Prevalence of Triad-RED-S symptoms in high-level Kenyan male and female distance runners and corresponding control groups.

PURPOSE: This study examined and compared select Triad-RED-S components/risk factors in high-level Kenyan male and female distance runners to corresponding control groups; focusing on examining energy intake (EI), bone indices, and hormonal markers. METHODS: A cross-sectional, observational design was used in which Kenyan male and female (n = 30 and n = 26, respectively) middle- and long-distance runners and corresponding male and female control groups (n = 29 and n = 29, respectively) were examined. The participant's bone mineral density (BMD) at the lumbar spine, right femur, and total body were measured using a dual-energy X-ray absorptiometry analysis. Complete blood counts (CBC) were done on the whole blood specimens and hormonal measurements were performed on plasma specimens. In addition, athletes completed metabolic testing to determine maximal oxygen uptakes and 7-day dietary diaries. RESULTS: Overall daily EI across runners and controls within each sex were low, but not significantly different (p > 0.05). Prevalence of low BMD values (Z score < - 2.0) was comparable across groups in each sex (p > 0.05). CBC measures suggested that both runners and controls were healthy. Finally, slight hormonal differences between runners and their respective controls existed (p < 0.05), but were not clinically meaningful or observed in typical Triad-RED-S-related parameters. CONCLUSION: High-level Kenyan male and female runners had low daily EI, but no tendency toward a higher prevalence of low BMD, or Triad-RED-S-related hormonal abnormalities. The occurrence of low EI was not a major risk factor in our athletes; this calls into question whether the current criteria for Triad-RED-S are entirely applicable for athletes of African ethnicity.

Relative Energy Deficiency in Sport (RED-S): Scientific, Clinical, and Practical Implications for the Female Athlete.

Problem: If athletes develop low energy availability (LEA), it can lead to a Relative Energy Deficiency in Sport (RED-S) syndrome which has severe health consequences if not treated. Methodology: A narrative review of the most recent and pertinent literature on the topic, with special emphasis on women. Results: In assessing the current literature, we have synthesized: i) the scientific implications of LEA and RED-S, ii) the clinical manifestations of the conditions currently available for detection, as well as iii) the practical implications for healthcare and support for female athletes and teams in planning intervention or prevention strategies (maintaining EA >45 kcal/kg FFM/day). Discussion: The 'Female Athlete Triad" emerged in the 1990s as researchers understood more of the etiological adaptation of female athlete health to sports training. In the last 10 years, the scientific community has recognized that the 'Triad' approach was too narrow in focus, and the broader concept of RED-S emerged. Both the Triad and RED-S are consequences of a frequently prevalent LEA in athletes (<30 kcal/kg FFM/day). Developing LEA and RED-S compromises training adaptation, performance capacity, and health in athletes. For these reasons, it is critical that an athlete's support team recognize the behaviors that may indicate RED-S evolution. In this way, we can assist female athletes in reaching their full potential in sports while protecting their health.

Birth sex ratio in the offspring of professional male soccer players: influence of exercise training load.

