Can conditions of skeletal muscle loss be improved by combining exercise with anabolic-androgenic steroids? A systematic review and meta-analysis of testosterone-based interventions.

Sarcopenia, cachexia, and atrophy due to inactivity and disease states are characterized by a loss of skeletal muscle mass, often accompanied by reduced levels of anabolic hormones (e.g. testosterone). These conditions are associated with an increase in mortality, hospitalization and worsening in quality of life. Both physical exercise (EX) and anabolic-androgenic steroid (AAS) administration can improve the prognosis of patients as they increase physical functionality. However, there is a gap in the literature as to the impact of these therapies on the gains in strength and muscle mass and their implications for patient safety. Accordingly, we performed a random-effects meta-analysis to elucidate the effects of AAS and/or EX interventions on lean body mass (LBM) and muscle strength in conditions involving muscle loss. A systematic search for relevant clinical trials was conducted in MEDLINE, EMBASE, SCOPUS, Web of Science, and SPORTDiscus. Comparisons included AAS vs. Control, EX vs. Control, AAS vs. EX, AAS + EX vs. AAS and AAS + EX vs. EX. A total of 1114 individuals were analyzed. AAS increased LBM (effect size [ES]: 0.46; 95% CI: 0.25, 0.68, P = 0.00) and muscle strength (ES: 0.31; 95% CI: 0.08, 0.53, P = 0.01) when compared to a control group. EX promoted an increase in muscular strength (ES: 0.89; 95% CI: 0.53, 1.25, P = 0.00), with no effect on LBM when compared to the control group (ES: 0.15; 95% CI: -0.07, 0.38, P = 0.17). AAS did not demonstrate statistically significant differences when compared to EX for LBM and muscle strength. The combination of EX + AAS promoted a greater increase in LBM and muscular strength when compared to AAS or EX in isolation. Qualitatively, AAS administration had relatively few side effects. Significant heterogeneity was found in some analyses, which may be explained by the use of different AAS types and EX protocols. Our findings suggest that AAS administration in cachectic and sarcopenic conditions may be a viable interventional strategy to enhance muscle function when exercise is not a possible approach. Moreover, combining AAS with exercise may enhance positive outcomes in this population.

International society of sports nutrition position stand: caffeine and exercise performance.

Following critical evaluation of the available literature to date, The International Society of Sports Nutrition (ISSN) position regarding caffeine intake is as follows: 1. Supplementation with caffeine has been shown to acutely enhance various aspects of exercise performance in many but not all studies. Small to moderate benefits of caffeine use include, but are not limited to: muscular endurance, movement velocity and muscular strength, sprinting, jumping, and throwing performance, as well as a wide range of aerobic and anaerobic sport-specific actions. 2. Aerobic endurance appears to be the form of exercise with the most consistent moderate-to-large benefits from caffeine use, although the magnitude of its effects differs between individuals. 3. Caffeine has consistently been shown to improve exercise performance when consumed in doses of 3-6 mg/kg body mass. Minimal effective doses of caffeine currently remain unclear but they may be as low as 2 mg/kg body mass. Very high doses of caffeine (e.g. 9 mg/kg) are associated with a high incidence of side-effects and do not seem to be required to elicit an ergogenic effect. 4. The most commonly used timing of caffeine supplementation is 60 min pre-exercise. Optimal timing of caffeine ingestion likely depends on the source of caffeine. For example, as compared to caffeine capsules, caffeine chewing gums may require a shorter waiting time from consumption to the start of the exercise session. 5. Caffeine appears to improve physical performance in both trained and untrained individuals. 6. Inter-individual differences in sport and exercise performance as well as adverse effects on sleep or feelings of anxiety following caffeine ingestion may be attributed to genetic variation associated with caffeine metabolism, and physical and psychological response. Other factors such as habitual caffeine intake also may play a role in between-individual response variation. 7. Caffeine has been shown to be ergogenic for cognitive function, including attention and vigilance, in most individuals. 8. Caffeine may improve cognitive and physical performance in some individuals under conditions of sleep deprivation. 9. The use of caffeine in conjunction with endurance exercise in the heat and at altitude is well supported when dosages range from 3 to 6 mg/kg and 4-6 mg/kg, respectively. 10. Alternative sources of caffeine such as caffeinated chewing gum, mouth rinses, energy gels and chews have been shown to improve performance, primarily in aerobic exercise. 11. Energy drinks and pre-workout supplements containing caffeine have been demonstrated to enhance both anaerobic and aerobic performance.

