more studies are warranted.

Energy cost differences between marathon runners and soccer players: Constant versus shuttle running

Purpose: In the last decades, the energy cost assessment provided new insight on shuttle or constant running as training modalities. No study, though, quantified the benefit of constant/shuttle running in soccer-players and runners. Therefore, the aim of this study was to clarify if marathon runners and soccer players present specific energy cost values related to their training experience performing constant and shuttle running. Methods: To this aim, eight runners (age 34 ± 7.30y; training experience 5.70 ± 0.84y) and eight soccer-players (age 18.38 ± 0.52y; training experience 5.75 ± 1.84y) were assessed randomly for 6' on shuttle-running or constant-running with 3 days of recovery in-between. For each condition, the blood lactate (BL) and the energy cost of constant (C_r) and shuttle running (C_Sh) was determined. To assess differences for metabolic demand in terms of C_r, C_Sh and BL over the two running conditions on the two groups a MANOVA was used. Results: V·O_2max were 67.9 ± 4.5 and 56.8 ± 4.3 ml·min^-1 kg^-1 (p = 0.0002) for marathon runners and soccer players, respectively. On constant running, the runners had a lower C_r compared to soccer players (3.86 ± 0.16 J kg^-1m^-1 vs. 4.19 ± 0.26 J kg^-1 m^-1; F = 9.759, respectively; p = 0.007). On shuttle running, runners had a higher C_Sh compared to soccer players (8.66 ± 0.60 J kg^-1 m^-1 vs. 7.86 ± 0.51 J kg^-1 m^-1; F = 8.282, respectively; with p = 0.012). BL on constant running was lower in runners compared to soccer players (1.06 ± 0.07 mmol L^-1 vs. 1.56 ± 0.42 mmol L^-1, respectively; with p = 0.005). Conversely, BL on shuttle running was higher in runners compared to soccer players 7.99 ± 1.49 mmol L^-1 vs. 6.04 ± 1.69 mmol L^-1, respectively; with p = 0.028). Conclusion: The energy cost optimization on constant or shuttle running is strictly related to the sport practiced.

Perceived Pain in Athletes: A Comparison between Endurance Runners and Powerlifters through a Cold Experimental Stimulation and Two Sessions of Various Physical Activation

Few studies in the literature have illustrated cold hypoalgesia induced by strength training. Objectives of this contribution were to compare the ratings of perceived pain in endurance running (n = 22) and powerlifting (n = 22) male athletes and controls (n = 22) at baseline and after two bouts of 40 min aerobic/strength training respectively, using the Cold Pressor Test (CPT) and simultaneously monitoring changes in blood pressure (BP), heart rate (HR), and body temperature. A two-way repeated measures ANOVA was conducted to examine the effects of training sessions in endurance runners vs. powerlifting athletes vs. controls on the intensity of perceived pain at CPT. A statistically significant two-way interaction between the group and training resulted in p < 0.001, ηp2 = 0.513. A simple main effects analysis showed that as the participants went through the strength training session, pain perception at CPT was significantly lower in powerlifters compared to runners and controls. Considering the physiological parameters, powerlifters reported significantly higher values of BP and HR. This difference was present at baseline but after training as well, and before and after CPT, despite a slight hypotensive effect. The differences reported after CPT at baseline, but very significantly after the strength activation session in the powerlifters, provide interesting insights into the hypoalgesic effect of high-intensity strength training.

Increased Plasma L-Arginine Levels and L-Arginine/ADMA Ratios after Twelve Weeks of Omega-3 Fatty Acid Supplementation in Amateur Male Endurance Runners

It is not fully understood how supplementation with omega-3 fatty acids affects the metabolism of amino acids required for the bioavailability/synthesis of NO, i.e., L-arginine (L-arg), asymmetric dimethylarginine (ADMA), their metabolites, and the L-arg/ADMA ratio and their impact on running economy (RE) in runners. Thus, 26 male amateur endurance runners completed a twelve-week study in which they were divided into two supplemented groups: the OMEGA group (n = 14; 2234 mg and 916 mg of eicosapentaenoic and docosahexaenoic acid daily) or the MCT group (n = 12; 4000 mg of medium-chain triglycerides daily). At the same time, all participants followed an endurance training program. Before and after the 12-week intervention, blood was collected from participants at two time points (at rest and immediately post-exercise) to determine EPA and DHA in red blood cells (RBCs) and plasma levels of L-arg, ADMA, and their metabolites. RBC EPA and DHA significantly increased in the OMEGA group (p < 0.001), which was related to the resting increase in L-arg (p = 0.001) and in the L-arg/ADMA ratio (p = 0.005) with no changes in the MCT group. No differences were found in post-exercise amino acid levels. A total of 12 weeks of omega-3 fatty acid supplementation at a dose of 2234 mg of EPA and 916 mg of DHA daily increased levels of L-arg and the L-arg/ADMA ratio, which indirectly indicates increased bioavailability/NO synthesis. However, these changes were not associated with improved RE in male amateur endurance runners.

