The Impact of a Short-Term Ketogenic Low-Carbohydrate High-Fat Diet on Biomarkers of Intestinal Epithelial Integrity and Gastrointestinal Symptoms.

Endurance exercise can disturb intestinal epithelial integrity, leading to increased systemic indicators of cell injury, hyperpermeability, and pathogenic translocation. However, the interaction between exercise, diet, and gastrointestinal disturbance still warrants exploration. This study examined whether a 6-day dietary intervention influenced perturbations to intestinal epithelial disruption in response to a 25-km race walk. Twenty-eight male race walkers adhered to a high carbohydrate (CHO)/energy diet (65% CHO, energy availability = 40 kcal·kg FFM-1·day-1) for 6 days prior to a Baseline 25-km race walk. Athletes were then split into three subgroups: high CHO/energy diet (n = 10); low-CHO, high-fat diet (LCHF: n = 8; <50 g/day CHO, energy availability = 40 kcal·kg FFM-1·day-1); and low energy availability (n = 10; 65% CHO, energy availability = 15 kcal·kg FFM-1·day-1) for a further 6-day dietary intervention period prior to a second 25-km race walk (Adaptation). During both trials, venous blood was collected pre-, post-, and 1 hr postexercise and analyzed for markers of intestinal epithelial disruption. Intestinal fatty acid-binding protein concentration was significantly higher (twofold increase) in response to exercise during Adaptation compared to Baseline in the LCHF group (p = .001). Similar findings were observed for soluble CD14 (p < .001) and lipopolysaccharide-binding protein (p = .003), where postexercise concentrations were higher (53% and 36%, respectively) during Adaptation than Baseline in LCHF. No differences in high CHO/energy diet or low energy availability were apparent for any blood markers assessed (p > .05). A short-term LCHF diet increased intestinal epithelial cell injury in response to a 25-km race walk. No effect of low energy availability on gastrointestinal injury or symptoms was observed.

Repeated-Sprint Exercise in the Heat Increases Indirect Markers of Gastrointestinal Damage in Well-Trained Team-Sport Athletes.

INTRODUCTION: Athletes engaged in repeated-sprint training in the heat can be at an increased risk of gastrointestinal ischemia and damage in response to a redistribution of blood to working skeletal muscles and the skin. This study investigated the effects of repeated sprinting in hot and cool conditions on markers of gastrointestinal damage. METHODS: Twenty-five, well-trained, nonheat acclimated male team-sport athletes completed a five-session, repeated-sprint training regimen over 7 days in either HOT (40 °C and 40% relative humidity [RH]) or COOL (20 °C and 40% RH) conditions. Participants underwent a 20-min warm-up and four sets of 5 × 6-s maximal cycling sprints, with 24-s rest and 5-min recovery between sets. Venous blood was collected pre-, post-, and 1 hr postexercise and analyzed for intestinal fatty acid binding protein, lipopolysaccharide binding protein, soluble CD14, and heat-shock protein. RESULTS: Intestinal fatty acid binding protein concentrations were significantly increased (p < .004) postexercise (593 and 454 pg/ml) and 1 hr postexercise (466 and 410 pg/ml) on both Days 1 and 5 in HOT. Soluble CD14 increased by 398 and 308 ng/ml postexercise (p = .041), and lipopolysaccharide binding protein increased by 1,694 ng/ml postexercise on Day 1 in HOT (p < .05) and by 1,520 ng/ml on Day 5 in COOL (p = .026). Core and skin temperature, rating of perceived exertion, and thermal sensation were higher (p < .05) in HOT on Days 1 and 5 during sprinting. CONCLUSIONS: Repeated sprinting in the heat induced greater thermal strain and mild changes in gastrointestinal damage, likely attributable to the combination of environmental conditions and maximal-intensity exercise.

Effect of Exercising in the Heat on Intestinal Fatty Acid-Binding Protein, Endotoxins, and Lipopolysaccharide-Binding Protein Markers in Trained Athletic Populations: A Systematic Literature Review.

