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BACKGROUND: A novel sodium bicarbonate (SB) product has come to market named the "Bicarb System" (M-SB; Maurten AB, Gothenburg, Sweden). It claims to minimise gastrointestinal (GI) discomfort whilst still improving exercise performance. AIM: To investigate the effects of M-SB ingestion on repeated 4 km cycling time trials (TT1 and TT2) in well-trained male cyclists. METHODS: The study recruited ten well-trained cyclists (maximal oxygen uptake ( V Ë O 2 max ): 67 ± 4 ml kg-1 min-1 BM; peak power output (PPO) at V Ë O 2 max : 423 ± 21 W) to take part in this randomised, crossover and double-blinded study. Following one visit to determine V Ë O 2 max , participants completed a second visit to identify individual time to peak blood bicarbonate (HCO3-) (ITTP) in a rested state. Visit three was a familiarisation trial mimicking the experimental procedures. Visits four to seven consisted of completing 2 × 4 km cycling TTs separated by 45 min passive recovery, following one of either: 0.3 g kg-1 BM M-SB, 0.21 g kg-1 BM sodium chloride (placebo; PLA) in vegetarian capsules (size 00), or a control trial (CON). Supplements (M-SB or placebo) were ingested pre-exercise at their respective ITTP. RESULTS: Performance in TT1 was faster in the M-SB condition compared with TT1 in CON (- 5.1 s; p = 0.004) and PLA (- 3.5 s; p < 0.001). In TT2, performance was also significantly faster in the M-SB condition compared with CON (- 4.4 s; p = 0.018) or PLA (- 4.1 s; p = 0.002). Total aggregated GI symptoms were generally low and not significantly different between PLA and the M-SB conditions for a range of symptoms. CONCLUSIONS: The ingestion of M-SB improves repeated 4 km cycling TT performance and the recovery of acid-base balance between bouts, whilst causing minimal GI discomfort.
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INTRODUCTION: Sodium bicarbonate (NaHCO3) ingestion has been found to be ergogenic in high-intensity exercise that ranges from 1 to 10 min; however, limited studies have investigated high-intensity exercise beyond this duration. PURPOSE: The present study aimed to determine the effect of NaHCO3 ingested using a carbohydrate hydrogel delivery system on 40 km time trial (TT) performance in trained male cyclists. METHODS: Fourteen trained male cyclists ingested 0.3 g kg-1 BM NaHCO3 (Maurten AB, Sweden) to determine individualised peak alkalosis, which established time of ingestion prior to exercise. Participants completed a 40 km familiarisation TT, and two 40 km experimental TTs after ingestion of either NaHCO3 or placebo in a randomised, double-blind, crossover design. RESULTS: NaHCO3 supplementation improved performance (mean improvement = 54.14 s ± 18.16 s; p = 0.002, g = 0.22) and increased blood buffering capacity prior to (HCO3- mean increase = 5.6 ± 0.2 mmol L-1, p < 0.001) and throughout exercise (f = 84.82, p < 0.001, pη2 = 0.87) compared to placebo. There were no differences in total gastrointestinal symptoms (GIS) between conditions either pre- (NaHCO3, 22 AU; Placebo, 44 AU; p = 0.088, r = 0.46) or post-exercise (NaHCO3, 76 AU; Placebo, 63 AU; p = 0.606, r = 0.14). CONCLUSION: The present study suggests that ingesting NaHCO3 mini-tablets in a carbohydrate hydrogel can enhance 40 km TT performance in trained male cyclists, with minimal GIS. This ingestion strategy could therefore be considered by cyclists looking for a performance enhancing ergogenic aid.
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Information referenced to the self is retrieved more accurately than information referenced to others, known as the memory self-reference effect. It is unclear, however, whether social context (identity of the other) or task factors alter decision-making processes. In a virtual object allocation task, female participants sorted objects into their own or another's (stranger or mother) basket based on a colour cue. Subsequently, they performed a recognition memory task in which they first indicated whether each object was old or new, and then whether it had been allocated to themselves or to the other. We obtained owner-specific hit rates and false-alarm rates and applied signal detection theory to derive separate recognition sensitivity (d') and recognition criterion parameters (c) for self- and other-owned objects. While there was no clear evidence of a recognition self-reference effect, or a change in sensitivity, participants adopted a more conservative recognition criterion for self- compared with other-owned objects, and particularly when the other-referent was the participant's mother compared with the stranger. Moreover, when discriminating whether the originally presented objects were self- or other-owned, participants were biased toward ascribing ownership to the 'other'. We speculate that these findings reflect ownership-based changes in decisional processing during the recognition memory self-reference paradigm.
