Influence of Exogenous ß-Hydroxybutyrate on Walking Economy and Rating of Perceived Exertion.

This study investigates the effect of a supplementary ketone, ß-hydroxybutyrate (BHB), on walking economy and ratings of perceived exertion in apparently healthy individuals. In a repeated-measures, crossover design, ten non-aerobically trained participants (three males; seven females) performed two stages of a duration-modified Bruce treadmill protocol. Participants blindly consumed either 1 ounce of an exogenous BHB solution (KETO) or a noncaloric placebo (CON) 30 minutes prior to exercise testing. Blood ketone and glucose concentrations were measured prior to supplementation (baseline), immediately before exercise, and after exercise. Oxygen consumption (VO2), respiratory exchange ratio (RER), energy expenditure (EE), and rating of perceived exertion (RPE) were recorded during the last two minutes of each stage. Blood BHB concentrations were significantly elevated at the pre-exercise and postexercise time points as compared to the CON condition (p < .001), and blood glucose was significantly elevated postexercise in both conditions as compared to baseline levels (p < .001). No significant between-trial differences (p > .05) were found for VO2, RER, EE, or RPE. The intervention of this study did not produce evidence of an ergogenic benefit from BHB supplementation in a healthy subject pool.

The effects of beetroot juice supplementation on exercise economy, rating of perceived exertion and running mechanics in elite distance runners: A double-blinded, randomized study.

PURPOSE: Nitrate-rich beetroot juice supplementation has been extensively used to increase exercise economy in different populations. However, its use in elite distance runners, and its potential effects on biomechanical aspects of running have not been properly investigated. This study aims to analyze the potential effects of 15 days of beetroot juice supplementation on physiological, psychological and biomechanical variables in elite runners. METHODS: Twelve elite middle and long-distance runners (age = 26.3 ± 5.1yrs, VO2Max = 71.8±5.2 ml*kg-1*min-1) completed an incremental running test to exhaustion on a treadmill before and after a 15-days supplementation period, in which half of the group (EG) consumed a daily nitrate-rich beetroot juice and the other group (PG) consumed a placebo drink. Time to exhaustion (TEx), running economy, vastus lateralis oxygen saturation (SmO2), leg stiffness and rate of perceived exertion (RPE) were measured at 15, 17.1 and 20 km/h during the incremental test. RESULTS: Likely to very likely improvements in EG were observed for the RPE (Standardized mean difference (SMD) = -2.17, 90%CI = -3.23, -1.1), SmO2 (SMD = 0.72, 90%CI = 0.03, 1.41) and TEx (SMD = 1.18, 90%CI = -0.14, 2.5) in comparison with PG. No other physiological or biomechanical variable showed substantial improvements after the supplementation period. CONCLUSIONS: Fifteen days of nitrate-rich beetroot juice supplementation produced substantial improvements in the time to exhaustion in elite runners; however, it didn't produce meaningful improvements in running economy, VO2Max or mechanical parameters.

Effects of Energy Drinks on Economy and Cardiovascular Measures.

Peveler, WW, Sanders, GJ, Marczinski, CA, and Holmer, B. Effects of energy drinks on economy and cardiovascular measures. J Strength Cond Res 31(4): 882-887, 2017-The use of energy drinks among athletes has risen greatly. Caffeine and taurine are the 2 primary performance enhancing ingredients found in energy drinks. The number of emergency department visits involving energy drinks doubled over the past 5 years. Reviews of the health complications have highlighted adverse cardiovascular events. The literature reveals that caffeine is known to moderately increase blood pressure (BP) and heart rate (HR). The purpose of this study was to determine the effect of 3 different energy drinks on cardiovascular and performance measures. Fifteen recreational runners completed 5 trials. The first trial consisted of a graded exercise protocol. The 4 remaining trials consisted of 15-minute economy trials at a treadmill speed consistent with 70% of subject's V[Combining Dot Above]O2max. An hour before subjects ingested 1 of the 3 energy drinks or a placebo. HR, BP, V[Combining Dot Above]O2, and rating of perceived exertion (RPE) were recorded during the 15-minute trial. Mean values for dependent measures were compared using repeated-measures analysis of variance. Fifteen-minute systolic BP readings were significantly lower in the placebo trials (156.93 ± 15.50) in relation to the 3 energy drink trials (163.87 ± 13.30, 166.47 ± 13.71, and 165.00 ± 15.23). There were no significant differences in diastolic BP and HR. There were no significant differences found in V[Combining Dot Above]O2 or RPE measures. Ingestion of energy drinks demonstrated no change in V[Combining Dot Above]O2 or RPE during the economy trials. The findings show no performance benefits under the conditions of this study. However, there does appear to be a significant increase in systolic BP.