Along with digestion and absorption of nutrients, the gastrointestinal epithelium acts as a primary intestinal defense layer, preventing luminal pathogens from entering the circulation. During exercise in the heat, epithelial integrity can become compromised, allowing bacteria and bacterial endotoxins to translocate into circulation, triggering a systemic inflammatory response and exacerbating gastrointestinal damage. While this relationship seems clear in the general population in endurance/ultraendurance exercise, the aim of this systematic review was to evaluate the effect of exercise in the heat on blood markers of gastrointestinal epithelial disturbance in well-trained individuals. Following the 2009 Preferred Reporting Items for Systematic Reviewed and Meta-Analyses guidelines, five electronic databases were searched for appropriate research, and 1,885 studies were identified. Five studies met the inclusion criteria and were subject to full methodological appraisal by two reviewers. Critical appraisal of the studies was conducted using the McMasters Critical Review Form. The studies investigated changes in markers of gastrointestinal damage (intestinal fatty acid-binding protein, endotoxin, and/or lipopolysaccharide-binding protein) following acute exercise in warm to hot conditions (≥ 30 °C) and included trained or well-trained participants with direct comparisons to a control temperate condition (≤ 22 °C). The studies found that prolonged submaximal and strenuous exercise in hot environmental conditions can acutely increase epithelial disturbance compared with exercise in cooler conditions, with disturbances not being clinically relevant. However, trained and well-trained populations appear to tolerate exercise-induced gastrointestinal disturbance in the heat. Whether this is an acquired tolerance related to regular training remains to be investigated.

Special Environments: Altitude and Heat.

High-level athletes are always looking at ways to maximize training adaptations for competition performance, and using altered environmental conditions to achieve this outcome has become increasingly popular by elite athletes. Furthermore, a series of potential nutrition and hydration interventions may also optimize the adaptation to altered environments. Altitude training was first used to prepare for competition at altitude, and it still is today; however, more often now, elite athletes embark on a series of altitude training camps to try to improve sea-level performance. Similarly, the use of heat acclimation/acclimatization to optimize performance in hot/humid environmental conditions is a common practice by high-level athletes and is well supported in the scientific literature. More recently, the use of heat training to improve exercise capacity in temperate environments has been investigated and appears to have positive outcomes. This consensus statement will detail the use of both heat and altitude training interventions to optimize performance capacities in elite athletes in both normal environmental conditions and extreme conditions (hot and/or high), with a focus on the importance of nutritional strategies required in these extreme environmental conditions to maximize adaptations conducive to competitive performance enhancement.

International Association of Athletics Federations Consensus Statement 2019: Nutrition for Athletics.

The International Association of Athletics Federations recognizes the importance of nutritional practices in optimizing an Athlete's well-being and performance. Although Athletics encompasses a diverse range of track-and-field events with different performance determinants, there are common goals around nutritional support for adaptation to training, optimal performance for key events, and reducing the risk of injury and illness. Periodized guidelines can be provided for the appropriate type, amount, and timing of intake of food and fluids to promote optimal health and performance across different scenarios of training and competition. Some Athletes are at risk of relative energy deficiency in sport arising from a mismatch between energy intake and exercise energy expenditure. Competition nutrition strategies may involve pre-event, within-event, and between-event eating to address requirements for carbohydrate and fluid replacement. Although a "food first" policy should underpin an Athlete's nutrition plan, there may be occasions for the judicious use of medical supplements to address nutrient deficiencies or sports foods that help the athlete to meet nutritional goals when it is impractical to eat food. Evidence-based supplements include caffeine, bicarbonate, beta-alanine, nitrate, and creatine; however, their value is specific to the characteristics of the event. Special considerations are needed for travel, challenging environments (e.g., heat and altitude); special populations (e.g., females, young and masters athletes); and restricted dietary choice (e.g., vegetarian). Ideally, each Athlete should develop a personalized, periodized, and practical nutrition plan via collaboration with their coach and accredited sports nutrition experts, to optimize their performance.

Training Quantification and Periodization during Live High Train High at 2100 M in Elite Runners: An Observational Cohort Case Study.

