Evaluating the influence of differences in methodological approach on metabolic thresholds and fat oxidation points relationship.

In this study, we aimed to determine the exercise intensities eliciting the highest (FATmax) and the lowest (FATmin) fat oxidation rate in male cyclists and to compare these intensities with their individual aerobic (AeT) and anaerobic (AnT) thresholds, respectively. Twenty-two moderately trained male cyclists performed a 2-min stage graded exercise test until exhaustion using breath-by-breath gas analysis to determine maximal oxygen consumption (VO2max). The fat oxidation rate was calculated using a stoichiometric equation, with metabolic thresholds being determined by ventilatory gas analysis. In the present group of subjects, FATmax was found at a 21.34 ± 3.64 ml·kg-1·min-1 corresponding to 45.05 ± 7.68% VO2max. AeT occurred at an exercise intensity of 22.15 ± 4.84 ml·kg-1·min-1, matching 46.76 ± 10.24% VO2max. AnT and FATmin were located at intensities equivalent to 32.56 ± 5.52 ml·kg-1·min-1 and 32.30 ± 5.35 ml·kg-1·min-1 which corresponded to 68.74 ± 11.65 and 68.19 ± 11.29% VO2max, respectively. The correlation between FATmax and AeT was strong (r = 0.80, p < 0.05). No statistical difference was observed between FATmin and AnT (r = 0.99, p < 0.05). The strong relationship between observed indices can be used to provide a more tailored exercise approach.

Heritability of arterial function, fitness, and physical activity in youth: a study of monozygotic and dizygotic twins.

OBJECTIVES: To examine the role of heredity in determining flow-mediated dilation in young people by comparing conduit artery endothelial function in monozygotic and dizygotic twins. We also determined relationships between physical activity and fitness in each twin subset. STUDY DESIGN: Flow-mediated dilation was assessed with high-resolution ultrasonography of the brachial artery in 22 twin pairs (11 monozygotic pairs 13.3 ± 1.6 years, 11 dizygotic pairs 13.6 ± 1.6 years). Fitness was assessed as peak oxygen uptake during an incremental treadmill test. Physical activity was measured with accelerometry. Twin versus twin intraclass correlations were performed for both groups. RESULTS: Flow-mediated dilation was significantly correlated in monozygotic twins only (r = 0.60, P = .02). Heritability of flow-mediated dilation was estimated at 0.44. Total PA time (monozygotic r = 0.77, dizygotic r = 0.60, P < .05) and light physical activity time (monozygotic r = 0.67, dizygotic r = 0.63, P < .05) correlated significantly in both groups. The peak oxygen uptake (r = 0.84, P < .01) was correlated only in monozygotic twins. CONCLUSION: Genetic factors appear to be responsible for a modest portion of the flow-mediated dilation response, suggesting that flow-mediated dilation can be influenced by environmental factors.

Changes in quadriceps femoris muscle perfusion following different degrees of cold-water immersion.

We examined the influence of graded cold-water immersion (CWI) on global and regional quadriceps muscle perfusion with positron emission tomography (PET) and [15O]H2O. In 30 healthy men [33 ± 8 yr; 81 ± 10 kg; 184 ± 5 cm; percentage body fat: 13 ± 5%; peak oxygen uptake (V̇o2peak): 47 ± 8 mL·kg-1·min-1] quadriceps perfusion, thigh and calf cutaneous vascular conductance (CVC), intestinal, muscle, and local skin temperatures, thermal comfort, mean arterial pressure, and heart rate were assessed before and after 10 min of CWI at 8°C, 15°C, or 22°C. Global quadriceps perfusion did not change beyond a clinically relevant threshold (0.75 mL·100 g·min-1) in any condition and was similar between conditions {range of differences [95% confidence interval (CI)]: 0.1 mL·100 g·min-1 (-0.9 to 1.2 mL·100 g·min-1) to 0.9 mL·100 g·min-1 (-0.2 to 1.9 mL·100 g·min-1)}. Muscle perfusion was greater in vastus intermedius (VI) compared with vastus lateralis (VL) (2.2 mL·100 g·min-1; 95% CI 1.5 to 3.0 mL·100 g·min-1) and rectus femoris (RF) (2.2 mL·100 g·min-1; 1.4 to 2.9 mL·100 g·min-1). A clinically relevant increase in VI muscle perfusion after immersion at 8°C and a decrease in RF muscle perfusion at 15°C were observed. A clinically relevant increase in perfusion was observed in VI in 8°C compared with 22°C water (2.3 mL·100 g·min-1; 1.1 to 3.5 mL·100 g·min-1). There were no clinically relevant between-condition differences in thigh CVC. Our findings suggest that CWI (8-22°C) does not reduce global quadriceps muscle perfusion to a clinically relevant extent; however, colder water increases (8°C) deep muscle perfusion and reduces (15°C) superficial muscle (RF) perfusion in the quadriceps muscle.NEW & NOTEWORTHY Using positron emission tomography, we report for the first time muscle perfusion heterogeneity in the quadriceps femoris in response to different degrees of cold-water immersion (CWI). Noxious CWI temperatures (8°C) increase perfusion in the deep quadriceps muscle, whereas superficial quadriceps muscle perfusion is reduced in cooler (15°C) water. Therefore, these data have important implications for the selection of CWI approaches used in the treatment of soft tissue injury, while also increasing our understanding of the potential mechanisms underpinning CWI.

