Inflated effect estimates for vitamin D supplementation are driven by common meta-analytical errors.

PURPOSE: Han et al. (J Int Soc Sports Nutr 16:55, 2019) sought to quantify the effects of vitamin D supplementation on strength outcomes among athletes in a meta-analysis. The authors reported a pooled effect size (standardized mean difference; SMD) of -0.75 (95% CI: -1.82 to 0.32, p = 0.17) in favor of supplementation, but the analytical approach was not appropriate for a pooled analysis of randomized controlled trials and the effect sizes were calculated incorrectly. This letter discusses how these issues impact the results and interpretation of the paper, then provides an update on the estimated average effect of vitamin D on strength outcomes in athletes. METHODS: Identified errors included the use of within-group rather than between-group effect size metrics, the use of standard error values in place of standard deviations, and failure to account for correlated observations within the model. The data were reanalyzed after correcting for these common meta-analytic errors. RESULTS: The results of this reanalysis reflect a dramatically smaller and statistically nonsignificant pooled effect estimate of SMD = 0.16 (-0.24 to 0.56, p = 0.43) in favor of supplementation. Further, the model from this reanalysis has more favorable statistical characteristics than the original analysis, as evidenced by a fairly symmetrical funnel plot and a nonsignificant result for Cochrane's Q test (Q = 5.02, p = 0.41). CONCLUSION: In order to disseminate robust information to sports nutrition practitioners and researchers, it is critically important for meta-analyses to produce valid effect estimates that are appropriate for the underlying study designs and calculated without error. This letter highlights common errors to inform the calculation and interpretation of future meta-analyses in sports nutrition.

N of 1: Optimizing Methodology for the Detection of Individual Response Variation in Resistance Training.

Most resistance training research focuses on inference from average intervention effects from observed group-level change scores (i.e., mean change of group A vs group B). However, many practitioners are more interested in training responses (i.e., causal effects of an intervention) on the individual level (i.e., causal effect of intervention A vs intervention B for individual X). To properly examine individual response variation, multiple confounding sources of variation (e.g., random sampling variability, measurement error, biological variability) must be addressed. Novel study designs where participants complete both interventions and at least one intervention twice can be leveraged to account for these sources of variation (i.e., n of 1 trials). Specifically, the appropriate statistical methods can separate variability into the signal (i.e., participant-by-training interaction) versus the noise (i.e., within-participant variance). This distinction can allow researchers to detect evidence of individual response variation. If evidence of individual response variation exists, researchers can explore predictors of the more favorable intervention, potentially improving exercise prescription. This review outlines the methodology necessary to explore individual response variation to resistance training, predict favorable interventions, and the limitations thereof.

The Effects of Intermittent Diet Breaks during 25% Energy Restriction on Body Composition and Resting Metabolic Rate in Resistance-Trained Females: A Randomized Controlled Trial.

The purpose of this study was to examine the effects of intermittent versus continuous energy restriction on body composition, resting metabolic rate, and eating behaviors in resistance-trained females. Thirty-eight resistance-trained females (mean ± standard deviation age: 22.3 ± 4.2 years) were randomized to receive either six weeks of a continuous 25% reduction in energy intake (n = 18), or one week of energy balance after every two weeks of 25% energy restriction (eight weeks total; n = 20). Participants were instructed to ingest 1.8 g protein/kilogram bodyweight per day and completed three weekly supervised resistance training sessions throughout the intervention. There were no differences between groups for changes over time in body composition, resting metabolic rate, or seven of the eight measured eating behavior variables (p > 0.05). However, a significant group-by-time interaction for disinhibition (p < 0.01) from the Three-Factor Eating Questionnaire was observed, with values (± standard error) in the continuous group increasing from 4.91 ± 0.73 to 6.17 ± 0.71, while values in the intermittent group decreased from 6.80 ± 0.68 to 6.05 ± 0.68. Thus, diet breaks do not appear to induce improvements in body composition or metabolic rate in comparison with continuous energy restriction over six weeks of dieting, but may be employed for those who desire a short-term break from an energy-restricted diet without fear of fat regain. While diet breaks may reduce the impact of prolonged energy restriction on measures of disinhibition, they also require a longer time period that may be less appealing for some individuals.