The questionable efficacy of Live High Train High altitude training (LHTH) is compounded by minimal training quantification in many studies. We sought to quantify the training load (TL) periodization in a cohort of elite runners completing LHTH immediately prior to competition. Eight elite runners (6 males, 2 females) with a V̇O2peak of 70 ± 4 mL·kg-1·min-1 were monitored during 4 weeks of sea-level training, then 3-4 weeks LHTH in preparation for sea-level races following descent to sea-level. TL was calculated using the session rating of perceived exertion (sRPE) method, whereby duration of each training session was multiplied by its sRPE, then summated to give weekly TL. Performance was assessed in competition at sea-level before, and within 8 days of completing LHTH, with runners competing in 800 m (n = 1, 1500 m/mile (n = 6) and half-marathon (n = 1). Haemoglobin mass (Hbmass) via CO rebreathing and running economy (RE) were assessed pre and post LHTH. Weekly TL during the first 2 weeks at altitude increased by 75% from preceding sea-level training (p = 0.0004, d = 1.65). During the final week at altitude, TL was reduced by 43% compared to the previous weeks (p = 0.002; d = 1.85). The ratio of weekly TL to weekly training volume increased by 17% at altitude (p = 0.009; d = 0.91) compared to prior sea-level training. Hbmass increased by 5% from pre- to post-LHTH (p = 0.006, d = 0.20). Seven athletes achieved lifetime personal best performances within 8 days post-altitude (overall improvement 1.1 ± 0.7%, p = 0.2, d = 0.05). Specific periodization of training, including large increases in training load upon arrival to altitude (due to increased training volume and greater stress of training in hypoxia) and tapering, were observed during LHTH in elite runners prior to personal best performances. Periodization should be individualized and align with timing of competition post-altitude.

Four Weeks of Classical Altitude Training Increases Resting Metabolic Rate in Highly Trained Middle-Distance Runners.

High altitude exposure can increase resting metabolic rate (RMR) and induce weight loss in obese populations, but there is a lack of research regarding RMR in athletes at moderate elevations common to endurance training camps. The present study aimed to determine whether 4 weeks of classical altitude training affects RMR in middle-distance runners. Ten highly trained athletes were recruited for 4 weeks of endurance training undertaking identical programs at either 2200m in Flagstaff, Arizona (ALT, n = 5) or 600m in Canberra, Australia (CON, n = 5). RMR, anthropometry, energy intake, and hemoglobin mass (Hbmass) were assessed pre- and posttraining. Weekly run distance during the training block was: ALT 96.8 ± 18.3km; CON 103.1 ± 5.6km. A significant interaction for Time*Group was observed for absolute (kJ.day-1) (F-statistic, p-value: F(1,8)=13.890, p = .01) and relative RMR (F(1,8)=653.453, p = .003) POST-training. No significant changes in anthropometry were observed in either group. Energy intake was unchanged (mean ± SD of difference, ALT: 195 ± 3921kJ, p = .25; CON: 836 ± 7535kJ, p = .75). A significant main effect for time was demonstrated for total Hbmass (g) (F(1,8)=13.380, p = .01), but no significant interactions were observed for either variable [Total Hbmass (g): F(1,8)=1.706, p = .23; Relative Hbmass (g.kg-1): F(1,8)=0.609, p = .46]. These novel findings have important practical application to endurance athletes routinely training at moderate altitude, and those seeking to optimize energy management without compromising training adaptation. Altitude exposure may increase RMR and enhance training adaptation,. During training camps at moderate altitude, an increased energy intake is likely required to support an increased RMR and provide sufficient energy for training and performance.

Altitude Exposure at 1800 m Increases Haemoglobin Mass in Distance Runners.