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Oxidative stress is a key contributing factor in neurodegeneration, cognitive ageing, cognitive decline, and diminished cognitive longevity. Issues stemming from oxidative stress both in relation to cognition and other areas, such as inflammation, skin health, eye health, and general recovery, have been shown to benefit greatly from antioxidant use. Astaxanthin is a potent antioxidant, which has been outlined to be beneficial for cognitive function both in vitro and in vivo. Given the aforementioned promising effects, research into astaxanthin with a focus on cognitive function has recently been extended to human tissue and human populations. The present critical review explores the effects of astaxanthin on cognitive function and neurodegeneration within human populations and samples with the aim of deciphering the merit and credibility of the research findings and subsequently their potential as a basis for therapeutic use. Implications, limitations, and areas for future research development are also discussed. Key findings include the positive impacts of astaxanthin in relation to improving cognitive function, facilitating neuroprotection, and slowing neurodegeneration within given contexts.
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Antioxidantes , Xantofilas , Humanos , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Xantofilas/farmacologia , Xantofilas/uso terapêutico , Estresse Oxidativo , CogniçãoRESUMO
BACKGROUND: A new commercially available sodium bicarbonate (SB) supplement claims to limit gastrointestinal (GI) discomfort and increase extracellular buffering capacity. To date, no available data exists to substantiate such claims. Therefore, the aim of this study was to measure blood acid-base balance and GI discomfort responses following the ingestion of SB using the novel "Bicarb System" (M-SB). Twelve well-trained male cyclists completed this randomised crossover designed study. Maximal oxygen consumption was determined in visit one, whilst during visits two and three participants ingested 0.3 gâkg-1 BM SB using M-SB (Maurten, Sweden) or vegetarian capsules (C-SB) in a randomised order. Finger prick capillary blood samples were measured every 30 min for pH, bicarbonate (HCO3-), and electrolytes (potassium, chloride, calcium, and sodium), for 300 min. Visual analogue scales (VAS) were used to assess GI symptoms using the same time intervals. RESULTS: Peak HCO3- was 0.95 mmolâL-1 greater following M-SB (p = 0.023, g = 0.61), with time to peak HCO3- achieved 38.2 min earlier (117 ± 37 vs. 156 ± 36 min; p = 0.026, r = 0.67) and remained elevated for longer (p = 0.043, g = 0.51). No differences were observed for any electrolytes between the conditions. Aggregated GI discomfort was reduced by 79 AU following M-SB (p < 0.001, g = 1.11), with M-SB reducing stomach cramps, bowel urgency, diarrhoea, belching, and stomach-ache compared to C-SB. CONCLUSIONS: This is the first study to report that M-SB can increase buffering capacity and reduce GI discomfort. This presents a major potential benefit for athletes considering SB as an ergogenic supplement as GI discomfort is almost eliminated. Future research should determine if M-SB is performance enhancing.
The novel 'Bicarb System' (M-SB) reduced, and almost eliminated the gastrointestinal (GI) discomfort compared to vegetarian capsules (C-SB). The changes in acid-base balance following ingestion of M-SB were significantly greater compared to C-SB. It is unkown if this would translate to increased performance benefits, however, and the next step therefore is to determine the performance responses from M-SB. The increase in HCO3− was sustained >5 mmol L−1 HCO3− for longer with M-SB ingestion versus C-SB. This might suggest there is an "ergogenic window", and ingestion timing could therefore be flexible prior to exercise.