Left ventricular wall segment motion after ultra-endurance exercise in humans assessed by myocardial speckle tracking.

AIMS: Assessment of the left ventricular responses to prolonged exercise has been limited by technology available to assess cardiac tissue movement. Recently developed strain and strain rate imaging provide the unique opportunity to assess tissue deformation in all planes of motion. METHODS AND RESULTS: Nineteen runners (mean+/-SD age; 41+/-9 years) were assessed prior to and within 60 min (34+/-10 min) of race finish (Comrades Marathon, 89 km). Standard echocardiography assessed ejection fraction and the ratio of early to atrial (E/A) peak transmitral blood flow velocities. Myocardial speckle tracking determined segmental strain as well as systolic and diastolic strain rates in radial, circumferential, and longitudinal planes. Cardiac troponin T (cTnT) assessed cardiomyocyte insult. Ejection fraction (71+/-5 to 64+/-6%) and E/A (1.47+/-0.35 to 1.25+/-0.30) were reduced (P<0.05). Peak strain and peak systolic and diastolic strain rates were altered post-race in circumferential (e.g. peak strain reduced from 21.3+/-2.4 to 17.3+/-3.2%, P<0.05) and radial planes. Some individual heterogeneity was observed between segments and planes of motion. A post-race elevation in cTnT (range 0.013-0.272 microg/L) in 5/12 runners did not differentiate changes in LV function. CONCLUSION: Completion of the Comrades Marathon resulted in a depression in ejection fraction, E/A, as well as radial and circumferential strain and strain rates. Group data, however, masked some heterogeneity in cardiac function.

Directional Change Mediates the Physiological Response to High-Intensity Shuttle Running in Professional Soccer Players.

The purpose of this study was to investigate the influence that different frequencies of deceleration and acceleration actions had on the physiological demands in professional soccer players. Thirteen players were monitored via microelectromechanical devices during shuttle running protocols which involved one, three, or seven 180 degree directional changes. Heart rate exertion (HRE) (1.1 ± 0.7) and rating of perceived exertion (RPE) (5 ± 1) were significantly higher for the protocol which included seven directional changes when compared to the protocols which included one (HRE 0.5 ± 0.3, ES = 1.1, RPE 3 ± 0, ES = 2.7) or three (HRE 0.5 ± 0.2, ES = 1.1, RPE 3 ± 1, ES = 1.9) directional changes (p < 0.05). The gravitational force (g-force) as measured through accelerometry (ACC) also showed a similar trend when comparing the seven (8628.2 ± 1630.4 g) to the one (5888.6 ± 1159.1 g, ES = 1.9) or three (6526.9 ± 1257.6 g, ES = 1.4) directional change protocols (p < 0.05). The results of this study suggest that increasing the frequency of decelerations and accelerations at a high intensity running (HIR) speed alters the movement demands and elevates the physiological responses in professional players. This data has implications for the monitoring of physical performance and implementation of training drills.

Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I): a randomised controlled trial to examine the impact of an intensive lifestyle intervention consisting of a low-energy diet and physical activity on body weight and metabolism in early type 2 diabetes mellitus: study protocol for a randomized controlled trial.

BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM. METHODS: The planned study is an ongoing, non-blinded, pragmatic, randomised controlled, parallel-group trial examining the impact of an LED-based ILI on body weight and diabetes remission in younger (18-50 years) T2DM individuals with early diabetes (≤ 3-year duration). The ILI will be compared to usual medical care (UMC). The primary outcome will be weight loss at 12 months. Other key outcomes of interest include diabetes remission, glycaemic control, diabetes complications, cardiovascular health, physical activity, mental health, and quality of life. It is planned for the study to include 138 subjects for assessment of the primary outcome. Safety will be assessed throughout. DISCUSSION: If DIADEM-I demonstrates a clinically significant effect for younger individuals with early T2DM, it will inform clinical guidelines and services of the future for management of T2DM. TRIAL REGISTRATION: ISRCTN: ISRCTN20754766 (date assigned: 7 June 2017); ClinicalTrials.gov, ID: NCT03225339 Registered on 26 June 2017.

Exercise training and artery function in humans: nonresponse and its relationship to cardiovascular risk factors.

The objectives of our study were to examine 1) the proportion of responders and nonresponders to exercise training in terms of vascular function; 2) a priori factors related to exercise training-induced changes in conduit artery function, and 3) the contribution of traditional cardiovascular risk factors to exercise-induced changes in artery function. We pooled data from our laboratories involving 182 subjects who underwent supervised, large-muscle group, endurance-type exercise training interventions with pre-/posttraining measures of flow-mediated dilation (FMD%) to assess artery function. All studies adopted an identical FMD protocol (5-min ischemia, distal cuff inflation), contemporary echo-Doppler methodology, and observer-independent automated analysis. Linear regression analysis was used to identify factors contributing to changes in FMD%. We found that cardiopulmonary fitness improved, and weight, body mass index (BMI), cholesterol, and mean arterial pressure (MAP) decreased after training, while FMD% increased in 76% of subjects (P < 0.001). Training-induced increase in FMD% was predicted by lower body weight (ß = -0.212), lower baseline FMD% (ß = -0.469), lower training frequency (ß = -0.256), and longer training duration (ß = 0.367) (combined: P < 0.001, r = 0.63). With the exception of a modest correlation with total cholesterol (r = -0.243, P < 0.01), changes in traditional cardiovascular risk factors were not significantly related to changes in FMD% (P > 0.05). In conclusion, we found that, while some subjects do not demonstrate increases following exercise training, improvement in FMD% is present in those with lower pretraining body weight and endothelial function. Moreover, exercise training-induced change in FMD% did not correlate with changes in traditional cardiovascular risk factors, indicating that some cardioprotective effects of exercise training are independent of improvement in risk factors.

Skin microvascular reactivity in children and adolescents with type 1 diabetes in relation to levels of physical activity and aerobic fitness.

No studies to date have evaluated the relationship between exercise and microvascular function in youth with type 1 diabetes mellitus (T1DM). Twenty-nine complication free children and adolescents with T1DM were assessed for skin microvascular reactivity, aerobic fitness (VO2peak) and physical activity. VO2peak but not physical activity was significantly and independently associated with maximal hyperemia of the skin microcirculation (p < .01). No significant associations were found between venoarteriolar reflex (VAR) vasoconstriction and VO2peak or physical activity. Aerobic fitness may be an important indicator or mediator of effective microvascular endothelial function in youth with T1DM.

Ascorbic acid supplementation does not attenuate post-exercise muscle soreness following muscle-damaging exercise but may delay the recovery process.

Exercise involving lengthening muscle actions, such as downhill running, results in delayed onset muscle soreness (DOMS), which may be attributable to reactive oxygen species (ROS). Although exercise causes oxidative stress, any link between ROS and DOMS remains speculative. There is emerging evidence to suggest that ROS play an important physiological role, assisting in the recovery process and protecting the cell from future damage; however, this has not been fully established. Despite this uncertainty as to the precise role of ROS, attempts to prevent post-exercise ROS production through antioxidant intervention are still common. The study investigated the effects of ascorbic acid supplementation on ROS production and DOMS following downhill running. Subjects were assigned to two groups. The ascorbic acid group (group AA) received 1 g ascorbic acid 2 h pre-, and for 14 d post-downhill running, whilst the placebo group (Pl group) received a placebo. Blood samples were drawn pre-supplement, pre- and post-exercise, and then 1, 2, 3, 4, 7 and 14 d post-exercise for analysis of ascorbate, malonaldehyde and total glutathione. DOMS was assessed using a visual analogue scale and pressure algometry. Muscle function was assessed using isokinetic dynamometry. Plasma ascorbate was elevated throughout in group AA compared with the Pl group. Downhill running resulted in DOMS in both groups. Muscle function was impaired post-exercise in both groups, although a delayed recovery was noted in group AA. Malonaldehyde increased 4 d post-exercise in the Pl group only. Ascorbic acid supplementation attenuates ROS production following downhill running, without affecting DOMS. Furthermore, ascorbic acid supplementation may inhibit the recovery of muscle function.

