24-h passive heat and cold exposures did not modify energy intake and appetite but strongly modify food reward.

Effects of acute thermal exposures on appetite appear hypothetical in reason of very heterogeneous methodologies. The aim of this study was therefore to clearly define the effects of passive 24-h cold (16°C) and heat (32°C) exposures on appetitive responses compared to a thermo neutral condition (24°C). Twenty-three healthy, young, and active male participants realised three sessions (from 1 pm) in a laboratory conceived like an apartment dressed with the same outfit (Clo=1). Three meals composed of three or four cold or warm dishes were served ad libitum to assess energy intake (EI). Leeds Food Preference Questionnaires were used before each meal to assess food reward. Subjective appetite was regularly assessed and levels of appetitive hormones (acylated ghrelin, GLP-1, leptin, and PYY) were assessed before and after the last meal (lunch). Contrary to the literature, total EI was not modified by cold or heat exposure (p=0.120). Accordingly, hunger scores (p=0.554) were not altered. Levels of acylated ghrelin and leptin were marginally higher during the 16 (p=0.032) and 32°C (p<0.023) sessions, respectively. Interestingly, implicit wanting for cold and low-fat foods at 32°C and for warm and high-fat foods at 16°C were increased during the whole exposure (p < 0.024). Moreover, cold entrées were more consumed at 32 °C (p<0.062) and warm main dishes more consumed at 16°C (p<0.025). Thus, passive cold and hot exposures had limited effects on appetite and it seems that offering some choice based on food temperature may help individuals to express their specific food preferences and maintain EI.

Relationship between Habitual Caffeine Consumption, Attentional Performance, and Individual Alpha Frequency during Total Sleep Deprivation.

(1) Background: Caffeine is a psychostimulant that is well known to mitigate the deleterious effects of sleep debt. Our aim was to assess the effects of acute caffeine intake on cognitive vulnerability and brain activity during total sleep deprivation (TSD), taking into account habitual caffeine consumption. (2) Methods: Thirty-seven subjects were evaluated in a double-blind, crossover, total sleep deprivation protocol with caffeine or placebo treatment. Vigilant attention was evaluated every six hours during TSD using the psychomotor vigilance test (PVT) with EEG recordings. The influence of habitual caffeine consumption was analyzed by categorizing subjects into low, moderate, and high consumers. (3) Results: The PVT reaction time (RT) increased during TSD and was lower in the caffeine condition vs. the placebo condition. The RT was shorter in the low-caffeine consumers compared to moderate and high consumers, regardless of conditions and treatments. The TSD-related increase in EEG power was attenuated by acute caffeine intake independently of habitual caffeine consumption, and the individual alpha frequency (IAF) was lower in the high-consumption group. The IAF was negatively correlated with daytime sleepiness. Moreover, a correlation analysis showed that the higher the daily caffeine consumption, the higher the RT and the lower the IAF. (4) Conclusions: A high level of habitual caffeine consumption decreases attentional performance and alpha frequencies, decreasing tolerance to sleep deprivation.

Appropriateness of indirect markers of muscle damage following lower limbs eccentric-biased exercises: A systematic review with meta-analysis.

PURPOSE: The aim of this review was to (1) characterize the time-course of markers of exercise-induced muscle damage (EIMD) based on the level of maximal voluntary contraction torque loss at 24-48h post-exercise (MVCloss24-48h), (2) identify factors (e.g., exercise and population characteristics) affecting the level of MVCloss24-48h, and (3) evaluate the appropriateness of EIMD markers as indicators of MVCloss24-48h. METHODS: Magnitude of change of each EIMD markers was normalized using the standardized mean differences method to compare the results from different studies. Time-course of EIMD markers were characterized according to three levels of MVCloss24-48h based on a clustering analysis of the 141 studies included. Association between MVCloss24-48h levels and participant´s characteristics or exercise type/modalities were assessed. Meta-regressions were performed to investigate the associations between MVCloss24-48h and EIMD markers changes at <6h, 24h, 48h, 72h and >96h after exercise. RESULTS: Time-course of EIMD markers recovery differs between levels of MVCloss24-48h. Training status and exercise type/modality were associated with MVCloss24-48h level (p<0.05). MVCloss24-48h was correlated to changes in myoglobin concentration (<6h), jump height (24h) and range of motion (48h) (p<0.001). CONCLUSION: As the exercise could differently affect markers as function of the EIMD severity (i.e., MVCloss24-48h levels), different markers should be used as function of the timing of measurement. Mb concentration should be used during the first hours after the exercise (<6h), whereas jump height (24h) and range of motion (48h) could be used as surrogate for maximal voluntary contraction later. Moreover, training status and exercise type/modality could influence the magnitude of MVCloss24-48h.