Influence of Resistance Training Proximity-to-Failure on Skeletal Muscle Hypertrophy: A Systematic Review with Meta-analysis.

BACKGROUND AND OBJECTIVE: This systematic review with meta-analysis investigated the influence of resistance training proximity-to-failure on muscle hypertrophy. METHODS: Literature searches in the PubMed, SCOPUS and SPORTDiscus databases identified a total of 15 studies that measured muscle hypertrophy (in healthy adults of any age and resistance training experience) and compared resistance training performed to: (A) momentary muscular failure versus non-failure; (B) set failure (defined as anything other than momentary muscular failure) versus non-failure; or (C) different velocity loss thresholds. RESULTS: There was a trivial advantage for resistance training performed to set failure versus non-failure for muscle hypertrophy in studies applying any definition of set failure [effect size=0.19 (95% confidence interval 0.00, 0.37), p=0.045], with no moderating effect of volume load (p=0.884) or relative load (p=0.525). Given the variability in set failure definitions applied across studies, sub-group analyses were conducted and found no advantage for either resistance training performed to momentary muscular failure versus non-failure for muscle hypertrophy [effect size=0.12 (95% confidence interval -0.13, 0.37), p=0.343], or for resistance training performed to high (>25%) versus moderate (20-25%) velocity loss thresholds [effect size=0.08 (95% confidence interval -0.16, 0.32), p=0.529]. CONCLUSION: Overall, our main findings suggest that (i) there is no evidence to support that resistance training performed to momentary muscular failure is superior to non-failure resistance training for muscle hypertrophy and (ii) higher velocity loss thresholds, and theoretically closer proximities-to-failure do not always elicit greater muscle hypertrophy. As such, these results provide evidence for a potential non-linear relationship between proximity-to-failure and muscle hypertrophy.

Influence of Acute Water Ingestion and Prolonged Standing on Raw Bioimpedance and Subsequent Body Fluid and Composition Estimates.

This study evaluated the influence of acute water ingestion and maintaining an upright posture on raw bioimpedance and subsequent estimates of body fluids and composition. Twenty healthy adults participated in a randomized crossover study. In both conditions, an overnight food and fluid fast was followed by an initial multi-frequency bioimpedance assessment (InBody 770). Participants then ingested 11 mL/kg of water (water condition) or did not (control condition) during a 5-minute period. Thereafter, bioimpedance assessments were performed every 10 minutes for one hour with participants remaining upright throughout. Linear mixed effects models were used to examine the influence of condition and time on raw bioimpedance, body fluids, and body composition. Water consumption increased impedance of the arms but not trunk or legs. However, drift in leg impedance was observed, with decreasing values over time in both conditions. No effects of condition on body fluids were detected, but total body water and intracellular water decreased by ~0.5 kg over time in both conditions. Correspondingly, lean body mass did not differ between conditions but decreased over the measurement duration. The increase in body mass in the water condition was detected exclusively as fat mass, with final fat mass values ~1.3 kg higher than baseline and also higher than the control condition. Acute water ingestion and prolonged standing exert practically meaningful effects on relevant bioimpedance variables quantified by a modern, vertical multi-frequency analyzer. These findings have implications for pre-assessment standardization, methodological reporting, and interpretation of assessments.

Sex Differences May Exist for Performance Fatigue but Not Recovery After Single-Joint Upper-Body and Lower-Body Resistance Exercise.

ABSTRACT: Lewis, MH, Siedler, MR, Lamadrid, P, Ford, S, Smith, T, SanFilippo, G, Waddell, B, Trexler, ET, Buckner, S, and Campbell, BI. Sex differences may exist for performance fatigue but not recovery after single-joint upper-body and lower-body resistance exercise. J Strength Cond Res 36(6): 1498-1505, 2022-This study evaluated sex differences in performance recovery and fatigue during dynamic exercise. Twenty-eight resistance-trained males (n = 16) and females (n = 12) completed a repeated-measures, randomized, parallel-groups design. The protocol consisted of a baseline assessment, a recovery period (4, 24, or 48 hours), and a postrecovery assessment. The assessments were identical consisting of 4 sets of 10 repetition maximum (10RM) bicep curls and 4 sets of 10RM leg extensions to failure. Recovery was quantified as the number of total repetitions completed in the postrecovery bout. Fatigue was quantified as the number of repetitions completed set to set within the session. For analysis, we set the level of significance at p ≤ 0.05. No sex differences in performance recovery were observed across any of the investigated time periods for either exercise modality. Regarding fatigue, significant effects were observed for set (p < 0.001) and sex (p = 0.031) for bicep curls. Repetitions dropped in later sets, and females generally completed a greater number of repetitions than males (8.8 ± 0.5 vs. 7.2 ± 0.5). For leg extension, a significant sex × set interaction was observed (p = 0.003), but post hoc tests revealed these sex differences as marginal. Our results suggest that in dynamic bicep curls and leg extensions, other factors unrelated to sex may be more impactful on performance recovery. To optimize an athlete's desired adaptations, it may be more important to consider other variables unrelated to sex such as volume, perceived exertion, and training history when formulating training prescriptions for single-joint exercises.