Dopamine antagonism decreases willingness to expend physical, but not cognitive, effort: a comparison of two rodent cost/benefit decision-making tasks.

Successful decision making often requires weighing a given option's costs against its associated benefits, an ability that appears perturbed in virtually every severe mental illness. Animal models of such cost/benefit decision making overwhelmingly implicate mesolimbic dopamine in our willingness to exert effort for a larger reward. Until recently, however, animal models have invariably manipulated the degree of physical effort, whereas human studies of effort have primarily relied on cognitive costs. Dopamine's relationship to cognitive effort has not been directly examined, nor has the relationship between individuals' willingness to expend mental versus physical effort. It is therefore unclear whether willingness to work hard in one domain corresponds to willingness in the other. Here we utilize a rat cognitive effort task (rCET), wherein animals can choose to allocate greater visuospatial attention for a greater reward, and a previously established physical effort-discounting task (EDT) to examine dopaminergic and noradrenergic contributions to effort. The dopamine antagonists eticlopride and SCH23390 each decreased willingness to exert physical effort on the EDT; these drugs had no effect on willingness to exert mental effort for the rCET. Preference for the high effort option correlated across the two tasks, although this effect was transient. These results suggest that dopamine is only minimally involved in cost/benefit decision making with cognitive effort costs. The constructs of mental and physical effort may therefore comprise overlapping, but distinct, circuitry, and therapeutic interventions that prove efficacious in one effort domain may not be beneficial in another.

Supplementation with eicosapentaenoic acid-rich fish oil improves exercise economy and reduces perceived exertion during submaximal steady-state exercise in normal healthy untrained men.

Based on the effects of n-3 polyunsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on reduction of blood viscosity, we theorized that PUFA could improve aerobic performance by increasing oxygen supply to tissues. Twenty male subjects were randomly divided into two groups (n = 10): a fish oil group (FG) and a control (CG). Maximal oxygen uptake and oxygen uptake during submaximal exercise were measured using a cycle ergometer. For 8 weeks, the FG then ingested capsules containing 3.6 g/day of EPA-rich fish oil, while the CG took 3.6 g/day of a medium-chain triglyceride. After supplementation, erythrocyte EPA and DHA in the FG were significantly increased. In the FG, a negative linear correlation was detected in the change between erythrocyte EPA and whole oxygen uptake during submaximal exercise pre- and post-supplementation. The present study showed that EPA-rich fish oil supplementation improves exercise economy in humans.

Effects of resveratrol in patients with type 2 diabetes mellitus on skeletal muscle SIRT1 expression and energy expenditure.