The influence of low natural altitudes (< 2000 m) on erythropoietic adaptation is currently unclear, with current recommendations indicating that such low altitudes may be insufficient to stimulate significant increases in haemoglobin mass (Hbmass). As such, the purpose of this study was to determine the influence of 3 weeks of live high, train high exposure (LHTH) at low natural altitude (i.e. 1800 m) on Hbmass, red blood cell count and iron profile. A total of 16 elite or well-trained runners were assigned into either a LHTH (n = 8) or CONTROL (n = 8) group. Venous blood samples were drawn prior to, at 2 weeks and at 3 weeks following exposure. Hbmass was measured in duplicate prior to exposure and at 2 weeks and at 3 weeks following exposure via carbon monoxide rebreathing. The percentage change in Hbmass from baseline was significantly greater in LHTH, when compared with the CONTROL group at 2 (3.1% vs 0.4%; p = 0.01;) and 3 weeks (3.0% vs -1.1%; p < 0.02, respectively) following exposure. Haematocrit was greater in LHTH than CONTROL at 2 (p = 0.01) and 3 weeks (p = 0.04) following exposure. No significant interaction effect was observed for haemoglobin concentration (p = 0.06), serum ferritin (p = 0.43), transferrin (p = 0.52) or reticulocyte percentage (p = 0.16). The results of this study indicate that three week of natural classic (i.e. LHTH) low altitude exposure (1800 m) results in a significant increase in Hbmass of elite distance runners, which is likely due to the continuous exposure to hypoxia. Key pointsTwo and three weeks of LHTH altitude exposure (1800 m) results in a significant increase in HbmassLHTH altitude exposure increased Hbmass by 3.1% after 2 weeks, and 3.0% after 3 weeks of exposureLHTH altitude exposure may be a practical method to increase Hbmass in well-trained athletes.

Increased Hypoxic Dose After Training at Low Altitude with 9h Per Night at 3000m Normobaric Hypoxia.

This study examined effects of low altitude training and a live-high: train-low protocol (combining both natural and simulated modalities) on haemoglobin mass (Hbmass), maximum oxygen consumption (VO2max), time to exhaustion, and submaximal exercise measures. Eighteen elite-level race-walkers were assigned to one of two experimental groups; lowHH (low Hypobaric Hypoxia: continuous exposure to 1380 m for 21 consecutive days; n = 10) or a combined low altitude training and nightly Normobaric Hypoxia (lowHH+NHnight: living and training at 1380 m, plus 9 h.night(-1) at a simulated altitude of 3000 m using hypoxic tents; n = 8). A control group (CON; n = 10) lived and trained at 600 m. Measurement of Hbmass, time to exhaustion and VO2max was performed before and after the training intervention. Paired samples t-tests were used to assess absolute and percentage change pre and post-test differences within groups, and differences between groups were assessed using a one-way ANOVA with least significant difference post-hoc testing. Statistical significance was tested at p < 0.05. There was a 3.7% increase in Hbmass in lowHH+NHnight compared with CON (p = 0.02). In comparison to baseline, Hbmass increased by 1.2% (±1.4%) in the lowHH group, 2.6% (±1.8%) in lowHH+NHnight, and there was a decrease of 0.9% (±4.9%) in CON. VO2max increased by ~4% within both experimental conditions but was not significantly greater than the 1% increase in CON. There was a ~9% difference in pre and post-intervention values in time to exhaustion after lowHH+NH-night (p = 0.03) and a ~8% pre to post-intervention difference (p = 0.006) after lowHH only. We recommend low altitude (1380 m) combined with sleeping in altitude tents (3000 m) as one effective alternative to traditional altitude training methods, which can improve Hbmass. Key pointsIn some countries, it may not be possible to perform classical altitude training effectively, due to the low elevation at altitude training venues. An additional hypoxic stimulus can be provided by simulating higher altitudes overnight, using altitude tents.Three weeks of combined (living and training at 1380 m) and simulated altitude exposure (at 3000 m) can improve haemoglobin mass by over 3% in comparison to control values, and can also improve time to exhaustion by ~9% in comparison to baseline.We recommend that, in the context of an altitude training camp at low altitudes (~1400 m) the addition of a relatively short exposure to simulated altitudes of 3000 m can elicit physiological and performance benefits, without compromise to training intensity or competition preparation. However, the benefits will not be greater than conducting a traditional altitude training camp at low altitudes.

Relationship between changes in haemoglobin mass and maximal oxygen uptake after hypoxic exposure.