Biopsychosocial Effects of Competition Preparation in Natural Bodybuilders.

Bodybuilders are judged on the subjective visual assessment of their muscular size, proportion, and leanness. This case series tracked four drug-free bodybuilders (3 male) during the off-season, pre-competition and recovery phases. This study aimed to comprehensively profile key biopsychosocial changes occurring pre/post competition in a group of British natural bodybuilders. We measured: resting metabolic rate (RMR), body composition (via BIA, ultrasound and sum of 7 skinfolds), lipid profiles, fasted glucose, blood pressure, power output (Wingate), grip strength, and carried out psychometric questionnaires (EAT-26, STAI, BUT) over an eight-month period. Mean weight loss from 5 months (5M) to pre-contest (PRE) was 8.6 ± 4.1 kg, followed by an increase of 7.9 ± 1.6 kg two months post contest (POST). The mean RMR of the cohort was stable from 1899 ± 630 kcal (5M) to 1897 ± 598 kcal (PRE), before decreasing to 1797 ± 242 kcal (POST). Mean peak power declined from 770 ± 113.0 w (5M), to 700.0 ± 134.4 w (PRE), before increasing to 816.0 ± 116.2 w (POST). Competition dieting had no effect on EAT-26 or BUT scores, suggesting no body dysmorphic or eating disorder concerns, although trait anxiety was elevated in three out of the four participants throughout the observation. Many of the biopsychosocial changes that occur to bodybuilders as they prepare for competition return to baseline measurements 2 months post competition.

International society of sports nutrition position stand: caffeine and exercise performance.

Following critical evaluation of the available literature to date, The International Society of Sports Nutrition (ISSN) position regarding caffeine intake is as follows: 1. Supplementation with caffeine has been shown to acutely enhance various aspects of exercise performance in many but not all studies. Small to moderate benefits of caffeine use include, but are not limited to: muscular endurance, movement velocity and muscular strength, sprinting, jumping, and throwing performance, as well as a wide range of aerobic and anaerobic sport-specific actions. 2. Aerobic endurance appears to be the form of exercise with the most consistent moderate-to-large benefits from caffeine use, although the magnitude of its effects differs between individuals. 3. Caffeine has consistently been shown to improve exercise performance when consumed in doses of 3-6 mg/kg body mass. Minimal effective doses of caffeine currently remain unclear but they may be as low as 2 mg/kg body mass. Very high doses of caffeine (e.g. 9 mg/kg) are associated with a high incidence of side-effects and do not seem to be required to elicit an ergogenic effect. 4. The most commonly used timing of caffeine supplementation is 60 min pre-exercise. Optimal timing of caffeine ingestion likely depends on the source of caffeine. For example, as compared to caffeine capsules, caffeine chewing gums may require a shorter waiting time from consumption to the start of the exercise session. 5. Caffeine appears to improve physical performance in both trained and untrained individuals. 6. Inter-individual differences in sport and exercise performance as well as adverse effects on sleep or feelings of anxiety following caffeine ingestion may be attributed to genetic variation associated with caffeine metabolism, and physical and psychological response. Other factors such as habitual caffeine intake also may play a role in between-individual response variation. 7. Caffeine has been shown to be ergogenic for cognitive function, including attention and vigilance, in most individuals. 8. Caffeine may improve cognitive and physical performance in some individuals under conditions of sleep deprivation. 9. The use of caffeine in conjunction with endurance exercise in the heat and at altitude is well supported when dosages range from 3 to 6 mg/kg and 4-6 mg/kg, respectively. 10. Alternative sources of caffeine such as caffeinated chewing gum, mouth rinses, energy gels and chews have been shown to improve performance, primarily in aerobic exercise. 11. Energy drinks and pre-workout supplements containing caffeine have been demonstrated to enhance both anaerobic and aerobic performance.