Exercise thermoregulation and hyperprolactinaemia.

The anterior pituitary hormone prolactin (PRL), measured in the peripheral blood circulation, reflects alterations in central brain 5-hydroxytryptamine (serotonin) and dopaminergic activity and is used as a marker of 'central fatigue' during active heat exposure. Significant correlations have consistently been found between PRL and core temperature (T(CORE)) during prolonged exercise. There has been no investigation into the relationship between PRL and other key thermoregulatory variables during exercise, such as weighted mean skin (T(SK)) and mean body temperature (T(B)), heat storage (HS), thermal gradient (T(GRAD)), heart rate (HR) and skin blood flow (cutaneous vascular conductance, CVC). Therefore, the aim of this study was to ascertain if a significant relationship exists between PRL and these thermoregulatory variables during prolonged exercise. Nine active male subjects conducted three trials of approximately 60% VO(2peak) at 70-80 rpm for 45 min on a semi-recumbent cycle ergometer at three different ambient temperatures [6 degrees C (Cold), 18 degrees C (Neutral) and 30 degrees C (Hot)] to elicit varying levels of thermoregulatory stress during exercise. Significant differences existed in T(SK), T(B), HS, T(GRAD) and CVC across the environmental conditions (p < 0.001). Core temperature (T(CORE)), HR and PRL were significantly elevated only in Hot (p < 0.05). Moderate correlations were found for T(CORE), T(SK), T(B), HS, T(GRAD), HR and CVC with post-exercise PRL (rho = 0.358-0.749). The end-of-exercise <38.0 degrees C T(CORE) responses were not (rho = -0.129, p > 0.05) but the >38.0 degrees C T(CORE) responses were (rho = 0.845, p < 0.001) significantly related to their corresponding PRL responses. The significant relationships between PRL release and T(SK), T(B), HS, T(GRAD), HR and CVC have extended previous research on T(CORE) and PRL release and indicate an association between these thermoregulatory variables, as well as T(CORE), and serotonergic/dopaminergic activity during prolonged exercise.

Eccentric exercise, isokinetic muscle torque and delayed onset muscle soreness: the role of reactive oxygen species.

There is growing evidence that reactive oxygen species (ROS) are involved in the muscular damage and soreness that is observed following strenuous or unaccustomed exercise. This study investigated the relationship between delayed onset muscle soreness (DOMS), muscle function and ROS following downhill running using electron spin resonance (ESR) spectroscopy and plasma malonaldehyde (MDA) concentrations. Eight physically active male subjects participated in two trials consisting of 30 min of running at approximately 65% VO(2max) on the flat (FLA) or a 15% downhill (DWN) gradient. Venous blood samples were drawn before, immediately after, and then 24, 48 and 72 h post exercise, and at the same time DOMS and muscle function were assessed. Blood was analysed for markers of ROS, total and differential white blood cell count, and creatine kinase. Muscle function was measured on an isokinetic dynamometer, whilst DOMS was assessed using a visual analogue scale. An increase in ROS, detected via ESR spectroscopy and MDA, was observed following DWN ( P<0.05) but not following FLA. Increased DOMS and loss of muscle function were observed following DWN ( P<0.05) but not following FLA ( P>0.05). DWN resulted in a transient leukocytosis ( P<0.05) occurring immediately post-exercise but returning to pre-exercise levels by 24 h. Although DWN resulted in an increase in ROS production, the increase occurred after the peak decline in muscle function and DOMS, suggesting that there may be a disassociation in the temporal relationship between ROS, loss of muscle function and DOMS.