STUDY QUESTION: Can the exercise training load of elite male athletes influence the sex ratio of their offspring? SUMMARY ANSWER: This is the first study assessing the influence of exercise training load on the offspring sex ratio of children from male professional athletes, observing a bias toward more females being born as a result of both high-intensity and high-volume loads, with intensity having the greatest effect. WHAT IS KNOWN ALREADY: There is a relatively constant population sex ratio of males to females among various species; however, certain events and circumstances may alter this population sex ratio favoring one sex over the other. STUDY DESIGN, SIZE, DURATION: Observational, descriptive cross-sectional study with a duration of 3 months. PARTICIPANTS/MATERIALS, SETTING, METHODS: Seventy-five male professional soccer players from First Division soccer teams. Offspring variables were sex of the offspring, number of children and order of birth. Exercise training variables were volume and intensity. MAIN RESULTS AND THE ROLE OF CHANCE: Total offspring was 122 children (52 males (42.6%), 70 females (57.4%)). Analysis revealed that increase in either the volume (P < 0.001) or intensity (P < 0.001) of training by the players shifted the birth offspring ratio more toward females. Within the sample of females born, more births (i.e. number) were observed as a consequence of training at the highest intensity (45 out of 70; P < 0.001), no such pattern occurred within males (P > 0.05). When female versus male births were compared within each intensity, only the high-intensity comparison was significant (45 (75%) females vs 15 (25%) males, P < 0.001). LIMITATIONS, REASONS FOR CAUTION: While this is the first study assessing differences in the sex ratio of the offspring of male athletes (i.e. soccer players), we acknowledge there are limitations and confounders within our approach; e.g. small sample size, ethnic background and variations in the timing of intercourse relative to ovulation as well as in sex hormone levels. As such, we propose that future research is needed to confirm or refute our findings. It is recommended that such work expand on the measurements obtained and conduct direct assessment of sperm characteristics. WIDER IMPLICATIONS OF THE FINDINGS: The findings of the study support the fact that different stressors on the body may alter the sex of the offspring. While in the present study the stressor is the excessive training load of soccer players, other events may lead to similar results. The bias in offspring sex ratio may have important implications for demography and population dynamics, as well as genetic trait inheritance. STUDY FUNDING/COMPETING INTEREST(S): There is no funding nor competing interests. TRIAL REGISTRATION NUMBER: N/A.

Influence of resistance training and herbal supplementation on plasma apelin and metabolic syndrome risk factors in postmenopausal women.

Purpose ­: Menopause is a normal condition that all women experience as they age. The aim of this study was to assess the effects of circuit resistance exercise training with Zataria multiflora (Avishan-e-Shirazi) dietary supplementation on plasma apelin, glucose, insulin, insulin sensitivity and insulin resistance. Methods ­: Ninety-six volunteer postmenopausal women were allocated into 8 groups. Resistance training consisted of 12 stations had been done for 8 weeks. Blood samples were collected at pre- and -post intervention. Results ­: Circuit RT increases apelin and decreases both insulin and blood glucose, whereas Zataria multiflora has no independent effect on apelin but does decrease blood glucose and is likely to be in some means synergistic with circuit RT effects. Conclusion ­: These results suggest that circuit resistance training augments plasma apelin and decreases both insulin and blood glucose. However, Zataria multiflora has no independent effect on apelin but does decrease blood glucose which is likely to be to some extent synergistic with training effects.

Objectif ­: La ménopause est une situation physiologique qui affecte toutes les femmes autour de la cinquantaine. Le but de cette étude était d'évaluer les effets d'un entraînement en résistance de type « circuit training ¼ avec supplémentation orale en Zataria multiflora (Avishan-e-Shirazi) sur l'apeline plasmatique, le glucose, l'insuline, la sensibilité à l'insuline et la résistance à l'insuline. Méthodologie ­: Quatre-vingt quatre femmes postménopausées bénévoles ont été réparties en 8 groupes. L'entraînement en circuit training comprenait 12 séances sur 8 semaines. Des échantillons sanguins ont été prélevés avant et après intervention. Résultats ­: Le circuit training augmente l'apeline et diminue à la fois l'insuline et la glycémie, alors que Zataria multiflora n'a pas d'effet indépendant sur l'apeline, mais diminue la glycémie et est semble synergique des effets du circuit training. Conclusion ­: Ces résultats suggèrent que le circuit training augmente l'apeline plasmatique et diminue insuline et glucose dans le sang. Cependant, Zataria multiflora n'a pas d'effet indépendant sur l'apeline mais fait diminuer la glycémie, ce qui est susceptible d'être dans une certaine mesure synergique avec les effets de l'entraînement.

Correction to: Estrogen and muscle stiffness have a negative relationship in females.

In the original publication the name of the fourth reviewer was incorrectly published.

Exercise, adipokines and pediatric obesity: a meta-analysis of randomized controlled trials.