Post-Exercise Ingestion of Low or High Molecular Weight Glucose Polymer Solution Does Not Improve Cycle Performance in Female Athletes.

ABSTRACT: Mock, MG, Hirsch, KR, Blue, MNM, Trexler, ET, Roelofs, EJ, and Smith-Ryan, AE. Postexercise ingestion of low or high molecular weight glucose polymer solution does not improve cycle performance in female athletes. J Strength Cond Res 35(1): 124-131, 2021-The current study sought to evaluate the effects of postexercise ingestion of a high molecular weight (HMW) glucose polymer solution compared with an isocaloric low molecular weight (LMW) solution or placebo (PLA) on subsequent cycling performance in female athletes. In a randomized, double-blind, placebo-controlled, cross-over design, 10 competitive female cyclists (Mean ± SD; Age = 25.7 ± 5.0 years; V̇o2peak = 49.7 ± 4.3 ml·kg-1·min-1) completed 3 testing sessions separated by 7-10 days. Visits consisted of a ride-to-exhaustion (RTE) at 75% V̇o2peak, followed by immediate consumption of 700 ml containing either: 1.2 g·kg-1 LMW (maltodextrin/dextrose/fructose); 1.2 g·kg-1 HMW (Vitargo); or 0.066 g·kg-1 PLA (noncaloric flavoring). After 2 hours of rest, subjects performed a 15-minute time trial (TT). Respiratory exchange ratio (RER) was assessed via indirect calorimetry during exercise. Total body water (TBW) was measured using bioelectrical impedance to assess fluid balance. When covaried for estrogen, there was no treatment effect on distance (km; p = 0.632) or power output (watts; p = 0.974) during the 15-minute TT. Respiratory exchange ratio was not significantly different during the LMW and HWM TTs (p > 0.999), but both were significantly higher than PLA (p = 0.039, p = 0.001, respectively). Changes in total body water pre-exercise to postexercise were not significantly different between trials (p = 0.777). Despite benefits of HMW on cycling performance previously reported in males, current results demonstrate no ergogenic effect of HMW or LMW in females. Sex differences in substrate utilization may account for the discrepancy, and further research involving performance nutrition for female athletes is merited.

The Acute Effects of a Multi-Ingredient Herbal Supplement on Performance Fatigability: A Double-Blind, Randomized, and Placebo-Controlled Trial.

The purpose of the present study was to examine the acute effects of an herbal supplement containing a 70:30 blend of Rhaponticum carthamoides extract and Rhodiola rosea extract, respectively, on performance fatigability and the affective responses prior to and following exercise. Thirty men (age = 22.3 ± 4.1 years) volunteered for this randomized, placebo-controlled, double-blind, cross-over study. Following familiarization, participants visited the laboratory on three separate occasions where they consumed one 350 mg dose, a 175 mg dose of the supplement plus 175 mg of maltodextrin, or a placebo. Participants completed feeling, arousal, and mood surveys at supplement ingestion and following testing. Ninety minutes following ingestion, participants performed five sets of 30 maximal, concentric, leg extension muscle actions at 180°/sec, with one minute of rest between sets. Peak torque, average torque, and total work were calculated for each set, and the rating of perceived exertion (RPE) was assessed after each set. Data were analyzed with a repeated measures analysis of variance and intent-to-treat approach. For the performance variables, there was no interaction (p ≥ 0.317) or treatment effect (p ≥ 0.660), however, all torque variables decreased across sets and plateaued at sets 4-5, whereas RPE increased across sets (p < 0.001). For the affective responses, there was no interaction (p ≥ 0.781) or treatment effect (p ≥ 0.314); however, participants felt better, had an improved mood, and felt more aroused following testing (p < 0.047). This combination of herbal extracts likely does not acutely influence performance fatigability during high-intensity, repeated muscle actions.

Provision of ready-to-drink protein following bariatric surgery: An evaluation of tolerability, body composition, and metabolic rate.