OBJECTIVES: The primary aims of the study were to examine the effect of resveratrol on skeletal muscle SIRT1 expression and energy expenditure in subjects with Type 2 diabetes mellitus (T2DM). BACKGROUND: Animal and in vivo studies indicate that resveratrol increases SIRT1 expression that stimulates PGC1α activity. Subsequent upregulation of AMPK and GLUT4 expression are associated with improved insulin sensitivity in peripheral tissues. METHODS: Ten subjects with T2DM were randomized in a double-blind fashion to receive 3g resveratrol or placebo daily for 12 weeks. Secondary outcomes include measures of AMPK, p-AMPK and GLUT4 expression levels, energy expenditure, physical activity levels, distribution of abdominal adipose tissue and skeletal muscle fiber type composition, body weight, HbA1c, plasma lipid subfraction, adiponectin levels, and insulin sensitivity. RESULTS: There was a significant increase in both SIRT1 expression (2.01 vs. 0.86 arbitrary units [AU], p = .016) and p-AMPK to AMPK expression ratio (2.04 vs. 0.79 AU, p = .032) in the resveratrol group compared with the placebo group. Although the percentage of absolute change (8.6 vs. -13.9%, p = .033) and percentage of predicted resting metabolic rate (RMR; 7.8 vs. -13.9%, p = .013) were increased following resveratrol, there was a significant reduction in average daily activity (-38 vs. 43.2%, p = .028) and step counts (-39.5 vs. 11.8%, p = .047) when compared with placebo. CONCLUSIONS: In patients with T2DM, treatment with resveratrol regulates energy expenditure through increased skeletal muscle SIRT1 and AMPK expression. These findings indicate that resveratrol may have beneficial exercise-mimetic effects in patients with T2DM.

Assessment of vitamin D concentration in non-supplemented professional athletes and healthy adults during the winter months in the UK: implications for skeletal muscle function.

The current study implemented a two-part design to (1) assess the vitamin D concentration of a large cohort of non-vitamin D supplemented UK-based athletes and 30 age-matched healthy non-athletes and (2) to examine the effects of 5000 IU · day(-1) vitamin D(3) supplementation for 8-weeks on musculoskeletal performance in a placebo controlled trial. Vitamin D concentration was determined as severely deficient if serum 25(OH)D < 12.5 nmol · l(-1), deficient 12.5-30 nmol · l(-1) and inadequate 30-50 nmol · l(-1). We demonstrate that 62% of the athletes (38/61) and 73% of the controls (22/30) exhibited serum total 25(OH)D < 50 nmol · l(-1). Additionally, vitamin D supplementation increased serum total 25(OH)D from baseline (mean ± SD = 29 ± 25 to 103 ± 25 nmol · l(-1), P = 0.0028), whereas the placebo showed no significant change (53 ± 29 to 74 ± 24 nmol · l(-1), P = 0.12). There was a significant increase in 10 m sprint times (P = 0.008) and vertical-jump (P = 0.008) in the vitamin D group whereas the placebo showed no change (P = 0.587 and P = 0.204 respectively). The current data supports previous findings that athletes living at Northerly latitudes (UK = 53° N) exhibit inadequate vitamin D concentrations (<50 nmol · l(-1)). Additionally the data suggests that inadequate vitamin D concentration is detrimental to musculoskeletal performance in athletes. Future studies using larger athletic groups are now warranted.

Obesity is a sign - over-eating is a symptom: an aetiological framework for the assessment and management of obesity.

Obesity is characterized by the accumulation of excess body fat and can be conceptualized as the physical manifestation of chronic energy excess. Using the analogy of oedema, the consequence of positive fluid balance or fluid retention, obesity can be seen as the consequence of positive energy balance or calorie 'retention'. Just as the assessment of oedema requires a comprehensive assessment of factors related to fluid balance, the assessment of obesity requires a systematic assessment of factors potentially affecting energy intake, metabolism and expenditure. Rather than just identifying and describing a behaviour ('this patient eats too much'), clinicians should seek to identify the determinants of this behaviour ('why, does this patient eat too much?'). This paper provides an aetiological framework for the systematic assessment of the socio-cultural, biomedical, psychological and iatrogenic factors that influence energy input, metabolism and expenditure. The paper discusses factors that affect metabolism (age, sex, genetics, neuroendocrine factors, sarcopenia, metabolically active fat, medications, prior weight loss), energy intake (socio-cultural factors, mindless eating, physical hunger, emotional eating, mental health, medications) and activity (socio-cultural factors, physical and emotional barriers, medications). It is expected that the clinical application of this framework can help clinicians systematically assess, identify and thereby address the aetiological determinants of positive energy balance resulting in more effective obesity prevention and management.

