Antioxidant-rich foods and response to altitude training: A randomized controlled trial in elite endurance athletes.

High doses of isolated antioxidant supplements such as vitamin C and E have demonstrated the potential to blunt cellular adaptations to training. It is, however, unknown whether intake of high doses of antioxidants from foods has similar effects. Hence, the aim of the study was to investigate whether intake of antioxidant-rich foods affects adaptations to altitude training in elite athletes. In a randomized controlled trial, 31 national team endurance athletes (23 ± 5 years) ingested antioxidant-rich foods (n = 16) or eucaloric control foods (n = 15) daily during a 3-week altitude training camp (2320 m). Changes from baseline to post-altitude in hemoglobin mass (Hbmass ; optimized CO rebreathing), maximal oxygen uptake (VO2max ; n = 16) or 100 m swimming performance (n = 10), and blood parameters were compared between the groups. The antioxidant group significantly increased total intake of antioxidant-rich foods (~118%) compared to the control group during the intervention. The total study population improved VO2max by 2.5% (1.7 mL/kg/min, P = .006) and Hbmass by 4.7% (48 g, P < .001), but not 100 m swimming performance. No difference was found between the groups regarding changes in Hbmass , VO2max or swimming performance. However, hemoglobin concentration increased more in the antioxidant group (effect size = 0.7; P = .045) with a concomitantly larger decrease in plasma and blood volumes compared to control group. Changes in ferritin and erythropoietin from pre- to post-altitude did not differ between the groups. Doubling the intake of antioxidant-rich foods was well tolerated and did not negatively influence the adaptive response to altitude training in elite endurance athletes.

[The flexibility of family medicine]. / La flexibilité en médecine générale.

We are a European academic group of family doctors and we propose a definition of flexibility in family medicine. A review of the literature shows that flexibility and complexity are emerging concepts in the field of family practice. The outcomes of a workshop at the WONCA-Europe congress in 2014 are discussed. The flexibility is a capability of the general practitioner to deal with complex clinical situations in a biomedical and societal changing world. Flexibility is framed by ethics. It could improve the quality of care, be useful against burnout and used in medical research. In conclusion, family medicine should adopt a specific definition of the flexibility describing its specificity, a useful and teachable capacity.

Extracts of dietary plants are efficient modulators of nuclear factor kappa B.

Convincing evidence suggest that a plant-based diet is associated with a reduced risk of several chronic diseases, but the mechanisms for this association is not fully elucidated. The transcription factor nuclear factor kappa B (NF-kappa B) plays a critical role in cellular stress-, immune- and inflammatory responses. Also, NF-kappa B is identified as a promising therapeutic target both in cancer and chronic inflammation. We used monocytes stably transfected with a NF-kappa B-luciferase reporter construct in a screening of plant extracts for NF-kappa B modulators. Our aim was to identify dietary components which could induce basal NF-kappa B activity to produce a preconditioning effect, or inhibit induction of disease related NF-kappa B activity. When screening 34 dietary plants for their ability to induce basal NF-kappa B activity or inhibit lipopolysaccharide induced NF-kappa B activity we observed that 23 dietary plant extracts induced basal NF-kappa B activity, while 15 extracts attenuate induced NF-kappa B activation. These results indicate that dietary plants contain compounds that efficiently modulate NF-kappa B activity. We suggest dietary modulation of NF-kappa B may contribute to the observed beneficial effects of dietary plants on the risk of chronic diseases.