BACKGROUND & AIMS: It is recommended that patients consume at least 60 g of dietary protein per day to attenuate loss of fat-free mass (FFM) following bariatric surgery. To date, research on the effectiveness and tolerability of protein supplementation in bariatric patients is limited. The purpose of the current study was to determine if provision of 12-weeks of daily protein supplementation was an effective and tolerable method of facilitating higher protein intakes in bariatric surgery patients. A secondary aim was to evaluate the effects of protein supplementation on body composition, metabolic rate, and functional outcomes. An exploratory aim was to compare body composition estimates from bioelectrical impedance spectroscopy and dual-energy x-ray absorptiometry. METHODS: Bariatric surgery patients (n = 49; 88% female) (mean ± standard deviation; Age: 43.7 ± 10.7 yrs; BMI: 51.2 ± 13.7 kg m-2) were provided with either a 12-week supply of ready-to-drink protein shakes (PRO; n = 25) or instructed to follow standard-of-care recommendations (SOC; n = 24) following surgery. Patients completed measures of body composition (fat mass [FM], percent body fat [%BF], FFM; bioelectrical impedance [BIS] and/or dual-energy x-ray absorptiometry [DXA]), resting metabolic rate (RMR; indirect calorimetry), a 30-s chair stand, and 3-day food logs prior to surgery (base), 3-weeks, 12-weeks, and 24-weeks post-surgery. RESULTS: About 80% of all patients achieved the recommended intake of 60 g per day, with no significant differences in protein intake between groups (p < 0.05). Patients in PRO were more likely to increase protein consumption over the course of the entire intervention compared to SOC. Both groups experienced significant decreases in weight, BMI, %BF, FM, FFM, and total body water (TBW) (p < 0.05). The percentage of weight lost as FFM was significantly greater when measured by BIS (39.1%) compared to when measured by DXA (17.8%) (p < 0.05). There was a significant decrease in RMR from base-3 weeks for both groups (p = 0.002; 95% confidence interval [-370.6, -90.7]); there were no significant changes after 3 weeks (p > 0.05). The number of sit-to-stand trials increased at each testing session after the first 3 weeks (p < 0.05). CONCLUSIONS: Patients were able to achieve the recommended 60 g of protein per day post-surgery, but the provision of ready-to-drink protein shakes may help bariatric patients achieve higher post-surgery protein intakes. Both groups experienced significant decreases in weight, BMI, and body composition; results varied depending on the method of body composition used. Changes in FFM measured by BIS may reflect greater changes in TBW as opposed to actual muscle mass. Registered at ClinicalTrials.gov, ID#NCT02951663.

Alterations in Body Composition, Resting Metabolic Rate, Muscular Strength, and Eating Behavior in Response to Natural Bodybuilding Competition Preparation: A Case Study.

Schoenfeld, BJ, Alto, A, Grgic, J, Tinsley, G, Haun, CT, Campbell, BI, Escalante, G, Sonmez, GT, Cote, G, Francis, A, and Trexler, ET. Alterations in body composition, resting metabolic rate, muscular strength, and eating behavior in response to natural bodybuilding competition preparation: A case study. J Strength Cond Res 34(11): 3124-3138, 2020-We carried out a prospective case study in a high-level amateur natural male bodybuilder throughout preparation for 4 competitions and during the ensuing postcontest recovery period. Laboratory testing was conducted monthly over a 1-year period, which included the following assessments: B-mode ultrasound evaluation of muscle thickness (MT), multifrequency bioelectrical impedance analysis, blood pressure and heart rate assessment, resting metabolic rate via indirect calorimetry, skinfold testing, vertical jump height, isometric lower-body strength testing, and a 3-factor eating questionnaire. Blood work (including testosterone, thyroid hormone, sex hormone binding globulin, glomerular filtration rate, blood urea nitrogen, aspartate aminotransferase, alanine aminotransferase, white blood count, albumin to globulin ratio, and lipoprotein A) was obtained separately from an outside laboratory at 4 time points. We also assessed the effectiveness of a carbohydrate (carb) deplete and carb load peaking strategy employed immediately before competition. The subject employed a high-volume, high-frequency, whole-body training program throughout the study period. Average daily nutritional intakes ranged from 1,953 to 3,415 kcal: 104-386 g carb; 253-263 g protein, and; 57-95 g lipid. Body fat was reduced to very low levels (∼5%) immediately before competition, but this corresponded with a loss of lean mass. Alterations in metabolism, hormonal status, explosive strength, and psychological aspects of eating were observed during precontest preparation; however, all of these variables recovered quickly postcompetition. The implementation of a carb depleteand carb load peaking strategy acutely increased MT and thus may be a viable precontest approach to maximize muscular aesthetics.