The adenosine A2A antagonist MSX-3 reverses the effects of the dopamine antagonist haloperidol on effort-related decision making in a T-maze cost/benefit procedure.

RATIONALE: Mesolimbic dopamine (DA) is a critical component of the brain circuitry regulating behavioral activation and effort-related processes. Research involving choice tasks has shown that rats with impaired DA transmission reallocate their instrumental behavior away from food-reinforced tasks with high response requirements and instead select less effortful food-seeking behaviors. OBJECTIVE: Previous work showed that adenosine A(2A) antagonism can reverse the effects of the DA antagonist haloperidol in an operant task that assesses effort-related choice. The present work used a T-maze choice procedure to assess the effects of adenosine A(2A) and A(1) antagonism. MATERIALS AND METHODS: With this task, the two arms of the maze have different reinforcement densities (four vs. two food pellets), and a vertical 44 cm barrier is positioned in the arm with the higher density, presenting the animal with an effort-related challenge. Untreated rats strongly prefer the arm with the high density of food reward and climb the barrier in order to obtain the food. RESULTS: Haloperidol produced a dose-related (0.05-0.15 mg/kg i.p.) reduction in the number of trials in which the rats chose the high-barrier arm. Co-administration of the adenosine A(2A) receptor antagonist MSX-3 (0.75, 1.5, and 3.0 mg/kg i.p.), but not the A(1) antagonist 8-cyclopentyl-1,3-dipropylxanthine (0.75, 1.5, and 3.0 mg/kg i.p.), reversed the effects of haloperidol on effort-related choice and latency. CONCLUSIONS: Adenosine A(2A) and D2 receptors interact to regulate effort-related decision making, which may have implications for the treatment of psychiatric symptoms such as psychomotor slowing or anergia that can be observed in depression, parkinsonism, and other disorders.

Translating exercise biology into the Venezuelan medical education and health care system.

In the absence of pharmacological agents, physical exercise was widely used by physicians in the late 19th century to treat a number of maladies. In the 1950's, epidemiological evidence suggested an association between physical activity and health, and increased interest in clinical exercise biology. By the 1990's, sufficient research data was accumulated on the benefits of exercise, such that North American medical associations, government agencies, and the World Health Organization have published guidelines on exercise for public and clinical populations. Despite this, leaders in medical education have remained reluctant to incorporate exercise biology into the core medical curriculum, or to systematically implement it in graduate medical education. This work reviews Venezuelan exercise biology literature, and its medical applications. Venezuelan scientists and clinicians have invested efforts in cardiopulmonary exercise testing, skeletal muscle adaptations to training and exercise cardiovascular pharmacology in patients, sedentary subjects and athletes. It is suggested here, that there is a need to develop education and research programs in basic and clinical exercise biology in the formal training of medical students, physicians in residency programs, and allied health care professionals. Tentative steps to initiate this process are proposed.

Betaine supplementation decreases plasma homocysteine concentrations but does not affect body weight, body composition, or resting energy expenditure in human subjects.