BACKGROUND/OBJECTIVE: Adipokines are involved in the etiology of diabetes, insulin resistance, and the development of atherosclerosis and other latent-onset complications. The objective of this meta-analysis was to determine the effectiveness of exercise interventions on adipokines in pediatric obesity. SUBJECTS/METHODS: A computerized search was made using three databases. The analysis was restricted to studies that examined the effect of exercise interventions on adipokines (adiponectin, leptin, resistin and visfatin) in pediatric obesity (6-18 years old). Fourteen randomized controlled trials (347 youths) were included. Weighted mean difference (WMD) and 95% confidence intervals were calculated. RESULTS: Exercise was associated with a significant increase in adiponectin (WMD=0.882 µg ml-1, 95% CI, 0.271-1.493) but did not alter leptin and resistin level. Likewise, exercise intensity and change in body fat; as well as total exercise program duration, duration of the sessions, and change in body fat all significantly influenced the effect of exercise on adiponectin and leptin, respectively. CONCLUSIONS: Exercise seems to increase adiponectin levels in childhood obesity. Our results also suggested that exercise on its own, without the concomitant presence of changes in body composition levels, does not affect leptin levels.

Adrenal Hormone and Metabolic Biomarker Responses to 30 min of Intermittent Cycling Exercise in Breast Cancer Survivors.

The aim of this study was to explore the effect of one bout of aerobic exercise on epinephrine, norepinephrine, cortisol, glucose, lactate, and free fatty acid (FFA) responses in breast cancer survivors and healthy controls. 9 female breast cancer survivors and 9 women without a history of cancer completed 30 min of cycle ergometry exercise at 60% of VO2peak. Blood samples were taken pre-exercise, immediately post-exercise, and 2 h post-exercise from which plasma concentrations of study variables were measured. Immediately and 2 h post-exercise, increases were observed in epinephrine (control group only) norepinephrine (both groups), lactate (both groups), and FFA (both groups immediately post-exercise; breast cancer survivor group only at 2 h post-exercise) (p<0.05). Cortisol decreased immediately and 2 h post-exercise in the control group while glucose decreased immediately post-exercise in the breast cancer survivor group (p<0.05). In conclusion, breast cancer survivors appeared to display attenuated epinephrine, cortisol, and lactate responses while displaying larger magnitude changes in glucose and FFA responses compared to controls. These preliminary findings may have implications for the regulation of metabolism during exercise in breast cancer survivors.

Osteoarthritis-related biomarkers following anterior cruciate ligament injury and reconstruction: a systematic review.

OBJECTIVE: There is an increased risk of developing knee osteoarthritis (OA) following anterior cruciate ligament (ACL) injury. Biomarkers may provide diagnostic, prognostic, or burden of disease indicators of OA before radiographic changes become apparent. Unfortunately, there has been no systematic review to clarify which biomarkers may be most informative following injury. Therefore, this review critically investigated existing studies of OA-related biomarkers in ACL-deficient (ACL-D) and reconstructed (ACL-R) patients to summarize the current evidence and identify knowledge gaps. DESIGN: A systematic review of the literature in Web of Science and PubMed databases (1960-June 2014) was performed. All English-language case-control and longitudinal studies assessing OA-related biomarkers in ACL-D and ACL-R patients were considered. Data regarding biomarker changes over time within ACL-D and ACL-R patients as well as differences in ACL-D/ACL-R patients compared with a control group were extracted from pertinent studies. RESULTS: A descriptive summary of 20 included studies was produced. In ACL-D patients compared with controls, synovial fluid biomarkers indicated elevated collagen turnover, while the inflammatory cytokine response was inconclusive. In ACL-R patients, serum concentrations indicated decreased collagen breakdown, but urine concentrations were indicative of greater collagen breakdown when compared to controls. Compared to preoperative values, the overall inflammatory cytokine response measured with synovial fluid biomarkers increased while plasma biomarkers did not change following reconstruction. CONCLUSION: Patients with ACL-D or ACL-R have altered biomarkers indicative of OA. More research with standardized reporting is needed to effectively determine which biomarkers are the most indicative for OA development and progression following ACL injury.