Nutritional Recommendations for Physique Athletes.

The popularity of physique sports is increasing, yet there are currently few comprehensive nutritional guidelines for these athletes. Physique sport now encompasses more than just a short phase before competition and offseason guidelines have recently been published. Therefore, the goal of this review is to provide an extensive guide for male and female physique athletes in the contest preparation and recovery period. As optimal protein intake is largely related to one's skeletal muscle mass, current evidence supports a range of 1.8-2.7 g/kg. Furthermore, as a benefit from having adequate carbohydrate to fuel performance and activity, low-end fat intake during contest preparation of 10-25% of calories allows for what calories remain in the "energy budget" to come from carbohydrate to mitigate the negative impact of energy restriction and weight loss on training performance. For nutrient timing, we recommend consuming four or five protein boluses per day with one consumed near training and one prior to sleep. During competition periods, slower rates of weight loss (≤0.5% of body mass per week) are preferable for attenuating the loss of fat-free mass with the use of intermittent energy restriction strategies, such as diet breaks and refeeds, being possibly beneficial. Additionally, physiological and psychological factors are covered, and potential best-practice guidelines are provided for disordered eating and body image concerns since physique athletes present with higher incidences of these issues, which may be potentially exacerbated by certain traditional physique practices. We also review common peaking practices, and the critical transition to the post-competition period.

Effects of Citrulline Supplementation on Exercise Performance in Humans: A Review of the Current Literature.

Gonzalez, AM and Trexler, ET. Effects of citrulline supplementation on exercise performance in humans: A review of the current literature. J Strength Cond Res 34(5): 1480-1495, 2020-L-citrulline, a nonessential amino acid found primarily in watermelon, has recently garnered much attention for its potential to augment L-arginine bioavailability, nitric oxide production, and exercise performance. Over the past decade, L-citrulline has received considerable scientific attention examining potentially ergogenic properties for both aerobic and anaerobic exercise performance. Thus, the purpose of this article is to summarize the theoretical rationale behind L-citrulline supplementation and to comprehensively review the available scientific evidence assessing the potential ergogenic value of L-citrulline supplementation on vascular function and exercise performance in humans. In addition, research that has investigated the potential synergistic effects of L-citrulline with other dietary ingredients (e.g., arginine, antioxidants, nitrates, and branched-chain amino acids) is reviewed. Oral L-citrulline and citrulline malate supplementation have shown to increase plasma citrulline and arginine concentrations, along with total nitrate and nitrite concentrations. Although blood flow enhancement is a proposed mechanism for the ergogenic potential of L-citrulline, evidence supporting acute improvements in vasodilation and skeletal muscle tissue perfusion after supplementation is scarce and inconsistent. Nevertheless, several studies have reported that L-citrulline supplementation can enhance exercise performance and recovery. Given the positive effects observed from some investigations, future studies should continue to investigate the effects of both acute and chronic supplementation with L-citrulline and citrulline malate on markers of blood flow and exercise performance and should seek to elucidate the mechanism underlying such effects.

Impact of resistance training program configuration on the circulating brain-derived neurotrophic factor response.