BACKGROUND: Endurance athletes have been using altitude training for decades to improve near sea-level performance. The predominant mechanism is thought to be accelerated erythropoiesis increasing haemoglobin mass (Hb(mass)) resulting in a greater maximal oxygen uptake (VO2(max)). Not all studies have shown a proportionate increase in VO2(max) as a result of increased Hb(mass). The aim of this study was to determine the relationship between the two parameters in a large group of endurance athletes after altitude training. METHODS: 145 elite endurance athletes (94 male and 51 female) who participated in various altitude studies as altitude or control participants were used for the analysis. Participants performed Hb(mass) and VO2(max) testing before and after intervention. RESULTS: For the pooled data, the correlation between per cent change in Hb(mass) and per cent change in VO2(max) was significant (p<0.0001, r(2)=0.15), with a slope (95% CI) of 0.48 (0.30 to 0.67) intercept free to vary and 0.62 (0.46 to 0.77) when constrained through the origin. When separated, the correlations were significant for the altitude and control groups, with the correlation being stronger for the altitude group (slope of 0.57 to 0.72). CONCLUSIONS: With high statistical power, we conclude that altitude training of endurance athletes will result in an increase in VO2(max) of more than half the magnitude of the increase in Hb(mass), which supports the use of altitude training by athletes. But race performance is not perfectly related to relative VO2(max), and other non-haematological factors altered from altitude training, such as running economy and lactate threshold, may also be beneficial to performance.

Running in a minimalist and lightweight shoe is not the same as running barefoot: a biomechanical study.

AIM: The purpose of this study was to determine the changes in running mechanics that occur when highly trained runners run barefoot and in a minimalist shoe, and specifically if running in a minimalist shoe replicates barefoot running. METHODS: Ground reaction force data and kinematics were collected from 22 highly trained runners during overground running while barefoot and in three shod conditions (minimalist shoe, racing flat and the athlete's regular shoe). Three-dimensional net joint moments and subsequent net powers and work were computed using Newton-Euler inverse dynamics. Joint kinematic and kinetic variables were statistically compared between barefoot and shod conditions using a multivariate analysis of variance for repeated measures and standardised mean differences calculated. RESULTS: There were significant differences between barefoot and shod conditions for kinematic and kinetic variables at the knee and ankle, with no differences between shod conditions. Barefoot running demonstrated less knee flexion during midstance, an 11% decrease in the peak internal knee extension and abduction moments and a 24% decrease in negative work done at the knee compared with shod conditions. The ankle demonstrated less dorsiflexion at initial contact, a 14% increase in peak power generation and a 19% increase in the positive work done during barefoot running compared with shod conditions. CONCLUSIONS: Barefoot running was different to all shod conditions. Barefoot running changes the amount of work done at the knee and ankle joints and this may have therapeutic and performance implications for runners.

Altitude training and haemoglobin mass from the optimised carbon monoxide rebreathing method determined by a meta-analysis.

OBJECTIVE: To characterise the time course of changes in haemoglobin mass (Hbmass) in response to altitude exposure. METHODS: This meta-analysis uses raw data from 17 studies that used carbon monoxide rebreathing to determine Hbmass prealtitude, during altitude and postaltitude. Seven studies were classic altitude training, eight were live high train low (LHTL) and two mixed classic and LHTL. Separate linear-mixed models were fitted to the data from the 17 studies and the resultant estimates of the effects of altitude used in a random effects meta-analysis to obtain an overall estimate of the effect of altitude, with separate analyses during altitude and postaltitude. In addition, within-subject differences from the prealtitude phase for altitude participant and all the data on control participants were used to estimate the analytical SD. The 'true' between-subject response to altitude was estimated from the within-subject differences on altitude participants, between the prealtitude and during-altitude phases, together with the estimated analytical SD. RESULTS: During-altitude Hbmass was estimated to increase by ∼1.1%/100 h for LHTL and classic altitude. Postaltitude Hbmass was estimated to be 3.3% higher than prealtitude values for up to 20 days. The within-subject SD was constant at ∼2% for up to 7 days between observations, indicative of analytical error. A 95% prediction interval for the 'true' response of an athlete exposed to 300 h of altitude was estimated to be 1.1-6%. CONCLUSIONS: Camps as short as 2 weeks of classic and LHTL altitude will quite likely increase Hbmass and most athletes can expect benefit.

Position statement--altitude training for improving team-sport players' performance: current knowledge and unresolved issues.