Improved Oxygen Uptake Efficiency Parameters Are Not Correlated with VO2peak or Running Economy and Are Not Affected by Omega-3 Fatty Acid Supplementation in Endurance Runners

Peak oxygen uptake (VO_2peak) is one of the most reliable parameters of exercise capacity; however, maximum effort is required to achieve this. Therefore, alternative, and repeatable submaximal parameters, such as running economy (RE), are needed. Thus, we evaluated the suitability of oxygen uptake efficiency (OUE), oxygen uptake efficiency plateau (OUEP) and oxygen uptake efficiency at the ventilatory anaerobic threshold (OUE@VAT) as alternatives for VO_2peak and RE. Moreover, we evaluated how these parameters are affected by endurance training and supplementation with omega-3 fatty acids. A total of 26 amateur male runners completed a 12-week endurance program combined with omega-3 fatty acid supplementation or medium-chain triglycerides as a placebo. Before and after the intervention, the participants were subjected to a treadmill test to determine VO_2peak, RE, OUE, OUEP and OUE@VAT. Blood was collected at the same timepoints to determine eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in erythrocytes. OUE correlated moderately or weakly with VO_2peak (R² = 0.338, p = 0.002) and (R² = 0.226, p = 0.014) before and after the intervention, respectively. There was a weak or no correlation between OUEP, OUE@VAT, VO_2peak and RE despite steeper OUE, increased OUEP and OUE@VAT values in all participants. OUE parameters cannot be treated as alternative parameters for VO_2peak or RE and did not show changes following supplementation with omega-3 fatty acids in male amateur endurance runners.

Aging and Possible Benefits or Negatives of Lifelong Endurance Running: How Master Male Athletes Differ from Young Athletes and Elderly Sedentary?

Regular physical activity, recommended by the WHO, is crucial in maintaining a good physical fitness level and health status and slows down the effects of aging. However, there is a lack of knowledge of whether lifelong endurance running, with a volume and frequency above the WHO limits, still brings the same benefits, or several negative effects too. The present study aims to examine the protentional benefits and risks of lifelong endurance running training in Master male athletes, as this level of physical activity is above the WHO recommendations. Within the study, four main groups of participants will be included: (1) endurance-trained master athletes, (2) endurance-trained young athletes, (3) young sedentary adults, and (4) elderly sedentary. Both groups of athletes are strictly marathon runners, who are still actively running. The broad spectrum of the diagnostic tests, from the questionnaires, physical fitness testing, and blood sampling to muscle biopsy, will be performed to obtain the possibility of complexly analyzing the effects of lifelong endurance physical activity on the human body and aging. Moreover, the study will try to discover and explain new relationships between endurance running and diagnostic parameters, not only within aging.

The Effect of Normobaric Hypoxia in Middle- and/or Long-Distance Runners: Systematic Review

BACKGROUND

The use of normobaric hypoxia can bring benefits to sports performance because it improves haematological parameters and/or physical activity tests. Our objective was to conduct a systematic review so as to analyse the methods used in hypoxia and to detect its effects on middle- and/or long-distance runners.

METHODS

Research was conducted using five electronic databases (PubMed, SportDiscus, Cochrane Library, Scopus and PEDro) until December 2021. The methodological quality of the included studies was assessed using the PEDro scale.

RESULTS

Having analysed 158 studies, 12 were chosen for the qualitative and quantitative synthesis. A significant improvement on time until exhaustion was detected, and oxygen saturation decreased after the intervention. There were no significant changes in the 3000-metre time trial or in the haematocrit percentage. The changes in percentage of reticulocytes, heart rate, maximal heart rate, lactate concentration and erythropoietin were heterogeneous between the different research studies.

CONCLUSION

short exposure (less than 3 h to normobaric hypoxia significantly increases the time to exhaustion). However, longer exposure times are necessary to increase haemoglobin. Altitude and exposure time are highly heterogeneous in the included studies.

Effects of Gradient and Speed on Uphill Running Gait Variability

BACKGROUND

The aim of this study was to investigate the effects of gradient and speed on running variability (RV) and local dynamic stability (LDS) during uphill running.