Resistance training exercise selection: efficiency, safety and comfort analysis method / Seleção do exercício no treinamento resistido: método de análise eficiência, segurança e conforto

Abstract Manipulation of resistance training variables has been shown to have a substantial effect on muscular adaptations. A major variable in this process is exercise selection. In addition to the effectiveness of a given exercise to recruit the target muscle groups, safety considerations and individual comfort during execution of a lift should be considered. The correct biomechanics of the chosen exercise will assist in promoting desired muscle adaptations, while proper safety procedures will reduce risk of injury. Lifting comfort will facilitate enjoyment and foster adherence to the program. Therefore, the purpose of this paper was to offer guidelines for selection of resistance training exercises based on the Efficiency, Safety, and Comfort Analysis Method (ESCAM).

Resumo A manipulação das variáveis do treinamento resistido demonstraram ter um efeito substancial nas adaptações musculares. Uma variável importante neste processo é a seleção de exercícios. Além da eficácia de um determinado exercício para recrutar os grupos musculares-alvo, as considerações de segurança e conforto individual durante a execução de um levantamento devem ser considerados. A biomecânica correta do exercício escolhido ajudará a promover as adaptações musculares desejadas, enquanto os procedimentos de segurança adequados reduzirão o risco de lesões. O conforto no levantamento facilitará o prazer e promoverá a adesão ao programa. Portanto, o objetivo deste artigo é oferecer orientações para a seleção de exercícios no treinamento resistido com base no Método de Análise de Eficiência, Segurança e Conforto (ESCAM).

ADOR2A C Allele Carriers Exhibit Ergogenic Responses to Caffeine Supplementation.

Caffeine's ergogenic effects on exercise performance are generally explained by its ability to bind to adenosine receptors. ADORA2A is the gene that encodes A2A subtypes of adenosine receptors. It has been suggested that ADORA2A gene polymorphisms may be responsible for the inter-individual variations in the effects of caffeine on exercise performance. In the only study that explored the influence of variation in ADORA2A-in this case, a common polymorphism (rs5751876)-on the ergogenic effects of caffeine on exercise performance, C allele carriers were identified as "non-responders" to caffeine. To explore if C allele carriers are true "non-responders" to the ergogenic effects of caffeine, in this randomized, double-blind study, we examined the acute effects of caffeine ingestion among a sample consisting exclusively of ADORA2A C allele carriers. Twenty resistance-trained men identified as ADORA2A C allele carriers (CC/CT genotype) were tested on two occasions, following the ingestion of caffeine (3 mg/kg) and a placebo. Exercise performance was evaluated with movement velocity, power output, and muscle endurance during the bench press exercise, countermovement jump height, and power output during a Wingate test. Out of the 25 analyzed variables, caffeine was ergogenic in 21 (effect size range: 0.14 to 0.96). In conclusion, ADORA2A (rs5751876) C allele carriers exhibited ergogenic responses to caffeine ingestion, with the magnitude of improvements similar to what was previously reported in the literature among samples that were not genotype-specific. Therefore, individuals with the CT/CC genotype may still consider supplementing with caffeine for acute improvements in performance.

Dietary vs. pharmacological doses of zinc: A clinical review.

Zinc deficiency has a global impact on health in both developing and developed countries, especially among children and the elderly. By modulating anti-inflammatory and antioxidant pathways, zinc supplementation is recommended for the treatment of several ailments, such as liver disease, male hypogonadism, cancers, heart disease (e.g. dyslipidemia) and central nervous system disorders; however, the topic of dietary vs. pharmacological doses of zinc remains controversial. This paper provides a detailed critical review of the effects of zinc supplementation in medicinal doses (i.e. >40 mg/d of elemental zinc) on human health. We further highlight the difficulty in achieving a therapeutic dose of zinc from foodstuffs.

Synergist ablation-induced hypertrophy occurs more rapidly in the plantaris than soleus muscle in rats due to different molecular mechanisms.