The effect of estrogen on muscle damage biomarkers following prolonged aerobic exercise in eumenorrheic women.

This study assessed the influence of estrogen (E2) on muscle damage biomarkers [skeletal muscle - creatine kinase (CK); cardiac muscle - CK-MB] responses to prolonged aerobic exercise. Eumenorrheic women (n=10) who were physically active completed two 60-minute treadmill running sessions at ∼60-65% maximal intensity during low E2 (midfollicular menstrual phase) and high E2 (midluteal menstrual phase) hormonal conditions. Blood samples were collected prior to exercise (following supine rest), immediately post-, 30 min post-, and 24 hours post-exercise to determine changes in muscle biomarkers. Resting blood samples confirmed appropriate E2 hormonal levels Total CK concentrations increased following exercise and at 24 hours post-exercise were higher in the midfollicular low E2 phase (p<0.001). However, CK-MB concentrations were unaffected by E2 level or exercise (p=0.442) resulting in the ratio of CK-MB to total CK being consistently low in subject responses (i.e., indicative of skeletal muscle damage). Elevated E2 levels reduce the CK responses of skeletal muscle, but had no effect on CK-MB responses following prolonged aerobic exercise. These findings support earlier work showing elevated E2 is protective of skeletal muscle from exercise-induced damage associated with prolonged aerobic exercise.

Response of testosterone to prolonged aerobic exercise during different phases of the menstrual cycle.

PURPOSE: To examine the androgen response to exercise in women under conditions of high (H) and low (L) estrogen (E2) levels. METHODS: Ten exercise trained eumenorrheic women (mean ± SD: 20.0 ± 2.2 years, 58.7 ± 8.3 kg, 22.3 ± 4.9 % body fat, VO2max = 50.7 ± 9.0 mL/kg/min) completed a 60 min treadmill run at ~70 % of VO2max during both the mid-follicular (L-E2, 69.7 ± 7.3 % VO2max) and mid-luteal (H-E2, 67.6 ± 7.9 % VO2max) phases of their menstrual cycle. Blood samples were taken pre-exercise (PRE), immediately post (POST), and 30 min into recovery (30R) from exercise and analyzed for total testosterone using ELISA assays. Results were analyzed using repeated measures ANOVA. RESULTS: Testosterone responses were (mean ± SD: L-E2, pre = 1.41 ± 0.21, post = 1.86 ± 0.21, 30R = 1.75 ± 0.32 nmol/L; H-E2, pre = 1.27 ± 0.23, post = 2.43 ± 0.56, 30R = 1.69 ± 0.34 nmol/L). Statistical analysis indicated no significant interaction existed between high and low estrogen conditions across the blood sampling times (p = 0.138). However, a main effect occurred for exercise (p < 0.004) with the post-testosterone concentration being greater than pre, although pre vs. 30R was not different (p > 0.05). All testosterone hormonal concentrations immediately post-exercise greatly exceeded the level of hemoconcentration observed during the L-E2 and H-E2 exercise sessions. CONCLUSIONS: Prolonged aerobic exercise induces short-term elevations in testosterone in trained eumenorrheic women, which appears unrelated to estrogen levels and menstrual cycle phase. These increases may occur due to either increased androgen production and/or decreased degradation rates of the hormone, and are not solely the result of plasma fluid shifts from the exercise.

Resting IL-6 and TNF-α level in children of different weight and fitness status.