BACKGROUND: Betaine (trimethylglycine) is found in several tissues in humans. It is involved in homocysteine metabolism as an alternative methyl donor and is used in the treatment of homocystinuria in humans. In pigs, betaine decreases the amount of adipose tissue. OBJECTIVE: The aim of the study was to examine the effect of betaine supplementation on body weight, body composition, plasma homocysteine concentrations, blood pressure, and serum total and lipoprotein lipids. DESIGN: Forty-two obese, white subjects (14 men, 28 women) treated with a hypoenergetic diet were randomly assigned to a betaine-supplemented group (6 g/d) or a control group given placebo for 12 wk. The intervention period was preceded by a 4-wk run-in period with a euenergetic diet. RESULTS: Body weight, resting energy expenditure, and fat mass decreased significantly in both groups with no significant difference between the groups. Plasma homocysteine concentrations decreased in the betaine group ( +/- SD: 8.76 +/- 1.63 micro mol/L at 4 wk, 7.93 +/- 1.52 micro mol/L at 16 wk; P = 0.030 for the interaction of time and treatment). Diastolic blood pressure decreased without a significant difference between the groups. Serum total and LDL-cholesterol concentrations were higher in the betaine group than in the control group (P < 0.05). CONCLUSION: A hypoenergetic diet with betaine supplementation (6 g daily for 12 wk) decreased the plasma homocysteine concentration but did not affect body composition more than a hypoenergetic diet without betaine supplementation did.

Sucrose intake as a function of its cost and the cost of chow.

The avid consumption of pure carbohydrate solutions, which often results in a distortion of nutrient balance, is generally presumed to be driven by their taste. In the first of two experiments, we examined the effect of consumption cost on rats' intake of three concentrations of sucrose solution (8%, 16%, and 32%) when a nutritionally complete chow was concurrently freely available. In the second experiment, we examined the intake of 24% sucrose solution and chow as the consumption costs of both were varied. Increasing the cost of sucrose resulted in a reduction in the percent calories taken from sucrose; the steepness of the decline in intake with price was inversely related to the sucrose concentration and to the cost of chow. Chow calories were substituted for relatively expensive sucrose calories. An increase in the cost of chow resulted in a reduction in the percent of calories taken from chow and a protein-poor diet. The cost of sucrose did not affect the slope of the chow intake curve, presumably because, despite its sweet taste, sucrose was not a substitute for the protein, fat, and micronutrients in chow. Total caloric intake was conserved in all cases.Thus, the avid consumption of sucrose solution is curtailed when it is costly; but the degree of change in intake with cost depends on the cost of an alternative food. These results suggest that diet selection involves a comparison not only of the taste and post-ingestive consequences of available foods, but also of the cost of calories and nutrients in the foods. Selection appears to be guided first by caloric requirements and the relative cost of calories, then by nutrient requirements and the relative cost of nutrients, and finally by taste.

Assessment of drug effects on performance.

Few definitive studies have been performed that unequivocally demonstrate the ability of a drug to alter the performance of a horse. Nonetheless, the use of drugs in competing horses is regulated worldwide. Drugs have been categorized according to their abuse potential. However, there is still some confusion over what is meant by the terms "performance" and "drug." In the racing community, performance means speed, and fatigue and pain are among its greatest detractors. Speed is most appropriately measured on the racetrack. There are a multiplicity of internal and external variables that influence a horse's racetrack performance. Consequently, it is difficult to show drug-induced changes in speed, experimentally, on the racetrack. However; rigorous experimental designs and larger numbers of horses may enhance the value of this approach. High-speed equine treadmills provide a modified racing laboratory environment. A number of performance-related variables such as heart rate, oxygen consumption, and lactate production can be measured, and correlations with actual performance times have been shown. Drug-induced changes in some of these variables have been demonstrated. Behavioral pharmacology techniques have been adapted to the horse. Finite changes in spontaneous locomotor activity and pain perception have been demonstrated following the administration of putative stimulants, depressants, and anesthetics. Precise onset, duration of action, and potency of the various agents can be determined using this approach. Drug-induced changes in heart and respiratory rates in laboratory horses at rest also may be of some predictive value. Retrospective studies of racing times in medicated horses have yielded some interesting results. At the present time, the regulatory science of "doping control" is still heavily reliant on inference and extrapolated knowledge of human and equine pharmacology.

Self-reported exertion levels on time/activity diaries: application to exposure assessment.