We examined molecular mechanisms that were altered during rapid soleus (type I fiber-dominant) and plantaris (type II fiber-dominant) hypertrophy in rats. Twelve Wistar rats (3.5 mo old; 6 female, 6 male) were subjected to surgical right-leg soleus and plantaris dual overload [synergist ablation (SA)], and sham surgeries were performed on left legs (CTL). At 14 days after surgery, the muscles were dissected. Plantaris mass was 27% greater in the SA than CTL leg (P < 0.001), soleus mass was 13% greater in the SA than CTL leg (P < 0.001), and plantaris mass was higher than soleus mass in the SA leg (P = 0.001). Plantaris total RNA concentrations and estimated total RNA levels (suggestive of ribosome density) were 19% and 47% greater in the SA than CTL leg (P < 0.05), protein synthesis levels were 64% greater in the SA than CTL leg (P = 0.038), and satellite cell number per fiber was 60% greater in the SA than CTL leg (P = 0.003); no differences in these metrics were observed between soleus SA and CTL legs. Plantaris, as well as soleus, 20S proteasome activity was lower in the SA than CTL leg (P < 0.05), although the degree of downregulation was greater in the plantaris than soleus muscle (-63% vs. -20%, P = 0.001). These data suggest that early-phase plantaris hypertrophy occurs more rapidly than soleus hypertrophy, which coincided with greater increases in ribosome biogenesis, protein synthesis, and satellite cell density, as well as greater decrements in 20S proteasome activity, in the plantaris muscle.

Vinegar (acetic acid) intake on glucose metabolism: A narrative review.

Vinegar intake is considered a food item that improves blood glucose in humans. This review aimed to discuss studies that investigated the impact of vinegar intake on the glycemic profile in humans and the putative mechanistic cellular pathways in both human and animal models. A search of literature was performed on the Cochrane, MEDLINE and Web of Science databases for articles published between 1995 and 2018. There is considerable support for vinegar having a positive acute effect on blood glucose levels when combined with carbohydrate-rich meals. Conversely, there are few chronic interventions analyzing the impact of vinegar intake on blood glucose. Based on available evidence, we hypothesize three pathways by which vinegar may improve blood glucose: The inhibition of α-amylase action; increased glucose uptake; and mediation by transcription factors. When evaluating the current body of literature, daily vinegar intake in amounts of ∼10-30 mL (∼2-6 tablespoons) appear to improve the glycemic response to carbohydrate-rich meals; however, there is a paucity of studies investigating chronic effects of vinegar intake.

Oxidative stress, inflammation, psychological status, and severity of respiratory infections are negatively affected during the pre-contest period in amateur bodybuilders.

We examined whether off-season (OffS) and pre-contest (PreC) periods affect blood oxidative stress, inflammatory, immunological, and psychological markers in 20 bodybuilders. The athletes recorded their food intake (3-day record), physical activities, mood states (Profile of Mood States, POMS), recovery-stress (Recovery-Stress Questionnaire for Athletes, RESTQ-Sport), and upper respiratory symptoms (Wisconsin Upper Respiratory Symptom Survey, WURSS-21), and blood was obtained for biochemical analysis. Almost all athletes were in positive energy balance during OffS, while bodybuilders presented markedly restricted energy intake (∼45%) leading to loss of weight (-9%) and fat mass (-45%) with preservation of fat-free mass in PreC. Protein intake was high during both periods, while lipid and carbohydrate intakes were reduced ∼50% in PreC. Almost all athletes consumed 100% of the Recommended Dietary Allowance (RDA) for micronutrients in OffS, while 45% and 75% of the athletes had intakes below the RDA for vitamins A and E in PreC. Oxidative damage to lipids (thiobarbituric acid reactive substances, TBARS), protein carbonyls, and the TBARS/total antioxidant capacity ratio increased in PreC (32%, 27%, 60%), as did plasma tumor necrosis factor α (4-fold) and WURSS-21 scores (25%). There were no significant changes in serum catalase, glutathione reductase, and superoxide dismutase activities nor in interleukin 1ß and immunoglobulins. In PreC, POMS showed negative changes in vigor (-20%), fatigue (23%), and total mood disturbance (35%), and RESTQ-Sport showed alterations for general and sport stress (34% and 50%, respectively) and sport recovery (-23%). Thus, PreC negatively affects nutrient intake, which may worsen oxidative stress, inflammation, psychological status, and the severity of respiratory infections in bodybuilders.

Hypertrophic Effects of Concentric vs. Eccentric Muscle Actions: A Systematic Review and Meta-analysis.