The impact of 16-h heat exposure on appetite and food reward in adults.

Heat exposure is thought to reduce energy intake (EI) but studies are sparse and results not always concordant. The aim of this study was to examine whether a 16-h exposure to 32 °C leads to reduced EI compared to a control session (22 °C) and whether modifications in appetite sensations or food reward are implied. Sixteen healthy, lean, and active participants (9 women and 7 men, 25 ± 5 yo, body mass index: 22.0 ± 2.4 kg m-2) were passively exposed to two different thermal temperatures from 4:00 p.m. to 8:00 a.m. under controlled conditions. Hunger and thirst scores were regularly assessed using visual analogue scales. A fixed dinner meal (3670 ± 255 kJ) was consumed at 7:30 p.m. and an ad libitum breakfast buffet (20 foods/drinks varying in temperature, fat, and carbohydrate content) at 7:30 a.m. Components of reward (explicit liking [EL] and implicit wanting [EI]) for fat and sweet properties of food were assessed before each meal using the Leeds Food Preference Questionnaire (LFPQ). Ad libitum EI at breakfast did not differ between sessions (2319 ± 1108 vs 2329 ± 1141 kJ, in 22 and 32 °C sessions, respectively; p = 0.955). While thirst scores were higher in the 32 than the 22 °C session (p < 0.001), hunger scores did not differ (p = 0.580). EL and IW for high fat foods relative to low fat foods were decreased in 32 compared to 22 °C before dinner and breakfast (p < 0.001 for all). Although EI and hunger were not affected by a 16-h exposure to heat, modifications in food reward suggested a reduction in the preference of high-fat foods. Future research should investigate whether reduced EI in response to heat exposure is due to spontaneous selection of low-fat foods rather than altered appetite sensations.

Effects of Acute Heat and Cold Exposures at Rest or during Exercise on Subsequent Energy Intake: A Systematic Review and Meta-Analysis.

The objective of this meta-analysis was to assess the effect of acute heat/cold exposure on subsequent energy intake (EI) in adults. We searched the following sources for publications on this topic: PubMed, Ovid Medline, Science Direct and SPORTDiscus. The eligibility criteria for study selection were: randomized controlled trials performed in adults (169 men and 30 women; 20-52 years old) comparing EI at one or more meals taken ad libitum, during and/or after exposure to heat/cold and thermoneutral conditions. One of several exercise sessions could be realized before or during thermal exposures. Two of the thirteen studies included examined the effect of heat (one during exercise and one during exercise and at rest), eight investigated the effect of cold (six during exercise and two at rest), and three the effect of both heat and cold (two during exercise and one at rest). The meta-analysis revealed a small increase in EI in cold conditions (g = 0.44; p = 0.019) and a small decrease in hot conditions (g = -0.39, p = 0.022) for exposure during both rest and exercise. Exposures to heat and cold altered EI in opposite ways, with heat decreasing EI and cold increasing it. The effect of exercise remains unclear.

Effect of heat acclimation on metabolic adaptations induced by endurance training in soleus rat muscle.