Despite the limited research on the effects of altitude (or hypoxic) training interventions on team-sport performance, players from all around the world engaged in these sports are now using altitude training more than ever before. In March 2013, an Altitude Training and Team Sports conference was held in Doha, Qatar, to establish a forum of research and practical insights into this rapidly growing field. A round-table meeting in which the panellists engaged in focused discussions concluded this conference. This has resulted in the present position statement, designed to highlight some key issues raised during the debates and to integrate the ideas into a shared conceptual framework. The present signposting document has been developed for use by support teams (coaches, performance scientists, physicians, strength and conditioning staff) and other professionals who have an interest in the practical application of altitude training for team sports. After more than four decades of research, there is still no consensus on the optimal strategies to elicit the best results from altitude training in a team-sport population. However, there are some recommended strategies discussed in this position statement to adopt for improving the acclimatisation process when training/competing at altitude and for potentially enhancing sea-level performance. It is our hope that this information will be intriguing, balanced and, more importantly, stimulating to the point that it promotes constructive discussion and serves as a guide for future research aimed at advancing the bourgeoning body of knowledge in the area of altitude training for team sports.

Comparison of live high: train low altitude and intermittent hypoxic exposure.

Live High:Train Low (LHTL) altitude training is a popular ergogenic aid amongst athletes. An alternative hypoxia protocol, acute (60-90 min daily) Intermittent Hypoxic Exposure (IHE), has shown potential for improving athletic performance. The aim of this study was to compare directly the effects of LHTL and IHE on the running and blood characteristics of elite triathletes. Changes in total haemoglobin mass (Hbmass), maximal oxygen consumption (VO2max), velocity at VO2max (vVO2max), time to exhaustion (TTE), running economy, maximal blood lactate concentration ([La]) and 3 mM [La] running speed were compared following 17 days of LHTL (240 h of hypoxia), IHE (10.2 h of hypoxia) or Placebo treatment in 24 Australian National Team triathletes (7 female, 17 male). There was a clear 3.2 ± 4.8% (mean ± 90% confidence limits) increase in Hbmass following LHTL compared with Placebo, whereas the corresponding change of -1.4 ± 4.5% in IHE was unclear. Following LHTL, running economy was 2.8 ± 4.4% improved compared to IHE and 3mM [La] running speed was 4.4 ± 4.5% improved compared to Placebo. After IHE, there were no beneficial changes in running economy or 3mM [La] running speed compared to Placebo. There were no clear changes in VO2max, vVO2max and TTE following either method of hypoxia. The clear difference in Hbmass response between LHTL and IHE indicated that the dose of hypoxia in IHE was insufficient to induce accelerated erythropoiesis. Improved running economy and 3mM [La] running speed following LHTL suggested that this method of hypoxic exposure may enhance performance at submaximal running speeds. Overall, there was no evidence to support the use of IHE in elite triathletes. Key PointsDespite a clear 3.2% increase in haemoglobin mass following 17 days of Live High: Train Low altitude training, no change in maximal aerobic capacity was observed.There were positive changes in running economy and the lactate-speed relationship at submaximal running speeds following Live High: Train Low altitude training.There was no evidence to support the use of daily 60-90 minute Intermittent Hypoxic Exposure in elite triathletes.

Influence of altitude training modality on performance and total haemoglobin mass in elite swimmers.

We compared changes in performance and total haemoglobin mass (tHb) of elite swimmers in the weeks following either Classic or Live High:Train Low (LHTL) altitude training. Twenty-six elite swimmers (15 male, 11 female, 21.4 ± 2.7 years; mean ± SD) were divided into two groups for 3 weeks of either Classic or LHTL altitude training. Swimming performances over 100 or 200 m were assessed before altitude, then 1, 7, 14 and 28 days after returning to sea-level. Total haemoglobin mass was measured twice before altitude, then 1 and 14 days after return to sea-level. Changes in swimming performance in the first week after Classic and LHTL were compared against those of Race Control (n = 11), a group of elite swimmers who did not complete altitude training. In addition, a season-long comparison of swimming performance between altitude and non-altitude groups was undertaken to compare the progression of performances over the course of a competitive season. Regardless of altitude training modality, swimming performances were substantially slower 1 day (Classic 1.4 ± 1.3% and LHTL 1.6 ± 1.6%; mean ± 90% confidence limits) and 7 days (0.9 ± 1.0% and 1.9 ± 1.1%) after altitude compared to Race Control. In both groups, performances 14 and 28 days after altitude were not different from pre-altitude. The season-long comparison indicated that no clear advantage was obtained by swimmers who completed altitude training. Both Classic and LHTL elicited ~4% increases in tHb. Although altitude training induced erythropoeisis, this physiological adaptation did not transfer directly into improved competitive performance in elite swimmers.