Reports suggest children with high aerobic fitness (VO2max; mL/kg/min) have healthier profiles of TNF-α and IL-6; however, research has not accounted for differences in adiposity between high-fit and low-fit individuals. Thus, this study examined differences in inflammatory markers of obese and normal weight children of different fitness levels, using two different VO2max units: per unit of fat free mass (VO2FFM) or total body mass (VO2kg). Children (n = 124; ages 8-12) were divided into four matched groups; normal weight high-fit (NH), normal weight low- fit (NL), obese high-fit (OH), and obese low-fit (OL). Height, weight, skinfolds, body mass index (BMI), and predicted VO2max were measured and a morning, fasting blood sample taken. IL-6 was elevated in the NL and OL groups compared with the NH group, as well as the OL group compared with the OH group. No differences were found in TNF-α. The relationship between IL-6 or TNF-α and the two units of predicted VO2max did not differ suggesting that either VO2FM or VO2kg can be used to describe aerobic power when studying inflammation and exercise in youth. The relationship between IL-6 or TNF-α and predicted VO2max, whether expressed per mass or per fat-free mass was similar, suggesting that both can be used to describe aerobic power when studying inflammation and exercise in youth. Given the polar design of this study, this relationship should be confirmed including overweight subjects.

Feasibility of home-based exercise training in men with metastatic castration-resistant prostate cancer.

BACKGROUND: Home-based training increases accessibility to exercise and mitigates the side effects of hormone therapy for prostate cancer (PC). However, it is unknown if men with more advanced disease are willing to partake in such interventions. PURPOSE: To determine the feasibility of a home-based exercise intervention in men with metastatic castration-resistant prostate cancer (mCRPC). METHODS: mCRPC patients on androgen receptor signaling inhibitors (ARSI) were prescribed a 12-week, home-based exercise intervention using resistance bands and walking. Feasibility was assessed using recruitment, retention, adherence, and outcome capture. Physiological changes and patient reported outcomes were assessed before and after the intervention. RESULTS: Of the 62 referrals, 47 were eligible with 22 men performing baseline testing (47% recruitment rate) and 16 completing the intervention (73% retention). Task completion was >86% for all physiological tests. Walking adherence was 80% and resistance training was 63%, the latter falling short of the study target (75%). Training increased thigh muscle cross-sectional area by 22%, time to exhaustion by 19% (both p < 0.05) and peak oxygen uptake by 6% (p = 0.057). Improvements in short physical performance battery scores and 400 m walk demonstrated moderate effect sizes that did not reach significance. CONCLUSIONS: Home-based exercise is feasible during ARSI treatment for mCRPC. Greater endurance capacity and localized hypertrophy appear as the primary improvements following training. These preliminary findings suggest home-based training may increase exercise accessibility, with important lessons that will inform subsequent trials investigating the efficacy of home-based exercise interventions during mCRPC.

Testosterone responses to intensive interval versus steady-state endurance exercise.

Free testosterone (FT) hormonal responses were compared between high-intensity interval exercise (IE) and steadystate endurance exercise (SSE) in endurance trained males (no.=15). IE session was repeated periods of 90-sec treadmill running at 100-110% maximal oxygen uptake (VO2max) and 90-sec active recovery at 40% VO2max for 42-47 min. The SSE session consisted of a continuous 45-min run at 60-65% VO2max. Total work output was equal for each exercise session. A 45-min supine rest control session (CON) was also performed. All three sessions were on separate days. Pre-session (PRE), immediate post-session (POST), and 12-h post-session (12POST) blood samples were collected and used to determine FT, SHBG, LH, 3- α-androstanediol glucuronide (3-α Diol G) and cortisol. Analysis of variance compared IE and SSE biomarker responses to the reference CON session. IE and SSE each caused an increase (p<0.01) in FT, but IE more so than SSE (p<0.05). The 5α-reductase marker 3-α Diol G response at 12POST IE was elevated while FT was reduced (p<0.05); no such change occurred following SSE. These findings suggest IE might produce a more pronounced turnover of FT by androgen sensitive tissue than the SSE form of exercise.

Estrogen and muscle stiffness have a negative relationship in females.