HYPOTHESES

(1) Both gradient and speed increase metabolic effort, in terms of heart rate (HR) and perceived exertion (CR10), in line with the contemporary literature, and (2) gradient increases RV and impairs LDS.

STUDY DESIGN

"Crossover" observational design.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 25 runners completed 10-minute running trials in 3 different conditions and in a randomized order: gradient at 0% (0CON), 2% (2CON), and 2% at isoefficiency speed (2IES). 0CON and 2CON speeds were calculated as the "best 10-km race performance" minus 1 km·h^-1, whereas 2IES speed was adjusted to induce the same metabolic expenditure as 0CON. HR and perceived exertion as well as running kinematic variables were collected across all trials and conditions. Running variability was calculated as the standard deviation of the mean stride-to-stride intervals over 100 strides, while LDS was expressed by the Lyapunov exponent (LyE) determined on running cycle time over different running conditions.

RESULTS

Increases in HR and CR10 were observed between 0CON and 2CON (P < 0.001) and between 2IES and 2CON (P < 0.01). Higher RV was found in 2CON compared with 0CON and 2IES (both P < 0.001). Finally, the largest LyE was observed in 2IES compared with 0CON and 2CON (P = 0.02 and P = 0.01, respectively).

CONCLUSION

Whereas RV seems to be dependent more on metabolic effort, LDS is affected by gradient to a greater extent.

CLINICAL RELEVANCE

Running variability could be used to monitor external training load in marathon runners.

Effects of Isometric Exercises versus Static Stretching in Warm-up Regimens for Running Sport Athletes: A Systematic Review

The objective of this review was to identify studies that report the pre-exercise effects of isometric exercise versus static stretching on performance and injury rates of running athletes in comparison to their outcomes. Seven electronic databases were searched: Cochrane, PEDro, CINAHL, PubMed, MEDLINE, SportDiscus, and GoogleScholar. Data was collected using an established PICO question, and assembled logic grid. The included articles were required to (1) assess running performance or injury prevention and (2) include isometric exercises/muscle activation and/or static stretching. Articles published prior to the year 2000, non-English, and non-human studies were excluded. Quality was assessed using the PEDro quality appraisal tool for RCTs, and NIH-NHLBI appraisal tool for others. The Cochrane collaboration tool for risk of bias as well as the PRISMA 2020 statement were also used in this review. In the nine articles appraised in the study, variables assessed included running economy, injury rate, soreness levels, sprint times, and countermovement and drop jump height. Static stretching demonstrated a significant negative effect on sprint performance and countermovement/drop jump height. It also demonstrated a decrease in variables associated with injury over extended periods and no impact on running economy. Isometric holds demonstrated no significant effect on sprint performance or countermovement/drop jump height. It also demonstrated decreases in soreness levels and no impact on running economy. Isometric holds have positive effects/fewer negative results on running athletes when compared to static stretching for pre-exercise performance. Research with decreased risk of bias is needed to determine maximal benefits from timing/dosage of isometric hold in warm-up.

Does Arch Stiffness Influence Running Spatiotemporal Parameters? An Analysis of the Relationship between Influencing Factors on Running Performance

This study aimed to determine the influence of arch stiffness on running spatiotemporal parameters at a common speed for a wide range of endurance runners (i.e., 12 km·h⁻¹). In total, 97 runners, 52 men and 45 women, completed a treadmill running protocol at 12 km·h⁻¹. Spatiotemporal parameters were measured using the OptoGait system, and foot structure was assessed by determining arch stiffness. Since between-sex differences were found in anthropometric and foot structure variables, data analysis was conducted separately for men and women, and body mass and height were considered as covariates. For both sexes, a k-means cluster analysis grouped participants according to arch stiffness, by obtaining a group of low-arch stiffness (LAS group) and a group of high-arch stiffness (HAS group), with significant differences in arch stiffness (p < 0.001, for both men and women). No significant differences between LAS and HAS groups were found in running spatiotemporal parameters, regardless of sex (p ≥ 0.05). For both sexes, the partial correlation analysis reported no significant correlations (p ≥ 0.05) between foot structure variables and running spatiotemporal parameters. The results obtained show no differences in spatiotemporal gait characteristics during running at submaximal velocity between runners with low-arch stiffness and those with high-arch stiffness, regardless of sex. These findings may have important implications for clinicians and coaches by adding more evidence to the debate about the use of static foot classification measures when characterizing the foot and its biomechanics during running.