Aerobic training leads to well-known systemic metabolic and muscular alterations. Heat acclimation may also increase mitochondrial muscle mass. We studied the effects of heat acclimation combined with endurance training on metabolic adaptations of skeletal muscle. Thirty-two rats were divided into four groups: control (C), trained (T), heat-acclimated (H), and trained with heat acclimation (H+T) for 6 weeks. Soleus muscle metabolism was studied, notably by the in situ measurement of mitochondrial respiration with pyruvate (Pyr) or palmitoyl-coenzyme A (PCoA), under phosphorylating conditions ( V˙max ) or not ( V˙0 ). Aerobic performance increased, and retroperitoneal fat mass decreased with training, independently of heat exposure (p < 0.001 and p < 0.001, respectively). Citrate synthase and hydroxyl-acyl-dehydrogenase activity increased with endurance training (p < 0.001 and p < 0.01, respectively), without any effect of heat acclimation. Training induced an increase of the V˙0 and V˙max for PCoA (p < .001 and p < .01, respectively), without interference with heat acclimation. The training-induced increase of V˙0 (p < 0.01) for pyruvate oxidation was limited when combined with heat acclimation (-23%, p < 0.01). Training and heat acclimation independently increased the V˙max for pyruvate (+60% p < 0.001 and +50% p = 0.01, respectively), without an additive effect of the combination. Heat acclimation doubled the training effect on muscle glycogen storage (p < 0.001). Heat acclimation did not improve mitochondrial adaptations induced by endurance training in the soleus muscle, possibly limiting the alteration of carbohydrate oxidation while not facilitating fatty-acid utilization. Furthermore, the increase in glycogen storage observed after HA combined with endurance training, without the improvement of pyruvate oxidation, appears to be a hypoxic metabolic phenotype.

Four-month operational heat acclimatization positively affects the level of heat tolerance 6 months later.

Benefits obtained after heat acclimation/acclimatization should be completely lost after an estimated period of 6 weeks. However, this estimate is still hypothetical. We evaluate the long-term effects of heat acclimatization on the level of heat tolerance. Physiological and subjective markers of heat tolerance were assessed during a heat stress test (HST: 3 × 8-min runs outdoors [~ 40 °C and 20% RH] at 50% of their estimated speed at VO2max) performed on the 2nd day upon arrival to the desert military base in the United Arab Emirates after a first day of mostly passive exposure to heat. Among the 50 male French soldiers, 25 partook in a 4-month military mission in countries characterized by a hot environment ~ 6 months prior to the study (HA). The other 25 participants were never heat acclimatized (CT). Rectal temperature (p = 0.023), heart rate (p = 0.033), and perceived exertion (p = 0.043) were lower in the HA than CT group at the end of HST. Soldiers who experienced a former 4-month period of natural heat acclimatization very likely had a higher level of heat tolerance during exercise in the heat, even 6 months after returning from the previous desert mission, than that of their non-acclimatized counterparts.

A basal heat stress test to detect military operational readiness after a 14-day operational heat acclimatization period.

A basal heat stress test (HST) to predict the magnitude of adaptive responses during heat acclimatization (HA) would be highly useful for the armed forces. The aim was to identify physiological markers assessed during a HST (three 8-min running sets at 50% of the speed at VO2max) performed just before a 14-day HA period that would identify participants still at "risk" at the end of HA. Individuals that responded poorly (large increases in rectal temperature [Trec] and heart rate [HR]) during the initial HST were more likely to respond favorably to HA (large reductions in Trec and HR). However, they were also more likely to exhibit lower tolerance to HST at D15. Basal Trec was found to efficiently discriminate participants showing a Trec > 38.5°C after HA, who are considered to be "at risk". Finally, participants were classified by quartiles based on basal Trec and HR at the end of the HST and physiological strain index (PSI). Most of the participants "at risk" were among the upper quartile (i.e. the least tolerant) of Trec and PSI (p = 0.011 for both). Overall, these results show that the individuals who are less tolerant to a basal HST are very likely to benefit the most from HA but they also remain less tolerant to heat at the end of HA than those who better tolerated the basal HST. A basal HST could therefore theoretically help the command to select the most-ready personnel in hot conditions while retaining those who are less tolerant 6.

Beneficial effects of exercise training on cognitive performances during total sleep deprivation in healthy subjects.