PURPOSE: Hormonal fluctuations are one potential reason why females might have a greater rate of noncontact ACL injury. The hamstrings are capable of limiting anterior cruciate ligament (ACL) loading. This study examined whether relationships existed between reproductive hormones (estradiol-ß-17, free testosterone, and progesterone) and hamstring neuromechanical variables (hamstring musculotendinous stiffness (MTS), rate of force production (RFP), time to 50% peak torque (T50%), and electromechanical delay (EMD)) in genders combined and independently. METHODS: Muscle properties of the hamstrings and reproductive hormones were evaluated in 30 subjects (15 males and 15 females) that were free from lower extremity injury and had no history of ACL injury. Females were tested 3-5 days after the onset of menses and were not using oral contraceptive. Pearson correlation coefficients were calculated for each hormone and muscle property. RESULTS: For genders combined, estrogen (mean = 46.0 ± 28.2 pg/mL) was negatively correlated with RFP (mean = 758.8 ± 507.6 N/kg s(-1), r = -0.43, P = 0.02) and MTS (mean = 12.8 ± 2.6 N/cm, r = -0.43, P = 0.02). Free testosterone (mean = 13.2 ± 13.0 pg/mL) was positively correlated with RFP (r = 0.56, P < 0.01) and MTS (r = 0.46, P = 0.01) but negatively correlated with T50% (mean = 114.7 ± 38.9 ms, r = -0.43, P = 0.02). When gender was considered separately, females demonstrated negative correlation between estrogen (mean = 68.0 ± 23.2 pg/mL) and MTS (mean = 11.7 ± 1.5 N/cm, r = -0.53, P = 0.05) and free testosterone (mean = 1.5 ± 0.6 pg/mL) and MTS (r = -0.52, P = 0.05). Males alone displayed no significant correlations between the selected hormones and muscle properties. CONCLUSIONS: Correlations exist between muscle properties and reproductive hormones. Females, however, may be more sensitive to reproductive hormones and their fluctuations.

Association of Quality of Life With Moderate-to-Vigorous Physical Activity After Anterior Cruciate Ligament Reconstruction.

CONTEXT: Better knee function is linked to psychological readiness to return to sport after anterior cruciate ligament reconstruction (ACLR). Individuals with ACLR participate in less physical activity than matched uninjured control individuals, yet the association between knee function and physical activity post-ACLR remains unclear. OBJECTIVE: To determine the associations between (1) patient-reported knee function measured using the Knee Injury and Osteoarthritis Outcome Score Knee-Related Quality of Life (KOOS-QOL), daily steps, and minutes spent in moderate-to-vigorous physical activity (MVPA) of individuals with ACLR and (2) KOOS-QOL and daily steps and MVPA in individuals with ACLR who presented with (ie, symptomatic) or without (ie, asymptomatic) clinically meaningful knee-related symptoms. DESIGN: Cross-sectional study. SETTING: Laboratory, free-living conditions. PATIENTS OR OTHER PARTICIPANTS: A total of 66 individuals with primary unilateral ACLR (36 women, 30 men; age = 22 ± 4 years, height = 1.71 ± 0.1 m, mass = 71.3 ± 12.6 kg, body mass index = 24.2 ± 2.9, time post-ACLR = 28 ± 33 months). MAIN OUTCOME MEASURE(S): We collected KOOS data and retrospectively stratified participants into those with (symptomatic group, n = 30) or without (asymptomatic group, n = 36) clinically meaningful knee-related symptoms based on previously defined KOOS cutoffs. We assessed daily steps and MVPA using accelerometers that participants wore on the right hip for 7 days. We conducted linear regressions to determine associations between KOOS-QOL and daily steps and MVPA. RESULTS: In the entire sample, no associations existed between KOOS-QOL and daily steps (ΔR2 = 0.01, P = .50) or MVPA (ΔR2 = 0.01, P = .36). In the symptomatic group, a greater KOOS-QOL was associated with more time in MVPA (ΔR2 = 0.12, P = .05). In the asymptomatic group, no associations were identified between the KOOS-QOL and daily steps and MVPA. CONCLUSIONS: Individuals with symptoms post-ACLR who spent more time in MVPA reported higher QOL.