Mechanical Power in Endurance Running: A Scoping Review on Sensors for Power Output Estimation during Running

Mechanical power may act as a key indicator for physiological and mechanical changes during running. In this scoping review, we examine the current evidences about the use of power output (PW) during endurance running and the different commercially available wearable sensors to assess PW. The Boolean phrases endurance OR submaximal NOT sprint AND running OR runner AND power OR power meter, were searched in PubMed, MEDLINE, and SCOPUS. Nineteen studies were finally selected for analysis. The current evidence about critical power and both power-time and power-duration relationships in running allow to provide coaches and practitioners a new promising setting for PW quantification with the use of wearable sensors. Some studies have assessed the validity and reliability of different available wearables for both kinematics parameters and PW when running but running power meters need further research before a definitive conclusion regarding its validity and reliability.

How Do Spatiotemporal Parameters and Lower-Body Stiffness Change with Increased Running Velocity? A Comparison Between Novice and Elite Level Runners

This study aimed to examine the effect of running velocity on spatiotemporal parameters and lower-body stiffness of endurance runners, and the influence of the performance level on those adaptations. Twenty-two male runners (novice [NR], n = 12, and elite runners [ER], n = 10) performed an incremental running test with a total of 5 different running velocities (10, 12, 14, 16, 18 km/h). Each condition lasted 1 min (30 s acclimatization period, and 30 s recording period). Spatiotemporal parameters were measured using the OptoGait system. Vertical (Kvert) and leg (Kleg) stiffness were calculated according to the sine-wave method. A repeated measures ANOVA (2 x 5, group x velocities) revealed significant adaptations (p < 0.05) to increased velocity in all spatiotemporal parameters and Kvert in both NR and ER. ER showed a greater flight time (FT) and step angle (at 18 km/h) (p < 0.05), longer step length (SL) and lower step frequency (SF) (p < 0.05), whereas no between-group differences were found in contact time (CT) nor in the sub-phases during CT at any speed (p ≥ 0.05). ER also showed lower Kvert values at every running velocity (p < 0.05), and no differences in Kleg (p ≥ 0.05). In conclusion, lower SF and Kvert and, thereby, longer FT and SL, seem to be the main spatiotemporal characteristics of high-level runners compared to their low-level counterparts.

Age-Predicted Maximal Heart Rate in Recreational Marathon Runners: A Cross-Sectional Study on Fox's and Tanaka's Equations

Age-based prediction equations of maximal heart rate (HR_max), such as the popular formulas Fox's 220-age, or Tanaka's 208-0.7 × age, have been widely used in various populations. Surprisingly, so far these equations have not been validated in marathon runners, despite the importance of the role of HR_max for training purposes in endurance running. The aim of the present study was to examine the validity of Fox and Tanaka equations in a large sample of women and men recreational marathon runners. Participants (n = 180, age 43.2 ± 8.5 years, VO_2max 46.8 mL/min/kg, finishers in at least one marathon during the last year) performed a graded exercise test on a treadmill, where HR_max was measured. Measured HR_max correlated largely with age in the total sample (r = −0.50, p < 0.001), women (r = −0.60, p < 0.001) and men (r = −0.53, p < 0.001). In women, a large main effect of method on HR_max (p = 0.001, η² = 0.294) was shown with measured HR_max lower than Fox-HR_max (−4.8 bpm; −8.4, −1.3) and Tanaka-HR_max (−4.9 bpm; −8.1, −1.8). In men, a moderate effect of assessment method on HR_max was found (p = 0.001, η² = 0.066) with measured HR_max higher than Fox-HR_max (+2.8; 1.0, 4.6), Tanaka-HR_max higher than Fox-HR_max (+1.2; 0.7, 1.7). Based on these findings, it was concluded that Fox and Tanaka' formulas overestimated HR_max by ~5 bpm in women, whereas Fox underestimated HR_max in men by ~3 bpm. Thus, we recommend the further use of Tanaka's formula in men marathon runners. In addition, exercise physiologists and sport scientists should consider the observed differences among various assessment methods when performing exercise testing or prescribing training program relying on HR.