OBJECTIVE: Exercise training has been shown to improve learning and memory, and to protect against the negative impact of sleep deprivation. The aim of this study was to investigate the effects of seven weeks of moderate- and high-intensity interval exercise training on vigilance/sustained attention, inhibition processes and working memory during 40-h total sleep deprivation (TSD) in 16 healthy young men. METHODS: The subjects were evaluated before (Baseline, BAS) and during TSD, and the day after a night of recovery sleep (Recovery, REC). RESULTS: Exercise training significantly decreased errors and increased speed assessed by the psychomotor vigilance task (PVT) during TSD and REC while no difference was found in executive inhibition (Go-noGo task) and working memory (2-Back task) performances. The multiple sleep latency test results were higher during BAS and REC at Post-exercise training, and no difference occurred in subjective sleepiness and daytime microsleeps over the 40-h TSD. The PVT speed was positively correlated with maximal oxygen consumption and maximal aerobic power measured before entry in the in-laboratory TSD protocol, and stage 3 sleep duration measured during the first night in the in-laboratory TSD protocol (N-1). Exercise training effects on sleep were found during the night recovery with lower stage-3 sleep and higher rapid eye movement (REM) sleep durations. An exercise training effect was also found on free insulin-like growth factor I levels with lower levels during TSD at Post-exercise training. CONCLUSIONS: In healthy young men, exercise training reduced sleep pressure at baseline and protected against sustained attention deficits induced by TSD with persistent effect after one night of recovery sleep. Nevertheless, exercise training was not effective in reducing deficits in executive inhibition and working memory induced by TSD.

Resting Muscle Shear Modulus Measured With Ultrasound Shear-Wave Elastography as an Alternative Tool to Assess Muscle Fatigue in Humans.

The aim of this study was to investigate the time course of the resting vastus lateralis (VL) muscle shear elastic modulus (µ) measured with ultrasound shear-wave elastography during repetition of isometric maximal voluntary contractions (MVCs) of the knee extensors (KE). Fifteen well-trained young males repeated 60 5-s isometric MVCs. Evoked electrical stimulations and the VLµ were measured every ten MVCs at rest. The resting VLµ significantly decreased (-34.7 ± 6.7%; P < 0.001) by the end of the fatigue protocol. There was also a 38.4 ± 12.6 % decrease in MVC after exercise (P < 0.001). The potentiated doublet and single twitch torque amplitudes and properties were significantly modified by the end of exercise (P < 0.001). This study shows the time course of the resting VLµ during the repetition of maximal voluntary fatiguing exercise of the KE muscles. The decrease of the resting VLµ could directly affect the force transmission capabilities accounting for peripheral fatigue.

The effect of a physiological increase in temperature on mitochondrial fatty acid oxidation in rat myofibers.

We investigated the effect of temperature increase on mitochondrial fatty acid (FA) and carbohydrate oxidation in the slow-oxidative skeletal muscles (soleus) of rats. We measured mitochondrial respiration at 35°C and 40°C with the physiological substrates pyruvate + 4 mM malate (Pyr) and palmitoyl-CoA (PCoA) + 0.5 mM malate + 2 mM carnitine in permeabilized myofibers under nonphosphorylating (V˙0) or phosphorylating (V˙max) conditions. Mitochondrial efficiency was calculated by the respiratory control ratio (RCR = V˙max/V˙0). We used guanosine triphosphate (GTP), an inhibitor of uncoupling protein (UCP), to study the mechanisms responsible for alterations of mitochondrial efficiency. We measured hydrogen peroxide (H2O2) production under nonphosphorylating and phosphorylating conditions at both temperatures and substrates. We studied citrate synthase (CS) and 3-hydroxyl acyl coenzyme A dehydrogenase (3-HAD) activities at both temperatures. Elevating the temperature from 35°C to 40°C increased PCoA-V˙0 and decreased PCoA-RCR, corresponding to the uncoupling of oxidative phosphorylation (OXPHOS). GTP blocked the heat-induced increase of PCoA-V˙0. Rising temperature moved toward a Pyr-V˙0 increase, without significance. Heat did not alter H2O2 production, resulting from either PCoA or Pyr oxidation. Heat induced an increase in 3-HAD but not in CS activities. In conclusion, heat induced OXPHOS uncoupling for PCoA oxidation, which was at least partially mediated by UCP and independent of oxidative stress. The classically described heat-induced glucose shift may actually be mostly due to a less efficient FA oxidation. These findings raise questions concerning the consequences of heat-induced alterations in mitochondrial efficiency of FA metabolism on thermoregulation.NEW & NOTEWORTHY Ex vivo exposure of skeletal myofibers to heat uncouples substrate oxidation from ADP phosphorylation, decreasing the efficiency of mitochondria to produce ATP. This heat effect alters fatty acids (FAs) more than carbohydrate oxidation. Alteration of FA oxidation involves uncoupling proteins without inducing oxidative stress. This alteration in lipid metabolism may underlie the preferential use of carbohydrates in the heat and could decrease aerobic endurance.