This study examined the acute and resting changes of brain-derived neurotrophic factor (BDNF) and inteleukin-6 (IL-6) and if changes in these biomarkers were correlated during resistance training (RT). Fifteen men with ≥2 years of RT experience (age: 23 ± 3 years, body mass: 84.4 ± 12.3 kg) participated. Subjects performed RT 3×/week for 6 weeks in either a high-repetition (HR; n = 8) or low-repetition (LR; n = 7) group. Protocols during week 1 were HR - Monday: 4 (sets) × 12 (repetitions) at 60% of 1-repetition maximum, Wednesday: 4 × 10 at 65%, Friday: 5 × 8 at 70%; LR - Monday: 8 × 6 at 75%, Wednesday 9 × 4 at 80%, Friday: 10 × 2 at 85%. Total volume was equated for the 6 weeks but not for individual sessions. Greater volume and intensity were performed in LR versus HR (p < 0.01) on Mondays. Plasma was collected immediately before and after exercise of the Monday session. There were no significant interactions or main effects for BDNF (p > 0.05). There was a moderate between-group effect size (0.57) in favor of LR in week 6, suggesting a potentially greater acute increase in BDNF in LR versus HR. For IL-6, a statistically significant main effect was observed for training (p < 0.0001), showing an acute increase in IL-6 in both weeks (p < 0.01); however, no other 3-way or 2-way interactions existed (p > 0.05). A minimum volume threshold of RT may be needed to induce acute elevations in BDNF. Novelty A minimum RT volume threshold may be needed to elicit BDNF. A close proximity to failure may be needed to elicit BDNF. BDNF and IL-6 did not correlate.

Effects of Citrulline Malate and Beetroot Juice Supplementation on Energy Metabolism and Blood Flow During Submaximal Resistance Exercise.

The ergogenic effects of citrulline malate (CitMal) and beetroot juice (BEET) have been widely studied, but their effects on physiological outcomes related to resistance exercise are not fully understood. The purpose of this randomized, double-blind, crossover study was to investigate the effects of CitMal (8 g) and BEET (400 mg nitrate) on blood pressure (BP), blood flow, and energy efficiency during submaximal leg extension. Recreationally active males (n = 27; age: 22 ± 4 yrs) completed familiarization, followed by three testing visits. Supine and standing BP were measured upon arrival, followed by supplement ingestion, a 2-h rest period, postsupplement BP measurement, and a bout of repeated submaximal isotonic leg extensions at 25% of maximal voluntary contraction torque. Diameter (aDIAM) and blood flow (aBF) of the superficial femoral artery, and cross-sectional area (CSA) and echo intensity (EI) of the vastus lateralis, were measured before and after exercise via ultrasonography. Muscle blood flow (mBF) and oxygen consumption (mVO2), along with whole-body energy expenditure (EE) and respiratory exchange ratio (RER), were measured before and during exercise via indirect calorimetry and near-infrared spectroscopy. Baseline RER values differed among treatments (p = 0.01); BEET was higher than CitMal (p = 0.01) but not PLA (p = 0.58); CitMal and PLA were not significantly different (p = 0.12). No other measurements were significantly affected by treatment (all p > 0.05). Results suggest that neither CitMal nor BEET significantly influence resting BP, blood flow, or metabolic efficiency during submaximal leg extension in recreationally active males.

Physiological, Psychological and Performance-Related Changes Following Physique Competition: A Case-Series.

The purpose of this case-series was to evaluate the physiological, psychological and performance-related changes that occur during the postcompetition period. Participants included three male (34.3 ± 6.8 years, 181.6 ± 8.9 cm) and four female (29.3 ± 4.9 years, 161.4 ± 6.0 cm) natural physique athletes. Body composition (fat mass (FM) and fat-free mass (FFM); Skinfold), resting metabolic rate (RMR; indirect calorimetry), total body water (TBW; bioelectrical impedance analysis), sleep quality (PSQI; Pittsburgh Sleep Quality Index), quality of life measures (RAND SF36), menstrual irregularities, and knee extension performance were assessed 1-2 weeks prior to competition, and 4 weeks and 8-10 weeks postcompetition. Blood hormones (free triiodothyronine; T3, free thyroxine; T4, and leptin) were assessed at 1-2 weeks prior to competition and 8-10 weeks postcompetition. Participants tracked daily macronutrient intake daily for the duration of the study. Group-level data were analyzed using exploratory, one-tailed, nonparametric statistical tests. Bodyweight, FM, bodyfat%, RMR, and blood hormones (T3, T4, and leptin) increased significantly (p < 0.05) at the group level. Relative (%Δ) increases in fat mass were associated with △RMR (τ = 0.90; p = 0.001) and △leptin (τ = 0.68; p = 0.02), and △leptin was associated with △RMR (τ = 0.59; p = 0.03). The time course for recovery appears to vary substantially between individuals potentially due to strategies implemented postcompetition.