Comparison of Site-Specific Bone Mineral Densities between Endurance Runners and Sprinters in Adolescent Women

We aimed to compare site-specific bone mineral densities (BMDs) between adolescent endurance runners and sprinters and examine the relationship of fat-free mass (FFM) and nutrient intake on BMD. In this cross-sectional study, 37 adolescent female endurance runners and sprinters (16.1 ± 0.8 years) were recruited. BMD and FFM were assessed by dual-energy X-ray absorptiometry. Nutrient intake and menstrual state were evaluated by questionnaires. After adjusting for covariates, spine and total bone less head (TBLH) BMDs were significantly higher in sprinters than endurance runners (TBLH, 1.02 ± 0.05 vs. 0.98 ± 0.06 g/cm²; spine, 0.99 ± 0.06 vs. 0.94 ± 0.06 g/cm²; p < 0.05). There was no significant difference between groups in other sites. The rate of menstrual abnormality was higher in endurance runners compared with sprinters (56.3% vs. 23.8%; p < 0.05). FFM was a significant covariate for BMD on all sites except the spine (p < 0.05). Dietary intake of vitamin D was identified as a significant covariate only for pelvic BMD (p < 0.05). The BMDs of different sites among endurance runners and sprinters were strongly related to FFM. However, the association of FFM with spine BMD cannot be explained by FFM alone. Other factors, including nutrition and/or mechanical loading, may affect the spine BMD.

Repeated sprint performance and metabolic recovery curves: effects of aerobic and anaerobic characteristics

To examine the influence of aerobic and anaerobic indices on repeated sprint (RS) performance and ability (RSA), 8 sprinters (SPR), 8 endurance runners (END), and 8 active participants (ACT) performed the following tests: (i) incremental test; (ii) 1-min test to determine first decay time constant of pulmonary oxygen uptake off-kinetics and parameters related to anaerobic energy supply, lactate exchange, and removal abilities from blood lactate kinetics; and (iii) RS test (ten 35-m sprints, departing every 20 s) to determine best (RSbest) and mean (RSmean) sprint times and percentage of sprint decrement (%Dec). While SPR had a 98%-100% likelihood of having the fastest RSbest (Cohen's d of 1.8 and 1.4 for ACT and END, respectively) and RSmean (2.1 and 0.9 for ACT and END, respectively), END presented a 97%-100% likelihood of having the lowest %Dec (0.9 and 2.2 for ACT and SPR, respectively). RSmean was very largely correlated with RSbest (r=0.85) and moderately correlated with estimates of anaerobic energy supply (r=-0.40 to -0.49). RSmean adjusted for RSbest (which indirectly reflects RSA) was largely correlated with lactate exchange ability (r=0.55). Our results confirm the importance of locomotor- and anaerobic-related variables to RS performance, and highlight the importance of disposal of selected metabolic by-products to RSA.

Relationships between V̇O2 and blood lactate responses after all-out running exercise

To verify the effects of training status and blood lactate concentration (BLC) responses on the early excess postexercise oxygen consumption (EPOC), 8 sprinters, 7 endurance runners, and 7 untrained subjects performed an incremental test to determine maximal oxygen uptake and a 1-min all-out test to determine BLC and oxygen uptake recovery curves. BLC kinetics was evaluated to assess the quantity of lactate accumulated during exercise (QlaA), lactate removal ability (k2), and quantity of lactate removed from 0 to 10 min postexercise (QlaR). Oxygen uptake off-kinetics was evaluated to assess the decay time constants (τ1 and τ2); moreover, EPOC was measured during the first 10 min after exercise. While sprinters had 98%-100% and 94%-100% likelihood of having the highest EPOC and decay time constants, endurance runners had 98%-100% and 95%-100% likelihood of having the lowest EPOC and decay time constants. EPOC was correlated with QlaA (r = 0.74) and QlaR (r = 0.61). τ1 and τ2 were correlated with maximal oxygen uptake (r > -0.57), k2 (r > -0.48), and QlaR relative to QlaA (r > -0.60). Our findings indicate that oxygen uptake recovery is associated with fast lactate removal and aerobic training. Furthermore, the metabolites derived from anaerobic energy production seem to induce a greater EPOC after all-out exercise.

Genetic aspects of athletic performance: the African runners phenomenon

The current dominance of African runners in long-distance running is an intriguing phenomenon that highlights the close relationship between genetics and physical performance. Many factors in the interesting interaction between genotype and phenotype (eg, high cardiorespiratory fitness, higher hemoglobin concentration, good metabolic efficiency, muscle fiber composition, enzyme profile, diet, altitude training, and psychological aspects) have been proposed in the attempt to explain the extraordinary success of these runners. Increasing evidence shows that genetics may be a determining factor in physical and athletic performance. But, could this also be true for African long-distance runners? Based on this question, this brief review proposed the role of genetic factors (mitochondrial deoxyribonucleic acid, the Y chromosome, and the angiotensin-converting enzyme and the alpha-actinin-3 genes) in the amazing athletic performance observed in African runners, especially the Kenyans and Ethiopians, despite their environmental constraints.