Short-Term Very High Carbohydrate Diet and Gut-Training Have Minor Effects on Gastrointestinal Status and Performance in Highly Trained Endurance Athletes.

We implemented a multi-pronged strategy (MAX) involving chronic (2 weeks high carbohydrate [CHO] diet + gut-training) and acute (CHO loading + 90 g·h−1 CHO during exercise) strategies to promote endogenous and exogenous CHO availability, compared with strategies reflecting lower ranges of current guidelines (CON) in two groups of athletes. Nineteen elite male race walkers (MAX: 9; CON:10) undertook a 26 km race-walking session before and after the respective interventions to investigate gastrointestinal function (absorption capacity), integrity (epithelial injury), and symptoms (GIS). We observed considerable individual variability in responses, resulting in a statistically significant (p < 0.001) yet likely clinically insignificant increase (Δ 736 pg·mL−1) in I-FABP after exercise across all trials, with no significant differences in breath H2 across exercise (p = 0.970). MAX was associated with increased GIS in the second half of the exercise, especially in upper GIS (p < 0.01). Eighteen highly trained male and female distance runners (MAX: 10; CON: 8) then completed a 35 km run (28 km steady-state + 7 km time-trial) supported by either a slightly modified MAX or CON strategy. Inter-individual variability was observed, without major differences in epithelial cell intestinal fatty acid binding protein (I-FABP) or GIS, due to exercise, trial, or group, despite the 3-fold increase in exercise CHO intake in MAX post-intervention. The tight-junction (claudin-3) response decreased in both groups from pre- to post-intervention. Groups achieved a similar performance improvement from pre- to post-intervention (CON = 39 s [95 CI 15−63 s]; MAX = 36 s [13−59 s]; p = 0.002). Although this suggests that further increases in CHO availability above current guidelines do not confer additional advantages, limitations in our study execution (e.g., confounding loss of BM in several individuals despite a live-in training camp environment and significant increases in aerobic capacity due to intensified training) may have masked small differences. Therefore, athletes should meet the minimum CHO guidelines for training and competition goals, noting that, with practice, increased CHO intake can be tolerated, and may contribute to performance outcomes.

Neuromuscular control and running economy is preserved in elite international triathletes after cycling.

Running is the most important discipline for Olympic triathlon success. However, cycling impairs running muscle recruitment and performance in some highly trained triathletes; though it is not known if this occurs in elite international triathletes. The purpose of this study was to investigate the effect of cycling in two different protocols on running economy and neuromuscular control in elite international triathletes. Muscle recruitment and sagittal plane joint angles of the left lower extremity and running economy were compared between control (no preceding cycle) and transition (preceded by cycling) runs for two different cycle protocols (20-minute low-intensity and 50-minute high-intensity cycles) in seven elite international triathletes. Muscle recruitment and joint angles were not different between control and transition runs for either cycle protocols. Running economy was also not different between control and transition runs for the low-intensity (62.4 +/- 4.5 vs. 62.1 +/- 4.0 ml/min/kg, p > 0.05) and high-intensity (63.4 +/- 3.5 vs. 63.3 +/- 4.3 ml/min/kg, p > 0.05) cycle protocols. The results of this study demonstrate that both low- and high-intensity cycles do not adversely influence neuromuscular control and running economy in elite international triathletes.

The relationship between performance and biomechanics in middle-distance runners.

The present study aimed to identify movement patterns most related to running performance among highly trained middle-distance runners. Eleven male runners performed overground running trials on an indoor running track, and three-dimensional analyses techniques were used to measure running kinematics and kinetics. Performance was measured as season and personal best time over 1500 m. The average velocity during the running trials was 7.2 ± 0.3 m/s. The average season and personal best 1500 m race times were 3:49.7 ± 0:05.8 and 3:46.0 ± 0:08.3 minutes, respectively. Regression analysis revealed that a smaller range of sagittal-plane hip motion during swing, less thorax flexion at toe-off and a smaller ankle plantarflexion angle at contact accounted for 95.7% (p < 0.001) of the variation in season best running performance. Less sagittal-plane hip motion during swing and a smaller ankle plantarflexion angle at contact also explained 79% of the variance in personal best time. Slower middle-distance runners make initial ground contact with a more plantarflexed ankle and greater forward lean of the trunk. We recommend that coaches and runners pay attention to ankle, shank and thorax angles during technical development and training to identify opportunities to optimise middle-distance running mechanics and performance.