Visceral adipose tissue normative values in adults from the United States using GE Lunar iDXA.

OBJECTIVES: To create normative data for visceral adipose tissue (VAT) derived from the GE Lunar iDXA specific to sex and age cohorts for adults in the United States (US). METHODS: A cross-sectional analysis of 649 adults were evaluated [Mean ± SD (Range): Males: n = 351; Age = 33·2 ± 17·4 years (18-75 years); Body mass index (BMI) = 26·5 ± 5·4 kg·m-2 (17·5-44·2 kg·m-2 ); Females: n = 298; Age = 28·5 ± 14·3 years (18·0-75·0 years); BMI=25·8 ± 6·9 kg·m-2 (17·9-54·8 kg·m-2 )]. From a total body dual-energy X-ray absorptiometry (DXA) scan, VAT mass (kg) and volume (cm3 ) were quantified from the software-delineated region-of-interest. The relationship between VAT and age was evaluated using regression analysis. Separate VAT percentiles were stratified by age range (18-19 years; 20-24 years; 25-50 years; 50+ years) for males and females. RESULTS: In both males and females, there was a positive, non-linear relationship between VAT and age (R2  = 0·47-0·49; P<0·0001). In males, the 50th percentile for VAT mass and volume, stratified by age was: 18-19 years (0·18 kg; 185·67 cm3 ), 20-24 years (0·25 kg; 261·21 cm3 ), 25-49 years (0·71 kg; 746·27 cm3 ) and 50+ years (1·62 kg; 1708·36 cm3 ). In females, the 50th percentile for VAT mass and volume, stratified by age was: 18-19 years (0·04 kg; 44·90 cm3 ), 20-24 years (0·06 kg; 59·57 cm3 ), 25-49 years (0·55 kg; 579·28 cm3 ) and 50+ years (1·21 kg; 1284·59 cm3 ). CONCLUSION: These normative values provide a reference for VAT mass and volume in US adults 18-75 years of age obtained using the GE Lunar iDXA. Measures of VAT provide important information about metabolic and cardiovascular health risk beyond that of BMI and per cent body fat.

Effects of Citrulline Malate and Beetroot Juice Supplementation on Blood Flow, Energy Metabolism, and Performance During Maximum Effort Leg Extension Exercise.

Trexler, ET, Keith, DS, Schwartz, TA, Ryan, ED, Stoner, L, Persky, AM, and Smith-Ryan, AE. Effects of citrulline malate and beetroot juice supplementation on blood flow, energy metabolism, and performance during maximum effort leg extension exercise. J Strength Cond Res 33(9): 2321-2329, 2019-Citrulline malate (CitMal) and beetroot juice (BEET) are increasingly popular ergogenic aids, but few studies have rigorously investigated their effects on resistance exercise performance and underlying mechanisms. The current randomized, double-blind, crossover study evaluated the effects of CitMal and BEET supplementation on blood flow, metabolic efficiency, and performance during maximal isokinetic leg extension exercise. After familiarization, 27 recreationally active men (age: 22 ± 4 years) completed 3 visits in which subjects ingested a treatment beverage (CitMal [8 g], BEET [400-mg nitrate], or placebo [PLA]), followed by a 2-hour rest period, warm-up, and 5 sets of 30 concentric leg extensions. Before and after exercise, ultrasound was used to measure diameter (aDIAM) and blood flow (aBF) of the superficial femoral artery, along with cross-sectional area and echo intensity of the vastus lateralis. Plasma analytes (lactate, nitrate/nitrite [NOx], and urea nitrogen [BUN]) were also assessed at these times, and indirect calorimetry was used to measure energy expenditure and respiratory exchange ratio before and during exercise. Resting NOx values were higher in BEET (233.2 ± 1.1 µmol·L) compared with CitMal (15.3 ± 1.1, p < 0.0001) and PLA (13.4 ± 1.1, p < 0.0001). Postexercise NOx values, adjusted for resting differences, were higher in BEET (86.3 ± 1.2 µmol·L) than CitMal (21.3 ± 1.1, p < 0.0001) and PLA (18.1 ± 1.1, p < 0.0001). No other variables were affected by treatment (all p > 0.05). While BEET increased NOx, neither treatment was found to enhance performance, blood flow, metabolic efficiency, nor the hormonal response to leg extension exercise.