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Enterically coated (ENT) or delayed-release (DEL) capsules may lessen gastrointestinal symptoms (GIS) following acute sodium citrate (SC) ingestion, although the effects on blood acid-base balance are undetermined. Fourteen active males ingested 0.4 g.kg-1 body mass (BM) SC, within gelatine (GEL), DEL and ENT capsules or 0.07 g.kg-1 BM sodium chloride control (CON). Blood acid-base balance and GIS were measured for 4 h. Ingestion form had no significant effect on total GIS experienced (GEL: 2 ± 7; DEL: 1 ± 8; ENT: 1 ± 4 AU). Most (7/14) participants experienced zero symptoms throughout. Peak GIS typically emerged ≤100 min post-ingestion, with a similar time to reach peak GIS between ingestion form (GEL: 36 ± 70; DEL: 13 ± 28; ENT: 15 ± 33 AU). Blood [HCO3-] was significantly higher with ENT versus GEL (ENT: 29.0 ± 0.8; GEL: 28.5 ± 1.1 mmol.L-1, P = 0.037). Acute ingestion of a reduced SC dose elicited minimal GIS, producing significant changes in blood [HCO3-] from rest, irrespective of ingestion form (GEL: 6.0 ± 0.9; DEL: 5.1 ± 1.0; ENT: 6.2 ± 0.8 mmol.L-1). The necessity of individualized ingestion strategies is also challenged, with sustained increases in blood [HCO3-] of ≥4 mmol.L-1 for up to 153 min highlighted. If commencing exercise at peak alkalosis augments subsequent performance above starting at a standardized time point where HCO3- is still elevated remains unclear.
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The aim of this study was to observe the nutritional supplement practices of highly trained swimmers on a national talent pathway, since it is often reported that swimmers engage in widespread supplement use at the elite level. Thus, this study employed a validated supplement intake questionnaire with forty-four swimmers from a high-performance swimming club, which had three distinct talent stages: development (aged 11-14 years, n = 20), age-group (aged 13-17 years, n = 13), and national level (aged ≥ 16 years, n = 11). Ninety-eight percent of the interviewed swimmers reported using at least one supplement, with performance (34%) and recovery (19%) cited as the primary reasons. National swimmers used more total supplements (8.1 ± 3.4 supplements) compared to age-group (4.8 ± 2.0 supplements, p = 0.003, g = 1.17) and development (3.9 ± 1.7 supplements, p < 0.001, g = 1.69) swimmers, mostly because of a greater intake of ergogenic aids (2.4 ± 1.4 supplements vs. age-group: 0.5 ± 0.5 supplements, p < 0.001, g = 1.12; vs. development: 0.1 ± 0.2 supplements, p < 0.001, g = 1.81). Parents/guardians were the primary supplement informants of development swimmers (74%, p < 0.001, V = 0.50), whereas performance nutritionists informed ~50% of supplements used by age-group and national swimmers (p < 0.001, V = 0.51). Based on these results, supplement education and greater focus on basic sport nutrition practices may be required for parents/guardians at the development level. Moreover, further research is needed to support the high number of ergogenic aids used by national swimmers, with the efficacy of these supplements currently equivocal in the applied setting.
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Atletas , Natação , Humanos , Suplementos Nutricionais , Estado Nutricional , Reino UnidoRESUMO
PURPOSE: The use of sodium bicarbonate (SB) as a preexercise ergogenic aid has been extensively studied in short-duration high-intensity exercise. Very few studies have considered the effects of SB ingestion before prolonged high-intensity exercise. The aim of the present study was to determine the effects of a 0.3 g·kg -1 body mass dose of SB ingested before the start of a 16.1-km cycling time trial in cyclists. METHOD: Ten trained male cyclists (age, 31.1 ± 9 yr; height, 1.84 ± 0.05 m; body mass, 82.8 ± 8.5 kg; and VÌO 2peak , 60.4 ± 3.1 mL·kg -1 ·min -1 ) completed this study. Participants ingested 0.3 g·kg -1 in gelatine (SB-G) and enteric capsules (SB-E) 1 wk apart to determine individualized time-to-peak alkalosis for each ingestion form. Using a randomized crossover design, participants then performed simulated 16.1-km time trials after ingestion of SB-G, SB-E, or a placebo. RESULTS: There were significant differences in performance between the SB and placebo ingestion strategies ( f = 5.50, P = 0.014, p η2 = 0.38). Performance time was significantly improved by SB ingestion (mean improvement: 34.4 ± 42.6 s ( P = 0.031) and 40.4 ± 45.5 s ( P = 0.020) for SB-G and SB-E, respectively) compared with the placebo. Gastrointestinal symptoms were lower after SB-E compared with SB-G (36.3 ± 4.5 vs 5.6 ± 3.1 AU, P < 0.001, g = 7.09). CONCLUSIONS: This study demonstrates that increased buffering capacity after acute preexercise SB ingestion can improve endurance cycling time-trial performances. The use of SB could be considered for use in 16.1-km cycling time trials, but further work is required to establish these effects after a preexercise meal.