Schoenfeld, BJ, Ogborn, DI, Vigotsky, AD, Franchi, MV, and Krieger, JW. Hypertrophic effects of concentric vs. eccentric muscle actions: A systematic review and meta-analysis. J Strength Cond Res 31(9): 2599-2608, 2017-Controversy exists as to whether different dynamic muscle actions produce divergent hypertrophic responses. The purpose of this paper was to conduct a systematic review and meta-analysis of randomized controlled trials comparing the hypertrophic effects of concentric vs. eccentric training in healthy adults after regimented resistance training (RT). Studies were deemed eligible for inclusion if they met the following criteria: (a) were an experimental trial published in an English-language refereed journal; (b) directly compared concentric and eccentric actions without the use of external implements (i.e., blood pressure cuffs) and all other RT variables equivalent; (c) measured morphologic changes using biopsy, imaging (magnetic resonance imaging, computerized tomography, or ultrasound), bioelectrical impedance, and/or densitometry; (d) had a minimum duration of 6 weeks; and (e) used human participants without musculoskeletal injury or any health condition that could directly, or through the medications associated with the management of said condition, be expected to impact the hypertrophic response to resistance exercise. A systematic literature search determined that 15 studies met inclusion criteria. Results showed that eccentric muscle actions resulted in a greater effect size (ES) compared with concentric actions, but results did not reach statistical significance (ES difference = 0.25 ± 0.13; 95% confidence interval: -0.03 to 0.52; p = 0.076). The mean percent change in muscle growth across studies favored eccentric compared with concentric actions (10.0% vs. 6.8, respectively). The findings indicate the importance of including eccentric and concentric actions in a hypertrophy-oriented RT program, as both have shown to be effective in increasing muscle hypertrophy.

Acute effect of different warm-up interventions on neuromuscular performance of recreational soccer players / Efeito agudo de diferentes intervenções de aquecimento pré-exercício sobre o desempenho neuromuscular de jogadores amadores de futebol

Pre-exercises interventions are frequently implemented in order to maximize athletic performance. In this sense, the aim of this study was to evaluated the effect of three distinct pre-exercise interventions on acute neuromuscular performance in recreational soccer players: 1) parallel squat; 2) static stretching; and 3) ballistic stretching. After all interventions, participants performed a flexibility evaluation (sit-and-reach-test), followed by a squat jump, a counter-movement jump and a 30 meter-sprint test. A one-way analysis of variance revealed: a) a significant decrease in jumping performance was induced by both Stretching conditions when compared to the parallel squat intervention; b) a significant increase in lower limb flexibility after both stretching interventions when compared to parallel squat. In conclusion, it is suggested that a pre-exercise intervention comprised of stretching exercises acutely increase flexibility, while may interfere in jump performance in recreational athletes...(AU)

Intervenções pré-exercício são frequentemente adotadas para maximizar o desempenho atlético. Nesse sentido, o objetivo deste estudo foi avaliar o efeito de três diferentes intervenções pré- exercício sobre o desempenho neuromuscular de jogadores de futebol amadores: 1) agachamento paralelo, 2) alongamento estático e 3) alongamento balístico. Após as intervenções, os participantes realizaram a avaliação de flexibilidade (teste de sentar e alcançar) e, em seguida, o salto com agachamento, o salto com contramovimento e o teste de velocidade de 30 metros. Os resultados da ANOVA one-way revelaram: a) redução significante no desempenho do salto para ambas às condições de alongamento quando comparadas ao agachamento paralelo e b) aumento significante da flexibilidade dos membros inferiores após ambas às intervenções de alongamento em comparação ao achamento paralelo. Em conclusão, sugere-se que as intervenções pré-exercício compostas de exercícios de alongamento aumentam agudamente a flexibilidade, paralelamente, podendo prejudicar o desempenho de saltos de atletas amadores...(AU)

Resistance training improves inflammatory level, lipid and glycemic profiles in obese older women: A randomized controlled trial.

The main purpose of the present study was to investigate the effect of resistance training on inflammatory levels, lipid and glycemic profile in obese older women. Thirty-eight obese older women (68.2±4.2years, and 41.0±6.2% of body fat) were randomly assigned to one of two groups: A training group (TG, n=19) that performed 8weeks of RT; or a control group (CG, n=19) that did not perform any type of exercise. The RT program consisted of 8 whole-body exercises for 3 sets of 10-15 repetition maximum (RM) carried out 3 times a week. Anthropometric, body composition (DXA), muscular strength (1RM), and blood sample measurements were performed pre- and post-training. After the intervention period, the TG demonstrated significantly (P<0.05) lower values than CG for interleukin-6 (TG=3.3±1.2pg/mL vs. CG=3.8±1.4pg/mL), tumor necrosis factor alpha (TG=3.1±1.5pg/mL vs. CG=3.5±1.8pg/mL), C-reactive protein (TG=1.8±1.4mg/L vs. CG=3.2±1.8mg/L), low-density lipoprotein (TG=85.1±11.0mg/dL vs. CG=148.7±0.1mg/dL), glucose (TG=90.8±11.1mg/dL vs. CG=97.9±6.9mg/dL), trunk fat (TG=12.7±3.5kg vs. CG=14.1±4.3kg), and total body fat (TG=37.5±5.7% vs. CG=43.1±5.6%). Furthermore, TG presented significantly (P<0.05) higher values for high-density lipoprotein (TG=58.3±15.4mg/dL vs. CG=55.2±11.8mg/dL). These results suggest that 8weeks of RT promote improvements on inflammatory levels, and the lipid and glycemic profile in obese older women. These findings further support the important role of RT in healthy aging.