Uncoupling psychological from physiological markers of heat acclimatization in a military context.

Heat acclimatization may help personnel who travel to areas with a hot climate (WBGT > 27 °C), making them operationally more efficient and performant through improvements in physiological and psychological parameters. Their work-related physical activities may aid active heat acclimatization. However, it is unknown whether adding physical training to improve adaptation is effective, particularly if there is sufficient time for full acclimatization, classically reached after 15 days. Thirty French soldiers (Training group, T) performed a progressive and moderate (from three to five 8-min running sets at 50-60% of their speed at VO2max with 4-min periods of active recovery in between) aerobic training program upon arriving at their base in United Arab Emirates (~40 °C and 20% RH). A control group (30 soldiers; No Training, NT) continued to perform only their usual outdoor military activities (~5 h d-1). A field heat stress test (HST: three 8-min running sets at 50% of the speed at VO2max) was performed before (D0), during (D10), and after (D15) the heat acclimatization period to assess physiological and psychological changes. An 8-km trial in battledress was then performed at D17. Although physiological modifications were mostly similar (p < 0.001 for all) for both groups (rectal temperature at the end of the HST: -0.58 ±â€¯0.51 vs -0.53 ±â€¯0.40 °C, HR at the end of the HST: -21 ±â€¯12 vs -19 ±â€¯9 bpm, and sweat osmolality: -47 ±â€¯30 vs -26 ±â€¯32 mOsmol.l-1 between D15 and D0 for T and NT groups, respectively), thermal discomfort (-31 ±â€¯4 vs -11 ±â€¯5 mm between D15 and D0, p = 0.001) and rates of perceived exertion (-3.0 ±â€¯0.4 vs -1.4 ±â€¯0.3 D15 and D0, p = 0.001) were much lower in the T than NT group during the HST. HST-induced modifications in facial temperature only decreased in the T group (-1.08 ±â€¯0.28 between D15 and D0, p < 0.001). Moreover, there was a difference in perceived thermal discomfort during the 8-km trial (40 ±â€¯20 vs 55 ±â€¯22 mm for the T and NT groups, respectively, p = 0.010). Thus, a 15-day, low-volume training regimen during a mission in a hot and dry environment has a modest impact on physiological adaptation but strongly decreases the perceived strain of exertion and climate potentially via greater reductions in facial temperature, even during a classical operational physical task in a military context.

Short-Term, Low-Volume Training Improves Heat Acclimatization in an Operational Context.