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Alcalose , Bicarbonato de Sódio , Adulto , Humanos , Masculino , Adulto Jovem , Ciclismo , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Ingestão de AlimentosRESUMO
PURPOSE: Sodium bicarbonate (SB) supplementation can improve exercise performance, but few studies consider how effective it is in female athletes. The aim of the study was to establish the effect of individually timed pre-exercise SB ingestion on 2 km rowing time trial (TT) performance in female athletes. METHODS: Eleven female CrossFit® athletes (mean ± SD age, 29 y ± 4 y, body mass, 64.5 kg ± 7.1 kg, height, 1.7 m ± 0.09 m, peak oxygen uptake [VO2peak], 53.8 ± 5.7 mL·kg-1âmin-1). An initial trial identified individual time-to-peak [HCO3-] following enteric-coated 0.3 g·kg-1 BM SB ingestion. Participants then completed a 2 km TT familiarisation followed by a placebo (PLA) or SB trial, using a randomised cross-over design. RESULTS: The ingestion of SB improved rowing performance (514.3 ± 44.6 s) compared to the PLA (529.9 ± 45.4 s) and FAM trials (522.2 ± 43.1 s) (p = 0.001, pη2 = 0.53) which represents a 2.24% improvement compared to the PLA. Individual time-to-peak alkalosis occurred 102.3 ± 22.1 min after ingestion (range 75-150 min) and resulted in increased blood [HCO3-] of 5.5 ± 1.5 mmolâ L-1 (range = 3.8-7.9 mmolâ L-1). The change in blood [HCO3-] was significantly correlated with the performance improvement between PLA and SB trials (r = 0.68, p = 0.020). CONCLUSIONS: Ingesting a 0.3 g·kg-1 BM dose of enteric-coated SB improves 2 km rowing performance in female athletes. The improvement is directly related to the extracellular buffering capacity even when blood [HCO3-] does not change ≥ 5.0 mmolâ L-1.
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Desempenho Atlético , Esportes Aquáticos , Humanos , Feminino , Adulto , Bicarbonato de Sódio/farmacologia , Atletas , Estudos Cross-Over , Método Duplo-Cego , Suplementos Nutricionais , PoliésteresRESUMO
INTRODUCTION AND OBJECTIVES: Pediatric patients with limited lower extremity mobility may be at increased risk of developing nephrolithiasis due to bone mineral metabolic derangements. This study sought to assess whether nephrolithiasis management and related outcomes differ between ambulatory versus non-ambulatory pediatric patients. METHODS: This was a retrospective review of ambulatory and non-ambulatory pediatric patients with nephrolithiasis from 2010 to 2021 from a single tertiary care center. Demographics, surgical history, stone compositions, and 24-h urine data were reviewed. Adjusted logistic and linear regression models were utilized to assess whether mobility status was associated with nephrolithiasis-related management and outcomes, including: age at first stone; requiring surgical intervention for stones; number of surgeries; stone compositions; urine culture results; and completion of 24-h urine studies. RESULTS: Among 339 pediatric patients with nephrolithiasis, 67 (19.8%) were non-ambulatory. In adjusted analyses, non-ambulatory patients had 3.24 times greater odds of requiring surgical intervention for stones (95% CI: 1.93-6.84; p < 0.0001); among those who required surgery, non-ambulatory patients required an average of 0.82 more surgical interventions (95% CI: 0.35-1.30; p = 0.0008) than ambulatory patients. Additionally, non-ambulatory patients had 5.28 times greater odds of having a positive urine culture at the time of surgery (95% CI: 2.35-14.08; p = 0.0001) and were significantly less likely to undergo 24-h urine studies (OR: 0.35; 95% CI: 0.15-0.83; p = 0.02). Stone composition significantly varied by mobility status, with non-ambulatory patients being significantly more likely to form calcium apatite (OR: 5.1; 95% CI: 2.18-11.93; p = 0.0002) or struvite (OR 3.72; 95% CI: 1.18-11.74; p = 0.03) stones, and significantly less likely to form calcium oxalate stones (OR: 0.19; 95 CI: 0.08-0.47; p = 0.0003). Among all patients, age at first stone occurred at a median age of 13.4 years (IQR: 8.2-16.4) and did not significantly differ by mobility status (p = 0.92). CONCLUSIONS: Patients with limited mobility required surgery for nephrolithiasis at significantly higher rates and had different stone compositions than ambulatory patients. Obtaining a 24-h urine study in patients with comorbidities affecting ambulation was uncommon, compared to ambulatory patients. Similarly to ambulatory patients, pediatric patients with limited mobility who develop nephrolithiasis tend to first present with stones in early adolescence.