Influence of the Menstrual Cycle Phase on Marathon Performance in Recreational Runners.

PURPOSE: To examine the potential impact of fluctuations in sex steroid hormones across the menstrual cycle (MC) on marathon running performance of recreational female athletes. METHODS: A survey questionnaire was administered to recreational, nonelite runners who had completed multiple marathons within the last 18 months. RESULTS: A total of 599 questionnaires were returned and deemed viable for review. From these, 185 survey participants were found to have complete information and eligibility to have their surveys used in the statistical analysis. A total of 106 women had their best marathon performance in the luteal phase (high sex steroid hormones) of the MC, and 79 had their best performance in the follicular phase (low sex steroid hormones) of the MC (responses were significantly different; z-score value = 1.11; P < .05). CONCLUSION: Recreational female runners have varying performances in the marathon across their MC phases, specifically performing better in the luteal phase of the cycle.

Body composition, physical function and quality of life in healthy men and across different stages of prostate cancer.

BACKGROUND: Androgen deprivation therapy (ADT) for prostate cancer (PC) has detrimental effects on physical function and quality of life (QoL), but the addition of androgen receptor signalling inhibitors (ARSI) on these outcomes is unclear. PURPOSE: To compare body composition, physical function, and QoL across progressive stages of PC and non-cancer controls (CON). METHODS: In men with hormone sensitive PC (HSPC, n = 43) or metastatic castration-resistant PC (mCRPC, n = 22) or CON (n = 37), relative and absolute lean and fat mass, physical function (6 m walk, chair stands, timed up and go [TUG], stair climb), and QoL were determined. RESULTS: Relative body composition differed amongst all groups, along with ~39% greater absolute fat mass in mCRPC vs. CON. TUG and chair stands were ~71% and ~33% slower in mCRPC compared to both CON and HSPC, whereas stair climb was ~29% and 6 m walk was ~18% slower in mCRPC vs. CON. Relative body composition was correlated with physical function (r = 0.259-0.385). Clinically relevant differences for mCRPC were observed for overall QoL and several subscales vs. CON, although body composition and physical function did not influence QoL. CONCLUSIONS: PC progression is associated with deteriorations in body composition and physical function. As ADT length was similar between groups, ARSI use for mCRPC likely contributed in part to these changes. Given the difficulties of improving lean mass during ADT, interventions that reduce adiposity may lessen the side effects of hormone therapy.

Exercise, Dietary Protein, and Combined Effect on IGF-1.

Insulin-like growth factor 1 (IGF-1) is a dichotomous hormone. While beneficial for growth/repair, and regulating muscle hypertrophy, high concentrations of IGF-1 are associated with increased risk of cancer and mortality. Factors thought to mediate IGF-1 include dietary protein and exercise. The purpose of this study was to analyze acute effects of dietary protein and/or exercise on plasma free IGF-1 and the time-course thereof to inform individuals who may benefit from increased IGF-1 (muscle growth/repair) or reduced IGF-1 (risk/diagnosis of cancer). Twenty-four participants (11 females, 24.9±4.6y) completed the three-way crossover study consisting of: (1)a high protein (42g) meal; (2)exercise (20min with four 30sec sprints); and (3)exercise followed by a high protein meal. Blood samples were collected fasted at rest, immediately after rest (or 5min after exercise), and at regular intervals throughout a 5h recovery. An additional fasted venipuncture was performed the morning following each condition (24h after baseline). Free IGF-1 was higher at immediately after exercise in the exercise condition (p=0.04). In the protein condition the 24h IGF-1 was 17.5% higher (p=0.02) than baseline. IGF-1 did not change over time in response to exercise with protein. The data gleaned from this study can enhance the knowledge of the time-course effects from protein and/or exercise on IGF-1. This study can provide a foundation for future research to investigate optimal timing and dosage to enhance muscle protein synthesis for athletes, as well as investigate whether consistent high protein meals may chronically elevate IGF-1 and increase the risk of deleterious health outcomes.