Running at Increasing Intensities in the Heat Induces Transient Gut Perturbations.

PURPOSE: The risk of exercise-induced endotoxemia is increased in the heat and is primarily attributable to changes in gut permeability resulting in the translocation of lipopolysaccharides (LPS) into the circulation. The purpose of this study was to quantify the acute changes in gut permeability and LPS translocation during submaximal continuous and high-intensity interval exercise under heat stress. METHODS: A total of 12 well-trained male runners (age 37 [7] y, maximal oxygen uptake [VO2max] 61.0 [6.8] mL·min-1·kg-1) undertook 2 treadmill runs of 2 × 15-minutes at 60% and 75% VO2max and up to 8 × 1-minutes at 95% VO2max in HOT (34°C, 68% relative humidity) and COOL (18°C, 57% relative humidity) conditions. Venous blood samples were collected at the baseline, following each running intensity, and 1 hour postexercise. Blood samples were analyzed for markers of intestinal permeability (LPS, LPS binding protein, and intestinal fatty acid-binding protein). RESULTS: The increase in LPS binding protein following each exercise intensity in the HOT condition was 4% (5.3 µg·mL-1, 2.4-8.4; mean, 95% confidence interval, P < .001), 32% (4.6 µg·mL-1, 1.8-7.4; P = .002), and 30% (3.0 µg·mL-1, 0.03-5.9; P = .047) greater than in the COOL condition. LPS was 69% higher than baseline following running at 75% VO2max in the HOT condition (0.2 endotoxin units·mL-1, 0.1-0.4; P = .011). Intestinal fatty acid-binding protein increased 43% (2.1 ng·mL-1, 0.1-4.2; P = .04) 1 hour postexercise in HOT compared with the COOL condition. CONCLUSIONS: Small increases in LPS concentration during exercise in the heat and subsequent increases in intestinal fatty acid-binding protein and LPS binding protein indicate a capacity to tolerate acute, transient intestinal disturbance in well-trained endurance runners.

Effectiveness of intermittent training in hypoxia combined with live high/train low.

Elite athletes often undertake altitude training to improve sea-level athletic performance, yet the optimal methodology has not been established. A combined approach of live high/train low plus train high (LH/TL+TH) may provide an additional training stimulus to enhance performance gains. Seventeen male and female middle-distance runners with maximal aerobic power (VO2max) of 65.5 +/- 7.3 mL kg(-1) min(-1) (mean +/- SD) trained on a treadmill in normobaric hypoxia for 3 weeks (2,200 m, 4 week(-1)). During this period, the train high (TH) group (n = 9) resided near sea-level (approximately 600 m) while the LH/TL+TH group (n = 8) stayed in normobaric hypoxia (3,000 m) for 14 hours day(-1). Changes in 3-km time trial performance and physiological measures including VO2max, running economy and haemoglobin mass (Hb(mass)) were assessed. The LH/TL+TH group substantially improved VO2max (4.8%; +/-2.8%, mean; +/-90% CL), Hb(mass) (3.6%; +/-2.4%) and 3-km time trial performance (-1.1%; +/-1.0%) immediately post-altitude. There was no substantial improvement in time trial performance 2 weeks later. The TH group substantially improved VO2max (2.2%; +/-1.8%), but had only trivial changes in Hb(mass) and 3-km time-trial performance. Compared with TH, combined LH/TL+TH substantially improved VO2max (2.6%; +/-3.2%), Hb(mass) (4.3%; +/-3.2%), and time trial performance (-0.9%; +/-1.4%) immediately post-altitude. LH/TL+TH elicited greater enhancements in physiological capacities compared with TH, however, the transfer of benefits to time-trial performance was more variable.