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Cálculos Renais , Nefrolitíase , Adolescente , Humanos , Criança , Nefrolitíase/complicações , Nefrolitíase/cirurgia , Cálculos Renais/metabolismo , Oxalato de Cálcio , Estudos Retrospectivos , UrináliseRESUMO
Strict lockdown measures were introduced in response to the COVID-19 pandemic, which caused mass disruption to adolescent swimmers' daily routines. To measure how lockdown impacted nutritional practices in this cohort, three-day photograph food diaries were analysed at three time points: before (January), during (April), and after (September) the first UK lockdown. Thirteen swimmers (aged 15 ± 1 years) from a high-performance swimming club submitted satisfactory food diaries at all time points. During lockdown, lower amounts of energy (45.3 ± 9.8 vs. 31.1 ± 7.7 kcalâkg BMâday-1, p<0.001), carbohydrate (5.4 ± 1.2 vs. 3.5 ± 1.1 gâkg BMâday-1, p<0.001), protein (2.3 ± 0.4 vs. 1.7 ± 0.4 gâkg BMâday-1, p = 0.002), and fat (1.6 ± 0.4 vs. 1.1 ± 0.3 gâkg BMâday-1, p = 0.011) were reported. After lockdown, no nutritional differences were found in comparison compared to before lockdown (energy: 44.0 ± 12.1 kcalâkg BMâday-1; carbohydrate: 5.4 ± 1.4 gâkg BMâday-1; protein: 2.1 ± 0.6 gâkg BMâday-1; fat: 1.5 ± 0.6 g âkg BMâday-1, all p>0.05), despite fewer training hours being completed (15.0 ± 1.4 vs. 19.1 ± 2.2 hâweek-1, p<0.001). These findings highlight the ability of adolescent swimmers to alter their nutrition based on their changing training circumstances when receiving sport nutrition support. However, some individuals displayed signs of suboptimal nutrition during lockdown that were not corrected once training resumed. This warrants future research to develop interactive education workshops that maintain focus and motivation towards optimal nutrition practices in isolated periods away from training.
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COVID-19 , Adolescente , COVID-19/epidemiologia , Carboidratos , Controle de Doenças Transmissíveis , Ingestão de Alimentos , Humanos , PandemiasRESUMO
PURPOSE: To compare the prevalence of vesicoureteral reflux (VUR), febrile urinary tract infection (fUTI), and chronic kidney disease (CKD) among patients with multicystic dysplastic kidney (MCDK) diagnosed by renal scintigraphy (RS) versus follow-up renal ultrasound (RUS) alone. METHODS: This was a retrospective review of patients seen at a tertiary care center from 2010 to 2020 with MCDK diagnosed by RS or follow-up RUS. Differences in the prevalence of VUR, fUTI, and CKD by cohort were assessed using logistic regression analysis, Pearson X2 , and Fisher's Exact tests. Temporal trends in diagnostic methods used (RUS versus RUS + RS) were evaluated using the Cochran-Armitage trend test. RESULTS: One-hundred seventy-two patients were included: 50% (n = 86) underwent RUS + RS and 50% (n = 86) underwent RUS alone to diagnose MCDK. Prevalence of VUR, fUTI, and CKD did not significantly vary between groups. Among patients who had a VCUG, 4.4% had contralateral VUR (1.7% RUS + RS group; 7.4% RUS group; p = 0.19) and 14.5% had at least one fUTI (16.3% RUS + RS group; 12.8% RUS group; p = 0.52). Females were significantly more likely to have at least one fUTI (p = 0.04). Four patients (2.3%) developed CKD, all in the RUS + RS cohort (p = 0.12). Diagnosis of MCDK by RUS versus RUS + RS did not significantly vary over time (p = 0.17). CONCLUSION: Patients with unilateral MCDK confirmed by RS versus RUS alone do not significantly vary in the prevalence of VUR, fUTI, or CKD. Renal scintigraphy studies may not be necessary in unilateral MCDK diagnosis but continue to be used.