Personnel who travel to areas with a hot climate (WBGT > 27°C) may suffer from the heat (physiological strain, thermal discomfort, increased probability of heat illness), making them partially or fully inoperative. Performing physical activities during heat acclimatization is known to improve this process (i.e., improve measures of acclimatization for the same duration of acclimation). However, it is unknown whether such training would be efficient in an operative context, characterized by a high volume of work-related physical activity. Thirty French soldiers (Training group, T) performed a short (5 days), progressive, moderate (from three to five 8-min running sets at 50% of the speed at VO2max for 32-56 min) aerobic training program upon arriving at their base in United Arab Emirates (~40°C and 12% RH). A control group (30 soldiers; No Training, NT) continued to perform their usual outdoor military activities (~6 h.d-1). A field heat stress test (HST; three 8-min running sets at 50% of the speed at VO2max) was performed, before and after the heat acclimatization period, to assess physiological and subjective changes. Rectal temperature, heart rate (HR), thermal discomfort at rest and at the end of exercise, rates of perceived exertion (RPE), and sweat loss and osmolality decreased following heat acclimatization in both groups. However, the decreases in the T group were larger than those in the NT group for HR at the end of exercise (-20 ± 13 vs. -13 ± 6 bpm, respectively, p = 0.044), thermal discomfort at rest (-2.6 ± 2.7 vs. -1.4 ± 2.1 cm, respectively, p = 0.013) and at the end of exercise (-2.6 ± 1.9 vs. -1.6 ± 1.7 cm, respectively, p = 0.037) and RPE (-2.3 ± 1.8 vs. -1.3 ± 1.7, respectively, p = 0.035). Thus, we showed that adding short (<60 min), daily, moderate-intensity training sessions during a professional mission in a hot and dry environment accelerated several heat-acclimatization-induced changes at rest and during exercise in only 5 days.

Protective effects of exercise training on endothelial dysfunction induced by total sleep deprivation in healthy subjects.

BACKGROUND: Sleep loss is a risk factor for cardiovascular events mediated through endothelial dysfunction. AIMS: To determine if 7weeks of exercise training can limit cardiovascular dysfunction induced by total sleep deprivation (TSD) in healthy young men. METHODS: 16 subjects were examined during 40-h TSD, both before and after 7weeks of interval exercise training. Vasodilatation induced by ACh, insulin and heat (42°C) and pulse wave velocity (PWV), blood pressure and heart rate (HR) were assessed before TSD (controlday), during TSD, and after one night of sleep recovery. Biomarkers of endothelial activation, inflammation, and hormones were measured from morning blood samples. RESULTS: Before training, ACh-, insulin- and heat-induced vasodilatations were significantly decreased during TSD and recovery as compared with the control day, with no difference after training. Training prevented the decrease of ACh-induced vasodilation related to TSD after sleep recovery, as well as the PWV increase after TSD. A global lowering effect of training was found on HR values during TSD, but not on blood pressure. Training induces the decrease of TNF-α concentration after TSD and prevents the increase of MCP-1 after sleep recovery. Before training, IL-6 concentrations increased. Cortisol and testosterone decreased after TSD as compared with the control day, while insulin and E-selectin increased after sleep recovery. No effect of TSD or training was found on CRP and sICAM-1. CONCLUSIONS: In healthy young men, a moderate to high-intensity interval training is effective at improving aerobic fitness and limiting vascular dysfunction induced by TSD, possibly through pro-inflammatory cytokine responses.(ClinicalTrial:NCT02820649).

External beam radiotherapy in the management of spinal metastases: review of current strategies and perspectives for highly conformal irradiation modalities.

Bone metastases are frequent in advanced metastatic solid tumors. These secondary lesions are responsible for significant impairment of quality of life of patients with onset of pain, which is frequently resistant to standard analgesics. The therapeutic challenge for a patient with spinal metastasis is to maintain a quality of life as good as possible, commensurate with its life expectancy. Radiotherapy can provide efficient pain relief, but it should be integrated into a multidisciplinary approach. In the case of epidural spinal cord compression, it should be performed whenever possible after surgery. New highly conformal irradiation modalities have emerged for treatment of spinal metastases with therapeutic perspectives. Stereotactic radiosurgery could be provided for patients with single lesions or oligometastatic disease, a good general condition, absence of cord compression, and a life expectancy greater than 6 months. It is particularly promising for the treatment of classically radioresistant tumors or relapsing disease. Intensity-modulated radiotherapy, including Helical Tomotherapy, is a new perspective for treatment of multiple metastases. However, if these new techniques can provide efficient pain sedation, hindsight is currently low to judge their therapeutic benefit and these techniques are hardly available in most centers. Here, we offer a quick review of current strategies and new modalities of radiotherapy to put into perspective the place of these techniques in therapy of spinal metastases.