Effects of Resistance Training Frequency on Measures of Muscle Hypertrophy: A Systematic Review and Meta-Analysis.

BACKGROUND: A number of resistance training (RT) program variables can be manipulated to maximize muscular hypertrophy. One variable of primary interest in this regard is RT frequency. Frequency can refer to the number of resistance training sessions performed in a given period of time, as well as to the number of times a specific muscle group is trained over a given period of time. OBJECTIVE: We conducted a systematic review and meta-analysis to determine the effects of resistance training frequency on hypertrophic outcomes. METHODS: Studies were deemed eligible for inclusion if they met the following criteria: (1) were an experimental trial published in an English-language refereed journal; (2) directly compared different weekly resistance training frequencies in traditional dynamic exercise using coupled concentric and eccentric actions; (3) measured morphologic changes via biopsy, imaging, circumference, and/or densitometry; (4) had a minimum duration of 4 weeks; and (5) used human participants without chronic disease or injury. A total of ten studies were identified that investigated RT frequency in accordance with the criteria outlined. RESULTS: Analysis using binary frequency as a predictor variable revealed a significant impact of training frequency on hypertrophy effect size (P = 0.002), with higher frequency being associated with a greater effect size than lower frequency (0.49 ± 0.08 vs. 0.30 ± 0.07, respectively). Statistical analyses of studies investigating training session frequency when groups are matched for frequency of training per muscle group could not be carried out and reliable estimates could not be generated due to inadequate sample size. CONCLUSIONS: When comparing studies that investigated training muscle groups between 1 to 3 days per week on a volume-equated basis, the current body of evidence indicates that frequencies of training twice a week promote superior hypertrophic outcomes to once a week. It can therefore be inferred that the major muscle groups should be trained at least twice a week to maximize muscle growth; whether training a muscle group three times per week is superior to a twice-per-week protocol remains to be determined.

Muscle Activation Pattern During Isometric Ab Wheel Rollout Exercise in Different Shoulder Angle-Positions / Padrão isométrico de ativação muscular durante o exercício AB Wheel Rollout em diferentes posições do complexo articular do ombro

OBJECTIVE: To investigate muscle activation of the shoulder extensors and trunk stabilizers by surface electromyography (sEMG) activity during the isometric Ab Wheel Rollout exercise in different shoulder joint positions. METHOD: We recruited 8 young, healthy, resistance trained men (age: 25 ± 3 years, height: 178 ± 5 cm, and total body mass: 81 ± 2 kg). All subjects performed two sets of 10 sec. maximal isometric contractions of the Ab Wheel Rollout exercise keeping the knees fixed on the floor and the arms taut. To perform the exercise, all subjects were randomly assessed in the following three positions related to the angle between the arms and trunk, in random order: arms aligned vertically with the Ab Wheel Rollout exercise (neutral); 90º and 150º. A rest period of 5 minutes was provided between tests. The sEMG signals were recorded in the following muscles: Latissimus Dorsi; Pectoralis Major; Erector Spinae; Rectus Abdominis. RESULTS: There were significant increases in Rectus Abdominis muscle activity between: neutral vs. 90º, neutral vs. 150º and 90º vs. 150º. There was a significant increase in Pectoralis Major muscle activity between neutral x 150º. CONCLUSION: The present findings indicate that (a) Ab Wheel Rollout exercise emphasizes the muscle action of the Pectoralis Major and Rectus Abdominis more than the Latissimus Dorsi and Erector Spinae; (b) the level of muscle activation depends on the external force created by the body mass and lever arm from the center of mass.