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Rim Displásico Multicístico , Insuficiência Renal Crônica , Infecções Urinárias , Refluxo Vesicoureteral , Feminino , Humanos , Lactente , Rim/diagnóstico por imagem , Rim Displásico Multicístico/diagnóstico por imagem , Rim Displásico Multicístico/epidemiologia , Cintilografia , Insuficiência Renal Crônica/epidemiologia , Estudos Retrospectivos , Infecções Urinárias/diagnóstico por imagem , Infecções Urinárias/epidemiologia , Refluxo Vesicoureteral/diagnóstico por imagem , Refluxo Vesicoureteral/epidemiologiaRESUMO
Few data are available that describe how probiotics influence systemic metabolism during endurance exercise. Metabolomic profiling of endurance athletes will elucidate mechanisms by which probiotics may confer benefits to the athlete. In this study, twenty-four runners (20 male, 4 female) were block randomised into two groups using a double-blind matched-pairs design according to their most recent Marathon performance. Runners were assigned to 28-days of supplementation with a multi-strain probiotic (PRO) or a placebo (PLB). Following 28-days of supplementation, runners performed a competitive track Marathon race. Venous blood samples and muscle biopsies (vastus lateralis) were collected on the morning of the race and immediately post-race. Samples were subsequently analysed by untargeted 1H-NMR metabolomics. Principal component analysis (PCA) identified a greater difference in the post-Marathon serum metabolome in the PLB group vs. PRO. Univariate tests identified 17 non-overlapped metabolites in PLB, whereas only seven were identified in PRO. By building a PLS-DA model of two components, we revealed combinations of metabolites able to discriminate between PLB and PRO post-Marathon. PCA of muscle biopsies demonstrated no discernible difference post-Marathon between treatment groups. In conclusion, 28-days of probiotic supplementation alters the metabolic perturbations induced by a Marathon. Such findings may be related to maintaining the integrity of the gut during endurance exercise.
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As a nitric oxide (NO) enhancer, citrulline malate (CM) has recently been touted as a potential ergogenic aid to both resistance and high-intensity exercise performance, as well as the recovery of muscular performance. The mechanism has been associated with enhanced blood flow to active musculature, however, it might be more far-reaching as either ammonia homeostasis could be improved, or ATP production could be increased via greater availability of malate. Moreover, CM might improve muscle recovery via increased nutrient delivery and/or removal of waste products. To date, a single acute 8 g dose of CM on either resistance exercise performance or cycling has been the most common approach, which has produced equivocal results. This makes the effectiveness of CM to improve exercise performance difficult to determine. Reasons for the disparity in conclusions seem to be due to methodological discrepancies such as the testing protocols and the associated test-retest reliability, dosing strategy (i.e., amount and timing), and the recent discovery of quality control issues with some manufacturers stated (i.e., citrulline:malate ratios). Further exploration of the optimal dose is therefore required including quantification of the bioavailability of NO, citrulline, and malate following ingestion of a range of CM doses. Similarly, further well-controlled studies using highly repeatable exercise protocols with a large aerobic component are required to assess the mechanisms associated with this supplement appropriately. Until such studies are completed, the efficacy of CM supplementation to improve exercise performance remains ambiguous.
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Desempenho Atlético , Citrulina/análogos & derivados , Malatos/farmacologia , Substâncias para Melhoria do Desempenho/farmacologia , Citrulina/farmacologia , Suplementos Nutricionais , HumanosRESUMO
The timing of sodium bicarbonate (NaHCO3) supplementation has been suggested to be most optimal when coincided with a personal time that bicarbonate (HCO3-) or pH peaks in the blood following ingestion. However, the ergogenic mechanisms supporting this ingestion strategy are strongly contested. It is therefore plausible that NaHCO3 may be ergogenic by causing beneficial shifts in the strong ion difference (SID), though the time course of this blood acid base balance variable is yet to be investigated. Twelve highly trained, adolescent swimmers (age: 15.9 ± 1.0 years, body mass: 65.3 ± 9.6 kg) consumed their typical pre-competition nutrition 1-3 hours before ingesting 0.3 gâkg BM-1 NaHCO3 in gelatine capsules. Capillary blood samples were then taken during seated rest on nine occasions (0, 60, 75, 90, 105, 120, 135, 150, 165 min post-ingestion) to identify the time course changes in HCO3-, pH, and the SID. No significant differences were found in the time to peak of each blood measure (HCO3-: 130 ± 35 min, pH: 120 ± 38 min, SID: 98 ± 37 min; p = 0.08); however, a large effect size was calculated between time to peak HCO3- and the SID (g = 0.88). Considering that a difference between time to peak blood HCO3- and the SID was identified in adolescents, future research should compare the ergogenic effects of these two individualized NaHCO3 ingestion strategies compared to a traditional, standardized approach.