Recent developments in air pollution analysis have focused on methods for collecting data on contaminant levels in the locations actually frequented by people, especially personal monitoring. While there is still much to understand about human exposures, the next advancements will be in the area of dose assessment. This paper discusses the results of a study designed to provide data for linking exposure to dose. Specifically, we used time/activity diaries to collect information on the exertion levels associated with the reported activities. As part of a community health study, 91 children between the ages of 9 and 11 kept diaries over a two-week summer-time period (July 1989) and during a two-week school-time period (September 1989). The diary was also administered for two days to 42 teenagers between the ages of 15 and 17. This paper describes our concerns about interpreting self-reported exertion levels, particularly with respect to the disparity between participant and researcher perception and coding. We then present the distribution of exertion levels associated with children's activities, highlighting seasonal, day-of-week, and age-group differences.

The effect of a soluble dietary fibre supplement on 24-hour energy expenditure during a standardized physical activity programme.

Twenty-four hour energy expenditure during a standard physical activity programme was investigated in 19 healthy volunteers in a randomized, double-blind, cross-over design, after supplementation with a soluble dietary fibre amounting 7 g/day for 2 weeks. Energy intake and food fibre intake were kept constant during the treatment period. Twenty-four hour energy expenditure decreased insignificantly during fibre treatment (1.3 +/- 1.7 per cent). The dietary fibre supplement also had no significant effect on body weight, faecal energy loss or heart rate. Systolic blood pressure was insignificantly reduced during both placebo and fibre treatment (P = 0.09). There was, however, no difference between the groups after treatment.

Echocardiographic assessment of lack of beta 1-receptor down-regulation during prolonged therapy with xamoterol.

The effects of xamoterol 0.2 mg kg-1 i.v. on haemodynamics at rest and on exercise were tested in eight patients, before and after 60 days regular treatment with 200 mg b.d. Left ventricular function improved equally with xamoterol on both occasions. Tachyphylaxis and beta-receptor down-regulation do not occur during xamoterol therapy.

Clinical and research implications of new concepts in the assessment of cardiac pumping performance in heart failure.

Every cardiac pump has its own maximum performance, which denotes its pumping capability. The difference between the performance in the resting state and that at maximum is called pumping reserve. Cardiac pumping performance is therefore best quantified by its hydraulic power output. Cardiac pumping capability is predictive of the ultimate prognosis of patients in severe heart failure whereas pumping reserve is a major determinant of exercise capacity. The therapeutic efficacy of cardiotonic drugs used in the treatment of ambulant heart failure patients should be evaluated with reference to the way they alter the relation between cardiac pumping reserve and exercise capacity.

Assessment of left ventricular function in coronary artery disease with the nuclear probe during intervention studies.

The nuclear probe was used for measuring left ventricular function in 11 normal subjects and the results compared with those using a digital gammacamera. The probe was then used to measure left ventricular function in patients with coronary artery disease during dynamic exercise and stress atrial pacing. The ability of the probe to detect changes induced by glyceryl trinitrate was also evaluated in separate parallel studies. In the 11 normal subjects there was a good correlation between the left ventricular ejection fraction measured by the gammacamera and the nuclear probe both at rest and during exercise. Exercise increased this value by at least 5% in all normal subjects during measurements with both the gammacamera and the nuclear probe. The mean (SD) difference was -0.3% (2.60) at rest and 2.3% (5.02) at peak exercise. Both exercise and pacing produced angina in the patient group and the mean (SEM) value fell from 52% (3.5) to 28% (2.6) and from 46% (5.1) to 34% (3.2) respectively. Glyceryl trinitrate prolonged the exercise and pacing times, and the corresponding falls in ejection fraction were significantly reduced. The non-imaging nuclear probe is a cheap and portable instrument capable of assessing left ventricular function in patients with cardiac disease. It is designed for high count rate acquisition over a short period of time and can thus provide both beat to beat and summated left ventricular time activity curves suitable for quantitative analysis. It therefore has important advantages in the clinical setting and during controlled interventions compared with the gammacameras.