RESUMO OBJETIVO: O objetivo do estudo foi investigar o padrão de atividade muscular isométrica de extensores de ombro e estabilizadores de tronco através de eletromiografia de superfície (sEMG) durante diferentes posições do complexo articular do ombro durante o exercício Ab Wheel Rollout. MÉTODO: Foram recrutados 8 voluntários jovens e treinados em força, com idade: 25 ± 3 anos, estatura: 178 ± 5 cm, e massa corporal total: 81 ± 2 kg. Os participantes realizaram duas séries de 10 segundos em contração isométrica utilizando o Ab Wheel Rollout, e mantiveram os joelhos apoiados no chão e os braços estendidos. Três posições de ombro (em relação ao tronco) foram avaliadas de forma aleatória entre os participantes: braços posicionados na vertical e alinhado ao eixo do Ab Wheel Rollout (neutra); 90 graus and 150 graus. Um período de cinco minutos de repouso foi respeitado entre posições e tentativas. Os sinais mioelétricos foram medidos para os seguintes músculos: Latíssimo do Dorso; Peitoral Maior; Eretor da Coluna; Reto do Abdome. RESULTADOS: Foi observado um aumento significante da atividade muscular isométrica para o músculo Reto do Abdome entre as posições: neutra x 90º, neutra x 150º e 90º x 150º. Houve aumento significante na ativação muscular isométrica do Peitoral Maior entre a posição neutra x 150º. CONCLUSÃO: O presente estudo indica que (a) o exercício Ab Wheel Rollout enfatiza a ação muscular do Peitoral Maior e do Reto do Abdome em relação ao Latíssimo do Dorso e aos Eretores da Coluna; (b) o nível de ativação mioelétrica depende das forças externas criadas pelo peso corporal e pelo braço de alavanca do centro de massa.

Effect of repetition duration during resistance training on muscle hypertrophy: a systematic review and meta-analysis.

BACKGROUND: Maximizing the hypertrophic response to resistance training (RT) is thought to be best achieved by proper manipulation of exercise program variables including exercise selection, exercise order, length of rest intervals, intensity of maximal load, and training volume. An often overlooked variable that also may impact muscle growth is repetition duration. Duration amounts to the sum total of the concentric, eccentric, and isometric components of a repetition, and is predicated on the tempo at which the repetition is performed. OBJECTIVE: We conducted a systematic review and meta-analysis to determine whether alterations in repetition duration can amplify the hypertrophic response to RT. METHODS: Studies were deemed eligible for inclusion if they met the following criteria: (1) were an experimental trial published in an English-language refereed journal; (2) directly compared different training tempos in dynamic exercise using both concentric and eccentric repetitions; (3) measured morphologic changes via biopsy, imaging, and/or densitometry; (4) had a minimum duration of 6 weeks; (5) carried out training to muscle failure, defined as the inability to complete another concentric repetition while maintaining proper form; and (6) used human subjects who did not have a chronic disease or injury. A total of eight studies were identified that investigated repetition duration in accordance with the criteria outlined. RESULTS: Results indicate that hypertrophic outcomes are similar when training with repetition durations ranging from 0.5 to 8 s. CONCLUSIONS: From a practical standpoint it would seem that a fairly wide range of repetition durations can be employed if the primary goal is to maximize muscle growth. Findings suggest that training at volitionally very slow durations (>10s per repetition) is inferior from a hypertrophy standpoint, although a lack of controlled studies on the topic makes it difficult to draw definitive conclusions.

Potential mechanisms for a role of metabolic stress in hypertrophic adaptations to resistance training.

It is well established that regimented resistance training can promote increases in muscle hypertrophy. The prevailing body of research indicates that mechanical stress is the primary impetus for this adaptive response and studies show that mechanical stress alone can initiate anabolic signalling. Given the dominant role of mechanical stress in muscle growth, the question arises as to whether other factors may enhance the post-exercise hypertrophic response. Several researchers have proposed that exercise-induced metabolic stress may in fact confer such an anabolic effect and some have even suggested that metabolite accumulation may be more important than high force development in optimizing muscle growth. Metabolic stress pursuant to traditional resistance training manifests as a result of exercise that relies on anaerobic glycolysis for adenosine triphosphate production. This, in turn, causes the subsequent accumulation of metabolites, particularly lactate and H(+). Acute muscle hypoxia associated with such training methods may further heighten metabolic buildup. Therefore, the purpose of this paper will be to review the emerging body of research suggesting a role for exercise-induced metabolic stress in maximizing muscle development and present insights as to the potential mechanisms by which these hypertrophic adaptations may occur. These mechanisms include increased fibre recruitment, elevated systemic hormonal production, alterations in local myokines, heightened production of reactive oxygen species and cell swelling. Recommendations are provided for potential areas of future research on the subject.