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Equilíbrio Ácido-Base/fisiologia , Atletas , Bicarbonatos/sangue , Bicarbonato de Sódio/administração & dosagem , Adolescente , Eructação/etiologia , Feminino , Humanos , Concentração de Íons de Hidrogênio , Masculino , Náusea/etiologia , Substâncias para Melhoria do Desempenho/administração & dosagem , Substâncias para Melhoria do Desempenho/efeitos adversos , Substâncias para Melhoria do Desempenho/química , Bicarbonato de Sódio/efeitos adversos , Bicarbonato de Sódio/química , NataçãoRESUMO
BACKGROUND: Hydronephrosis (HN) is the most common abnormality detected on prenatal ultrasound. This study sought to stratify outcomes of patients by severity of prenatal HN with postnatal outcomes. METHODS: This was a retrospective review of patients referred to a tertiary care fetal-maternal clinic with diagnosis of prenatal HN from 2004 to 2019. HN severity was categorized as mild, moderate, or severe. Data were analyzed to determine the association between HN severity and surgical intervention. Decision for surgery was based on factors including history of multiple urinary tract infections, evidence of renal scarring, and/or reduced renal function. Surgery-free survival time was represented by the Kaplan-Meier method, and hazard ratios were calculated using the log-rank test. RESULTS: 131 kidneys among 101 infants were prenatally diagnosed with hydronephrosis; 35.9% had mild HN, 29.0% had moderate HN, and 35.1% had severe HN. 8.5% of patients with mild HN, 26.3% of patients with moderate HN, and 65.2% of patients with severe HN required surgery. Patients with severe HN were 12.2 (95% CI 6.1-24.4; p < 0.001) times more likely to undergo surgery for HN than patients with mild HN and 2.9 (95% CI 1.5-5.3; p = 0.003) times more likely to undergo surgery than patients with moderate HN. Patients with moderate HN were 4.3 times more likely to require surgery than patients with mild HN (95% CI 1.5-12.9; p = 0.01). Median age at surgery was 11.8 months among patients with mild HN (IQR 11.7-14.1 months), 6.6 months among patients with moderate HN (IQR 4.2-16.4 months), and 5.4 months among patients with severe HN (3.7-12.4 months). CONCLUSION: Among this cohort of referrals from a fetal-maternal clinic, severity of HN correlated with increased likelihood of surgical intervention. Continued assessment of patients with prenatal HN should be evaluated to best determine the role of the pediatric urologist in cases of prenatal HN.
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Hidronefrose/diagnóstico por imagem , Hidronefrose/cirurgia , Ultrassonografia Pré-Natal , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Cuidado Pré-Natal , Estudos Retrospectivos , Índice de Gravidade de Doença , Centros de Atenção Terciária , Resultado do TratamentoRESUMO
To compare the bicarbonate kinetics and gastrointestinal (GI) symptom responses between an equal dose of sodium bicarbonate and sodium citrate using delayed-release capsules. Thirteen active males (age 20.5 ± 2.1 y, height 1.8 ± 0.1 m and body mass [BM] 76.5 ± 9.6 kg) consumed either 0.3 g.kg-1 BM sodium bicarbonate, sodium citrate or a placebo, using a double-blind, randomized crossover design. Blood bicarbonate ion (HCO3-) concentration, pH and GI symptoms were measured pre-consumption and every 10 min for 180 min post-consumption. Blood HCO3- concentration (P < 0.001) and pH (P = 0.040) were significantly higher in the sodium bicarbonate condition compared with sodium citrate condition up to 3 h post-consumption. Peak blood HCO3- concentration was significantly higher with the sodium bicarbonate compared with citrate (P < 0.001). Mean GI symptom scores were lower (P = 0.037) for sodium citrate (1.5 ± 1.8 AU) than bicarbonate (2.6 ± 3.1 AU), with considerable inter-individual variability. No GI symptoms were reported following consumption of the placebo. Both substances increase HCO3- values significantly, with sodium bicarbonate causing significantly higher pH and HCO3- values than the same dose of sodium citrate, but results in slightly more severe GI symptoms.
Assuntos
Bicarbonatos/sangue , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/metabolismo , Bicarbonato de Sódio/administração & dosagem , Citrato de Sódio/administração & dosagem , Cápsulas , Estudos Cross-Over , Preparações de Ação Retardada , Método Duplo-Cego , Humanos , Concentração de Íons de Hidrogênio , Masculino , Adulto JovemRESUMO
Introduction: Sodium bicarbonate (NaHCO3) is a well-established nutritional ergogenic aid that is typically ingested as a beverage or consumed in gelatine capsules. While capsules may delay the release of NaHCO3 and reduce gastrointestinal (GI) side effects compared with a beverage, it is currently unclear whether the capsule size may influence acid-base responses and GI symptoms following supplementation. Aim: This study aims to determine the effects of NaHCO3 supplementation, administered in capsules of different sizes, on acid-base responses, GI symptoms, and palatability. Methods: Ten healthy male subjects (mean ± SD: age 20 ± 2 years; height 1.80 ± 0.09 m; weight 78.0 ± 11.9 kg) underwent three testing sessions whereby 0.3 g NaHCO3/kg of body mass was consumed in either small (size 3), medium (size 0), or large (size 000) capsules. Capillary blood samples were procured pre-ingestion and every 10 min post-ingestion for 180 min. Blood samples were analyzed using a radiometer (Radiometer ABL800, Denmark) to determine blood bicarbonate concentration ([ HCO 3 - ]) and potential hydrogen (pH). GI symptoms were measured using a questionnaire at the same timepoints, whereas palatability was recorded pre-consumption. Results: Capsule size had a significant effect on lag time (the time [ HCO 3 - ] changed, T lag) and the timing of peak blood [ HCO 3 - ] (T max). Bicarbonate T lag was significantly higher in the large-sized (28 ± 4 min) compared with the small-sized (13 ± 2 min) capsules (P = 0.009). Similarly, T max was significantly lower in the small capsule (94 ± 24 min) compared with both the medium-sized (141 ± 27 min; P < 0.001) and the large-sized (121 ± 29 min; P < 0.001) capsules. The GI symptom scores were similar for small-sized (3 ± 3 AU), medium-sized (5 ± 3 AU), and large-sized (3 ± 3 AU) capsules, with no significant difference between symptom scores (F = 1.3, P = 0.310). Similarly, capsule size had no effect on palatability (F = 0.8, P = 0.409), with similar scores between different capsule sizes. Conclusion: Small capsule sizes led to quicker T lag and T max of blood [ HCO 3 - ] concentration compared to medium and large capsules, suggesting that individuals could supplement NaHCO3 in smaller capsules if they aim to increase extracellular buffering capacity more quickly.
RESUMO
The remote food photography method, often referred to as "Snap-N-Send" by sport nutritionists, has been reported as a valid method to assess energy intake in athletic populations. However, preliminary studies were not conducted in true free-living conditions, and dietary assessment was performed by one researcher only. The authors, therefore, assessed the validity of Snap-N-Send to assess the energy and macronutrient composition in experienced (EXP, n = 23) and inexperienced (INEXP, n = 25) sport nutritionists. The participants analyzed 2 days of dietary photographs, comprising eight meals. Day 1 consisted of "simple" meals based around easily distinguishable foods (i.e., chicken breast and rice), and Day 2 consisted of "complex" meals, containing "hidden" ingredients (i.e., chicken curry). The estimates of dietary intake were analyzed for validity using one-sample t tests and typical error of estimates (TEE). The INEXP and EXP nutritionists underestimated energy intake for the simple day (mean difference [MD] = -1.5 MJ, TEE = 10.1%; -1.2 MJ, TEE = 9.3%, respectively) and the complex day (MD = -1.2 MJ, TEE = 17.8%; MD = -0.6 MJ, 14.3%, respectively). Carbohydrate intake was underestimated by INEXP (MD = -65.5 g/day, TEE = 10.8% and MD = -28.7 g/day, TEE = 24.4%) and EXP (MD = -53.4 g/day, TEE = 10.1% and -19.9 g/day, TEE = 17.5%) for both the simple and complex days, respectively. Interpractitioner reliability was generally "poor" for energy and macronutrients. The data demonstrate that the remote food photography method/Snap-N-Send underestimates energy intake in simple and complex meals, and these errors are evident in the EXP and INEXP sport nutritionists.